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Background Trauma is a highly prevalent and costly global health problem. Prevention and control of infection is a major challenge in the management of traumatic wounds, while prolonged absence of skin washing after trauma will increase the incidence of wound infection, as well as the discomfort. Although many patients are willing to take a bath after trauma, the timing and method of bathing remains unclear. Therefore, it is necessary to build an appropriate scheme of bathing with wounds to keep the skin and wounds clean. Objective To construct a bathing with wounds at home scheme suitable for patients with traumatic wounds in China, and to provide a feasible care scheme for keeping the skin of trauma patients clean and improving the outcome of wound healing. Methods Database at home and abroad were searched to obtain original literature, the first draft of the items of bathing with wounds at home scheme for patients with traumatic wounds was formulated through evidence-based analysis, generalization, group discussion. Fifteen wound care experts with associate or higher titles were included, and Delphi consultation was used to modify and improve the bathing with wounds scheme, with an interval of one week for each round of correspondences, the reliability of the consultation results was evaluated by the expert positive and authority coefficients. The consistency of the consultation results was evaluated by the coefficient of variation, a revised draft was formulated with terminated consultation when the coefficient of variation less than 0.25, which means that the expert opinions tend to be consistent. Thirty patients with traumatic wounds were enrolled in the pre-test, Likert 5-point scale was used to verify the convenience, safety and patient compliance of the bathing with wounds scheme, and the final scheme was developed after discussion and modification. Results After the inclusion of 23 related papers, the first draft of bathing with wounds scheme was developed through evidence-based analysis and discussion, involving three first-level items (including preparation befor bathing, bathing operation and treatment after bathing), seven second-level items, nine third-level items and four fourth-level items. The opinions of the 15 experts converged after 2 rounds of correspondence, with recall rates of 93.75% and 100.00%, with authority coefficients of 0.947 and 0.957, respectively. The variation coefficients of importance and maneuverability of each item in the first round were 0-0.25 and 0-0.23, and those in the second round were 0.09-0.18 and 0.07-0.14, respectively, a total of 2 items were deleted, 5 items were modified and 2 items were added, resulting in a revised draft. The 30 enrolled patients with traumatic wounds took baths (2.70±0.47) times per week according to the bathing scheme, with the average bath time of 10-15min, convenience and compliance scores of (4.67±0.48) and (4.70±0.47), and no bathing-related adverse events and wound infection occurred.The pre-test proved that the bathing plan was safe、reliable、simple and have good patient compliance. The final draft of the bathing with wounds scheme for traumatic wound patients included three first-level items, eight second-level items, nine third-level items and three fourth-level items. Conclusion In the construction process of the bathing with wounds scheme for traumatic wound patients, the positive and authority coefficients of experts are high, which has been unanimously approved by corresponding experts. The compliance of 30 patients with traumatic wounds in the pre-test was high, suggesting that the bathing with wounds scheme is safe and convenient, which can be applied to bathing with wounds at home for patients with traumatic wounds in China.

