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Although numerous participatory methods and assessments have been tested in the western context, the community participation practice is still limited in China, a developing country. In addition, due to the diversity of cultural, historical, economic, and social backgrounds, Chinese community participation differs from similar international approaches. Hence it is critical to explore how engaging Chinese people with their own heritage properties can foster stewardship, multi-stakeholder connection, and support policy and strategy making.It is very challenging to preserve the character of historic urban landscapes because they change over time in a rapidly developing urban context. Research on revealing people's stories and preferences concerning the Chinese historic urban landscape in their visiting and living experience is needed to address this concern directly. The study applies a novel approach to explore public attitudes based on the fusion of social media data, land use data and other information. It examines the spatial patterns of public responses towards the government-led urban heritage conservation projects in the historic city centre of Harbin, China, in sixteen months (2021–2022). The article concludes that social media plays an important role in accessing broader communities, monitoring people's preferences, and observing heritage attributes and values for inclusive urban heritage management. [ABSTRACT FROM AUTHOR]

The support practice factor (P) is an essential component of the common Universal Soil Loss Equation (USLE) model. Although concerns about soil loss in the typical black soil areas of Northeast China are increasing, little research exists on the P factor of extreme rainfall in soil loss. Therefore, we conducted an orthogonal simulation experiment of artificial rainfall employing different rainfall intensities, slopes, and tillage practices. The aim of the design was to establish the values and calculation methods for the P factor of different tillage practices under various slope and rainfall intensity conditions. Our results showed that for No tillage (NT) and longitudinal wide ridge (LWR), a significant logarithmic decreasing relationship was found between the P factor and the product of rainfall erosivity (R) and slope factor (S). When RS was < 9.18 MJ·mm/(hm2 ·h), contour ridge tillage was the optimal practice to decrease soil loss.The P factor of contour narrow ridge (CNR) was higher than those of other tillage practices after contour ridge failure occurred. When maximum rainfall intensity was > 75 mm/h, NT was superior in reducing soil loss. The results could provide a basis for predicting soil loss under extreme rainfall conditions. [ABSTRACT FROM AUTHOR]

To delineate temporal and spatial variations in suspended sediment concentration (SSC) in the Yangtze (Changjiang) Estuary and adjacent coastal waters, surface-water samples were taken twice daily from 10 stations over periods ranging from 2 to 12 years (total number of samples >28,000). Synoptic measurements in 2009 showed an increase in surface SSC from 0.058 g/l in the upper sections of the estuary to ∼0.6 g/l at the Yangtze River turbidity maximum at the river mouth, decreasing seaward to 0.057 g/l. Annual periodicities reflect variations in the Yangtze discharge, which affect the horizontal distribution and transport of SSC, and seasonal winds, which result in vertical resuspension and mixing. Over the past 10-20 years, annual surface SSC in the lower Yangtze River and the upper estuary has decreased by 55%, due mainly to dam construction in the upper and middle reaches of the river. The 20-30% decrease in mean surface SSC in the lower estuary and adjacent coastal waters over the same period presumably reflects sediment resuspension, in part due to erosion of the subaqueous Yangtze Delta. SSCs in the estuary and adjacent coastal waters are expected to continue to decline as new dams are constructed in the Yangtze basin and as erosion of the subaqueous delta slows in coming decades. [ABSTRACT FROM AUTHOR]

Recently, we studied hepatitis C virus (HCV) sera-prevalence among 559 890 first-time volunteer blood donors in China. From randomly selected 450 anti-HCV positive donors, we detected HCV RNA in 270 donors. In this study, we amplified HCV E1 and/or NS5B sequences from 236 of these donors followed by DNA sequencing and phylogenetic analysis. The results indicate new trends of HCV infection in China. The HCV genotype distribution differed according to the donors' region of origin. Among donors from Guangdong province, we detected subtypes 6a, 1b, 3a, 3b, 2a, and 1a at frequencies of 49.7%, 31.0%, 7.6%, 5.5%, 4.1%, and 2.1%, respectively. Among donors from outside Guangdong, we detected 1b, 2a, 6a, 3b, 3a, 6e, and 6n at frequencies 57.1%, 13.2%, 11.0%, 9.9%, 4.4%, 2.2%, and 2.2%, respectively. Although we found no significant differences among regions in age or gender, subtype 6a was more common ( P < 0.001) in donors from Guangdong than those from elsewhere, whilst subtypes 1b ( P < 0.02) and 2a ( P < 0.001) were more frequent outside Guangdong. Disregarding origins, the male/female ratio was higher for subtype 6a-infected donors ( P < 0.05) than for subtype 1b donors, whilst the mean age of subtype 2a donors was 8-10 years older ( P < 0.05) than that for all other subtypes. Detailed phylogenetic analysis of our sequence data provides further insight into the transmission of HCV within China, and between China and other countries. The predominance of HCV 6a among blood donors in Guangdong is striking and mandates studies into risk factors for its acquisition. [ABSTRACT FROM AUTHOR]

The article reflects on a report of Pestalotioposis versicolor that cause leaf-trip blight on acacia in China. It states that leaf-tip blight was observed on 80-92 percent of acacia tress in Guangxi, China, causing defoliation and stunting. According to the report, the blight was angular, initiating at the leaf tip and extending to the middle leaf. Diseased leaf tissues became distorted and brown, producing numerous acervuli with black and slimy spore masses. The incident is the first report of the fungus as a pathogen on acacia in China.

Livestock production in peri-urban areas constitutes an important sub-sector of the agricultural production system in China, and contributes to environmental degradation and local air borne pollution contributing to smog. As a result, local policies are being implemented to safeguard the environment. However, there has been little attempt to quantify the impact of environmental policies on livestock production structure, spatial distribution and their related greenhouse gases (GHGs) and ammonia (NH 3 ) emissions. Here, we calculated the inventories of GHGs and NH 3 emissions for 2010 and 2014 for peri-urban livestock production in Beijing, using reliable spatially explicit data, which was collected from 1748 industrial farms in 2010 and 2351 industrial farms in 2014, including pig, dairy, beef cattle, poultry and sheep farms. Our estimates indicated that total industrial livestock production increased by 17% between 2010 and 2014, even under the more strict environmental protection polices, with farm size decreasing by between 7% and 47%. Up to 50% of the industrial livestock farms have remained in operation, with the rest closing down or being moved to other regions. Following this trend, total GHGs emission decreased from 5.0 to 4.5 Tg CO 2 -eq between 2010 and 2014. Most of the GHGs emission reduction was due to the lowering of energy related carbon dioxide (CO 2 ) emission in 2014. Total NH 3 emission decreased from 102 to 96 Gg between 2010 and 2014, mainly due to more stringent environmental regulations for new and extended farms (increased in farm size), e.g. Discharge standard for pollutants for livestock and poultry breeding. Our study identified that GHGs and NH 3 emission hotspots were concentrated in suburban areas (around the city centre and with less agricultural resource and population density) in 2010. However, between 2010 and 2014 these hotspots moved to the exurban plain and mountain area following the closure or sub-division of intensive farms in suburban regions and construction of new and small farms in exurban areas (around the suburban and with more agricultural resource and lower population density). Scenario analysis suggests that total GHGs emission can be reduced by up to 1.0 Tg CO 2 -eq (23% of total livestock sector emissions) in Beijing, using a combination of modifications of farm type, livestock diet and manure management. The integrated scenario can reduce CH 4 , N 2 O and NH 3 emissions by 27%, 9% and 35%, compared to the reference scenario. Within this short period of time (5 years), policies have had direct impacts on peri-urban livestock production in Beijing, resulting in marked changes in the structure of different livestock sectors, as well as the GHGs and NH 3 emission inventories and their spatial distribution. Our analysis clearly shows that the success of these (and future) polices relies on optimizing spatial management of new livestock production systems. Policy and farmer guidance should focus on optimizing livestock diet and on-farm manure management, industrial production systems and the pig and poultry sectors in peri-urban regions. [ABSTRACT FROM AUTHOR]

Abstract: Crop and animal production in China has increased significantly during the last decades, but at the cost of large increases in nitrogen (N) and phosphorus (P) losses, which contribute to ecosystem degradation and human health effects. This information is largely based on scattered field experiments, surveys and national statistics. As a consequence, there is as yet no comprehensive understanding of the changes in N and P cycling and losses at regional and national scales. Here, we present the results of an integrated assessment of the N and P use efficiencies (NUE and PUE) and N and P losses in the chain of crop and animal production, food processing and retail, and food consumption at regional scale in 1980 and 2005, using a uniform approach and databases. Our results show that the N and P costs of food production–consumption almost doubled between 1980 and 2005, but with large regional variation. The NUE and PUE of crop production decreased dramatically, while NUE and PUE in animal production increased. Interestingly, NUE and PUE of the food processing sector decreased from about 75% to 50%. Intake of N and P per capita increased, but again with large regional variation. Losses of N and P from agriculture to atmosphere and water bodies increased in most regions, especially in the east and south of the country. Highest losses were estimated for the Beijing and Tianjin metropolitan regions (North China), Pearl River Delta (South China) and Yangzi River Delta (East China). In conclusion, the changes and regional variations in NUE and PUE in the food chain of China are large and complex. Changes occurred in the whole crop and animal production, food processing and consumption chain, and were largest in the most populous areas between 1980 and 2005. [Copyright &y& Elsevier]

