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Introduction: COVID-19 has demonstrated the importance of competent staff with expertise in public health emergency preparedness and response in the civil aviation system. The civil aviation system is a critical sentinel and checkpoint to prevent imported cases and slow the spread of communicable diseases. Understanding the current competencies of staff to deal with public health emergencies will help government agencies develop targeted training and evidence-based policies to improve their public health preparedness and response capabilities. Methods: This cross-sectional pilot study was conducted from November 2022 to October 2023, involving 118 staff members from various positions within China's civil aviation system. A 59-item questionnaire was translated and developed according to a competency profile. Data were collected using the self-report questionnaire to measure the workforce's self-perceptions of knowledge and skills associated with public health emergency proficiency, categorized into (1) general competency, (2) preparedness competency, (3) response competency, and (4) recovery competency. KMO & Bartlett test and Cronbach's α reliability analysis were used to test the reliability and validity of the questionnaire. Descriptive statistics, independent sample T-test, ANOVA, and linear regression models were performed to analyze the competencies. Results: A total of 107 staff members from the aviation system were surveyed in this study. The KMO & Bartlett test, (KMO = 0.919, P < 0.001) and Cronbach's α coefficients (α = 0.985) for this questionnaire were acceptable. The results suggested that respondents scored a mean of 6.48 out of 9 for the single question. However, the staff needed to acquire more knowledge in investigating epidemic information (5.92) and case managing (5.91) in the response stage. Overall, males scored higher (409.05 ± 81.39) than females (367.99 ± 84.97), with scores in the medical department (445.67 ± 72.01) higher than management (387.00 ± 70.87) and general department (362.32 ± 86.93). Additionally, those with completely subjective evaluation (425.79 ± 88.10) scored higher than the general group (374.39 ± 79.91). To predict the total score, female medical workers were more likely to have lower scores (β = -34.5, P = 0.041). Compared with those in the medical department, the management workers (β = -65.54, P = 0.008) and general workers (β = -78.06, P < 0.001) were associated with a lower total score. Conclusions: There was still a gap between the public health emergency competencies of the civil aviation system and the demand. Staff in China's civil aviation systems demonstrated overall competence in public health emergency preparedness and response. However, there was a need to enhance the accumulation of practical experience. Implementing effective training programs for public health emergencies was recommended to mitigate knowledge gaps. Meanwhile, regular training evaluations were also recommended to give comprehensive feedback on the value of the training programs. [ABSTRACT FROM AUTHOR]

Summary: Chronic refractory primary immune thrombocytopenia (CRITP) is currently defined as refractory to multiple therapeutic of second‐line agents with or without splenectomy, faced with the threat of severe bleeding and challenging to obtain effective treatment. Although stable and effective drug therapy is needed, it is tough to find one. Daratumumab (Dara), an anti‐CD38 monoclonal antibody presented the target cloned plasma cells in multiple myeloma, has also been reported to be effective in refractory autoimmune cytopenia in some case or series reports and ongoing clinical trials for adult patients with CRITP. Here, we report the early and durable response of Dara combination with avatrombopag in three CRITP patients (2 male and 1 female aged 12, 5 and 7 years, respectively) in our centre, with a follow‐up period of more than 25 weeks. Before Dara, the duration of immune thrombocytopenia was 9, 1.4 and 4 years, respectively, a baseline platelet count of 4, 6, 9 × 109/L, the bleeding score was all above level 2 and the number of previous drugs was >3. The time to response (R: Plt ≥30 × 109/L with at least a twofold increase in the baseline count) of Dara was on Day 45, 6 and 4 and achieved complete response (CR: Plt ≥100 × 109/L) on Day 51, 6 and 8, the sustained response (SR: Plt >30 × 109/L following Dara at ≥75% of the platelet count assessment at follow‐up end‐point since the patient achieved response) was 48, 175 and 204 days with the follow‐up time of 39.1, 25.9 and 29.7 weeks. The bleeding score decreased from grade 3 to grade 0 during follow‐up. No significant treatment‐related adverse events were found during follow‐up. Dara combination with avatrombopag may be a safe and efficacious therapy for children with CRITP, but it needs to be further explored. [ABSTRACT FROM AUTHOR]

Purpose: Anatomical structures and organ preservation concepts of the head and neck are important for patients with locally advanced head and neck squamous cell carcinoma (LA HNSCC). Neoadjuvant chemotherapy has been applied to improve organ preservation; however, pathological complete remission is still unsatisfactory. The purpose of this study was to explore the pathological complete response (pCR) rate and safety of immune checkpoint blockade combined with neoadjuvant chemotherapy (NAC) in patients with LA HNSCC. Methods: Fifty-one patients participated in this retrospective study, and of these, 25 received NAC only (cisplatin+5-fluorouracil+nab-paclitaxel), and 26 received NAC (cisplatin+5-fluorouracil) plus pembrolizumab. Pathological complete remission, the objective response rate (ORR), delayed surgery and toxicity were compared between the two groups. Results: A significant difference was observed in the pCR rate and ORR between the NAC+ICB group and the NAC group. Delaying surgery and Grade 3 or 4 AEs occurred more frequently in the NAC group. In the NAC-only group, during a median follow-up period of 31.80 months, the recurrence-free survival (RFS) rate was 80.0%, the disease-free survival (DFS) rate was 80.0% and the overall survival (OS) rate was 88.0%. In the NAC+ICB group, during the median follow-up period of 22.99 months, the RFS rate was 96.2%, the DFS rate was 96.2% and the OS rate was 100%. Conclusion: The combination of pembrolizumab with NAC could improve the pathological response without increasing the risk of toxicity, which provides pathological evidence for the treatment of LA HNSCC patients with NAC+ICB. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic emphasized the importance of public spaces. Accessing public spaces during the pandemic improves physical health, reduces feelings of loneliness, and lessens depression. However, not all public spaces can provide an effective response during the pandemic. The public spaces' ability to respond to the pandemic varies depending on their resilience level, which refers to the capability of those spaces to adapt to the challenges posed by the COVID-19 pandemic and maintain functionality to meet users' needs during this crisis. By investigating the response of existing public spaces to the COVID-19 pandemic and identifying and examining the criteria of pandemic resilience, this study aims to explore and improve public spaces' capability to respond effectively during the pandemic. One hundred and sixty nine public spaces in three regions in Chongqing City in China are studied. Four main criteria involving 9 sub-criteria of pandemic resilience that can be integrated into public spaces' planning and design are studied. Three questionnaire surveys are used in this study to examine how public spaces adapt to the pandemic and evaluate the pandemic resilience criteria. The questionnaire data is analyzed using the Statistical Package for Social Sciences (SPSS) software. The pandemic resilience criteria are assessed and analyzed using a Geographic Information System (GIS). The study utilized the analytic hierarchy process (AHP) to assign weights to the criteria of pandemic resilience. Weighted overlay analysis (WOA) is applied to assess the pandemic resilience level in public spaces. Results indicate various possibilities for pandemic resilience depending on the characteristics of the area. However, these resilience levels are inadequate to respond effectively to the pandemic, resulting in diminished utilization of public spaces during the COVID-19 pandemic across all studied regions compared to the periods preceding the pandemic and after the complete reopening. This study presents a remarkable source for strengthening the resilience of cities against pandemic emergencies. [ABSTRACT FROM AUTHOR]

As a less-powerful state threatened by a rising China in both security and economic domains irrespective of increasing economic cooperation and sharing a border and political affinity with China, Vietnam is expected to warmly welcome the United States (US) -led Indo-Pacific Strategy (IPS) The country, nonetheless, has remained low-key in responding to the IPS. The article argues that Hanoi is truly interested in a regional rules-based order promoted in the IPS, but it has proposed a hedging response to this strategy through cautious statements and limited engagement in into this strategy. Vietnam’s hedging response to the IPS is framed by its post-Doi Moi foreign policy of independence, self-reliance, multilateralisation, and diversification. The year 2023 marks a milestone in bilateral relations between the US and Vietnam as both states upgraded their diplomatic relations to comprehensive strategic partnership which is the highest level in Vietnamese diplomatic ranking. This may become a favourable catalyst for further cooperation between Washington and Hanoi under the IPS within the context of a rising China. [ABSTRACT FROM AUTHOR]

This article was to reveal the spatio-temporal variation of summer precipitation in China and its response to El Niño-Southern Oscillation (ENSO). The results showed that the precipitation increased in 1900 s~1950 s, then decreased in 1960 s~1970 s, and increased in 1980 s~2010 s again. In space, it presented a "five-layered sandwich structure" featuring rising-falling-rising-falling-rising from northwest to southeast. The precipitation was generally less when ENSO occurred, but there were differences in intensities, regions, and so on. For example, When El Niño (all types) occurred, there was more precipitation in the western Continental Basin and the southern Huaihe River Basin, but less in the Yellow River Basin. When the extremely strong and medium La Niña occurred, the precipitation was more in the central and less in the north and the south. When the weak La Niña occurred, the precipitation increased in the northwest, decreased in the southeast, and vice versa for the extremely weak La Niña. Precipitation and Oceanic Niño Index (ONI) were negatively correlated in time, however, in space, there was a negative correlation in the north, and a positive correlation in the south, the dividing line was approximately at 29°N. In addition, the correlation between precipitation and ONI was proportional to the intensity of ENSO. [ABSTRACT FROM AUTHOR]

