Co-targeting ASK1 and THRß synergistically improves steatohepatitis and fibrosis in a MASH animal model.

PURPOSE: Metabolic dysfunction-associated steatohepatitis (MASH) is a liver disease that has gained widespread attention globally. Unfortunately, there is no approved treatment for this condition yet. However, recent research has identified Apoptosis signal-regulating kinase 1 (ASK1) and thyroid hormone receptor-ß (THR-ß) as potential targets for treating MASH. Although the individual effects of these two targets have been studied, their combinatory effect has not been well defined. Therefore, further research is needed to investigate the potential benefits of targeting both ASK1 and THR-ß for treating MASH. METHODS: We established a MASH model using the HFHFrC diet (high fat, high fructose, and cholesterol) and carbon tetrachloride (CCL4). Forty mice were evenly assigned to four groups: vehicle, GS4997 (an ASK1 inhibitor), MGL3196 (a THRß agonist), GS4997+ MGL3196 combination (combo). The drugs were administered for 8 weeks, after which the mice were sacrificed for serum biochemical tests, liver TG and TC evaluation, liver histopathological study, and gene expression validation. RESULTS: GS4997 and MGL3196, when used in combination, have been shown to have synergistic effects on various parameters. Firstly, they synergistically reduced body weight and liver body weight ratio. Secondly, this combination also synergistically lowered AST and TC. Thirdly, synergistic effects were also observed in liver TG and TC reduction. Fourthly, we further confirmed that GS4997 mildly improved liver inflammation, ballooning, and fibrosis, but exhibited incredible histopathological efficacy when combined with MGL3196. Finally, this combinatory effect can be interpreted by synergistically regulating lipid-related genes such as Dio1, Ctp1-α, and Cat, inflammation-related genes such as Il-6, Il-8, and Mcp-1, and fibrosis-related genes such as Tgf-ß, Col1α1, and Col6α3. CONCLUSION: GS4997 and MGL3196, when used in combination, have been shown to have a comprehensive effect on MASH by synergistically regulating lipid, inflammation, and fibrosis-related gene expression through co-targeting ASK1 and THRß.

Development and validation of a delirium care critical-thinking scale for intensive care unit nurses: A mixed-method study.

AIM AND OBJECTIVES: To develop a Delirium Care Critical-Thinking Scale for nurses caring for patients in the intensive care unit and examine the scale's psychometric properties. BACKGROUND: There is a tool to evaluate nurses' critical thinking skills to determine nursing competency when delirium care is required. DESIGN: This cross-sectional, mixed-methods study. METHODS: The Delphi method was applied for collection and analysis of data during conceptualization and item generation of the tool (Phase I). Item analysis, assessment of validity and reliability of the scale (Phase II) involved 318 nurses recruited by convenience sampling from nine adult intensive care units in medicine and surgery at one medical centre. Confirmatory factor analysis assessed construct validity. Internal consistency and 2-week test-retest stability measured reliability. A Critical Thinking Disposition Inventory Scale examined concurrent validity. RESULTS: After three rounds, the Delphi method resulted in 31 scale items. Item analysis demonstrated construct reliability ranged from 9.23 to 16.18. Confirmatory factor analysis eliminated one item and extracted five factors: applying knowledge, confirming the problem and accuracy of information, reasoning logically, choosing appropriate strategies and remaining open-minded. Average variance extracted values of all factors indicated good convergent validity. Cronbach's α for internal consistency was .96 with good test-retest reliability. The correlation coefficient for concurrent validity was .301. CONCLUSION: The new Delirium Care Critical-Thinking Scale for intensive care nurses was demonstrated to be a reliable and valid tool for evaluating their ability to assess patients with delirium. RELEVANCE TO CLINICAL PRACTICE: This new scale could be used to assess outcomes of education interventions and the effectiveness of nursing care quality involving patients with delirium in intensive and critical care units. REPORTING METHOD: The COSMIN checklist was used as the reporting guideline for this study. PATIENT OR PUBLIC CONTRIBUTION: None.

Polarized Active Pairs at Grain Boundary Boost CO2 Chemical Fixation.

