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Introduction: Lucerne (Medicago sativa), is a cornerstone of China's livestock industry, however, due to the backward agronomic strategies and technology, lucerne in China faces cultivation challenges that result in lower productivity and quality than global standards. Therefore, we undertook a meta-analysis to evaluate the impact of five distinct fertilization types on lucerne yield and nutritional quality in various locations in China. The fertilizer practices included manure application, combined mineral fertilizer and manure application (FM), biological fertilizer application, unbalanced application of two or more mineral fertilizer types, and balanced mineral fertilizer application. Furthermore, we investigate influential factors of yield and quality of lucerne under fertilization, including climatic variables (mean annual precipitation, mean annual temperature), initial soil properties (soil organic carbon; total nitrogen, pH), and agronomic factors (seeding rate, harvest frequency, and lucerne stand age). Methods: Our study analyzed 53 published papers to discern the most beneficial fertilizer for enhancing lucerne yield and nutritional quality. Results and discussion: The results showed that the fertilizer practices, on average, significantly improved yield by 31.72% and crude protein content by 11.29%, with FM emerging as the most effective, this is because mineral fertilizers provide available nutrients for lucerne, manure provides essential organic matter for microorganisms and improve soil properties. In addition, the fertilizer practices significantly reduced neutral and acid detergent fiber contents by 6.28% and 8.50%, respectively, while increasing ash content and relative feeding value. Furthermore, climatic variables, soil properties, and planting system factors such as sowing date and harvest frequency significantly affected yield and nutritional quality. The practical implications of our results emphasize the need for balanced and strategic fertilizer application to optimize lucerne production and highlight the potential to adjust cultivation practices according to environmental conditions. Balanced and strategic fertilizer application can simultaneously improve soil properties, enhance soil carbon sequestration, and reduce the emission of greenhouse gases from the soil, which is a vital measure for realizing sustainable agricultural development. [ABSTRACT FROM AUTHOR]

Purpose: Given the unique features of the liver, it is necessary to combine immunotherapy with other therapies to improve its efficacy in patients of advanced cancer with liver metastases (LM). High-intensity focused ultrasound (HIFU) ablation is now widely used in clinical practice and can enhanced immune benefits. The study is intended to prospectively evaluate the safety and clinical feasibility of HIFU ablation in combination with systemic immunotherapy for patients with liver metastases. Methods: The study enrolled 14 patients with LM who received ultrasound-guided HIFU ablation combined with immune checkpoint inhibitors (ICIs) such as anti-programmed cell death protein 1 (anti-PD-1 agents manufactured in China) at Mianyang Central Hospital. Patients were followed up for adverse events (AEs) during the trial, using the CommonTerminology Criteria for Adverse Events v5.0(CTCAE v5.0) as the standard. Tumour response after treatment was assessed using computerized tomography. Results: The 14 patients (age range, 35–84 years) underwent HIFU ablation at 19 metastatic sites and systemic immunotherapy. The mean lesion volume was 179.9 cm3 (maximum: 733.1 cm3). Median follow-up for this trial was 9 months (range: 3–21) months. The study is clinically feasible and acceptable to patients. Conclusion: This prospective study confirmed that HIFU combined with immunotherapy is clinically feasible and safe for treating liver metastases. [ABSTRACT FROM AUTHOR]

Rana hanluica: an endemic amphibian of China, is found in the hills and mountains south of the Yangtze River. In this comprehensive study, we collected 162 samples from 14 different localities to delve into the genetic diversity of Rana hanluica using mitochondrial Cytb and nuclear RAG2 as genetic markers. Our findings reveal that the Nanling Mountains, specifically regions like Jiuyi Shan, Jinggang Shan, Mang Shan, and Qiyun Shan, are genetic hotspots harboring remarkable diversity. The research results also indicate that there is gene flow among the various populations of the species, and no distinct population structure has formed, which may be due to migration. Moreover, populations in some regions, as well as the overall population, show signs of a possible genetic bottleneck, which we speculate may have been caused by climate change. However, given the exploratory nature of our study, further investigations are warranted to confirm these observations. Through phylogenetic analyses, we uncovered indications that R. hanluica might have originated within the Nanling region, dispersing along the east-west mountain ranges, with a significant contribution originating from Jiuyi Shan. The genetic distributions uncovered through our research reflect historical migratory patterns, evident in the distinct haplotypes of the RAG2 gene between the western and eastern parts of the studied area. Moreover, Heng Shan and Yangming Shan exhibited unique genetic signatures, possibly influenced by geographic isolation, which has shaped their distinct genotypes. The insights gained from this study hold profound implications for conservation efforts. By identifying regions rich in genetic diversity and crucial gene flow corridors, we can develop more effective conservation strategies. Preserving these genetically diverse areas, especially within the Nanling Mountains, is vital for maintaining the evolutionary potential of R. hanluica. In conclusion, our research has laid a solid foundation for understanding the genetic landscape of R. hanluica, shedding light on its origins, population structures, and evolutionary trajectories. This knowledge will undoubtedly guide future research endeavors and inform conservation strategies for this endemic amphibian. [ABSTRACT FROM AUTHOR]

Angelica dahurica is a kind of Chinese traditional herbs with economic and ornament value, widely distributed in China. Despite its significance, there have been limited comprehensive investigations on the genome of A. dahurica, particularly regarding mitochondrial genomes. To investigate the conversion between mitochondrial genome and chloroplast genome, a complete and circular mitochondrial genome was assembled using Oxford Nanopore Technologies (ONT) long reads. The mitochondrial genome of A. dahurica had a length of 228,315 base pairs (bp) with 45.06% GC content. The mitochondrial genome encodes 56 genes, including 34 protein-coding genes, 19 tRNA genes and 3 rRNA genes. Moreover, we discovered that 9 homologous large fragments between chloroplast genome and mitochondrial genome based on sequence similarity. This is the first report for A. dahurica mitochondrial genome, which could provide an insight for communication between plastid genome, and also give a reference genome for medicinal plants within the Angelica family. [ABSTRACT FROM AUTHOR]

Aims: This study aims to explore the experiences of rehabilitation specialist nurses in providing bowel care to stroke patients and to identify the factors that either facilitate or hinder their practice. Design: This was a descriptive qualitative design study. Methods: Between May 2022 and October 2022, we conducted in-depth and semistructured interviews with 12 rehabilitation specialist nurses from two tertiary hospitals in Changsha, China. Thematic analysis was employed to analyse the interview transcripts. Findings: Three key themes were revealed from our analysis: (1) acceptance of bowel care as a process, (2) high level of recognition improves the experience and (3) challenges stemming from limited knowledge and rights. Acceptance of bowel care as a dynamic process, coupled with a high level of recognition, enabled nurses to prioritize the health and safety of patients over personal feelings and achieve professional accomplishments. However, they encountered challenges in terms of professional development and restricted prescribing rights for bowel care. Conclusion: The experiences of rehabilitation specialist nurses in providing bowel care are dynamic. These findings have important implications for healthcare improvement, including the need for collaboration with healthcare professionals and nurturing nurses' self-identity, comprehensive training plans, innovative programs and expanding the scope of rehabilitation specialist nurses' rights. Impact: This study enhances our understanding of the challenges faced by rehabilitation specialist nurses caring for stroke patients with neurogenic bowel dysfunction. The findings provide insights into how to enhance bowel care experience and develop further in this field. Reporting Method: This study adhered to the EQUATOR guideline and utilized the COREQ checklist. [ABSTRACT FROM AUTHOR]

Objective: A large number of studies have found that the prevalence of cognitive impairment varies in different regions. However, data on cognitive impairment in the Chinese population is still lacking. The goal of this study was to assess the prevalence of cognitive impairment among the elderly in a region of China and explore the associated risk factors. Methods: We performed a population‐based cross‐sectional survey from April to June 2022. Residents come from three villages and six urban communities in the county‐level city of Liuyang in southern China (N = 3233) and the coverage rate of our study population reached 73%. Participants were assessed with a series of clinical examinations and neuropsychological measures. A total of 2598 participants were selected after filtering out those under 60 years old or with incomplete data. Patients with cognitive impairment included those with mild cognitive impairment (MCI) or dementia who met standard diagnostic criteria. Results: The prevalence of cognitive impairment, MCI, and dementia among participants aged 60 years and older were 21.48% (95% CI, 19.90–23.10), 15.70% (95% CI, 14.30–17.10), and 5.77 (95% CI, 4.90–6.70), respectively. And residents in villagers were more likely to have cognitive impairment than in urban communities (p < 0.001). Age growth and education level were independent influencing factors for cognitive impairment in all populations (p < 0.001). For lifestyles factors, both smoking and drinking reduced the risk of cognitive impairment (p < 0.05), but when further quantified, the link disappeared. Moreover, having cerebrovascular disease and severe vision impairment were risk factors (p < 0.05). Conclusion: A representative prevalence of cognitive impairment, MCI, and dementia was found in the elderly Han Chinese population in Southern China. And we further explored the role of known risk factors, particularly in physical activity, smoking, and alcohol consumption. [ABSTRACT FROM AUTHOR]

