The chain mediating role of rumination and social withdrawal in the relationship between smartphone distraction and depression among Chinese nursing students.

Smartphone distraction (SD) is closely related to depression, and the prevalence of SD among nursing students is gradually increasing. However, the potential mechanism of the effect of SD on nursing students' depression is unclear. A total of 574 nursing students were assessed using Smartphone Distraction Scale, Ruminative Response Scale, Hikikomori Questionnaire, and Patient Health Questionnaire-9. The results indicated that SD among nursing students had an impact on depression through four pathways: (1) SD was positively associated with depression (ß = 0.353, P < 0.001); (2) Rumination (ß = 0.199, 95% CI: 0.081 to 0.162) and social withdrawal (ß = 0.061, 95% CI: 0.034 to 0.091) mediated the effects of SD on depression, respectively; and (3) Rumination and social withdrawal played a chain mediating role in the effect of SD on nursing students' depression (ß = 0.027, 95% CI: 0.015 to 0.042). The negative impact of SD on nursing students' mental health should not be taken lightly. Schools and hospitals should guide nursing students to use smartphones correctly, including providing mental health education and professional psychological counselling; families could play a supervisory role and communicate regularly to understand the psychological state and learning of nursing students. These measures can help nursing students cope with stress and reduce the risk of depression.

Reducing transient severe motion artifacts of gadoxetate disodium-enhanced MRI by oxygen inhalation: effective for pleural effusion but not ascites.

OBJECTIVES: To evaluate the efficacy of low-flow oxygen inhalation in mitigating transient severe motion (TSM) artifacts associated with gadoxetate disodium-enhanced hepatic magnetic resonance imaging (MRI). METHODS: Patients undergoing gadoxetate disodium-enhanced MRI were included. During the examination, the experimental group received oxygen at 2 L/min via nasal cannula, while the control group did not. Images and TSM scores were evaluated and compared across precontrast, arterial, venous, and hepatobiliary phases. Subgroup analyses were conducted based on the presence of pleural effusion or ascites. RESULTS: A total of 325 patients were included. The motion scores were highest in the arterial phase and lowest in the hepatobiliary phase in both groups, but were significantly lower in the experimental group (p < 0.05). The incidence of TSM was significantly lower in the experimental group (3.29%) compared to the control group (13.29%, p = 0.01). While pleural effusion was associated with reduced image quality in both groups (p < 0.05), the image quality in the pleural effusion category was higher in the experimental group than in the control group. Oxygen inhalation showed limited efficacy in mitigating TSM related to ascites. CONCLUSIONS: Low-flow oxygen inhalation can effectively reduce the occurrence of gadoxetate disodium-related TSM. Pleural effusion may impair respiratory function and contribute to TSM, which can be alleviated by oxygen supplementation. However, Oxygen inhalation is less effective under the condition of ascites.

Association between the triglyceride-glucose (TyG) index and stroke risk in Chinese normal-weight adults: a population-based study.

BACKGROUND: Identifying high-risk populations and promoting stroke prevention measures can be achieved through studies on stroke and its risk factors. As a new alternative indicator of insulin resistance (IR), the triglyceride glucose (TyG) index may potentially increase stroke risk. However, the evidence confirming this association is inadequate and inconsistent, possibly due to variations in stroke assessment criteria or characteristics of the study populations. This study aims to evaluate the association between the TyG index and stroke risk level among individuals with normal-weight. METHODS: A total of 30,895 participants aged ≥ 40 years with normal-weight were enrolled in this study. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Normal-weight was described as a body mass index (BMI) of 18.5-<24.0 kg/m2. Stroke risk was assessed by the Stroke Risk Assessment Scale, developed by the China National Stroke Screening and Prevention Project. To evaluate the associations between the TyG index and stroke risk level, multivariate logistic regression models were employed. RESULTS: Results showed that when the TyG index was considered as a continuous variable, each one unit increase in the TyG index was associated with a significantly higher risk of stroke [Moderate-risk (OR, 2.15; 95% CI, 2.03-2.28; P<0.001); High-risk (OR, 3.83; 95% CI, 3.57-4.10; P<0.001)]. Compared with Q1 of the TyG index, Q4 was significantly associated with moderate stroke risk (OR, 2.73; 95% CI, 2.50-2.99; P<0.001) and high stroke risk (OR, 5.39; 95% CI, 4.83-6.01; P<0.001). The continuous TyG index was an important risk factor for high stroke risk in the metabolically obese, normal-weight (MONW) individuals (OR, 3.44;95% CI, 2.92-4.06; P < 0.001). In the MONW individuals, when Q1 was used as a reference, participants in Q4 (OR, 5.33; 95% CI, 4.19-6.78; P < 0.001) was significantly associated with high stroke risk. Subgroup analysis showed significant interaction in the age and sex subgroups in the overall population (Pinteraction <0.001). CONCLUSION: The risk of stroke is increased with the TyG index among Chinese adults of normal weight; hence, the index may be an important indicator for identifying high-risk stroke populations among individuals with normal body weight.