The chemical fixation of CO2 as a C1 feedstock is considered one of the most promising ways to obtain long-chain chemicals, but its efficiency was limited by the ineffective activation of CO2. Herein, we propose a grain boundary engineering strategy to construct polarized active pairs with electron poor-rich character for effective CO2 activation. By taking CeO2 as a model system, we illustrate that the polarized "Ce4+-Ce3+-Ce4+" pairs at the grain boundary can simultaneously accept and donate electrons to coordinate with O and C, respectively, in CO2. By the combination of synchrotron radiation in situ technique and density functional theory calculations, the mechanism of the catalytic reaction has been systematically investigated. As a result, the CeO2 nanosheets with a rich grain boundary show a high DMC yield of 60.3 mmol/gcat with 100% atomic economy. This study provides a practical way for the chemical fixation of CO2 to high-value-added chemicals via grain boundary engineering.

Mangrove colonization on tidal flats causes straightened tidal channels and consequent changes in the hydrodynamic gradient and siltation potential.

A healthy mangrove ecosystem includes diverse landscape structures, such as tidal flats, tidal channels, and areas with circulating waters, in addition to mangrove stands. The complex structure of mangrove forests affects the hydrodynamics and sediment transport behaviour of tidal channels. Understanding the influence of the mangrove invasion of tidal flats on the pattern and stability of tidal channels is essential. In this study, two types of remote sensing images, Google Earth images and aerial photographs, were collected to analyze the relationship between mangrove colonization and changes in tidal channel patterns. After applying binary image processing, these two kinds of images show similar abilities to discriminate the locations, extents, and boundaries of mangroves and tidal channels. We found that the mangrove area was inversely proportional to the tidal channel sinuosity and width. The tidal channels exhibited a meandering pattern with a wider width before the mangroves invaded the tidal flats. After the expansion of the mangroves, the tidal channels gradually transformed into a straight shape with a narrower width. After the mangroves developed into forests, the tidal channels maintained a straight and stable pattern. Since mangroves promote siltation and increase the elevation of the surrounding mudflats, the habitat suitability for mangroves in the neighbouring tidal flat areas may vary. These processes may help expand mangrove habitats, thereby compressing the area of flats and changing the shape of tidal channels. Due to tidal current effects, the unit stream power of a straight tidal channel is approximately twice that of a meandering channel, indicating that straight tidal channels have a stronger anti-siltation capability. Our research also found that the tidal channels may return to a meandering pattern when mangroves are degraded or die and their area decreases. This study provides key evidence that mangroves affect tidal channel types and hydrodynamic characteristics, thus providing a useful reference for restoring and managing estuarine mangrove ecosystems.

The Spatial Heterogeneity Effect of Green Finance Development on Carbon Emissions.

This paper uses the entropy method to estimate China's green financial development from four aspects, namely, green credit, green securities, green insurance, and green investment, based on the provincial-level panel data from 2008 to 2019. The spatial Durbin model (SDM) is adopted to estimate the spatial effect of green finance on carbon emissions. We then compare the heterogeneous effect in the South and North of China. The results show that China's green financial development can significantly reduce carbon emissions, and regional heterogeneities are obvious. In the South of China, this effect from local and adjacent regions is not significant, while on the whole, green finance can significantly reduce carbon emissions; but for Northern China, this effect is not significant; nationally, the development of green finance and carbon emissions in adjacent areas showed an inverted U-shaped relationship. China's green financial development and carbon emissions also showed an inverted U-shaped relationship. These results suggest that the effect of green finance development on carbon emissions exhibits substantial regional heterogeneity in China. Our paper provides some concrete empirical evidence for policymakers to formulate green financial policies to achieve the double carbon goal in China.

Ultrathin In-Plane Heterostructures for Efficient CO2 Chemical Fixation.

Chemical fixation of carbon dioxide (CO2 ) into value-added organics is regarded as a competitive and viable method in large scale industrial production, during which the catalysts with promoting CO2 activation ability are needed. Herein, we proposed an in-plane heterostructure strategy to construct Lewis acid-base sites for efficient CO2 activation. By taking ultrathin in-plane Cu2 O/Cu heterostructures as a prototype, we show that Lewis acid-base sites on heterointerface can facilitate a mixed C and O dual coordination on surface, which not only strengthen CO2 adsorption, but also effectively activate the inert molecules. As revealed by in situ diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) and quasi in situ X-ray photoelectron spectroscopy (XPS), Lewis acid-base sites could readily activate CO2 to . CO2 - species, which is the key intermediate radical for CO2 fixation. As a result, abundant Lewis acid-base sites endow Cu2 O/Cu nanosheets with excellent performances for dimethyl carbonate generation, a high conversion yield of 28 % with nearly 100 % selectivity under mild conditions. This study provides a model structure for CO2 fixation reactions.

