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The aim Methods Results Conclusion To explore and describe workplace stress levels and health‐promoting behaviours reported by emergency nurses in China, and to investigate factors associated with workplace stress and health‐promoting lifestyle behaviours among emergency nurses.A cross‐sectional study was conducted between October 2019 and January 2020. Nurses (n = 1565) were recruited from the emergency departments of 54 hospitals within the Sichuan Province of West China. Each subject completed the Chinese versions of the Nurse Workplace Stress Scale, the Health‐Promoting Lifestyle Profile (HPLP‐II) and demographic questions. Linear regression analyses were used to identify associations between workplace stress and the health‐promoting lifestyle and risk factors correlated with these two measurements.Workplace stress was negatively associated with health‐promoting behaviours. Linear regression analysis showed that gender, marital status, whether wages met expected standards and professional rank were found to be associated with health promotion behaviours; marital status, whether income met expected standards, the number of night shifts per month and health promotion behaviours were found to be associated with workplace stress.Higher levels of workplace stress are associated with lower levels of engagement in health‐promoting behaviours, suggesting the potential for reducing workplace stress through the adoption of healthier habits. Policies should prioritize workplace stress by promoting healthy lifestyle initiatives. [ABSTRACT FROM AUTHOR]

Auricularia cornea is a widely prized basidiomycetous mushroom with culinary and medicine value, which is cultivated artificially on a large scale in China. However, little attention has been paid to the differences in metabolic profiles under different pH growth conditions. In the present study, weakly acidic and weakly alkaline artificial substrates were developed and used for the cultivation of A. cornea, and the metabolic profiles of its fruiting bodies were determined using ultra performance liquid chromatography-tandem mass spectrometry. The results show that the weakly alkaline substrate environment promoted mycelial growth, increased body surface area, and improved yield and transformation efficiency, but attenuated metabolite accumulation by A. cornea. A total of 412 different metabolites were identified in negative and positive ion mode, of which 99 had significantly different amounts and covered 51 metabolic pathways. Principal component analysis and orthogonal patrial least squares discriminant analysis showed clear separation between two treatments, indicating different metabolic profiles. The different metabolites mainly included seven chemical categories, including amino acids and derivatives, nucleotides and derivatives, phenolic acids, organic acids, lipids, flavonoids and alkaloids. This study revealed the biological significance of these metabolites, which could be useful for further unexplored compounds and possible biological functions of A. cornea. [ABSTRACT FROM AUTHOR]

Recent years have witnessed climate change characterized by increasingly frequent extreme precipitation events, and the assumption of stationarity in traditional frequency analyses is gradually being questioned. In terms of the current research status in China, there is a lack of thorough investigations on the linkage between extreme precipitation and climate change. This paper aims to determine the dominant climate indices as well as the corresponding significant time scales and periods affecting extreme precipitation over China for dynamic assessments of the upcoming rainstorm risk. Correlations between 15 climate indices and precipitation extremes, as well as the correlations among climate indices, are fully explored to identify potential predictors for non-stationary modeling. Then, 21 non-stationary generalized extreme value (GEV) models are constructed, and the optimal covariates as well as their lag times with extreme precipitation at 769 stations are ascertained in a Bayesian framework. Finally, a complete predictive process is developed, and the national rainstorm risk under non-stationary conditions is assessed. The results indicate that precipitation extremes remain stationary only at 74 stations (less than 10%). WPI is dominant in modeling the variability in precipitation extremes for nearly 22% of the total stations, ranking first among all the climate indices. The predominant time scale affecting extreme precipitation at the majority of stations is 3 months. Ignoring the non-stationarity of extreme precipitation inevitably leads to misperceptions of rainstorm risks, and the spatial distribution of the maximum case of the design rainstorms under non-stationary conditions differs remarkably from that under stationary conditions. Our findings have important implications for the in-depth understanding of the real drivers of extreme precipitation non-stationary and enable advanced predictions of rainstorm risks for mitigating subsequent disasters. [ABSTRACT FROM AUTHOR]

Given the carbon limitation of low C/N wastewater, the improvement of nitrogen-removal efficiency remains a challenging task of municipal wastewater treatment plants (WWTPs) in China. In this study, a partial nitrification/anammox (PN/A) system was established to facilitate the anaerobic-anoxic-aerobic (A2/O) treatment of low C/N (C/N = 3) wastewater with insufficient carbon sources. Effects of dissolved oxygen (DO) concentration and internal reflux ratio on nitrogen-removal efficiency and pathway were investigated. Under the optimal DO (0.5–0.8 mg·L−1) and internal reflux ratio (250%), the highly efficient NH4+-N removal (97.21%) and TN removal (80.92%) were achieved based on PN/A. Moreover, the relative abundance of ammonia-oxidizing bacteria (Nitrosomonas) was 3 times higher than the abundance of nitrite-oxidizing bacteria (Nitrospira) in phase V, which was the main cause of PN in the reactor. Anaerobic ammonia-oxidizing bacteria (Candidatus Brocadia, Pirellula, and Gemmata) were also found and considered as the key microbes involved in anammox. This study reports that the A2/O process can achieve advanced nitrogen removal of low C/N wastewater based on PN/A by optimizing conventional process parameters. The outcomes of this study may provide practical engineering applications as a reference for nitrogen removal based on the A2/O process. [ABSTRACT FROM AUTHOR]

Aquatic environments are important reservoirs for drug resistance. Aquatic foods may act as carriers to lead antibiotic-resistant commensal bacteria into the human gastrointestinal system, then contacting gut microbiota and spreading antibiotic resistance. Here, several shrimp farms were investigated to identify colistin resistance among commensal bacteria of aquaculture. A total of 884 (41.6%) colistin-resistant isolates were identified among 2126 strains. Electroporation demonstrated that colistin-resistant fragments were present in some commensal bacteria that could be transferred to other bacteria. Most of the resistant bacteria were Bacillus spp., with 69.3% of the Bacillus species exhibiting multiple drug resistance. Bacillus licheniformis was prevalent, with 58 strains identified that comprised six sequence types (ST) based on multilocus sequence typing. Whole-genome sequencing and comparisons with previous B. licheniformis genomes revealed a high degree of genomic similarity among isolates from different regions. Thus, this species is widely distributed, and this study provides new insights into global antibiotic-resistant characteristics of B. licheniformis. Sequence analyses further revealed some of these strains are even pathogenic and virulent, suggesting the antibiotic resistance and hazards of commensal bacteria in aquaculture should be considered. Considering the "One Health" perspective, improved monitoring of aquatic food is needed to prevent the spread of drug-resistant commensal bacteria from food-associated bacteria to humans. [ABSTRACT FROM AUTHOR]

Objective: We report the application of enhanced recovery after surgery (ERAS) regimens to pediatric patients undergoing laparoscopic pyeloplasty (LP), aiming to guide the practice of ERAS in pediatric LP. Methods: From October 2018, we prospectively implemented a twenty-point ERAS regimen, including a modified LP procedure, for pediatric UPJO patients in a single institution. Data from 2018 to 2021 were collected and analyzed retrospectively. The variables gathered included: demographics, preoperative details and recovery elements. Outcomes were postoperative length of stay (POS), readmission rate, operation time and blood loss. Results: A total of 75 pediatric patients (0–14 years) were included. The mean POS was 2.4 ± 1.4 days, shorter than that in recent studies in China (3.3 ± 1.4 days, 6 (3–16) days). None were redo, and six restenosis (8%) were improved after treatment with ureteral balloon dilatation. The mean operation time was 257.9 ± 54.4 min, and blood loss was 11.8 ± 10.0 ml. In the univariable analysis and multivariable analysis, no external drainage, sacral anesthesia, and withdrawal of the catheter on day one were independently associated with a POS of ≤ 2 d (p < 0.05). Conclusion: The implementation of this ERAS protocol for pediatric LP has resulted in a shorter length of stay without a higher readmission rate. Surgery techniques, drainage management and analgesia are the key to further improvement. ERAS for pediatric pyeloplasty should be encouraged. [ABSTRACT FROM AUTHOR]