Abstract Background Choosing the appropriate antipsychotic drug (APD) treatment for patients with schizophrenia (SCZ) can be challenging, as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers. Previous studies have indicated the association between treatment response and genetic and epigenetic factors, but no effective biomarkers have been identified. Hence, further research is imperative to enhance precision medicine in SCZ treatment. Methods Participants with SCZ were recruited from two randomized trials. The discovery cohort was recruited from the CAPOC trial (n = 2307) involved 6 weeks of treatment and equally randomized the participants to the Olanzapine, Risperidone, Quetiapine, Aripiprazole, Ziprasidone, and Haloperidol/Perphenazine (subsequently equally assigned to one or the other) groups. The external validation cohort was recruited from the CAPEC trial (n = 1379), which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine, Risperidone, and Aripiprazole groups. Additionally, healthy controls (n = 275) from the local community were utilized as a genetic/epigenetic reference. The genetic and epigenetic (DNA methylation) risks of SCZ were assessed using the polygenic risk score (PRS) and polymethylation score, respectively. The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis, methylation quantitative trait loci, colocalization, and promoter-anchored chromatin interaction. Machine learning was used to develop a prediction model for treatment response, which was evaluated for accuracy and clinical benefit using the area under curve (AUC) for classification, R 2 for regression, and decision curve analysis. Results Six risk genes for SCZ (LINC01795, DDHD2, SBNO1, KCNG2, SEMA7A, and RUFY1) involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response. The developed and externally validated prediction model, which incorporated clinical information, PRS, genetic risk score (GRS), and proxy methylation level (proxyDNAm), demonstrated positive benefits for a wide range of patients receiving different APDs, regardless of sex [discovery cohort: AUC = 0.874 (95% CI 0.867–0.881), R 2 = 0.478; external validation cohort: AUC = 0.851 (95% CI 0.841–0.861), R 2 = 0.507]. Conclusions This study presents a promising precision medicine approach to evaluate treatment response, which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ. Trial registration Chinese Clinical Trial Registry ( https://www.chictr.org.cn/ ), 18. Aug 2009 retrospectively registered: CAPOC—ChiCTR-RNC-09000521 ( https://www.chictr.org.cn/showproj.aspx?proj=9014 ), CAPEC—ChiCTR-RNC-09000522 ( https://www.chictr.org.cn/showproj.aspx?proj=9013 ).

Until now the genus Amana (Liliaceae), known as ‘East Asian tulips’, has contained just seven species. In this study, a phylogenomic and integrative taxonomic approach was used to reveal two new species, Amana nanyueensis from Central China and A. tianmuensis from East China. A. nanyueensis resembles Amana edulis in possessing a densely villous-woolly bulb tunic and two opposite bracts, but differs in its leaves and anthers. Amana tianmuensis resembles Amana erythronioides in possessing three verticillate bracts and yellow anthers, but differs in aspects of its leaves and bulbs. These four species are clearly separated from each other in principal components analysis based on morphology. Phylogenomic analyses based on plastid CDS further support the species delimitation of A. nanyueensis and A. tianmuensis and suggests they are closely related to A. edulis. Cytological analysis shows that A. nanyueensis and A. tianmuensis are both diploid (2n = 2x = 24), different from A. edulis, which is either diploid (northern populations) or tetraploid (southern populations, 2n = 4x = 48). The pollen morphology of A. nanyueensis is similar to other Amana species (single-groove germination aperture), but A. tianmuensis is quite different because of the presence of a sulcus membrane, which creates the illusion of double grooves. Ecological niche modelling also revealed a niche differentiation between A. edulis, A. nanyueensis and A. tianmuensis.

