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Muscovy duck parvovirus (MDPV) usually causes high morbidity and mortality in 1to 3-wkold Muscovy ducklings due to serious infections, which is an imminent threat to the commercial duck industry in China, The objectives of this study were to develop and evaluate a simple, rapid, and inexpensive ioopmediated isothermal amplification (LAMP) method for specific detection of MDPV and to compare it with the PCR method in rapidity, sensitivity, and accuracy. The novel LAMP assay used a set of 4 specific primers to recognize 6 distinct genomic sequences of capsid protein (VP3) from MDPV, which could be completed within 50 mm at 63°C in a simple water bath. The diagnostic results demonstrated that the LAMP assay detected all 7 preserved MDPV isolates, had no cross-reactivity with other duck pathogens (i.e., goose parvovirus, duck plague virus, H9N2 avian influenza virus, duck hepatitis type virus I, and Muscovy duck reovirus). The LAMP assay was at least 10-fold more sensitive than the routine PCR assay and obtained more sensitivity in 61 clinical samples. Therefore, the newly developed LAMP assay provides a specific and sensitive means for detecting MDPV and can be simply applied both in field conditions and in laboratory operations in a costeffective manner with primary care facilities. [ABSTRACT FROM AUTHOR]

The human gastric pathogen, Helicobacter pylori, has co-evolved with its host and established itself in the human stomach possibly millions of years ago. Therefore, the diversity of this bacterium is important in its clinical manifestations. Our aim has been to evaluate the genetic diversity of 40 H. pylori clinical isolates from four different parts of China. The methods of multi-locus sequence typing and vacA allele genotyping were used to assess their genetic diversity. To discriminate MLST, the vacA genotype method was used to identify strains. Patients from the northern, eastern, southern, and southwestern parts of China were recruited randomly from the cities of Beijing, Shanghai, Guangzhou, and Chongqing, respectively. Most of the sequence types are new and have never been reported in the database of the H. pylori multi-locus sequence typing system. The most prevalent vacA genotype in patients was s1a/m2 (80.0%), followed by s1b/m2 (17.5%). In contrast, the s1a/m1 genotype was scarcely represented (2.5%). The vacA genotype varied for each ST. These results showed that the MLST method offers high resolution of the H. pylori isolates in China when compared to vacA genotyping. The vacA allelic s1a has been correlated with the peptic ulcer. Because of the paucity of data on human isolates due to the absence of systematic investigations of H. pylori in China, the data provide useful information for understanding the epidemiology of H. pylori in China from the viewpoint of nucleotide sequence databases. [ABSTRACT FROM AUTHOR]

Over the past several decades, a series of new methods have been developed in China for the diagnosis of foot-and-mouth disease (FMD). These methods are theoretically consistent with Office International des Epizooties standards for FMD diagnosis and include: antigen-capture ELISA and colloid-gold test strip for viral antigen typing, liquid-phase blocking ELISA (LPBE) for detection of antibodies against O and Asia 1 FMDV, and an indirect ELISA for detection of antibodies against the non-structural protein (NSP) 3ABC (3ABC-I-ELISA). Several molecular diagnostic methods have also been developed for detection of fragments of the FMDV genome within viral samples, such as multiplex RT–PCR, typing RT–PCR and real-time RT–PCR. In China, FMD vaccines are compulsorily used in all livestock. In such a situation, monitoring of the immune status of animal herds and disease surveillance become very important. Liquid-phase blocking ELISA is routinely used in China for monitoring the immune status, and 3ABC-I-ELISA is feasible for large-scale serological surveys based on differentiation of FMDV-infected animals from vaccinated animals. Combined use of 3ABC-ELISA and mRT–PCR is described for survey of FMD virus-prevalent herds and virus carriers. [ABSTRACT FROM AUTHOR]

Foot-and-mouth disease (FMD) virus is the aetiological agent of an important disease of livestock and has a great global impact. The outbreak of FMD type Asia 1 in China was first confirmed at the beginning of May 2005. Subsequent outbreaks occurred in 10 areas in different provinces of China. [ABSTRACT FROM AUTHOR]

Adeno-associated virus (AAV; genus Dependoparvovirus, family Parvoviridae) was first discovered in 1965 as a contaminant in adenovirus preparations. The AAVs are generally considered nonpathogenic, and they have the ability to attenuate the replication of other more pathogenic viruses, which makes them attractive as potential therapeutics or preventative measures. This study characterized a novel AAV isolated from Muscovy ducks in China. The novel virus (MHH-05-2015) was isolated after propagating a field isolate of the DAdV-3 virus (a type 3 duck adenovirus) in duck embryo fibroblasts. The full genome sequence of MHH-05-2015 was determined, and the nucleotide and amino acid sequences were compared to other avian AAVs. The genomic distribution of the structural and non-structural protein-coding genes in MHH-05-2015 was conserved and consistent with the other AAVs. Compared to previously isolated avian AAVs, MHH-05-2015 had approximately 63 to 64% sequence identity. Phylogenetic analysis indicated that MHH-05-2015 clustered separately from other avian AAVs, suggesting that MHH-05-2015 was not directly descended from other Dependoparvovirus family members. These results suggest that MHH-05-2015 is a new subtype of AAV that is distinct from other avian AAVs. [ABSTRACT FROM AUTHOR]

Forty-seven strains of H9 subtype avian influenza viruses identified by specific reverse transcription-PCR method were isolated from the chicken and duck flocks in different areas of China during the 2002 to 2009 epizootic period. Hemagglutinin (HA) genes of these strains were sequenced and analyzed with the representative strains published in GenBank. The results indicated that the HA genes of these strains and the vaccine strains displayed nucleotide homologies ranging from 91.7 to 96.6% and amino acid homologies ranging from 92.3 to 95.7%, respectively. Analysis of the mature peptide sequences of these HA genes showed that the presence of leucine at position 216 (corresponding to residue 226 in H3 numbering) indicated a preference to the binding of α (2-6) sialic acid receptors, which was the same as human isolates. Extra potential glycosylation sites appeared in the HA genes of most tested isolations compared with the vaccine strains. The HA cleavage sites of most of the strains were the 335PSRSSR↓GLF341, but all of the strains met the characteristics of low-pathogenic avian influenza. The results of phylogenetic analysis indicated that all 47 strains and the current vaccine strains belong to the same phylogenetic lineage h9.4.2, but they had some genetic deviation in the last decade. Compared with the vaccine strains, 7 mutations were found in the antigen epitope region of the HA genes of the field strains. These results suggested that the commercial vaccine might not induce satisfactory prevention against infection of H9N2 avian influenza virus. [ABSTRACT FROM AUTHOR]