Reducing carbon emissions is the only way to solve the global climate problem, which obviously requires the joint efforts of all regions. From the perspective of carbon emission reduction demand, this research obtains the data of low‐carbon patents and CO2 emissions from 2000 to 2019, and then explores the innovation effect of low‐carbon technology transfer in the Yangtze River Economic Belt (YREB). We draw the following conclusions: (1) Low‐carbon technology transfer has a positive impact on low‐carbon technology innovation. However, a large number of low‐carbon technology transfers are concentrated between developed regions in the YREB at present. (2) No matter from the perspective of total amount or efficiency, carbon emission reduction demand can play positive moderating role in the process of exerting the innovation effect of low‐carbon technology transfer, indicating that the transfer of low‐carbon technologies to regions with high demand is efficient. (3) The moderating effect of carbon emission reduction demand in different regions has regional heterogeneity. Carbon emissions per unit of GDP plays a greater role in moderating the innovation effect of low‐carbon technology transfer in the eastern region, while CO2emissions plays a greater role in the central and western regions. Therefore, we propose to strengthen the transfer of low‐carbon technologies between developed and less‐developed regions, and adopt differentiation strategies according to the actual situation of each region. Our research has deepened the understanding of environmental economic geography on the innovation effect of low‐carbon technology transfer, and has reference significance for global low‐carbon technology cooperation. [ABSTRACT FROM AUTHOR]

Objective: Tinnitus is a highly prevalent hearing disorder, and the burden of tinnitus diagnosis and treatment is very heavy, especially in China. In order to better benefit the majority of tinnitus patients, we developed a new mobile app based on our patented invention – named the Fudan Tinnitus Relieving System (FTRS) – for tinnitus management. The FTRS app aims to alleviate patients' tinnitus symptoms using customized sound therapy, to evaluate the treatment effect, to provide a doctor-patient communication platform, and to support tinnitus rehabilitation and auditory health. Methods: In this study, we introduced the major functions of the FTRS app, analyzed the geographical distribution of users around China, and performed an analysis on the demographic and clinical characteristics of patients with tinnitus, including age and tinnitus position, duration, frequency, and severity in both men and women based on the user information collected by the FTRS. The data for 22,867 participants (males: 13,715; females: 9,152) were included in the statistical analysis. Results: The FTRS app has been popular with tinnitus patients since its launch in May 2018 with its integrated pitch-matching test, individualized sound therapy, follow-up assessment, and provision of easy-to-understand science and education for tinnitus. The users were located throughout Mainland China but primarily concentrated in Shanghai, Jiangsu, Zhejiang, Guangdong, and Shandong provinces. We observed gender differences regarding age and tinnitus frequency, severity, and position among the app's users. The FTRS has not only facilitated patients' access to treatment at times and places that are convenient for them, but also provides a large amount of data based on user feedback in order to support clinical tinnitus research. Conclusions: Compared with traditional face-to-face medical treatment, the FTRS greatly reduced medical costs and enabled patients with tinnitus to arrange their own treatment times. At the same time, the FTRS has provided standardized tinnitus data that have laid a foundation for clinical research on tinnitus. However, because of differences in the popularity and utilization of smart devices, FTRS user data might only reflect the situation of tinnitus patients who can effectively use smart devices. Therefore, the findings of this study need to be interpreted with caution. [ABSTRACT FROM AUTHOR]

Maize ear rot, one of the most destructive diseases in summer‐sown maize areas of China, is caused by several Fusarium spp. Not only does this pathogen lower maize yields, but also negatively impacts both animal and human health through the production of fumonisin mycotoxins. In this study, we collected 472 unique isolates of F. verticillioides from 480 samples of maize ear rots across eight Chinese summer‐sown maize regions and evaluated their genetic variability and aggressiveness. Analysis of polymorphic intersimple sequence repeat (ISSR) loci revealed high levels of genetic variation, particularly in Henan and Shandong provinces. The STRUCTURE result showed that all F. verticillioides isolates clustered into three populations, rather than eight distinct geographical provinces, and there was no significant positive correlation between genetic distance and geographical distance. Most of the variation resulted from genetic differences within rather than between populations. Pathogenicity varied among the evaluated F. verticillioides isolates, and most isolates examined, caused a moderate level of disease; there was no strong correlation between pathogenicity and genetic diversity. This is the first comprehensive report of both the genetic variability and pathogenicity of F. verticillioides across the whole summer‐sown maize region in China. These results provide important information that can inform efforts to control maize ear rot and fumonisin contamination caused by F. verticillioides. [ABSTRACT FROM AUTHOR]

Rabbit antithymocyte globulin (rATG) instead of horse ATG has been used for severe aplastic anemia (SAA) patients in China. This study aimed to investigate the hematologic responses and long-term overall survival (OS) outcomes in SAA patients who received rATG and cyclosporine as first-line immunosuppressive therapy. We analyzed data of 542 SAA patients treated with this therapy between 2005 and 2019. The median age was 20 (range, 2-80) years, and the median follow-up time was 45.5 (range, 0.1-191.4) months. The early mortality rate was 3.9%. The overall response rates (ORRs) were 40.2%, 56.1%, and 62.4% at 3, 6, and 12 months, respectively. The 6- and 12-month ORR of patients treated with 3 mg/kg/d of rATG in 2015-2019 seemed higher than that of patients treated with 3.5-3.75 mg/kg/day in 2005-2014 (60.2% vs. 54.9%, P = 0.30 and 69.9% vs. 60.1%, P = 0.049, respectively). The 10-year cumulative incidences of relapse and clonal evolution were 10.6 ± 2.9% and 7.5 ± 1.5%, respectively. The 10-year OS rate and event-free survival rate were 80.1 ± 2.1% and 75.6 ± 3.7%, respectively. Age, disease severity, treatment periods, and the interval from diagnosis to IST were independent predictors of OS. In conclusion, 3 mg/kg/day rATG is effective as first-line treatment for SAA. [ABSTRACT FROM AUTHOR]

The Chang'an Chong Cu-Mo deposit is located in the Chang'an Cu-Mo-Au ore cluster in the southern Ailaoshan tectonic belt in southwestern China. There are six intrusive bodies in the mining area, among which the No.Ⅱ intrusive body is the largest and most closely related to Cu-Mo mineralization of skarn. The No. 1 main orebody is composed of the No. 1 copper orebody and No. 1 molybdenum orebody, which are distributed in parallel with similar shapes. In this paper, the age of skarn is determined by the LA-SF-ICP-MS U-Pb dating of garnet, and it is nearly consistent with the age of alkaline porphyry in this region (41–32 Ma). Compared with the U-Pb age of zircon from the ore-bearing porphyry and the Re-Os age of molybdenite, the U-Pb age of garnet was consistent with them within error, indicating that they were the same mineralization event, which further proves that the porphyry-skarn Cu-Mo-Au mineralization event along the Ailaoshan-Red River fault zone mainly occurred at 38~32 Ma. In-situ S isotope results show that the δ34S mean values of disseminated pyrite (PyI), pyrite of sulfide veins (PyⅡ) and chalcopyrite (Ccp) in the main mineralization period are 2.35‰, 3.60‰ and 0.55‰, respectively. These δ34S values are similar to those of magma and slightly enriched in δ34S, and the δ34S value of chalcopyrite is mainly concentrated near 0‰, so it can be considered that the S of the ore-forming fluid came from magmatic-hydrothermal fluids. Based on the comprehensive analysis of the regional metallogenic background, deposit chronology and isotope geochemistry, it is concluded that the Chang'an Chong Cu-Mo deposit was formed in an intra-plate post-collision strike-slip environment. [ABSTRACT FROM AUTHOR]

The aquaculture environment, especially the culture ponds and aquaculture products, is considered to be an important reservoir of colistin resistance genes. However, systematic investigations of colistin resistance in Penaeus vannamei farming in different culture modes are scarce. In this study, a total of 93 non‐duplicated samples were collected from P. vannamei farms in five cities in China from 2019 to 2021. The prevalence, antibiotic resistance and multilocus sequence typing (MLST) of colistin‐resistant bacteria were measured and analysed. The results showed that among the 1601 isolates in P. vannamei and its environmental samples, the pollution of colistin‐resistant bacteria was serious (the overall prevalence was 37.3% and 28.8%, respectively), regardless of the earthen pond or high‐density polyethylene (HDPE) film‐lined pond. Among 533 isolates, the prevalence of mobile colistin resistance (mcr) genes, mcr‐1, was the highest (60%, 320/533), followed by mcr‐4 (1.5%, 8/533), mcr‐8 (0.9%, 5/533), mcr‐10 (0.6%, 3/533) and mcr‐7 (0.4%, 2/533). The prevalence of mcr‐1 in earthen ponds was significantly higher than that in HDPE film‐lined ponds (67.5% vs. 49.1%, p <.001). The dominant strain carrying mcr‐1 was Bacillus spp. (54.1%, 173/320), followed by Enterobacter spp. (8.1%, 26/320), Staphylococcus spp. (6.3%, 20/320) and Aeromonas spp. (5.3%, 17/320). The antibiotic resistance profiles of 173 Bacillus spp. varied among different sampling locations and culture types. These isolates were highly resistant to cefepime, ceftriaxone, trimethoprim‐sulfamethoxazole and ceftiofur (>45%), and multidrug‐resistant isolates were common (62.4%, 108/173). Sequence type (ST) 26 (37/66, 56%) was found to be the most prevalent ST in mcr‐1‐positive Bacillus cereus isolated from the aquaculture environment. In summary, our study pointed out that it is necessary to continuously monitor antibiotic usage and its residues regardless of the pond types, especially with regard to critical drugs such as colistin. [ABSTRACT FROM AUTHOR]

