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Objective: To evaluate the efficacy and safety of Chinese medicine (CM) Zihua Wenfei Zhisou Granule (ZWZG) in postinfectious cough (PIC) patients with CM syndrome of wind-cold invading Fei (Lung, WCIF). Methods: This is a multicenter, randomized, double-blind, parallel-group, placebo-controlled phase II clinical trial. PIC patients with WCIF syndrome were recruited from the Respiratory Departments in 6 hospitals across China between March 2019 and December 2020. Eligible patients were randomly assigned to group A (ZWZG-matched placebo 15 g), group B (active ZWZG 15 g), and group C (active ZWZG 10 g plus ZWZG-matched placebo 5 g) in a 1:1:1 ratio. All medications were taken orally 3 times daily for 14 consecutive days. The primary outcomes were cough relief rate and cough disappearance rate. The secondary outcomes included time to cough relief, time to cough disappearance, and changes in cough symptom score (CSS), cough Visual Analog Scale (VAS) value, Cough-Specific Quality of Life Questionnaire (CQLQ) score, and CM syndrome score from baseline (day 0) to post-treatment (day 14). Adverse events (AEs) in each group were recorded. Results: A total of 198 patients were included in the full analysis set (FAS) and safety analysis set (SS), while 183 were enrolled in the per-protocol analysis set (PPS). In the FAS population, the cough relief rate was 47.76%, 90.77% and 84.85% in groups A, B, and C, respectively; while the cough disappearance rate was 31.34%, 72.31% and 68.18%, respectively. The cough relief rates and cough disappearance rates in groups B and C were significantly higher than group A (P<0.0001). Both the median time to cough relief and cough disappearance in groups B and C were shorter than group A (P<0.0001). Compared with group A, groups B and C showed significantly greater improvements from baseline to post-treatment in CSS during daytime and nighttime as well as VAS (P<0.05). There were no significant differences in changes from baseline to post-treatment in CQLQ and CM syndrome scores among 3 groups (P>0.05). Results in the PPS population were consistent with those in the FAS population. Groups B and C showed lower incidence in AEs than group A (P<0.05), while there was no significant difference between groups B and C (P>0.05). No drug-related severe AEs were reported. Conclusions: ZWZG can increase cough disappearance rate and cough relief rate; and it is beneficial in shortening cough duration and reducing cough severity and frequency in patients suffering from PIC. It is safe and generally well tolerated. (Registration No. ChiCTR1900022078) [ABSTRACT FROM AUTHOR]

Providing further knowledge to and refinement of public facility location theory, this paper focuses on the distribution of basic educational facilities in China. The aim towards an equilibrium in the distribution of education resources has captured widespread attention in recent years. The basis of an education equilibrium is the balanced distribution of teaching facilities. Using the spatial analysis function of ArcGIS, this article discusses the evolution characteristics of education equilibrium and explores its dynamics with reference to primary and middle schools in Changchun City, Jilin Province from 2007 to 2013. The study found the spatial distribution of primary and middle schools in Changchun was uneven and the characteristic of close internal but sparse external has not changed. Low-level equilibrium of primary and middle schools in Changchun has been basically realized, but high-level equilibrium is far from being realized. Although there has been a trend towards suburbanization of these schools in recent years, the high entrance threshold has determined that high-quality school opportunity (schools with high-level resource allocation) has not increased for people. The spatial distribution of primary and middle schools is related to the factors of population, real estate, transportation and the education system itself. Education space, living space, and traffic space all interact and together affect urban spatial structure.

Background: Bismuth-containing quadruple therapy is the first-line treatment for eradicating Helicobacter pylori (H. pylori). The optimal duration for H. pylori eradication using bismuth-containing quadruple therapy remains controversial. Therefore, we aimed to compare the clinical effects of the 10- and 14-day bismuth-containing quadruple treatment regimen to eradicate H. pylori. Methods: Treatment-naïve patients with H. pylori infection (n = 1300) were enrolled in this multicenter randomized controlled study across five hospitals in China. They were randomized into 10- or 14-day treatment groups to receive bismuth-containing quadruple therapy as follows: vonoprazan 20 mg twice daily; bismuth 220 mg twice daily; amoxicillin 1000 mg twice daily; and either clarithromycin 500 mg twice daily or tetracycline 500 mg four times daily. At least 6 weeks after treatment, we performed a 13C-urea breath test to evaluate H. pylori eradication. Results: The per-protocol eradication rates were 93.22% (564/605) and 93.74% (569/607) (p < 0.001) and the intention-to-treat eradication rates were 88.62% (576/650) and 89.38% (581/650) (p = 0.007) for the 10- and 14-day regimens, respectively. Incidence of adverse effects was lower in patients who received 10- vs. 14 days of treatment (22.59% vs. 28.50%, p = 0.016). We observed no significant differences in the compliance to treatment or the discontinuation of therapy because of severe adverse effects between the groups. Conclusion: Compared with the 14-day bismuth-containing quadruple regimens, the 10-day regimen demonstrated a non-inferior efficacy and lower incidence of adverse effects. Therefore, the 10-day regimen is safe and tolerated and could be recommended for H. pylori eradication (NCT05049902). [ABSTRACT FROM AUTHOR]

In a platform society, the realization of the public value of platforms is not only affected by goals constructed based on national interest but also closely related to the rights and interests of platform users. In this context, how a platform mediates between the interests of a country, its users, and its businesses becomes a topic worthy of discussion. Through participatory observation and in-depth interviews, this study reveals that online platforms strategically transfer public values that enjoy national policy support and have a broad popular base into their ecosystems, employing techniques such as bridging different parties, gamification management, and the masking effect to produce green users. The findings reveal the unique logic of contemporary China's platform-driven environmental protection practices and mainstream value cultivation while also highlighting the conflicts and contradictions inherent in realizing public values. This study provides a valuable perspective for understanding the Chinese platform society in terms of public value realization. [ABSTRACT FROM AUTHOR]

Davidia involucrata Baill. 1871 (D. involucrata), as a tertiary relict plant unique to China, is a national Class I protected plant with high economic value. Oil extracted from its seeds and peels can be used for both consumption and industrial purposes. It has become a popular income-earning export tree in China because of its graceful posture and beautiful white bracts. Climate change affects the distribution of the species' potential habitat areas. Thus, studying its natural distribution pattern and future potential habitat distribution changes has great significance for the sustainable resource utilization and biodiversity conservation of D. involucrata. Here, we employed the MaxEnt model and ArcGIS software to predict the current and future (the 2050s and 2070s) potential habitats of D. involucrata via 130 species distribution records and 37 environmental variables. Meanwhile, we used the jackknife method to assess the importance of environmental factors. Our results showed the following: (1) When the RM = 4 and FC = LQHPT, the MaxEnt model exhibited the lowest complexity and overfitting degree while achieving high model prediction accuracy. The area under the curve (AUC) value of the simulated training was 0.958, indicating an excellent forecast. (2) Under the current climate scenario, D. involucrata was mainly concentrated in eastern Sichuan, western Hubei, northern Guizhou, and northwestern Hunan, with an area of 98.02 × 104 km2. (3) The precipitation in the warmest quarter (Bio18, 30%), mean temperature in the driest quarter (Bio9, 24.4%), annual mean radiation (Bio20, 14.6%), and elevation (ele, 12.7%) were the main environmental factors affecting its habitat distribution; the t contribution was 82.1%. (4) Under different future climate scenarios, the potential habitat area of D. involucrata decreased overall. Compared with the current climate scenario, the areas of potential habitats gradually decreased in both the 2050s and 2070s under the ssp126 and ssp585 climate scenarios but decreased in the 2050s and then increased in the 2070s under the ssp370 climate scenario. Therefore, it is of great significance to track and monitor the existing population or community on the basis of the possible changes in its distribution area. Moreover, the artificial breeding of its seedlings should be considered in the future to improve the quality of its germplasm resources. In summary, our findings can provide a scientific understanding of D. involucrata distribution in China and are conducive to conservation and utilization. [ABSTRACT FROM AUTHOR]

The development of China's solid wood furniture industry is relatively mature. As a precious raw wood material, rosewood plays an important role in the solid wood furniture industry. The number of imported rosewood in China has also increased year by year. The traditional identification method of rosewood categories mainly relied on the experience of professionals, so accurate and scientific identification of rosewood was very important for both furniture industry and handicrafts. In this article, a rosewood recognition method based on the surrounding features of wood was proposed. The BP neural network algorithm was used to establish a recognition model, which has been proven to have good recognition effect and can provide a new method for the identification of rosewood. [ABSTRACT FROM AUTHOR]