Background: There is a lack of diagnostic non-invasive imaging technology for assessing the early structural and functional changes of the kidney in type 2 cardiorenal (CRS) patients. This study aims to explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for clinical application in type 2 CRS patients, to provide imaging markers for the assessment of kidney damage., Methods: This is a retrospective observational clinical study conducted in Nanjing, China. The clinical characteristics, including age, gender, medical history, laboratory results, and ultrasound and magnetic resonance imaging results were collected from the electronic medical record. Thirty-one patients with type 2 CRS, 20 patients with chronic heart failure (HF) and 20 healthy controls were enrolled and divided into type 2 CRS, HF and control groups. All the participants underwent magnetic resonance imaging (MRI) scanning. The apparent diffusion coefficient (ADC) value and IVIM-DWI parameters including true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were obtained. The correlation between estimated glomerular filtration rate (eGFR), renal size and imaging parameters was evaluated by Spearman correlation analysis., Results: ADC and D of the renal cortex in patients with type 2 CRS were lower than those in the healthy control group. ADC and f in the HF group were lower than those in the control group. D was positively correlated with the length (r = 0.3752, P = 0.0013) and transverse diameter (r = 0.3258, P = 0.0056) of the kidney. ADC (r = 0.2964, P = 0.0121) and D (r = 0.3051, P = 0.0097) were positively correlated with eGFR. Renal cortical ADC and D values could distinguish type 2 CRS patients from the healthy controls with area under the curve (AUC) of 0.723 and 0.706, respectively., Conclusion: The ADC and D values were not only correlated with renal function, but also had lower levels in type 2 CRS. The IVIM-DWI parameter D was also related to kidney size, but further research is needed to determine whether it can be used as a novel imaging marker for type 2 CRS., Competing Interests: Declarations Ethics approval and consent to participate The study has been approved by the Ethics Committee of Nanjing Brian Hospital (Approval ID: 2020-KY155-01). The work was conducted in accordance with the World Medical Association Declaration of Helsinki. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Gyrovirus galga1 (GyVg1), formerly known as AGV2, was initially identified in chickens in southern Brazil. The prevalence of GyVg1 from 2021 to 2024 in 28 out of the 63 poultry farms located in Jiangsu, Anhui, Henan, Hunan, Shandong, and Hubei provinces in eastern and central China was detected via PCR. The complete genomes of the 28 strains were sequenced and exhibited a full length of 2,376 bp. Similarity analysis of these strains did not suggest definite correlation with evolutionary branching and geographical distribution. Compared with the reference GyVg1 strains, HN2202 shared the highest similarity of 99.71% with HLJ1511 (chicken-originated) from northeastern China in 2015 to 2016. Recombination analysis revealed that AH2102 was a potential recombinant of peafowl-originated HN2019-PF1 and chicken-originated HLJ1506-2, whereas HN2304 was a recombinant of peafowl-originated HN2019-PF1 and the Hungarian ferret strain G13. Mutation site analysis of the capsid protein revealed that highly mutated regions occurred between sites 288 to 316 and 383 to 419. These results indicate that GyVg1 may have undergone an interspecies transmission, which involved complex mutations and recombination. This study may provide a reference for subsequent investigations targeting the molecular epidemiology and viral evolution of GyVg1., Competing Interests: DISCLOSURES The authors have no competing interests to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Although there are many reasons for extubation failure, maintaining negative or lower positive fluid balances 24 hours before extubation may be a key measure for successful extubation., Aim: To assess the predictive value of fluid balance before extubation and its outcome in mechanically ventilated cases in the intensive care unit (ICU)., Study Design: This retrospective cohort study involved collecting clinical data from patients undergoing mechanical ventilation in Lanzhou general adult ICU from January 2022 to December 2022. Based on extubation outcomes, the patients were divided into a successful extubation group and a failed extubation group. Their fluid balance levels 24 h before extubation were compared with analyse the predictive value of fluid balance on extubation outcomes in patients undergoing mechanical ventilation., Results: In this study, clinical data from 545 patients admitted to a general adult ICU were collected. According to the inclusion and exclusion criteria, 265 (48.6%) patients were included, of which 197 (74.3%) were successfully extubated; extubation was unsuccessful in 68 (25.7%) patients. The total intake and fluid balance levels in patients in the failed extubation group 24 h before extubation were significantly higher than those in the successful extubation group, with a median of 2679.00 (2410.44-3193.50) mL versus 2435.40 (1805.04-2957.00) mL, 831.50 (26.25-1407.94) mL versus 346.00 (-163.00-941.50) mL. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off value for predicting extubation outcomes was 497.5 mL (sensitivity 64.7%, specificity 59.4%) for fluid balance 24 h before extubation. The area under the ROC curve was 0.627 (95% confidence interval [CI] 0.547-0.707). Based on the logistic regression model, cumulative fluid balance >497.5 mL 24 h before extubation could predict its outcomes in mechanically ventilated patients in the ICU (OR = 5.591, 95% CI [2.402-13.015], p < .05)., Conclusions: The fluid balance level 24 h before extubation was correlated with the outcome of extubation in mechanically ventilated patients in the ICU. The risk of extubation failure was higher when the fluid balance level was >497.5 mL., Relevance to Clinical Practice: Tracheal intubation is a crucial life support technique for many critically ill patients, and determining the appropriate time for extubation remains a challenge for clinicians. Although there are many reasons for extubation failure, acute pulmonary oedema caused by continuous positive fluid balance and volume overload is one of the main reasons for extubation failure. Therefore, it is very important to study the relationship between fluid balance and extubation outcome to improve the prognosis of patients with invasive mechanical ventilation in ICU., (© 2024 British Association of Critical Care Nurses.)

This study comprehensively examined the accumulation of cadmium (Cd) in soybeans grown in low- and high-Cd soils around the high geological background areas in Guizhou province. The aim was to analyze the relationship between soybean Cd and soil pH and soil Cd, alongside assessing the potential carcinogenic and non-carcinogenic risks associated with Cd in soybeans. Cd content of soybeans cultivated in the high-Cd area (0.430 mg/kg) was significantly higher than that in low-Cd areas (0.156 mg/kg) (P < 0.05). Biological concentration factors (BCFs) of soybean for Cd in low- and high-Cd areas were 0.282 and 0.314, respectively, with no significant differences (P > 0.05). Multiple linear regression results indicated that soil pH was a determining factor for Cd accumulation in soybeans in both areas. Furthermore, soil pH and soil Cd could accurately predict Cd accumulation in soybeans according to the neural network model. These findings suggest that regulating soil pH could reduce Cd accumulation in soybeans in areas with high geological background. In both areas, there was no significant non-carcinogenic risk for the adult population (HQ value < 1) through soybean consumption. However, according to the Monte Carlo model, the percentage of Cd in soybeans exceeding the acceptable range (CR value > 1.00 × 10 -04) in areas was 99.18%, indicating an unacceptable carcinogenic risk for the adult population. Our discussion revealed that reducing the soybean intake and increasing soil pH did not effectively lower the carcinogenic risk of Cd in soybeans to an acceptable range (CR value ≤ 1.00 × 10 -04). These findings necessitate further exploration of alternative remediation strategies to ensure the safe production of soybeans, such as screening for low-Cd accumulation soybean varieties and implementing the combined remediation strategies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tian 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: Major depressive disorder (MDD) is a serious and disabling condition characterized by abnormal mood changes. Clinical guidelines for depression treatment recommend antidepressant medications, with benzodiazepines acting as short-term synergists. However, little is currently known about the prevalence and associated clinical risk factors of benzodiazepine use among Chinese patients with MDD. This study aimed to explore the prevalence and clinical risk factors associated with benzodiazepine use in this population., Methods: A total of 2742 patients with MDD (males/females = 816/1926, aged 14-60 years) participated in this cross-sectional observational study. General information and psychosis assessments were collected online. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), anxiety symptoms using the Generalized Anxiety Disorder-7 (GAD-7), and sleep problems and suicidal tendencies using the third and ninth items of the PHQ-9. Multivariable logistic regression analysis models were employed to identify factors associated with benzodiazepine use., Results: The prevalence of benzodiazepine use among patients with MDD was 42.9 %. Among these patients, 99.6 % used a single benzodiazepine, with oxazepam being the most frequently prescribed. Age, severity of sleep problems, depressive symptoms, and anxiety symptoms were significantly correlated with benzodiazepine use (all P < 0.001)., Limitations: The cross-sectional design of this study precludes establishing causal relationships., Conclusion: Our findings indicate a high prevalence of benzodiazepine use among Chinese patients with MDD. Factors such as severe depressive symptoms, anxiety symptoms, age, and sleep problems appear to be associated with benzodiazepine use. These results underscore the importance of vigilance regarding benzodiazepine use in patients with MDD., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts with any financial interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Contaminant accumulation in organisms can be influenced by both biological traits and environmental conditions. However, delineating the main factors affecting contaminant burdens in organisms remains challenging. Here, we conducted an initial investigation into the impact of diet and habitat on the accumulation of short- (SCCPs) and medium-chain chlorinated paraffins (MCCPs) in Indo-Pacific humpback dolphins (2003-2020, n = 128) from the Pearl River Estuary (PRE), a highly polluted estuary in China. The detected levels of SCCPs (5897 ± 3480 ng g -1 lw) and MCCPs (13,960 ± 8285 ng g -1 lw) in blubber samples of humpback dolphin are the highest among recorded values marine mammals. Both SCCPs and MCCPs exhibited biomagnification factor values exceeding 1, suggesting their biomagnification potential within the dolphins and their diet. Quantitative diet analysis using the dolphin fatty acid signatures revealed that humpback dolphins inhabiting the western PRE consumed a larger proportion of carnivorous fish than those from the eastern PRE. However, spatial analysis showed that humpback dolphins in the western PRE contained lower SCCP/MCCP concentrations than those from the eastern PRE. Based on these findings we suggest that, compared to diet differences, spatial variations of SCCPs/MCCPs in humpback dolphins may be predominantly influenced by their space-use strategies, as the eastern PRE is closer to the pollutant discharge source and transfer routes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: As a real mortality salience, a public crisis would have a major impact on individual minds, behaviors, and lifestyles. COVID-19 provides us with a stark real-world example to understand these implications. Previous research has revealed that some individuals become more willing to help the infected at the risk of their own lives, while others become more self-centered and indifferent during COVID-19. To explain this paradoxical phenomenon, our study used two rival mediators in the relationship between mortality salience and helping behavior during COVID-19: death anxiety and death reflection., Methods: A cross-sectional survey was conducted among Chinese college students (N = 684) during the pandemic. We used a parallel mediation model to explore the mediating roles of death anxiety and death reflection in the relationship between mortality salience and helping behavior during COVID-19., Results: The results of our study indicate two key findings. First, mortality salience is negatively related to helping behavior during COVID-19 via death anxiety. This suggests that individuals with higher levels of mortality salience experienced increased death anxiety, which in turn led to a decrease in helping behavior. Second, mortality salience is positively related to helping behavior during COVID-19 via death reflection. This indicates that individuals with higher levels of mortality salience engaged in deeper reflection on death, which subsequently resulted in an increase in helping behavior., Conclusion: Our study provides valuable insights into the complex relationship between mortality salience and helping behaviors in the time of public crisis, and can help lead to more positive attitudes toward public crisis events such as COVID-19., 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 © 2024 Xie, Yan, Lai and Wei.)