Five severe floods occurred in the Yangtze River Basin, China, between July and August 2020, and the Three Gorges Reservoir (TGR) located in the middle Yangtze River experienced the highest inflow since construction. The world's largest cascade-reservoir group, which counts for 22 cascade reservoirs in the upper Yangtze River, cooperated in real time to control floods. The cooperation prevented evacuation of 600,000 people and extensive inundations of farmlands and aquacultural areas. In addition, no water spillage occurred during the flood control period, resulting in a world-record annual output of the TGR hydropower station. This work describes decision making challenges in the cooperation of super large reservoir groups based on a case-study, controlling the 4th and 5th floods (from Aug-14 to Aug-22), the efforts of technicians, multi-departments, and the state, and reflects on these. To realize the full potential of reservoir operation for the Yangtze River Basin and other basins with large reservoir groups globally, we suggest: (i) improve flood forecast accuracy with a long leading time; (ii) strengthen and further develop ongoing research on reservoir group cooperation; and (iii) improve and implement institutional mechanisms for coordinated operation of large reservoir groups. [ABSTRACT FROM AUTHOR]

Aim: To analyse the frequency and core elements of nursing work interruptions in Chinese emergency nursing settings. Background: Little is known about nursing interruptions, which affect the quality of services in Chinese emergency nursing setting. Method(s): A cross‐sectional observational study was conducted in three units of an emergency department in a Chinese tertiary hospital. Participants comprised 60 nurses. Data were collected using a questionnaire developed by the researchers specifically for this study. Results: In total, 25,965 min of work was observed and 2333 interruptions were identified. Most interruptions were from patients, their families and nurses. Therapeutic nursing and patient observation and documentation were the most frequently interrupted procedures. Most interruptions were negative, and a majority of the nurses immediately responded to interruptions. Significant differences existed in the overall distribution of the core elements among the three nursing units. Conclusions: The frequency of emergency nursing interruptions was moderate. Most interruptions tend to lead to negative treatment outcomes for patients. Implications for Nursing Management: Emergency nursing managers should recognize the importance of interruptions, understand work situations better and develop ways to reduce the incidence of interruptions. Thus, nursing risks can be avoided by reducing the adverse outcomes caused by work interruptions. [ABSTRACT FROM AUTHOR]

Mind-body exercises such as Yoga or Qi Gong have demonstrated a wide range of health benefits and hold great promise for employment in clinical practice. However, the psychophysiological mechanism underlying these effects remains unclear. Theoretical frameworks highlight regulation as a characteristic and specific mechanism of mind-body exercise for which empirical evidence is scarce. To investigate the exact nature of this mechanism, we tracked acute changes in autonomic nervous system (ANS) activity and subjective state over a common form of mind-body exercise (Qi Gong). Heart rate variability (HRV) and subjective state were assessed in 42 Qi Gong practitioners from China and Germany during a standard moving Qi Gong exercise (Baduanjin). Relaxation in supine position prior and after the exercise served as a control condition to Qi Gong and to assess changes before and after the exercise. Following Qi Gong, all practitioners reported significantly increased subjective calmness and perceived body activation, attentional focus, and subjective vitality. On the physiological level, a significant decrease of parasympathetic modulation and increase in heart rate indicated a pattern of moderate general physiological activation during Qi Gong. A significant increase in overall RR-interval modulation and cardiac coherence during Qi Gong were indicative of a mechanism of active regulation. Examination of the RR-interval trajectories revealed a rhythmic pattern of ANS activation and deactivation in sync with activating and relaxing segments of the exercise. Significant changes in subjective state, not on the physiological level, before and after the exercise were observed. Significant associations between Qi-Gong-specific beliefs, age, cultural background, and experiential and physiological measures demonstrated the complexity of mind-body exercises as multicomponent interventions. Overall, this study highlights moderate general physiological activation, exercise-dependent rhythmic ANS modulation, and induction of a characteristic state of eutonic calmness as potential psychophysiological mechanisms underlying the health benefits of mind-body exercise. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic is a major public health issue and challenge to health professionals. In similar epidemics, nurses experienced more distress than other providers. Methods: We surveyed both on-duty nurses caring for infected patients and second-line nurses caring for uninfected patients from Hubei and other provinces throughout China. Results: We received completed surveys from 1,364 nurses from 22 provinces: 658 front-line and 706 second-line nurses. The median (IQR) GHQ-28 score of all nurses was 17 (IQR 11–24). The overall incidence of mild-to-moderate distress (GHQ score > 5) was 28%; that for severe distress (GHQ score > 11) was 6%. The incidence of mild-to-moderate distress in the second-line nurses was higher than that in the front-line nurses (31 vs. 25%; OR, 0.74; 95 CI, 0.58–0.94). Living alone (OR, 0.62; 95% CI, 0.44–0.86) and feeling supported (OR, 0.82, 95% CI, 0.74–0.90) independently predicted lower anxiety. Conclusions: During the COVID-19 pandemic, the psychological problems of all nurses were generally serious. The interviewed second-line nurses face more serious issues than the front-line nurses. [ABSTRACT FROM AUTHOR]

The peak flow of a flash flood is an important factor concerning flood risk management. Empirical approaches based on measured hydrological data at gauging sites can be applied to estimate flood peaks; however, they are not suitable for catchments with limited available rainfall and streamflow data, especially ungauged small mountainous catchments. This paper presents a novel method for estimating flash flood peaks in small mountainous catchments based on derived distributed geomorphologic unit hydrographs (DGUHs) using fuzzy c -means (FCM) clustering. Data from 25,130 small mountainous catchments in Gansu Province, located in northwest China, are selected for this study. The results show that (1) the derived DGUHs can reflect the strong nonlinearity of the hydrologic process over small mountainous catchments; (2) the FCM clustering method performs well in the clustering of the DGUHs, and the optimal number of clusters in this case is insensitive to the excess rainfall intensity; and (3) empirical formulas based on catchment characteristics (including drainage area, length, and the longitudinal gradient of main channel networks) can estimate flash flood peaks accurately in small mountainous catchments. [ABSTRACT FROM AUTHOR]

• An immunomodulatory peptide was isolated from Stolephorus chinensis. • The amino acid sequence of immunomodulatory peptide was identified as Tyr-Val-Met-Arg-Phe. • Fraction with molecular weight of < 1 kDa showed maximum RPR toward RAW 264.7 cells (70.03 %). Immunomodulatory peptides derived from marine organisms are potential sources of new immunomodulating drugs. This study aimed to investigate the optimal enzymatic hydrolysis conditions of immunoregulatory peptides from Stolephorus chinensis. The relative proliferation rate (RPR) of RAW264.7 macrophages was set as the screening index. The immunoregulatory peptides from S. chinensis was prepared via process optimization, ultrafiltration, ion-exchange chromatography, and reverse-phase high-performance liquid chromatography (RP-HLPC). The amino acid sequence of the immunoregulatory peptide from S. chinensis (IPSC) was identified to be Tyr-Val-Met-Arg-Phe (YVMRF; MW 715.4 Da) using Edman degradation and mass spectrometry. In addition, the macrophages became larger with more pseudopods after IPSC treatment, indictating that IPSC stimulated RAW 264.7 differentiation. IPSC also increased productions of nitric oxide (NO), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α). Our results provide a theoretical basis for preparing immunomodulatory functional food from S. chinensis in future. [ABSTRACT FROM AUTHOR]

University–industry interactions have been extensively discussed by economic geographers. However, while universities increasingly engage in local and nonlocal interactions with the industry, there is a lack of evidence concerning the consequences of universities becoming involved in these open innovation processes. Therefore, this study empirically examines the effects of local and nonlocal knowledge interactions on the innovative performance of universities by utilizing a large panel database constructed from a sample of 185 universities in China. First, we observe that both local and nonlocal interactions have an inverted U‐shaped relationship with university innovative performance. Second, local interactions combined with nonlocal interactions have a negative effect on the innovative performance of universities. Finally, we find that a balance is required between local and nonlocal interactions to enhance university performance. These results have important implications for policy design. [ABSTRACT FROM AUTHOR]

