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Biodiversity in tropical regions is facing threats from agricultural expansion and intensification. Therefore, a promising future for local ecosystem conservation depends not only on traditional protected areas but also on well‐managed agricultural landscapes. In this study, we compared the ecological traits of bird species in paddy fields outside of protected areas and natural forests within the protected areas of Xishuangbanna, southern China. There were 148 species in total, of which 98 were in forests and 55 in paddy fields. The abundance of birds in paddy fields was 176 per kilometer, which was much higher than the 60 per kilometer in forests. There were 26 law‐protected species observed, half of which were found in each habitat. The main functional groups living in nature reserves are invertivores and frugivores, whereas paddy fields provide habitats for aquatic predator and granivore bird species. Our results indicate that paddy fields act as a refuge for wetland and grassland bird species when natural wetlands disappear, highlighting the urgent need to focus more on wetland protection and eco‐friendly agricultural schemes at the landscape scale in future conservation policies. [ABSTRACT FROM AUTHOR]

The primary active components of plant ginseng are saponins, and rare saponins play a specific antitumor action. In this study, Lactobacillus that can efficiently transform rare saponins were screened as fermentation strains of ginseng enzymes. The fermentation process was optimized to investigate the changes in various biochemical indicators and antioxidant activities of the enzymes before and after fermentation. The results showed that Lactiplantibacillus plantarum had the highest conversion efficiency for diol saponins, among which the content of rare ginsenoside-CK increased by 256%. The optimum optimizing method was a 1 : 1 : 10 ratio of ginseng extract/concentrated apple juice/water, fermentation time of 16 days, initial pH of 6.0, fermentation temperature of 37°C, and sterilization amount of 1.0%. The contents of rare ginsenoside-Rh1, ginsenoside-F2, ginsenoside-Rg3, and ginsenoside-CK increased by 18.48%, 135.73%, 343.03%, and 441.80%, respectively, and the process was stable and controllable. After fermentation, the scavenging rates for hydroxyl radical, DPPH radical, and superoxide anion radical were increased by more than 9%, and new organic acids were produced. In general, this study established an efficient, stable, and controllable ginseng fermentation process to improve the rare saponin content and biological activity of ginseng enzymes, which can provide new ideas for traditional Chinese medicine and medicinal health food in China. [ABSTRACT FROM AUTHOR]

Evaluating the responses of net primary productivity (NPP) to climate change is essential for regional ecosystem management and adaptations to climate change. The Yangtze River Economic Belt (YREB) is a key ecological functional area and hotspot of carbon sequestration in China due to the high degree of forest coverage. We used a process-based ecosystem model to project terrestrial NPP and analyzed the response to climate change over the 21st century in the YREB under two representative concentration pathway (RCP) scenarios using the regional climate model. The results show that the projection of NPP generally increased by 13.5% under RCP4.5 and 16.4% under RCP8.5 in the middle of the century, by 23% under RCP4.5, and by 35% under RCP8.5 in the late term of the century compared with that from a reference period of current climate conditions (1985–2006). The rate of NPP change under the RCP8.5 scenario is higher than that under the RCP4.5 scenario. Similarly, the NPP is also projected to increase both with 1.5 and 2 °C global warming targets in the YREB. The magnitudes of NPP increment are approximately 14.7% with 1.5 °C and 21% with 2 °C warming targets compared with the current climate, which are higher than the average increments of China. Although NPP is projected to increase under the two scenarios, the tendency of NPP increasingly exhibits a slowdown after the 2060 s under the RCP4.5 scenario, and the growth rate of NPP is projected to drop in more than 31% of regional areas with the additional 0.5 °C warming. In contrast, under the RCP8.5 scenario, the trend in NPP keeps rising substantially, even above 2 °C global warming. However, the NPP in some provinces, including Jiangxi and Hunan, is projected to reduce at the end of the 21st century, probably because of temperature rises, precipitation decreases, and water demand increases. Generally, the NPP is projected to increase due to climate change, particularly temperature increase. However, temperature rising does not always show a positive effect on NPP increasing; the growth rate of NPP will slow down under the RCP4.5 scenario in the mid-late 21st century, and NPP will also reduce by the end of this century under the RCP8.5 scenario in some places, probably presenting some risks to terrestrial ecosystems in these areas, in terms of reduced functions and service decline, a weakened capacity of carbon sequestration, and reduced agricultural production. [ABSTRACT FROM AUTHOR]