Abstract Background Lamotrigine is approved as a maintenance therapy for bipolar I disorder in many countries, including China in 2021. This study evaluated the efficacy and safety of lamotrigine in controlling relapse and/or recurrence of mood episodes in Chinese patients with bipolar I disorder. Methods Patients aged ≥ 18 years with bipolar I disorder who met response criteria (Clinical Global Impression–Severity [CGI-S] score of ≤ 3 for ≥ 4 consecutive weeks) during treatment with lamotrigine in a 6–16 week open-label (OL) phase, and who were maintained for ≥ 1 week on lamotrigine 200 mg/day monotherapy, were randomised (1:1) to continue receiving lamotrigine 200 mg/day or switch to placebo in a 36-week randomised double-blind (RD) phase. The primary efficacy outcome measure was time from entry into the RD phase to intervention for relapse and/or recurrence of a mood episode (TIME). Post hoc analyses assessed the impact of OL baseline mood severity on TIME. Safety assessments were conducted throughout the study. Results Of 420 patients treated in the OL phase, 264 were randomised to receive lamotrigine (n = 131) or placebo (n = 133). Overall, 112 patients had an intervention for relapse and/or recurrence of a mood episode (lamotrigine, n = 50/130 [38.5%]; placebo, n = 62/133 [46.6%]), with no significant difference in TIME between groups (adjusted hazard ratio [95% confidence interval (CI)] 0.93 [0.64, 1.35]; p = 0.701). Post hoc analyses indicated a significant difference in TIME, favouring lamotrigine over placebo, for patients with baseline CGI-S score ≥ 4 (hazard ratio [95% CI] 0.52 [0.30, 0.89]; p = 0.018) and with baseline Hamilton Depression Rating Scale ≥ 18 or Young Mania Rating Scale ≥ 10 (0.44 [hazard ratio [95% CI] 0.25, 0.78]; p = 0.005). Lamotrigine was well tolerated with no new safety signals. Conclusions Lamotrigine was not significantly superior to placebo in preventing relapse and/or recurrence of mood episodes in this study of Chinese patients with bipolar I disorder but post hoc analyses suggested a therapeutic benefit in patients with moderate/severe mood symptoms at baseline. The discrepancy between these findings and the positive findings of the pivotal studies may be attributable to the symptom severity of the bipolar patients recruited, a high dropout rate, and the comparatively short duration of the RD phase rather than race/ethnicity differences. Clinical trial registration ClinicalTrial.gov Identifier NCT01602510; 21st May 2012; https://clinicaltrials.gov/ct2/show/NCT01602510 .

Elsholtzia zhongyangii (Lamiaceae), a new species from Sichuan Province, China, is described and illustrated. The new species is morphologically similar to E. feddei f. feddei, but it can be easily distinguished from E. feddei f. feddei by smaller corolla (3.2–3.5 mm vs. 4.5–5.3 mm), bract indumentum (glabrous, except margin ciliate vs. villous, especially on veins abaxially, glabrous adaxially) and bract stalked (ca. 1.2 mm vs. sessile). Phylogenetic analyses, based on two nuclear ribosomal (ETS, ITS) and five plastid (rbcL, matK, trnL-F, ycf1, ycf1-rps15) regions, confirmed that the new species formed a monophyletic clade with robust support. The new species is currently known from western Sichuan.

Potassium ion batteries (PIBs) are attractive for the rapidly emerging large-scale energy storage market for intermittent renewable resources. The cost of PIBs can be substantially reduced by utilizing easily synthesized and long cycle-life active materials. This study introduces a one-step solid-state synthesis approach for the encapsulation of FeSe2 nanorods within a ketjenblack (KB) carbon matrix, yielding an FeSe2@C-3 composite. As an anode material for PIBs, it exhibits an excellent cycling performance (a high specific capacity of 286 mA h g−1 after 3500 cycles at 1.0 A g−1). Equally noteworthy is its superior rate performance, demonstrating a reversible specific capacity of 303 mA h g−1 at a high-rate density of 2.0 A g−1. Theoretical calculation confirms that the superior potassium storage performance of FeSe2 is attributed to the low K+ intercalation energy. Additionally, the immobilization of FeSe2 nanorods within the conductive KB network can preserve the electrical and structural integration of the whole electrode. Furthermore, when coupled with perylene-3,4,9,10-tetracarboxylic dianhydride as the cathode, the FeSe2@C-3 full cell sustains a specific capacity of 107 mA h g−1 at 0.1 A g−1 and effectively powers 40 light-emitting diode light bulbs after 200 cycles. This study presents a cost-effective way to produce Fe-based anode materials and introduces a novel structural design strategy aimed at extending the cycle life. [ABSTRACT FROM AUTHOR]