Tick-borne rickettsial disease (TBRD) is a perilous acute infection that often eludes diagnosis in its early stages. The triad of knowledge, attitudes, and practices (KAPs) among medical professionals is key to reducing missed diagnosis rates. Therefore, a meticulous evaluation of KAPs is imperative. This study aimed to delve into the understanding of TBRD and explore the beliefs and practices related to personal prevention methods among individuals in Lu'an, a hotspot for TBRD. During the summer months of 2023, convenience sampling was employed by circulating a confidential questionnaire to 1,206 participants in the endemic regions of China. This questionnaire painted a comprehensive picture of the participants' sociodemographic profiles and their KAPs levels vis-à-vis TBRD. The findings revealed that participants scored a mere 55.78% in knowledge, while their attitudes and practices garnered impressive scores of 90.09% and 90.83%, respectively. Upon further analysis using multiple linear regression, several intriguing patterns emerged. Male participants, employed in the Infectious Disease Department, held vice-senior or higher titles, or had prior medical training demonstrated superior knowledge scores. On the other hand, medical personnel who were younger than 30, possessed graduate degrees or higher qualifications, and had training excelled in attitudes and practices. Notably, when employing the Boston Consulting Group (BCG) matrix, a significant distribution of medical personnel was observed across the four quadrants. Specifically, 37.43%, 13.19%, 19.61%, and 29.77% fell into the first, second, third, and fourth quadrants. This survey underscores the commendable attitudes and practices of medical staff towards TBRD in endemic regions of China. However, their knowledge level remains wanting and demands urgent improvement., Competing Interests: The authors declare that they have no competing interests., (© 2024 Shao et al.)

This study investigates the dynamic relationship between cross-border e-commerce and logistics co-development strategies within the context of small and medium-sized enterprises (SMEs) in China. The primary objective is to formulate an empirical model capable of estimating the utility and flexibility of cross-border e-commerce logistics, specifically focusing on its role in achieving competitive advantage for SMEs. The research employs a comprehensive approach, considering various factors that influence the formulation and implementation of cross-border e-commerce logistics strategies. Factors such as scale, quality, potential, and infrastructure are scrutinized to provide a nuanced understanding of the dynamic interplay. Real-world data is analyzed using advanced statistical techniques to derive meaningful insights. The data of CBEC and logistics planning in Guangdong from 2013 to 2018 was used as a case example to demonstrate its and flexibility and usefulness of empirically proposed model estimation and develop a holistic indicator system for the evaluation of the synergistic development of CBEC and logistics. This research focus on the modelling of the CBEC for the synergistic effect analysis and evaluate the usefulness and flexibility of CBEC to achieve competitive advantage. The study aims to uncover insights into the most effective approaches for Chinese SMEs in navigating the landscape of cross-border e-commerce. By examining the results derived from the empirical model, the research sheds light on the impact of cross-border e-commerce logistics on competitive advantage. The findings contribute to a deeper understanding of how SMEs can strategically position themselves in the cross-border e-commerce arena. Through the analysis of real-world data and the application of advanced statistical methods, this research offers valuable insights for Chinese SMEs. The insights generated from the study not only illuminate the intricacies of cross-border e-commerce logistics but also provide practical recommendations to reduce associated costs. Ultimately, the study aims to equip SMEs with the knowledge necessary to thrive in the evolving landscape of cross-border e-commerce., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Qi 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.)

Background: Despite the numerous advantages of mastering biostatistics, medical students generally perceive biostatistics as a difficult and challenging subject and even experience anxiety during the courses. Evidence for the correlation between students' academic achievements and their attitudes, indicating that attitudes at the beginning of the biostatistics course may affect cognitive competence at the end of the course and subsequently influence student academic performance. However, there are current disagreements regarding the measurement and evaluation of attitudes related to statistics. Thus, there is a need for standard instruments to assess them. This study was conducted to develop a Chinese version of the Survey of Attitudes Toward Statistics (SATS-36) in order to acquire a valid instrument to measure medical students' attitudes toward biostatistics under Chinese medical educational background., Methods: The Chinese version SATS-36 was developed through translation and back-translation of the original scale, with subsequent revisions based on expert advice to ensure the most appropriate item content. The local adaption was performed with a cohort of 1709 Chinese-speaking medical undergraduate and graduate students enrolled in biostatistics courses. And then, the reliability, validity and discrimination of the questionnaires were evaluated through correlation coefficient calculation, factor analysis, parallel analysis and other methods., Results: The Chinese version SATS-36 consisted of 36 items and loaded a five-factor structure by factor analysis, which offered an alternative similar but not equal to that original six-factor structure. The cumulative variance contribution rate was 62.20%, the Cronbach's α coefficient was 0.908, the Guttman split-half reliability coefficient was 0.905 and the test-retest reliability coefficient was 0.752. Discriminant analysis revealed small to large significant differences in the five attitude subscales., Conclusions: The Chinese version SATS-36 with good validity and reliability in this study can be used to evaluate the learning framework of Chinese medical students., (© 2024. The Author(s).)

Genome-wide association studies of brain imaging phenotypes are mainly performed in European populations, but other populations are severely under-represented. Here, we conducted Chinese-alone and cross-ancestry genome-wide association studies of 3,414 brain imaging phenotypes in 7,058 Chinese Han and 33,224 white British participants. We identified 38 new associations in Chinese-alone analyses and 486 additional new associations in cross-ancestry meta-analyses at P < 1.46 × 10 -11 for discovery and P < 0.05 for replication. We pooled significant autosomal associations identified by single- or cross-ancestry analyses into 6,443 independent associations, which showed uneven distribution in the genome and the phenotype subgroups. We further divided them into 44 associations with different effect sizes and 3,557 associations with similar effect sizes between ancestries. Loci of these associations were shared with 15 brain-related non-imaging traits including cognition and neuropsychiatric disorders. Our results provide a valuable catalog of genetic associations for brain imaging phenotypes in more diverse populations., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Objective: Maternal vitamin D deficiency is a prevalent public health issue worldwide. While isolated reports from certain cities in China have highlighted the existence of maternal vitamin D deficiency, no nationwide investigation has been conducted on this topic. Therefore, we conducted a meta-analysis and systematic review to examine the prevalence and associated influencing factors of maternal vitamin D deficiency in mainland China. This study aims to provide a theoretical foundation for future prevention and supplementation strategies for maternal vitamin D., Methods: We retrieved relevant Chinese and English literature on the status of maternal vitamin D deficiency in mainland China from databases such as CNKI, Wanfang Data, VIP, CBM, Web of Science, Google Scholar, and PubMed. The literature search and database construction were conducted until September 8, 2023. Data were extracted and synthesized following PRISMA guidelines.After literature screening and quality assessment, we performed meta-analysis, sensitivity analysis, and identified publication bias using RevMan 5.3 software., Results: A total of 26 articles were reviewed, involving 128,820 pregnant women. Among them, 108,768 had vitamin D insufficiency or deficiency, resulting in a prevalence of 84% (95% CI: 81%~88%). Subgroup analysis revealed the highest prevalence of vitamin D deficiency or insufficiency among pregnant women in mainland China to be in the northwest region (94%, 95% CI: 94%~95%). Furthermore, the highest prevalence was observed during the winter and spring seasons (80%, 95% CI: 77%~83%) and in the early stages of pregnancy (93%, 95% CI: 90%~95%). Significant statistical differences (P<0.05) were found among these three subgroups. No publication bias was detected, and sensitivity analysis indicated the stability of the meta-analysis outcome., Conclusion: This study provides evidence of the prevalence of vitamin D deficiency or insufficiency among pregnant women in mainland China. To improve the overall health and well-being of the population, relevant health authorities should develop policies aimed at alleviating this phenomenon., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chen 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.)

Etomidate is a sedative and hypnotic drug through intravenous administration that act on the central nervous system through GABA (Gamma-Amino Butyric Acid) receptors, which is widely used in anesthesia induction and maintenance and long-term sedation in severe patients. The study aimed to evaluate the pharmacokinetic and pharmacodynamic properties of two etomidate fat emulsions after administration through the intravenous infusion pump in healthy Chinese subjects. A randomized, open-label, 2-period crossover study was performed in 52 healthy subjects. The wash-out period was 7 days. Blood samples and pharmacodynamic index values were collected at the specified time points. Etomidate concentrations were measured using validated liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were analyzed using a non-compartment model method. Pharmacodynamic parameters were calculated using pharmacodynamic index values. The study also evaluated the safety of the etomidate. Both the pharmacokinetic parameters and pharmacodynamic parameters result of the test and reference formulation were very similar. The 90% confidence intervals (CI) of the geometric least-squares mean (GLSM) ratios of the test to reference formulation were 91.33-104.96% for the maximum plasma concentration (C max ), 97.21-102.03% for the area under the plasma concentration time curve from time 0 to the time of the last measurable concentration (AUC 0-t ), and 97.22-102.33% for the area under the plasma concentration time curve from time 0 to infinity (AUC 0-∞ ). Meanwhile, the 90% CI of the GLSM ratios of the test to reference formulation were 102.28-110.69% for the minimal BIS value (BIS min ), 99.23-101.17% for the area under the BIS time curve from time 0-60 min after administration (BISAUC 0-60 min ), respectively. The 90% CI of these pharmacokinetic and pharmacodynamic parameters all fall in the accepted bioequivalence range of 80.00-125.00%. No serious adverse events occurred during the study. This study has shown that the etomidate fat emulsion test and reference formulation had similar pharmacokinetic and pharmacodynamic characteristics in vivo. The two formulations exhibited good safety and well-tolerance.Clinical trials registration number: http://www.chinadrugtrials.org.cn/index.html . # CTR20191836., (© 2024. The Author(s).)