Background: Hypertension is an established risk factor for mild cognitive impairment (MCI) in elderly individuals. Nevertheless, the impact of different levels of blood pressure on the progression of MCI remains uncertain. This study aims to investigate the non-linear relationship between blood pressure and MCI in the elderly and detect the critical blood pressure threshold, thus, improving blood pressure management for individuals at high risk of MCI., Methods: Data was obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohort. We chose normal cognitive elderly individuals who entered the cohort in 2014 for a 5-year follow-up to observe the progression of MCI. Subsequently, we utilized the Cox regression model to identify risk factors for MCI and conducted a Cox-based restricted cubic spline regression (RCS) model to examine the non-linear relationship between systolic blood pressure (SBP) and diastolic blood pressure (DBP) with MCI, determining the critical blood pressure threshold for MCI progression., Results: In the elderly population, female (HR = 1.489, 95% CI: 1.017-2.180), lacking of exercise in the past (HR = 1.714, 95% CI: 1.108-2.653), preferring animal fats (HR = 2.340, 95% CI: 1.348-4.061), increased age (HR = 1.061, 95% CI: 1.038-1.084), increased SBP (HR = 1.036, 95% CI: 1.024-1.048), and increased DBP (HR = 1.056, 95% CI: 1.031-1.081) were associated with MCI progression. After adjusting factors such as gender, exercise, preferred types of fats, and age, both SBP (P non-linear  < 0.001) and DBP (P non-linear  < 0.001) in elderly individuals exhibited a non-linear association with MCI. The risk of MCI rose when SBP exceeded 135 mmHg and DBP was in the range of 80-88 mmHg. However, when DBP exceeded 88 mmHg, there was a declining trend in MCI progression, although the HR remained above 1. The identified critical blood pressure management threshold for MCI was 135/80 mmHg., Conclusion: In this study, we discovered that risk factors affecting the progression of MCI in elderly individuals comprise gender (female), preferring to use animal fat, lack of exercise in the past, increased age, increased SBP, and increased DBP. Additionally, a non-linear relationship between blood pressure levels and MCI progression was confirmed, with the critical blood pressure management threshold for MCI onset falling within the prehypertensive range., (© 2024. Fondazione Società Italiana di Neurologia.)

Objective: Hepatitis B surface antigen (HBsAg) loss is the optimal outcome for patients with chronic hepatitis B (CHB) but this rarely occurs with currently approved therapies. We aimed to develop and validate a prognostic model for HBsAg loss on treatment using longitudinal data from a large, prospectively followed, nationwide cohort., Design: CHB patients receiving nucleos(t)ide analogues as antiviral treatment were enrolled from 50 centres in China. Quantitative HBsAg (qHBsAg) testing was prospectively performed biannually per protocol. Longitudinal discriminant analysis algorithm was used to estimate the incidence of HBsAg loss, by integrating clinical data of each patient collected during follow-up., Results: In total, 6792 CHB patients who had initiated antiviral treatment 41.3 (IQR 7.6-107.6) months before enrolment and had median qHBsAg 2.9 (IQR 2.3-3.3) log 10 IU/mL at entry were analysed. With a median follow-up of 65.6 (IQR 51.5-84.7) months, the 5-year cumulative incidence of HBsAg loss was 2.4%. A prediction model integrating all qHBsAg values of each patient during follow-up, designated GOLDEN model, was developed and validated. The AUCs of GOLDEN model were 0.981 (95% CI 0.974 to 0.987) and 0.979 (95% CI 0.974 to 0.983) in the training and external validation sets, respectively, and were significantly better than those of a single qHBsAg measurement. GOLDEN model identified 8.5%-10.4% of patients with a high probability of HBsAg loss (5-year cumulative incidence: 17.0%-29.1%) and was able to exclude 89.6%-91.5% of patients whose incidence of HBsAg loss is 0. Moreover, the GOLDEN model consistently showed excellent performance among various subgroups., Conclusion: The novel GOLDEN model, based on longitudinal qHBsAg data, accurately predicts HBsAg clearance, provides reliable estimates of functional hepatitis B virus (HBV) cure and may have the potential to stratify different subsets of patients for novel anti-HBV therapies., Competing Interests: Competing interests: JH received consulting fees from GlaxoSmithKline, Gilead Sciences and a Grant from Roche. NVN is an independent advisor to HistoIndex and a member of the scientific advisory board for InSphero. The other authors declare no conflicts of interest that pertain to this work., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Adolescents with temporomandibular joint (TMJ) anterior disk displacement (ADD) frequently develop dentofacial deformities. It is unknown whether adjunctive arthroscopic diskopexy compared with orthodontic treatment alone increases condylar growth and then improves dentofacial deformity. This study aimed to determine whether arthroscopic diskopexy before functional appliance (joint-occlusal treatment) or single functional appliance (occlusal treatment) increases condylar growth and improves dentofacial deformity among adolescents with TMJ ADD., Methods: A multicenter, randomized, parallel, controlled trial was conducted in 3 centers in China. Adolescents diagnosed with TMJ ADD and dentofacial deformity were enrolled. Eligible participants were randomly assigned to a joint-occlusal group or occlusal group at a ratio of 2:1. Magnetic resonance imaging scans and cephalometric radiographs were evaluated at baseline, at 8 months, and at 14 months. The primary outcome was changes in condylar height from 14 months to baseline. Secondary outcomes were changes in skeletal position., Results: A total of 240 patients (14.65 ± 1.88 years of age) were randomized (joint-occlusal group, 160; occlusal group, 80). The overall difference in condylar height between groups was 3.65 mm (95% CI, 3.10 to 4.19 mm; P < 0.001). The between-group differences in condylar height on the left and right sides were 3.60 mm (95% CI, 2.92 to 4.28 mm; P < 0.001) and 3.69 mm (95% CI, 3.06 to 4.32 mm; P < 0.001), respectively. Significant between-group differences were noted in skeletal position (all P < 0.001)., Conclusion: Joint-occlusal treatment can promote condylar growth and improve dentofacial deformity in adolescents after 14 months when compared with single occlusal treatment., Clinical Question/level of Evidence: Therapeutic, I., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons.)

The "reemergence of pertussis" has elicited international concerns, occurring paradoxically amidst the expansion of immunization programs. This study was aimed to evaluate quantitatively the economic burden and identify the determinants that influence the cost associated with treating pertussis in Chinese children. We evaluated the economic burden by Chinese children diagnosed with pertussis at the Children's Hospital, Zhejiang University School of Medicine in 2022. Direct medical expenses and the utilization of medical resources attributed to pertussis were calculated. A generalized linear regression model was applied to analyze the determinants that were associated with the direct medical expenses among patients. Among the 1110 pertussis patients included in the study, 1060 were outpatients and 50 were inpatients. The average direct medical cost was ¥1878.70(i.e. $279.33). Living in urban areas (OR:1.27, p  = .04), complications (OR:1.40, p  < .001), hospitalization (OR:10.04, p  < .001), and ≥ 3 medical visits (OR:3.71, p  < .001) were associated with increased direct medical expenses. Having received four doses of the pertussis vaccine was associated with reduced direct medical expenses (OR:0.81, p  = .04). This study underscores a substantial economic burden of pertussis in Hangzhou, with pronounced implications for patients residing in urban areas, experiencing complications, requiring hospitalization, having multiple medical consultations, or lacking comprehensive pertussis vaccination.