The Bacterial and Fungal Compositions in the Rhizosphere of Asarum heterotropoides Fr. Schmidt var. mandshuricum (Maxim.) Kitag. in a Typical Planting Region.

Asarum is a traditional Chinese medicinal plant, and its dried roots are commonly used as medicinal materials. Research into the traits of the bacteria and fungus in the Asarum rhizosphere and how they relate to the potency of medicinal plants is important. During four cropping years and collecting months, we used ITS rRNA gene amplicon and sequencing to assess the population, diversity, and predominant kinds of bacteria and fungus in the rhizosphere of Asarum. HPLC was used to determine the three bioactive ingredients, namely asarinin, aristolochic acid I, and volatile oil. The mainly secondary metabolites of Asarum, relationships between microbial communities, soil physicochemical parameters, and possible influences on microbial communities owing to various cropping years and collecting months were all statistically examined. The cropping years and collecting months affected the abundance and diversity of rhizosphere bacteria and fungi, but the cropping year had a significant impact on the structures and compositions of the bacterial communities. The rhizosphere microorganisms were influenced by both the soil physicochemical properties and enzyme activities. Additionally, this study revealed that Trichoderma was positively correlated with the three bioactive ingredients of Asarum, while Tausonia showed entirely opposite results. Gibberella and Leptosphaeria demonstrated a significantly negative correlation with asarinin and violate oil, but they were weakly correlated with the aristolochic acid I content. This study revealed variations in the Asarum rhizosphere microorganism population, diversity, and dominant types across four cropping years and collecting months. The relationship between Asarum secondary metabolites, the soil physicochemical properties, enzyme activities, and rhizosphere microorganisms was discussed. Our results will guide the exploration of the soil characteristics and rhizosphere microorganisms' structures by regulating the microbial community to enhance Asarum quality.

The effect of internet use on depressive symptoms in middle-aged and older adults with functional disability: the mediating role of social isolation.

Objective: The popularization of the internet provides the possibility to improve the depressive symptoms (DS) and social isolation of middle-aged and older adults with functional disability. There was a significant correlation between internet use and DS in middle-aged and older adults with functional disability, but the relationship between internet use, social isolation, and DS remains to be confirmed. Methods: Data were obtained from 7,955 middle-aged and older adults aged 45 years and older from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Multiple linear regression models were used to analyze the association between internet use and DS, and the Sobel test was used to explore mediating models. Results: Results showed that internet use was negatively associated with DS among Chinese middle-aged and older adults. Among them, social needs (B = -0.770, p = 0.041), and information reception (B = -1.067, p = 0.007) were significantly related to DS in middle-aged and older adults. Only information reception (B = -3.161, p = 0.031) was significantly related to DS among middle-aged and older adults with functional disability. Social isolation partially mediated the association between internet use and DS in middle-aged and older adults without functional disability, whereas it was fully mediated in middle-aged and older adults with functional disability. Conclusion: This study indicates that when formulating health policies to promote the mental health of Chinese middle-aged and older adults, the use of the internet should not be overlooked.

Bioinspired Tactile Sensation Based on Synergistic Microcrack-Bristle Structure Design toward High Mechanical Sensitivity and Direction-Resolving Capability.