Objective To preliminarily summarize the epidemiological and clinical characteristics of functional movement disorder (FMD) based on movement disorders clinic in China. Methods and Results A total of 593 patients with movement disorders newly diagnosed in movement disorders clinic of 22 clinical medical centers from August to September in 2023 were included, including 37 patients (6.24%) with FMD and 556 patients (93.76%) with organic movement disorder. Comparison of the epidemiological characteristics of the 2 groups, the proportions of corona virus disease (COVID-19) infection (χ² = 4.217, P = 0.040) and psychopsychological symptoms (χ² = 18.694, P = 0.000) in the FMD group were higher than those in the organic movement disorder group, while age (t = 3.757, P = 0.000), age of onset (t = 3.720, P = 0.000) and proportion of hypertension (χ² = 4.736, P = 0.030) were lower than those in the organic movement disorder group. Comparison of the clinical characteristics of the 2 groups, the FMD group had higher proportions of tremor (χ² = 3.955, P = 0.047) and myoclonus (Fisher's exact probability: P = 0.011) than the organic movement disorder group, and the proportions of parkinsonism (χ² = 8.491, P = 0.004) and gait disorder (χ² = 5.028, P = 0.025) were lower than those in the organic movement disorder group. Conclusions The age and age of onset, as well as the proportions of COVID-19 infection, hypertension, psychopsychological symptoms, tremor, myoclonus, parkinsonism and gait disorder with FMD were different from those with organic movement disorder in China. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a serious, worldwide public health crisis. Surveillance of antimicrobial use forms part of an essential strategy to contain AMR. We aimed to conduct a national point prevalence survey (PPS) on antimicrobial use, and to compare this data with similar international surveillance programs to provide a reference for future AMR strategy development in China. Twenty general hospitals encompassing 10,881 beds and 10,209 inpatients around the country participated the survey using a standardized protocol, at 8am of someday from October 10th to November 31st, 2019. Of the patients, 37.00% (3777/10209) received antimicrobial agents, 31.30% (1630/5208) had surgical operations, and 76.63% (1249/1630) received prophylactic antibiotic. The prevalence of antimicrobial use in medical, surgical, and intensive care units (ICU) patients was 38.84% (1712/4408), 32.07% (1670/5208), and 66.61% (395/593), respectively. Of prescriptions, 5.79% (356/6151) were made in the absence of indication. The intensity of antimicrobial use was 61.25 DDDs/100 patient days, while the intensity of use in internal medicine, surgery, and ICU were 67.79, 45.81, 124.45 DDDs/100 patient days, respectively. Only 11.62% (715/6151) of prescriptions had a reason described in the patient record. Furthermore, 8.44% (210/2487), 14.19% (424/2989), and 12% (81/675) of the prescriptions in internal medicine, surgery, and ICU had a recorded indication, respectively. The review and stop date recorded for antimicrobial therapy was 43.73% (1976/4518). Of the patients, 38.07% (1438/3777) received combination therapy. The classes of antimicrobials prescribed were limited, and the proportion of prescriptions encompassed by the top 20 antimicrobial agents was 75.06% (4617/6151). The prevalence of antimicrobial use in China is close to that of Sweden, the UK, and Canada, but lower than that in India, and higher than that in Switzerland. The data described in this report indicate that the quality of antimicrobial prescriptions requires improvement in China. Further, hospitals should implement professional interventions to improve the rational use of antimicrobials. [ABSTRACT FROM AUTHOR]

The bark of Streblus indicus, a Dai medicine in China, has been listed in the Chinese Materia Medica as possessing hemostatic and analgesic properties. Ethnic medicine books record that its bark or leaves for the treatment of mumps and lymphoma. However, according to the literature survey, anti-inflammatory and analgesic studies available for leaves and branches of S. indicus have been seldom reported so far. The current study focuses on the metabolites of S. indicus bark and leaves responsible for anti-inflammatory and analgesic effects on the basis of bioactive-included acetic acid writhing, hot-plate, and xylene-induced ear swelling. The secretion of inflammatory mediators, TNF-α, IL-6, IL-1β, IL-4, and IL-10, were evaluated for their anti-inflammatory by xylene-induced in mouse ear cells. Histological examination was used to assess the anti-inflammatory and analgesic effects of the branches and leaves of S. indicus, and Western blot analysis determined the mechanism of the methanolic extract of branches and leaves. Different metabolites of S. indicus significantly alleviated analgesic and antiinflammatory effects, with no discernable differences among them. All metabolites decreased the levels of TNF-α, IL-1β, and IL-6 and increased the levels of IL-4 and IL-10. The analgesic and anti-inflammatory mechanism of the methanolic extract was related to the NF-kB signaling pathway. These results not only would account for scientific knowledge for the traditional application of S. indicus, but also provide a credible theoretical foundation for the further development of anti-inflammatory and analgesic agents. [ABSTRACT FROM AUTHOR]

Background: Mucormycosis is a rare form of invasive, rapidly progressive and lethal opportunistic fungal infection caused by Mucorales. Although Rhizopus arrhizus (R. arrhizus) is the most commonly isolated Mucorales worldwide, infections caused by Apophysomyces variabilis (A. variabilis) are increasing. Objectives and Methods: We present a case of necrotizing fasciitis caused by A. variabilis in an immunocompetent woman. In order to further understand the characteristics of the strain isolated from the patient, we identified the strain through ITS sequencing, assessed the ability to tolerate salt concentrations and temperature conditions, in addition to performing in vitro drug susceptibility testing against common antifungal agents. Results: The strain showed 98.76% identity with A. variabilis in the NCBI database, and it was found to tolerate higher temperatures and salt concentrations than previously reported strains. The strain was sensitive to amphotericin B and posaconazole, but not to voriconazole, itraconazole, 5‐fluorocytosine and echinocandins. Conclusions: This case indicates that Mucorales caused by A. variabilis should be recognised as an emerging pathogen that can cause a high mortality rate in the absence of prompt diagnosis and proper treatment in China, aggressive surgical debridement combined with prompt and appropriate antifungal treatment may improve outcomes. [ABSTRACT FROM AUTHOR]

In 1984 and 2000, respectively, the Party Central Committee and the state council decided to establish the Tibet Class and the Xinjiang Class in some interior provinces and municipalities ("neidi") to promote economic development and social progress in the motherland's frontier regions as well as to ensure state security and consolidate border defense. These decisions initiated a new model of running interior-region schools oriented toward assisting ethnic minority education. It was also an effective policy and a major measure for using the economic and educational advantages of the developed interior regions and organizing the developed interior regions to intensify the efforts for assisting education in ethnic border regions. The Tibet Class and the Xinjiang Class in the interior regions are typical models of cross-cultural education. Studies targeted at the difficulties encountered by ethnic minority students during their interior-region ("neidi") cross-cultural studies and the implementation of effective countermeasures to overcome such difficulties are urgently required to bring greater efficiency to the special ethnic minority education policy of managing schools in the interior regions. (Contains 2 footnotes.)

The fundamental way for China to achieve carbon peak and carbon neutrality is to continuously improve the penetration of renewable energy (RE) in the power system and establish an electricity mix dominated by RE power. According to China's 14th Five-Year Plan, the proportion of non-fossil energy power generation should reach about 39% by 2025. However, the impact of the increase in share of RE power on carbon emissions of the electricity sector remains to be estimated. To this end, the purpose of this paper is to capture the nonlinear characteristics of RE on electricity-related carbon emissions by using panel smooth transition regression (PSTR) model and provincial panel data covering the period 1991–2020 under the background of provincial RE quota system. The estimation results indicate that, (i) in the four transition variables of PSTR model such as the installed capacity of power generation, substation equipment capacity, total electricity consumption and total power generation, the nexus between RE deployment and electricity-related carbon emissions was detected as nonlinear. (ii) The heterogeneous RE carbon abatement effect is reflected in its increasing penetration in provincial power systems. (iii) Carbon abatement performance of RE generation decreases in the negative range with the increase of transition variables. (iv) The estimation coefficient of RE is positive at the higher value of the transition variable in the PSTR model of carbon emissions per capita. As a result, the RE quota with the best emission abatement performance should be designed based on the provincial power resource endowment and the medium and long-term expected electricity consumption. [ABSTRACT FROM AUTHOR]