Background: There is a dearth of research combining geographical big data on medical resource allocation and growth with various statistical data. Given the recent achievements of China in economic development and healthcare, this study takes China as an example to investigate the dynamic geographical distribution patterns of medical resources, utilizing data on healthcare resources from 290 cities in China, as well as economic and population-related data. The study aims to examine the correlation between economic growth and spatial distribution of medical resources, with the ultimate goal of providing evidence for promoting global health equity., Methods: The data used in this study was sourced from the China City Statistical Yearbook from 2001 to 2020. Two indicators were employed to measure medical resources: the number of doctors per million population and the number of hospital and clinic beds per million population. We employed dynamic convergence model and fixed-effects model to examine the correlation between economic growth and the spatial distribution of medical resources. Ordinary least squares (OLS) were used to estimate the β values of the samples., Results: The average GDP for all city samples across all years was 36,019.31 ± 32,029.36, with an average of 2016.31 ± 1104.16 doctors per million people, and an average of 5986.2 ± 6801.67 hospital beds per million people. In the eastern cities, the average GDP for all city samples was 47,672.71 ± 37,850.77, with an average of 2264.58 ± 1288.89 doctors per million people, and an average of 3998.92 ± 1896.49 hospital beds per million people. Cities with initially low medical resources experienced faster growth (all β < 0, P < 0.001). The long-term convergence rate of the geographic distribution of medical resources in China was higher than the short-term convergence rate (|β i + 1 | > |β i |, i = 1, 2, 3, …, 9, all β < 0, P < 0.001), and the convergence speed of doctor density exceeded that of bed density (bed: |β i | >doc: |β i |, i = 3, 4, 5, …, 10, P < 0.001). Economic growth significantly affected the convergence speed of medical resources, and this effect was nonlinear (doc: β i < 0, i = 1, 2, 3, …, 9, P < 0.05; bed: β i < 0, i = 1, 2, 3, …, 10, P < 0.01). The heterogeneity between provinces had a notable impact on the convergence of medical resources., Conclusions: The experiences of China have provided significant insights for nations worldwide. Governments and institutions in all countries worldwide, should actively undertake measures to actively reduce health inequalities. This includes enhancing healthcare standards in impoverished regions, addressing issues of unequal distribution, and emphasizing the examination of social determinants of health within the domain of public health research., (© 2024. The Author(s).)

Objective: This study aimed to examine the differential magnitude of associations between specific dimensions of patient experience and overall patient satisfaction., Design: A descriptive, cross-sectional design was used to collect patient experience and overall satisfaction data., Setting: Participants were recruited at one tertiary general hospital, one tertiary specialised hospital, and one secondary hospital in Shanghai, China. These three institutes represent the main kinds of hospitals in the Chinese healthcare system., Participants: 1532 inpatients were recruited, and 1469 were included. The inclusion criteria were as follows: (1) having received inpatient service for at least 2 days; (2) able to understand the questions in the questionnaires; and (3) aged>18 years old. Patients who had impaired cognitive function and completed the questionnaires with missing information were excluded., Primary and Secondary Outcome Measure: Patient experience was measured using the Inpatient Experience with Nursing Care Scale, which is widely used in the China. The overall patient satisfaction was measured with 10-point response option., Results: The LASSO (least absolute shrinkage and selection operator) regression results showed that as the penalty factor (λ) = 0.0162, age, marriage status, financial status, length of hospital stay and numbers of previous of hospitalisation and six dimensions of nursing care remained in the model. As λ increases to 0.1862, only four patient experience variables, potentially the most influential on patient satisfaction, remained in the model. Patient experience with emotional support was the most significant dimension explaining patient satisfaction (β=0.1564), the second most significant dimension was admission and discharge management (β=0.1562), and the third was monitoring and coping with the progress of diseases (β=0.0613)., Conclusion: Patient experience with emotional support, admission and discharge management, monitoring and coping with the progress of diseases, and information and education are the most significant dimensions explaining patient satisfaction., 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.)

Purpose: Existing evidence indicates an association between cognitive functioning and both geriatric depression and suicidality, with mixed evidence regarding the direction of the relationship between cognitive functioning and aspects of geriatric lifetime suicidal ideation. This study aims to examine the relationship between cognitive functioning, depression, and suicide ideation and to explore the intermediary role of depression between cognitive functioning and suicidal ideation in the older adults., Methods: A multi-stage random cluster sampling method was used to collect a sample of 3896 individuals aged 60 and above. Descriptive statistics of the sample data were analyzed using one-way ANOVA, and then the correlation between variables was obtained by binary logistic regression analysis. SPSS macro program PROCESS V3.5 was used to test the mediating role of depression in the relationship between cognitive function and lifetime suicidal ideation., Results: The prevalence of lifetime suicidal ideation among older adults was 3.9%. Lifetime suicidal ideation was associated with depression (OR = 1.308, P < 0.001) but was not significantly correlated with cognitive function (OR = 0.972, P > 0.05). The relationship between cognitive function and depression was also supported in this study (β = - 0.0841, P < 0.001). Depression completely mediated the relationship between cognitive function and lifetime suicidal ideation., Conclusion: There was no significant correlation between cognitive impairment in older adults and a heightened risk of lifetime suicidal ideation. However, this relationship was completely mediated by depression. It is crucial to prevent the onset of depression among older adults with cognitive impairment, as depression is strongly linked to lifetime suicidal ideation., (© 2024. The Author(s), under exclusive licence to European Geriatric Medicine Society.)

Introduction: Newspapers are a predominant channel through which the Chinese public learns about nurses and the nursing profession. However, little nursing research has been performed in China to investigate the newspaper portrayal of nurses, and how the public perceives the role of nurses in the Chinese context is still an ambiguous phenomenon. This study aimed to clarify the public portrayals of nurses in China, and to analyze whether there are changes over time in news content related to nurses in the national newspapers., Design: A content analysis of the newspaper articles citing nurses that have been published since each newspaper was established., Method: We selected two national daily newspapers as sources to systematically search for articles about nurses from 1949 to 2022. A coding instrument was developed to quantitatively extract the contents of the articles identified. Then, using a mixed methods approach, we analyzed newspaper content to show the roles of nurses presented to the public by the media., Results: A total of 317 articles were analyzed. Nurses have been depicted with heterogeneous images in both newspapers with positive wordings and up to 28 types of public images. More than half of the articles portrayed two, three, or more types of images. Among the images of nurses identified, "overworked" appeared the most frequently, followed by "dedicated," "philanthropic and benevolent," and "with a sense of responsibility," and then "technically skilled." By analyzing the image of nurses in both newspapers over time, we found that images related to virtue have largely increased with time, while images about professionalism have decreased., Conclusion: Nursing continues to be depicted as a virtuous caregiving profession, often forgetting the wide need for knowledge, skill, and expertise required in the occupation. The public image of nurses portrayed in the national newspapers does not accurately match their actual roles., Clinical Relevance: The public image of nurses portrayed in the national newspapers does not accurately match their actual roles. To actualize a professional role and increase social status of nurses, intentional image management is needed. Nursing schools, nursing associations, and nursing professionals should be more proactive in overcoming the stereotypical image portrayed of them and use the news media as a tool to invite attention from and dialogue with the public about the value of nursing to reframe the public's understanding of the expert role of the professional nurse in health care and to create a new and more professional image for nursing., (© 2023 Sigma Theta Tau International.)

Real-world evidence on the effectiveness of COVID-19 vaccines marketed in China against the Omicron BA.2.2 variant remains scarce. A case-control study was conducted to estimate the vaccine effectiveness (VE) of COVID-19 vaccines marketed in China (inactivated vaccines, an Ad5-nCoV vaccine, and a recombinant protein vaccine). There were 414 cases infected with SARS-CoV-2 and 828 close contacts whose test results were consecutively negative as controls during the outbreak of the Omicron variant in Lu'an City, Anhui Province, China, in April 2022. The overall adjusted VE against Omicron BA.2.2 variant infection in the vaccinated group with any COVID-19 vaccine was 35.0% (95% CI: -9.1-61.3%), whereas the adjusted VE for booster vaccination was 51.6% (95% CI: 15.2-72.4%). Subgroup analysis showed that the overall adjusted VE of the Ad5-nCoV vaccine (65.8%, 95% CI: 12.8-86.6%) during the outbreak while any dose of inactivated vaccines and recombinant protein vaccine offered no protection. The adjusted VE of three-dose inactivated vaccines was 48.0% (95% CI: 8.0-70.6%), and the two-dose Ad5-nCoV vaccine was 62.9% (95% CI: 1.8-86%). There is no protection from a three-dose recombinant protein vaccine. COVID-19 vaccines offered 46.8% (95% CI: 9.5-68.7%) protection from infection within six months. There were statistically significant differences between the VEs of heterologous booster (VE = 76.4%, 95% CI: 14.3-93.5%) and homologous booster vaccination (VE = 51.8%, 95% CI: 9.6-74.3%) ( P  = .036). Booster vaccination of COVID-19 vaccines offered more protection than full vaccination. A booster vaccination campaign for a booster dose after three doses of a recombinant protein vaccine must be urgently conducted.