Atom-Economical Synthesis of Dimethyl Carbonate from CO2 : Engineering Reactive Frustrated Lewis Pairs on Ceria with Vacancy Clusters.

The chemical conversion of CO2 to long-chain chemicals is considered as a highly attractive method to produce value-added organics, while the underlying reaction mechanism remains unclear. By constructing surface vacancy-cluster-mediated solid frustrated Lewis pairs (FLPs), the 100 % atom-economical, efficient chemical conversion of CO2 to dimethyl carbonate (DMC) was realized. By taking CeO2 as a model system, we illustrate that FLP sites can efficiently accelerate the coupling and conversion of key intermediates. As demonstrated, CeO2 with rich FLP sites shows improved reaction activity and achieves a high yield of DMC up to 15.3 mmol g-1 . In addition, by means of synchrotron radiation in situ diffuse reflectance infrared Fourier-transform spectroscopy, combined with density functional theory calculations, the reaction mechanism on the FLP site was investigated systematically and in-depth, providing pioneering insights into the underlying pathway for CO2 chemical conversion to long-chain chemicals.

Selective CO2 Photoreduction to CH4 via Pdδ+ -Assisted Hydrodeoxygenation over CeO2 Nanosheets.

Here, noble-metal-doped two-dimensional metal oxide nanosheets are designed to realize selective CO2 photoreduction to CH4 . As a prototype, Pd-doped CeO2 nanosheets are fabricated, where the active sites of Pdδ+ (2<δ<4) and Ce3+ -Ov are revealed by quasi in situ X-ray photoelectron spectra and in situ electron paramagnetic resonance spectra. Moreover, in situ Fourier-transform infrared spectra of D2 O photodissociation and desorption verify the existence of the Pd-OD bond, implying that Pdδ+ sites can participate in water oxidation to deliver H* species for facilitating the protonation of the intermediates. Furthermore, theoretical calculations suggest the Pd doping could regulate the formation energy barrier of the key intermediates CO* and CH3 O*, thus making CO2 reduction to CH4 become the favorable process. Accordingly, Pd-doped CeO2 nanosheets achieve nearly 100 % CH4 selectivity of CO2 photoreduction, with the raising CH4 evolution rate of 41.6 µmol g-1 h-1 .

A comprehensive approach to stool donor screening for faecal microbiota transplantation in China.

BACKGROUND: Faecal microbiota transplantation (FMT) is an effective therapy for recurrent Clostridium difficile infections and chronic gastrointestional infections. However, the risks of FMT and the selection process of suitable donors remain insufficiently characterized. The eligibility rate for screening, underlying microbial basis, and core ethical issues of stool donors for FMT are yet to be elucidated in China. RESULTS: The potential stool donors were screened from December 2017 to December 2019 with the help of an online survey, clinical assessments, and stool and blood testing. Bioinformatics analyses were performed, and the composition and stability of gut microbiota in stool obtained from eligible donors were dynamically observed using metagenomics. Meanwhile, we build a donor microbial evaluation index (DoMEI) for stool donor screening. In the screening process, we also focused on ethical principles and requirements. Of the 2071 participants, 66 donors were selected via the screening process (3.19% success rate). Although there were significant differences in gut microbiota among donors, we found that the changes in the gut microbiota of the same donor were typically more stable than those between donors over time. CONCLUSIONS: DoMEI provides a potential reference index for regular stool donor re-evaluation. In this retrospective study, we summarised the donor recruitment and screening procedure ensuring the safety and tolerability for FMT in China. Based on the latest advances in this field, we carried out rigorous recommendation and method which can assist stool bank and clinicians to screen eligible stool donor for FMT.

Restoration recommendations for mitigating habitat fragmentation of a river corridor.