Circadian clocks are endogenous timekeeping mechanisms that coordinate internal physiological responses with the external environment. EARLY FLOWERING3 (ELF3), PSEUDO RESPONSE REGULATOR (PRR9), and PRR7 are essential components of the plant circadian clock and facilitate entrainment of the clock to internal and external stimuli. Previous studies have highlighted a critical role for ELF3 in repressing the expression of PRR9 and PRR7. However, the functional significance of activity in regulating circadian clock dynamics and plant development is unknown. To explore this regulatory dynamic further, we first employed mathematical modeling to simulate the effect of the prr9/prr7 mutation on the elf3 circadian phenotype. These simulations suggested that simultaneous mutations in prr9/prr7 could rescue the elf3 circadian arrhythmia. Following these simulations, we generated all Arabidopsis elf3/prr9/prr7 mutant combinations and investigated their circadian and developmental phenotypes. Although these assays could not replicate the results from the mathematical modeling, our results have revealed a complex epistatic relationship between ELF3 and PRR9/7 in regulating different aspects of plant development. ELF3 was essential for hypocotyl development under ambient and warm temperatures, while PRR9 was critical for root thermomorphogenesis. Finally, mutations in prr9 and prr7 rescued the photoperiod-insensitive flowering phenotype of the elf3 mutant. Together, our results highlight the importance of investigating the genetic relationship among plant circadian genes. [ABSTRACT FROM AUTHOR]

Background and objective As a new technique developed in recent years, bronchoscopic intervention therapy has the advantages of minimal invasion, high safety and repeatability. The aim of this study is to investigate the clinical characteristics of bronchopleural fistula (BPF) induced by surgeries for lung malignancies or benign diseases and the effect of bronchoscopic intervention therapy for BPF, so as to provide support for prevention and treatment of BPF. Methods Data 64 patients with BPF who were treated by bronchoscopic intervention in Respiratory Disease Center of Dongzhimen Hospital, Beijing University of Chinese Medicine from June 2020 to September 2023 were collected. Patients with fistula diameter ≤5 mm were underwent submucous injection of macrogol, combined with blocking therapy with N-butyl cyanoacrylate, medical bioprotein glue or silicone prosthesis. Patients with fistula diameter >5 mm were implanted with different stents and cardiac occluders. Locations and characteristics of fistulas were summarized, meanwhile, data including Karnofsky performance status (KPS), shortbreath scale (SS), body temperature, pleural drainage volume and white blood cell count before and after operation were observed. Results For all 64 patients, 96 anatomic lung resections including pneumonectomy, lobectomy and segmentectomy were executed and 74 fistulas occurred in 65 fistula locations. The proportion of fistula in the right lung (63.5%) was significantly higher than that in the left (36.5%). Besides, the right inferior lobar bronchial fistula was the most common (40.5%). After operation, KPS was significantly increased, while SS, body temperature, pleural drainage volume and white blood cell count were significantly decreased compared to the preoperative values (P<0.05). By telephone follow-up or readmission during 1 month to 38 months after treament, median survival time was 21 months. 33 patients (51.6%) showed complete response, 7 patients (10.9%) showed complete clinical response, 18 patients (28.1%) showed partial response, and 6 patients (9.4%) showed no response. As a whole, the total effective rate of bronchoscopic intervention for BPF was 90.6%. Conclusion BPF induced by pulmonary surgery can lead to severe symptoms and it is usually life-threating. Bronchoscopic intervention therapy is one of the fast and effective therapeutic methods for BPF. [ABSTRACT FROM AUTHOR]

Objectives: Pharyngocutaneous fistula (PCF) formation following open surgical treatment of hypopharyngeal cancer (HPC) is a common and troublesome complication. To date, the postoperative protocol of restarting oral intake is not clear, and vast discrepancies exist in the literature and among institutions. This study aimed to explore the impact of a postoperative protocol of restarting oral intake on PCF formation after open surgical treatment of primary HPC, and its impact on overall survival (OS) and swallowing function based on the functional outcome swallowing scale (FOSS). Materials and Methods: This was a prospective observational study of 42 patients who received open surgical treatment for primary HPC at Beijing Friendship Hospital between April 2019 and August 2021. This cohort included two groups: patients who restarted oral intake on the 10th postoperative day (Group 1), and those who started on the 20th (Group 2). The Chi-square test and Fisher's exact chi-squared test were used for comparing qualitative data among the groups. Results: Group 1 (n = 27) and Group 2 (n = 15) were comparable in clinical characteristics. PCF occurred in 7 (25.9%) patients in Group 1, while none occurred in Group 2 (P = 0.038). The 2-year OS of all 42 patients was 75.6%; 65.8% and 93.3% for Groups 1 and 2, respectively (P = 0.07). The swallowing function was satisfactory (FOSS Grades 0–III) for 19 (70.4%) patients in Group 1 and 15 (100%) patients in Group 2 (P = 0.035). Laryngeal preservation was achieved in 25 (59.5%) patients, while decannulation was successful in 22 (88.0%) patients. Conclusions: Delayed oral feeding significantly reduces PCF after open surgical treatment of primary HPC, and improves the swallowing function outcome without jeopardizing the OS. [ABSTRACT FROM AUTHOR]

Helicobacter pylori (HP) infections affect approximately one-third of children worldwide. In China, the incidence of HP infection in children ranges from approximately 30% to 60%. In addition to damaging the gastrointestinal tract mucosa, HP infection in children can negatively affect their growth and development, hematology, respiratory and hepatobiliary system, skin, nutritional metabolism, and autoimmune system. However, the rate of HP eradication also fell considerably from the previous rate due to the presence of drug-resistant HP strains and the limited types of antibiotics that can be used in young patients. Vitamin D3 (VitD3) is a steroid hormone that can reduce inflammation in the stomach mucosa induced by HP and can alleviate and eradicate HP through a variety of pathways and mechanisms, including immune regulation and the stimulation of antimicrobial peptide (AMP) secretion and Ca2+ influx, to reestablish lysosomal acidification; thus, these results provide new strategies and ideas for the eradication of drug-resistant HP strains. [ABSTRACT FROM AUTHOR]

BACKGROUND Triglyceride-glucose (TyG) index values are a new surrogate marker for insulin resistance. This study aimed to explore the relationship between cumulative TyG index values and atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). METHODS A total of 576 patients with AF who underwent RFCA at the Second Affiliated Hospital of Xi'an Jiaotong University were included in this study. The participants were grouped based on cumulative TyG index values tertiles within 3 months after ablation. Cox regression and restricted cubic spline analyses were used to determine the relationship between cumulative TyG index values and AF recurrence. The predictive value of all risk factors was assessed by receiver operating curve analysis. RESULTS There were 375 patients completed the study (age: 63.23 ± 10.73 years, 64.27% male). The risk of AF recurrence increased with increasing cumulative TyG index values tertiles. After adjusting for potential confounders, patients in the medium cumulative TyG index group [hazard ratio (HR) = 4.949, 95% CI: 1.778-13.778, P = 0.002] and the high cumulative TyG index group (HR = 8.716, 95% CI: 3.371-22.536, P < 0.001) had a higher risk of AF recurrence than those in the low cumulative TyG index group. The restricted cubic spline regression model also showed an increased risk of AF recurrence with increasing cumulative TyG index values. When considering cumulative TyG index values, left atrial diameter, and lactate dehydrogenase levels as a comprehensive factor, the model could effectively predict AF recurrence after RFCA [area under the curve (AUC) = 0.847, 95% CI: 0.797-0.897, P < 0.001]. CONCLUSIONS Cumulative TyG index values were a risk factor for AF recurrence after RFCA. Monitoring longitudinal TyG index values may assist with optimized for risk stratification and outcome prediction for AF recurrence. [ABSTRACT FROM AUTHOR]