Objective: The worldwide incidence of primary small intestinal lymphoma (PSIL) is increasing. However, little is known about the clinical and endoscopic characteristics of this disease. The aim of this study was to investigate the clinical and endoscopic data of patients with PSIL, with the goal of enhancing our understanding of the disease, improving diagnostic accuracy, and facilitating more accurate prognosis estimation. Methods: Ninety-four patients diagnosed with PSIL were retrospectively studied at Qilu Hospital of Shandong University between 2012 and 2021. The clinical data, enteroscopy findings, treatment modalities, and survival times were collected and analyzed. Results: Ninety-four patients (52 males) with PSIL were included in this study. The median age of onset was 58.5 years (range: 19-80 years). Diffuse large B-cell lymphoma (n=37) was the most common pathological type. Abdominal pain (n=59) was the most frequent clinical presentation. The ileocecal region (n=32) was the most commonly affected site, and 11.7% of patients had multiple lesions. At the time of diagnosis, the majority of patients (n=68) were in stages I-II. A new endoscopic classification of PSIL was developed, including hypertrophic type, exophytic type, follicular/polypoid type, ulcerative type, and diffusion type. Surgery did not show a significant increase in overall survival; chemotherapy was the most commonly administered treatment. T-cell lymphoma, stages III-IV, "B" symptoms, and ulcerative type were associated with poor prognosis. Conclusion: This study provides a comprehensive analysis of the clinical and endoscopic features of PSIL in 94 patients. This highlights the importance of considering clinical and endoscopic characteristics for accurate diagnosis and prognosis estimation during small bowel enteroscopy. Early detection and treatment of PSIL is associated with a favorable prognosis. Our findings also suggest that certain risk factors, such as pathological type, "B" symptoms, and endoscopic type, may affect the survival of PSIL patients. These results underscore the need for careful consideration of these factors in the diagnosis and treatment of PSIL. [ABSTRACT FROM AUTHOR]

The purpose of this study is to implement point prevalence survey (PPS), assess antimicrobial prescribing and resistance in general hospitals and clinical specialties in China, and compare them with similar data from other parts of the world. Twenty general hospitals in China were surveyed in October or November, 2019. A standardized surveillance protocol was used to collect data on patient demographics, diagnosis of infection, the prevalence and intensity of antimicrobial use, prescribing quality, bacterium type and resistance spectrum, and the prevalence and type of healthcare-associated infections (HAIs). Overall, 10,881 beds and 10,209 inpatients were investigated. The overall prevalence of antibiotic use was 37.00%, the use of antibiotic prophylaxis in surgical patients was high (74.97%). The intensity of antimicrobial use was 61.25 DDDs/100 patient days. Only 11.62% of antimicrobial prescriptions recorded the reason for prescribing. Intravenous or combination treatments comprised 92.02% and 38.07%, respectively, and only 30.65% of prescriptions referred to a microbiological or biomarker tests. The incidence of HAIs in all patients was 3.79%. The main associated factors for HAIs included more frequent invasive procedures (27.34%), longer hospital stay (> 1-week stay accounting for 51.47%), and low use of alcohol hand rubs (only 29.79% placed it bedside). Most of the resistant bacteria declined; only carbapenem-resistant Enterobacter is higher than previously reported. The prevalence of antibiotic use in general hospitals fell significantly, the overall bacterial resistance declined, and the incidence of HAI was low. However, the low quality of antimicrobial use requires urgent attention. [ABSTRACT FROM AUTHOR]

Background: Bismuth‐containing quadruple therapy is an effective regimen for Helicobacter pylori (H. pylori) treatment. No head‐to‐head comparison trials have been conducted to evaluate the efficacy of colloidal bismuth pectin (CBP) in quadruple therapy for eradicating H. pylori. We aimed to compare the efficacy and safety of CBP quadruple therapy and bismuth potassium citrate (BPC) quadruple therapy for 14 days in the first‐line treatment of H. pylori. Methods: In this multicenter, randomized, double‐blind, non‐inferiority clinical trial, H. pylori‐infected subjects without eradication history were randomized to receive amoxicillin 1 g twice daily, tetracycline 500 mg three time daily, esomeprazole 20 mg twice daily in combination with CBP 200 mg three time daily or BPC 240 mg twice daily for 14 days. 13C‐urea breath tests were used to access the eradication rate at least 4 weeks after treatment. Results: Between April 2021 and July 2022, 406 patients were assessed for eligibility and 339 subjects were randomized. The cure rates (primary outcome) of CBP and BPC quadruple therapy were 90.5% and 92.3% (p = 0.56) by intention‐to‐treat analysis, respectively, and 96.1% and 96.2% (p = 1.00) by per‐protocol analysis, respectively. CBP quadruple therapy was non‐inferior to BPC quadruple therapy in the intention‐to‐treat and per‐protocol analysis (p < 0.025). The frequency of adverse events and compliance were not different among the two groups (p > 0.05). Conclusions: Both CBP and BPC quadruple therapy for 14 days provide high efficacy, good compliance, and safety in the first‐line treatment of H. pylori in China. [ABSTRACT FROM AUTHOR]

Due to the precise and continuous regulation of phase, holographic encryption based on metasurfaces and liquid crystals (LCs) has been proposed to encrypt the information by manipulating the wavelength, polarization, etc. However, the security cannot be fully guaranteed since the requirements of decoding methods for these schemes are generally not very strict and vulnerable for exhaustive attack. Furthermore, any part of the hologram stolen may lead to the disclosure of the hidden information regardless of the generation mode of phase delay or the selection of media material, so the security needs to be further improved. Here, inspired by Tiger Amulet, embodying the encryption consciousness of ancient China, we propose a simple but effective encryption method and design a "four-in-one" hologram based on photopatterned LCs. Specifically, the most important encrypted image can only be displayed when the four LC holograms in the same group are spliced into a whole according to the designed order. On the contrary, the camouflage information would be displayed if the holograms are placed in the optical path separately or spliced in wrong order. It is even more interesting that with the LC directors tilted with applied external voltages, the holographic efficiency of the LC hologram will change accordingly. This sets further demanding requirement on the decryption condition and thus increases the encryption security. With the advantages of simple design, high security, and low crosstalk, our encryption scheme has great potential in the fields of information hiding and image encryption. [ABSTRACT FROM AUTHOR]

Metro-led underground space (MUS) plays a crucial role in modern underground space utilisation. Recent studies have shown its great potential for high-quality urban development. However, limited evidence about MUS was available on a national scale, resulting in incomplete and unsystematic knowledge of MUS utilisation. The interaction relationship between MUS and the surrounding built environment also remains unclear. To fill the research gap, an automatic method for MUS identification and development features extraction was proposed based on point of interest data. We applied the method to identify the MUS in 28 Chinese cities and estimated the development status of MUS in China for the first time. The nationwide statistics of MUS and correlation analysis of development features were conducted. Results show that complex MUS (CMUS) share is significantly lower than that of simple MUS. Besides, CMUS development in China is primarily dominated by public transport and does not have a solid functional link to its surroundings. The comparative analysis of MUS development in four primary urban agglomerations was also conducted, and their development characteristics were discussed. The study aims to expand the planning toolkit and construct the MUS database, which sheds light on the datadriven planning for MUS. [ABSTRACT FROM AUTHOR]

In south China, warm-sector rainstorms are significantly different from the traditional frontal rainstorms due to complex mechanism, which brings great challenges to their forecast. In this study, based on ensemble forecasting, the high-resolution mesoscale numerical forecast model WRF was used to investigate the effect of initial errors on a warmsector rainstorm and a frontal rainstorm under the same circulation in south China, respectively. We analyzed the sensitivity of forecast errors to the initial errors and their evolution characteristics for the warm-sector and the frontal rainstorm. Additionally, the difference of the predictability was compared via adjusting the initial values of the GOOD member and the BAD member. Compared with the frontal rainstorm, the warm-sector rainstorm was more sensitive to initial error, which increased faster in the warm-sector. Furthermore, the magnitude of error in the warm-sector rainstorm was obviously larger than that of the frontal rainstorm, while the spatial scale of the error was smaller. Similarly, both types of the rainstorm were limited by practical predictability and inherent predictability, while the nonlinear increase characteristics occurred to be more distinct in the warm-sector rainstorm, resulting in the lower inherent predictability. The comparison between the warm-sector rainstorm and the frontal rainstorm revealed that the forecast field was closer to the real situation derived from more accurate initial errors, but only the increase rate in the frontal rainstorm was restrained evidently. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to examine serum leukocyte cell-derived chemotaxin 2 (LECT2) levels in osteoporosis subjects to confirm its association with osteoporosis. Methods A total of 204 adult subjects were recruited. Bone mineral densities (BMD) were assessed and blood samples were collected for measurements of biomedical parameters and the bone turnover markers. Serum LECT2 levels were measured by enzyme-linked immunosorbent assay. The relationships between serum LECT2 levels and other parameters were analyzed using the Spearman correlation coefficient. Results Serum LECT2 levels were significantly increased in osteoporosis subjects over controls. We found a significantly negative correlation of serum LECT2 with BMD, 25-hydroxy-vitamin D, and creatinine and a significantly positive correlation with C-terminal telopeptide of type 1 collagen and total cholesterol. Conclusion Serum LECT2 levels were significantly upregulated in osteoporosis subjects and correlated with the severity of bone loss. Serum LECT2 could be a potential biomarker to assess the risk of bone loss. [ABSTRACT FROM AUTHOR]