Natural tactile sensation is complex, which involves not only contact force intensity detection but also the perception of the force direction, the surface texture, and other mechanical parameters. Nevertheless, the vast majority of the developed tactile sensors can only detect the normal force, but usually cannot resolve shear force or even distinguish the directions of the force. Here, we present a new paradigm of bioinspired tactile sensors for resolving both the intensity and the directions of mechanical stimulations via synergistic microcrack-bristle structure design and cross-shaped configuration engineering. The microcrack sensing structure gives high mechanical sensitivity to the tactile sensors, and the synergistic bristle structure further amplifies the sensitivity of the sensors. The cross-shaped configuration engineering of the synergistic microcrack-bristle structure further endows the tactile sensors with good capability to detect and distinguish the directions of the applied mechanical forces. The as-fabricated tactile sensors exhibit a high sensitivity (25.76 N-1), low detection limit (5.4 mN), desirable stability (over 2,500 cycles), and good capability to resolve both mechanical intensity and directional features. As promising application scenarios, surface texture recognition and biomimetic path explorations are successfully demonstrated with these tactile sensors. This newly proposed tactile sensation strategy and technology have great potential applications in ingenious tactile sensation and construction of various robotic and bionic prostheses with high operational dexterity.

Shengxian decoction protects against chronic heart failure in a rat model via energy regulation mechanisms.

BACKGROUND: Chronic heart failure (CHF) is actually a disease caused by an imbalanced energy metabolism between myocardial energy demand and supply, ultimately resulting in abnormal myocardial cell structure and function. Energy metabolism imbalance plays an important role in the pathological process of chronic heart failure (CHF). Improving myocardial energy metabolism is a new strategy for the treatment of CHF. Shengxian decoction (SXT), a well-known traditional Chinese medicine (TCM) formula, has good therapeutic effects on the cardiovascular system. However, the effects of SXT on the energy metabolism of CHF is unclear. In this study, we probed the regulating effects of SXT on energy metabolism in CHF rats using various research methods. METHODS: High-performance liquid chromatography (HPLC) analysis was used to perform quality control of SXT preparations. Then, SD rats were randomly assigned into 6 groups: sham, model, positive control (trimetazidine) and high-, middle-, and low-dose SXT groups. Specific reagent kits were used to detect the expression levels of ALT and AST in rats' serum. Echocardiography was used to evaluate cardiac function. H&E, Masson and TUNEL staining were performed to examine myocardial structure and myocardial apoptosis. Colorimetry was used to determine myocardial ATP levels in experimental rats. Transmission electron microscopy was used to observe the ultrastructure of myocardial mitochondria. ELISA was used to estimate CK, cTnI, and NT-proBNP levels, and LA、FFA、MDA、SOD levels. Finally, Western blotting was used to examine the protein expression of CPT-1, GLUT4, AMPK, p-AMPK, PGC-1α, NRF1, mtTFA and ATP5D in the myocardium. RESULTS: HPLC showed that our SXT preparation method was feasible. The results of ALT and AST tests indicate that SXT has no side effect on the liver function of rats. Treatment with SXT improved cardiac function and ventricular remodelling and inhibited cardiomyocyte apoptosis and oxidative stress levels induced by CHF. Moreover, CHF caused decrease ATP synthesis, which was accompanied by a reduction in ATP 5D protein levels, damage to mitochondrial structure, abnormal glucose and lipid metabolism, and changes in the expression of PGC-1α related signal pathway proteins, all of which were significantly alleviated by treatment with SXT. CONCLUSION: SXT reverses CHF-induced cardiac dysfunction and maintains the integrity of myocardial structure by regulating energy metabolism. The beneficial effect of SXT on energy metabolism may be related to regulating the expression of the PGC-1α signalling pathway.

Single-Crystal 2D Covalent Organic Frameworks for Plant Biotechnology.

Molecules chemically synthesized as periodic two-dimensional (2D) frameworks via covalent bonds can form some of the highest-surface area and -charge density particles possible. There is significant potential for applications such as nanocarriers in life sciences if biocompatibility can be achieved; however, significant synthetic challenges remain in avoiding kinetic traps from disordered linking during 2D polymerization of compatible monomers, resulting in isotropic polycrystals without a long-range order. Here, we establish thermodynamic control over dynamic control on the 2D polymerization process of biocompatible imine monomers by minimizing the surface energy of nuclei. As a result, polycrystal, mesocrystal, and single-crystal 2D covalent organic frameworks (COFs) are obtained. We achieve COF single crystals by exfoliation and minification methods, forming high-surface area nanoflakes that can be dispersed in aqueous medium with biocompatible cationic polymers. We find that these 2D COF nanoflakes with high surface area are excellent plant cell nanocarriers that can load bioactive cargos, such as the plant hormone abscisic acid (ABA) via electrostatic attraction, and deliver them into the cytoplasm of intact living plants, traversing through the cell wall and cell membrane due to their 2D geometry. This synthetic route to high-surface area COF nanoflakes has promise for life science applications including plant biotechnology.