Afforestation and reforestation are pivotal in mitigating land degradation and bolstering the carbon sink capacity of terrestrial ecosystems. However, the potential economic ramifications of afforestation and reforestation in the context of climate change remain largely unexplored. In this study, we employed an interdisciplinary methodology to establish a framework for assessing future forest potential and carbon sequestration in the Eastern Loess Plateau region of China. Our findings indicate that an estimated 17,392.99 km 2 of land suitable for afforestation still existed within the region, exhibiting a propensity to aggregate around existing forests rather than being dispersed randomly. Notably, 4385.36 km 2 was prioritized for afforestation initiatives. Projections suggest a significant enhancement of the forest carbon sink within the study area by 2050, ranging from 36.93 Mt to 105.38 Mt. The corresponding economic value for this enhancement is estimated to vary between US$3.25 billion and US$17.68 billion. Of significance is the observed polarization of the region's carbon sink capacity over time, with half of the total carbon sinks concentrated within 10% of the districts. Additionally, approximately 26% of the counties are expected to transition from carbon sinks to carbon sources. These findings underscore the substantial impact of climate change on forest distribution and suggest a targeted approach to combat forest degradation by circumventing ineffective afforestation activities., 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 © 2023 Elsevier Ltd. All rights reserved.)

Background: Genetic variants of outer dynein arm docking complex subunit 2 (ODAD2) have been reported to be closely associated with primary ciliary dyskinesia and colorectal cancer in previous studies, but the association of genetic variants of ODAD2 with hepatocellular carcinoma (HCC) has not been reported., Methods: We enrolled 80 healthy subjects and 468 Guangxi hepatitis B virus (HBV)-related HCC patients in this study. A case-control study method was used to explore the association of different ODAD2-rs7893462 genotypes with hepatocarcinogenesis. A comprehensive survival analysis was used to explore the association of rs7893462 with the prognosis of HBV-related HCC in Guangxi., Results: Through a case-control study, we observed that patients carrying the G allele of rs7893462 had a markedly increased susceptibility to hepatocarcinogenesis (odds ratio = 1.712, 95% confidence interval = 1.032-2.839, P = 0.037). We found that there were significant prognosis differences among three different genotypes of rs7893462. Nomogram analysis suggested that the contribution of rs7893462 polymorphisms to the prognosis of HBV-related HCC was second only to the BCLC stage. Stratified survival analysis suggested that the AG genotype of rs7893462 was an independent prognostic risk factor for HBV-related HCC. Joint effect survival analysis also observed that the AG genotype of rs7893462 combined with clinical parameters could significantly identify HBV-related HCC patients with different prognostic outcomes more accurately, and the AG genotype was also observed to be independent of clinical factors in HBV-related HCC survival., Conclusion: The ODAD2-rs7893462 polymorphisms can be used as an independent prognostic indicator of HBV-related HCC overall survival and are significantly associated with susceptibility to hepatocarcinogenesis., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: To assess the value of using flat-sided culture tubes for preparing chromosomes through chorionic villi (CV) and amniotic fluid (AF) cell cultures during prenatal diagnosis., Methods: From February to March 2020, 157 CV samples and 147 AF samples subjected to prenatal diagnosis at the Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region were selected as the study subjects. For each sample, one flat-sided tube and one flask culture were set up by following the standard protocols. The methods were evaluated by comparing the cell growth, experimental process, quality of chromosome preparation and costs., Results: The success rates for the culturing of CV and AF samples by the flat-sided culture tube method were 97.45% (153/157) and 97.96% (144/147), respectively. By contrast, the success rates for the conventional flask method were 98.72% (155/157) for CV and 98.64% (145/147) for AF samples. No significant difference was found between the two methods (P > 0.05). The average harvest time required by the flat-sided culture tube method was 8.45 days for CV and 9.43 days for AF cultures, whilst the average harvest time for conventional flask method was 9.05 days and 9.54 days, respectively. The flat-sided culture tube method for CV had required significantly shorter average harvest time than the conventional method (P < 0.001). No statistical significant difference was found in the average harvest time for AF by the two methods (P > 0.05). The conventional culturing method had required three containers with two sample transfers. By contrast, the flat-sided culture tube method was carried out in one tube without any sample transfer. The average total amount of medium used was 3.91 mL for each flat-sided culture tube and 6.26 mL for each conventional flask., Conclusion: The flat-sided culture tube method can provide a simple, cost-effective and error-reducing procedure for the CV and AF samples culture during prenatal diagnosis.

Emission trading scheme (ETS) is one of the most important ways to mitigate carbon emissions. As the largest carbon emitter in the world, China implemented ETS policy in 2013. Whether ETS policy can boost enterprise green technological innovation (GTI) quality in China remains to be discussed after reviewing the previous studies. All 318 A-share listed enterprises of China's eight high-carbon emission industries from 2008 to 2021 are chosen to investigate the influence of the ETS policy on enterprise GTI quality by the difference-in-difference (DID) method. Furthermore, heterogeneous effects of ETS policy on the quality of enterprise GTI are analyzed from three aspects: enterprise life cycle, corporate environmental management, and industry classification. The findings indicate that China's ETS policy has a positive influence on the quality of GTI in eight high-carbon emission industries. Further heterogeneity analysis demonstrates (1) China's ETS policy has varying effects on the eight high-carbon emission industries; (2) China's ETS policy can improve GTI quality of enterprises in the maturity stage of their life cycle, but not for those in their growth stage. (3) Comparing the effect of China's ETS policy, GTI quality of enterprises with higher environmental management score is stimulated, while GTI quality of those with lower score is not., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The prevalence of human immunodeficiency virus (HIV) is becoming more common among college students in China. However, latest data on the prevalence and correlates of HIV testing among sexually experienced college students is rarely., Methods: An online survey was conducted among college students aged 18 years or older using multistage stratified cluster sampling from 16 colleges. Data on socio-demographic, HIV testing, HIV-related awareness, attitudes, sexual education and behaviors were collected. Propensity score matching (PSM) and logistic regression model were used to identify factors associated with HIV testing., Result: A total of 108,987 students participated the survey, of which 13,201 sexually experienced college students were included in this study. 1,939 (14.69%) college students with sexual experience reported uptake of HIV testing in the preceding year. The uptake of HIV testing increased for college students with a rising HIV knowledge score and sexual health knowledge. Being awareness of HIV-related knowledge (aOR = 1.15, 95%CI: 1.01-1.30), accepting one-night stands (aOR = 1.16, 95%CI:1.03-1.32), obtaining satisfactory sexual interpretation from parent(s) (aOR = 1.24, 95%CI: 1.07-1.43), ever had unintended pregnancy (aOR = 1.78, 95%CI: 1.32-2.38), ever had received HIV-related preventive service(s) (aOR = 1.37, 95%CI: 1.10-1.70), ever had participated HIV-related preventive services (aOR = 3.76, 95%CI: 2.99-4.75) and ever had anal sex (aOR = 2.66, 95%CI: 2.11-3.34) were positively associated with uptake of HIV testing. However, accepting premarital sex (aOR = 0.76, 95%CI: 0.66-0.88), accepting cohabitation (aOR = 0.75, 95%CI: 0.61-0.92), occasionally discussing sex with parent(s) (aOR = 0.68, 95%CI: 0.50-0.91), and being with moderate satisfaction of school sex courses (aOR = 0.74, 95%CI: 0.58-0.95) were negatively associated with uptake of HIV testing., Conclusion: The prevalence of HIV testing was relatively low. Participation in HIV-related services and high-risk sexual behaviors were important enablers for testing. Improving sex education for students, increasing HIV preventive services on campus, and improving family sex education are necessary to increase HIV testing among college sexually experienced students., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objectives: Previous studies have found an association between socioeconomic status (SES) and depressive symptoms among older adults, however the mechanisms underlying this association remained unclear. This study aimed to examine the mediating role of social support and the moderating role of living arrangement in the association between SES and depressive symptoms., Methods: Data was collected from the 2020 Household Health Interview Survey in Taian city, Shandong Province, China. A total of 3896 older adults aged 60 and above were included in this study. Depressive symptoms was measured by the Patient health Questionnaire-9 (PHQ-9), Social support by the Multidimensional Scale of Perceived Social Support (MSPSS), and other variables by related demographic scales. The moderated mediation model was examined using HAYES PROCESS 3.5., Results: SES negatively predicted depressive symptoms among older adults, and social support could mediate this association. Living arrangement played a moderating role in the relationship between social support and depressive symptoms (the second half of the mediating effect), and the effect was stronger among older adults who lived alone., Conclusions: Social support partially mediated the relationship between SES and depressive symptoms among older adults, and living alone strengthened the effect of social support on depressive symptoms. Interventions that address older adults' social support and living arrangement may ameliorate depressive symptoms among older adults., (© 2023 John Wiley & Sons Ltd.)

Rice production is crucial for human nutrition and food safety globally. However, it has been a significant sink for potentially harmful metals because of intensive anthropogenic activities. The study was conducted to characterize heavy metal translocation from soil to rice at the filling, doughing and maturing stages, and influencing factors of their accumulation in rice. The distribution and accumulation patterns varied for metal species and growth stages. Cd and Pb accumulation mainly occurred in roots, Cu and Zn were readily transported to stems. Cd, Cu, and Zn accumulation in grains had a descending order of filling > doughing > maturing. Soil heavy metals, TN, EC, and pH exerted important impacts on heavy metals uptake by roots during the period from filling stage to maturing stage. Concentrations of heavy metals in grains were positively correlated with the translocation factors TF stem-grain (from stem to grain) and TF leaf-grain (from leaf to grain). Grain Cd exhibited significant correlations with total Cd and DTPA-Cd in the soil at each of the three growth stages. Moreover, Cd in maturing grain could be effectively predicted by soil pH and DTPA-Cd at the filling stage., 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 © 2023 Elsevier Ltd. All rights reserved.)