Objective: To assess the outcomes of children with acquired aplastic anemia (AA) treated in China with first‐line porcine anti‐lymphocyte immunoglobulin (p‐ALG)/rabbit anti‐thymocyte immunoglobulin (r‐ATG) combined with cyclosporine A (CSA). Methods: We performed a single‐center, non‐randomized, retrospective cohort study to assess the outcomes of 189 children with AA treated in China with first‐line p‐ALG/r‐ATG combined with CSA between 2014 and 2018. Results: No significant differences were observed in the overall response rates at 3, 6, 12, or 24 months (3 months: 61.9% vs 67.4%, P =.5; 6 months: 70.9% vs 73.9%, P =.69; 12 months: 77.3% vs 73.3%, P =.58; 24 months: 81.6% vs 78.6%, P =.59) after either p‐ALG‐ or r‐ATG‐based immunosuppressive therapy. No significant differences were observed in overall survival or failure‐free survival between the p‐ALG group and the r‐ATG group. Conclusion: Our results reveal that the therapeutic efficacy and safety of p‐ALG combined with CSA did not differ significantly from those of r‐ATG combined with CSA as first‐line therapy for pediatric patients with AA. Moreover, p‐ALG has the advantage of significantly lower cost compared with r‐ATG. [ABSTRACT FROM AUTHOR]

Purpose: Extant consumer behavior research has alluded to consumer learning; however, little research exists regarding situated learning and its relation to coping with respect to stressful consumption experiences. The purpose of this research is to study situated or in situ learning in two cultural contexts – that of the USA and China. Design/methodology/approach: Online data were collected from non-students in both the USA and China, and structural equations modeling was used to analyze data. Findings: Results demonstrated that situated learning helped cope better with stressful episodes for both cultures. Psychological closeness to the problem mediated the relationship between the antecedents and situated learning for US consumers more than for Chinese consumers. Research limitations/implications: Since US consumers tend to be psychologically close to the stressor during the consumption process, firms should preemptively inform and educate them about potential stressors to help them learn and cope. However, as Chinese consumers tend not to be psychologically close to the problem, they need to be dealt differently. Originality/value: This research provides a holistic view of situated learning and coping as a process involving consumers, firms and situations and examines their underlying factors in stressful consumption encounters. It establishes the mediating role of psychological closeness between antecedents and consumers' situated learning and explores the differences of psychological closeness in two different cultures, that of the USA and China. [ABSTRACT FROM AUTHOR]

A survey of mushrooms was conducted in Xishuangbanna, Yunnan Province, China, in the rainy season (May to October) of 2012, 2013, and 2014, during which 16 specimens of Termitomyces were collected. Preliminary macro- and micro-characteristics, together with ITS sequence data, showed that four of the specimens belonged to a new species (Termitomyces fragilis), while the other 12 belonged to T. aurantiacus, T. eurrhizus, T. globules, T. microcarpus, and T. bulborhizus. In this paper, T. fragilis is introduced as a species new to science based on morphological characterization and phylogenetic analyses. Macro- and micro- morphological descriptions, color photographs and line drawings of the new species, and a phylogenetic tree to show the placement of the new species are provided. T. fragilis is then compared with other closely related taxa in the genus Termitomyces. [ABSTRACT FROM AUTHOR]

This study investigated the lifetime prevalence of suicide attempts (SA) and independent demographic and clinical correlates in stabilized schizophrenia inpatients. A cross-sectional study was conducted in three psychiatric hospitals in Anhui province, an agricultural province located in east China. Psychopathology and depressive symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and Hamilton Depression Rating Scale (HAMD), respectively. A total of 315 stable schizophrenia inpatients were interviewed prior to discharge. The lifetime prevalence of SA was 22.2%. Multiple logistic regression analysis revealed that female gender (P < 0.001, OR = 3.4, 95%CI: 1.9–6.0), being married (P = 0.02, OR = 2.2, 95%CI: 1.1–4.4) and having more severe depressive symptoms (P = 0.014, OR = 1.2, 95%CI: 1.01–1.3) were independently and significantly associated with higher risk of SA. Lifetime SA is common among hospitalized schizophrenia patients living in agricultural areas of China. For suicide prevention, regular assessments, appropriate interventions and clinical management should be integrated into a community-based psychiatric service model for this population. [ABSTRACT FROM AUTHOR]

Truffles are ascomycetous ectomycorrhizal fungi that have elevated status in the culinary field due to their unique aroma and taste as well as their nutritional value and potential biological activities. Tuber melanosporum , T. indicum , T. panzhihuanense , T. sinoaestivum , and T. pseudoexcavatum are five commercial truffle species mainly distributed in Europe or China. In this study, an untargeted metabolomics technology based on an ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method was applied to analyze the metabolic profiles and variations among these five truffle species. In our results, a total of 2376 metabolites were identified under positive ion mode, of which 1282 had significantly differential amounts and covered 110 pathways or metabolisms. Principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) revealed a clear separation from each of these five truffles, indicating a significantly different metabolic profile among them, with the biggest difference between T. melanosporum and the other four truffles. The differential metabolites covered various chemical categories, and a detailed analysis was performed for nine metabolic categories, including amino acids, saccharides and nucleosides, organic acids, alkaloids, flavonoids, carnitines, phenols and alcohols, esters, and sulfur compounds. For each of the nine categories, most of metabolites predominantly accumulated in T. melanosporum compared with the other four truffles. Meanwhile, there were significant differences of the average ion intensity in each category among the five truffles, e.g., higher amounts of amino acids was detected in T. panzhihuanense and T. pseudoexcavatum; T. indicum contained significantly more carnitines, while there were more alkaloids in T. melanosporum. Additionally, some metabolites with biological activities were discussed for each category, such as acetyl-L-carnitine, adenine, neobavaisoflavone, and anandamide. Generally, this study may provide the valuable information regarding the variation of the metabolic composition of these five commercial truffle species, and the biological significance of these metabolites was uncovered to explore the metabolic mechanisms of truffles, which would be helpful for further research on the compounds and potential biological functions in truffles that have not yet been investigated. [ABSTRACT FROM AUTHOR]

• The training time of Long Short-Term Memory Network is reduced by sharing weights. • A new hybrid model is proposed for wind speed probabilistic forecasting. • Four experiments are designed to verify the performance and reliability of the model. Wind energy has received more and more attention around the world since it is a kind of clean, economical and renewable energy. However, the strong randomness of the wind speed makes wind power difficult to integrate into the power grid. Obtaining reliable high-quality wind speed prediction results is very important for the planning and application of wind energy. In this study, Shared Weight Long Short-Term Memory Network (SWLSTM) is proposed to decrease the number of variables that need to be optimized and the training time of Long Short-Term Memory Network (LSTM) without significantly reducing prediction accuracy. Furthermore, a new hybrid model combined SWLSTM and GPR, called SWLSTM-GPR, is proposed to obtain reliable wind speed probabilistic prediction result. SWLSTM-GPR is applied to four wind speed prediction cases in Inner Mongolia, China and compared with the state-of-the-art wind speed prediction methods from four aspects: point prediction accuracy, interval prediction suitability, probability prediction comprehensive performance and training time. The reliability test of SWLSTM-GPR guarantees that the prediction results are reliable and convincing. The experimental results show that SWLSTM-GPR can obtain high-precision point prediction, appropriate prediction interval and reliable probabilistic prediction results with shorter training time on the wind speed prediction problems. [ABSTRACT FROM AUTHOR]

Urban air pollution is a prominent problem related to the urban development in China, especially in the densely populated urban agglomerations. Therefore, scientific examination of regional variation of air quality and its dominant factors is of great importance to regional environmental management. In contrast to traditional air pollution researches which only concentrate on a single year or a single pollutant, this paper analyses spatiotemporal patterns and determinants of air quality in disparate regions based on the air quality index (AQI) of the Yangtze River Delta region (YRD) of China from 2014 to 2016. Results show that the annual average value of the AQI in the YRD region decreases from 2014 to 2016 and exhibit a basic characteristic of 'higher in winter, lower in summer and slightly high in spring and autumn'. The attainment rate of the AQI shows an apparently spatial stratified heterogeneity, Hefei metropolitan area and Nanjing metropolitan area keeping the worst air quality. The frequency of air pollution occurring in large regions was gradually decreasing during the study period. Drawing from entropy method analysis, industrialization and urbanization represented by per capita GDP and total energy consumption were the most important factors. Furthermore, population agglomeration is a factor that cannot be ignored especially in some mega-cities. Limited to data collection, more research is needed to gain insight into the spatiotemporal pattern and influence mechanism in the future. [ABSTRACT FROM AUTHOR]