Design of Biodegradable, Climate-Specific Packaging Materials That Sense Food Spoilage and Extend Shelf Life.

The AgriFood systems in tropical climates are under strain due to a rapid increase in human population and extreme environmental conditions that limit the efficacy of packaging technologies to extend food shelf life and guarantee food safety. To address these challenges, we rationally designed biodegradable packaging materials that sense spoilage and prevent molding. We nanofabricated the interface of 2D covalent organic frameworks (COFs) to reinforce silk fibroin (SF) and obtain biodegradable membranes with augmented mechanical properties and that displayed an immediate colorimetric response (within 1 s) to food spoilage, using packaged poultry as an example. Loading COF with antimicrobial hexanal also mitigated biotic spoilage in high-temperature and -humidity conditions, resulting in a four-order of magnitude decrease in the total amount of mold growth in soybeans packaged in silk-COF, when compared to cling film (i.e., polyethylene). Together, the integration of sensing, structural reinforcement, and antimicrobial agent delivery within a biodegradable nanocomposite framework defines climate-specific packaging materials that can decrease food waste and enhance food safety.

Spirocitrinols A and B, citrinin derivatives with a spiro[chromane-2,3'-isochromane] skeleton from Penicillium citrinum.

Spirocitrinols A (1) and B (2), two new citrinin-derived metabolites possessing a spiro[chromane-2,3'-isochromane] skeleton, were isolated from cultures of Penicillium citrinum. Their structures were elucidated primarily by NMR experiments. The absolute configurations of 1 and 2 were assigned by electronic circular dichroism calculations. Compound 2 is the first naturally occurring trimeric citrinin derivative with a spiro[chromane-2,3'-isochromane] core. Compound 1 showed modest cytotoxicity against A549 human tumor cells.

Interfacial Electrostatic Self-Assembly of Amyloid Fibrils into Multifunctional Protein Films.

Amyloid fibrils have generated steadily increasing traction in the development of natural and artificial materials. However, it remains a challenge to construct bulk amyloid films directly from amyloid fibrils due to their intrinsic brittleness. Here, a facile and general methodology to fabricate macroscopic and tunable amyloid films via fast electrostatic self-assembly of amyloid fibrils at the air-water interface is introduced. Benefiting from the excellent templating properties of amyloid fibrils for nanoparticles (such as conductive carbon nanotubes or magnetic Fe3 O4 nanoparticles), multifunctional amyloid films with tunable properties are constructed. As proof-of-concept demonstrations, a magnetically oriented soft robotic swimmer with well-confined movement trajectory is prepared. In addition, a smart magnetic sensor with high sensitivity to external magnetic fields is fabricated via the combination of the conductive and magnetic amyloid films. This strategy provides a convenient, efficient, and controllable approach for the preparation of amyloid-based multifunctional films and related smart devices.

Spatial and temporal dynamics of microbial community composition and factors influencing the surface water and sediments of urban rivers.

The temporal and spatial characteristics of urban river bacterial communities help us understand the feedback mechanism of bacteria to changes in the aquatic environment. The Fuhe River plays an important role in determining the water ecological environment of Baiyangdian Lake. 16S rRNA gene sequencing was used to study the microbial distribution characteristics in the Fuhe River in different seasons. The results showed that some environmental factors of the surface water (ammonia nitrogen (NH3-N), total nitrogen (TN), and total phosphorus (TP)) were different on the spatial and temporal scales. Moreover, there were no seasonal differences in the contents of TN, TP, total organic carbon (TOC), or heavy metals in the sediments. The distributions of Cyanobacteria, Actinomycetes and Firmicutes in the water and Actinomycetes and Planctomycetes in the sediments differed significantly among seasons (P < 0.05). There were significant spatial differences in bacteria in the surface water, with the highest abundance of Proteobacteria recorded in the river along with the highest nutrient concentration, while the abundance of Bacteroidetes was higher in the upstream than the downstream. Microbial communities in the water were most sensitive to temperature (T) and the TP concentration (P < 0.01). Moreover, differences in the bacterial community were better explained by the content of heavy metals in the sediments than by the chemical characteristics. A PICRUSt metabolic inference analysis showed that the effect of high summer temperatures on the enzyme action led to an increase in the abundances of the metabolic-related genes of the river microorganisms.