Aims: To compare cyclosporine (CSA) combining eltrombopag (EPAG) with or without antithymocyte globulin (ATG) in aplastic anemia (AA) patients in the real world. Methods: AA patients who received ATG combining CSA and EPAG (Group A) and CSA + EPAG (Group B) as front‐line treatment in 13 medical centers in China were enrolled. The efficacy and safety were compared. Results: A total of 89 patients were enrolled with 51 patients in Group A and 38 patients in Group B. The 6‐month overall response (OR)/complete response (CR) was 73.3%/24.4% and 60.6%/27.3% in Groups A and B (p >.1). For severe AA patients, the 6‐month OR was 74.1% versus 50% and 6‐month CR was 25.9% versus 20% in Groups A and B (p > 0.1). Multivariate analysis showed gender affects the 6‐month OR with females better OR (p =.017, OR 6.045, 95% CI: 1.377–26.546) and time from disease onset to treatment affected the 12‐month CR (p =.026, OR 0.263, 95% CI: 0.081–0.852). No difference was found in side effects except ATG infusion reaction and serum sickness. Mortality was 7.8% in Group A and no patient died in Group B. Conclusions: CSA + EPAG had a similar response and less side effects compared with standard immunosuppressive therapy + EPAG in newly diagnosed AA. [ABSTRACT FROM AUTHOR]

Using spatial autocorrelation methods, we explored the spatial and temporal differences in the response of soil conservation (SC) and water conservation (WC) to ecosystem fragmentation during 1990 to 2019 in Qilian Mountain National Park (QMNP) of China. We found that the degree of ecosystem fragmentation decreased over the past 30 years, improving the WC and SC capacity of the ecosystems. However, the relationship among them varied temporally and exhibited a variety of spatial patterns. The correlation between fragmentation and WC increases year by year, and the correlation with SC weakens. There is a mismatch between park-level and regional autocorrelation between fragmentation and WC and SC. The spatial relationships between fragmentation and WC and SC in the QMNP show "high-high" and "low-low" patterns in its eastern and western sections, respectively. This heterogeneity is related to the differences in ecosystem composition, especially in ecosystem WC and SC capacity, and the characteristics of ecosystem fragmentation in the east–west direction of the QMNP. [ABSTRACT FROM AUTHOR]

Purpose: Comammox Nitrospira can complete nitrification independently, and they are important participants in the nitrogen cycle. In this study, we investigated the comammox Nitrospira in the sediments of Xiaojiang River basin, a tributary of the Three Gorges, and explored the differences in the responses of its different clades to water quality recovery during a cyanobacteria outbreak period and a water quality recovery period. Materials and methods: Sediment samples were taken from the two water quality periods of the Yangtze River tributary Xiaojiang, namely, the cyanobacteria outbreak period and the water quality recovery period. The diversity of comammox Nitrospira clade A and comammox Nitrospira clade B, and the abundance of comammox Nitrospira clade A, comammox Nitrospira clade B, ammonia-oxidizing archaea (AOA), and ammonia-oxidizing bacteria (AOB) were measured. Results and discussion: The results showed that during the water quality recovery period, the abundance of both comammox clade A amoA (4.32 × 106 ± 1.32 × 106 copies g−1) and comammox clade B amoA (4.06 × 106 ± 2.91 × 106 copies g−1) exhibited an increasing trend. Compared with that in the cyanobacteria outbreak period, the abundance of comammox clade A was increased by 450% during the water quality recovery period, while comammox clade B was increased by 195%. During the water quality recovery period, both comammox Nitrospira species richness (Chao1) and species diversity (Pielou, Shannon, and Simpson) were increased. Conclusions: During the water quality recovery period, comammox clade A amoA exhibited a greater increase in abundance and a quicker response to water quality recovery than comammox clade B. Water quality recovery favored the growth of comammox Nitrospira. [ABSTRACT FROM AUTHOR]

purpose of this study was to discuss the risks and benefits of medical student participation in healthcare in the context of COVID-19. Methods: An online cross-sectional survey was distributed to 300 Medical students undergoing standardized training program (STP) in China-Japan Union Hospital of Jilin University. The survey included questions about basic demographic characteristics, roles and mental state of interns during the pandemic, comments on the University's management of medical students. Data were processed using SPSS 25.0 statistical analysis software, the comparison between two groups of data was performed using t-test; the non-normally distributed variables were analyzed using Mann–Whitney U-test, differences between groups were compared using chi-square test for analysis. p < 0.05 was considered statistically significant. Results: A total of 191 students completed the survey (response rate 63.67%). The epidemic had a significant psychological impact on students, but most of them believed that participation in clinical work under voluntary, precise protective measures and strict supervision were benefit for their future. Older, married, female, and salaried students are more willing to engage in pandemic-related activities. The biggest challenge of working under the pandemic focused on high working pressure and insufficient protection, the biggest harvest was getting knowledge and accumulating experience. Conclusion: Circumstances, cultures, outbreaks and strategies for coping with COVID-19 varied around the world. Medical students do not need to be overprotected, participation in pandemic work in an optimized system is acceptable and beneficial to their career plan. Medical education should focus on improving the social status of infectious diseases and cultivating future doctors with awareness of epidemic prevention and control. [ABSTRACT FROM AUTHOR]

Ecosystem water use efficiency (eWUE) can be used to obtain a better comprehension of the ecosystem water-carbon cycle. This study aimed to characterize the regional-scale responses and adaptations of different vegetation categories to drought changes and the spatiotemporal characteristics of WUE and associated drought factors for nine vegetation categories in Inner Mongolia, China, from 2000 to 2020. This study estimated drought, the association between drought and eWUE among varying vegetation categories, and the differences in eWUE between the drought stage and the post-drought stage by analyzing the spatiotemporal variations in eWUE of different vegetation categories based on MODIS ET (evapotranspiration), GPP (gross primary productivity), and temperature vegetation drought index data. The results illustrated the following: (1) the multi-year mean eWUE from 2000 to 2020 was 1.03 g·m−2·mm−1, with an overall significantly increasing trend of 0.008 g·m−2·mm−1 and eWUE decreasing from northeast to southwest. (2) The rank of vegetation types in Inner Mongolia according to multi-year mean eWUE was evergreen coniferous forest > savanna > evergreen broadleaf forest > forested grassland > farmland > deciduous broadleaf forest > mixed forest > closed scrub > grassland. All vegetation categories illustrated an increasing trend in eWUE over time. (3) eWUE was inversely associated with drought in the drought stage and a clear effect of drought legacy was identified in which harsh drought impacted the eWUE of the ecosystem, whereas eWUE was positively associated with drought. (4) The eWUE values of ecosystems increased significantly after drought, indicating that ecosystems that are adapted to drought show high capacity to recovery from drought stress. [ABSTRACT FROM AUTHOR]

Introduction: Low light stress inhibits plant growth due to a line of physiological disruptions in plants, and is one of the major barriers to protected cucumber cultivation in northern China. Methods: To comprehensively understand the responses of cucumber seedlings to low-light stress, the low-light-tolerant line (M67) and The lowlight-sensitive line (M14) were conducted for the analysis of photosynthetic phenotype, RNA sequencing (RNA-seq) and the expression level of photosynthesis-related genes in leaves under low-light stress and normal light condition (control). Results: The results showed that there was a sharp decrease in the photosynthate accumulation in the leaves of the sensitive line, M14, resulting in a large decrease in the photosynthetic rate (Pn) (with 31.99%) of leaves compared to that of the control, whichmay have been caused by damage to chloroplast ultrastructure or a decrease in chlorophyll (Chl) content. However, under the same low-light treatment, there was no large drop in the photosynthate accumulation and even no decrease in Pn and Chl content for the tolerant line, M67. Moreover, results of gene expression analysis showed that the expression level of genes CsPsbQ (the photosystemII oxygen-evolving enhancer protein 3 gene) and Csgamma (ATPase, F1 complex gene) in the M14 leaves decreased sharply (by 35.04% and 30.58%, respectively) compared with the levels in the M67 leaves, which decreased by 14.78% and 23.61%, respectively. The expression levels of genes involved in Chl synthesis and carbohydrate biosynthesis in the leaves of M14 decreased markedly after low-light treatment; in contrast, there were no sharp decreases or changes in leaves of M67. Discussion: Over all, the ability of cucumber to respond to low-light stress, as determined on the basis of the degree of damage in leaf structure and chloroplast ultrastructure, which corresponded to decreased gene expression levels and ATP phosphorylase activity, significantly differed between different low-light-tolerant lines, which was manifested as significant differences in photosynthetic capacity between them. Results of this study will be a reference for comprehensive insight into the physiological mechanism involved in the low-light tolerance of cucumber. [ABSTRACT FROM AUTHOR]