The assessment of ecosystem services provides an intuitive source of information on the benefits humans derive from ecosystems. The equivalent factor method was applied to calculate the ecosystem service value (ESV) in combination with net primary productivity (NPP) calculated by the process-based Carnegie–Ames–Stanford approach (CASA) model. This study evaluated grassland ESV and its spatial evolution characteristics in China from 2001 to 2020 and revealed the impact of climate factors. For 2001–2020, the annual grassland ESV ranged from 1.17 × 1012 to 1.51 × 1012 yuan (renminbi, China yuan—the same below; $0.15 × 1012–$0.20 × 1012, US dollar), with an average of 1.37 × 1012 yuan ($0.18 × 1012). The spatial pattern of ESV per unit area of grassland was notably characterized by an increase from northwest to southeast. However, the value of grassland ecosystem services was relatively large (exceeding 10 × 106 yuan; $1.30 × 106) in northern and western provinces and was the lowest (less than 0.2 × 106 yuan; $0.03 × 106) in eastern and southern provinces. In the last 20 years, grassland ESV has increased in most areas of China and has decreased only in some western and northern areas. Compared with the first 10 years, the average ESV of grassland in most areas increased in the last 10 years, usually by less than 20%. However, it decreased in the western and northern parts of China, mainly concentrated in the alpine meadow and alpine grassland of the Qinghai–Tibet Plateau and the grassland around the Yili region of Xinjiang. Precipitation was the main regulating factor of grassland ESV and had a positive impact in 79% grassland areas, especially in northern China. Evapotranspiration and sunshine hours exhibited a marginal impact on ESV, but temperature and relative humidity had no significant effect. Overall, this study contributes to exploring the spatiotemporal patterns of grassland ecosystem service value and the impact of climate factors in China, thereby providing reliable guidance for grassland ecosystem management. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) have recently accounted for an alarmingly increasing proportion of HIV-1 transmission in China. In order to investigate the immune status as a result of CRF01_AE infection and CXCR4 co-receptor usage in a young Shanghai-based HIV-1-infected MSM population in Shanghai, 364 HIV-1-infected MSM with average age of 22.7 years old, newly diagnosed between Jan 2009 and Jul 2013 were analyzed for CD4+T cell count, subtyping using phylogenetic analysis, and viral co-receptor tropism using Geno2pheno and webPSSM in combination. A total of 276 individuals were identified as recently infected. Subtype assignment were as follows: 176 (63.8%) CRF01_AE, 77 (27.9%) CRF07_BC, and 23 (8.3%) subtype B. Besides, 24 second-generation recombinant strains were identified. A lower CD4+T cell count at baseline survey was observed among CRF01_AE strain-infected individuals, compared to those who were infected with CRF07_BC (P<0.01). The frequency of baseline CD4+T cell count <200 was higher and the frequency of CD4 T counts >500 lower in CRF01_AE infection than CRF07_BC infection. It is worth noting that 32.4%–40.9% of CRF01_AE strain-infected individuals were predicted to carry CXCR4-tropic viruses whereas none of CRF07_BC and subtype B were found to be as CXCR4-tropic viruses (P<0.001). As could be expected CXCR4 tropism was associated with lower CD4 T counts. This study revealed that CRF01_AE strains with high frequency of CXCR4 tropism are prevailing in the young MSM population in China and could potentially cause a severe loss of CD4+T cell count and rapid disease progression. A regular surveillance of HIV-1 subtypes, CD4+T cell count and viral co-receptor usage would be greatly beneficial for effectively monitoring disease progression, improvement of antiretroviral therapy strategy and prompt intervention of transmission. [ABSTRACT FROM AUTHOR]