Drug Delivery in Plants Using Silk Microneedles.

New systems for agrochemical delivery in plants will foster precise agricultural practices and provide new tools to study plants and design crop traits, as standard spray methods suffer from elevated loss and limited access to remote plant tissues. Silk-based microneedles can circumvent these limitations by deploying a known amount of payloads directly in plants' deep tissues. However, plant response to microneedles' application and microneedles' efficacy in deploying physiologically relevant biomolecules are unknown. Here, it is shown that gene expression associated with Arabidopsis thaliana wounding response decreases within 24 h post microneedles' application. Additionally, microinjection of gibberellic acid (GA3 ) in A. thaliana mutant ft-10 provides a more effective and efficient mean than spray to activate GA3 pathways, accelerating bolting and inhibiting flower formation. Microneedle efficacy in delivering GA3 is also observed in several monocot and dicot crop species, i.e., tomato (Solanum lycopersicum), lettuce (Lactuca sativa), spinach (Spinacia oleracea), rice (Oryza Sativa), maize (Zea mays), barley (Hordeum vulgare), and soybean (Glycine max). The wide range of plants that can be successfully targeted with microinjectors opens the doors to their use in plant science and agriculture.

Access, charge and quality of tele-dermatology e-consults in China: A standardized patients study.

Objective: Direct-to-consumer telemedicine is rapidly changing the way that patients seek medical care. This study provided the first report on access, cost and quality of text- and image-based tele-dermatology e-consults, in China. Methods: We adopted the Standardized Patients approach to evaluate the services of tele-dermatology e-consults in two metropolitan cities, that is, Beijing and Hangzhou, in China. We measured quality from four dimensions: service process, diagnosis accuracy, prescription and treatment comprehensiveness, based on China's national clinical guidelines. We performed logistic regressions to investigate factors that were associated with high-quality care. Results: For 114 physicians eligible for inclusion, we succeeded in 87 (76%) validated visits. The median waiting time was 100 minutes (IQR 19-243 minutes) and the median length of consultation was 636 minutes (about 10 hours, IQR 188-1528 minutes). Per visit costs varied from $0 to $38, with a median of $8 (IQR 4-9). Among all, 15% of visits showed high quality in service process, 84% arrived in the correct diagnosis, 24% provided high-quality prescriptions and 71% provided comprehensive treatment. Providing images was associated with high quality in service process (OR 7.22, 95% CI 1.49-34.88). Visits in metropolitan Beijing and on non-work days had better prescription quality than that in metropolitan Hangzhou (OR 6.05, 95% CI 1.75-20.95) and that on workdays (OR 3.75, 95%CI 1.27-11.04), respectively. Conclusions: Tele-dermatology e-consults seem to be easy to access and less expensive in China. However, great efforts are warranted to ensure that service processes and prescriptions adhere to clinical guidelines.

Digitized Construction of Iontronic Pressure Sensor with Self-Defined Configuration and Widely Regulated Performance.

Flexible pressure sensors are essential components for wearable smart devices and intelligent systems. Significant progress has been made in this area, reporting on excellent sensor performance and fascinating sensor functionalities. Nevertheless, geometrical and morphological engineering of pressure sensors is usually neglected, which, however, is significant for practical application. Here, we present a digitized manufacturing methodology to construct a new class of iontronic pressure sensors with optionally defined configurations and widely modulated performance. These pressure sensors are composed of self-defined electrode patterns prepared by a screen printing method and highly tunable pressure-sensitive microstructures fabricated using 3D printed templates. Importantly, the iontronic pressure sensors employ an iontronic capacitive sensing mechanism based on mechanically regulating the electrical double layer at the electrolyte/electrode interfaces. The resultant pressure sensors exhibit high sensitivity (58 kPa-1), fast response/recovery time (45 ms/75 ms), low detectability (6.64 Pa), and good repeatability (2000 cycles). Moreover, our pressure sensors show remarkable tunability and adaptability in device configuration and performance, which is challenging to achieve via conventional manufacturing processes. The promising applications of these iontronic pressure sensors in monitoring various human physiological activities, fabricating flexible electronic skin, and resolving the force variation during manipulation of an object with a robotic hand are successfully demonstrated.

