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Background: Accurately stratifying patients with pulmonary arterial hypertension (PAH) is very important, and traditional risk scores still have internal heterogeneity. This study aimed to construct a risk stratification model that can accurately identify clinical worsening (CW) events in conventional low‐intermediate risk patients with pulmonary hypertension under targeted drug treatment by using echocardiographic parameters. Methods: This study is a single‐center, prospective study, including 105 PAH patients who underwent regular follow‐up at Guangdong Provincial People's Hospital from October 2021 to April 2023. The primary endpoint was the occurrence of CW, including death, hospitalization due to pulmonary hypertension, escalation of targeted drug therapy, and worsening of PAH. The predictive value of the echocardiography‐based three‐strata risk model was assessed using Kaplan‐Meier curves and COX regression analysis. Results: A total of 98 PAH patients were ultimately included in this study. The median follow‐up duration was 26 months (range 7–28 months). The echocardiography‐based three‐strata model included the ratio of tricuspid annular plane systolic excursion and pulmonary artery systolic pressure (TAPSE/PASP) and inferior vena cava (IVC). The echocardiography‐based three‐strata model had higher diagnostic value (C‐index =.76) compared to the 2022 ESC/ERS three‐strata model and four‐strata model (C‐index =.66 and C‐index =.61, respectively). PAH patients with lower TAPSE/PASP and wider IVC showed a higher CW rate compared to patients with higher TAPSE/PASP and normal IVC (HR = 15.1, 95%CI:4.4‐51.9, p <.001). Conclusion: The echocardiography‐based three‐strata model based on TAPSE/PASP and IVC can effectively improve the stratification of low‐intermediate risk PAH patients under targeted treatment. [ABSTRACT FROM AUTHOR]

A Gram-stain-positive, rod-shaped, facultatively anaerobic, motile and spore-forming bacterium with multiple flagella designated GXH0341T was isolated from the soil associated with decayed pine tree samples collected from Weizhou Island, Beihai, Guangxi, China. Growth occurred at 4–37 °C (optimum 30 °C), at pH 5.0–11.0 (optimum 8.0) and in the presence of 0–7% (w/v) NaCl (optimum 2%). Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain GXH0341T was most closely related to Bacillus mesophilus DSM 101000 T (98.9%), followed by Bacillus salitolerans KC1T (96.95%) and Margalitia shackletonii DSM 18435 T (96.67%). Phylogenetic analysis revealed that strain GXH0341T represented a separate lineage within the genus Bacillus. Peroxidase is positive. The predominant quinone was MK-7 and the cell-wall diagnostic diamino acid was meso-diaminopimelic acid. The predominant polar lipids are diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine, and two unidentified phospholipids. The major fatty acids are iso-C14:0, iso-C15:0, anteiso-C15:0 and iso-C16:0. The genome of GXH0341T comprises the biosynthetic gene cluster for T3PKS, terpene, lassopeptide and RRE-containing element as secondary metabolites. The average nucleotide identity values and the digital DNA-DNA hybridization values between GXH0341T and B. mesophilus DSM 101000 T were 78.22% and 21.00%, respectively, which were in the range of the recommended level for interspecies identity. The results of phenotypic, chemotaxonomic and genotypic analyses clearly indicated strain GXH0341T represents a novel species of the genus Bacillus, for which the name Bacillus pinisoli sp. nov. is proposed. The type strain is GXH0341T (= MCCC 1K07157T = JCM 35212 T). [ABSTRACT FROM AUTHOR]

In the context of depletion of fossil energy and environmental impacts of its use, society has begun to develop vigorously renewable energy (RE). As a result, concerns about the availability of critical minerals used in RE systems have been raised. This paper uses a generalized Weng model to analyze the long-term production of critical minerals for China's RE development. In our pessimistic case, the results show that the production of most of the minerals investigated for China will peak before 2030, with a relatively high decline rate thereafter. This is an unsustainable situation for China's RE development unless large and growing quantities of these minerals can be imported. In our optimistic case, although this delays the peak date only slightly, it significantly increases the maximum production rate and lowers the subsequent decline rate. The impacts of many other factors on production, and the implications of China's domestic minerals production on world's minerals supply chain, are also analyzed. We conclude that both China and the world should pay close attention to the potential supply risks to critical minerals. Possible measures in response are suggested for both China and the world. [ABSTRACT FROM AUTHOR]