Background: Juvenile recurrent parotitis (JRP) is defined as recurrent parotid inflammation, generally associated with nonobstructive sialectasis of the parotid gland. In addition, the etiology remains unclear, probably immunologically mediated. Aim: The purposes of the present study were to report the relationship between JRP and immune function from the measurement of the JRP patients' immunoglobulins and T-lymphocyte subset. Methods: Immunologic assay from 2014 to 2017 of 100 children diagnosed with JRP at Shanghai Ninth Hospital compared with the 100 normal children by age. Results: The CD4 level of JRP children aged >6 years was significant lower than the one of JRP preschool children (p < .05), while the IgG level was significant higher than the one of the JRP preschool children (p < .05). In comparison with the normal children, the value of CD8 T cells, immunoglobulin G (IgG), immunoglobulin E (IgE), immunoglobulin A (IgA) and C3 (p < .01) of JRP children was significant higher, while the value of CD4 T cells was lower (p < .01) in spite of age. What is more, the value of CD8 T cells of JRP preschool children was much significant higher than the one of the normal preschool children (p < .01). Conclusion: The immune function of JRP patients may become disorder: the suppression cellular immune function and inadequate humoral immune expression. [ABSTRACT FROM AUTHOR]

This paper presents an empirical analysis of hierarchical tendencies and functional patterns in the development of Mainland China’s space-economy by operationalizing the concept of “megaregions.” Drawing on the burgeoning literature on megaregions, we first argue that under conditions of economic globalization the megaregion concept does indeed present an effective tool to study the spatial agglomeration of the key components of China’s economic development. Second, we analyze the development status and the key functional characteristics of 16 prospective Chinese megaregions by constructing an index system consisting of 5 functions and 36 indicators. Third, we calculate an entropy index to rank megaregions according to their overall development status and reveal functional differences by applying cluster analysis. We find that the Yangtze River Delta, Beijing–Tianjin–Hebei Metropolitan Area, and the Pearl River Delta stand out, identify different varieties of megaregions according to their dominant functional characteristics, and explore the main policy dimensions of the persistent west–east divides observed. The paper is concluded with a discussion of potential avenues for future research. [ABSTRACT FROM PUBLISHER]

Bartonella species are emerging human pathogens. Bats are known to carry diverse Bartonella species, some of which are capable of infecting humans. However, as the second largest mammalian group by a number of species, the role of bats as the reservoirs of Bartonella species is not fully explored, in term of their species diversity and worldwide distribution. China, especially Northern China, harbors a number of endemic insectivorous bat species; however, to our knowledge, there are not yet studies about Bartonella in bats in China. The aim of the study was to investigate the prevalence and genetic diversity of Bartonella species in bats in Northern China. Bartonella species were detected by PCR amplification of gltA gene in 25.2% (27/107) bats in Mengyin County, Shandong Province of China, including 1/3 Rhinolophus ferrumequinum, 2/10 Rhinolophus pusillus, 9/16 Myotis fimbriatus, 1/5 Myotis ricketti, 14/58 Myotis pequinius. Phylogenetic analysis showed that Bartonella species detected in bats in this study clustered into ten groups, and some might be novel Bartonella species. An association between Bartonella species and bat species was demonstrated and co-infection with different Bartonella species in a single bat was also observed. Our findings expanded our knowledge on the genetic diversity of Bartonella in bats, and shed light on the ecology of bat-borne Bartonella species. [ABSTRACT FROM AUTHOR]

The comprehensive assessment of climatic and hydrological droughts in terms of their temporal and spatial evolutions is very important for water resources management and social development in the basin scale. To study the spatial and temporal changes of climatic and hydrological droughts and the relationships between them, the SPEI and SDI are adopted to assess the changes and the correlations of climatic and hydrological droughts by selecting the Jialing River basin, China as the research area. The SPEI and SDI at different time scales are assessed both at the entire Jialing River basin and at the regional levels of the three sub basins. The results show that the SPEI and SDI are very suitable for assessing the changes and relationships of climatic and hydrological droughts in large basins. Based on the assessment, for the Jialing River basin, climatic and hydrological droughts have the increasing tendency during recent several decades, and the increasing trend of climatic droughts is significant or extremely significant in the western and northern basin, while hydrological drought has a less significant increasing trend. Additionally, climatic and hydrological droughts tend to increase in the next few years. The results also show that on short time scales, climatic droughts have one or two months lag impact on hydrological droughts in the north-west area of the basin, and have one month lag impact in south-east area of the basin. The assessment of climatic and hydrological droughts based on the SPEI and SDI could be very useful for water resources management and climate change adaptation at large basin scale. [ABSTRACT FROM AUTHOR]

With much more higher requirement for the precision of flood forecasting and length of forecast period in the hydrological operational predication, three coupling forecast methods which include real-time correction-combination forecast (RC-CF) method, combination forecast-real-time correction (CF-RC) method, and Integral Parameters Optimization (IPO) method are proposed in this paper for the purpose of improving the precision of flood forecasting. These coupling forecast methods are based on the real-time correction and combination forecast methods. Thereafter, two methods (method A & method B) are proposed for the purpose of prolonging the forecast period. Furthermore, indices of accuracy assessment which consist of mean absolute error, mean relative error, certainty coefficient and root-mean-square error are utilized to evaluate the forecast results of coupling forecast methods. Moreover, with a case study of Xiangjiaba station in the Jinsha River, advantages and disadvantages of these coupling forecast methods are obtained through the comparison of forecast results calculated by these methods, and they provide the basis for selection of coupling forecast methods. The result shows that the IPO method performs better than other two methods which behave undifferentiated. It is found that the IPO method combined with method B can be a viable alternative for flood forecasting of multiple hydrological models. [ABSTRACT FROM AUTHOR]

Purpose: (1) To investigate associations between single nucleotide polymorphisms (SNPs) in osteopontin (OPN) and its receptor-cluster of differentiation 44 (CD44) genes and gastric cancer susceptibility. (2) To explore the correlation of OPN and CD44 expression of gastric cancer. Methods: We detected 26 SNPs of the genes in gastric cancer patients from the Chinese Han population by Sequenom technique and performed expression of OPN in combination with CD44 in 243 tissues samples of the cases by tissue microarray and immunohistochemistry (IHC). Results: We found that the minor alleles of OPN rs4754C>T and OPN rs9138C>A remained strongly associated with decreased gastric cancer risk ( P = 1.53 × 10, odds ratio (OR) 0.642, 95 % confidence interval (CI) 0.511-0.808 and P = 1.59 × 10, OR 0.642, 95 %CI 0.510-0.809). OPN variant rs1126772A>G and CD44 variant rs353639A>C significantly contributed to elevated risk of gastric cancer ( P = 0.042, OR 1.279, 95 % CI 1.008-1.622 and P = 0.047, OR 1.334, 95 % CI 1.003-1.772). Haplotypes of OPN and CD44 variants significantly influenced risk of gastric cancer. Clinical data indicated that rs4754 and rs9138 of OPN were significantly associated with smoking ( P = 0.029, OR 0.343, 95 % CI 0.127-0.926 and P = 0.029, OR 0.343, 95 %CI 0.127-0.926) and OPN rs1126772 revealed associations with tumor-node-metastasis (TNM) stage ( P = 0.025, OR 1.765, 95 % CI 1.073-2.905) and tumor differentiation ( P = 0.031, OR 1.722, 95 % CI 1.049-2.825). OPN expression was observed in 133 of the 243 cases (54.7 %) by IHC and was correlated with serosa invasion ( P = 0.013), TNM stage ( P = 0.003) and lymph node metastasis ( P = 0.002). CD44 expression was found in 92 of the 243 cases (37.9 %) and was associated with tumor size ( P = 0.005) and lymph node metastasis ( P = 0.023), respectively. The OPN expression displayed a positive association with CD44 ( P = 0.01, r = 0.164). Conclusions: We found that the polymorphisms rs4754, rs9138 and rs1126772 of OPN gene and rs353639 of CD44 gene were significantly associated with gastric cancer. Our IHC data indicated that interaction of OPN and CD44 protein would promote progression and metastasis of gastric cancer. [ABSTRACT FROM AUTHOR]