Objectives: COVID-19 has brought challenges to the health of all mankind. It is particularly important to promote the construction of a 'Healthy China' and build a 'healthy community'. The aims of this study were to construct a reasonable conceptual framework for the Healthy City concept and to assess Healthy City construction in China., Study Design: This study combined qualitative and quantitative research., Methods: This study proposes the concept model of 'nature-human body-Healthy City' and accordingly constructs an evaluation index system for the construction of a Healthy City that integrates five dimensions, namely, the medical level, economic basis, cultural development, social services, and ecological environment to explore the spatial and temporal heterogeneity of Healthy City construction in China. Finally, the influencing factors of Healthy City construction patterns are explored using GeoDetector., Results: (1) The pace of Healthy City construction is generally on the rise; (2) the construction of Healthy Cities exhibits significant global spatial autocorrelation and gradually increasing agglomeration. The spatial distribution of cold hotspot areas was relatively stable; (3) medical and health progress is an important factor; the level of economic development is the leading support; the endowment of resources and environment is the basic condition; public service support provides important support; and scientific and technological innovation capabilities provide technical support for the construction of a Healthy City., Conclusions: The spatial heterogeneity of Healthy City construction in China is evident, and the state of spatial distribution is relatively stable. The spatial pattern of Healthy City construction is shaped by a combination of factors. Our research will provide a scientific basis for promoting the construction of Healthy Cities and helping to implement the Health China Strategy., (Copyright © 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Microplastic pollution is widespread in terrestrial and aquatic environments; however, a systematic assessment of the ecological risks of microplastics is lacking. This study collected research studies on microplastics in soil, aquatic and sediment environments, and screened 128 articles including 3459 sites to assess the ecological risks posed by microplastics in China following a literature quality assessment. We developed a systematic ecological risk assessment framework for microplastics in terms of spatial characterization, biotoxicity and anthropogenic impacts. The results of the pollution load index indicated that 74% and 47% of the soil and aquatic environments studied, respectively, faced a medium or higher level of pollution. Comparing predicted no effect concentrations (PNEC) and measured environmental concentrations (MECs), revealed that soil (97.70%) and aquatic (50.77%) environmental studies were at serious ecological risk from microplastics. The results of the pressure-state-response model showed that the microplastic pollution in Pearl River Delta was in a high-risk state. In addition, we found that ultraviolet radiation and rainfall exacerbate soil microplastic pollution, and higher river runoff may carry large amounts of microplastic from the source. The framework developed in this study will help assess the ecological risks of microplastics in the region to promote the mitigation of plastic pollution., 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 © 2023 Elsevier Ltd. All rights reserved.)

Soil contamination by microplastics (MPs) has gained widespread attention, whose fate may be influenced by land use types. The effects of land use types and the intensity of human activities on the distribution and sources of soil MPs at the watershed scale are unclear. In this study, 62 surface soil sites in representing five land use types (urban, tea garden, dryland, paddy field and woodland) and 8 freshwater sediment sites were investigated in the Lihe River watershed. MPs were detected in all samples, and the average abundance of soil and sediments was 401.85 ± 214.02 and 222.13 ± 54.66 items/kg, respectively. The soil MPs abundance followed the sequence: urban > paddy field > dryland > tea garden > woodland. Soil MP distribution and MP communities were significant different (p < 0.05) among land use types. The similarity of MP community highly correlated with geographic distance, and woodlands and freshwater sediments may be a potential fate for MPs in the Lihe River watershed. Soil clay, pH, and bulk density significantly correlated with MP abundance and fragment shape (p < 0.05). The positive correlation between population density, Total- Point of Interest (POI) and MP diversity indicates the importance of intensity of human activities in exacerbating soil MP pollution (p < 0.001). Plastic waste sources accounted for 65.12%, 58.60%, 48.15% and 25.35% of MPs in urban, tea garden, dryland and paddy field soils, respectively. Differences in the intensity of agricultural activities and cropping patterns were associated with different percentages of mulching film sources in the three types of agricultural soils. This study provides new ideas for the quantitative analysis of soil MP sources in different land use types., 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 © 2023 Elsevier Ltd. All rights reserved.)

Evidence of more recent studies should be updated to evaluate the effect of long-term exposure to particulate matter (PM) on blood pressure and hypertension.        Studies of long-term effects of PM 1 , PM 2.5 and PM 10 on blood pressure (SBP, DBP, MAP), hypertension were searched in Pubmed, Web of Science and Embase before May, 2021. Meta-analysis of 41 studies showed that exposure to PM 1 , PM 2.5 was associated with SBP (1.76 mmHg (95%CI:0.71, 2.80) and 0.63 mmHg (95%CI:0.40, 0.85), per 10 μg/m 3 increase in PM), all three air pollutants (PM 1 , PM 2.5 , PM 10 ) was associated with DBP (1.16 mmHg (95%CI:0.34, 1.99), 0.31 mmHg (95%CI:0.16, 0.47), 1.17 mmHg (95%CI:0.24, 2.09), respectively. As for hypertension, PM 1 , PM 2.5 and PM 10 were all significantly associated with higher risk of hypertension (OR=1.27 (95%CI:1.06, 1.52), 1.15 (95%CI:1.10, 1.20) and 1.11 (95%CI:1.07, 1.16). In conclusion, our study indicated a positive association between long-term exposure to particulate matter and increased blood pressure, hypertension.

The benthic gastropods Bellamya aeruginosa (B. aeruginosa) is ubiquitous in freshwater in China and neighboring countries with great edible value. It has been recognized as a potential manipulator to control harmful algal blooms due to its filtration on algal cells. In this study, the control effect of B. aeruginosa on toxic and non-toxic Microcystis aeruginosa (M. aeruginosa), and the accumulation and depuration of microcystins (MCs) in the snail were systematically explored. Results indicated that although toxic M. aeruginosa could protect itself via producing MCs, the introduction of B. aeruginosa could still effectively inhibit the algae with cell density below 1 × 10 6 cells/mL. Hepatopancreas was the primary target of MCs in all tissues of B. aeruginosa, presenting a maximum of 3089.60 ng/g DW when exposed to toxic M. aeruginosa of 1.0 × 10 7 cells/mL. The enrichment of MCs in other tissues following the order of digestive tract > gonad > mantle > muscle. Interestingly, snail could again excrete previously enriched MCs when transferred to non-toxic M. aeruginosa, giving rise to over 80% reduction of MCs in the body. After depuration, the estimated daily intake (EDI) of free MCs in intact individuals and the edible parts of B. aeruginosa were both lower than the tolerable daily intake (TDI). These results implicated that B. aeruginosa could control low density of M. aeruginosa in spring. Particularly, the snail could be perfectly safe to consume by purifying for a while after using as manipulator., 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 © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

China has the largest worldwide cumulative installed photovoltaic (PV) capacity, which is expected to be 1300 GW in 2050. Industrial production, population explosion and fossil fuel combustion would reduce the surface solar radiation that could be received by PV panels. However, it is still a problem to explore the integrated effects of socio-economic and air pollutant emissions on PV power potential in China. In this study, climate change impact on PV power potential in 2023-2100 were assessed using the Coupled Model Intercomparison Project Phase 6 (CMIP6) model, combining Shared Socio-economic Pathway (SSPs) and Representative Concentration Pathways (RCPs). The validation results with ground-based surface solar radiation measurements collected from 17 China Meteorological Administration (CMA) stations showed that the Meteorological Research Institute Earth System Model version 2-0 (MRI-ESM2-0) attained a better performance with mean correlation coefficients (R), Root Mean Square Error (RMSE), and Mean Absolute Error (MAE) of 0.85, 35.80 Wm -2 and 29.37 Wm -2 , respectively. Then, the MRI-ESM2-0 model was selected to analyze the spatial and temporal variations in PV power potential. PV power potential decreased significantly in SSP585 ranging from 192.71 Wm -2 to 189.96 Wm -2 in 2023-2100 corresponding to the growing resource intensity and fossil fuel dependency. In contrast, if China continues on the path of sustainable and low-carbon development and keeps temperature rise to about 1.5 °C by 2100, PV power potential will increase by 1.36-5.90 Wm -2 . Meanwhile, the effects of climatological factors on PV power potential were analyzed by Empirical Orthogonal Function (EOF) method. Results indicated that surface solar radiation had the highest contribution of >50 %, and the contribution of aerosols and cloud cover was about 20 %. This study is conducive to the full utilization of solar resources and has important implications for the future formulation of solar energy policy in China., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

In order to scientifically evaluate the characteristics and impact outcomes of transportation carbon emissions, this paper uses the panel statistics of 286 cities to measure transportation carbon emissions and analyze their spatial correlation characteristics. Afterwards, primarily based on the current research, a system of indicators for the impact factors of transportation carbon emissions was established. After that, ordinary least squares regression, geographically weighted regression, and multiscale geographically weighted regression models were used to evaluate and analyze the data, and the outcomes of the multiscale geographically weighted regression model were selected to analyze the spatial heterogeneity of the elements influencing transportation carbon emissions. The effects exhibit that: (1) The spatial characteristics of China's transportation carbon emissions demonstrate that emissions are high in the east, low in the west, high in the north, and low in the south, with high-value areas concentrated in the central cities of Beijing-Tianjin-Hebei, the Yangtze River Delta, the Guangdong-Hong Kong-Macao region, and the Chengdu-Chongqing regions, and the low values concentrated in the Western Sichuan region, Yunnan, Guizhou, Qinghai, and Gansu. (2) The spatial heterogeneity of transportation carbon emissions is on the rise, but the patten of local agglomeration is obvious, showing a clear high-high clustering, and the spatial distribution of high-high agglomeration and low-low agglomeration is positively correlated, with high-high agglomeration concentrated in the eastern region and low-low agglomeration concentrated in the western region. (3) The effects of three variables-namely, GDP per capita, vehicle ownership, and road mileage-have a predominantly positive effect on transportation carbon emissions within the study area, while another three variables-namely, constant term, population density, and number of people employed in transportation industry-have different mechanisms of influence in different regions. Constant term, vehicle ownership, and road mileage have greater impacts on transportation carbon emissions.