Sanjiang Plain is the largest marsh distribution area of China, and marshes in this region significantly affect regional carbon cycle and biodiversity protection. The vegetation phenology of marsh significantly affects the energy exchange and carbon cycle in that region. Under the influence of global climatic change, identifying the changes in phenology and their responses to climatic variation in marshes of Sanjiang Plain is essential for predicting the carbon stocks of marsh ecosystem in that region. Using climate and NDVI data, this paper analyzed the spatiotemporal variations in the start (SOS), end (EOS), and length (LOS) of vegetation growing season and explored the impacts of climatic variation on vegetation phenology in marshes of Sanjiang Plain. Results showed that the SOS advanced by 0.30 days/a, and EOS delayed by 0.23 days/a, causing LOS to increase significantly (p <.05) by 0.53 days/a over marshes of Sanjiang Plain. Spatially, the large SOS advance and EOS delay resulted in an obvious increasing trend for LOS in northern Sanjiang Plain. The rise of spring and winter temperatures advanced the SOS and increased the LOS, and the rise in temperature in autumn delayed the EOS in marshes of Sanjiang Plain. Our findings highlight the necessity of considering seasonal climatic conditions in simulating marsh vegetation phenology and indicate that the different influences of climatic variation on marsh vegetation phenology in different regions should be fully considered to assess the marsh ecosystem response to climatic change in Sanjiang Plain. [ABSTRACT FROM AUTHOR]

Methotrexate (MTX) and iguratimod (IGU) are conventional synthetic disease modifying antirheumatic drugs widely used in the treatment of Rheumatoid arthritis (RA) in China. Although MTX combined with IGU can significantly inhibit the progression of RA, some patients do not respond to the treatment. The purpose of this study is to explore the difference of serum protein expression between RA patients with good and poor response to the combined therapy by label-free quantitative proteomic approach. From the proteomics data, a total of 782 proteins in the serum of RA patients were detected, and of which 9 were upregulated and 18 were downregulated in the good response group compared to poor response group. Among them, four significantly differentially expressed proteins (RELN, LDHA, MRC1 and TKT) were further validated by multiple reaction monitoring (MRM)-based quantification approach, and three of them (RELN, LDHA and MRC1) were confirmed to be correlated with the response to MTX/IGU therapy. Logistic regression and ROC analysis indicated that the combination of RELN, LDHA and MRC1 had good performance in evaluating the response. This result proved the different serum proteins signature fingerprint between response group and non-response group; and highlighted the potential of the label-free and mass spectrometry-based quantitative proteomic approach in screening biomarkers for evaluating clinical response to MTX/IGU therapy in RA. • The expression of serum proteins is different between R and NR group after treating by MTX combined with IGU. • 9 upregulated and 18 downregulated proteins were detected in two groups, respectively. • Combination of RELN, LDHA and MRC1 was validated to be the candidate biomarker to evaluate the efficacy. • Several dysregulated serum proteins are involved in the anti-inflammatory progress of MTX and IGU. • The study provides a new option for further research on the mechanism of MTX and IGU. [ABSTRACT FROM AUTHOR]

(a) Background: Omalizumab is an anti-IgE humanized monoclonal antibody marketed in China for the conventional treatment of poorly controlled moderate-to-severe allergic asthma. Numerous clinical trials have demonstrated the effectiveness of omalizumab, but the data from studies in actual clinical treatment are still relatively limited. (b) Methods: Thirty-two patients with moderate-to-severe allergic asthma treated with omalizumab on the basis of ICS-LABA (inhaled corticosteroids/long-acting beta2-agonist) were selected. Clinical characteristics before and after treatment were collected to analyze the relationship between changes in serum total IgE levels and peripheral blood EOS (eosinophil) levels, FEV1 (forced expiratory volume in 1 second), PEF (peak expiratory flow), OCS (oral glucocorticoid) dosage, ATC (asthma control test) score, and the number of acute exacerbations and the treatment response, in order to observe the efficacy of omalizumab in addition to primary therapy, and to investigate whether baseline clinical characteristics such as serum total IgE and EOS levels could predict a treatment response. (c) Results: Using the ACT score as an evaluation, 68.75% of patients benefited from omalizumab treatment at the end of 16 weeks. The response group has a reduction in OCS dosage (p-values of 0.026 and 0.039), a significant reduction in ACT scores (both p < 0.001), and a reduction in the number of acute exacerbations (p = 0.034 and 0.025, respectively) after omalizumab treatment. The binary logistics analysis of factors affecting the effectiveness of omalizumab in the treatment of allergic asthma were total serum IgE and the presence of comorbidities (p-values of 0.039 and 0.046, respectively). (d) Conclusions: Combining omalizumab with ICS-LABA for 16 weeks significantly improves asthma symptoms in Chinese adults and can be used as an add-on treatment. In addition, high serum IgE levels and the presence of comorbidities were predictors of its therapeutic efficacy. [ABSTRACT FROM AUTHOR]

Shrinkage in China's cities has gradually received increasing attention. Specifically, county-level shrinking cities are numerous and widely distributed. City shrinkage even appears throughout Zhejiang Province, which is highly developed and has stable economic growth. County-level shrinking cities resulting from regional competition can still maintain long-term and stable economic growth, but their economic growth lags behind the whole competitive region. We identified five county-level shrinking cities in Zhejiang Province, and characterized the shrinkage phenomenon in Changshan County using census, nighttime lighting (NTL), and Tencent Location Big Data. City shrinkage resulted from the comprehensive effects of declining traditional industries, backward per capita income, highly skilled labor force shortages, and population age structure changes. Given the shrinkage status of Changshan, we proposed countermeasures and suggestions including aspects of industrial development, urban planning, social governance, and care for the elderly. [ABSTRACT FROM AUTHOR]

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GLS-010 (zimberelimab) is a novel, fully human, anti-programmed death-1 monoclonal antibody that shows promising efficacy and safety in advanced solid tumors. This trial aimed to evaluate the efficacy and safety of GLS-010 (zimberelimab) in Chinese patients with relapsed or refractory classical Hodgkin lymphoma (r/r-cHL). This phase II, single-arm, open-label, multicenter clinical trial was conducted at 24 centers in China and enrolled patients with r/r-cHL after two or more lines of therapy. The patients were administered intravenous GLS-010 (zimberelimab) (240 mg, once every 2 weeks) until progression, death, unacceptable toxicity, or consent withdrawal. The primary end-point was the objective response rate assessed by an independent radiology review committee (IRC). This study was registered (NCT03655483). Eighty-five patients were enrolled between August 2018 and August 2019. The median follow-up was 15.8 months. Seventy-seven patients (90.6%; 95% confidence interval [CI] 82.3–95.9) had an IRC-assessed objective response. The complete response rate was 32.9% (n = 28). The 12-month progression-free survival and overall survival rates were 78% (95% CI 67.5–85.6) and 99% (95% CI 91.9–99.8), respectively. Treatment-related adverse events (TRAEs) were observed in 92.9% of participants. Grade III or IV TRAEs occurred in 24 (28.2%) of the 85 participants. The most common grade III or IV TRAEs were abnormal hepatic function (5.9%), hyperuricemia (4.7%), decreased neutrophil count (3.5%), and increased weight (3.5%). Only one grade V AE, gastrointestinal infection, occurred. GLS-010 (zimberelimab) appears to be effective and safe for the treatment of Chinese patients with r/r-cHL. Long-term follow-up is required to confirm these clinical benefits. • GLS-010 (zimberelimab) is a novel, fully human, anti-PD-1 monoclonal antibody. • This phase II, single-arm trial aimed to evaluate the effect of GLS-010 in r/r-cHL. • The ORR was 90.6% in this study with 32.9% patients achieved CR. • GLS-010 appears to be effective and safe for the treatment of r/r-cHL. [ABSTRACT FROM AUTHOR]