• A first comprehensive and systematic review on the research of extreme precipitation in China. • Variation and regional characteristics of extreme precipitation under non-stationary conditions due to climate change and human activities. • Supports and basis for engineering application and further research on extreme precipitation and flood in China. Recent years have witnessed global massive property losses and casualties caused by extreme precipitation and its subsequent natural disasters, including floods and landslides. China is one of the countries deeply affected by these casualties. If the statistical characteristics and laws of extreme precipitation could be clearly grasped, then the negative impacts triggered by it may be minimized. China is a vast country and diverse in climate and terrain, hence different regions may be suitable for different analyses and research methods. Therefore, it is necessary to clarify the research progress, methods and current status of extreme precipitation across the country. This paper attempts to provide a comprehensive review of techniques and methods used in extreme precipitation research and engineering practice and their applications. The literature is reviewed focusing on seven aspects: (1) annual maxima method (AM), (2) peaks over threshold method (POT), (3) probable maximum precipitation (PMP), (4) non-stationary analysis of precipitation extremes, (5) intensity-duration-frequency curves (IDF), (6) uncertainty in extreme precipitation frequency analysis, and (7) spatial variability of extreme precipitation. Research on extreme precipitation in China is generally based or centered on the above seven aspects. The current study aims to provide ideas for further research on extreme precipitation frequency analysis and its response to climate change and human activities. [Display omitted] [ABSTRACT FROM AUTHOR]

Extant consumer behavior research has alluded to consumer learning; however, little research exists regarding situated learning and its antecedents with respect to stressful service experiences. Through this research, we qualitatively and quantitatively examine the topic of situated or in situ learning in two cultural contexts—that of the U.S. and China. Results demonstrate the importance of situated learning in dealing with stressful service encounters. The search for possibilities positively impacted situated learning for both U.S. and Chinese consumers. Unlike their U.S. counterparts, Chinese consumers initiated the process of learning long before experiencing the actual service, learned more because of uncertainty of service standards, and stressed the importance of timely decision making as ways to learn and reduce stress. Interestingly, U.S. participants discussed the importance of empathy from service providers, trust, and propensity for upfront feedback in enhancing learning. Theoretical and managerial implications are provided. [ABSTRACT FROM AUTHOR]

This study evaluated and intercompared seven near-real-time (NRT) versions of satellite-based precipitation products (SPPs) with latencies of less than one day, including GSMaP-NRT, GSMaP-Gauge-NRT, GSMaP-NOW, IMERG-Early, IMERG-Late, TMPA 3B42RT, and PERSIANN-CCS for wet seasons from 2008 to 2019 in a typical middle–high latitude temperate monsoon climate basin, namely, the Nierji Basin in China, in four aspects: flood sub-seasons, rainfall intensities, precipitation events, and hydrological utility. Our evaluation shows that the cell-scale and area-scale intercomparison ranks of NRT SPPs are similar in these four aspects. The performances of SPPs at the areal scale, at the event scale, and with light magnitude are better than those at the cell scale, at the daily scale, and with heavy magnitude, respectively. Most SPPs are similar in terms of their Pearson Correlation Coefficient (CC). The main difference between SPPs is in terms of their root-mean-square error (RMSE). The worse performances of TMPA 3B42RT are mainly caused by the poor performances during main flood seasons. The worst performances of PERSIANN-CCS are primarily reflected by the lowest CC and the underestimation of precipitation. Though GSMaP-NOW has the highest RMSE and overestimates precipitation, it can reflect the precipitation variation, as indicated by the relatively high CC. The differences among SPPs are more significant in pre-flood seasons and less significant in post-flood seasons. These results can provide valuable guidelines for the selection, correction, and application of NRT SPPs and contribute to improved insight into NRT-SPP retrieval algorithms. [ABSTRACT FROM AUTHOR]

• Both variety and maturity drove the changes of proteomics profiles in white truffles. • T. panzhihuanense had a greater response to maturation process, with a more complex interaction network between proteins. • Some key proteins related to truffle aroma formation were regulated by maturity or variety. • Oxidation-reduction process was enriched between different species and maturity. T. panzhihuanense and T. latisporum are white truffle species native to China, of which T. panzhihuanense has significant commercial potential, with high nutritional value and unique flavor. Maturity is an important factor affecting the nutrition and aroma of truffles, which determines their economic status. Here, a label-free-based comparative proteomics method was used to determine the proteomic profiles of T. panzhihuanense and T. latisporum at two different stages of maturity. The results showed that both maturity and species significantly affected the protein expression patterns. T. panzhihuanense responded stronger to maturity than T. latisporum , accompanied by a more complex interaction network between proteins. Some critical proteins were regulated by maturity and variety, including those involved in aroma formation, e.g., S-adenosyl-methionine synthetase. The enrichment of oxidation–reduction processes, glycolysis, and SNARE interactions in vesicular transport were driven by species and maturity. This study provides the first insights into the proteomic profiles of T. panzhihuanense and T. latisporum , revealing the roles of key proteins and biological processes in their maturation. [ABSTRACT FROM AUTHOR]

The article presents a study which discusses features of sedimentary facies and copper enrichment metallogenic regularities of Kuzigongsu Group in Sareke Glutenite Type copper deposits in Wuqia, Xinjiang, China. It mentions that Kuzigongsu group mainly comprise alluvial fan conglomerate, lenticular sandstone and siltstone. It also reveals that Sarekbayi basin provides good paleogeographic conditions for formation of Sareke glutenite type copper deposit.

Background. Emergency department (ED) overcrowding is influenced by several factors including the hospital's capacity, staff, patient discharges, and community resources. The number of annual ED visits has increased, with patients' medical needs exceeding emergency capacity, resulting in a widespread concern about emergency room overcrowding. Nonemergency patients tend to use large amounts of emergency medical resources, which is one reason for ED overcrowding. Most patients consider their medical cases urgent, whereas medical professionals consider many cases to be nonemergency. Only a few studies have examined self-rated health among nonemergency patients. Methods. This cross-sectional study was conducted in the ED of a tertiary hospital in China using the European Quality of Life Five-Dimensional Questionnaire to investigate the health status of nonemergency patients. Results. Among the 545 respondents, 246 (45.14%) self-assessed their health as excellent, 186 (34.13%) as very good, 70 (12.84%) as good, 32 (5.87%) as average, and 11 (2.02%) as poor. Problems related to pain/discomfort were reported by 317 (58.17%) participants, 214 (39.27%) responded that they had problems related to daily activities, 212 (38.90%) responded that they felt anxious or depressed, 211 (38.35%) responded that they had problems related to self-care, and some or extreme problems related to mobility were stated by 193 people (35.41%). Conclusions. Nonemergency patients generally reported good health. Pain/discomfort was the most significant factor affecting the health of nonemergency patients, followed by limitation of daily activities. The duration of illness onset and self-rated health status were common factors influencing the health status of nonemergency patients. This trial is registered with ChiCTR1900023578. [ABSTRACT FROM AUTHOR]

The Greater Mekong River Subregion (GMS) is a global biodiversity hotspot. Macrofungi play an essential role as decomposers, parasites, and symbionts, and are also an important source of medicine, food, and income for many communities in the GMS; however, the diversity and composition of macrofungi in this region remain poorly understood. In order to help address this knowledge gap, we established 20 permanent study plots in the GMS (native forests, tea plantation, pine plantations, mixed rubber and coffee plantation). Macrofungal diversity and community composition were evaluated across four study sites classified to two climate types and two management methods. Heat maps and nonmetric multidimensional scaling (NMDS) were used to show differences in macrofungal community composition, and linear relationships were illustrated in order to analyze how environmental factors influenced macrofungal diversity and community composition. In total, 7028 specimens were collected, belonging to 1360 species, 216 genera, and 79 families. Russula, Lactarius, Amanita, Mycena, Suillus, and Inocybe were found to be the dominant genera in the GMS. We found that ectomycorrhizal fungi were dominant in temperate forests and that saprobic fungi were dominant in tropical forests. We also found that macrofungal community composition in native forests differed from that of plantation forests, indicating that plantations can provide different and complementary habitats for macrofungal growth. Our analysis of environmental factors revealed that macrofungal diversity was weakly correlated with tree species richness, and strongly correlated with elevation and latitude. [ABSTRACT FROM AUTHOR]