Background: Our previous study revealed marked differences in tongue images between individuals with gastric cancer and those without gastric cancer. However, the biological mechanism of tongue images as a disease indicator remains unclear. Tongue coating, a major factor in tongue appearance, is the visible layer on the tongue dorsum that provides a vital environment for oral microorganisms. While oral microorganisms are associated with gastric and intestinal diseases, the comprehensive function profiles of oral microbiota remain incompletely understood. Metaproteomics has unique strength in revealing functional profiles of microbiota that aid in comprehending the mechanism behind specific tongue coating formation and its role as an indicator of gastric cancer. Methods: We employed pressure cycling technology and data-independent acquisition (PCT-DIA) mass spectrometry to extract and identify tongue-coating proteins from 180 gastric cancer patients and 185 non-gastric cancer patients across 5 independent research centers in China. Additionally, we investigated the temporal stability of tongue-coating proteins based on a time-series cohort. Finally, we constructed a machine learning model using the stochastic gradient boosting algorithm to identify individuals at high risk of gastric cancer based on tongue-coating microbial proteins. Results: We measured 1432 human-derived proteins and 13,780 microbial proteins from 345 tongue-coating samples. The abundance of tongue-coating proteins exhibited high temporal stability within an individual. Notably, we observed the downregulation of human keratins KRT2 and KRT9 on the tongue surface, as well as the downregulation of ABC transporter COG1136 in microbiota, in gastric cancer patients. This suggests a decline in the defense capacity of the lingual mucosa. Finally, we established a machine learning model that employs 50 microbial proteins of tongue coating to identify individuals at a high risk of gastric cancer, achieving an area under the curve (AUC) of 0.91 in the independent validation cohort. Conclusions: We characterized the alterations in tongue-coating proteins among gastric cancer patients and constructed a gastric cancer screening model based on microbial-derived tongue-coating proteins. Tongue-coating proteins are shown as a promising indicator for identifying high-risk groups for gastric cancer. 1cCPG45EGUX3nZjXKAFgvf Video Abstract [ABSTRACT FROM AUTHOR]

Background In early adolescence, youth are highly prone to suicidal behaviours. Identifying modifiable risk factors during this critical phase is a priority to inform effective suicide prevention strategies. Aims To explore the risk and protective factors of suicidal behaviours (ie, suicidal ideation, plans and attempts) in early adolescence in China using a social-ecological perspective. Methods Using data from the cross-sectional project 'Healthy and Risky Behaviours Among Middle School Students in Anhui Province, China', stratified random cluster sampling was used to select 5724 middle school students who had completed self-report questionnaires in November 2020. Network analysis was employed to examine the correlates of suicidal ideation, plans and attempts at four levels, namely individual (sex, academic performance, serious physical illness/disability, history of self-harm, depression, impulsivity, sleep problems, resilience), family (family economic status, relationship with mother, relationship with father, family violence, childhood abuse, parental mental illness), school (relationship with teachers, relationship with classmates, school-bullying victimisation and perpetration) and social (social support, satisfaction with society). Results In total, 37.9%, 19.0% and 5.5% of the students reported suicidal ideation, plans and attempts in the past 6 months, respectively. The estimated network revealed that suicidal ideation, plans and attempts were collectively associated with a history of self-harm, sleep problems, childhood abuse, school bullying and victimisation. Centrality analysis indicated that the most influential nodes in the network were history of self-harm and childhood abuse. Notably, the network also showed unique correlates of suicidal ideation (sex, weight=0.60; impulsivity, weight=0.24; family violence, weight=0.17; relationship with teachers, weight=-0.03; school-bullying perpetration, weight=0.22), suicidal plans (social support, weight=-0.15) and suicidal attempts (relationship with mother, weight=-0.10; parental mental illness, weight=0.61). Conclusions This study identified the correlates of suicidal ideation, plans and attempts, and provided practical implications for suicide prevention for young adolescents in China. Firstly, this study highlighted the importance of joint interventions across multiple departments. Secondly, the common risk factors of suicidal ideation, plans and attempts were elucidated. Thirdly, this study proposed target interventions to address the unique influencing factors of suicidal ideation, plans and attempts. [ABSTRACT FROM AUTHOR]

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In the context of global warming and the increasing water shortage in dry areas, it is necessary to find a sustainable pathway for utilization of land resources (ULR) to solve these problems. For this purpose, using socioeconomic and environmental indicators from 2006 to 2018 and taking the Tarim Basin, China as an example, this study employed an integrated approach composed of the indicator evaluation system (IES) and the System Dynamics (SD) model to evaluate the possibility of sustainable ULR in the basin. During the simulation, three scenarios namely traditional development (TD), economic priority (EP) and harmonious development (HD) were designed, and different thresholds were set for each indicator of potential ULR in each sub-region to predict their future development status. The IES was established to derive the sustainable utilization degree (SUD) of ULR. The results show that the SUD in Tarim in 2030 is likely be 0.60 (TD), 0.62 (EP) and 0.68 (HD), indicating that only in HD scenario is it possible to find pathway to solve water scarcity problem and achieve sustainable ULR. This study provides a supportive idea for decision-making on sustainable ULR in Tarim and also an approach for similar sustainability assessment in other dry areas. [ABSTRACT FROM AUTHOR]

Earthen dams are exposed to complex environments where their safety is often affected by multiple uncertain risks. A Bayesian network (BN) is often used to analyze the dam failure risk, which is an effective tool for this issue as its excellent ability in representing uncertainty and reasoning. The validity of the BN model is strongly dependent on the quality of the sample data, making convincing modeling rationale a challenge. There has been a lack of systematic analysis of the dam failure data of China, resulting in limited exploration of the potential associations between risk factors. In this paper, we established a comprehensive database containing various dam failure cases in China. Herein, historical dam failure statistics are used to develop BN models for risk analysis of earthen dams in China. In order to unleash the value of the historical data, we established a Bayesian network through the Causal Loop Diagrams (CLD) based on the nonlinear causal analysis. We determined the conditional probabilities using Word Frequency Analysis (WFA). By comparing with the Bayesian Learning results, the modeling method of BN proposed in our study has apparent advantages. According to the BN model established in this paper, the probabilities of dam failure due to seepage damage, overtopping, and structural instability are estimated to be 22.1%, 58.1%, and 7.9%, respectively. In addition, we presented a demonstration of the inference process for the dam failure path, which will offer valuable insights to dam safety practitioners during their decision-making process. [ABSTRACT FROM AUTHOR]

INTRODUCTION The World Health Organization recommends banning all forms of e-cigarette advertising, promotion, and sponsorship. The aims of the present study were to: 1) examine young people's exposure to e-cigarette advertising across a wide range of media in four diverse countries; and 2) identify any association between the number of different types of media exposures and e-cigarette use. METHODS A cross-sectional online survey was administered to approximately 1000 people aged 15-30 years in Australia, China, India, and the United Kingdom (n=4107). The survey assessed demographic characteristics, e-cigarette and tobacco use, numbers of friends and family members who vape, and exposure to multiple forms of e-cigarette advertising (e.g. television, radio, print, and various types of social media). Descriptive analyses were conducted on those who had heard of e-cigarettes (n=3095, significance threshold p<0.001) and a logistic regression analysis was used to identify factors associated with e-cigarette ever use (significance threshold p<0.05). RESULTS The majority (85%) of respondents who had heard of e-cigarettes reported being exposed to e-cigarette advertising on at least one type of media, and the average number of types of media to which respondents were exposed was 5 (range: 0-17). The number of media types was significantly associated with ever use of e-cigarettes (OR=1.05; 95% CI: 1.02-1.08, p=0.001). CONCLUSIONS Despite advertising restrictions in place in all four countries, large majorities of young people reported being exposed to e-cigarette advertising. Social media and advertising on/around vape shops and other retailers appear to be key exposure locations. Urgent attention is needed to address these forms of exposure given their apparent association with e-cigarette use. [ABSTRACT FROM AUTHOR]