Objective: To analyze the clinical characteristics and prognosis of primary and secondary pancreatic diffuse large B-cell lymphoma (DLBCL) . Methods: Clinical data of patients with pancreatic DLBCL admitted at Shanghai Rui Jin Hospital affiliated with Shanghai Jiao Tong University School of Medicine from April 2003 to June 2020 were analyzed. Gene mutation profiles were evaluated by targeted sequencing (55 lymphoma-related genes). Univariate and multivariate Cox regression models were used to evaluate the prognostic factors of overall survival (OS) and progression-free survival (PFS) . Results: Overall, 80 patients were included; 12 patients had primary pancreatic DLBCL (PPDLBCL), and 68 patients had secondary pancreatic DLBCL (SPDLBCL). Compared with those with PPDLBCL, patients with SPDLBCL had a higher number of affected extranodal sites ( P <0.001) and had higher IPI scores ( P =0.013). There was no significant difference in the OS ( P =0.120) and PFS ( P =0.067) between the two groups. Multivariate analysis indicated that IPI intermediate-high/high risk ( P =0.025) and double expressor (DE) ( P =0.017) were independent adverse prognostic factors of OS in patients with pancreatic DLBCL. IPI intermediate-high/high risk ( P =0.021) was an independent adverse prognostic factor of PFS in patients with pancreatic DLBCL. Targeted sequencing of 29 patients showed that the mutation frequency of PIM1, SGK1, BTG2, FAS, MYC, and MYD88 in patients with pancreatic DLBCL were all >20%. PIM1 ( P =0.006 for OS, P =0.032 for PFS) and MYD88 ( P =0.001 for OS, P =0.017 for PFS) mutations were associated with poor OS and PFS in patients with SPDLBCL. Conclusion: There was no significant difference in the OS and PFS between patients with PPDLBCL and those with SPDLBCL. IPI intermediate-high/high risk and DE were adverse prognostic factors of pancreatic DLBCL. PIM1, SGK1, BTG2, FAS, MYC, and MYD88 were common mutations in pancreatic DLBCL. PIM1 and MYD88 mutations indicated worse prognosis.

Liucheng county, as a suburb of Liuzhou City in Guangxi province, has a prominent ozone (O 3 ) pollution problem; however, there have been no relevant analyses of the cause of local O 3 pollution reported. In order to investigate the causes of O 3 pollution, an online observation of 116 VOCs with a time resolution of 1 h was carried out in Liucheng county from October 1 st to 15 th , and the sensitivity of ozone to the relative changes in the NO x and VOCs was analyzed. The results showed that the average value of φ ［total volatile organic compounds (TVOCs)］ during the observation period was 27.52×10 -9 , and the average value of φ (TVOCs) during the polluting process (October 1 st to 6 th ) was 32.15×10 -9 , which was 32.79% higher than that of the non-pollution process (October 8 th to 15 th ). In terms of species concentration, oxygenated volatile organic compounds (OVOCs) contributed the highest, accounting for 43.70%, followed by alkanes (23.00%), aromatics (11.75%), and halocarbons (7.35%). In terms of ozone formation potential (OFP), OVOCs contributed the highest (41.96%) to OFP, followed by aromatics (32.60%) and alkenes (17.92%). During the observation period, VOCs mainly came from motor vehicle emissions (32.44%), biomass combustion sources (29.31%), solvent use sources (16.43%), plant sources (11.34%), and chemical industry emissions (10.49%). The contribution ratios of solvent use sources and plant sources in the pollution process increased by 28.58% and 28.53%, respectively. The EKMA curve shows that, during the observation period, Liucheng county was in a synergistic control area for VOCs and nitric oxide (NO x ). Therefore, in the high ozone-occurrence autumn of Liucheng county, the key will be to reduce both VOCs and NO x emissions.

Varicella (chickenpox) is a serious public health problem in China, with the most reported cases among childhood vaccine-preventable infectious diseases, and its reported incidence has increased over 20-fold since 2005. Few previous studies have explored the association of multiple meteorological factors with varicella and considered the potential confounding effects of air pollutants. It is the first study to investigate and analyze the effects of multiple meteorological factors on varicella incidence, controlling for the confounding effects of various air pollutants. Daily meteorological and air pollution data and varicella cases were collected from January 1, 2015, to December 31, 2020, in Lu'an, Eastern China. A combination of the quasi-Poisson generalized additive model (GAM) and distributed lag nonlinear model (DLNM) was used to evaluate the meteorological factor-lag-varicella relationship, and the risk of varicella in extreme meteorological conditions. The maximum single-day lag effects of varicella were 1.288 (95%CI, 1.201-1.381, lag 16 day), 1.475 (95%CI, 1.152-1.889, lag 0 day), 1.307 (95%CI, 1.196-1.427, lag 16 day), 1.271 (95%CI, 0.981-1.647, lag 4 day), and 1.266 (95%CI, 1.162-1.378, lag 21 day), when mean temperature, diurnal temperature range (DTR), mean air pressure, wind speed, and sunshine hours were -5.8°C, 13.5°C, 1035.5 hPa, 6 m/s, and 0 h, respectively. At the maximum lag period, the overall effects of mean temperature and pressure on varicella showed W-shaped curves, peaked at 17.5°C (RR=2.085, 95%CI: 1.480-2.937) and 1035.5 hPa (RR=5.481, 95%CI: 1.813-16.577), while DTR showed an M-shaped curve and peaked at 4.4°C (RR=6.131, 95%CI: 1.120-33.570). Sunshine hours were positively correlated with varicella cases at the lag of 0-8 days and 0-9 days when sunshine duration exceeded 10 h. Furthermore, the lag effects of extreme meteorological factors on varicella cases were statistically significant, except for the extremely high wind speed. We found that mean temperature, mean air pressure, DTR, and sunshine hours had significant nonlinear effects on varicella incidence, which may be important predictors of varicella early warning., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Identification of tumor dependencies is important for developing therapeutic strategies for liver cancer., Methods: A genome-wide CRISPR screen was performed for finding critical vulnerabilities in liver cancer cells. Compounds screen, RNA sequencing, and human phospho-receptor tyrosine kinase arrays were applied to explore mechanisms and search for synergistic drugs., Findings: We identified mitochondrial translation-related genes associated with proliferation for liver cancer cells. Tigecycline induced deficiency of respiratory chain by disturbing mitochondrial translation process and showed therapeutic potential in liver cancer. For liver cancer cells extremely insensitive to tigecycline, a compounds screen was applied to identify MEK inhibitors as synergistic drugs to tigecycline-insensitive liver cancer cells. Mechanistically, sustained activation of EGFR-ERK1/2-MYC cascade conferred the insensitivity to tigecycline, which was mediated by enhanced secretion of EREG and AREG. Moreover, glycolytic enzymes, such as HK2 and PKM2 were upregulated to stimulate glycolysisin a MYC-dependent manner. Tigecycline induced respiratory chain deficiency in combination with cutting off EGFR-ERK1/2-MYC cascade by MEK inhibitors or EGFR inhibitors, resulting in decrease of both oxidative phosphorylation and glycolysis in liver cancer cells., Interpretation: Our study proved that blocking EGFR-ERK1/2-MYC cascade combined with tigecycline could be a potential therapeutic strategy for liver cancer., Funding: This work was funded by grants from the National Natural Science Foundation of China (82073039,82222047, 81920108025), Program of Shanghai Academic/Technology Research Leader (22XD1423100), Shanghai Municipal Science and Technology Project (20JC1411100), 111 Project (B21024), Innovative Research Team of High-level Local Universities in Shanghai (SHSMU-ZDCX20212700, SHSMU-ZDCX20210802) and Shanghai Jiao Tong University School of Medicine (YG2019GD01)., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Population aging has led to depression becoming a serious public health problem both in China and worldwide. Marital relationships, relationships with their children, and air pollution might play an important role in the process of depressive disorders. In this study, we aimed to reveal the mechanism of the effects of these factors on depression., Methods: Participants were recruited from The China Health and Retirement Longitudinal Study (CHARLS) (wave 4) from July 2018 to March 2019. Depression symptoms were evaluated using the 10-item Center for Epidemiologic Studies depression scale (CESD-10). Marital relationships, relationships with their children, air quality satisfaction, and perceived health status were analyzed using Likert 5-point evaluation methods. Structural equation modeling-path (SEM) models were used to explore these variables' mediation effects on depression symptoms., Results: Marital relationships, relationships with their children, air quality satisfaction, perceived health status, and depression symptoms were significantly associated with each other (P < 0.001). Mediation analysis showed that family relationships (standardized beta = -0.28 [-0.31, -0.26]) and quality satisfaction (standardized beta = -0.03 [-0.05, -0.01]) had negative effects on depression symptoms. The total indirect effects of family relationships and air quality satisfaction on depression symptoms were -0.06 (95% confidence interval (CI) = [-0.07, -0.05]) and -0.016 (95% CI = [-0.02, -0.01]), respectively., Conclusion: Family relationships, air quality satisfaction, and perceived health status influenced depression symptoms. The effects of family relationships and air quality satisfaction on depression symptoms were significantly mediated by perceived health status. Therefore, perceived health status aspects should be considered when conducting targeted intervention toward depression symptoms among middle-aged and elderly adults., (© 2022. The Author(s).)