The effect of paleo-Pacific subduction on the geological evolution of the western Pacific and continental China is likely complex. Nevertheless, our analysis of the distribution of Mesozoic granitoids in the eastern continental China in space and time has led us to an interesting conclusion: The basement of the continental shelf beneath East and South China Seas may actually be of exotic origin geologically unrelated to the continental lithosphere of eastern China. By accepting the notion that the Jurassic-Cretaceous granitoids in the region are genetically associated with western Pacific subduction and the concept that subduction may cease to continue only if the trench is being jammed, then the termination of the granitoid magmatism throughout the vast region at ~88 ± 2 Ma manifests the likelihood of 'sudden', or shortly beforehand (~100 Ma), trench jam of the Mesozoic western Pacific subduction. Trench jam happens if the incoming 'plate' or portion of the plate contains a sizeable mass that is too buoyant to subduct. The best candidate for such a buoyant and unsubductable mass is either an oceanic plateau or a micro-continent. We hypothesize that the basement of the Chinese continental shelf represents such an exotic, buoyant and unsubductable mass, rather than seaward extension of the continental lithosphere of eastern China. The locus of the jammed trench (i.e., the suture) is predictably located on the shelf in the vicinity of, and parallel to, the arc-curved coastal line of the southeast continental China. It is not straightforward to locate the locus in the northern section of the East China Sea shelf because of the more recent (<20 Ma) tectonic re-organization associated with the opening of the Sea of Japan. We predict that the trench jam at ~100 Ma led to the re-orientation of the Pacific plate motion in the course of NNW direction as inferred from the age-progressive Emperor Seamount Chain of Hawaiian hotspot origin (its oldest unsubdued Meiji and Detroit seamounts are ~82 Ma), making the boundary between the Pacific plate and the newly accreted plate of eastern Asia a transform fault at the location east of the continental shelf of exotic origin. This explains the apparent ~40 Myr magmatic gap from ~88 to ~50 Ma prior to present-day western Pacific subduction initiation. We propose that basement penetration drilling on well-chosen sites is needed to test the hypothesis in order to reveal the true nature of the Chinese continental shelf basement. This testing becomes critical and cannot longer be neglected in order to genuinely understand the tectonic evolution of the western Pacific and its effect on the geology of eastern China since the Mesozoic, including the cratonic lithosphere thinning, related magmatism/mineralization, and the mechanism of the subsequent South China Sea opening, while also offering novel perspectives on aspects of the plate tectonics theory. We also suggest the importance of future plate tectonic reconstruction of the western Pacific to consider the nature and histories of the Chinese continental shelf of exotic origin as well as the probable transform plate boundary from ~100 to ~50 Ma. Effort is needed to reveal the true nature and origin of the ~88 ± 2 Ma granitic gneisses in Taiwan and the 110-88 Ma granitoids on the Hainan Island. [ABSTRACT FROM AUTHOR]

Abstract: Background: Automated hematology analyzer is widely used by clinical laboratories to examine blood cell counts and differential leukocyte counts. However, a microscopic examination of a well-prepared blood film is still necessary and useful in most cases. Methods: Two patients with severe disease were required complete blood counts (CBC) after admission at West China Second University Hospital in Southwest China. Results: A false “platelet clumps?” flag was generated by the automated hematology analyzer Sysmex XE-2100. However, when the well-prepared blood film was reviewed, there was echinocytosis rather than clumps of platelets. In addition, both patients had severe metabolic acidosis with arterial blood pH <7.00 and HCO3– <4mmol/l. On day 2 of admission, the false platelet clumps flags were not presented in both cases. Conclusions: Our further results suggested that the false platelet clumps had been flagged probably due to the influence of the extremely low blood pH. These two cases emphasized that a microscopic examination of a blood film was central to the morphology of blood cells. When the result of microscopic examination was abnormal, it was suggested that the physician should consider further testing to find underlying condition. [Copyright &y& Elsevier]

[Display omitted] • A qLAMP method for detection of DIV1 was established and evaluated. • qPCR is more sensitive to DIV1 than qLAMP, and qLAMP is faster than qPCR. • qPCR and qLAMP are suitable methods for the rapid detection of DIV1. Decapod iridescent virus 1 (DIV1) is a new virus discovered in recent years that infects farmed shrimp. DIV1 is highly infectious and causes substantial economic loss to the aquaculture industry of China. To prevent and control the spread and outbreak of DIV1 in a timely manner, it is necessary to establish an efficient method for DIV1 diagnosis. In this study, quantitative real-time polymerase chain reaction (qPCR) and quantitative real-time loop-mediated isothermal amplification (qLAMP) detection methods were established based on the specific sequence of the viral ATPase gene. The results indicated that the minimum detection limits of qPCR and qLAMP were 1.9 × 101 copies/μL and 1.9 × 102 copies/μL, respectively; the designed primer had good specificity for DIV1 and did not react with 13 other viruses, including white spot syndrome virus (WSSV), Enterocytozoon hepatopenaei (EHP), acute hepatopancreatic necrosis disease (AHPND), infectious hypodermal and haematopoietic necrosis virus (IHHNV), etc. A total of 43 clinical samples suspected of DIV1 infection were diagnosed by qPCR and qLAMP. Our qPCR demonstrated results consistent with a qPCR assay published previously, and the diagnostic sensitivity (DSe) and diagnostic specificity (DSp) of qLAMP were 85.71% and 100%, respectively. This result indicates that qPCR and qLAMP have good accuracy in the detection of DIVI in clinical samples. As established in this study, qPCR and qLAMP combined with a comprehensive comparative analysis can provide effective new solutions for the detection of DIV1. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a public health emergency of international concern and has caused traumatic experience for nurses worldwide. However, the prevalence of depression and anxiety symptoms in nurses, and how psychosocial factors influence nurses in this public crisis are unknown. To determine the effect of COVID-19 on the mental health of nurses and the prevalence of anxiety and depression symptoms among nurses in China during the outbreak. A cross-sectional study. A total of 3,228 nurses in Sichuan Province and Wuhan City were selected by convenience sampling. All participants were invited to complete the questionnaire through WeChat from January 27 to February 3, 2020. A self-reported questionnaire combining depression and anxiety scale was used to collect data anonymously. Binary and multivariate logistic regression was applied to measure the odds of psychosocial factors of anxiety and depression and perceived health, respectively. The total incidence of depression (34.3%) and anxiety (18.1%) during the COVID-19 outbreak was lower than that during the SARS outbreak; however, the rate of depression in our study (47.1%) was high and similar in a recent study (50.4%) about the health care workers exposed to COVID-19 in China. The results indicated that COVID-19-related stress, relationship quality with family, and demographic characteristics were associated with depression, anxiety, and perceived health status. Furthermore, the prevalence of depression was similar between nurses working in low-risk COVID-19 wards was as high as working in high-risk COVID-19 wards (OR, 1.078; 95% CI, 0.784–1.481). Our study revealed the high prevalence of depression and anxiety among nurses during the outbreak of COVID-19. COVID-19 factors and psychosocial factors were associated with mental health of nurses. The results suggest that hospitals should implement effective mental health promotion programs focused on occupational safety and family support to improve the well-being of nurses. [ABSTRACT FROM AUTHOR]

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: The clinical manifestations of nonclassical 11beta-hydroxylase deficiency are very similar to those of non-classical 21-hydroxylase deficiency. For this study, we investigated the relationship between the clinical and molecular features of congenital adrenal hyperplasia caused by 11beta-hydroxylase deficiency and reviewed the related literature, which are expected to provide assistance for the clinical diagnosis and analysis of congenital adrenal hyperplasia., Methods: Clinical data for 10 Chinese patients diagnosed with congenital adrenal hyperplasia in our hospital from 2018 to 2022 were retrospectively analyzed. We examined the effects of gene mutations on protease activity and constructed three-dimensional structure prediction models of proteins., Results: We describe 10 patients with 11beta-hydroxylase gene mutations (n = 5, 46,XY; n = 5, 46,XX), with 10 novel mutations were reported. Female patients received treatment at an early stage, with an average age of 2.08 ± 1.66 years, whereas male patients received treatment significantly later, at an average age of 9.77 ± 3.62 years. The most common CYP11B1 pathogenic variant in the Chinese population was found to be c.1360C > T. All mutations lead to spatial conformational changes that affect protein stability., Conclusions: Our study found that there was no significant correlation between each specific mutation and the severity of clinical manifestations. Different patients with the same gene pathogenic variant may have mild or severe clinical manifestations. The correlation between genotype and phenotype needs further study. Three-dimensional protein simulations may provide additional support for the physiopathological mechanism of genetic mutations., (© 2023. The Author(s).)