Genome-Wide Analysis and Profile of UDP-Glycosyltransferases Family in Alfalfa (Medicago sativa L.) under Drought Stress.

Drought stress is one of the major constraints that decreases global crop productivity. Alfalfa, planted mainly in arid and semi-arid areas, is of crucial importance in sustaining the agricultural system. The family 1 UDP-glycosyltransferases (UGT) is indispensable because it takes part in the regulation of plant growth and stress resistance. However, a comprehensive insight into the participation of the UGT family in adaptation of alfalfa to drought environments is lacking. In the present study, a genome-wide analysis and profiling of the UGT in alfalfa were carried out. A total of 409 UGT genes in alfalfa (MsUGT) were identified and they are clustered into 13 groups. The expression pattern of MsUGT genes were analyzed by RNA-seq data in six tissues and under different stresses. The quantitative real-time PCR verification genes suggested the distinct role of the MsUGT genes under different drought stresses and abscisic acid (ABA) treatment. Furthermore, the function of MsUGT003 and MsUGT024, which were upregulated under drought stress and ABA treatment, were characterized by heterologous expression in yeast. Taken together, this study comprehensively analyzed the UGT gene family in alfalfa for the first time and provided useful information for improving drought tolerance and in molecular breeding of alfalfa.

The Added Value of Virtual Unenhanced Images Obtained From Dual-energy CT Urography in the Detection and Measurement of Urinary Stone.

OBJECTIVE: To evaluate the detection and quantification of urinary stones using virtual unenhanced images (VUE) at different phases and slice thickness in contrast-enhanced dual-energy CT Urography (DECTU) in comparison with true unenhanced images (TUE). METHODS: One hundred and twelve urinary stone patients who required triphasic DECTU were analyzed. Data were reconstructed as the followings: TUE images with 1.25 mm thickness (TUE portal venous phase VUE images with 1.25 and 5-mm thickness (VUE(VP)_1.25 mm and VUE(VP)_5 mm) and excretory phase VUE images with 1.25 and 5-mm thickness (VUE(EP)_1.25mm and VUE(EP)_5mm). The. The stones were divided into large (≥5 mm) and small stones. The detection rate, size and CT value of stones were assessed by 2 radiologists and statistically compared among the above groups. RESULTS: Two hundred and thirty urinary stones (163 large and 67 small stones) were detected on TUE_1.25 mm images. For large stones, the detection rate on VUE(VP)_1.25 mm, VUE(VP)_5 mm, VUE(EP)_1.25 mm and VUE(EP)_5 mm was 100%, 96.9%, 85.9%, and 80.4%; while for small stones, the rate was 77.6%, 37.3%, 46.3%, and 23.9%, respectively. VUE(VP) images significantly improved the stone detection rate compared with VUE(EP) images at both slice thicknesses. In general, VUE images identified stones with smaller sizes and lower Hounsfield units, but thinner slice thickness images reduced the inaccuracy. Inter-reader agreement of the stone detection revealed a k value range from 0.85 to 0.94 for TUE and VUE images. CONCLUSION: Large stones (≥5 mm) can reliably be detected on thin section VUE(VP) images with 33% radiation dose reduction. However, for small stones TUE remains superior. Stone size is underestimated on VUE images.

Trust in the Doctor-Patient Relationship in Chinese Public Hospitals: Evidence for Hope.

Purpose: Trust is an essential component in a successful health care relationship. Doctor-patient trust involves the subjects of both sides, including the direction of patients' trust in physicians (patients' perception) and physicians' trust in patients (physicians' perception). This study aims to assess the status quo and explore suggestions for improving trust between doctors and patients. Patients and Methods: In May 2018, we collected data from six representative hospitals in Beijing, China, including 610 questionnaires (310 physicians and 300 patients). Participants were Chinese-speaking, age 14 and older, who expressed their opinions clearly. Kruskal-Wallis H-test and Wilcoxon rank sum test were used to analyze the difference in the trust scores of the responses. Results: Based on the doctor and patient characteristics, the data show that inpatients are trusted more than outpatients, and patients who often visit the clinic are more doubtful of doctors. The family trust is the highest, and social trust is the lowest. In general, the degree of trust between doctors and patients is good, but the score of physicians (Mean=3.87; SD=0.79) is lower than that of patients (Mean=4.05; SD=0.76). Physicians' evaluation of the degree of trust tends to be more negative than patients'. Conclusion: In spite of recent negative press reports, there remains a high degree of trust between patients and doctors in Beijing. Despite this, one should not be complacent. We need to explore the root cause of the trust between doctors and patients from a deeper perspective to promote better medical services to meet the health needs of patients.