Since 2015, stroke has become the leading cause of death and disability in China, posing a significant threat to the health of its citizens as a major chronic non-communicable disease. According to the China Stroke High-risk Population Screening and Intervention Program, an estimated 17.8 million [95% confidence interval (CI) 17.6–18.0 million] adults in China had experienced a stroke in 2020, with 3.4 million (95% CI 3.3–3.5 million) experiencing their first-ever stroke and another 2.3 million (95% CI 2.2–2.4 million) dying as a result. Additionally, approximately 12.5% (95% CI 12.4–12.5%) of stroke survivors were left disabled, as defined by a modified Rankin Scale score greater than 1, equating to 2.2 million (95% CI 2.1–2.2 million) stroke-related disabilities in 2020. As the population ages and the prevalence of risk factors like diabetes, hypertension, and hyperlipidemia continues to rise and remains poorly controlled, the burden of stroke in China is also increasing. A large national epidemiological survey initiated by the China Hypertension League in 2017 showed that the prevalence of hypertension was 24.7%; the awareness, treatment, and control rates in hypertensive patients were: 60.1%, 42.5%, and 25.4%, respectively. A nationally representative sample of the Chinese mainland population showed that the weighted prevalence of total diabetes diagnosed by the American Diabetes Association criteria was 12.8%, suggesting there are 120 million adults with diabetes in China, and the awareness, treatment, and control rates in diabetic patients were: 43.3%, 49.0%, and 49.4%, respectively. The "Sixth National Health Service Statistical Survey Report in 2018" showed that the proportion of the obese population in China was 37.4%, an increase of 7.2 points from 2013. Data from 1599 hospitals in the Hospital Quality Monitoring System and Bigdata Observatory Platform for Stroke of China (BOSC) showed that a total of 3,418,432 stroke cases [mean age ± standard error (SE) was (65.700 ± 0.006) years, and 59.1% were male] were admitted during 2020. Of those, over 80% (81.9%) were ischemic stroke (IS), 14.9% were intracerebral hemorrhage (ICH) strokes, and 3.1% were subarachnoid hemorrhage (SAH) strokes. The mean ± SE of hospitalization expenditures was Chinese Yuan (CNY) (16,975.6 ± 16.3), ranging from (13,310.1 ± 12.8) in IS to (81,369.8 ± 260.7) in SAH, and out-of-pocket expenses were (5788.9 ± 8.6), ranging from (4449.0 ± 6.6) in IS to (30,778.2 ± 156.8) in SAH. It was estimated that the medical cost of hospitalization for stroke in 2020 was CNY 58.0 billion, of which the patient pays approximately CNY 19.8 billion. In-hospital death/discharge against medical advice rate was 9.2% (95% CI 9.2–9.2%), ranging from 6.4% (95% CI 6.4–6.5%) for IS to 21.8% for ICH (95% CI 21.8–21.9%). From 2019 to 2020, the information about 188,648 patients with acute IS receiving intravenous thrombolytic therapy (IVT), 49,845 patients receiving mechanical thrombectomy (MT), and 14,087 patients receiving bridging (IVT + MT) were collected through BOSC. The incidence of intracranial hemorrhage during treatment was 3.2% (95% CI 3.2–3.3%), 7.7% (95% CI 7.5–8.0%), and 12.9% (95% CI 12.3–13.4%), respectively. And in-hospital death/discharge against medical advice rate was 8.9% (95% CI 8.8–9.0%), 16.5% (95% CI 16.2–16.9%), and 16.8% (95% CI 16.2–17.4%), respectively. A prospective nationwide hospital-based study was conducted at 231 stroke base hospitals (Level III) from 31 provinces in China through BOSC from January 2019 to December 2020 and 136,282 stroke patients were included and finished 12-month follow-up. Of those, over 86.9% were IS, 10.8% were ICH strokes, and 2.3% were SAH strokes. The disability rate [% (95% CI)] in survivors of stroke at 3-month and 12-month was 14.8% (95% CI 14.6–15.0%) and 14.0% (95% CI 13.8–14.2%), respectively. The mortality rate [% (95% CI)] of stroke at 3-month and 12-month was 4.2% (95% CI 4.1–4.3%) and 8.5% (95% CI 8.4–8.6%), respectively. The recurrence rate [% (95% CI)] of stroke at 3-month and 12-month was 3.6% (95% CI 3.5–3.7%) and 5.6% (95% CI 5.4–5.7%), respectively. The Healthy China 2030 Stroke Action Plan was launched as part of this review, and the above data provide valuable guidelines for future stroke prevention and treatment efforts in China. [ABSTRACT FROM AUTHOR]

The middle Eocene climatic optimum (MECO, ca. ~42 Ma) is a key time period for understanding Cenozoic cooling of the global climate. Still, midlatitude terrestrial records of climate evolution during MECO epoch are rare. In this study, continuous high-resolution record of shale sediments in mid-Eocene Shahejie Formation (MES shales) in the Bohai Bay Basin were performed with major-element and wavelet analysis. The midlatitude paleoweathering and paleoclimatic evolution during MECO epoch were analyzed in this study. The MES shales experienced weak-moderate paleoweathering under a subtropical monsoon paleoclimate with mean annual temperature of 8.3-12.9 °C and mean annual precipitation of 685-1100 mm/yr. The MES shales record a mixed provenance involving intermediate igneous rocks, and low compositional maturity. The nutrient-rich environment led to enrichment in organic matter in the MES shales. Wavelet analysis revealed good periodicity about the paleoclimate and weathering during MECO epoch. In the stage I of MES shales depositional process, the paleolake was high in nutrients, and the MES shales experienced high chemical weathering due to a relatively warmer and more humid climate. In contrast, the climate in stage II was relatively cold and dry, and the maturity of the MES shales was relatively high during this stage, suggesting a relatively stable tectonic background. This work provides more terrestrial records of MECO epoch for midlatitude region, and is benefit for better understanding of the palaeoenvironment when MES shales formed. The implication of organic matters enrichment in this study is meaningful for the shale oil/gas exploration in Nanpu Sag. [ABSTRACT FROM AUTHOR]

Background: With the increasing development of medical imaging, the use of iodinated contrast media has become more widespread. Adverse reactions caused by iodinated contrast media have drawn much attention. Despite this, there is still a lack of unified standards for the safe infusion process of iodinated contrast media in clinical practice both domestically and internationally. Objectives: Establishing a risk management service system to better predict the risks associated with iodinated contrast media infusion, reduce the incidence of adverse reactions and minimize patient harm. Method: A prospective interventional study was carried out from April 2021 to December 2021 at Nanjing Drum Tower Hospital in China. During this study, a service system was established to manage the risks associated with the infusion of iodinated contrast media. Personalized risk identification and assessment were performed by a pharmacist-led multidisciplinary team before iodinated contrast media infusion. Early warning, prevention, and adverse reaction management were performed according to different risk levels during and after infusion. Results: A multidisciplinary team led by pharmacists was established to evaluate the risks associated with infusion of iodinated contrast media. A total of 157 patients with risk factors related to the iodinated contrast media were screened out, which prevented 22 serious adverse events and enhanced the quality of medical care. All participants expressed high satisfaction with the service. Conclusion: Through practical exploration, the pharmacist-led multidisciplinary team can provide advance warning and effectively limit the risks of adverse reactions caused by iodinated contrast media to a preventable and controllable level. This approach serves as a valuable reference for developing strategies and schemes to reduce the incidence of such reactions. Therefore, we encourage the implementation of this intervention in other areas of China. [ABSTRACT FROM AUTHOR]

With potential hydrocarbon source rocks, the Mesozoic Lower Cretaceous interval in the Aitegle Sag of the Yingen-Ejinaqi Basin in China has a bright petroleum exploration prospect. Considering the scarcity of wells in Aitegle Sag, we have systematically carried out the research on the sequence structure and sedimentary system evolution of the Lower Cretaceous based on seismic, core, and logging data, guided by the Vail classic sequence stratigraphy, and innovatively introduced the self-organizing mapping neural network (SOM) learning algorithm to assist in seismic geological analysis. The results are as follows: (1) after RMSAmp, LyapIndex, FrctDim, and InfoEntr clustering, five zones are divided, which are corresponding to five seismic facies (showing medium-strong amplitude and parallel-subparallel reflection; medium-strong amplitude and wedge-shaped divergent reflection; medium-strong amplitude and continuous-relatively continuous, parallel-subparallel reflection; strong amplitude and continuous sheet-like or blank reflection; and weak amplitude and mound-shaped chaotic reflection, respectively), and interpreted as five subfacies including delta plain front, prodelta-shallow lake, semideep lake, deep lake, and sublacustrine fan. (2) The Lower Cretaceous formation includes one second-order sequence, three third-order sequences (SQ2–SQ4), and six system tracts. In the SQ2–SQ4 circle, the delta system formed by sediments from southeast varies remarkably in the progradational zones in different system tracts, and tectonic movements and sediment supply control the sequence stratigraphy in the study area as major factors. (3) It is feasible to apply SOM learning algorithm to seismic attribute clustering analysis. This method effectively realizes the combination of geophysical methods based on big data analysis and geological problem analysis, which not only strengthens the use of seismic data but also ensures the effectiveness and reliability of clustering results. These findings offer basic data and scientific supports for the exploration and development of unconventional reservoirs (e.g., shale and tight oil/gas reservoirs) in the Aitegle Sag and also provide new ideas for studying the sequence-sediment in the target zones in the fault basin regions with scarce wells. [ABSTRACT FROM AUTHOR]