In order to understand the transfer of macroelements and toxic metals in the terrestrial food web, barn swallows, terrestrial frogs, and insects were collected from farmlands in the Leizhou Peninsula, and analyzed for macroelements carbon (C), nitrogen (N), phosphorus (P), and sulfur (S) and trace metals nickel (Ni), zinc (Zn), selenium (Se), copper (Cu), chromium (Cr), cadmium (Cd), lead (Pb), and mercury (Hg). The multi-element ecological stoichiometry was discussed to trace the food web flow of nutrients and toxicants. The percentage contents of C, N, P, and S were 35.43-59.91%, 6.89-12.11%, 0.49-4.66%, and 0.44-2.19%, respectively. The concentrations of Ni, Zn, Se, Cu, Cr, Cd, Pb, and Hg were 0.163-116 mg/kg, 38.7-227 mg/kg, 0.0453-3.82 mg/kg, 3.11-141 mg/kg, not detected-79.6 mg/kg, 0.0203-0.358 mg/kg, 0.148-4.57 mg/kg, and 0.00159-1.46 mg/kg, respectively. Organisms at high trophic levels had higher contents of N, P, and S, and lower contents of C. Significant correlations were observed between δ 15 N and ratios of C: N, C: P, C: S, N: P, N: S, and S: P, indicating selective transfer of biogenic elements for predators in the terrestrial food web. Most metals including Ni, Zn, Se, Cu, Cr, Pb, and Hg had biomagnification factors and trophic magnification factors higher than 1, because the whole body of organisms rather than tissues were used. The negative correlations between the detoxification ratios of Se: X (each toxic metal) and metal concentrations suggest potential adverse effect of metals on terrestrial organisms., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: There have been some shifts in the frequency and distribution of biopsy-proven renal diseases in China over recent years. The aim of the study was to investigate the changing spectrum of renal diseases from the view of kidney biopsy data in a single center of China., Methods and Results: A total of 10,996 cases of native renal biopsies from patients aged ≥15 years old in Huashan Hospital, Fudan University, between 2008 and 2018 were analyzed retrospectively. The results showed that primary glomerular nephropathy (PGN) remained the most common biopsy-proven renal disease (69.42% of total), with IgA nephropathy (IgAN) accounting for 44.40% of PGN, membranous nephropathy (MN) for 28.55%, minimal change disease (MCD) for 13.26% and focal segmental glomerulosclerosis (FSGS) for 8.00%. During the study period, the proportion of MN in PGN appeared an increasing tendency, while that of IgAN and MCD remained stable and that of FSGS showed a decline. Secondary glomerular nephropathy (SGN) constituted 21.54% of total cases, among which the leading two diseases were lupus nephritis (LN) and Henoch-Schonlein purpura nephritis (HSN) which accounted for 41.08% and 19.11% respectively., Conclusions: The 11-year retrospective study revealed that PGN was the predominant histologic diagnosis among patients undergoing renal biopsy and the most frequent type of PGN remained to be IgAN, followed by MN which increased dramatically.

Background: This is a retrospective cohort study from a single center of Chest Medical District of Nanjing Brain Hospital Affiliated to Nanjing Medical University, Jiangsu Province, China. It was aim to evaluate the diagnostic value of radial endobronchial ultrasound (R-EBUS) combination with rapid on-site evaluation (ROSE) guided transbronchial lung biopsy (TBLB) for peripheral pulmonary lesions in patients with emphysema., Methods: All 170 patients who underwent PPLs with emphysema received an R-EBUS examination with or without the ROSE procedure, and the diagnostic yield, safety, and possible factors influencing diagnosis were analyzed between the two groups by the SPSS 25.0 software., Results: The pooled and benign diagnostic yields were not different in the two groups (P = 0.224, 0.924), but the diagnostic yield of malignant PPLs was significantly higher in the group with ROSE than the group without ROSE (P = 0.042). The sensitivity of ROSE was 79.10%, the specificity, 91.67%, the positive predictive value, 98.15%, and the negative predictive value, 84.62%. The diagnostic accuracy, was 95.52%. In the group of R-EBUS + ROSE, the procedural time and the number of times of biopsy or brushing were both significantly reduced (all P<0.05). The incidence of pneumothorax (1.20%) and bleeding (10.84%) in the group of R-EBUS + ROSE were also less than those in the group of R-EBUS (P<0.05). The lesion's diameter ≥ 2 cm, the distance between the pleura and the lesion ≥ 2 cm, the positive air bronchograms sign, the location of the ultrasound probe within the lesion, and the even echo with clear margin feature of lesion ultrasonic image, these factors are possibly relevant to a higher diagnostic yield. The diagnostic yield of PPLs those were adjacent to emphysema were lower than those PPLs which were away from emphysema (P = 0.048) in the group without ROSE, however, in the group of R-EBUS + ROSE, there was no such difference whether the lesion is adjacent to emphysema or not (P = 0.236)., Conclusion: Our study found that the combination of R-EBUS and ROSE during bronchoscopy procedure was a safe and effective modality to improve diagnostic yield of PPLs with emphysema, especially for malignant PPLs. The distance between the pleura and the lesion ≥ 2 cm, the positive air bronchograms sign, the location of the ultrasound probe within the lesion, and the even echo with clear margin feature of lesion ultrasonic image, these factors possibly indicated a higher diagnostic yield. Those lesions' position is adjacent to emphysema may reduce diagnostic yield but ROSE may make up for this deficiency., (© 2024. The Author(s).)

As a significant trade item on the ancient Silk Road, the evolution of mug shapes represents a confluence of Eastern and Western economic history and cultural-artistic exchanges, also reflecting the flourishing export culture of Guangzhou. This paper analyzes the functional and social factors influencing the morphological changes of Lingnan mugs from 1616 to 1949 from the perspective of quantitative typological analysis. The overall design trend of these mugs transitioned from complex to simple, enhancing user comfort, while variations in mug scale reflect the diversity of consumer classes and regional drinking cultures. Among the 30 mugs analyzed, the average capacity was 356ml, with a range of 1588ml. Common shapes included cylindrical bodies and ear-shaped handles. Morphologically, the belly of the mugs transformed from arc-barrel bodies (emphasizing heat retention) to bulbous bodies, and eventually to cylindrical bodies (combining heat retention, practicality, and economy), with handles also showing signs of East-West integration. The analysis of the mug body' s inclination, with handle-side junction angles ranging from 34° to 53° and wall-side junction angles from 50° to 90°, indicates that these features are associated with stability in placement, aesthetic design, and practicality in liquid containment. These morphological evolutions reflect genuine responses to market demands and advancements in production technology, manifesting as products of market orientation and societal needs. By measuring changes in morphology, scale, volume, and external contour curves, this paper addresses how social factors shape material morphology in an academic context., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ao 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 geological environment determines the initial content of various elements in soil, while the late input of toxic elements produced through weathering and leaching is a persistent threat to food security and human health. In this study, we selected the Lou Shao Basin, a black rock system background, and combined geostatistical analysis and multivariate statistics to quantify the specific contribution of weathering of the black rock system, and to analyze the source traces, spatial distributions, and ecological risks of the soil toxicity of elements. The results show that the soils in the study area are acidic, which is related to the weathering of sulfides in the black rock system. The concentrations of most elements in the soil were determined to exceed the soil background values, and the Cd, Se and N contents, exceeded more than five times, especially Se, Mo nearly as high as 13 times. Strong positive correlation between Se, Cu, V and P, low correlation between N and Se, Cu, V, P, Ni and Cd.72.52%, 43%, 77.79%, 82%, 77%, and 44.1% of Cd, Se, Ni, Cu, B, and Mo came from the black rock system, respectively, which were greatly affected by geogenic weathering; V, Zn, Pb, and As are mainly from biomass burning sources; N and P are mainly from agricultural surface sources. Comparison found that the Cd and Se elements in the rocks in the study area were 16.78 times and 1.36 times higher than the world shale average, respectively, and need to pay attention to the weathering process of the two, and the spatial distribution of the 12 elements in soils showed a striped and centralized block distribution pattern, specifically around the distribution of carbonate and metamorphic rocks and other high-geology blocks. The ecological risk results showed that Cd was the main element causing high ecological risk, followed by Se and N, which were at moderate to high ecological risk levels, and Se and N showed similar ecological risk patterns, which may be related to the fact that selenium can promote the uptake and transformation of nitrogen. The present results add to the endogenous sources of toxic elements, quantify the source contributions of toxic elements in soils with high geologic backgrounds, fill this knowledge gap, and provide new insights for pollution control and ecological protection in areas with high geochemical backgrounds., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Abstract: Intestinal microecology (IM) is the largest and most important microecological system of the human body. Furthermore, it is the key factor for activating and maintaining the physiological functions of the intestine. Numerous studies have investigated the effects of the gut microbiota on the different tissues and organs of the human body as well as their association with various diseases, and the findings are gradually being translated into clinical practice. The gut microbiota affects the occurrence, progression, treatment response, and toxic side effects of tumors. The deepening of research related to IM and tumors has opened a new chapter in IM research driven by methods and technologies such as second-generation sequencing and bioinformatics. The IM maintains the function of the host immune system and plays a pivotal role in tumor-control drug therapy. Increasing evidence has proven that the efficacy of tumor-control drugs largely depends on the IM balance, and strategies based on the IM technology show promising application prospects in the diagnosis and treatment of tumor. The Tumor and Microecology Professional Committee of the Chinese Anti-cancer Association gathered relevant experts to discuss and propose the "Chinese guidelines for integrated diagnosis and treatment of IM technologies in tumor application (2024 Edition)," which was established based on the research progress of the application of the IM technology in tumor to provide a basis for the standardization of the diagnosis and treatment of the IM technology in the tumor., (Copyright © 2024 Copyright: © 2024 Journal of Cancer Research and Therapeutics.)