Importance: The efficacy of a semirecumbent position (SRP) in reducing postoperative hypoxemia during anesthesia emergence is unclear despite its widespread use., Objective: To determine the differences in postoperative hypoxemia between patients in an SRP and a supine position., Design, Setting, and Participants: This randomized clinical trial was performed at a tertiary hospital in China between March 20, 2021, and May 10, 2022. Patients scheduled to undergo laparoscopic upper abdominal surgery under general anesthesia were enrolled. Study recruitment and follow-up are complete., Interventions: Patients were randomized to 1 of the following positions at the end of the operation until leaving the postanesthesia care unit: supine (group S), 15° SRP (group F), or 30° SRP (group T)., Main Outcomes and Measures: The primary outcome was the incidence of postoperative hypoxemia in the postanesthesia care unit. Severe hypoxemia was also evaluated., Results: Out of 700 patients (364 men [52.0%]; mean [SD] age, 47.8 [11.3] years), 233 were randomized to group S (126 men [54.1%]; mean [SD] age, 48.2 [10.9] years), 233 to group F (122 men [52.4%]; mean [SD] age, 48.1 [10.9] years), and 234 to group T (118 women [50.4%]; mean [SD] age, 47.2 [12.1] years). Postoperative hypoxemia differed significantly among the 3 groups (group S, 109 of 233 [46.8%]; group F, 105 of 233 [45.1%]; group T, 76 of 234 [32.5%]; P = .002). This difference was statistically significant for groups T vs S (risk ratio [RR], 0.69 [95% CI, 0.55-0.87]; P = .002) and groups T vs F (RR, 0.72 [95% CI, 0.57-0.91]; P = .007), but not for groups F vs S (RR, 0.96 [95% CI, 0.79-1.17]; P = .78). Severe hypoxemia also differed among the 3 groups (group S, 61 of 233 [26.2%]; group F, 53 of 233 [22.7%]; group T, 36 of 234 [15.4%]; P = .01). This difference was statistically significant for groups T vs S (RR, 0.59 [95% CI, 0.41-0.85]; P = .005)., Conclusions and Relevance: In this randomized clinical trial of SRP during anesthesia recovery in patients undergoing laparoscopic upper abdominal surgery, postoperative hypoxemia was significantly reduced in group T compared with group F or group S., Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2100045087.

Background: The outbreak of the COVID-19 pandemic has caused great panic among the public, with many people suffering from adverse stress reactions. To control the spread of the pandemic, governments in many countries have imposed lockdown policies. In this unique pandemic context, people can obtain information about pandemic dynamics on the internet. However, searching for health-related information on the internet frequently increases the possibility of individuals being troubled by the information that they find, and consequently, experiencing symptoms of cyberchondria., Objective: We aimed to examine the relationships between people's perceived severity of the COVID-19 pandemic and their depression, anxiety, and stress to explore the role of cyberchondria, which, in these relationship mechanisms, is closely related to using the internet. In addition, we also examined the moderating role of lockdown experiences., Methods: In February 2020, a total of 486 participants were recruited through a web-based platform from areas in China with a large number of infections. We used questionnaires to measure participants' perceived severity of the COVID-19 pandemic, to measure the severity of their cyberchondria, depression, anxiety, and stress symptoms, and to assess their lockdown experiences. Confirmatory factor analysis, exploratory factor analysis, common method bias, descriptive statistical analysis, and correlation analysis were performed, and moderated mediation models were examined., Results: There was a positive association between perceived severity of the COVID-19 pandemic and depression (β=0.36, t=8.51, P<.001), anxiety (β=0.41, t=9.84, P<.001), and stress (β=0.46, t=11.45, P<.001), which were mediated by cyberchondria (β=0.36, t=8.59, P<.001). The direct effects of perceived severity of the COVID-19 pandemic on anxiety (β=0.07, t=2.01, P=.045) and stress (β=0.09, t=2.75, P=.006) and the indirect effects of cyberchondria on depression (β=0.10, t=2.59, P=.009) and anxiety (β=0.10, t=2.50, P=.01) were moderated by lockdown experience., Conclusions: The higher the perceived severity of the COVID-19 pandemic, the more serious individuals' symptoms of depression, anxiety, and stress. In addition, the associations were partially mediated by cyberchondria. Individuals with higher perceived severity of the COVID-19 pandemic were more likely to develop cyberchondria, which aggravated individuals' depression, anxiety, and stress symptoms. Negative lockdown experiences exacerbated the COVID-19 pandemic's impact on mental health., (©Lei Han, Yanru Zhan, Weizi Li, Yuqing Xu, Yan Xu, Jinzhe Zhao. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 16.09.2021.)