Importance: With the widespread use of anti-SARS-CoV-2 drugs, accumulating data have revealed potential viral load rebound after treatment., Objective: To compare COVID-19 rebound after a standard 5-day course of antiviral treatment with VV116 vs nirmatrelvir-ritonavir., Design, Setting, and Participants: This is a single-center, investigator-blinded, randomized clinical trial conducted in Shanghai, China. Adult patients with mild-to-moderate COVID-19 and within 5 days of SARS-CoV-2 infection were enrolled between December 20, 2022, and January 19, 2023, and randomly allocated to receive either VV116 or nirmatrelvir-ritonavir., Interventions: Participants in the VV116 treatment group received oral 600-mg VV116 tablets every 12 hours on day 1 and 300 mg every 12 hours on days 2 through 5. Participants in the nirmatrelvir-ritonavir treatment group received oral nirmatrelvir-ritonavir tablets with 300 mg of nirmatrelvir plus 100 mg of ritonavir every 12 hours for 5 days. Participants were followed up every other day until day 28 and every week until day 60., Main Outcomes and Measures: The primary outcome was viral load rebound (VLR), defined as a half-log increase in viral RNA copies per milliliter compared with treatment completion. Secondary outcomes included a reduction in the cycle threshold value of 1.5 or more, time until VLR, and symptom rebound, defined as an increase of more than 2 points in symptom score compared with treatment completion. The primary outcome and secondary outcomes were analyzed using the full analysis set. Sensitivity analyses were conducted using the per protocol set. Adverse events were analyzed using the safety analysis set., Results: The full analysis set included 345 participants (mean [SD] age, 53.2 [16.8] years; 175 [50.7%] were men) who received VV116 (n = 165) or nirmatrelvir-ritonavir (n = 180). Viral load rebound occurred in 33 patients (20.0%) in the VV116 group and 39 patients (21.7%) in the nirmatrelvir-ritonavir group (P = .70). Symptom rebound occurred in 41 of 160 patients (25.6%) in the VV116 group and 40 of 163 patients (24.5%) in the nirmatrelvir-ritonavir group (P = .82). Viral whole-genome sequencing of 24 rebound cases revealed the same lineage at baseline and at viral load rebound in each case., Conclusions and Relevance: In this randomized clinical trial of patients with mild-to-moderate COVID-19, viral load rebound and symptom rebound were both common after a standard 5-day course of treatment with either VV116 or nirmatrelvir-ritonavir. Prolongation of treatment duration might be investigated to reduce COVID-19 rebound., Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2200066811.

Background: Approximately 28%-57% of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) have an acute vertigo attack and probable vestibular dysfunction; however, the prognosis of vestibular function in these patients remains unclear., Methods: A prospective cohort study of patients with ISSNHL and vertigo was conducted to evaluate the prognosis of vestibular function, especially the roles of peripheral vestibular restoration and central compensation, in patients with ISSNHL and vertigo. Clinical data were recorded at baseline and at 60 days from onset in participants with unilateral ISSNHL with vertigo. Enrolment occurred from May 1, 2019 to May 1, 2022 in the outpatient clinics and inpatient departments of the Eye and ENT Hospital of Fudan University in Shanghai. The primary outcome measure was the recovery rate of vestibular function 60 days after onset as assessed by vestibular function tests, including caloric tests, cervical and ocular vestibular-evoked myogenic potential tests (cVEMP, oVEMP), video head impulse tests (vHIT), and sensory organization tests (SOT). The secondary outcome measure was the recovery of subjective evaluations in vestibular dysfunction (the dizziness handicap inventory [DHI], and the visual analogue scale for vertigo [VAS-V]) and hearing assessments (pure-tone audiometry [PTA])., Results: Overall, 86 patients were recruited, with an average duration of disease of 11.7 days and follow-up time of 60.7 days. Vestibular function was significantly improved (p < 0.05) after 60 days. The recovery rates were 100% for anterior semicircular canal (ASC), 56% for posterior semicircular canal (PSC), 41% for horizontal semicircular canal (HSC), 28% for saccule, and 23% for utricle. The recovery of vestibular function was not significantly related to changes in DHI (p = 0.245), VAS-V score (p = 0.509), or hearing outcome (p = 0.390)., Conclusions: Restoration of peripheral vestibular sensory input and central vestibular compensation can occur during the course of ISSNHL with vertigo. The otolith organs are at a higher risk of being affected and have worse recovery than the semicircular canals. Incomplete and in-process restoration of vestibular dysfunction may perturb and delay the establishment of central compensation for balance. Neither hearing outcomes nor subjective vestibular symptoms are related to recovery from vestibular dysfunction., Trial Registration: ClinicalTrials.gov (identifier NCT03951584)., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Malnutrition is associated with a high risk of mortality in adults with ischemic stroke (IS). This study aimed to investigate the relationship between malnutrition and the risk of stroke-associated pneumonia (SAP) as only a few studies examined the relationship between malnutrition and the risk of SAP in IS., Methods: Patients were included from emergency departments of five tertiary hospitals in the REtrospective Multicenter study for Ischemic Stroke Evaluation (REMISE) study from January 2020 to December 2020. Malnutrition was defined according to the Controlling Nutritional Status (CONUT), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI) systems. Multivariable logistic regression analysis was used to explore the association between malnutrition and risk of SAP., Results: We enrolled 915 patients with IS, 193 (14.75%), 495 (54.1%), and 148 (16.2%) of whom were malnourished according to the PNI, CONUT, and GNRI scores, respectively. SAP occurred in 294 (32.1%) patients. After adjusting for confounding influencing factors in the logistic regression analysis, malnutrition (moderate and severe risk vs. absent malnutrition) was independently associated with an increased risk of SAP based on the PNI (odds ratio [OR], 5.038; 95% confidence interval [CI] 2.435-10.421, P < 0.001), CONUT (OR, 6.941; 95% CI 3.034-15.878, P < 0.001), and GNRI (OR, 2.007; 95% CI 1.186-3.119, P = 0.005) scores. Furthermore, adding malnutrition assessment indices to the A 2 DS 2 score significantly improved the ability to predict SAP by analysis of receiver operating characteristic curves and net reclassification improvement., Conclusion: Malnutrition was notably prevalent in patients with IS and independently associated with an increased risk of SAP. Further studies are required to identify the effect of interventions on malnutrition to reduce the risk of SAP., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: When COVID-19 sweeps the world, traditional stethoscopes are seen as infectious agents and then the use of stethoscopes is limited especially when health providers were in their personal protective equipment. These reasons led to the ignoring of the values of stethoscopes during pandemics. This study aims to explore the value of wireless stethoscopes in patients of a makeshift hospital., Material and Methods: 200 consecutive hospitalized patients with confirmed SARS-CoV-2 at Lingang Makeshift Hospital in Shanghai, China, were enrolled from April 10 to May 10, 2022 (Trial Registration Number: ChiCTR2000038272,2020/9/15). They were randomly divided into two groups. In group A (n = 100), patients were examined without a stethoscope. In group B (n = 100), lung breath sounds and heart sounds were examined with a wireless stethoscope, and positive signs were recorded. The duration of cough and tachycardia symptoms, as well as emergency cases, were compared between the two groups. In addition, the pressure, anxiety, and depression of patients in the two groups were investigated using the DAS-21 questionnaire scale, to observe the psychological impact of the stethoscope-based doctor-patient communication on patients in the makeshift hospital., Results: There was no significant difference in baseline characteristics between the two groups. In group B, some significant positive signs were detected by wireless stethoscopes, including pulmonary rales and tachycardia, etc. Moreover, the therapeutic measures based on these positive signs effectively alleviated the symptoms of cough and tachycardia, which showed that the duration of symptoms was significantly shorter than that of group A (cough: 2.8 ± 0.9 vs. 3.6 ± 0.9; palpitation: 1.4 ± 0.7 vs. 2.6 ± 0.7). In particular, the number of emergency cases in group B is less than that in group A (1% vs. 3%), and the severity is lower. Notably, stethoscope-based doctor-patient communication was found to be effective in alleviating psychological measures of group B patients., Conclusion: Wireless stethoscopes in makeshift hospitals can avoid cross-infections and detect more valuable positive signs, which can help health providers make accurate decisions and relieve patients' symptoms more quickly. Moreover, stethoscope-based doctor-patient communication can diminish the psychological impacts of the epidemic on isolated patients in makeshift hospitals. Trial registration This study was registered in the Chinese Clinical Trial (ChiCTR2000038272) at http://www.chictr.org.cn . http://www.chinadrugtrials.org.cn/clinicaltrials.searchlistdetail.dhtml ., (© 2023. The Author(s).)