Humans perceive their surrounding environments largely through their experiences of sight and hearing. The perceived environmental information then brings on neurophysiological changes, so as to influence human emotions. These mutually influenced relations have been widely utilized by many environmental psychologists to explore potential avenues for improving human emotions through design interventions. However, to date, no efficient and accurate way has been established to describe these relationships. Inspired by Russell's model of emotion, this study aims to develop an efficient process that uses coordinate mapping and can intuitively describe the impact of visual-aural perceptive attributes on human emotions. Taking typical urban green spaces (UGSs) in Chengdu as examples, this study first measured the visual and aural characteristics of study sites perceived by people and their emotional responses. The study then established the use of emotional status on a coordinate axis, allowing each visual-aural attribute corresponding to each emotional response to be projected onto the coordinates. Results suggested that the dataset composed of 279 evaluations could be classified into three distinct types of visual-aural settings and the distribution of emotions is evidently varied in different settings. It was found that aesthetic and order of visual aspects as well as eventful and harmonious soundscape in environments are more likely to make people feel pleasure, while openness and layering of the visual landscape can easily arouse people's positive status. The research outcome broadens the practical path of soundscape research, centring on human emotions, experiences and feelings, such as the pleasantness and arousal raised in Russell's theory of emotion. The study also makes an empirical contribution to the design of UGSs based on multi-sensory perception and serves the purpose of improving people's environmental experiences. [ABSTRACT FROM AUTHOR]

We provide observational evidence that the stability of the stratospheric Polar vortex (PV) is a significant driver of sub‐seasonal variability in the thermosphere during geomagnetically quiet times when the PV is anomalously strong or weak. We find strong positive correlations between the Northern Annular Mode (NAM) index and subseasonal (10–90 days) Global Observations of the Limb and Disk (GOLD) O/N2 perturbations at low to mid‐northern latitudes, with a largest value of +0.55 at ∼30.0°N when anomalously strong or weak (NAM >2.5 or < −2.1) vortex times are considered. Strong agreement for O/N2 variability and O/N2‐NAM correlations is found between GOLD observations and the Whole Atmosphere Community Climate Model with thermosphere‐ionosphere eXtension (WACCM‐X) simulations, which is then used to delineate the global distribution of O/N2‐NAM correlations. We find negative correlations between subseasonal variability in WACCM‐X O/N2 and NAM at high northern and southern latitudes (as large as −0.54 at ∼60.0°S during anomalous vortex times). These correlations suggest that PV driven upwelling at low latitudes is accompanied by corresponding downwelling at high latitudes in the lower thermosphere (∼80–120 km), which is confirmed using calculations of residual mean meridional circulation from WACCM‐X. Plain Language Summary: The stratospheric Polar vortex (PV) is a large‐scale circulation pattern that forms over the poles during the winter months, characterized by strong winds circulating in a counterclockwise direction in the Northern Hemisphere. It has previously been demonstrated that the breakup of the PV during sudden stratospheric warming (SSW) events has a large effect on the composition of the thermosphere. We demonstrate that the PV also influences thermospheric composition during non‐SSW times, including time periods in which the vortex is strong and times in which the vortex is inactive, by correlating observations of thermospheric O/N2 from the Global Observations of the Limb and Disk (GOLD) instrument with the Northern Annular Mode (NAM) index, which tracks the strength of the PV. We also find strong anti‐correlations between O/N2 and tidal amplitudes from model simulations, which suggests that the PV influences thermospheric composition via changes in mean circulation induced by the dissipation of enhanced waves. We use model simulations to confirm that the NAM‐O/N2 correlations reflect PV induced changes in global circulation patterns. We find that the PV causes enhanced upwelling at low latitudes and corresponding downwelling at high latitudes in both the northern and southern hemispheres. Key Points: Polar vortex (PV) activity is correlated with sub‐seasonal O/N2 variability during low Kp winter times at all latitudesWe observe enhanced O/N2 at high southern latitudes and reduced O/N2 at low latitudes in response to northern hemisphere PV activityPV‐O/N2 correlations are shown to reflect PV induced modulations of the residual mean meridional circulation (MMC) [ABSTRACT FROM AUTHOR]