Background: The pathogens of suspected spinal tuberculosis (TB) include TB and non-TB bacteria. A rapid and effective diagnostic method that can detect TB and non-TB pathogens simultaneously remains lacking. Here, we used metagenomic next-generation sequencing (mNGS) to detect the pathogens in patients with suspected spinal TB. Methods: The enrolled patients with suspected spinal TB were regrouped three times into patients with spinal infection and controls, patients with spinal TB and controls, and patients with non-TB spinal infection and controls. We tested the three groups separately by using mNGS and conventional detection methods. Results: Ultimately, 100 patients were included in this study. Pathogens were detected in 82 patients. Among the 82 patients, 37 had TB and 45 were infected with other bacteria. In patients with spinal infection, the sensitivity of the mNGS assay was higher than that of culture and pathological examination (p < 0.001, p < 0.001). The specificity of the mNGS assay was not statistically different from that of culture and pathological examination (p = 1.000, p = 1.000). In patients with spinal TB, no statistical difference was found between the sensitivity of the mNGS assay and that of Xpert and T-SPOT.TB (p = 1.000, p = 0.430). The sensitivity of the mNGS assay was higher than that of MGIT 960 culture and pathological examination (p < 0.001, p = 0.006). The specificities of the mNGS assay, Xpert, MGIT 960 culture, and pathological examination were all 100%. The specificity of T-SPOT.TB (78.3%) was lower than that of the mNGS assay (100%; p < 0.001). In patients with non-TB spinal infection, the sensitivity of the mNGS assay was higher than that of bacterial culture and pathological examination (p < 0.001, p < 0.001). The specificity of the mNGS assay was not statistically different from that of bacterial culture and pathological examination (p = 1.000, p = 1.000). Conclusion: Data presented here demonstrated that mNGS can detect TB and non-TB bacteria simultaneously, with high sensitivity, specificity and short detection time. Compared with conventional detection methods, mNGS is a more rapid and effective diagnostic tool for suspected spinal TB. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study investigated the relationship between frailty and diabetes complicated with comorbidities. Background: Frailty is a common geriatric syndrome, and older adults with diabetes are prone to frailty. Patients with diabetes and comorbidities might be at increased risk of developing frailty. Design: A multicenter cross‐sectional study. Methods: A cross‐sectional study was conducted to identify older patients with diabetes and comorbidities in the internal medicine departments of five tertiary general hospitals in Sichuan Province, China, from March 2020 to June 2021. We used the FRAIL scale to identify frailty, and multinomial logistic regression was used to compare sociodemographic characteristics and comorbidities of frail or pre‐frail participants with robust participants. The STROBE checklist was used for this cross‐sectional study. Results: A total of 1652 patients (883 males, 53.5%) were included, and the prevalence of frailty was 26.5%. Multinomial logistic regression analysis revealed that compared with robust patients, diabetic patients with hypertension, coronary heart disease, chronic cardiac failure, COPD, cerebrovascular diseases, osteoarticular diseases, chronic renal diseases, chronic gastrointestinal diseases and cancer were more likely to be frail. In addition, patients who engaged in less exercise, presented more comorbidities, were older and had lower education levels, were more prone to frailty. Conclusion: There was a clear correlation between diabetes complicated with comorbidities and the development of frailty. Appropriate personalised care levels for patients with diabetes and comorbidities, and early screening for frailty might reduce the prevalence of frailty in these patients. Relevance to clinical practice: This study provided information for healthcare providers to identify circumstances that increase the risk of frailty and more effectively support patients with diabetes and comorbidities. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore possible associations between molecular subtypes and site of distant metastasis in advanced breast cancer (ABC). Methods: 3577 ABC patients were selected from 21 hospitals of seven geographic regions in China from 2012-2014. A questionnaire was designed to collect medical information regarding demographic characteristics, risk factors, molecular subtype, recurrence/metastasis information, and disease-free survival (DFS). The cancers were classified into Luminal A, Luminal B, HER2-enriched and Triple Negative subtypes. Chi-square test and multivariate Cox proportional hazard models were performed to explore the associations between molecular subtypes and distant metastasis sites. Results: A total of 2393 cases with molecular subtypes information were finally examined. Patients with Luminal A (51.1%) and Luminal B (44.7%) were most prone to bone metastasis, whereas liver metastasis was more frequently observed in HER2-enriched ABC patients (29.1%).The cumulative recurrence and metastasis rates of ABC patients at 36 months of DFS were the most significant within molecular types, of which Triple Negative was the highest (82.7%), while that of Luminal A was the lowest (58.4%). In the adjusted Cox regression analysis, Luminal B, HER2-enriched and Triple Negative subtypes increased the risk of visceral metastasis by 23%, 46% and 87% respectively. In addition, Triple Negative patients had a higher probability of brain metastasis (HR 3.07, 95% CI: 1.04-9.07). Conclusion: Molecular subtypes can predict the preferential sites of distant metastasis, emphasizing that these associations were of great help in choices for surveillance, developing appropriate screening and cancer management strategies for follow-up and personalized therapy in ABC patients. [ABSTRACT FROM AUTHOR]

Glioma stemming from glial cells of the central nervous system (CNS) is one of the leading causes of cancer death in childhood. The genetic predisposition of glioma is not fully understood. METTL1-WDR4 methyltransferase complex is implicated in tumorigenesis by catalyzing N7-methylguanosine (m7G) modification of RNA. This study is aimed at determining the association of glioma risk with three polymorphisms (rs2291617, rs10877013, and rs10877012) in METTL1 and five polymorphisms (rs2156315 rs2156316, rs6586250, rs15736, and rs2248490) in WDR4 gene in children of Chinese Han. We enrolled 314 cases and 380 controls from three independent hospitals. Genotypes of these polymorphisms were determined using the TaqMan assay. We found the WDR4 gene rs15736 was significantly associated with reduced glioma risk (GA/AA vs. GG: adjusted odds ratio = 0.63 , 95 % confidence interval = 0.42 − 0.94 , P = 0.023) out of the eight studied polymorphisms. Stratified analyses showed that the association of rs15736 with the risk of glioma remained significant in children aged 60 months or older, girls, the subgroups with astrocytic tumors, or grade I + II glioma. We also found the combined effects of five WDR4 gene polymorphisms on glioma risk. Finally, expression quantitative trait locus (eQTL) analyses elucidated that the rs15736 polymorphism was related to the expression level of WDR4 and neighboring gene cystathionine-beta-synthase (CBS). Our finding provided evidence of a causal association between WDR4 gene polymorphisms and glioma susceptibility in Chinese Han children. [ABSTRACT FROM AUTHOR]

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China's housing distribution system has undergone a major transformation, and the country's housing markets have experienced a rapid price increase. However, the extent to which urban housing prices influence female labor participation (FLP) in labor decision-making and how the FLP rate affects economic development has not been suficiently investigated. Accordingly, we first build a theoretical neoclassical economic development model that includes housing consumption factors to estimate the effect of housing price dynamics on FLP. We then use the 2017 China Family Panel Studies (CFPS) database to empirically estimate the intrinsic relationship between urban housing prices, FLP, and economic development through the lens of the balanced growth path, and we come up with four main findings. First, the theoretical model demonstrates that rising housing prices increase FLP, stimulating economic development. However, an excessive increase in housing prices will undermine women's ability to drive economic development. Second, the empirical evidence shows that a unit increase in housing prices increases the probability of FLP by 0.186%. Third, the effects of housing prices on economic development vary across China's Eastern, Central, and Northeastern regions. Finally, the threshold model shows that FLP positively influences economic development until the housing price logarithm reaches 8.8134, after which FLP's beneficial effect on economic development will be diminished. [ABSTRACT FROM AUTHOR]