Lidar at 1064 nm and Ka-band millimetre-wave cloud radar (MMCR) are powerful tools for detecting the height distribution of cloud boundaries and can monitor the entire life cycle of cloud layers. In this study, lidar and MMCR are employed to jointly detect cloud boundaries under different conditions. By enhancing the echo signal of lidar at 1064 nm and combining its signal-to-noise ratio (SNR), the cloud signal can be accurately extracted from the aerosol signals and background noise. The interference signal is eliminated from Doppler spectra of the MMCR by using the noise ratio of the smallest measurable cloud signal (SNR min⁡) and the spectral point continuous threshold (Nts). Moreover, the quality control of the reflectivity factor of MMCR obtained by the inversion is conducted, which improves the detection accuracy of the cloud signal. We analysed three typical cases studies; case one presents two interesting phenomena: (a) at 19:00–20:00 CST (China standard time), the ice crystal particles at the cloud top boundary are too small to be detected by MMCR, but they are well detected by lidar. (b) At 19:00–00:00 CST, the cirrus cloud changes to altostratus where the cloud particles eventually grow into large sizes, producing precipitation. Further, MMCR has more advantages than lidar in detection of the cloud top boundary within this period. Considering the advantages of the two devices, the change characteristics of the cloud boundary in Xi'an from December 2020 to November 2021 were analysed, with MMCR detection data as the main data and lidar data as the assistant data. The seasonal variation characteristics of clouds show that, in most cases, high clouds often occur in summer and autumn, and the low clouds are usually in winter. The normalized cloud cover shows that the maximum and minimum cloud cover occur in summer and winter, respectively. Furthermore, the cloud boundary frequency distribution results for the whole of the observation period show that the cloud bottom boundary below 1.5 km is more than 1 %, the frequency within the height range of 3.06–3.6 km is approximately 0.38 %, and the frequency above 8 km is less than 0.2 %. The cloud top boundary frequency distribution exhibits the characteristics of a bimodal distribution. The first narrow peak lies at approximately 1.0–3.1 km, and the second peak appears at 6.4–9.8 km. [ABSTRACT FROM AUTHOR]

Small town shrinkage has become a global social and economic phenomenon. County towns, which are characterized by large numbers, diverse types, important functions and wide distribution, are an indispensable component of small towns in China. The shrinkage of county towns in China is typical and unique in the global urban shrinkage system. Therefore, this study takes county towns in China as the basic unit, uses the rate of population change to identify shrinking towns, and analyzes the spatiotemporal patterns and distribution characteristics of the shrinking towns, from 2010 to 2018. Eleven indicators in six categories were selected, and temporal weighted regression (TWR) and geographically weighted regression (GWR) were used to explore the spatiotemporal heterogeneity of influencing factors. The results show that, during the study period, the number of shrinking towns in China increased. The phenomenon of urban shrinkage was common in seven geographical regions, mainly distributed in Northeast, Northwest, North and Southwest China during the study period. The shrinkage trajectory was dominated by two forms of shrinkage, namely potential shrinkage and segmented shrinkage. Both growing towns and shrinking towns were affected by population agglomeration, economic base, industrial structure, and space development. Traffic and location were unique factors that affected shrinking towns. The results also show that the influencing factors of shrinking towns were not significantly heterogeneous in time, but significantly heterogeneous in space. These findings help us to understand the complexity and diversity of small town shrinkage in China and also provide a reference for planners and decision makers to formulate corresponding governance strategies for shrinking towns in different regions. • Small town shrinkage has become the main component of urban shrinkage. • There are numerous and diverse types of shrinking county towns in China. • Influencing factors between shrinking and growing towns are distinguished. • There are different reasons for shrinking towns in seven geographical regions. • Geographically weighted regression analyzes the spatial heterogeneity of factors. [ABSTRACT FROM AUTHOR]

China has a large population of elderly in rural areas. Village doctors are acting as health-care gatekeepers for the rural elderly in China and are encouraged to provide more long-term care for patients with chronic diseases such as atrial fibrillation (AF). The data of AF registries from the rural elderly are limited. The present registry aims to provide contemporary data on the current AF-related health status of the rural elderly and the gaps in management of AF by village doctors. This study has two phases. The first phase is a cross-sectional study of AF screening in two rural towns of eastern China. All the residents aged ≥ 65 years are eligible and will be invited to attend a government-led health examination or an in-house AF screening program. The AF detection rate, the awareness of AF and the usage of oral anticoagulants and smartphones by AF patients, and the ability to diagnose and manage AF by village doctors will be assessed. Participants with AF detected in the first phase are eligible for the second phase. A variety of modes of intensified education will be provided to all AF patients and their family members to enrich their AF-related knowledge. Their village doctors will be offered a lecture-based training program focusing on Atrial fibrillation Better Care (ABC) pathway. Follow-up will be conducted for 1 year. The primary endpoint is the composite of all stroke and all-cause mortality. The first phase of AF screening was conducted between April 2019 and June 2019, and 18,712 participants with the mean age of 73.1± 5.8 years were enrolled. The second phase that includes 810 patients with AF, started on 1 May 2019. This study will provide a perspective of primary care system and would indirectly reflect the current status of chronic disease care in rural China. [ABSTRACT FROM AUTHOR]

Background: Fixed-dose combination (FDC) antibiotics can be clinically inappropriate and are concerning with regards to antimicrobial resistance, with little usage data available in low- and middle-income countries. Methods: Based on retrospective data from the Center for Antibacterial Surveillance, we investigated the consumption of FDC antibiotics in hospital inpatient settings in China from 1 January 2013 to 31 December 2019. The metric for assessing antibiotic consumption was the number of daily defined doses per 100 bed days (DDD/100BDs). FDC antibiotics were classified according to their composition and the Access, Watch, Reserve (AWaRe) classification of the World Health Organization. Results: A total of 24 FDC antibiotics were identified, the consumption of which increased sharply from 8.5 DDD/100BDs in 2013 to 10.2 DDD/100BDs in 2019 (p < 0.05) despite the reduction in the total antibiotic consumption in these hospitals. The increase was mainly driven by FDC antibiotics in the Not Recommended group of the AWaRe classification, whose consumption accounted for 63.0% (6.4 DDD/100BDs) of the overall FDC antibiotic consumption in 2019, while the consumption of FDC antibiotics in the Access group only accounted for 13.5% (1.4 DDD/100BDs). Conclusion: FDC antibiotic consumption significantly increased during the study period and accounted for a substantial proportion of all systemic antibiotic usage in hospitals in China. FDC antibiotics in the Not Recommended group were most frequently consumed, which raises concerns about the appropriateness of FDC antibiotic use. [ABSTRACT FROM AUTHOR]

The last decades of neuroimaging research has revealed atypical development of intrinsic functional connectivity within and between large-scale cortical networks in autism spectrum disorder, but much remains unknown about cortico-subcortical developmental connectivity atypicalities. This study examined cortico-striatal developmental intrinsic functional connectivity changes in autism spectrum disorder and explored how those changes may be correlated with autistic traits. We studied 49 individuals with autism spectrum disorder and 52 age-, sex-, and head motion–matched typically developing individuals (5–30 years old (14.0 ± 5.6)) using resting-state functional magnetic resonance imaging. Age-related differences in striatal intrinsic functional connectivity were compared between the two groups by adopting functional network–based parcellations of the striatum as seeds. Relative to typically developing individuals, autism spectrum disorder individuals showed atypical developmental changes in intrinsic functional connectivities between almost all striatal networks and sensorimotor network/ default network, with connectivity increasing with age in the autism spectrum disorder group and decreasing or constant in typically developing individuals. Age-related degree centrality and voxel-mirrored homotopic connectivity atypicalities in sensorimotor network/default network and voxel-mirrored homotopic connectivity disruptions in striatal regions were also observed in autism spectrum disorder. Significant correlations were found between cortico-striatal intrinsic functional connectivities and Autism Diagnostic Observation Schedule communication/repetitive and restricted-behavior subscores in autism spectrum disorder. Our results indicated that developmental atypicalities of cortico-striatal intrinsic functional connectivities might contribute to the neuropathology of autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Objective: To investigate the management of Helicobacter pylori (H. pylori) infection by gastroenterologists from secondary and tertiary hospitals in Shandong Province, China, where there is a high prevalence of H. pylori infection. Methods: A questionnaire‐based, stratified sampling survey was conducted from June 1 to August 30, 2021. The ratio of secondary to tertiary hospitals was set at 2:1. An electronic questionnaire was sent to the gastroenterologists via the WeChat platform. Results: A total of 89.09% (1053/1182) gastroenterologists were included. Overall, 34.19% and 60.59% of gastroenterologists recommended screening for and treating H. pylori infection in patients without any competing factors. The most preferred testing method in secondary and tertiary hospitals was the 13C‐urea breath test (53.92% and 80.48%), but the reexamination rate of results close to the cut‐off value was low (55.10% and 59.48%). Gastroenterologists preferred bismuth‐containing quadruple therapy (secondary and tertiary hospitals: 96.67% and 98.53%), but the antibiotic combination prescribed for patients with penicillin allergy was suboptimal in secondary hospitals. The overall post‐treatment follow‐up rate was 64.58%, and gastroenterologists in secondary hospitals were more proactive than those in tertiary hospitals (69.41% vs 60.04%, P = 0.001). Less than 80% of gastroenterologists emphasized the importance of post‐treatment reexamination to their patients. Only a minority of gastroenterologists in secondary and tertiary hospitals (30.79% and 34.36%) achieved acceptable eradication rates (exceeding 80%). Conclusions: Deficiencies exist in gastroenterologists from secondary and tertiary hospitals, and the H. pylori eradication rate is relatively low. Training programs for gastroenterologists are warranted to strengthen their comprehension of guidelines. [ABSTRACT FROM AUTHOR]