Background: Non-invasive prenatal screening (NIPS) is widely used as the alternative choice for pregnant women at high-risk of fetal aneuploidy. However, whether NIPS has a good detective efficiency for pregnant women at advanced maternal age (AMA) has not been fully studied especially in Chinese women., Methods: Twenty-nine thousand three hundred forty-three pregnant women at AMA with singleton pregnancy who received NIPS and followed-up were recruited. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), receiver operating characteristic (ROC) curves and the Youden Index for detecting fetal chromosomal aneuploidies were analyzed. The relationship between maternal age and common fetal chromosomal aneuploidy was observed., Results: The sensitivity, specificity, PPV, NPV of NIPS for detecting fetal trisomy 21 were 99.11, 99.96, 90.98, and 100%, respectively. These same parameters for detecting fetal trisomy 18 were 100, 99.94, 67.92, and 100%, respectively. Finally, these parameters for detecting trisomy 13 were 100, 99.96, 27.78, and 100%, respectively. The prevalence of fetal trisomy 21 increased exponentially with maternal age. The high-risk percentage incidence rate of fetal trisomy 21 was significantly higher in the pregnant women at 37 years old or above than that in pregnant women at 35 to 37 years old. (Youden index = 37)., Conclusion: It is indicated that NIPS is an effective prenatal screening method for pregnant women at AMA.

The purpose of this research is to solve the problems of unreasonable layout of the production plant, disorder of the logistics process, and unbalanced production line in discrete manufacturing plants. By analyzing the production process and characteristics, the timed Petri net model is constructed according to the function and connection of each production unit, which is then used to generate a FlexSim simulation model of the production plant logistics system with a simulation software. Therewith the FlexSim simulation model is used to simulate the original layout of the plant, and to analyse the simulation data synthetically to put forward an improvement strategy. Combined with the use of the systematic layout planning method to analyze the overall layout of the plant and logistics relations, we infer the relevant drawings between the production units and determine the improved layout of the facilities. Finally, by comparing the before and after improvement simulation results, it is verified that the combination of timed Petri nets and systematic layout planning is effective to ameliorate the layout of the plant facilities and the logistics system. This method makes up for the factors that traditional methods have not considered, achieves the goal of reducing the cross circuitous route of the plant and the idle rate of equipment, and improving the efficiency of production., Competing Interests: The CRRC Dalian R&D Co., Ltd. support in the form of salaries for author [Lin LIN], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Objective: To analyze clinical and genetic features of a family affected with Van der Woude syndrome., Methods: The umbilical cord blood of the proband and the peripheral blood of the parents were used for the whole exon sequencing to find the candidate gene.Peripheral blood of 9 members of the family were collected for Sanger sequencing verification, bioinformatics analysis and genotype-phenotype correlation analysis., Results: The proband was diagnosed with cleft lip and palate by ultrasound. His father and grandmother had hollow lower lip and all other family members did not have the similar phenotype. A missense c.263A>G (p.N88S) mutation was found in exon 4 of IRF6 gene in the proband, his father and his grandmother.The mutation was not found in other family members., Conclusions: A missense c.263A>G (p.N88S) mutation in IRF6 gene probably underlies the pathogenesis of Van der Woude syndrome in the family and the mutation has been firstly discovered in China.

Background: Before tyrosine kinase inhibitor (TKI) therapy can be administered in patients with advanced non-small cell lung cancer (NSCLC), EGFR mutation testing is required. However, few studies have evaluated the extent of EGFR testing in real-world practice in China., Methods: A multicenter, observational study of EGFR testing in NSCLC patients in North China was conducted. Treatment-naïve patients or those with postoperative recurrent stage IIIB/IV NSCLC were enrolled. The primary objective was EGFR testing rate. Secondary objectives included EGFR mutation status, EGFR testing methods and specimens, factors associated with EGFR testing, and overall survival with or without EGFR testing., Results: Overall, 2809 patients with stage IIIB/IV NSCLC were enrolled; 90.78% had adenocarcinoma. The EGFR screening rate was 42.54%. EGFR testing rates were higher in tumor samples obtained by lymph node puncture, and in patients with urban medical insurance, adenocarcinoma, non-smokers, or those located in developed cities (all P < 0.001). The EGFR mutation rate was 46.44%. The most commonly used specimens for EGFR testing were biopsy tumor samples (67.53%). PCR-based methods (72.05%), Sanger sequencing (5.36%), and Luminex liquid chip (5.10%) were the most frequently used testing platforms. Similar positive EGFR mutation rates were achieved with different platforms. TKI therapy was the first-line treatment administered to most EGFR-positive patients (56.22%), and chemotherapy in EGFR-negative patients (84.88%). Overall survival was higher in EGFR-tested than in untested patients (27.50 vs. 19.73 months; P = 0.007)., Conclusion: Real-world EGFR testing rates for NSCLC in North China were relatively low because of clinical and social factors, including medical insurance coverage., (© 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.)