(1) Objective: This study aimed to investigate the relationship between dietary patterns and depression in Chinese older adults. (2) Method: A cohort study was conducted on the relationship between dietary patterns and the risk of depression in older adults based on the China Health and Longevity Longitudinal Survey (CLHLS) from 2011 to 2014. Exploratory factor analysis was used to identify dietary patterns. The relationship between dietary patterns and the risk of depression after four years was examined using logistic regression, and subgroup analysis was carried out to determine whether the association differed by gender. (3) Results: A total of 2873 older adults were included in our cohort study. Three dietary patterns were identified: vegetable-egg-bean-milk pattern, meat-fish pattern, and salt-preserved vegetable-garlic pattern. The vegetable-egg-beans-milk pattern was negatively correlated with the risk of geriatric depression development (adjusted OR = 0.65 (95%CI: 0.49-0.87)), and the salt-preserved vegetable-garlic pattern was positively associated with aged depression risk (adjusted OR = 1.33 (95CI: 1.00-1.77)). The meat-fish pattern was not associated with the risk of depression in older adults. These associations were consistent in both men and women. (4) Conclusions: In this cohort study, the vegetable-egg-beans-milk dietary pattern was associated with lower risk of depression, while the salt-preserved vegetable-garlic dietary pattern was associated with higher risk of depression, and there were no gender differences in these associations.

Background: Duration of marriage (DoM) and age are important characteristics of married individuals, who are the critical population for eliminating mother-to-child transmission (MTCT) of syphilis. A deep understanding of the preconception syphilis seroprevalence (PSS) and its distribution among this population may be able to help to eliminate MTCT. However, few population-based epidemiological studies have been focused on this group, and the association of DoM and age with PSS remains unclear., Methodology/principal Findings: This study used data from 4,826,214 married individuals aged 21-49 years who participated in the National Free Preconception Health Examination Project in Guangdong Province, China, between 2014 and 2019. Syphilis was screened using the rapid plasma reagin (RPR) test. The seroprevalence time series, seroprevalence map, and hot spot analysis (HSA) were employed to visualize the spatiotemporal distribution. The restricted cubic spline (RCS) based on multivariate logistic regression was used to model the association of DoM and age with PSS. The interactions on the additive scale of DoM and age were also assessed. The PSS was 266.61 per 100,000 persons (95% CI: 262.03-271.24) and the burden was higher in economically underdeveloped area within the province. A strong J-shaped non-linearity association was observed between age and PSS. Specifically, the risk of seropositivity was relatively flat until 27 years of age among men and increased rapidly afterwards, with an adjusted odds ratio (aOR) of 1.13 (95% CI: 1.12-1.13) per unit. Among women, the risk of seropositivity was relatively flat until 25 years of age and increased rapidly afterwards with an aOR of 1.08 (95% CI: 1.08-1.09) per unit. DoM was negatively associated with PSS among married individuals. Moreover, the combined effects of age and DoM appeared to be synergistic., Conclusions/significance: Our findings suggest that attention should be paid to preventing syphilis in underdeveloped areas and that syphilis screening in newly married individuals who are in their late 20s or older should be recommended. Additionally, early syphilis prevention strategies should be implemented among young people as early as possible., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Xiong 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.)

The diurnal variation, gas-particle partitioning, health risks, and sources of polycyclic aromatic hydrocarbons (PAHs) were investigated in a northern basin city of China in winter, 2020. The mean concentrations of particulate and gaseous PAHs were 87.90 ng m -3 and 69.65 ng m -3 , respectively, and their concentrations were considerably enhanced during the domestic heating period. The relationship between the gas-particle partitioning coefficient of PAHs (K P ) and subcooled liquid vapor pressure of PAHs (P L 0 ) indicated organic absorption as the mechanism for this partitioning. However, the dual sorption model confirmed adsorption onto elemental carbon (EC). The health risks indicated by several equivalent parameters showed an important health effect of PAHs, especially of particulate PAHs bound onto PM 2.5 during the heating period. Environmentally persistent free radicals (EPFRs) were also studied as an auxiliary parameter to evaluate the health impact of PAHs. According to the diagnostic ratios of PAHs and PMF model results, petroleum volatilization and coal combustion were the dominant sources of particulate PAHs during the non-heating and heating periods, respectively. The source apportionment results can help efficiently control PAHs and their health risks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Several studies have explored the relationship between mental health and life satisfaction. However, few studies have clarified the mechanisms underlying the relationship between mental health and life satisfaction among a large sample of the whole population. The aim of this study was to explore the mediating role of perceived social support between mental health and life satisfaction among the residents in Taian City, China. A total of 8500 residents were included in the analysis. A descriptive analysis was conducted to describe the sample characteristics. Pearson correlation was employed to explore the correlation between mental health and life satisfaction. The mediating role of perceived social support was analyzed using SPSS26.0. This study found that the residents' average score of life satisfaction was 24.60 ± 4.12. Mental health was significantly correlated with perceived social support and life satisfaction. After adjusting for controlling variables, perceived social support played a partially mediating effect on mental health and life satisfaction, accounting for 21.04% of the total effect. However, data are cross-sectional, and causal conclusions cannot be drawn. Attention should be paid to the residents' mental health and intervention should be considered for residents with mental disorders to improve the residents' life satisfaction.

Few studies have focused on the sleep quality among migrant elderly following children (MEFC). This study aimed to investigate the effects of chronic disease and mental health on the sleep quality of MEFC in Weifang, China. A cross-sectional study was conducted by multi-stage cluster random sampling, and in total 613 participants were enrolled. Sleep quality and mental health were assessed by the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale (DASS-21), respectively. Chronic disease was assessed by the question "how many chronic diseases do you have?" A descriptive analysis and chi-square test were used to describe participants' sociodemographic variables, chronic disease, mental health, and sleep quality. The relationship between chronic disease, mental health, and sleep quality was explored by establishing binary logistic regression models. The results showed that 18.3% of MEFC's sleep quality was poor. MEFCs who were male were more likely to report good sleep quality. MEFCs who have similar monthly family income compared with others around, with multimorbidity, depression, and anxiety were more likely to report poor sleep quality. Nearly 1/5 of MEFCs were having poor sleep quality in this study. Results indicated that chronic diseases, depression, and anxiety were risk factors for the sleep quality of MEFC. Implications for the government, communities, and families of MEFC were given for improving their sleep quality.

Background: Relative deprivation has been confirmed as one of the pathways underlying the link between income inequality and health. However, the mechanism between relative deprivation and health was still unclear. This study aimed to test the mediating role of depression and the moderating role of social support in the association between relative deprivation and quality of life., Methods: Data were collected from the 2020 Household Health Interview Survey in Taian City, Shandong province. In total, 8496 adults were included to complete the measures of relative deprivation, depressive symptoms, perceived social support, and quality of life., Results: Relative deprivation was negatively associated with quality of life, and depressive symptoms could mediate this association. Furthermore, the direct effect of relative deprivation on quality of life and the indirect effect of depressive symptoms in this relationship were moderated by perceived social support. Both these two effects were stronger for individuals with a low level of perceived social support., Limitations: Data are cross-sectional, and causal conclusions cannot be drawn. All measures were based on participant self-report., Conclusions: Personal relative deprivation has negative effects on quality of life. Social support moderated the direct effect of relative deprivation and the mediating effect of depressive symptoms on quality of life. For individuals with a high level of relative deprivation, particularly those with a low level of social support, interventions tailoring psychological services and community-based activities could be designed to reduce relative deprivation and promote social support for disadvantaged individuals., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

This study aimed to compare the pharmacokinetics, safety, and immunogenicity of the prefilled syringe (PFS) with lyophilized (LYO) recombinant human tumor necrosis factor-α receptor II:lgG Fc fusion protein (rhTNFR:Fc) in healthy Chinese male subjects. A single-center, randomized, open-label, 2-period, crossover study was performed in healthy Chinese male subjects. Subjects were randomly assigned into 2 sequences and received a subcutaneous injection of 25 mg rhTNFR:Fc PFS or rhTNFR:Fc LYO (Anbainuo), with a 35-day washout between the 2 periods. Blood samples were collected at specified time intervals, and then serum concentrations of rhTNFR:Fc were analyzed by enzyme-linked immunosorbent assay. The maximum serum concentration, area under the concentration-time curve (AUC) from time 0 to the last quantifiable concentration, and AUC from time 0 to infinity were all calculated and evaluated. Meanwhile, safety and immunogenicity were also assessed. A total of 82 subjects completed the study, and six subjects withdrew for various reasons. The 90%CIs for geometric mean ratios of maximum serum concentration, AUC from time 0 to the last quantifiable concentration, and AUC from time 0 to infinity were all within the equivalence range of 80% to 125%. Safety was comparable between the 2 formulations with low immunogenicity. rhTNFR:Fc PFS exhibited similar pharmacokinetic and safety profiles of rhTNFR:Fc LYO (Anbainuo) in healthy Chinese male subjects., (© 2022, The American College of Clinical Pharmacology.)