Morels (Morchella spp.) are economically important mushrooms cultivated in many countries. However, their production and quality are hindered by white mold disease because of Paecilomyces penicillatus infection. In this study, we aimed to understand the genetic mechanisms of interactions between P. penicillatus and Morchella. M. sextelata , the most prevalent species of Morchella in China, was inoculated with P. penicillatus ; then, the expression profiles of both fungi were determined simultaneously at 3 and 6 days post-inoculation (dpi) using a dual RNA-Seq approach. A total of 460 and 313 differentially expressed genes (DEGs) were identified in P. penicillatus and M. sextelata , respectively. The CAZymes of β-glucanases and mannanases, as well as subtilase family, were upregulated in P. penicillatus , which might be involved in the degradation of M. sextelata cell walls. Chitin recognition protein, caffeine-induced death protein, and putative apoptosis-inducing protein were upregulated, while cyclin was downregulated in infected M. sextelata. This indicates that P. penicillatus could trigger programmed cell death in M. sextelata after infection. Laccase-2, tyrosinases, and cytochrome P450s were also upregulated in M. sextelata. The increased expression levels of these genes suggest that M. sextelata could detoxify the P. penicillatus toxins and also form a melanin barrier against P. penicillatus invasion. The potential pathogenic mechanisms of P. penicillatus on M. sextelata and the defense mechanisms of M. sextelata against P. penicillatus were well described. [ABSTRACT FROM AUTHOR]

Background: With the increasing application of large language models like ChatGPT in various industries, its potential in the medical domain, especially in standardized examinations, has become a focal point of research., Objective: The aim of this study is to assess the clinical performance of ChatGPT, focusing on its accuracy and reliability in the Chinese National Medical Licensing Examination (CNMLE)., Methods: The CNMLE 2022 question set, consisting of 500 single-answer multiple choices questions, were reclassified into 15 medical subspecialties. Each question was tested 8 to 12 times in Chinese on the OpenAI platform from April 24 to May 15, 2023. Three key factors were considered: the version of GPT-3.5 and 4.0, the prompt's designation of system roles tailored to medical subspecialties, and repetition for coherence. A passing accuracy threshold was established as 60%. The χ2 tests and κ values were employed to evaluate the model's accuracy and consistency., Results: GPT-4.0 achieved a passing accuracy of 72.7%, which was significantly higher than that of GPT-3.5 (54%; P<.001). The variability rate of repeated responses from GPT-4.0 was lower than that of GPT-3.5 (9% vs 19.5%; P<.001). However, both models showed relatively good response coherence, with κ values of 0.778 and 0.610, respectively. System roles numerically increased accuracy for both GPT-4.0 (0.3%-3.7%) and GPT-3.5 (1.3%-4.5%), and reduced variability by 1.7% and 1.8%, respectively (P>.05). In subgroup analysis, ChatGPT achieved comparable accuracy among different question types (P>.05). GPT-4.0 surpassed the accuracy threshold in 14 of 15 subspecialties, while GPT-3.5 did so in 7 of 15 on the first response., Conclusions: GPT-4.0 passed the CNMLE and outperformed GPT-3.5 in key areas such as accuracy, consistency, and medical subspecialty expertise. Adding a system role insignificantly enhanced the model's reliability and answer coherence. GPT-4.0 showed promising potential in medical education and clinical practice, meriting further study., (© Shuai Ming, Qingge Guo, Wenjun Cheng, Bo Lei. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

To investigate the clinical application value of pharmacogenetic testing in individualized drug therapy for adult male patients with schizophrenia. A total of 186 adult patients with schizophrenia were enrolled and randomised into the pharmacogenetic (PGx) intervention group and the standard care group. In the PGx intervention group, PGx testing was performed, and the medication regimen was adjusted according to the results of the pharmacogenomic analysis. In contrast, in the standard care group, patients were treated according to the physician's medication experience. Differences in the primary indicator of schizophrenia, the Positive and Negative Symptom Scale (PANSS), and the secondary efficacy measures, the Clinical Global Impressions-Severity of Illness scale (CGI-SI) and Clinical Global Impressions-Global Improvement (CGI-GI) scale, were compared between the intervention and standard care groups. At baseline, the PGx intervention group consisted of 109 individuals, while the standard care group had 77 participants. After 12 weeks of treatment, 49 individuals withdrew from the PGx group (a dropout rate of 45.0%), and 34 withdrew from the standard care group (a dropout rate of 44.2%), with no significant difference in dropout rates between the two groups. The PANSS score reduction rate in the PGx intervention group significantly exceeded that of the standard care group during weeks 3, 6, and 12 of follow-up (P < 0.05). At the 12th week, the PGx intervention group achieved a treatment response rate of 81.7%, significantly surpassing the 48.8% of the standard care group (odds ratio of 4.67, 95% confidence interval of 1.96-11.41; P = 0.001). Furthermore, the PGx intervention was significantly more effective than standard care regardless of whether the patient had a first episode or a relapse (P < 0.05). Furthermore, the Global Assessment of Functioning (GAF) scores and the Personal and Social Performance Scale (PSP) score changes in the PGx intervention group were both significantly different from those in the standard care group (P < 0.05). It is noteworthy that the PGx intervention similarly improves the prognostic outcomes for patients with and without a family history of mental disorders. In conclusion, the application of a PGx intervention treatment model based on PGx testing can significantly improve medication efficacy and shorten the time to achieve the effects of medication in schizophrenia., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

• The 57.00% of the Yangtze River Economic Belt area exhibited a significant increase in annual NPP. • The response of NPP on climate factors was nonlinear, with greater sensitivity to temperature. • The impact of topographic factors on NPP changes had a threshold effect. Net primary productivity (NPP) of terrestrial ecosystems serves as a crucial carbon sink, playing a significant role in mitigating climate change. This study, focusing on the Yangtze River Economic Belt (YREB), a key area for both economic development and ecological conservation in China, evaluates the temporal and spatial changes in regional NPP and its responses to climatic factors against the backdrop of global change. Utilizing long-term NPP and meteorological grid data from 1981 to 2017, we analyzed the annual change patterns of NPP and its linear and nonlinear responses to climatic factors using copula functions. Our findings indicate that 57.00 % of the YREB has experienced a significant increase in NPP, with the most substantial decreases observed in Shanghai and its surrounding areas (P < 0.05). Temperature emerged as the primary climatic driver, positively correlating with NPP changes in over half of the study area (P < 0.05). Moreover, the nonlinear response of NPP to temperature and precipitation underscores the complex interactions between these factors, revealing a sensitivity to temperature variations that surpasses that to precipitation. The study also highlights the influence of solar radiation and topographic factors, with a significant positive correlation between NPP and solar radiation observed in 15.85 % of the area (P < 0.05). The practical significance of these findings lies in their implications for regional ecological management and climate resilience strategies. The positive correlation between temperature and NPP underscores the potential for targeted temperature management to optimize carbon sequestration across the YREB. Furthermore, the identified nonlinear responses and the role of solar radiation and topography in influencing NPP offer valuable insights for the formulation of adaptive strategies that enhance ecosystem productivity and contribute to achieving carbon neutrality goals. By elucidating the dynamics of NPP in response to a range of environmental factors, this study provides a foundation for informed decision-making in ecological conservation and climate change mitigation efforts within the YREB and similar regions globally. [ABSTRACT FROM AUTHOR]

The summer rainfall change over East Asia in response to CO2 forcing and the associated processes are investigated via a set of pilot timeslice piSST experiments from the Cloud Feedback Model Intercomparison Project Phase 3 (CFMIP-3). The total response of rainfall to 4 × CO2 in coupled models is decomposed into components associated with uniform SST warming, SST pattern change, the direct radiative effect of increased CO2, and the plant physiological response. In general, the contributions of the individual responses of summer rainfall to different forcings are subject to a regional dependence. The uniform SST warming reduces rainfall in many land regions in East Asia, but increases rainfall over the northern East Asia. The spatial patterns of the rainfall change as the result of SST pattern change are nearly opposite to those of the uniform SST warming, which account for most inter-model uncertainty in the simulations. The direct radiative effect of increasing CO2 is largely responsible for an increase of rainfall across the East Asian continent, especially over the central China and southern Tibetan Plateau, and the plant physiological effect appears to increase rainfall over the eastern and southern China. Also discussed are the atmospheric circulation changes that are driven by the distinct aspects of CO2 forcing and directly tied to the summer rainfall changes. [ABSTRACT FROM AUTHOR]

Palladium (Pd) is widely used in automotive catalytic converters to reduce toxic gas emissions. The input of Pd in the rainfall-runoff is an important contributing factor to the accumulation of Pd in receiving water bodies. In this study, the Meishe River in Haikou, Hainan Province, China, was used as the research area, and palladium (Pd) was selected as the target pollutant. This study explored the response of Pd in the receiving water body to rainfall-runoff and to analyze the influencing factors. The results showed that the dissolved Pd concentration in the receiving water body had a corresponding relationship with that in rainfall-runoff. The response of suspended Pd in the receiving water body to rainfall-runoff was closely related to the location of the drainage outlet. Compared with that of suspended Pd, the response of dissolved Pd in the receiving water body to that in the rainfall-runoff was more obvious. Seven meters downstream from the outfall was the most sensitive response distance of dissolved Pd in receiving water bodies to rainfall-runoff, and the response time was approximately 0–10 min. The suspended Pd at 3 m downstream from the outfall also had a certain response to the rainfall-runoff, and the response time was approximately 15–25 min. The response time of the suspended Pd in the receiving water body depended largely on the first flush ability of the runoff. There was a moderately positive correlation between the dissolved Pd and Cl− in the receiving water body (r = 0.687; p < 0.05). The effects of pH, Eh, and total suspended solids (TSS) on suspended Pd were reduced in the response process of the receiving water body. The synergistic effect of multiple factors increased the uncertainty of the Pd response. [ABSTRACT FROM AUTHOR]