Objectives. Primary central nervous system lymphoma (PCNSL) usually has a poor prognosis. Cerebrospinal fluid (CSF) interleukin (IL)-10 has shown diagnostic, prognostic, and monitoring value in our previous studies. Cell-free circulating tumor DNA can be detected in the CSF of refractory/relapse cases and has also shown monitoring value. However, information about its monitoring value in newly diagnosed PCNSL patients and comparisons of CSF IL-10 and CSF cell-free DNA (cfDNA) are scarce. Methods. We performed next-generation sequencing on paraffin-embedded tissue and the serial CSF cfDNA of 10 newly diagnosed PCNSL patients and on the baseline CSF cfDNA of 11 other central nervous system lymphoma patients. We also monitored the CSF IL-10 levels of the 10 newly diagnosed PCNSL patients. Results. In seven newly diagnosed PCNSL patients with sufficient baseline CSF cfDNA, six had ≥1 mutated genes in their CSF cfDNA. The most common were MYD88(4/7), PIM1(3/7), MLL2(3/7), and ETV6(2/7). We also identified multiple somatic mutations, most commonly in PIM1. MYD88L265P can be detected in both tumor tissue and CSF cfDNA. The genomic profiles of CFS cfDNA were similar in PCNSL and PIOL patients. Newly diagnosed PCNSL patients with persistently positive cfDNA and negative IL-10 progressed quickly, while those with negative cfDNA and negative IL-10 were in maintenance therapy for more than 18 months. Two patients without cfDNA had increased CSF IL-10 concentrations before disease relapse. These results indicate that negative CSF cfDNA predicts better results, and persistently positive CSF cfDNA predicts disease progression earlier than conventional magnetic resonance imaging. Conclusion. In conclusion, CSF cfDNA is a potential predictor of relapse and progression, which complements the monitoring value of CSF IL-10 in newly diagnosed PCNSL patients. [ABSTRACT FROM AUTHOR]

Background: Fosfomycin is an important broad-spectrum bactericidal antibiotic to treat multidrug-resistant bacteria infections. It is generally accepted that heteroresistant bacteria are an intermediate stage in the formation of drug resistance, but there are few studies on the formation mechanism underlying fosfomycin heteroresistance (FHR).Objectives: To reveal the characteristics and formation mechanisms of FHR in Escherichia coli isolates obtained from chickens.Methods: We identified the FHR according to the population analysis profile (PAP) test and in vitro time-kill assay. Growth curves for FHR E. coli and their subpopulations were measured. Also, the subpopulations were repeatedly cultured in fosfomycin-free medium for 5-20 overnight incubation periods. The formation mechanisms of FHR in E. coli isolates were identified through accumulation assay, carbohydrate utilization testing, real-time relative quantitative PCR analysis, DNA sequencing, transcriptomic analysis, intracellular ATP and cAMP-level assessment.Results: Four of six E. coli strains were confirmed to show FHR, with a total of six subpopulations. The subpopulations restored phenotypic susceptibilities to fosfomycin within 5-20 overnight incubation sessions, but four of six subpopulations still maintained FHR characteristics. Differing from their parental isolates, the uptake of fosfomycin in the subpopulations through GlpT was reduced remarkably. Further studies identified that the low expression of glpT was due to the decrease of intracellular cAMP levels in the subpopulations, which was caused by the decreased ATP levels in cells.Conclusions: Our findings revealed the formation mechanism of E. coli isolates showing FHR obtained from chicken in China and characterized the dynamic change traits in vitro of the subpopulations. [ABSTRACT FROM AUTHOR]

Objective: We compared the clinical characteristics and survival outcomes after radical radiotherapy between nasopharyngeal carcinoma (NPC) with early and late metastases based on a relatively large cohort, which provides valuable data for the planning of clinical surveillance strategies. Methods: This was a single-center retrospective analysis of 10,566 patients who received radical radiotherapy in China from January 2000 to December 2016. Overall survival was the primary endpoint. Kaplan–Meier survival analysis and log-rank tests were applied to investigate the association between early or late metastasis and the endpoints. The prognostic value of clinicopathological features was identified using univariate and multivariate Cox proportional hazards models. Results: The cutoff value for time to metastasis was based on ROC analysis. A total of 559 (5.3%) patients developed distant metastases, 297 (53.1%) of which developed early metastatic disease, with the rest (46.9%) developing late metastatic disease. The K-M analysis showed that the patients with late metastatic foci had significantly better post-metastatic OS (P = 0.0056). Multivariate analysis indicated that age, liver metastasis, the number of metastatic foci and time to metastasis (P = 0.013) are independent prognostic factors for OS. After analyzing the impact of different treatment methods, we found that local treatment was an independent protective factor for LM, while local treatment was not associated with a survival benefit for EM disease. Conclusions: The time to metastasis after radical radiotherapy affected the prognosis of NPC patients and local treatment was an independent protective factor that could improve the survival of late metastatic NPC patients. [ABSTRACT FROM AUTHOR]

INTRODUCTION China has recently introduced a range of e-cigarette control policies with a focus on addressing an increase in youth vaping. This study aimed to investigate a wide range of e-cigarette-related attitudes and behaviors in a national sample of Chinese adolescents and young adults to obtain insights into their exposure to, experiences with, and attitudes to e-cigarettes on the cusp of new regulations coming into force. METHODS An online survey was administered to a sample of 1062 adolescents and young adults (aged 15-30 years) in China in November-December 2021. Quotas were applied to achieve an approximately equal gender split, representation across age sub-groups (15-17, 18-20, 21-23, 24-26, and 27-30 years), and approximately two-thirds representing low- and middle-income groups. Adjusted odds ratios (AORs) were also calculated. RESULTS Just under half (47%) reported no knowledge of e-cigarettes and/or vaping. One in five reported ever using e-cigarettes ('even once or twice'), 8% reported being current users, and 3% reported being daily users. Around two-thirds of those who had heard of e-cigarettes/vaping had friends who vaped and had seen e-cigarette advertising. Fruit flavors were most popular, and the most frequently nominated reasons for vaping were to cut down on cigarette smoking and because a friend used them. The factors positively associated with ever use of e-cigarettes were current tobacco smoking (AOR=68.26) or previous tobacco smoking (AOR=39.15) and having friends who vape (AOR=1.76). Perceptions of addictiveness were negatively associated with ever use (AOR=0.47). Strong support was evident for most assessed e-cigarette control policies. CONCLUSIONS The results indicate that young people in China have been able to access and use e-cigarettes, although rates of regular use are low. Generally, high levels of expressed support for a range of e-cigarette control policies among members of this age group suggest the new regulatory environment is consistent with their policy preferences. [ABSTRACT FROM AUTHOR]

The study investigates everyday parental practices involved in the transmission of cultural values and extends current literature on parenting in Chinese families. Children aged 6, 8, and 10 years from 240 Beijing families, and both their parents, were asked about ways in which expectations of child responsibility are transmitted through routine requests, reasoning, and negotiation about household work, an area in which Western parents are known to use such practices. Use of a range of parental requests and reasons was reported. Few child age or gender differences were found for reasons related to child responsibility. Child-initiated negotiation was reported as rare and unacceptable, its use restricted to tagging the relative importance of different spheres of child responsibility. (Contains 7 tables.)

This paper presents an integrated study on the effects of human activity, climate change and crustal movement on the changes of the middle reaches of the Tarim River in China. Remote sensing images and rainfall data from 38 stations from 1970 to 2021 were used for the research. The precise point positioning (PPP) approach was applied to ascertain the crustal movement of the study area using 256 Global Positioning System (GPS) station data of the recent 20 years. The results show that in the past 50 years the studied reaches of the river has moved north at maximum 2940 m or 57.9 m on average, and human activity may have played a dominant role in this change though extreme events of climate may have also taken a part in it. However, before the Anthropocene, its northeast migration is likely associated with crustal movement as the basin bottom inclines to northeast. [ABSTRACT FROM AUTHOR]

Promoting the development of new energy vehicles is one of the important measures to ensure energy security and deal with global warming. Technological innovation is an inexhaustible driving force for the development of the new energy vehicle industry. This study considered listed enterprises in China's new energy vehicle industry as research samples and used the fixed effect model to study the impact of government subsidies on the quantity and quality of technological innovation in the new energy vehicle industry. The empirical results show that government subsidies have a significant positive impact on the quantity of technological innovation in the new energy vehicle industry; however, government subsidies have no significant impact on the quality of technological innovation. Government subsidies increase the quantity of technological innovation in the new energy vehicle industry by increasing R&D investment, mitigating financing constraints, and improving the external attention of enterprises. Compared to downstream enterprises in the industrial chain, government subsidies have a better incentive effect on the technological innovation of upstream enterprises, which increases the number of patents and enhances the quality of utility model patents. Government subsidies have a better effect on promoting the quantity of technological innovation in large enterprises. [ABSTRACT FROM AUTHOR]