Simple Summary: We measured female reproductive traits of a colubrid snake (Lycodon rufozonatus) from Zhejiang, East China in four years (1999, 2010, 2011, and 2014). After removing the influence of female size, postpartum body mass was greater in 2010 than in 2014, clutch mass was greater in 2010 than in 2011 and 2014, and egg size was greater in 2010 than in the other three years. Egg size was positively related to postpartum body condition in each year. Females laid larger eggs in 2010 than in other three years after removing the influence of maternal size and body condition. Our study does not follow the prediction that reproductive females with different amounts of resources to invest should give priority to adjusting the number rather than size of offspring. Long-term studies are especially suited for disentangling the effects of extrinsic and intrinsic factors on both total reproductive investment and reproductive allocation in offspring number versus offspring size. Female reproductive traits of the red-banded wolf snake (Lycodon rufozonatus) from Zhejiang, East China were studied in four years between 1999 and 2014. Egg-laying dates overall extended from late June to late July, and varied among years. Postpartum body mass, clutch size, clutch mass, and egg size were positively related to female size (snout vent length, SVL) in each year. Postpartum body mass, clutch mass, and egg size differed among years after accounting for female SVL, whereas clutch size did not. Setting female SVL at the same level, postpartum body mass was greater in 2010 than in 2014, clutch mass was greater in 2010 than in 2011 and 2014, and egg size was greater in 2010 than in the other three years. Females did not trade off egg size against number. Egg size was positively related to postpartum body condition in each year. Females laid larger eggs in 2010 than in other three years after removing the influence of maternal body condition. Our study provides evidence for the traditional view that reproductive output is highly linked to maternal body size in snakes, but not following Smith and Fretwell's (1974) classic prediction that females with different amounts of resources to invest in reproduction should give priority to adjusting the number rather than size of their offspring. Maternal body size and condition both are important sources of variation in egg size, but factors other than these two variables may also affect the size of eggs produced by female L. rufozonatus. [ABSTRACT FROM AUTHOR]

Geological maps have wide coverage with low acquisition difficulty. When other geological survey data are scarce, they are a valuable source of geological structure information for geological modeling. However, for structures with large deformation, geological map information has difficulty meeting the requirement of its 3D geological modeling. Therefore, this paper takes the dome structure as an example to explore a 3D modeling method based on geological maps, DEM and related geological knowledge. The method includes: (1) adaptively calculating the attitude of points on the stratigraphic boundaries; (2) inferring and generating the bottom boundary of the model from the attitude data of the boundary points; (3) generating the model interface constrained by Bézier curves based on the bottom boundary; (4) generating the top and bottom surfaces of the stratum; and (5) stitching each surface of the geological body to generate the final dome model. Case studies of the dome in Wulongshan in China and the Richat structure in Mauritania show that this method can build a solid model of the dome based only on geological maps and DEM data, whose morphological features are basically consistent with those embodied in the section view or the model generated by traditional methods. [ABSTRACT FROM AUTHOR]

Background: Freshwater planarians of the genus Dugesia (Platyhelminthes, Tricladida, Dugesiidae) are distributed in a major part of the Old World and Australia, although until recently only very few species were known from China. Results: Two new species of Dugesia from Southern China are described on the basis of an integrative taxonomic approach. BI and ML phylogenetic trees based on the independent genes and on the concatenated dataset had similar topologies, only differing in some nodes that were weakly supported. Phylogenetic trees based on the concatenated dataset revealed that D. adunca Chen & Sluys, sp. nov. and D. tumida Chen & Sluys, sp. nov. are not closely related and belong to different clades. The two new species occupy separate long branches with high support values and, thus, are well-differentiated from their congeners. Separate species status of D. adunca and D. tumida is supported also by the genetic distances between the species included in our analysis, albeit that COI distances varied greatly among species. Dugesia adunca from Guangxi Province is characterized by the following features: living mature animals rather small; asymmetrical openings of the oviducts into the bursal canal; penis papilla with shape of an aquiline bill, albeit with a blunt tip; asymmetrical penis papilla, with a large antero-dorsal lip and a much smaller ventro-posterior lip; very large seminal vesicle, provided with trabeculae; small diaphragm; mixoploid karyotype with diploid complements of 2n = 2x = 16 and triploid complements of 2n = 3x = 24, with all chromosomes being metacentric. Dugesia tumida from Guangdong Province is characterized by a penis papilla provided with a large, symmetrical penial valve from the middle of which arises the small, distal section of the papilla; a duct intercalated between the seminal vesicle and the small diaphragm; ventrally displaced ejaculatory duct curving upwards before opening to the exterior; penis papilla highly asymmetrical, having a slim and long ventral portion and a short and stubby dorsal part; vasa deferentia separately opening into antero-dorsal portion of seminal vesicle; oviducts openings symmetrically into ventral portion of the bursal canal, near its opening into the atrium; mixoploid karyotype, with diploid chromosome portraits of 2n = 2x = 16, and triploid complements of 2n = 3x = 24, with all chromosomes being metacentric. In the context of the various kinds of mixoploidy and the sexualization of specimens, reproductive modalities within the genus Dugesia are shortly discussed. Conclusion: Molecular, morphological, and karyological markers show that the two populations examined represent members of the genus Dugesia and constitute two new, distinct species. [ABSTRACT FROM AUTHOR]

Meso-Neoproterozoic dolostone is abnormally well-developed in the platform areas in China, detailly, in the Mesoproterozoic Calymmian Wumishan Formation of North China Basin, Neoproterozoic Ediacaran Qigbulak Formation of Tarim Basin, and the Neoproterozoic Ediacaran Dengying Formation of Sichuan Basin. The outcrops and drilling cores from these basins show that these dolostones are mostly thick-bedded to massive, with mud-sized to silt-sized crystalline dolostone reaching 86%–97% of the total dolostone thickness. These dolostones basically suffered no secondary metasomatism, regardless of containing microorganisms (such as algae and bacteria) or not. The analyses of sedimentary palaeogeographic features indicate that: (1) the Meso-Neoproterozoic dolostone nearly covered the entire area basins, and was widely deposited in supratidal to intertidal zones, as well as in open platform environments; (2) the dolostone was subdivided according to the crystalline size, with the distribution controlled by geomorphology, i.e., the pure mud-sized crystalline dolostone developing in depression areas, whereas the grainy mud-sized crystalline dolostone or the mound stromatolitic mud-sized crystalline dolostone developing in uplift areas; (3) deep-water basins developed between the carbonate platforms, and the seismic profiles show that these basins were formed by syngenetic deep faults in the Meso-Neoproterozoic strata. These syngenetic faults increased Mg2+ concentration in the seawater by injecting rich-Mg2+-bearing hydrothermal fluids into the carbonate platforms. The analyses of geochemical and paleoclimatic indexes reveal that there is no obvious difference in carbon and oxygen isotope ratios between dolostones having different textures, with the ratios similar to those of the global seawater of the Meso-Neoproterozoic, indicating that the silt-sized crystalline dolostone has the same sedimentary origin as the mud-sized crystalline dolostone, i.e., the former is from authigenic recrystallization of the latter rather than secondary metasomatism. Therefore, whatever the crystalline sizes are, the dolostones are all originated from sedimentation. All the petrological, sedimentary and geochemical data suggest that the dolostones covering almost the whole Meso-Neoproterozoic typical platform areas of China are of relatively primary sedimentary origin. [ABSTRACT FROM AUTHOR]