Background: Learning engagement is a crucial predictor of academic achievement. It is essential to understand the factors influencing learning engagement among nursing students, especially from the learner's perspective, which is notably scarce but vital for designing effective educational interventions., Objectives: This study aims to investigate the mediating effect of self-efficacy on the relationship between professional identity and learning engagement for nursing students in higher vocational colleges., Design: A cross-sectional electronic survey was conducted., Setting: The study was conducted in four higher vocational colleges located in Guangdong Province, China., Participants: A total of 944 first- and second-year nursing students participated in the study between October and November 2022., Methods: Data were collected with questionnaires on general information, professional identity, self-efficacy, and learning engagement and analyzed with SPSS 26.0 and PROCESS v4.1 (Model 4), exploring relationships among professional identity, self-efficacy, and learning engagement through Pearson correlations, multivariate regression, and mediation analysis with 5000 bootstrap samples., Results: The participants exhibited moderate levels of professional identity (85.37 ± 13.52), self-efficacy (25.58 ± 5.74), and learning engagement (71.26 ± 16.17), which were all significantly correlated with each other (P < 0.01). In the model of the mediating effect, professional identity directly (β = 0.811, t = 27.484, P < 0.001) and indirectly [β = 0.112,95%CI (0.074-0.154)] significantly predicts college students' learning engagement; professional identity has a significant positive predictive effect on self-efficacy (β = 0.182, t = 14.459, P < 0.001) and self-efficacy significantly predicts learning engagement (β = 0.614, t = 8.292, P < 0.001). Furthermore, the direct effect of professional identity on learning engagement (0.699) and its mediating effect (0.112) account for 86.19 % and 13.81 % of the total effect (0.811), respectively., Conclusion: Participants exhibited moderate levels of professional identity, self-efficacy, and learning engagement. Professional identity and self-efficacy are interconnected and positively correlated, influencing learning engagement among nursing students, which highlights the need to foster these qualities to enhance education and future practice., Competing Interests: Declaration of competing interest No conflicts of interest have been declared by the authors., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

A Gram-stain-positive, rod-shaped, facultatively anaerobic, motile and spore-forming bacterium with multiple flagella designated GXH0341 T was isolated from the soil associated with decayed pine tree samples collected from Weizhou Island, Beihai, Guangxi, China. Growth occurred at 4-37 °C (optimum 30 °C), at pH 5.0-11.0 (optimum 8.0) and in the presence of 0-7% (w/v) NaCl (optimum 2%). Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain GXH0341 T was most closely related to Bacillus mesophilus DSM 101000  T (98.9%), followed by Bacillus salitolerans KC1 T (96.95%) and Margalitia shackletonii DSM 18435  T (96.67%). Phylogenetic analysis revealed that strain GXH0341 T represented a separate lineage within the genus Bacillus. Peroxidase is positive. The predominant quinone was MK-7 and the cell-wall diagnostic diamino acid was meso-diaminopimelic acid. The predominant polar lipids are diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine, and two unidentified phospholipids. The major fatty acids are iso-C 14:0 , iso-C 15:0 , anteiso-C 15:0 and iso-C 16:0 . The genome of GXH0341 T comprises the biosynthetic gene cluster for T3PKS, terpene, lassopeptide and RRE-containing element as secondary metabolites. The average nucleotide identity values and the digital DNA-DNA hybridization values between GXH0341 T and B. mesophilus DSM 101000  T were 78.22% and 21.00%, respectively, which were in the range of the recommended level for interspecies identity. The results of phenotypic, chemotaxonomic and genotypic analyses clearly indicated strain GXH0341 T represents a novel species of the genus Bacillus, for which the name Bacillus pinisoli sp. nov. is proposed. The type strain is GXH0341 T (= MCCC 1K07157 T  = JCM 35212  T )., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In this study, we isolated a novel Gram-stain-positive, aerobic, motile, rod-shaped bacterium, named GX 13764 T , from the rhizosphere soil of a decayed mangrove plant Kandelia candel collected from Beihai, Guangxi, PR China, and characterized using a polyphasic taxonomic approach. The strain exhibited yellow-orange, round, convex, shiny, smooth, opaque and 2-3 mm diameter colonies on marine agar 2216 media after 3 days of incubation at 30 °C and was capable of growth at 4-45 °C (optimum, 30 °C), pH 5.0-9.0 (optimum, pH 7.0) and 0-4 % NaCl (w/v; optimum, 2 %). The strain was positive for catalase and negative for the oxidase. The main cellular fatty acid was anteiso-C 15:0 , iso-C 15:0 , iso-C 16:0 and iso-C 14:0 . The cell-wall peptidoglycan comprised meso -diaminopimelic acid and the main menaquinone was MK-7. The polar lipids included one diphosphatidylglycerol, one phosphatidylglycerol, two glycolipids, two unidentified phospholipids and three unidentified lipids. Based on 16S rRNA gene analysis, GX 13764 T presented the highest sequence similarity to Metabacillus mangrovi KCTC 33872 T (97.04 %). The DNA G+C content of the type strain was 44.2 mol%. The average nucleotide identity values between GX 13764 T and M. mangrovi KCTC 33872 T , Metabacillus idriensis DSM 19097 T and Metabacillus indicus LMG 22858 T were 69.39, 68.87 and 68.95 %, respectively, with digital DNA-DNA hybridization values of 19.9, 19.5 and 19.5 %, respectively. Based on the polyphasic data, strain GX 13764 T should be nominated as a novel species of the genus Metabacillus , for which the name Metabacillus kandeliae sp. nov. is proposed. The type strain is GX 13764 T (=MCCC 1K06654 T =KCTC 43366 T ).