Background: The pathogens of suspected spinal tuberculosis (TB) include TB and non-TB bacteria. A rapid and effective diagnostic method that can detect TB and non-TB pathogens simultaneously remains lacking. Here, we used metagenomic next-generation sequencing (mNGS) to detect the pathogens in patients with suspected spinal TB. Methods: The enrolled patients with suspected spinal TB were regrouped three times into patients with spinal infection and controls, patients with spinal TB and controls, and patients with non-TB spinal infection and controls. We tested the three groups separately by using mNGS and conventional detection methods. Results: Ultimately, 100 patients were included in this study. Pathogens were detected in 82 patients. Among the 82 patients, 37 had TB and 45 were infected with other bacteria. In patients with spinal infection, the sensitivity of the mNGS assay was higher than that of culture and pathological examination (p < 0.001, p < 0.001). The specificity of the mNGS assay was not statistically different from that of culture and pathological examination (p = 1.000, p = 1.000). In patients with spinal TB, no statistical difference was found between the sensitivity of the mNGS assay and that of Xpert and T-SPOT.TB (p = 1.000, p = 0.430). The sensitivity of the mNGS assay was higher than that of MGIT 960 culture and pathological examination (p < 0.001, p = 0.006). The specificities of the mNGS assay, Xpert, MGIT 960 culture, and pathological examination were all 100%. The specificity of T-SPOT.TB (78.3%) was lower than that of the mNGS assay (100%; p < 0.001). In patients with non-TB spinal infection, the sensitivity of the mNGS assay was higher than that of bacterial culture and pathological examination (p < 0.001, p < 0.001). The specificity of the mNGS assay was not statistically different from that of bacterial culture and pathological examination (p = 1.000, p = 1.000). Conclusion: Data presented here demonstrated that mNGS can detect TB and non-TB bacteria simultaneously, with high sensitivity, specificity and short detection time. Compared with conventional detection methods, mNGS is a more rapid and effective diagnostic tool for suspected spinal TB. [ABSTRACT FROM AUTHOR]

Background: Acupuncture is widely used as adjuvant therapy for major depressive disorder (MDD). There is robust evidence that inflammation is closely associated with MDD. To date, only a few numbers of studies have investigated the potential relationship between acupuncture and the change of inflammatory biomarkers in patients with MDD. Additionally, the results are inconsistent among studies. The current study aims to provide a comprehensive, systematic review of the association between acupuncture and changes in peripheral inflammation of patients with MDD, and clarify the alterations of inflammatory cytokines before and after acupuncture treatment by meta-analysis. Methods and analysis: This study will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible randomized controlled trials (RCTs) reporting acupuncture, with inflammatory cytokines as the outcome measured before and after intervention in patients with MDD, were searched in electronic databases, such as PubMed, Embase, Cochrane, SINOMED, Wanfang, China national knowledge infrastructure (CNKI), and Chongqing VIP (CQVIP). Primary outcomes of interest will be validated to measure the levels of inflammatory cytokines before and after acupuncture treatment in patients with MDD. Discussion: Acupuncture can drive anti-inflammatory effects, as well as symptom changes in MDD, which may represent a viable, multi-faceted treatment approach in MDD. [ABSTRACT FROM AUTHOR]

The trend of the feminization of the aging population in China is accelerating, and the differences in the subjective well-being of older adults are becoming more and more obvious. This study combines gender theory with gender differences as an entry point, based on 436 survey data, and examines effects and differences between learning engagement on the subjective well-being of older Chinese learners by gender. The study found the following: learning can enhance the subjective well-being of older people; there were significant differences in the subjective well-being of older adult learners by gender in two dimensions, namely, physical and mental health experience and adaptation satisfaction experience; and the positive effect of learning engagement on subjective well-being of female older adults was more pronounced and thus had a stronger effect on their subjective well-being. In addition, the gender equality of older adults' learning participation and gender differences in learning needs are further explored based on the gender theory perspective, and this gives suggestions for enhancing older adult learners' subjective well-being. [ABSTRACT FROM AUTHOR]

To better understand the responses of vegetable yields in a greenhouse system to organic fertilizer through a quantitative evaluation based on peer-reviewed journal articles and in consideration of environmentalmanagerial factors. We conducted a meta-analysis of 453 paired observations from 68 peer-reviewed journal articles to assess the response of vegetable yields in greenhouse vegetable systems in China to organic fertilization. Compared with the control (no organic fertilizer), organic fertilization significantly increased the yields of vegetables by 44.11% on average. The response of vegetable yields to organic fertilizer tended to increase with the increasing experimental duration. Organic fertilizer application had the greatest potential for leafy vegetables (+76.44%), in loamy soils (+53.94%), at moderate organic fertilizer carbon input levels (+54.13%), and in soils with moderate initial soil total nitrogen levels (+50.89%). Aggregated boosted tree analysis indicated that organic fertilizer carbon inputs, vegetable type and experimental durationwere the predominant factors that manipulated the response of vegetable yields to organic fertilizer application. The rational application of farmyard manure would be a promising strategy for increasing vegetable yields in greenhouse vegetable systems in China. Factoring in vegetable type, carbon and nitrogen inputs of organic fertilizer, and soil texture would benefit vegetable yields with the application of organic fertilizer. [ABSTRACT FROM AUTHOR]

The increasing prevalence and transmission of tick-borne diseases, especially those emerging ones, have posed a significant threat to public health. Thus, the discovery of neglected pathogenic agents carried and transmitted by ticks is urgently needed. Using unbiased high-throughput sequencing, a novel Orthonairovirus designated as Meihua Mountain virus (MHMV), was identified in bloodsucking ticks collected from cattle and wild boars in Fujian province, Southeastern China. The full-length genome was determined by RT-PCR and RACE. Genomic architecture of MHMV shares typical features with orthonairoviruses. Phylogenetic analyses suggested that MHMV is clustered into the Nairobi sheep disease (NSD) genogroup of the genus Orthonairovirus and is closely related to the Hazara virus. The RdRp, GPC, and N protein of MHMV shares 62.3%-83.5%, 37.1%-66.1%, and 53.4%-77.3% amino acid identity with other NSD genogroup viruses, respectively, representing a novel species. The overall pooled prevalence of MHMV in ticks was 2.53% (95% CI: 1.62%-3.73%, 22 positives of 134 tick pools), with 7.38% (95% CI: 3.84%-12.59%, 11 positives of 18 pools) in Haemaphysalis hystricis, 6.02% (95% CI: 1.85%-14.22%, four positives of eight pools) in H. formosensis, 25.03% (95% CI: 9.23%-54.59%, six positive of eight pools) in Dermacentor taiwanensis, and 0.16% (95% CI: 0.01%-0.72%, one positive of 100 pools) in Rhipicephalus microplus. This study presented the first report of tick-carried Orthonairovirus in Fujian province and highlighted the broad geographic distribution and high genetic diversity of orthonairoviruses in China. [ABSTRACT FROM AUTHOR]

Objective To investigate the predictive value of the National Institutes of Health Stroke Scale (NIHSS) score combined with serum high -sensitivity C -reactive protein (hs-CRP) on admission to ischemic stroke. Methods A total of 487 patients with acute ischemic stroke admitted to the Department of Neurology of Tangshan Gongren Hospital from May 2018 to December 2019 were selected. The clinical data of patients were collected such as gender, age, hypertension, diabetes, coronary heart disease, previous stroke history, smoking and drinking history, serum low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), hs-CRP, homocysteine (Hcy), fasting blood glucose (FBG). The NIHSS scale was used to evaluate the degree of neurological deficit at admission, and the modified Rankin Scale (mRS) was used to evaluate the prognosis when the patient was discharged. The mRS score ≤ 2 was defined as good prognosis, and the mRS score > 2 was defined as poor prognosis. Univariate and multivariate forward Logistic regression analysis were used to screen risk factors for poor prognosis of ischemic stroke, and the receiver operating characteristic (ROC) curve was used to compare the predictive value of NIHSS and hs-CRP levels at admission alone or in combination for patient prognosis. Results Compared with the good prognosis group, the poor prognosis group had higher proportions of male patients (χ² = 4.729, P = 0.030), previous history of stroke (χ² = 13.665, P = 0.000), and drinking alcohol (χ² = 8.326, P = 0.004). The NIHSS score at admission (Z = -9.316, P = 0.000), serum FBG (Z =-3.234, P = 0.001), Hcy (Z =-3.652, P = 0.000) and hs-CRP (Z =-8.780, P = 0.000) level in poor prognosis group were higher than those in good prognosis group. Logistic regression analysis showed that the NIHSS score increased at admission (OR = 1.316, 95%CI: 1.223-1.417; P = 0.000), and the serum hs-CRP level increased (OR = 1.045, 95%CI: 1.032-1.058; P = 0.000) were risk factors for the prognosis of ischemic stroke. The area under the curve (AUC) predicted by the two combined (AUC = 0.903; 95%CI: 0.873-0.928, P = 0.000) exceeded than that of the NIHSS score at admission alone (AUC = 0.818; 95%CI: 0.781-0.852, P = 0.000) and the serum hs-CRP alone (AUC = 0.806; 95%CI: 0.768-0.840, P = 0.000); pairwise comparison found that the combination of the two was better than the NIHSS score at admission alone (Z = 3.187, P = 0.001) and serum hs-CRP alone (Z = 4.418, P = 0.000). Conclusions NIHSS score and high level of serum hs-CRP at admission are risk factors for poor prognosis of ischemic stroke. Combining NIHSS score and serum hs-CRP can provide an effective reference for clinical prediction of poor prognosis of ischemic stroke. [ABSTRACT FROM AUTHOR]