Lake wetlands are extremely important and special ecosystems, which are important for regional water resource storage, environmental protection, and biodiversity maintenance. Sediment bacteria are an important component of lake ecosystems and are a major driver of biogeochemical cycling in lakes. In order to investigate the community structure of bacteria in typical lake sediments in Yinchuan City and their influencing factors, three typical lakes in Yinchuan City (Yuehai Lake, Mingcui Lake, and Xiniu Lake) were selected for the study and surface sediments were collected in January, April, July, and October 2021. The composition of the sediment bacterial community was examined using 16S rDNA high-throughput sequencing technology, and the response relationships between them and heavy metals were explored. The results showed that the ecological hazard coefficient for heavy metals in the sediments of three typical lakes in Yinchuan City was far less than 40, and the ecological hazard index was far less than 150, all of which indicated a minor ecological hazard. There were no significant differences in bacterial community diversity among the three lakes, but there were significant variations in diversity among the lakes in different seasons and significant differences in community composition. The dominant phyla (top three in terms of relative abundance) in Yuehai Lake, Mingcui Lake, and Xiniu Lake were Proteobacteria, Bacteroidetes, and Chloroflexi. The dominant lower orders were Gammaproteobacteria, Alphaproteobacteria, and Deltaproteobacteria. The main divergent species that occurred at the phylum level in typical lakes in Yinchuan were Proteobacteria, Bacteroidetes, Euryarchaeota, Firmicutes, Actinobacteria, and Acidobacteria. The sediment bacterial community structure of Yuehai Lake was significantly correlated with Cu, Fe, Mn, Zn, As, and Pb; the sediment bacterial community structure of Lake Mingcui was significantly correlated with Fe, Pb, and Cr; and the sediment bacterial community structure of Xiniu Lake was not significantly correlated with heavy metals. The types and contents of sediment heavy metals had a significant effect on the bacterial community structure of sediments in Yinchuan Yuehai Lake and Mingcui Lake and were important environmental factors that caused changes in the bacterial community structure of lake sediments.

Accelerating losses of seagrass meadows has led to efforts to restore these highly productive and beneficial ecosystems globally. Depth and light availability are critical determinants of seagrass restoration success. Eelgrass (Zostera marina L.) is the dominant seagrass species in the temperate northern hemisphere, but its global distribution has reduced dramatically. The main aims of this study were to determine: (1) the depth limit for Z. marina survival in Ailian Bay, north China, and (2) how light availability affects the growth and recruitment of Z. marina as a basis for identifying a suitable depth range for successful restoration. To achieve these aims, Z. marina shoots were transplanted from a nearby donor site, Swan Lake, to an experimental site, Ailian Bay, and the temporal responses of Z. marina shoots to light availability at water depths ranging from 1 to 8 m were investigated using in situ suspended cultures. Four suspended shoot transplantation experiments were conducted in 4 years. The results showed that the transplanted Z. marina shoots could survive and branch during an annual growth cycle, permanently underwater, at a depth ≤3 m. Due to the local turbidity of the waters in Ailian Bay, a depth of 4 m led to sufficient light deprivation (reduced to 6.48–10.08% of surface irradiance) to negatively affect seagrass shoot density and clonal reproduction. In addition, reproductive shoot density also tended to decline with water depth and light deprivation. Our results indicated that Z. marina population recruitment, through sexual and asexual (clonal growth) reproduction, were negatively affected by increasing water depth and light deprivation. These findings may provide a suitable depth range for the successful restoration of Z. marina in local coastal waters. They may also be applied to the management and restoration of Z. marina globally. [ABSTRACT FROM AUTHOR]

Although pre-treatment paroxysmal nocturnal hemoglobinuria (PNH) clone has been reported in a fraction of aplastic anemia (AA) for a long time, its predictive value on response to immunosuppressive therapy (IST) remained debatable. Therefore, we conducted a meta-analysis to elaborate this issue. The identified articles were retrieved from five English databases PubMed, EMBASE, Web of Science, Medline, the Cochrane Library, and four Chinese databases Weipu, Wangfang, China National Knowledge Infrastructure (CNKI), and SinoMed. We extracted odds ratios (ORs) and the corresponding 95% confidential intervals (CIs) for response to IST in AA patients with pre-treatment PNH clone versus those without from the available studies. Twelve studies covering 1787 patients were included this meta-analysis. The pooled ORs indicated that the pre-treatment PNH clone had no impact on 3-month response (pooled OR: 1.323, 95% CI: 0.260–6.735, p = 0.736), 6-month response (OR: 1.668, 95% CI: 0.802–3.470, p = 0.171), and overall response (OR: 2.220, 95% CI: 0.870–5.665, p = 0.095), including overall response in pediatric patients (OR: 1.919, 95% CI: 0.378–9.738, p = 0.432). However, pre-treatment PNH clone had a favorable impact on 12-month response (OR: 2.725, 95% CI: 1.525–4.870, p = 0.001). Pre-treatment PNH clone is associated with favorable 12-month response to IST in AA, the underlying mechanism needs further exploring. [ABSTRACT FROM AUTHOR]

The success of immunization programs in lowering the incidence of vaccine preventable diseases (VPDs) has led to increased public attention on potential health risks associated with vaccines. As a result, a scientifically rigorous response to investigating reported adverse events following immunization (AEFI) and effective risk communications strategies are critical to ensure public confidence in immunization. Globally, an estimated 257 million people have chronic hepatitis B virus (HBV) infection, which causes more than 686,000 premature deaths from liver cancer and cirrhosis. Hepatitis B vaccination is the most effective way to prevent mother-to-child transmission of HBV infection, especially when a timely birth dose is given within 24 h of birth. However, an infant's risk of dying is highest in the neonatal period, and thus, administering HepB-BD within 24 h of birth overlaps with the most fragile period in an infant's life. A working group formed in July 2016 following the publication of the case reports of the effects on vaccination coverage of media reports of infant deaths after HepB-BD administration in China and Vietnam. The goal of the working group was to create a framework and describe best practices for preparing for and responding to AEFI reported after HepB-BD administration, using existing resources. The framework includes six steps, including three preparation steps and three response steps. This document is written for national and regional immunization program staff. Prior to using the framework for preparation and response to AEFIs reported after HepB-BD administration, staff members should be familiar with how AEFI are detected, reported, and investigated in the country. The document might also be of interest to national regulatory staff members who monitor vaccine safety within the country. [ABSTRACT FROM AUTHOR]

Determining the response of abrupt temperature changes/warming hiatuses to changes in their influencing factors can provide a reference for investigating their mechanism. The present study, using the Mann-Kendall test, based on data (including average minimum temperature (Tmin), average temperature (Tave) and average maximum temperature (Tmax)) recorded at 357 meteorological stations in northern China and its surrounding regions as well as large-spatial- scale data (e.g. Atlantic multidecadal oscillation (AMO), global radiative forcing of CO2 (RFCO2) and radiative forcing of annual greenhouse gases (RFAGG)) for the period 1951-2016, the characteristics of abrupt temperature changes/warming hiatuses and their response to their influencing factors were qualitatively and quantitatively determined. The following results were obtained. Overall, from the late 1970s to the 1990s, as the RFAGG continuously increased, the Pacific decadal oscillation (PDO) remained in a positive phase, the AMO and total solar radiation (SR) continuously increased, the multivariate El Niño southern oscillation (ENSO) index (MEI) changed abruptly, the wind speed (WS), atmospheric pressure (AP) and relative humidity (RH) in each zone continuously decreased/increased, their trends changing subsequently, and abrupt changes in the three temperature metrics (i.e. the Tmin, Tave and Tmax) occurred in each zone during the period 1977-2004. Similarly, in the 1990s, particularly after 1998, as the increase in the AMO slowed, the PDO was in either a positive phase but exhibited a decreasing trend or a negative phase, the MEI and SR decreased, the WS, AP and RH decreased/ increased, with subsequent changes in trends, and warming hiatuses occurred. The sensitivities of the responses of the Tmin to changes in the three types of influencing factors were the highest, followed by those of the Tave and Tmax. The effects of various influencing factors on the three kinds of temperature change and warming hiatus have strong spatial and temporal differences. As a result, there was a strong spatial difference in the year of the abrupt temperature change and the warming hiatus. [ABSTRACT FROM AUTHOR]