Fangcang hospitals, as tentative hospitals built to treat a huge turnover of patients with mild coronavirus disease 2019 (COVID-19) infections, have played a pivotal role to slow down the pandemic spread in China in 2020. However, anxiety and sleep disorders remain tough to address during the treatments. In this study, group psychological intervention in combination with pulmonary rehabilitation exercises were conducted in the trial group for the patients with mild COVID-19 infections in a Fangcang Hospital to mitigate the patients' anxiety and sleep disorders, while conventional nursing methods were done in the control group, with 70 randomly picked patients in each group. Effects were assessed through questionnaire method using state anxiety questionnaire (SAI) and Pittsburgh sleep quality index scale (PQSI) rating investigation. Results showed that both SAI and PSQI scores of the trial group were significantly lower than those of the control group (P < 0.05). The SAI scores of the trial group and the control group were 38.5 ± 13.2 and 45.8 ± 10.4 points (t = 3.600, P < 0.001), respectively, and the PSQI scores were 5.6 ± 3.0 and 7.1 ± 3.0 points (t = 2.982, P < 0.01), respectively. Our methods have significant advantages over conventional nursing methods to mitigate anxiety and sleep disorders for the patients with mild COVID-19 infections in the Fangcang Hospital. [ABSTRACT FROM AUTHOR]

We investigated a case of cutaneous infection in an immunocompromised patient in China that was caused by a novel species within the Mycobacterium gordonae complex. Results of whole-genome sequencing indicated that some strains considered to be M. gordonae complex are actually polyphyletic and should be designated as closely related species. [ABSTRACT FROM AUTHOR]

Star worship is an ever-growing phenomenon around the globe. Across various social media platforms in China, a new idol–fan relationship model has emerged, such that the fans have stepped up from merely worshipping the idols to being able to co-cultivate their idols, including their public images, the scope of their work, and even their personal lives. Based on a grounded theory approach, this study utilized text analysis and in-depth interviews to explore parakin relationships between fans and idols and proposed a dual motivation model to explain the motivations of fans for forming such a relationship. The findings extend current fandom literature by exploring a new front of fan–idol interactions in the context of social media. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Two new isobenzofuranone derivatives (1 and 2) together with six known compounds (3–8) were isolated from the roots of Phlomis betonicoides, a highly sweet plant in China. Their structures were determined by means of HR-ESI-MS and extensive 1D and 2D NMR spectroscopic studies. Compounds 1–8 were tested for their anti-rotavirus activity. The results showed that compounds 1–8 exhibited potent anti-rotavirus activity with therapeutic index value 7.5–16.4. [ABSTRACT FROM AUTHOR]

Background:  The medical consortium is an intensive and disease-specific association that integrates tertiary public hospitals and medical examination centers in China. We aimed to evaluate the feasibility of the medical consortium for screening upper gastrointestinal (GI) cancers (MCSC) by magnetically controlled capsule gastroscopy (MCCG).Methods:  6627 asymptomatic subjects underwent MCCG as part of health check-ups in the MCSC between March and November 2018. Relevant clinical data were collected and analyzed.Results:  The MCSC detected 32 patients with upper GI cancer (0.48 %) confirmed by pathology. The detection rate of early gastric cancer was 16.67 % (4 /24). Gastric polyps, ulcers, and submucosal tumors were found in 15.54 %, 3.76 %, and 3.17 % of subjects, respectively. The whole GI preparation and operation process were well tolerated.Conclusions:  The MCSC was a feasible model for upper GI cancer screening, especially for asymptomatic subjects. Further prospective studies with better operational quality control are warranted. [ABSTRACT FROM AUTHOR]

Much has been learned regarding orbital and millennial timescale climate changes after the onset of Northern Hemisphere glaciations (NHG) at ca. 2.7 Ma. By contrast, little is known about these variations before the NHG due to lack of high‐resolution records. Here we report first millennial resolution quantified East Asian summer monsoon (EASM) precipitation record from the north eastern Tibetan Plateau. The record supports astronomical forcing of EASM during the late Miocene, except for the period of 8.13–8.03 Ma when EASM experienced high amplitude variations at the 100‐, 20‐kyr, and suborbital bands, which is in sharp contrast with the damped astronomical forcing. Detection of strong 100‐kyr and millennial cycles during low eccentricity intervals of the warm late Miocene with ephemeral NH ice sheets cast doubt on NH ice sheet size variations as their exclusive forcing in the late Miocene and late Quaternary paleoclimatic records. Plain Language Summary: Millennial and 100‐kyr cycles in paleoclimate records are normally attributed to Northern Hemisphere ice sheet size variations. Here we present the first 1‐kyr resolution quantitative East Asian summer monsoon precipitation record from the northeastern Tibetan Plateau during the late Miocene, when Northern Hemisphere ice sheets were ephemeral. The record demonstrates strong 100‐kyr and clear millennial cycles. Detection of 100‐kyr and millennial cycles in this warm time interval cast doubt on Northern Hemisphere ice sheet size variations as their exclusive forcing in paleoclimatic records. Key Points: First 1‐kyr resolution quantitative northern China precipitation record during the late MioceneThe record reveals strong 100‐kyr and clear millennial cyclesDetection of 100‐kyr and millennial cycles in this warm interval challenges Northern Hemisphere (NH) ice sheet size variations as their exclusive forcing [ABSTRACT FROM AUTHOR]

This study analyzed the in vitro drug sensitivity of Cryptococcus spp. from Guangxi, Southern China. One hundred three strains of Cryptococcus were recovered from 86 patients; 14 were HIV positive and 72 were HIV negative. Ninety-two strains were identified as Cryptococcus neoformans var. grubii , while 11 strains were identified as Cryptococcus gattii (5 C. gattii sensu stricto and 6 Cryptococcus deuterogattii). The recovered strains were tested against commonly used antifungal drugs (fluconazole, amphotericin B, 5-fluorocytosine, itraconazole, and voriconazole) and to novel antifungal drugs (posaconazole and isavuconazole) using CLSI M27-A4 method. The results showed that all isolates were susceptible to most antifungal drugs, of which the minimum inhibitory concentration (MIC) ranges were as follows: 0.05–4 μg/ml for fluconazole, 0.25–1 μg/ml for amphotericin B; 0.0625–2 μg/ml for 5-fluorocytosine, 0.0625–0.25 μg/ml for itraconazole, 0.0078–0.25 μg/ml for voriconazole, 0.0313–0.5 μg/ml for posaconazole, 0.0020–0.125 μg/ml for isavuconazole for C. neoformans var. grubii isolates, and 1–16 μg/ml for fluconazole, 0.125–1 μg/ml for 5-fluorocytosine, 0.25–1 μg/ml for amphotericin B, 0.0625–0.25 μg/ml for itraconazole, 0.0156–0.125 μg/ml for voriconazole, 0.0156–0.25 μg/ml for posaconazole, and 0.0078–0.125 μg/ml for isavuconazole for C. gattii isolates. Furthermore, some C. neoformans var. grubii isolates were found to be susceptible-dose dependent to 5-fluorocytosine and itraconazole. In addition, a reduction in the potency of fluconazole against C. gattii is possible. We observed no statistical differences in susceptibility of C. neoformans var. grubii and C. gattii in the tested strains. Continuous observation of antifungal susceptibility of Cryptococcus isolates is recommended to monitor the emergence of resistant strains. [ABSTRACT FROM AUTHOR]

A Gram-staining negative, facultative anaerobic, motile and short rod-shaped bacterium, designated strain yh7-1T, was isolated from rhizosphere soil of Citrus sinenesis collected from the garden of Citrus sinenesis in Ailao Mountain, south-west China. Cells grew at 15–45 °C, pH 5.0–9.0 and were able to tolerate up to 1% (w/v) NaCl on R2A medium. The respiratory lipoquinone was Q-10 and the major cellular fatty acids contained summed feature 8 (C18:1 ω7c or C18:1 ω6c) and C18:0. Polar lipids in the cellular membrane were phosphatidylcholine, phosphatidylglycerol, phosphatidylethanolamine, two unidentified phospholipids and one unidentified aminophospholipid. The genomic DNA G+C content was 69.9 mol%. On basis of 16S rRNA gene sequence analysis, strain yh7-1T showed the highest similarities with Chthonobacter albigriseus KCTC 42450T (97.6%), Mongoliimonas terrestris KCTC 42635T (97.0%) and lower than 97.0% to other species. Phylogenetic trees based on 16S rRNA gene sequences indicated that strain yh7-1T clustered with C. albigriseus KCTC 42450T. The ANI values ranged between 78.1 and 82.7% for C. albigriseus KCTC 42450T, M. terrestris KCTC 42635T and strain yh7-1T, which were lower than the prokaryotic species delineation threshold of 95.0–96.0%. The digital DNA–DNA hybridization values between C. albigriseus KCTC 42450T, M. terrestris KCTC 42635T and strain yh7-1T indicated that the new isolate represents a novel genomic species. According to the phenotypic and genotypic characteristics, strain yh7-1T should belong to the genus Chthonobacter, for which the name Chthonobacter rhizosphaerae sp. nov. (type strain yh7-1T = CGMCC 1.17236T = CCTCC AB 2019258T = KCTC 82185T) is proposed. [ABSTRACT FROM AUTHOR]