A novel bacterium of the genus Pontibacter, designated GY10130 T , was isolated from rhizosphere soil of a mangrove plant Rhizophora stylosa collected from Guangxi province, China. Strain GY10130 T was Gram-stain negative, positive for oxidase activities, aerobic, short rod-shaped cells without flagella. Growth was observed at 10-40 °C (optimum, 28 °C), pH 6.0-9.0 (optimum, 7.0) and NaCl concentrations of 0-4% (optimum, 1%). Strain GY10130 T is closely related to members of the genus Pontibacter, namely P. beigongshangensis CGMCC 1.17104 T (97.8%) and P. amylolyticus CGMCC 1.12749 T (95.0%), P. humi SWU8 T (94.7%), and less than 94.0% with other currently described type strains of Pontibacter. The strain GY10130 T showed an ANI value of 80.6% and dDDH value of 23.2% with P. beigongshangensis CGMCC 1.17104 T , followed by P. amylolyticus CGMCC 1.12749 T with ANI and dDDH values of 72.9 and 13.8%, respectively. Strain GY10130 T contains carotenoid-like pigments, but flexirubin-type pigments were absent. The cellular fatty acids (> 10%) consist of summed feature 4 (17:1 iso I/anteiso B) and iso-C 15:0 . The predominant menaquinone is MK-7. The polar lipids comprise phosphatidylethanolamine, two unidentified glycolipids, two unidentified aminolipids and six unidentified phospholipids. The genome length of strain GY10130 T was 6.2 Mbp with a DNA G + C content of 47.1 mol% and 4727 protein-coding genes. The result of polyphasic taxonomic study show strain GY10130 T represents one novel species of Pontibacter, Pontibacter qinzhouensis sp. nov., with the type strain GY10130 T (=NBRC 113901 T   = CGMCC 1.16772 T )., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

A novel Gram-stain positive, facultatively anaerobic, motile, irregularly rod-shaped bacterium, designated GY 10621 T , was isolated from rhizosphere soil of Spartina alterniflora in Beihai City, Guangxi Province, PR China, and characterized using a polyphasic taxonomic approach. GY 10621 T was positive for catalase and oxidase. Growth occurred at 4-42 °C (optimum 30-37 °C), at pH 5.0-9.0 (optimum pH 7.0) and in the presence of 0-5% NaCl (w/v) (optimum 1-3%). The main menaquinones were MK-9 (H 4 ) (92.2 %) and MK-10 (7.8 %). The major cellular fatty acids were anteiso-C 15 : 0 and C 14 : 0 . The peptidoglycan was the type A4α (l-Lys-Ser-d-Glu). The polar lipids included four phosphoglycolipids, four glycolipids, an unidentified lipid and six unidentified phospholipids. The DNA G+C content of the type strain was 71.7 mol%. On the basis of the results of 16S rRNA gene analysis, the type strain of a species with a validly published name with the highest similarity to GY 10621 T was Flavimobilis soli KCTC 13155 T (97.16 %), followed by Sanguibacter suarezii NBRC 16159 T (96.39 %). The calculated results indicated that compared with GY 10621 T , the average nucleotide identity (ANI) values of three strains closely related to GY 10621 T (the two aforementioned type strains and ' S. massiliensis ' Marseille-P3815) were 74.18-94.97 %, and the digital DNA-DNA hybridization (dDDH) values were 20.3-60.6 %. The results of 16S rRNA-based and genome-based phylogenetic tree analysis indicated that GY 10621 T should be assigned to the genus Flavimobilis . On the basis of evidence from polyphasic studies, GY 10621 T should be designated as representing a novel species of the genus Flavimobilis , for which the name Flavimobilis rhizosphaerae sp. nov. is proposed. The type strain is GY 10621 T (=CGMCC 1.17411 T =KCTC 49515 T ).