Background: Nursing research ability is an important force in improving the quality of nursing care and driving the development of the discipline. As the main force and reserve force of nursing research, master's degree nursing students should have certain research ability. The contributing factors and their relationships that challenge research ability among master's degree nursing students must be fully understood, as this level of knowledge can support the development of strategies and interventions that improve the research ability of master's degree nursing students., Objective: The aim of this study was to examine the relationships among positive psychological capital, research motivation, and research ability by master's degree nursing students. In addition, we investigated whether research motivation mediates the relationship between positive psychological capital and research ability., Design: A descriptive cross-sectional study using an online questionnaire., Setting: The study sampled master's degree nursing students from colleges in Sichuan, Fujian, Hubei, and Tianjin Province, China., Participants: From February 2022 to April 2022, 377 master's degree nursing students were chosen by a convenience sample method., Methods: Data were gathered using a general information questionnaire, the Positive Psychological Capital Questionnaire (PPCQ), the Research Motivation Scale (RMS), and the Nursing Research Ability of Self-Evaluation Questionnaire (NRASQ). Both SPSS 26.0 and Amos 28.0. were used to handle and analyze the data. Descriptive statistics, Pearson correlation analysis, and structural equation modeling were all used in the data analysis process. The reporting followed the STROBE checklist., Results: Positive psychological capital was found to be positively correlated with research ability (P < 0.01). Research motivation was also positively correlated with research ability (P < 0.01), and had a mediating effect on the relationship between positive psychological capital and research ability (P < 0.01)., Conclusions: The positive psychological capital and research motivation of master's degree nursing students are positively correlated with research ability. Research motivation significantly mediates the relationship between positive psychological capital and research ability. The findings of this study can inform educational strategies and interventions for the development of research ability of master's degree nursing students., Competing Interests: Declaration of competing interest The authors have no potential conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Goose circovirus (GoCV) is a common pathogen that causes immunosuppression and promotes secondary infections with other infectious agents in geese worldwide. In the present study, we identified GoCV in 2 out of 93 duck flocks from China and successfully sequenced the complete genomes of 2 strains (AH22du and HN20du). The whole genome of the two strains shared a high identity of 90.5 to 98.63% with China GoCV reference, and low identity of 58.98% with DuCV reference, respectively. Phylogenetic tree constructed on the two and other genome sequences of GoCV revealed three main branches. Both strains sequenced in this study were distributed on different sub-branches with most other Chinese GoCV strains, and AH22du clustered into an independent sub-branch within the cluster. Recombination analysis predicted that HN20du might potentially recombine from the major parent of yk4 (Zhejiang Province, China, 2007) and minor parent of GD/YJ/g2 (Guangdong Province, China, 2020). To the best of our knowledge, this is the first report of GoCV in ducks from China. This broadened host spectrum of GoCVs requires attention from the waterfowl industry and researchers., Competing Interests: DISCLOSURES The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The establishment of green finance reform and innovation pilot zone (GFRIPZ) is a pivotal strategy for harmonizing the twin goals of economic prosperity and environmental preservation. By applying panel data on Chinese A-share listed firms from 2011 to 2022, this study examines the influence of China's green finance pilot policy on corporate environmental social responsibility (ESR) using a difference-in-differences (DID) model. The study's findings indicate that the green finance pilot policy promotes corporate environmental social responsibility. The results remain robust after a series of robustness tests. Moreover, mechanism analysis reveals that the pilot policy promotes firms' ESR through three key channels: financing constraints, green innovation, and corporate governance mechanisms. Additionally, analyst attention can positively moderate the promotional effect of the green finance pilot policy on corporate ESR. Furthermore, this study reveals that the green finance pilot policy's impact on corporate ESR is more pronounced among large-scale firms and firms operating in regions characterized by stringent environmental regulations and greater marketization. The empirical findings present evidence for enhancing ESR through the implementation of the green finance pilot policy in China and offer insights for refining the green finance system., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

As a highly infectious and contagious pathogen in chickens, infectious bronchitis virus (IBV) is currently grouped into nine genotypes (GI to GIX). However, the classification of serotypes of IBV is still not clear. In this study, 270 field strains of IBV were isolated from dead or diseased chicken flocks in eastern and southern China during January 2021 to April 2023. These isolated IBV strains could be classified into 2 genotypes, GI (including 5 lineages GI-1, GI-13, GI-19, GI-22, and GI-28) and GVI based on the complete S1 sequence. Further analysis showed that the GI-19, GI-13, GI-22, GI-28, and GVI were the dominant genotypes with the proportions of 61.48, 8.89, 8.89, 7.78, and 8.89% respectively, and the homology of S1 protein of these isolates ranged from 86.85 to 100% in GI-19, 92.22 to 100% in GI-13, 83.1 to 100% in GI-22, 94.81 to 100% in GI-28 and 90.0 to 99.8% in GVI, respectively. Moreover, cross-neutralization test with sera revealed that these isolates in GI-19 lineage could be classified into at least 3 serotypes according to the antigenic relationship. In addition, structure assay using PyMOL indicated that one mutation such as S120 in receptor binding site (RBD) of GI-19 might alter the antigenicity and conformation of S protein of IBV. Overall, our data demonstrate that not only multiple genotypes, but also multiple serotypes in a single genotype or lineage have been co-circulated in eastern and southern China, providing novel insights into the molecular evolution of the antigenicity of IBV and highlighting the significance of the selection of the dominant isolate for vaccine development in IBV endemic region., Competing Interests: DISCLOSURES The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Psychosocial function of Chinese temporomandibular disorders (TMD) pain patients and the correlation with somatosensory function has not been sufficiently studied., Objective: The study aims at assessing the psychosocial function of Chinese TMD pain patients by visualisation method and evaluating the correlations with somatosensory function quantitatively., Methods: The Symptom Checklist 90 (SCL-90) questionnaire and standardised quantitative sensory testing (QST) were administered to 70 Chinese TMD pain patients and age- and gender-matched healthy controls (HCs). Of these, 40 TMD arthralgia patients received QST before and after medication. Psychosocial and somatosensory parameters were transformed into standardised scores. Differences within groups were assessed through t tests. Correlations between psychosocial and somatosensory profiles were explored through correlation analyses with Bonferroni correction for multiple comparisons., Results: 100% of the Chinese TMD pain patients exhibited psychosocial distress in contrast to HCs. Anger and hostility showed negative correlation with the thermal nonnociceptive parameter (thermal sensory limen, p =.002) and nociceptive parameters (cold pain threshold and pain pressure threshold, p<.001). Correlation analysis indicated that cold detection threshold was negatively correlated with somatization and mechanical pain sensitivity had a negative correlation with anger and hostility through medical treatment (p <.001)., Conclusions: Visual psychosocial profiles provided an easy overview of psychosocial function in Chinese TMD pain patients. Anger and hostility was associated with increased thermal nonnociceptive and nociceptive sensitivity to stimuli. Psychosocial distress might be negatively associated with TMD treatment response which indicated a possible need for psychological intervention during treatment., (© 2024 John Wiley & Sons Ltd.)

This research aimed to investigate the characteristics of casein phosphopeptides in Chinese human milk, and their potential relationship to infant growth. Using the liquid chromatography-Orbitrap-mass spectrometry technique, a total of 15 casein phosphopeptides were identified from 200 human milk samples. Also, our results indicate that casein phosphopeptides were phosphorylated with only one phosphate. The relative concentrations of casein phosphopeptides at 6 months postpartum were increased compared with milk at 2 months (FDR < 0.05). Significantly positive correlations were observed between casein phosphopeptides and infant growth, as shown by four casein phosphopeptides were positively correlated with the infants' weight-for-age Z-scores (r s range from 0.20 to 0.29), and three casein phosphopeptides were positively correlated with the infants' length-for-age Z-scores (r s range from 0.19 to 0.27). This study is the first to reveal the phosphorylated level and composition of casein phosphopeptides in Chinese human milk, and their potential relationship with infant growth., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: Self-rated health (SRH) has been documented as an important predictor of quality of life among the elderly and its risk factors are vision-specific among elderly males. The aim of this study was to clarify vision-specific risk factors to SRH among elderly females without dementia in Chinese urban areas., Methods: From March to November 2012, 2147 elderly women in Liaoning Province of China were selected using a stratified sampling method. After cognitive screening, 1956 participants without dementia were finally enrolled. A questionnaire including SRH, visual ability and factors including demographic characteristics, physical conditions, lifestyle factors, social psychological status and social activities were analyzed. Multivariate logistic regression was used to clarify the association of SRH with risk factors, while stepwise multivariate logistic regression was used to examine the vision-specific associations with SRH., Results: The mean age was 73.6 ± 5.82 (mean ± SD). The percentages of good SRH in good and impaired visual ability groups were 36.2% and 24.4%, respectively. Most characteristics between elderly females with different visual abilities were significantly different. Visual ability had interactions with physical conditions, lifestyle factors and social activities to affect SRH. Among elderly females with good visual ability, depressive symptoms, rather than chronic disease had the strongest association with good SRH followed by marital status, regular diet, going out alone to distant places, taking a walk, smoking and alcohol consumption. In the impaired visual ability group, going out alone to distant places had the strongest association with good SRH followed by chronic disease, filial piety, taking a walk, participating in entertainment, ethnicity, quality of sleep, worrying about falling and alcohol consumption., Conclusions: Good SRH status was at a low level especially among elderly females with impaired visual ability and the risk factors differed between elderly females with different visual abilities. Social psychological status was crucial for SRH among elderly females with good visual ability whereas physical conditions were prominent for impaired visual ability group., (© 2024. The Author(s).)