Background: Genome-wide association studies (GWASs) have identified some immune-related single-nucleotide polymorphisms (SNPs) to be associated with leprosy. Methods: This study investigated the association of 17 SNPs based on previously published GWAS studies with susceptibility to leprosy, different polar forms and immune states of leprosy in a case–control study from southwestern China, including 1344 leprosy patients and 2732 household contacts (HHCs) (1908 relatives and 824 genetically unrelated contact individuals). The differences of allele distributions were analyzed using chi-squared analysis and logistic regression. Results: After adjusting covariate factors, rs780668 and rs3764147 polymorphisms influenced susceptibilities to genetically related or unrelated leprosy contact individuals. rs142179458 was associated with onset early cases, rs73058713 A allele and rs3764147 A allele increased the risk of reversal reaction, while rs3764147 G allele had higher risk to present lepromatous leprosy and erythema nodosum leprosum. Conclusion: Our results demonstrated that genetic variants in the LACC1, HIF1A, SLC29A3 and CDH18 genes were positively correlated with the occurrence of leprosy and leprosy clinical phenotypes, providing new insights into the immunogenetics of the disease. [ABSTRACT FROM AUTHOR]

The traditional paleoclimatological view suggests that monsoonal China was overall wetter when the East Asian summer monsoon (EASM) was strong. However, this view is at odds with the understanding of modern climate, which demonstrates an analogous "tripole precipitation pattern" in monsoonal China. Little is known about the spatial pattern of paleo‐precipitation in monsoonal China, particularly during the past glacial‐interglacial cycles. Here, we provide evidence for a potential tripole precipitation pattern in monsoonal China over the past 425 ka using climate modeling, and compare the results with paleoclimate records available from China. Our simulations illustrate that more (less) precipitation in North China and South China, and less (more) precipitation in the Central‐East China during strong (weak) EASM periods associated with high (low) boreal summer insolation. Our results agree with the present understanding of modern East Asian climate, and furthermore confirm that the boreal summer insolation is the dominant forcing for the intensity of EASM and the response of subtropical high pressures is fundamental in modulating the precipitation pattern in monsoonal China on orbital timescales. This temporal and spatial variability of precipitation, as revealed in our simulations, shows the potential high complexities in hydroclimatic conditions in monsoonal China throughout the past glacial‐interglacial cycles. Nevertheless, whether the tripole precipitation pattern in monsoonal China over the past 425 ka is robust enough still should be tested, preferable by taking advantage of existing and new well‐dated and explicit indicative precipitation archives in Central‐East China. Key Points: Our simulations suggest that the tripolar precipitation pattern in monsoonal China likely occurs on orbital timescalesThe boreal summer insolation is the dominant forcing for the intensity of East Asian summer monsoon on orbital time scalesThis study emphasizes the high complexities in hydroclimatic conditions in monsoonal China throughout the past glacial‐interglacial cycles [ABSTRACT FROM AUTHOR]

BACKGROUND The efficacy and safety of proprotein convertase subtilisin/kexin type 9 (PCSK-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not been evaluated. This study aims to describe the real world effectiveness of PCSK-9 inhibitors combined with statins compared with statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease (ASCVD). METHODS This is a multi-center observational study, enrolled patients from 32 hospitals who underwent percutaneous coronary intervention (PCI) from January to June in 2019. There are 453 patients treated with PCSK-9 inhibitors combined with statins in PCSK-9 inhibitor group and 2,610 patients treated with statins-based lipid lowering therapies in statins-based group. The lipid control rate and incidence of major adverse cardiovascular events (MACE) over six months were compared between two groups. A propensity score-matched (PSM) analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for MACE. RESULTS In a total of 3,063 patients, 89.91% of patients had received moderate or high-intensity statins-based therapy before PCI, but only 9.47% of patients had low-density lipoprotein cholesterol (LDL-C) levels below 1.4 mmol/L at baseline. In the PSM selected patients, LDL-C level was reduced by 42.57% in PCSK-9 inhibitor group and 30.81% (P < 0.001) in statins-based group after six months. The proportion of LDL-C = 1.0 mmol/L increased from 5.29% to 29.26% in PCSK-9 inhibitor group and 0.23% to 6.11% in statins-based group, and the proportion of LDL-C = 1.4 mmol/L increased from 10.36% to 47.69% in PCSK-9 inhibitor group and 2.99% to 18.43% in statins-based group (P < 0.001 for both). There was no significant difference between PCSK-9 inhibitor and statins-based treatment in reducing the risk of MACE (hazard ratio = 2.52, 95% CI: 0.49-12.97, P = 0.250). CONCLUSIONS In the real world, PCSK-9 inhibitors combined with statins could significantly reduce LDL-C levels among patients with very high risk of ASCVD in China. The long-term clinical benefits for patients received PCSK-9 inhibitor to reduce the risk of MACE is still unclear and requires further study. [ABSTRACT FROM AUTHOR]

Technological advances have the potential to balance climate change mitigation and economic development. However, it remains unclear how much technological advances alone can mitigate climate change and the associated economic losses in the future. Through designing a suite of technological advances scenarios and using an earth system model with an integrated assessment model, we illustrate that rapid technological progress without production control might achieve the 2°C global warming target in the 2100s. Relative to a world of stagnant technology, the frequency (intensity) of extreme warm events at the end of the 21st century (2081–2100) would be reduced by ∼21% (5.5°C) via rapid technological advances, with a reduction in extreme precipitation (droughts) by ∼41% (10 times). Furthermore, fast technological advances may reduce the global economic losses linked with climate change at 2081–2100 by ∼21% and those in China related to floods (droughts) by 86% (67%). Our results highlight the potential of technological advances to fill the emission gap between the Paris Agreement and unconditional Nationally Determined Contributions and hence to efficiently mitigate global warming. [ABSTRACT FROM AUTHOR]

Place attachment has been a research focus in the fields of park and recreation management. Place attachment plays an important role in promoting sustainable development of parks and mountain tourism destination, however, there are limited studies that identified the spatial patterns of place attachment, especially in the context of mountain tourism destinations in China. Also, the geospatial spectrum of visitors is usually broad, examining the multivariate relationships among spatial proximity, perceived authenticity, and place attachment are essential for mountain tourism destinations to promote destination image and strengthen emotional bonding with targeted visitor groups. In this study, we selected an iconic and highly visited park, Jiuzhai Valley National Park in China, as our study site and conducted an on-site visitor survey to collect 557 samples. Study uses factor analysis and the structure equation model to analyze the relationship among spatial proximity, perceived authenticity, and place attachment. Results validate the two-dimension structure of place attachment and perceived authenticity. Study findings suggest that spatial proximity has significant impacts on existential authenticity and place identity, but has no significant impacts on place dependence. Perceived authenticity has a positive impact on place attachment. Study results advance the theories of place attachment and provide effective strategies to enhance emotional attachment between visitors and mountain tourism destinations. [ABSTRACT FROM AUTHOR]

Introduction. To identify and analyze factors that influence administration, recognition, and compliance of medicine among community residents in Jilin Province, China. Methods. A survey was carried out among 2417 community residents in Jilin Province, China, to study their administration (CRA), recognition (CRR), and compliance (CRC) of medicine. Multivariate logistic regression analyses and chi-squared tests were performed to assess factors influencing CRA, CRR, and CRC. Results. Logistic analyses showed that gender, educational level, and occupation were influencing factors on CRA; age, educational level, smoking status, and health condition were influencing factors on CRR; and gender, age, occupation, and health condition were influencing factors on CRC. Conclusions. CRA, CRR, and CRC are associated with specific lifestyles and social economic statuses of community residents. Attention should be paid to influencing factors in order to facilitate community pharmaceutical care, promote the rational use of drugs, and ensure the safe use of medications. This study explores the type and extent of professional services provided through community pharmacies in Jilin Province, China, and provides evidence for optimizing the quality of community pharmacy services. [ABSTRACT FROM AUTHOR]