Although Wolbachia spp. are described as one of the most prevalent groups of endosymbiotic intracellular bacteria in invertebrates, studies often found large variations in Wolbachia infection rate at the species level. The underlying mechanisms of these variations however remain unclear. Given some phenotypic effects of Wolbachia such as cytoplasmic incompatibility and difficulties to be transmitted among host populations with deep genetic divergence, we hypothesized that cryptic species could play an important role in the spreading success of Wolbachia. Here we used Wiebesia pumilae, the morphospecies specifically pollinating Ficus pumila to test our hypothesis. We collected individuals from 40 locations covering most of its distribution range in China. Using a mtDNA gene, we suggested a total of three cryptic species in W. pumilae with a parapatric distribution pattern. At the morphospecies level, we detected an overall Wolbachia infection rate of 52.8%. In contrast, at the cryptic species level, we found that all infected individuals belonged to only one cryptic species. These results support our hypothesis and indicate that cryptic species boundaries can create a hierarchical Wolbachia infection pattern and the potential role of Wolbachia infection in restricting gene flow among cryptic species. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the influencing factors of frailty in elderly patients with multimorbidity and to develop a predictive risk model for frailty in elderly patients with multimorbidity. Methods: In total, 3836 elderly patients with multimorbidity who were admitted to the medical wards of five grade A tertiary hospitals in Sichuan Province from March 2020 to June 2021 were selected. Based on the general data of patients with multimorbidity, the independent risk factors for frailty were obtained using logistic analysis, and a risk prediction model of frailty was developed. Results: Independent risk factors for frailty in patients with multimorbidity were age, types of medication, and comorbidity with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) and chronic cerebrovascular disease (CCVD); and the protective factors for frailty were body mass index (BMI), exercise and education level. The expression of the model was Z = −2.054 + 0.016 × age − 0.029 × BMI − 0.153 × education level‐1.059 × exercise + 0.203 × types of medication + 0.788 × comorbidity with CHF + 0.950 × comorbidity with COPD + 0.363 × comorbidity with CCVD. Conclusion: Age, BMI, education level, exercise, types of medication, and comorbidity with CHF, COPD and CCVD can affect frailty risk in elderly patients with multimorbidity, which may be helpful to predict the frailty risk of elderly patients with multimorbidity. Geriatr Gerontol Int 2022; 22: 471–476. [ABSTRACT FROM AUTHOR]

In this study, the effect of strip clear-cutting on the natural regeneration performance of mature Pinus tabuliformis plantations in the three locations in western part of the Liaoning Province was analyzed. Strip clear-cutting, with clear-cut and uncut strip widths of 15, 20, 25 m, and 10 and 18 m, respectively, was conducted in spring 2014, and control, in each study location. Field investigations were conducted in 2017. Fifteen sample plots with sizes of 4 m² (2 m × 2 m) were established in each clear-cut strip, uncut strip, and control. One to four saplings were randomly selected to measure the current year increment, and the lengths and numbers for branch of the first whorl. Three saplings were randomly selected from the center of the strip to measure the photosynthetic rate. Three sample plots with sizes of 4 m² (2 m × 2 m) and 1 m² (1 m × 1 m) were developed in each strip and control to determine the biodiversity of shrubs and herbs as well as the water content of the decomposition and semi-decomposition layer. The results show that the current year increment and branch length of the first whorl can be ordered as follows: clear-cut strips > control > uncut strips. Number of the branches of the first whorl can be ordered as follows: clear-cut strips > uncut strips > control. Strip clear-cutting was a statistically significant treatment for the current year increment and length and number of branches of the first whorl. The saplings from the clear-cut strip with a width of 25 m have the largest photosynthetic capacity compared with those from the other strips and control. The transpiration rates of the large, medium, and small saplings from clear-cut strips are the largest and those of saplings from the control are the smallest. The water content of the decomposition and semi-decomposition layer in the control is the highest, but no significant difference was confirmed between the strip clear-cutting approaches. [ABSTRACT FROM AUTHOR]

Due to the large annual production of construction waste in China, the rapid changes in construction waste materials, and the need to quickly obtain high-precision 3D change information for construction waste, we have used a rapid monitoring method for construction waste accumulations, which uses unmanned aerial vehicle (UAV) photogrammetry to obtain a digital surface model (DSM) and a digital orthophoto map (DOM) of two study areas located in Pingdingshan City, China. Then, we built 3D models of waste accumulations in 2019 and 2020 for the two study areas. We also proposed a 3D change detection model combined with self-adaptive roughness quantification and supervised classification based on the elevation threshold to extract construction waste accumulations, and the extraction accuracies in 2019 and 2020 were 84.9 and 85.6%, respectively. Also, we used the adaptive threshold method and the discrete integral method to calculate the changes in areas and volumes of the accumulations. The calculation accuracy of the volume of construction waste reached 88%. This study provides a method for quickly obtaining 3D change information for construction waste accumulations. [ABSTRACT FROM AUTHOR]

Background. 5-fluorouracil-based multiagent chemotherapy has been used as the primary treatment for high-risk gestational trophoblastic neoplasia (GTN) in China for a few decades. This study aims to assess the efficacy and toxicity of floxuridine, actinomycin D, etoposide, and vincristine (FAEV) as a primary treatment for patients with GTN who had International Federation of Gynecology and Obstetrics (FIGO) scores ≥5. Materials and Methods. A total of 207 patients with GTN who had FIGO scores ≥5 were treated with FAEV as first-line chemotherapy at Peking Union Medical College Hospital between January 2002 and December 2017. Complete remission (CR), resistance, survival, toxicity, and reproductive outcomes were analyzed. Results. Of the 207 patients treated with FAEV, 9 (4.3%) required a change of chemotherapy owing to toxicity and 1 (0.5%) died of cerebral hernia 5 weeks after commencing treatment. The remaining 197 patients were assessable to determine the response to FAEV; among them, 168 (85.3%) achieved CR with FAEV and 29 (14.7%) developed resistance to FAEV. The 5-year overall survival rate of the entire cohort was 97.4%. Grade 3-4 neutropenia, thrombocytopenia, and anemia occurred in 28.4%, 6.8%, and 6.2% of cycles, respectively. No acute toxicity-related deaths occurred. Five patients developed acute myeloid leukemia 10-50 months after exposure to chemotherapy; another patient developed duodenal cancer 2 years after completing therapy. Sixty-one patients who preserved fertility wanted to become pregnant; 56 of them conceived. Conclusion. The FAEV regimen is an effective primary treatment for patients with GTN who have FIGO scores ≥5 and has predictable and manageable toxicity. [ABSTRACT FROM AUTHOR]

Glioma is a common central nervous system tumors in children. CMYC has a range of functions that are disrupted in various tumor cells, and may contribute to the occurrence and development of glioma. Two CMYC single nucleotide polymorphisms (rs4645943C>T and rs2070583 A>G) were genotyped in 190 cases and 248 controls from Wenzhou and Guangzhou hospitals. After adjusting for age and sex, odds ratio and 95% confidence interval values were calculated by logistic regression to evaluate the correlation between CMYC gene polymorphisms and glioma risk; no significant associations were detected. These results require future validation in a larger sample cohort. [ABSTRACT FROM AUTHOR]