Background: Ventilator-associated pneumonia (VAP) is a severe complication that occurs within patients who must use ventilators in the intensive care unit (ICU). Ventilator care bundles (VCB) have been applied across many developed regions and have produced positive results in controlling VAP. In this study, we report on the implementation and effects of using VCBs to manage VAP in a general tertiary hospital in the Inner Mongolia Autonomous Region of China., Methods: A targeted surveillance method was used to survey all the patients (n=4,716) in the ICU from June 1, 2017 to May 31, 2019. Patients from June 1, 2017 to May 31, 2018, and June 1, 2018, to May 31, 2019, were respectively divided into 2 groups: the control group (2,029 patients) and intervention group (2,687 patients). These dates were selected because VCB was implemented from June 1, 2018, in our institution. The variables that were associated with VCB and observed were the head-of-bed elevation, oral care, maintenance of the pressure for the cuff of the endotracheal tube, aspiration of subglottic secretion, daily sedation vacation protocol, daily extubation assessment results, and hand hygiene. After collecting the data, the compliance of VCB, ventilator use ratio, and the incidence rate of VAP in these 2 groups were compared., Results: We observed that compliance with all of the intervention measures for VCB improved results in the intervention group compared to the control. Furthermore, the compliance rate of hand hygiene increased from 71.99% to 91.97%, and the head-of-bed elevation of 30°-45° increased from 62.02% to 85.96%. All differences between these two groups were statistically significant, according to the χ 2 -test. The ventilator use ratio was statistically and significantly lower in the intervention group (34.86%) compared to the control group (40.29%) (χ 2 =95.513, P<0.001). The incidence rate of VAP was statistically and significantly lower in the intervention group (13.70‰) compared to the control group (18.85‰) (χ 2 =5.471, P=0.019)., Conclusions: Our results show that VCB prevents VAP. Therefore, personnel training, clinical supervision, and surveillance feedback could promote a reduction in intervention measures.

Background: The objective of this study was to understand the distribution and drug resistance of healthcare-associated infection (HAI) pathogens in an intensive care unit (ICU) of a general tertiary hospital in Inner Mongolia, and to classify carbapenem-resistant Acinetobacter baumannii (CR-AB) in ICU patients and environmental samples. Additionally, this study aimed to provide scientific evidence for the use of clinical antibiotics and effective prevention and control measures for CR-AB outbreak., Methods: The distribution and drug resistance of pathogens isolated from patient's samples in the ICU of 12 Hospitals from January to May 2019 were retrospectively analyzed. Meanwhile, CR-AB isolated from patients and environmental samples were collected and classified by pulsed-field gel electrophoresis (PFGE)., Results: The pathogens isolated from ICU samples, mainly Gram-negative bacteria (63.07%), were CR-AB, Klebsiella pneumoniae, and Pseudomonas aeruginosa; the main Gram-positive bacteria (22.13%) were Enterococcus faecium and Staphylococcus aureus; and fungi accounted for the remaining (14.80%). The samples mainly came from sputum (41.09%). Among non-fermenting bacteria, the resistance rates of CRAB to piperacillin, piperacillin/tazobactam, and other treatments were higher than those of Pseudomonas aeruginosa (P<0.05). Meanwhile, the resistance rates to ampicillin/sulbactam and compound sulfamethoxazole were lower than those of Pseudomonas aeruginosa (P<0.05). The resistance rates of Klebsiella pneumoniae to piperacillin/tazobactam, ceftazidime, and others were higher than those of Escherichia coli (P<0.05). Among Gram-positive bacteria, the resistance rates of Enterococcus faecium to erythromycin, clindamycin, and other treatment were higher than those of Staphylococcus aureus (P<0.05). A total of 62 bands were obtained from 63 strains of CR-AB by electrophoresis. Also, 16 clusters (A-P) were obtained with a 74% similarity coefficient, among which K, L, and N types (more than 9 strains) were more common., Conclusions: Gram-negative bacteria were the primary pathogens of HAI in the ICU, and their drug resistance was serious. There is homology in the PFGE typing of CR-AB. Therefore, hospitals should strengthen the surveillance of drug-resistant pathogenic bacteria. Additionally, further cleaning and disinfection measures are needed to improve environmental hygiene and prevent outbreaks of HAI.