Background: The associations between long-term exposure to ozone (O 3 ) and respiratory diseases are well established. However, its association with cardiovascular disease (CVD) remains controversial. In this study, we examined the associations between O 3 and the prevalence of hypertension and blood pressure, and the mediation effects of body mass index (BMI) in Chinese middle-aged and older adults., Methods: In this national cross-sectional study, we estimated the O 3 exposure of 12,028 middle-aged and older adults from 126 county-level cities in China, using satellite-based spatiotemporal models. Generalized linear mixed models were used to evaluate the associations of long-term exposure to O 3 with hypertension and blood pressure, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP). Mediation effect models were applied to examine the mediation effects of BMI among O 3 -induced hypertension and elevated blood pressure., Results: Each 10 μg/m 3 increase in O 3 concentration was significantly associated with an increase of 13.7% (95% confidence interval (CI): 4.8%, 23.3%) in the prevalence of hypertension, an increase of 1.128 mmHg (95% CI: 0.248, 2.005), 0.679 mmHg (95% CI: 0.059, 1.298), 0.820 mmHg (95%CI: 0.245, 1.358) in SBP, DBP, and MAP, respectively. Mediation effect models showed that BMI played 40.08%, 37.25%, 39.95%, and 33.51% mediation roles in the effects of long-term exposure to O 3 on hypertension, SBP, DBP, and MAP, respectively., Conclusions: Long-term exposure to O 3 can increase the prevalence of hypertension and blood pressure levels of middle-aged and older adults, and an increase of BMI would be an important modification effect for O 3 -induced hypertension and blood pressure increase., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: There are few studies reported on the acceptance of heterologous booster vaccination for the COVID-19 vaccine among healthcare workers (HCWs) and the general population. We aimed to address that gap and explore determinant factors of acceptance of the heterologous booster vaccination., Methods: We conducted a cross-sectional study to examine the prevalence and determinant factors of the acceptance of heterologous booster vaccination for the COVID-19 vaccine among HCWs and the targeted population., Results: A total of 364 HCWs and 1,898 targeted populations were investigated in our study. 76.4% HCWs would recommend heterologous booster vaccination to their patients and 59.8% targeted population endorsed a clear willingness to receive this strategy. Compared with the adenoviral vector vaccine (AD5-nCOV), recombinant protein vaccine (ZF2001) was more preferred by HCWs (79.1%) and the targeted population (72.0%) as a heterologous booster vaccine. HCWs who did not work in the vaccination clinics were more likely to recommend heterologous booster vaccination (OR = 3.3, CI: 1.5-7.3). The targeted population aged 18-59 years (OR = 1.5, 95% CI:1.1-2.3), had a positive attitude toward COVID-19 vaccination (OR = 3.8, 95% CI: 1.7-8.6), had confidence in the safety of COVID-19 vaccines (OR = 6.6, 95% CI: 4.2-10.2), followed the recommendation of HCWs (OR = 33.6, 95% CI: 22.0-51.2), took initiative in collecting booster shots information (OR = 2.1, 95% CI: 1.5-3.0), and were familiar with the heterologous strategy (OR = 1.9, 95% CI: 1.1-3.1) were more likely to choose heterologous booster vaccination. The history of side effects of inactivated COVID-19 vaccine was a negative factor in choosing heterologous booster vaccination (OR = 0.4, 95% CI: 0.4-1.0)., Conclusions: The heterologous booster vaccination strategy on the COVID-19 vaccine could be widely accepted among HCWs, whereas its acceptance among targeted population was only moderate. Public authorities should make efforts to communicate the public about the effectiveness and safety of the heterologous booster vaccination which could help increase their willingness to get vaccinated., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Qin, Zhang, Wang, Pan, Cheng, Huang, Song and Su.)

Bacterial biodiversity is tightly correlated with ecological functions of natural systems, and bacterial rare and abundant subcommunities make distinct contributions to ecosystem functioning. However, the biogeographic pattern and elevational differentiation of sedimentary bacterial diversity have rarely been studied in cross-river systems at a continental scale. This study analyzed the biogeographic patterns and elevational differentiations of the entire, abundant, and rare bacterial (sub)communities as well as the underlying mechanisms across nine rivers that span distinct geographic regions and large elevational gradients in China. We found that bacterial rare and abundant subcommunities shared similar biogeographic patterns and both demonstrated strong distance-decay relationships, despite their distinct community compositions. However, both null model and variation partitioning analysis results showed that while environmental selection governed rare subcommunity assemblies (contribution: 51.9%), dispersal limitation (62.7%) controlled the assembly of abundant subcommunities. The disparity was associated with the broader threshold width of abundant taxa to water temperature and pH variations than rare taxa. Elevation-induced bacterial composition variations were more evident than latitude-induced ones. Some specific operational taxonomic units (OTUs), representing 16.4% of the total sequences, much preferentially and even exclusively lived in high-elevation or low-elevation habitats and demonstrated some adaptations to local conditions. Greater positive: negative link ratios in bacterial co-occurrence networks of low elevations than high elevations ( P <  0.05) partly resulted from their harboring higher organic carbon: nitrogen ratios. Together, this study draws a biogeographic picture of sedimentary bacterial communities in a continental-scale riverine system and highlights the importance of incorporating elevation-associated patterns of microbial diversity into riverine microbial ecology studies. IMPORTANCE Bacterial diversity is tightly correlated with the nutrient cycling of river systems. However, previous studies on bacterial diversity are mainly constrained to one single river system, although microbial biogeography and its drivers exhibit strong spatial scale dependence. Moreover, elevational differentiations of bacterial communities across river systems have also rarely been studied. Bacterial rare and abundant subcommunities make distinct contributions to ecosystem functioning, and they share similar biogeographic patterns in some environments but not in others. Therefore, we explored the biogeography of the entire, abundant, and rare (sub)communities in nine rivers that cover a wide space range and large elevational gradient in China. Our results revealed that bacterial rare and abundant subcommunities shared similar biogeographic patterns but their assembly mechanisms were much different in these rivers. Moreover, bacterial communities showed evident differentiations between high elevations and low elevations. These findings will facilitate a better understanding of bacterial diversity features in river systems.

Background: The rapid response teams (RRTs) are early intervention Teams made up of physicians, nurses, and/or other designated personnel that conduct early assessment and intervention of patients with changing conditions outside the intensive care unit (ICU) in order to reduce ICU admissions and prevent further deterioration or promote early admission to the ICU in critically ill patients. Numerous studies have shown that RRT can effectively reduce the incidence of cardiac arrest and accidental death in patients. Nurses are the most indispensable members of multidisciplinary teams (MDT), and their ability is closely related to the success rate of RRT., Methods: Using the phenomenological method of qualitative research, we conducted semi-structured interviews with 16 non-nurse members of RRT, including 6 doctors, 5 anesthesiologists and 5 respiratory therapists, in a third class a general hospital in Shanghai. Colaizzi content analysis was used for data analysis., Results: After analysis and collation, three themes were extracted: professional theoretical knowledge, professional practical skills, and personality traits. Professional theoretical knowledge includes basic medical knowledge and knowledge of rapid response system. Professional practical skills include quick reaction capability, ability to assess illness, first aid skills and communication skills; Personality traits include imperturbable and cooperative spirit of group., Conclusions: Non-nurse members of the RRT expect the response team nurses to possess solid professional theoretical knowledge, skilled professional practical skills, and good personality qualities. Nursing managers should pay attention to the training of professional theoretical knowledge, professional practical skills and personality quality when carrying out the training practice of nurses' competency in RRT, so as to truly improve the success rate of RRT operation and further promote patient safety.

Objectives: To evaluate whether social isolation and loneliness mediates the relationship between hearing loss and depression symptoms in older adults in China., Methods: A cross-sectional analysis was conducted of 3769 participants (aged≥60 years) in Shandong province of China. Hearing loss was assessed using Pure-Tone Audiometry test, depression symptoms using 15-item Geriatric Depression Scale, loneliness through UCLA Loneliness Scale and social isolation using Lubben Social Network Scale. Regression and bootstrap analyses were performed to test both direct associations of hearing loss and depression symptoms, and whether the mediating role of social isolation and loneliness., Results: Overall, 44% of older adults had hearing loss, which was generally mild (30%) rather than moderate (10%), severe (3%) or profound (0.6%). Increasing levels of hearing loss was associated with increasing levels of social isolation and depressions. Hearing loss was also associated with loneliness, but here a threshold effect was apparent and no trend for increasing loneliness with increasing hearing loss. Models that included social isolation and loneliness showed an amelioration in the association of hearing loss and depression, although it remained significant at all levels of hearing loss. Overall, 8% of the total effect of hearing loss on depression symptoms was explained by the mediated effect through social isolation and 42% by loneliness., Conclusions: Psychosocial factors such as social isolation and loneliness might explain the association between hearing loss and depression. Interventions that address older adults' social isolation and loneliness may ameliorate depression in older adults with hearing loss., (© 2022 John Wiley & Sons Ltd.)