Objectives: This study aimed to investigate the associations between changes in blood pressure (BP) and cerebral small vessel disease (CSVD)., Methods: This study included 401 participants in the magnetic resonance imaging (MRI) sub-study conducted between 2018 and 2020 as a part of the Multidomain Interventions to Delay Dementia and Disability in Rural China project. MRI markers of CSVD were assessed based on international criteria. Individualized linear regression models evaluated changes in BP by estimating the trend of blood pressure changes over time and fitting a straight line from 2014 to 2018. The data were analyzed using logistic and general linear regression models., Result: The mean age of the participants was 64.48 ± 2.69 years, with 237 (59.1%) being females. Increases in systolic BP in later life were significantly associated with larger volumes of periventricular white matter hyperintensity (WMH), greater perivascular spaces in the basal ganglia (BG-PVS) burden, and the presence of deep lacunes and cerebral microbleeds. Additionally, increases in diastolic BP in later life were significantly associated with the presence of infratentorial and deep lacunes., Conclusions: CSVDs are associated with increased exposure to elevated BP later in life., (© 2024. The Author(s).)

BACKGROUND Non-syndromic cleft lip with cleft palate (NSCLP) is one of the most common congenital birth defects worldwide; it causes lifelong problems and imposes burdens on patients and their families. This study aimed to describe the genomic analysis and identification of de novo regulated endocrine-specific protein 18 (RESP18) rs2385404 and rs2385405 gene polymorphisms associated with NSCLP in a southern Chinese family and to improve prevention, treatment, and prognosis of NSCLP. MATERIAL AND METHODS We performed a genome-wide association study (GWAS) to investigate the association of NSCLP phenotype with gene mutation. We investigated a 5-persons NSCLP family to screen the genetic variation of Han nationality in southern Chinese. Whole-genome sequencing (WGS) was used to detect all candidate genetic variants, and whole-exome sequencing (WES) was implemented to further verify mutations. The Clinical Variation Data Base (ClinVar) was employed for screening gene mutations. Finally, Sanger sequencing was applied to verify gene variations. RESULTS The combined analysis of WGS, WES, and ClinVar showed that a total of 9 variation positions overlapped among the 3 study cohorts. Sanger sequencing verified Glu amino acid variation in 2 mutation sites (rs2385404, rs2385405) from the RESP18 gene, which caused abnormal RESP18 function and was associated with hereditary NSCLP. CONCLUSIONS The combined genomic results showed that 2 mutations (rs2385404 and rs2385405) of the RESP18 gene were related to NSCLP in the family. The RESP18 gene may play an important role in the etiology and pathogenesis of cleft lip and palate.

Parabens (PBs) and triclosan (TCS) are commonly found in pharmaceuticals and personal care products (PPCPs). As a result, they have been extensively found in the environment, particularly in aquaculture operations. Red swamp crayfish (Procambarus clarkii) consumption has significantly risen in China. Nevertheless, the levels of PBs and TCS in this species and the associated risk to human dietary intake remain undisclosed. This study assessed the amounts of five PBs, i.e., methyl-paraben (MeP), ethyl-paraben (EtP), propyl-paraben (PrP), butyl-paraben (BuP) and benzyl-paraben (BzP), as well as TCS in crayfish taken from five provinces of the middle-lower Yangtze River. MeP, PrP and TCS showed the highest detection rates (hepatopancreas: 46-86 %; muscle: 63-77 %) since they are commonly used in PPCPs. Significantly higher levels of ∑ 5 PBs (median: 3.69 ng/g) and TCS (median: 7.27 ng/g) were significantly found in the hepatopancreas compared to the muscle (median: 0.39 ng/g for ∑ 5 PBs and 0.16 ng/g for TCS) (p < 0.05), indicating bioaccumulation of these chemicals in the hepatopancreas. The estimated daily intake values of ∑ 5 PBs and TCS calculated from the median concentrations of crayfish were 6.44-7.94 ng/kg bw/day and 11.4-14.0 ng/kg bw/day, respectively. Although no health risk was predicted from consuming crayfish (HQ <1), consumption of the hepatopancreas is not recommended., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: The objective of this study was to compare ultrasound features and establish a predictive nomogram for distinguishing between triple-negative breast cancer (TNBC) and non-TNBC., Design: A retrospective cohort study., Setting: This study was conducted at Quanzhou First Hospital, a grade A tertiary hospital in Quanzhou, China, with the research data set covering the period from September 2019 to August 2023., Participants: The study included a total of 205 female patients with confirmed TNBC and 574 female patients with non-TNBC, who were randomly divided into a training set and a validation set at a ratio of 7:3., Main Outcome Measures: All patients underwent ultrasound examination and received a confirmatory pathological diagnosis. Nodules were classified according to the Breast Imaging-Reporting and Data System standard. Subsequently, the study conducted a comparative analysis of clinical characteristics and ultrasonic features., Results: A statistically significant difference was observed in multiple clinical and ultrasonic features between TNBC and non-TNBC. Specifically, in the logistic regression analysis conducted on the training set, indicators such as posterior echo, lesion size, presence of clinical symptoms, margin characteristics, internal blood flow signals, halo and microcalcification were found to be statistically significant (p<0.05). These significant indicators were then effectively incorporated into a static and dynamic nomogram model, demonstrating high predictive performance in distinguishing TNBC from non-TNBC., Conclusion: The results of our study demonstrated that ultrasound features can be valuable in distinguishing between TNBC and non-TNBC. The presence of posterior echo, size, clinical symptoms, margin, internal flow, halo and microcalcification was identified as predictive factors for this differentiation. Microcalcification, hyperechoic halo, internal flow and clinical symptoms emerged as the strongest predictive factors, indicating their potential as reliable indicators for identifying TNBC and non-TNBC., 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.)

Objectives: Burnout is common among medical personnel in China and may be related to excessive and persistent work-related stressors by different specialties. The aims of this study were to assess the prevalence of burnout, work overload and work-life imbalance according to different specialties and to explore the effect of specialty, work overload and work-life imbalance on burnout among medical personnel., Design: A cross-sectional study., Setting: This study was conducted in 1 tertiary general public hospital, 2 secondary general hospitals and 10 community health service stations in Liaoning, China., Participants: A total of 3299 medical personnel participated in the study., Methods: We used the 15-item Chinese version of the Maslach Burnout Inventory General Survey (MBI-GS) to measure burnout. Multivariable logistic regression models were used to explore the association between medical specialty, work overload, work-life imbalance and burnout., Results: 3299 medical personnel were included in this study. The prevalence of burnout, severe burnout, work overload and work-life imbalance were 88.7%, 13.6%, 23.4% and 23.2%, respectively. Compared with medical personnel in internal medicine, working in obstetrics and gynaecology (OR=0.61, 95% CI 0.38, 0.99) and management (OR=0.45, 95% CI 0.28, 0.72) was significantly associated with burnout, and working in ICU （Intensive Care Unit）(OR=2.48, 95% CI 1.07, 5.73), surgery (OR=1.66, 95% CI 1.18, 2.35) and paediatrics (OR=0.24, 95% CI 0.07, 0.81) was significantly associated with severe burnout. Work overload and work-life imbalance were associated with higher ORs for burnout (OR=1.64, 95% CI 1.16, 2.32; OR=2.79, 95% CI 1.84, 4.24) and severe burnout (OR=4.33, 95% CI 3.43, 5.46; OR=3.35, 95% CI 2.64, 4.24)., Conclusions: Burnout, work overload and work-life imbalance were prevalent among Chinese medical personnel but varied considerably by clinical specialty. Burnout may be reduced by decreasing work overload and promoting work-life balance across different specialties., 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.)