Background: Species-specific advertisement calls are the main mechanism of transmitting information between individuals in anuran amphibians and are therefore indispensable for anuran survival and reproduction. Survey methods that monitor these calls can be used for rapid species recognition, behavioral experiments, and conservation monitoring. In this study, we described in detail 10 call parameters from three sympatric species in the genus Microhyla and analyzed the differences in call parameter among these species to provide a basis for systematic monitoring, acoustic analysis and taxonomic study of this genus. Methods: The quantitative analyses of temporal and spectral call parameters were used in our study for the advertisement calls of three sympatric Microhyla species (M. beilunensis, M. fissipes and M. heymonsi) in Zhejiang Province, East China. Results: Our results showed the following: (1) Significant differences existed among the three sympatric Microhyla species in call duration (CD), call interval (CI), number of pulses (NP), pulse rate, call intensity (CIT), dominant frequency (DF) and frequency of the first to fourth formants (F1, F2, F3 and F4). (2) Some spectral parameters (DF, F1 and F3) were negatively correlated with the body size of the vocalizing individuals in each species. (3) The coefficients of variation within individuals (CVw) for CIT, DF and F1-F4 were smaller than 5%, whereas the CVW for CI was larger than 10% in each species. (4) The principal component analysis and discriminant function analysis showed that call parameters could distinguish the three Microhyla species. (5) The phylogenetic generalized least squares analysis showed that phylogenetic relationships affected CD and NP against snout-vent length (SVL), DF and NP against CD, and NP against DF, but not of DF against SVL; based on the phylogenetic analysis, CD and NP were not related to SVL, but DF was negatively related to SVL. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to evaluate the significance of transperineal two-dimensional ultrasound in the diagnosis and classification of female stress urinary incontinence (SUI).Methods: A total of 87 preoperative SUI patients (group A) from the Department of Gynecology of Peking University People's Hospital were included into this study. These patients were further divided into two groups (groups A1 and A2) according to the severity of their disease. In addition, during the same period, 72 age-matched women without SUI were enrolled into this study and assigned as the control group (group B). Through transperineal two-dimensional ultrasound technique, detrusor wall thickness (DWT) was measured in the resting state, the bladder neck descent (BND) was measured under the maximal valsalva maneuver, the proximal urethral rotation angle (α angle) and posterior vesicourethral angle (β angle) were measured, and the formation of the funnel-shaped urethra was observed.Results: Under the resting state, differences in DWT between groups A and B, as well as between groups A1 and A2, were not statistically significant (P> 0.05). The BND, α and β angles were significantly larger in group A than in group B under the maximal Valsalva maneuver; and the differences were statistically significant (P< 0.05). The formation rate of the funnel-shaped urethra was significantly higher in group A (94%) than in group B (3%), and the difference was statistically significant; while the difference between groups A1 and A2 was not statistically significant (P> 0.05).Conclusion: Transperineal two-dimensional ultrasound can play an assistant role in the diagnosis of female SUI. However, its role in the assessment of the severity of SUI remains to be studied. [ABSTRACT FROM AUTHOR]

Talaromyces marneffei is a common cause of infection in immunocompromised patients in Southeast Asia and Southern China. The pathogenicity of T. marneffei depends on the ability of the fungus to survive the cytotoxic processes of the host immune system and grow inside host macrophages. These mechanisms that allow T. marneffei to survive macrophage-induced death are poorly understood. In this study, we examined the role of a calcineurin homolog (cnaA) from T. marneffei during growth, morphogenesis and infection. Deletion of the cnaA gene in T. marneffei resulted in a strain with significant defects in conidiation, germination, morphogenesis, cell wall integrity, and resistance to various stressors. The Δ cnaA mutant showed a lower minimal inhibitory concentration (MIC) against caspofungin (16 μg/ml to 2 μg/ml) and micafungin (from 32 μg/ml to 4 μg/ml) compared with the wild-type. These results suggest that targeting calcineurin in combination with echinocandin treatment may be effective for life-threatening systemic T. marneffei infection. Importantly, the cnaA mutant was incapable of adapting to the macrophage environment in vitro and displayed virulence defects in a mouse model of invasive talaromycosis. For the first time, a role has been shown for cnaA in the morphology and pathogenicity of a dimorphic pathogenic filamentous fungus. [ABSTRACT FROM AUTHOR]

A new species of the genus Megophrys from Zhejiang Province, China is described. Molecular phylogenetic analyses supported the new taxon as an independent clade nested into the Megophrys clade and sister to M. lishuiensis. The new species could be distinguished from its congeners by a combination of the following morphological characteristics: (1) small size (SVL 31.0-36.3 mm in male and 41.6 mm in female); (2) vomerine ridge present and vomerine teeth absent; (3) tongue not notched behind; (4) a small horn-like tubercle at the edge of each upper eyelid; (5) tympanum distinctly visible, rounded; (6) two metacarpal tubercles in hand; (7) relative finger lengths: II < I < IV < III; (8) toes with rudimentary webbing at bases; (9) heels overlapping when thighs are positioned at right angles to the body; (10) tibiotarsal articulation reaching tympanum to eye when leg stretched forward; (11) an internal single subgular vocal sac in male; (12) in breeding male, the nuptial pads with black nuptial spines on the dorsal bases of the first and second fingers. [ABSTRACT FROM AUTHOR]

A new benzylated alkamide, N-(3,4-dimethoxybenzyl)-9Z-oleamide (1), along with two known ones (2 and 3) were isolated from the roots of Lepidium meyenii collected from Lijiang, Yunnan Province of China. Their structures were elucidated by extensive spectroscopic analyses and the new compound further confirmed by a one-step synthesis. All the isolated alkamides were evaluated for their cytotoxicity against five human cancer cell lines. However, no significant activities were detected at concentrations up to 40 μM. [ABSTRACT FROM AUTHOR]

Improving the deployment and penetration of renewable energy is considered to be the fundamental way to solve environmental problems, but whether higher penetration of renewable energy means higher energy efficiency remains to be empirically tested. To reveal the relationship between cleanliness and efficiency in the energy sector, this paper first uses the three-stage data envelopment analysis (DEA)method to measure the total factor energy efficiency (TFEE) of 30 provinces in China, and then applies static and dynamic panel threshold regression (PTR)models to estimate the nonlinear effect of renewable energy share on TFEE. The results show that renewable energy is usually beneficial for improving TFEE, but there are prominent heterogeneity and nonlinear characteristics in net electricity exporting and net electricity importing provinces. Renewable energy in low rather than high regimes can significantly improve energy efficiency, indicating that provinces with lower levels of economic development and energy consumption receive higher marginal energy efficiency and are more likely to achieve sustainable development goals. More renewable energy quotas should be given to economically developed and high energy consuming provinces, and comprehensive energy efficiency guarantees and improvement measures must be provided to achieve optimal emission mitigation. [ABSTRACT FROM AUTHOR]

Understanding the role of the Pacific Decadal Oscillation (PDO) during the Last Interglacial (LIG, ∼127 ka) may advance our knowledge on decadal climate variability in a warmer world. In this study, we investigate the PDO–precipitation relationship over eastern China during the LIG based on the NorESM2-LM, which shows the best performance in capturing the observed PDO pattern and the PDO–precipitation relationship among 12 models from the Paleoclimate Modelling Intercomparison Project Phase 4. Composite analysis shows that summer precipitation during the LIG is generally increased over eastern China in the positive PDO phases relative to the negative phases, which is different from the "drier-wetter-drier" triple pattern in the present day. The discrepant precipitation patterns between the LIG and preindustrial are caused by different responses of composite atmospheric circulations. Moreover, moisture budget analysis indicates that variations of vertical velocity over eastern China largely explain the PDO-linked precipitation patterns during both LIG and preindustrial, although the main causes for vertical motion changes are different across regions and periods based on the quasi-geostrophic ω equation. Additionally, these discrepancies in composite atmospheric circulations are largely linked to differences in PDO patterns and mean climate states between the LIG and preindustrial. Our results suggest a varying relationship between the PDO and precipitation over eastern China in a warmer-than-present world induced by Earth's orbit, which have important implications for PDO reconstructions during the LIG via the PDO-precipitation relationship reported here and shed light on decadal variability of precipitation as well as the associated decadal predictions in a future warmer world. • Divergent response of eastern China precipitation to PDO during the LIG. • Discrepant composite atmospheric circulations cause varied precipitation patterns. • PDO pattern/mean climate state regulate varied precipitation during the LIG jointly. [ABSTRACT FROM AUTHOR]