Background: Healthcare-associated infection (HAI) is a crucial factor influencing medical quality. Studies about HAI management situations are rare, especially for the Inner Mongolia region of China. Therefore, this study aimed to investigate management procedures and the overall evaluation of HAI in order to inform HAI management improvement more scientifically., Methods: A questionnaire was used to investigate HAI-related prevention and control indicators in tertiary hospitals in the Inner Mongolia region from July 2018 to June 2019., Results: The survey showed that the mean incidence rate of HAI was 3.79%. The mean rate of hand hygiene compliance of healthcare workers (HCWs), inpatient's antibiotics-use rate, and the detection of the antibiotic ratio before therapy was 54.34%, 34.33%, and 25.40%, respectively. The mean of the surgical site infection (SSI) rate of the level I incision and the preventive antibiotics-use ratio of the level I incision was 1.31% and 28.89%, respectively. The mean of the multi-drug resistant organism (MDRO) infection rate was 0.40% and the mean of the MDRO detection rate was 18.55%. The mean of the central line-associated bloodstream infection rate was 2.24%, the ventilator-associated pneumonia (VAP) rate was 11.17%, and the catheter-associated urinary tract infection (CAUTI) rate was 1.95‰. As for the overall evaluation, 19 (35.85%) hospitals had a bad grade, 18 (33.96%) hospitals had a medium grade, and 16 (30.19%) hospitals had a good grade., Conclusions: The incidence rate of HAI in tertiary hospitals in the Inner Mongolia region is higher than the national level. Also, the overall evaluation of bad-grade hospitals and their deficiencies should be used as an example to improve the HAI management level.

Foxtail millet (Setaria italica) is an important grain crop that is grown in arid regions. Here we sequenced 916 diverse foxtail millet varieties, identified 2.58 million SNPs and used 0.8 million common SNPs to construct a haplotype map of the foxtail millet genome. We classified the foxtail millet varieties into two divergent groups that are strongly correlated with early and late flowering times. We phenotyped the 916 varieties under five different environments and identified 512 loci associated with 47 agronomic traits by genome-wide association studies. We performed a de novo assembly of deeply sequenced genomes of a Setaria viridis accession (the wild progenitor of S. italica) and an S. italica variety and identified complex interspecies and intraspecies variants. We also identified 36 selective sweeps that seem to have occurred during modern breeding. This study provides fundamental resources for genetics research and genetic improvement in foxtail millet.

Cerebral infarction has become one of the leading diseases and a major mortality factor around the world. Atherosclerosis is recognized as one of the important causes of ischemic stroke. Recently, accumulating evidences have indicated that the anti-inflammatory and anti-apoptotic functions of the HSP70 family play an important role in cerebral ischemia. However, the association between HSP70 SNPs and ischemic stroke was also not well established. We chose 101 cases of cerebral ischemia and 100 healthy people from the Chinese Han population as our study subjects, and PCR-RFLP was employed to analyze HSP70 polymorphisms: HSP70-1+190G/C, HSP70-2+1267A/G and HSP70-hom+2437T/C. There were no significant differences in +1267A/G allele or genotype frequencies between patients with stroke and healthy controls. However, genotypes of +190CG and +2437TT were differentially distributed between the patients and controls. A significant difference of T allele distribution in the HSP70-hom+2437T/C site was observed. Logistic regression analysis indicated that genotypes of +190CG, +2437TT and T allele in HSP70-hom were risk factors of ischemic stroke. Moreover, the study has formulated that the interactions between hypertension and +190CG or +2437TT may increase the risks of ischemic stroke. The results from this study have suggested a clinical indicator for assessing the possibilities of cerebral stroke, and supply basis to clinicians to give precaution to people who are at risk of stroke., (Copyright © 2012 Elsevier B.V. All rights reserved.)