The all-round and multilevel responses to the epidemic, with professional medical institutions, the governments and the public as the main agents of response and the media as the bridge of communication, are key to developing the public health emergency management system with regard to emerging infectious diseases and diseases with unknown etiology in the information age. This study creates an analysis framework concerning the five dimensions of information—the epidemic itself and the medical, governmental, public and media responses—and analyzes the evolution, interaction and trends of five dimensions using big data within the period of observation For the four dimensions other than the media response, the level of information related to the epidemic and the medical response is relatively high, while the level of response by medical institutions and the governments are similar, and both are higher than the public response. The media coverage of the epidemic remains at a high level of information. In relation to such diseases, the government should take the role of big data analytics seriously, lead a multi-agent social collaboration network, and further strengthen the 'One Planning Plus Three Systems' framework related to emergency management in China. [ABSTRACT FROM AUTHOR]

Water Use Efficiency (WUE) refers to the ratio of water used in plant metabolism over water lost in evapotranspiration, indicating carbon-water coupling in terrestrial ecosystem and its response to global change. It is of great significance to clarify the long-term variation characteristics and influencing factors of WUE for the study of carbon and water cycles and the rational utilization of water resources. This study aims to estimate the vegetation WUE of a research site, particularly on the annual and interannual variation characteristics of WUE, and to establish the response relationship between WUE and key meteorological factors. The data used in this paper mainly include the flux and meteorological information from eight sites in China from January 2003 to December 2010. Unified quality control and interpolation methods were then used to pre-process the flux data. The daily flux and meteorological data were combined into 8-day data sets in each site. Pearson coefficient was used to analyze the correlation between vegetation WUE and Gross Primary Productivity (GPP), ET, average temperature, precipitation, and relative humidity factors. The characteristics and influencing factors of WUE were analyzed and compared in different ecosystem. The results showed that: 1)WUE fluctuated greatly in the whole year without obvious regularity in Qianyanzhou, Xishuangbanna and Dinghushan sites which locate in the tropical monsoon climate region, while WUE showed obvious seasonal variation characteristics in the other five sites, all of which increased significantly from April to July, and reached the maximum during the peak period (July to August), and then WUE decreased gradually from August to October. From November to February of the following year, WUE reached zero. 2) From 2003 to 2010, the annual WUE of alpine meadow (Damxung) was the lowest (0.18 g/kg), whereas, that of tropical rainforest (Xishuangbanna) was the highest (4.20 g/kg). The WUE increased annually in the grassland (Inner Mongolia), broad-leaved evergreen forest (Dinghu Mountain), farmland (Yucheng), alpine meadow (Damxung), and alpine meadow (Haibei), whereas, the decreasing trend occurred in the coniferous forest (Qianyanzhou), tropical rainforest (Xishuangbanna), deciduous broad-leaved and coniferous mixed forests (Changbai Mountain). 3) In the 8-day time scale, there was positively correlation between temperature and WUE in alpine meadow, farmland and grassland ecosystem, whereas there was the negatively correlation between temperature and WUE in forest ecosystem. And the negative correlation between WUE and temperature in coniferous forest ecosystem (R=-0.607, P<0.01) was higher than that in evergreen broad-leaved forest and coniferous broad-leaved mixed forest ecosystem. Compared with forest and farmland ecosystem, WUE in alpine meadow and grassland ecosystem had a higher correlation with relative humidity and precipitation; 4) In different ecosystem, the various approaches were proposed to enhance WUE of terrestrial ecosystem for the sustainable development of agriculture, forestry and animal husbandry. Soil management regulation and canopy pruning can improve water use efficiency in the case of forest ecosystem. In farmland ecosystem, water use efficiency can be elevated from irrigation mode and crop breeding. In alpine meadow and grassland ecosystem, man-made grass, rest grazing and area rotation grazing can be used to enhance grassland carbon sink, further to improve water use efficiency. The findings can provide promising potentials to alleviate water shortage against the background of global warming. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• This study concerns the risk of power system caused by magnetic storms. • Responses of power system to magnetic storms are studied. • Excitation current is proposed to be a suitable quantity for assessing the response. Geomagnetically induced currents (GICs) flowing through transformers result in a DC bias, which poses a threat to safe and stable power grid operation. To evaluate the influence of geomagnetic storms on power systems, it is necessary to study actual power system responses. In this paper, the power system response is represented separately using current and reactive power measurements acquired using phasor measurement units (PMUs). On the basis of the data obtained from a wide-area measurement system, the power system responses to geomagnetic disturbances at Yangquan Substation, Shanxi, China were obtained. By employing the plane wave method, the data acquired during two mild magnetic storms at the Shisanling Geomagnetic Observatory were used to calculate the electric field and GIC at Yangquan Substation. The response variables and calculated GIC results agreed well, and the response variables were thus applied to assess the GIC level in the power system. The results show that the fluctuations in the PMU measurements were caused by GICs in the power system, laying the foundation for a significantly more detailed geomagnetic storm risk monitor. [ABSTRACT FROM AUTHOR]

The vegetation coverage of temperate grasslands in China has changed substantially due to climate change during the past decades, which significantly affects the function of grassland ecosystems. To appropriately carry out adaptive management and protect temperate grassland vegetation, it is important to understand the variations in fractional vegetation coverage (FVC) of China's temperate grasslands and how they are responding to climate change. Using the GIMMS NDVI and climatic datasets, this study explored the dynamics of FVC and their climatic drivers across the temperate grassland region of China during 1982∼2015. The results showed that the growing season mean FVC increased by 0.12% per year during 1982∼2015. The increases in precipitation and minimum temperature in the growing-season (especially in spring) could enhance the FVC of various vegetation types. In summer, the FVC of temperate steppe and desert steppe could drastically increase with increasing precipitation. In addition, this study found that the impacts of daytime and night-time warming on the FVC of temperate grasslands were asymmetric. Daytime warming can moderately increase FVC of temperate grasslands, while night-time warming could significantly increase it. Furthermore, the increase in summer daytime and night-time temperatures leads to a weak decrease and a moderate increase in FVC, respectively. This asymmetric effect was more evident for the temperate steppe and desert steppe in the central area. In autumn, the temperatures increase had significant positive impacts on the FVC of temperate meadows and steppes. This study highlights the differences in the impacts of climate change at different time scales on the FVC of grasslands with various vegetation types, and indicates that the asymmetric influences of daytime and night-time temperatures in different seasons on FVC must be included in calculating the vegetation coverage of China's temperate grasslands. The results could provide information for maintaining grassland ecosystem functions and managing environmental systems. • The FVC of temperate grasslands has increased by 0.12% per year from 1982 to 2015. • Increases in growing season precipitation and minimum temperature enhanced the FVC. • Nighttime and daytime temperatures have asymmetric effects on the FVC. [ABSTRACT FROM AUTHOR]

Drought is a natural hazard caused by long-term precipitation deficiency and high evaporation resulted from high temperature, which is among the most common disasters around the world. In recent decades, with the intensification of climate change and human activities, drought occurrence is becoming more frequent in China, causing negative impacts on agricultural production, ecological environment and social economy. Therefore, it is significant to explore the impact of drought on vegetation for agricultural production and healthy development of ecological systems. In this paper, the response and sensitivity of vegetation to drought in different climatic zones in China were analyzed, and the effects of different climatic factors, including water balance (precipitation-potential evapotranspiration), annual precipitation, mean temperature and sunshine hours, on the relationship between different vegetation types including forestland, grassland and cultivated land and drought were explored, so as to reveal the response mechanism of ecological vegetation to drought from a macro perspective. Using the self-calibrating Palmer drought severity index (scPDSI) and normalized difference vegetation index (NDVI) data for the period of 1982-2015, the response rule and sensitivity of different types of vegetation to drought were analyzed by applying time-delay correlation method, and the influence of various climate factors on the relationship between vegetation and drought was analyzed by applying linear regression method. The results of the research showed that in northwest China, Inner Mongolia, north China plain and southern Qinghai-Tibet plateau, the correlation of shorter lag time scPDSI (1-3 months) and NDVI was close (Rmax>0.4), which indicated that vegetation growth was more sensitive to drought in these regions and that vegetation biomass were influenced mainly by the spatiotemporal characteristics of the water availability. In the humid areas of south China, including the middle and lower reaches of the Yangtze River and the Pearl River basin, the precipitation is abundant so that the correlation between NDVI and scPDSI was negative, and the response of vegetation was not sensitive to drought. The growth of vegetation is mainly controlled by energy factors such as temperature and sunshine hours. The relationship between vegetation and drought was significantly affected by the average annual water balance, precipitation, sunshine hours and temperature, among which the annual water balance was the main water controlling factor (R²=0.45). It can be concluded that the change of water availability was the key factor behind the change of vegetation vigor. Sunshine hours were the main energy controlling factor. When average annual temperature was less than 5, the effect of ℃ temperature on the correlation between scPDSI and NDVI was also significant. The sensitive areas of drought impact on vegetation were mainly in the northern arid regions, while the southern humid areas had strong resilience and resilience to drought. The sensitivity of different types of vegetation to drought varied greatly, and the order of sensitivity is grassland >forestland>cultivated land. The results can provide a scientific basis for the evaluation of the impact of drought on ecological vegetation in different regions of China, and thus help to guide agricultural and environmental production, protect vulnerable ecosystems and provide implications for sustainable socioeconomic development. [ABSTRACT FROM AUTHOR]