Palaeogeological events and climate oscillations profoundly impact the demographics and distributions of small-range species, increasing the extinction risk. The largest water strider worldwide, Gigantometra gigas (Hemiptera: Gerridae), exhibits restricted distributions in Vietnam and southern China. Herein, we generated three genomic datasets (mitogenomes, 146 nuclear protein-coding genes and single nucleotide polymorphisms) with ecological niche modelling (ENM) to explicitly test whether the present-day distribution of G. gigas actually resulted from geographical and climatic effects. We found that the origin of this largest water strider reached the divergence time of the genus within Gerridae, providing a greater opportunity to explore its response to geographic movements. The right-lateral motion of the Red River Fault facilitated the divergence of two phylogeographic lineages, resulting in the "north-south component" genetic pattern in G. gigas. The Hainan and southeast Vietnam populations of the southern linage were completely separated by the Beibu Gulf but exhibited similar genetic compositions, confirming that Hainan had a continental origin and that Hainan Island joined with the Indo-China Peninsula to promote gene exchange among populations. Additionally, we noticed the low genetic diversity but long demographic history of the northern lineage, which displayed population dynamics opposite to those of other organisms. Integrating the demographic changes and ENM findings revealed that suitable habitat contraction and rapid demographic decline during the Last Glacial Maximum (LGM) triggered the low genetic diversity of the northern lineage. Overall, the demographic history of the largest water strider was mainly shaped by geographical features, and first provided evidence from the phylogeographic perspective of aquatic insects to support the hypothesis of Hainan Island shifting., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This scoping review aims to investigate longitudinal changes in minerals and vitamins concentrations in human milk among the Chinese population. Following the PRISMA-ScR guidelines, a comprehensive and systematic literature search was conducted using both English and Chinese databases. Data were extracted and categorized into six defined lactation stages. We found that the concentration of most minerals decreased throughout the lactation period, although calcium (Ca) and magnesium (Mg) fluctuated slightly across lactation periods. Fat-soluble vitamins also showed a decline throughout the lactation period, while water-soluble vitamins exhibited an increasing trend. However, folic acid, biotin, and pantothenic acid demonstrated a downward trend. Overall, this review has identified the longitudinal changes in minerals and vitamins concentrations in human milk among the Chinese population. In order to conduct a more in-depth examination of maternal characteristics and nutritional factors of the composition of human milk, it is recommended to utilize standardized protocols for the collection and analysis of human milk samples.

Objective: To investigate the characteristics of Clostridioides difficile infection (CDI) in patients hospitalized for diarrhea and analyze the risk factors for CDI., Methods: Stool samples were collected from 306 patients with diarrhea hospitalized in 3 university hospitals in a mid-south city of China from October to December, 2020. C . difficile was isolated by anaerobic culture, and qRT-PCR was used to detect the expressions of toxin A ( tcdA ) and B ( tcdB ) genes and the binary toxin genes ( cdtA and cdtB ). Multilocus sequence typing (MLST) was performed for the isolated strains without contaminating strains as confirmed by 16S rDNA sequencing. Etest strips were used to determine the drug resistance profiles of the isolated strains, and the risk factors of CDI in the patients were analyzed., Results: CDI was detected in 25 (8.17%) out of the 306 patients. All the patients tested positive for tcdA and tcdB but negative for the binary toxin genes. Seven noncontaminated C . difficile strains with 5 ST types were isolated, including 3 ST54 strains and one strain of ST129, ST98, ST53, and ST631 types each, all belonging to clade 1 and sensitive to metronidazole and vancomycin. Hospitalization within the past 6 months ( OR = 3.675; 95% CI : 1.405-9.612), use of PPIs ( OR =7.107; 95% CI : 2.575-19.613), antibiotics for ≥1 week ( OR =7.306; 95% CI : 2.274-23.472), non-steroidal anti-inflammatory drugs ( OR =4.754; 95% CI : 1.504-15.031) in the past month, and gastrointestinal disorders ( OR =5.050; 95% CI : 1.826-13.968) were all risk factors for CDI in the patients hospitalized for diarrhea., Conclusion: The CDI rate remains low in the hospitalized patients with diarrhea in the investigated hospitals, but early precaution measures are recommended when exposure to the risk factors is reported to reduce the risk of CDI in the hospitalized patients.

Purpose: Cardiorespiratory fitness (CRF) is a strong predictor of cardiorespiratory diseases and varies by race. The purpose of this study was to provide CRF reference standards and a prediction equation for peak oxygen uptake (V˙O 2peak ) from treadmill-based cardiopulmonary exercise testing (CPX) in Chinese individuals., Methods: Healthy participants (n = 4199) who completed a CPX using a treadmill were studied. The percentiles of V˙O 2peak were determined for four age groups (decades). A regression prediction model was developed from the derivation cohort (n = 3361), validated in the independent validation cohort (n = 838), and compared with the widely used Wasserman equation and the Fitness Registry and the Importance of Exercise National Database (FRIEND) equation., Results: The mean V˙O 2peak values of four age groups (20-29, 30-39, 40-49, and 50-59 yr) were 42.6, 41.2, 38.7, and 35.9 mL/kg/min, respectively, for men, and 37.1, 34.7, 32.0, and 30.3 mL/kg/min, respectively, for women. The 50th percentiles of relative V˙O 2peak decreased with age for both sexes. The prediction equation was: Absolute V˙O 2peak (mL/min) = 236.68 - (504.64 × sex [male = 0; female = 1]) + (21.23× weight [kg]) - (14.31 × age [yr]) + (9.46 × height [cm]) (standard error of the estimate = 379.59 mL/min, R2 = 0.66, P < .001).Percentage predicted V˙O 2peak for the validation sample was 100.2%. The novel equation performed better than the other two equations., Conclusion: This study reports the first CRF reference standards and prediction equation generated from treadmill CPX in China. These reference standards provide a framework for interpreting the CRF of the Chinese population and could be useful information for a global CRF database., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: This study aimed to systematize the Zhuang medicinal herbs of Ardisia (ZMHA) in China, to clarify the traditional use in Zhuang medicine and the dynamics of international research on phytochemistry, pharmacology, clinical application, and toxicity., Key Findings: There are 25 species of ZMHA, approximately 938 compounds from the different part, including triterpenoids, phenolics, volatile oils, etc. Pharmacological activity studies have also shown that this genus has anti-tumour, anti-inflammatory, anti-oxidant, anti-bacterial, anti-microbial, etc., and significant effects on respiratory, digestive, urinary, and musculoskeletal system diseases without toxic side effects., Summary: The Ardisia has a medicinal history of nearly a thousand years, mainly for treating diseases of the injuries, musculoskeletal, and symptomatic system in Zhuang medicine. Some plants, such as A. crenata, A. gigantifolia, and A. japonica, are also commonly used in folk Zhuang medicine formulas, to treat musculoskeletal, injury, respiratory, and urinate systems disease. These diseases are related to inflammation. These could provide a new direction for future new drug development research. Therefore, species identification and resource investigation should be strengthened, and conducted in vitro mechanism, in vivo pharmacology, clinical efficacy, and toxicology studies and establish a perfect quality standard system., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society.)

To enhance the quality evaluation and control of traditional Chinese medicine (TCM) and ensure the safety and efficacy of clinical medication, it is imperative to establish a comprehensive quality assessment method aligned with TCM efficacy. This study uses a representative Chinese medicine with multi-origin and multi-efficacy, Paris polyphylla var. yunnanensis (PY), as an illustrative example. Surprisingly, despite the high fingerprint similarity among the 12 batches of PY samples collected from various regions in Yunnan, a notable variation in the composition and content of components was observed. The chromatographic analysis identified seven common peaks, namely, polyphyllin I, polyphyllin II, polyphyllin V, polyphyllin VI, polyphyllin VII, polyphyllin H, and polyphyllin D. In the bioactivity evaluation, an in vitro antiplatelet aggregation model induced by adenosine diphosphate was established, showcasing excellent stability. The maximum antiplatelet aggregation inhibition rate for all PY samples consistently remained stable at 73.1%-99.1%. However, the 50% inhibitory concentration (IC 50 ) values exhibited a range from 1.615 to 18.200 mg/mL. This approach not only meets high-throughput screening requirements but also demonstrates remarkable discrimination. The results of chemical and bioactivity evaluations were analyzed using hierarchical cluster analysis and canonical correlation analysis. Polyphyllin I, polyphyllin II, polyphyllin VII, polyphyllin H, and polyphyllin D were identified as the Q-markers for antiplatelet aggregation in PY samples. Validation of the bioactivity for these monomer components aligned with the previously mentioned findings. Notably, this study established a spectrum-effect model for PY samples, enhancing the scientific robustness of the quality evaluation method. Furthermore, these findings offer valuable research insights for improving the quality assessment of other TCMs., (© 2024 John Wiley & Sons Ltd.)