Distribution, ecological risk assessment and source identification of pollutants in soils of different land-use types in degraded wetlands.

BACKGROUND: Urbanization and global warming are generating ecological degradation and land pattern alteration problems in natural wetlands. These changes are greatly affecting the ecological services of wetlands. Therefore, there is an urgent need to explore the relationship between pollutants and land-use type for wetland restoration purposes. Zaozhadian Lake is a freshwater wetland in the North China Plain, which is facing degradation and land-use types changes. An experiment for analyzing soil pollutants was conducted in three land-use types of farmland, lake, and ditch in the Zaozhadian Lake. The aims of this study were to identify the distribution, pollution degree, and sources of pollutants in different land-use types, and to explore the influence of land-use type changes on contamination. METHODS: In this study, surface sediments (0-10 cm) of three land types (farmland, lake, and ditch) in Zaozhadian Lake were collected, and heavy metals (Cu, Ni, Zn, Pb, Cd, Cr, Hg), As, total nitrogen (TN), total phosphorus (TP) and organic matter (OM) were determined. Kriging interpolation was used to visualize the pollutants distribution. The pollution degree of TN and TP was evaluated by the Nemerow pollution index. The pollution of heavy metals and As was evaluated by the geological accumulation index (Igeo ) and the potential ecological risk index (RI). Then, dual hierarchical clustering analysis and the principal component analysis were performed to further analyze the impact of land type changes on pollutants. RESULTS: The heavy metal contents in the farmland were higher than other areas, while the TN (3.71 ± 1.03 g kg-1) and OM (57.17 ± 15.16 g kg-1) in lake sediments were higher than that in other regions. Farmland, lake, and ditches had low ecological risks, with RI values of 84.21, 71.34, and 50.78, respectively. The primary heavy metal pollutants are Pb, Cu, and Ni. Furthermore, Cu, As, Ni, Pb, and Zn were primarily derived from agriculture pollution, the source of Cd was the industrial pollution, and Cr mainly originated from natural sources. Nutrients primarily came from the decomposition of aquatic animals, plants, and human-related activities. When the lake area was converted into farmland, the heavy metal concentrations in the soils increased and the TN and OM decreased. Based on the results, this study put forward key strategies including the adjustment of the land-use type and restriction of the entry of pollutants into the wetland ecosystems in the Zaozhadian Lake. More attention should be paid to the impact of land-use type change on pollutants in wetlands.

Genome-Wide Analysis of the Rab Gene Family in Melilotus albus Reveals Their Role in Salt Tolerance.

Melilotus albus is a high-quality forage, due to its high protein content, and aboveground biomass and salt tolerance. Rab (Ras-related protein in the brain) proteins are the largest GTPase family which play a key role in intracellular membrane transport, and many Rab genes have been identified in eukaryotes. The growth and distribution of M. albus are severely hampered by soil salinization. However, little is known about candidate genes for salt tolerance in M. albus. In this study, 27 Rab family genes were identified for the first time from M. albus, and divided into eight groups (Groups A-H). The number of introns in MaRabs ranged from one to seven, with most genes containing one intron. In addition, most MaRab proteins showed similarities in motif composition. Phylogenetic analysis and structural-domain comparison indicated that Rab family genes were highly conserved in M. albus. Members of the MaRab gene family were distributed across all eight chromosomes, with the largest distribution on chromosome 1. Prediction of the protein interaction network showed that 24 Rab proteins exhibited protein-protein interactions. Analysis of the promoter cis-acting elements showed that MaRab-gene family members are extensively involved in abiotic stress responses. RNA-seq data analysis of the MaRab-gene-expression patterns suggested that the Rab gene family possesses differentially expressed members in five organs and under salt stress, drought stress, and ABA (Abscisic Acid) treatment. Differentially expressed genes under drought stress, salt stress and ABA stress were validated by quantitative real-time PCR. Furthermore, heterologous expression in yeast was used to characterize the functions of MaRab1 and MaRab17, which were upregulated in reaction to salt stress. In summary, this study provided valuable information for further research into the molecular mechanism of the response of M. albus to saline stress, as well as the possibility of developing cultivars with high salt-resistance characteristics.