Abstract Responses of a substructure adjacent to deep excavations are complex, especially when the substructure is connected to the supporting systems of the excavations. In this study, a three-dimensional (3D) numerical model is developed by finite difference (FD) software, FLAC3D v5.0, to examine the responses of a metro line to deep excavations through a case history in Shanghai, China. The developed numerical model includes four deep excavations, which were located at two sides of the metro line and were connected to the structures of the metro station. These deep excavations were constructed in stages and the construction processes are simulated in accordance with the practical execution. Responses of the rails to the deep excavations are illustrated and the numerical results are compared to the measured data to validate the developed numerical model and input parameters. Moreover, 3D structural responses of the metro station and shield tunnels to the deep excavations are presented and analyzed. Numerical results indicate that (i) the walls of the station move upward during the excavations and the slabs are uplifted by the walls; (ii) The station heaves significantly whereas the shield tunnels settle slightly. (iii) The station will be distorted if the unloading is asymmetric. [ABSTRACT FROM AUTHOR]

Airborne microorganisms (AM) have significant environmental and health implications. Extensive studies have been conducted to investigate the factors influencing the composition and diversity of AM. However, the knowledge of AM with anthropogenic activities has not reach a consensus. In this study, we took advantage of the dramatic decline of outdoor anthropogenic activities resulting from COVID-19 lockdown to reveal their associations. We collected airborne particulate matter before and during the lockdown period in two cities. The results showed that it was fungal diversity and communities but not bacteria obviously different between pre-lockdown and lockdown samples, suggesting that airborne fungi were more susceptible to anthropogenic activities than bacteria. However, after the implementation of lockdown, the co-occurrence networks of both bacterial and fungal community became more complex, which might be due to the variation of microbial sources. Furthermore, Mantel test and correlation analysis showed that air pollutants also partly contributed to microbial alterations. Airborne fungal community was more affected by air pollutants than bacterial community. Notably, some human pathogens like Nigrospora and Arthrinium were negatively correlated with air pollutants. Overall, our study highlighted the more impacts of anthropogenic activities on airborne fungal community than bacterial community and advanced the understanding of associations between anthropogenic activities and AM., 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., (Copyright © 2024. Published by Elsevier B.V.)

Purpose: Patients with unresectable locally advanced pancreatic cancer (LAPC) are still in dire need of effective therapies. We performed this cohort study in order to assess the efficacy and safety of high-intensity focused ultrasound (HIFU) ablation in treating patients with unresectable LAPC. Patients and methods: Eighty-seven cases with unresectable LAPC from January 2014 to December 2016 were finally recruited according to the inclusion criteria. The primary end point of our study was OS of all the cases, and the secondary end points included 6-month and 12-month survival rate, tumor response rate, carbohydrate antigen (CA) 19-9 response rate, VAS, quality of life, and safety. Results: All the 87 patients received HIFU ablation successfully, and were included in the efficacy and safety analysis. With a median follow-up of 16 months, median OS was estimated to be 12.2 months, with 95 % CI of 11.1–12.7 months. The 6-month and 12-month survival rates were 94.25% (95% CI =86.74–97.57) and 50.85% (95% CI =38.17–62.21), respectively. Multivariate analysis revealed that patients with VAS <4, Karnofsky performance status ≥80, and tumor size <3 cm have a significant improvement in their OS (adjusted HR [aHR] =0.26 [95% CI =0.12–0.57], P=0.001; aHR =0.34 [95% CI =0.17–0.68], P=0.02; and aHR =0.39 [95% CI =0.20–0.78], P=0.007; respectively). Tumor responses were observed in 32 (36.8%) of 87 patients and CA 19-9 response rate was 56.2%. Global health status, physical function, emotional function, and cognitive function of patients were significantly improved after HIFU treatment, and symptoms of fatigue and pain were significantly reduced. A total of 28.7% (25/87) of patients reported adverse events (AEs), mainly including fatigue (14/87), abdominal pain (7/87), fever (7/87), nausea (5/87), and rash (4/87). No severe AEs and HIFU-related deaths were reported. Conclusion: HIFU ablation might be a potentially effective and safe therapeutic option for the patients with unresectable LAPC. [ABSTRACT FROM AUTHOR]

The role of power in an English as a Second Language (ESL) classroom in secondary education has been widely investigated by action researchers such as Angel Lin in Hong Kong. Nonetheless, few studies have addressed this specific issue in tertiary education. This study aims to bridge the gap by using the framework of Critical Discourse Analysis (CDA) to uncover the relationship between language and power at the tertiary level. In class, the teacher used power and varied linguistic features to facilitate classroom teaching and learning. In this aspect, the socio-cognitive conditions that contribute to teaching and learning at tertiary setting are illuminated. The major methods are the tools (i.e., three questions) of CDA for analyzing the transcriptions of one English lesson, taken from the Hong Kong Corpus of Spoken English. A qualitative discourse analysis is used to interpret the selected spoken data; this article is concerned with understanding the distinctive ways of language use and the reasons behind it. [ABSTRACT FROM AUTHOR]

Annual monitoring data and centennial and millennial-scale paleolimnological records have revealed an increase in small-celled planktonic diatom species relative to heavier tycho-planktonic and small benthic diatoms in many high-altitude lakes, presumably in response to recent climatic warming. In addition to changes in the composition and structure of lacustrine diatom assemblages, there have also been changes in diatom biodiversity; however, these changes are not regionally consistent. In this study, we chose a temperate mid-latitude lake to explore the response of changes in diatom assemblages and biodiversity to recent climatic warming. The diatom record spans the past ca. 200 years and reveals that since 1966 CE the small-celled Cyclotella ocellata + stelligera has replaced the previously dominant, large-celled phytoplankton Cyclotella schroeteri . These changes are in accordance with the increasing trend in global mean surface temperature. Biodiversity increased remarkably from 1966 CE, but began to decline after 1990 CE, presumably in response to rapid climatic warming. Our findings indicate that the response of diatom biodiversity to climate change was a nonlinear process. [ABSTRACT FROM AUTHOR]

With the third-generation normalized difference vegetation index and a multiple-timescale drought index [standardized precipitation and evapotranspiration index (SPEI)], the relationships between vegetation activity in the growing season and drought occurrences during various seasons and at different timescales were investigated in northern China. Although poorly understood previously, knowledge of these relationships is crucial for climate, vegetation and hydrological studies. Our results show that over the past three decades, vegetation activity during the growing season was significantly correlated ( p < 0⋅05) with drought occurrences over 78⋅5% of northern China and highly significantly correlated ( p < 0⋅001) in semi-arid regions. In addition, there were spatially variable responses of vegetation activity to the seasonality of drought events across northern China. When drought events occurred in pre-season in the northern part of Inner Mongolia and Heilongjiang, parts of Shaanxi and Shanxi, and the western part of Xinjiang, they appear to have impacted vegetation activity, as indicated by the short and medium timescales of the drought indices (SPEI-3 and SPEI-6, with 3 and 6 months of accumulation, respectively). In the eastern part of Inner Mongolia, eastern part of Gansu and Qinghai, and southern parts of Ningxia, droughts during the growing season played a key role in vegetation growth, as recorded by the drought indices at all four timescales (SPEI-3, SPEI-6, SPEI-12 and SPEI-24). In addition, we also observed spatial variations in the responses of vegetation activity to droughts in northern China. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Because greenfields available for new developments in congested urban areas are scarce in China, more and more excavations for building basements or other underground facilities (e.g., new metro lines, underground shopping malls, parking garages) have to be carried out in the close proximity of existing metro lines. To ensure project safety, it is essential to know potential adverse effects of excavations on adjacent metro lines in service. Until now, many studies have contributed to the cases of excavations overlying existing tunnels. In contrast, only a few were known for excavations parallel to adjacent existing tunnels.With regard to the responses of existing metro stations to adjacent excavations, few case studies were reported in the literature. Through an extensive field instrumentation program in combination of numerical simulations, this study examines the performance of an oversized deep excavation in stiff clayey deposits and the corresponding responses of the adjacent metro station and twin shield tunnels in service. Taking advantage of the adopted zoned-construction procedure, both wall deflections and ground settlements of this oversized pit were not as significant as those reported in the literature, even smaller than those of long and narrow metro station pits. Consequently, both deformations and displacements of the existing metro line were within acceptable limits, and no obvious structural damage was observed. Throughout the excavation, the two-level island-type metro station exhibited a good structural integrity, which settled uniformly along the transverse direction and tilted slightly along the longitudinal direction. As to the twin shield tunnel linings, the one located within the primary ground influence zone developed considerably larger settlements and deformations than the other one within the secondary influence zone. As a product of the lateral stress relief attributable to soil removal, the tunnel lining experienced apparent elongations in the horizontal direction. [ABSTRACT FROM AUTHOR]