Purpose: This study aimed to explore the pharmacogenetic variability associated with the pharmacokinetics (PK) and pharmacodynamics (PD) of rivaroxaban in healthy Chinese subjects., Methods: This was a multicenter study that included 304 healthy adults aged 18 to 45 years with unknown genotypes. All participants were administered a single dose of rivaroxaban at 10 mg, 15 mg, or 20 mg. PK and PD parameters were measured, and exome-wide association analysis was conducted., Findings: Sixteen SNPs located on 11 genes influenced the AUC 0-t . Among these, the 3 most influential genes were MiR516A2, PARP14, and MIR618. Thirty-six SNPs from 28 genes were associated with the PD of rivaroxaban. The 3 most influential genes were PKNOX2, BRD3, and APOL4 for anti-Xa activity, and GRIP2, PLCE1, and MLX for diluted prothrombin time (dPT). Among them, BRD3 played an important role in both the PK and PD of rivaroxaban. Anti-Xa activity (ng/mL) differed significantly among subjects with BRD3 rs467387: 145.1 ± 55.5 versus 139.9 ± 65.1 versus 164.0 ± 68.6 for GG, GA, and AA carriers, respectively (P = 0.0002)., Implications: This study found that that the regulation of the BRD3 gene might affect the PK and PD of rivaroxaban, suggesting that it should be studied as a new pharmacologic target. The correlation between this gene locus and clinical outcomes has yet to be verified in patients undergoing clinical treatment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Resistance to extended-spectrum cephalosporins (ESCs) has become a public health concern with the spread of Neisseria gonorrhoeae and increasing antimicrobial resistance. Mutation of penA, encoding penicillin-binding protein 2, represents a mechanism of ESC resistance. This study sought to assess penA alleles and mutations associated with decreased susceptibility (DS) to ESCs in N. gonorrhoeae., Materials and Methods: In 2021, 347 gonococci were collected in Guangdong, China. Minimum inhibitory concentations (MICs) of ceftriaxone and cefixime were determined, and whole-genome sequencing and phylogenetic analysis were performed. Multi-locus sequence typing (MLST) and conventional resistance determinants such as penA, mtrR, PonA and PorB were analysed. penA was genotyped and sequence-aligned using PubMLST., Results: Genome-wide phylogenetic analysis revealed that the prevalence of DS to ESCs was highest in Clade 11.1 (100.0%), Clade 2 (66.7%) and Clade 0 (55.7%), and the leading cause was strains with penA-60.001 or new penA alleles in clades. The penA phylogenetic tree is divided into two branches: non-mosaic penA and mosaic penA. The latter contained penA-60.001, penA-10 and penA-34. penA profile analysis indicated that A311V and T483S are closely related to DS to ESCs in mosaic penA. The new alleles NEIS1753&#95;2840 and NEIS1753&#95;2837 are closely related to penA-60.001, with DS to ceftriaxone and cefixime of 100%. NEIS1753&#95;2660, a derivative of penA-10 (A486V), has increased DS to ceftriaxone. NEIS1753&#95;2846, a derivative of penA-34.007 (G546S), has increased DS to cefixime., Conclusion: This study identified critical penA alleles related to elevated MICs, and trends of gonococcus-evolved mutated penA associated with DS to ESCs in Guangdong., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: To assess the clinical efficacy of laparoscopic Lich-Gregoir (LLG) and transvesicoscopic Cohen reimplantation (TCR) in the treatment of vesicoureteral junction obstruction (VUJO) and vesicoureteral reflux (VUR)., Methods: This study retrospectively analyzed the clinical data of 66 pediatric patients with VUJO and VUR. They were classified into two groups, undergoing either the laparoscopic Lich-Gregoir operation (LLGO) (n = 35) or transvesicoscopic Cohen reimplantation operation (TCRO) (n = 31). The surgeries were performed between April 2018 and September 2022 at the First Affiliated Hospital of Guangxi Medical University, China. General characteristics, preoperative attributes, postoperative complications, renal function recovery, and improvement of hydronephrosis were compared between the two groups., Results: All surgical procedures were successful with no requirement for reoperation. Both groups were comparable with respect to gender, affected side, weight, and postoperative complications. Nonetheless, the LLGO group contained a greater number of children younger than 12 months. The LLGO group demonstrated superiority over the TCRO group regarding the duration of the operation, intraoperative blood loss, and length of postoperative hospital stay. In contrast, postoperative complications, recovery of renal function, and hydronephrosis improvement did not exhibit statistically significant differences between the two groups., Conclusion: Both LLGO and TCRO were demonstrated to be precise, safe, and reliable surgical methods for treating pediatric VUJO and VUR. LLGO ureteral reimplantation offers particular advantages in selecting cases and appears more suitable for children younger than 12 months who have a small bladder capacity., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background Aims: The Revised Electronic Causality Assessment Method (RECAM), a computerized update of the Roussel Uclaf Causality Assessment Methodology (RUCAM), was recently proposed. In this study, we validated and compared the utility of the RECAM and RUCAM in Chinese patients with a single conventional or herbal agent-induced liver injury., Methods: In this retrospective multicenter cohort of well-established DILI and non-DILI patients from 5 centers in China, the diagnostic performance of the RUCAM and RECAM was compared by AUC analysis. The consistency was evaluated by weighted kappa. The major causes of discrepancy were explored., Results: A total of 481 DILI and 100 non-DILI patients were included. In total, 62.6% of the DILI cases were induced by conventional agents, and 37.4% were induced by herbs. The RECAM had relatively higher AUC than RUCAM for overall [0.947 (0.926-0.964) vs. 0.867 (0.836-0.893), p=0.0016], conventional agents [0.923 (0.890-0.949) vs. 0.819 (0.775-0.858), p=0.0185], and herbs [0.972 (0.941-0.989) vs.0.911 (0.866-0.944), p=0.0199]. Latency, scores associated with hepatitis B, and hepatotoxicity information of the insulting drugs were the 3 main causes for the inconsistency between RECAM and RUCAM scores., Conclusions: The RECAM had relatively better diagnostic performance than RUCAM, with a higher AUC for Chinese DILI patients. Timely updates of the LiverTox category and refinement of serum markers to exclude hepatitis B activity would further improve the applicability of RECAM in areas where the use of herbs and resolution of past HBV infections are common., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.)

Objective: The purpose of this study was to systematically evaluate the methodological quality of massage-related clinical practice guidelines (CPGs)/consensus on massage using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument and to summarize the current status of recommendations in the CPGs., Methods: The Chinese National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM), PubMed, Embase, and guideline websites (such as the Chinese Medical Ace Base, the China Association of Chinese Medicine, the World Health Organization, Guideline International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network) were searched from inception to October 31, 2022. In addition, the reference lists of relevant studies were reviewed to identify domestic and overseas massage CPGs/consensus. The search terms adopted a combination of subject words and free words, mainly including traditional Chinese medicine, complementary therapies, Tuina, massage, manipulation, chiropractic/osteopathic, spinal, acupressure, guideline, and consensus. Two researchers independently completed the eligible records and extracted the data. Before the formal research, calibrations were performed twice on AGREE II, and all reviewers completed the pilot test three times until they understood and reached an agreement on the assessment items. Three researchers appraised the methodological quality of the included guidelines using the AGREE II instrument and calculated the overall intraclass correlation coefficient (ICC) of agreement., Results: The evaluation results showed that among the 49 eligible CPGs/consensus, 4 (8.2%) CPGs/consensus were considered "recommended", 15 (30.6%) CPGs/consensus were considered "recommended with modifications", and 30 (61.2%) CPGs/consensus were considered "not recommended", while the consensus was considered "not recommended". Generally, the scores in the six domains of the guidelines were all higher than the consensus. Evaluation results for the overall quality of 36 CPGs showed that 4 (11%) were "good quality", 15 (42%) were "sufficient quality" and 17 (47%) were "lower quality". The AGREE II quality scores of domains ranged from 0.30 to 0.75 ([ICC = 0.993, 95% CI (0.992, 0.995)]). The domain of scope and purpose (domain 1), with a median score of 0.75 (0.52~0.91), performed best in the guidelines with AGREE II, and stakeholder involvement (domain 2) [median 0.39 (0.31~0.56)] and application (domain 5) [median 0.30 (0.17~0.47] obtained lower scores. The consensus score of domain 1 was better at 26.0 (21.6~44.8), followed by rigor of development (domain 3) with a score of 18.0 (10.0~28.9). A total of 119 massage-related recommendations were extracted from 49 guidelines/consensuses, including "in favor" (102, 85.7%), "against" (9, 7.6%), and "did not make recommendations" (8, 6.7%)., Conclusion: The overall quality of the included guidelines was low, and most of the guidelines were not "recommended". In future guideline updates, the existing evidence should be used, the professional composition of members of the expert group should be enriched, and patients' values and preferences should be fully considered. It is necessary to clearly propose recognizable recommendations and strengthen the rigor and standardization of guideline formulation. Thus, clear standard guidelines can be formulated to better guide clinical practice., (© 2024. The Author(s).)