The crisis of medical response caused by catastrophic events might significantly affect emergency response, and might even initiate more serious social crisis. Therefore, early identification and timely blocking the formation of crisis in the early phase after a major disaster will improve the efficiency of medical response in a major disaster and avoid serious consequences. In the present paper, we described the emergency strategy to crisis management of medical response after a major disaster. Major catastrophic events often lead to various crises, including excess demand, the crisis of response in barrier and the structural crisis in response. The corresponding emergency response strategies include: (i) shunt of catastrophic medical surge; (ii) scalability of medical surge capacity; (iii) matching of the structural elements of response; (iv) maintaining the functions of support system for medical response and maximising the operation of the integrated response system; and (v) selection of appropriate care 'standard' in extreme situations of overload of disaster medical surge. In conclusion, under the impact of a major catastrophic event, medical response is often complex and the medical surge beyond the convention- al response capacity and it is easy to be in crisis. In addition to the current consensus of disaster response, three additional aspects should be considered. First, all relevant society forces led by the government and military should be linkages. Second, a powerful medical response system must be based on a strong support system. Third, countermeasures of medical surge should be applied flexibly to the special and specific disaster environment, to promote the effective medical response force. [ABSTRACT FROM AUTHOR]

The watershed buffering capacity is an important pivot to regulate phosphorus (P) pressure in aquatic environment, and land use is a key factor for its regulation. However, the response mechanism of buffer capacity to land use change remains unknown. Based on the variation of "buffering capacity index" in the Poyang Lake basin from 1990 to 2019, the mechanism of their response relationship was revealed via quantifying watershed P retention threshold and P removal process in different landscapes. Results showed that the watershed P buffering capacity was significantly affected by the scale of landscape subject to certain conditions of net anthropogenic P inputs (NAPI) in the Poyang Lake basin. The decreases in agricultural land, grassland and wetland and the increase of artificial land jointly explained 66.9% of watershed P buffering capacity decrease before accumulative P retention reached the threshold. The contribution of land use to watershed P buffering capacity change decreased to 53.8% when the P retention exceeded the threshold. Decreasing in watershed P buffering capacity was closely related to the increase of P loss in cultivated land, and wetland P removal provided an optimized direction for restoring the watershed buffering capacity. The findings reinforce the understanding of P hysteresis on watershed environment, and provide a policy basis for developing sustainable P management and pollution control from the perspective of optimizing land-use. [Display omitted] • The P buffering capacity affected by landscape scale subject to certain conditions of NAPI. • The response of watershed P buffering capacity to land-use changed when legacy P exceeded threshold. • Decreasing in watershed P buffering capacity was related to the landscapes with increased P loss. • Optimizing the distribution of wetlands may be an optimum way to improve buffering capacity. [ABSTRACT FROM AUTHOR]

Advance knowledge of the linkage between meteorological drought and vegetation drought is relevant for the risk of droughts and the impacts on vegetation health. This study employs a 3-dimensional clustering identification method to capture drought events and their characteristics (i.e., drought severity, intensity, area, center, and trajectory) in vegetated regions of China during 1982-2018. The probability of vegetation droughts, triggered by different types of drought events, is investigated by using a K-means trajectory clustering method and copula with the vegetation health index (VHI). Moreover, the impacts of moisture deficit and high temperature caused by drought on vegetation are examined with the vegetation condition index (VCI) and temperature condition index (TCI). The analysis has identified a total of 93 drought events in 1982-2018. The drought occurrences have become more concentrated in space along the time and droughts frequently occur in spring and summer. Drought events are categorized into three types, and droughts in type 1 lead to vegetation droughts with larger area, droughts in type 2 lead to vegetation droughts with stronger intensity, droughts in type 3 pose the least threat to vegetation. Additionally, the impacts of moisture deficit and high temperature have significant seasonal difference and contradictory trends over time. For example, grassland is most sensitive to moisture deficit in summer, while forest is the most sensitive to moisture deficit in spring and winter. The complex response of vegetation to drought is resulted from the combined effects of moisture and heat stress and different regional climate and vegetation types., 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., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Evaluation of the ecological effects of eco-compensation policies helps analyze policy rationality and feasibility and provides scientific and practical bases for perfecting eco-compensation systems. Taking the key ecological function area of the Loess Plateau, China as a case study, we have evaluated ecosystem responses to the Grain-for-Green Project that commenced in 1999. Six indicators were selected to assess changes in ecosystem structure, quality and function. The results showed that implementation of the Grain-for-Green Project has reduced sloping cropland by 1571 km2 and increased ecological land by 1337 km2. The increase in ecological land alters ecosystem structures across the study area and the decline in sloping cropland reduces farming activity interference; both of these are conducive to the restoration of natural vegetation. From 2000 to 2010, the vegetation cover of grassland, desert and forest ecosystems increased 10.89%, 8.34% and 4.24% respectively and average NPP rose 51%, with an average annual growth rate of around 5%. This indicates that eco-compensation has promoted the improvement of ecosystem quality. Total biomass of ecosystems increased two times on average from 2000 to 2010, meaning that the carbon sequestration capacity of ecosystems also increased. The reduction in the area of water loss and soil erosion and the increase in retained runoff by forests indicate an improvement in ecosystem function and services on the Loess Plateau. [ABSTRACT FROM AUTHOR]

Climate disasters are now on the rise and more likely to increase in frequency and/or severity under climate change in the future. To clearly illustrate spatial-temporal distributions of climate disasters and the response of wheat yields to disasters over the past three decades, several disaster indices including the impact of climate disasters, the sensitivity to climate disasters and the response index of wheat yield losses to climate disasters were defined and calculated. The impact and sensitivity indices were examined by the agricultural production losses due to climate disasters, and the response of wheat yields to climate disasters was assessed by wheat yield loss compared with the 5-year moving average. The results showed that the indices of climate disaster impacts and sensitivities as well as response index of wheat yields to climate disasters could represent the spatial-temporal distributions of climate disasters well in the whole China. Droughts in northern China had higher impacts and sensitivities than those in southern China during the period 1983-2008, but the impacts of floods were opposite. In northern China, although impacted area by drought was larger than that by flood, the flood sensitivities were larger than drought sensitivities when flood happened. Although drought significantly affected wheat yields in most of the regions with drier conditions during 1983-2008 in major wheat-producing regions, better management practices like irrigation and drought-tolerant cultivars applied in the Huang-Huai-Hai Plain can adapt to climate disasters especially droughts. To ensure the stability of agricultural production, future food security will need to be achieved through quantifying the relative effects of climate disasters and effective adaptation to increasingly frequent extreme climate events. [ABSTRACT FROM AUTHOR]

With the shrinking of indigenous malaria cases and endemic areas in the People's Republic of China (P.R. China), imported malaria predominates over all reported cases accounting for more than 90% of the total. On the way to eliminate malaria, prompt detection and rapid response to the imported cases are crucial for the prevention of secondary transmission in previous endemic areas. Through a comprehensive literature review, this chapter aims to identify risk determinants of potential local transmission caused by the imported malaria cases and discusses gaps to be addressed to reach the elimination goal by 2020. Current main gaps with respect to dealing with potential malaria resurgence in P.R. China include lack of cross-sectoral cooperation, lack of rapid response and risk assessment, poor public awareness, and inadequate research and development in the national malaria elimination programme. [ABSTRACT FROM AUTHOR]

The national action plan for malaria elimination in China (2010-2020) was issued by the Chinese Ministry of Health along with other 13 ministries and commissions in 2010. The ultimate goal of the national action plan was to eliminate local transmission of malaria by the end of 2020. Surveillance and response are the most important components driving the whole process of the national malaria elimination programme (NMEP), under the technical guidance used in NMEP. This chapter introduces the evolution of the surveillance from the control to the elimination stages and the current structure of national surveillance system in China. When the NMEP launched, both routine surveillance and sentinel surveillance played critical role in monitoring the process of NMEP. In addition, the current response strategy of NMEP was also reviewed, including the generally developed "1-3-7 Strategy". More effective and sensitive risk assessment tools were introduced, which cannot only predict the trends of malaria, but also are important for the design and adjustment of the surveillance and response systems in the malaria elimination stage. Therefore, this review presents the landscape of malaria surveillance and response in China as well as their contribution to the NMEP, with a focus on activities for early detection of malaria cases, timely control of malaria foci and epidemics, and risk prediction. Furthermore, challenges and recommendations for accelerating NMEP through surveillance are put forward. [ABSTRACT FROM AUTHOR]