Flow discharge and anthropogenic activities influence the composition and configuration of habitat patches in river ecosystems. Understanding the response of habitat landscapes and the corresponding fish habitat quality is crucial for river management. We investigated the reaction of fish habitat suitability and variant flow discharge performance in examining aquatic habitat patch fragmentation. The hydraulic simulation and fish habitat calculation were used to determine the flow characteristics, habitat conditions, and river landscapes. FRAGSTATS was applied to explore the composition and configuration of habitat patches. Cluster analysis and logistic regression were employed to compute the spatiotemporal variabilities of riverscape indices and establish the relationship between riverscape attributes and fish habitat quality. The results indicate that the changes in specific habitat features are associated with the riverscape indices of total edge (TE), mean nearest-neighbor distance (MNN), interspersion and juxtaposition index (IJI), mean patch size (MPS), and area-weighted mean patch fractal dimension (AWMPFD). The flow discharge is the key to determining habitat fragmentation in rivers, with natural barriers occurring at low flow. In contrast, weirs are anthropogenic obstacles that have significant adverse effects on the downstream corridor. A priority restoration activity to conserve river habitat is to create refuge pools during dry seasons by modifying channel morphology. The positive correlation between habitat suitability and MPS and the negative relationship between habitat suitability and AWMPFD highlight the patch size and shape complexity that are critical indices for pool creation. The prediction of the landscape attributes of the outcomes under different scenarios could support the decision-making in river management. The innovative integrated method presented in this study provides a solid foundation and supports the implementation of nature-based solutions for sustainable river management.

Chiral Metallacycles as Catalysts for Asymmetric Conjugate Addition of Styrylboronic Acids to α,ß-Enones.

Introducing self-assembly strategies into the construction of catalysts has been proven to have great advantages in asymmetric catalysis. We constructed two chiral metalla-triangles by highly efficient coordination-driven self-assembly from a chiral 3,3'-dipyridyl-substituted BINOL donor. They were successfully applied in asymmetric conjugate addition of a series of α,ß-unsaturated ketones with trans-styrylboronic acids. The use of these metalla-triangles as supramolecular catalysts is obviously conducive to the enhancement of catalytic activity and stereoselectivity in the presented addition reactions. Under induction of the chiral metalla-triangles, an array of α,ß-enones were converted to chiral γ,δ-unsaturated ketones in medium to quantitative yields (40-98%) with high enantioselectivities (87-96% ee).

A nonstructural flood prevention measure for mitigating urban inundation impacts along with river flooding effects.

In recent decades, urban developments along rivers have experienced high flooding risks, elevated by increasing urbanization. Due to the expansion of urban areas, flood mitigation strategies must rely on nonstructural flood management policies. This study evaluated the impacts of pluvial floods considering fluvial flooding effects through field surveys and numerical model simulations. Nonstructural flood protection measures are provided by establishing warning water levels based on variant scenario simulations. The results reveal that the aggravated drainage system overflow induced by elevated river water is significant when considering river flooding effects. As a result, current drainage systems have failed to meet the designed flood protection standards, indicating the need to produce potential inundation maps and to establish warning water levels. To prevent the main evacuation route of each settlement from being blocked due to flooding, the proposed warning water levels support timely and effective evacuations. Public community centers and schools in noninundation areas near settlements were identified as possible shelters based on the proposed warning water levels and inundation maps. We conclude that although the riverside areas without dike protection could sustain natural environments and landscapes, they must incorporate nonstructural flood protection measures. At the same time, it must be considered that river flood levels may reduce urban drainage capacity.

PCR Identification and Phylogenetic Analysis of Trichomonas gallinae from Domestic Pigeons in Guangzhou, China.

Avian trichomoniasis caused by Trichomonas gallinae is a serious protozoan disease worldwide. The domestic pigeon (Columba livia domestica) is the main host for T. gallinae and plays an important role in the spread of the disease. Based on the internal transcribed spacers of nuclear ribosomal DNA of this parasite, a pair of primers (TgF2/TgR2) was designed and used to develop a PCR assay for the diagnosis of T. gallinae infection in domestic pigeons. This approach allowed the identification of T. gallinae, and no amplicons were produced when using DNA from other common avian pathogens. The minimum amount of DNA detectable by the specific PCR assay developed in this study was 15 pg. Clinical samples from Guangzhou, China, were examined using this PCR assay and a standard microscopy method, and their molecular characteristics were determined by phylogenetic analysis. All of the T. gallinae-positive samples detected by microscopic examination were also detected as positive by the PCR assay. Most of the samples identified as negative by microscopic examination were detected as T. gallinae positive by the PCR assay and were confirmed by sequencing. The positive samples of T. gallinae collected from Guangzhou, China, were identified as T. gallinae genotype B by sequencing and phylogenetic analyses, providing relevant data for studying the ecology and population genetic structures of trichomonads and for the prevention and control of the diseases they cause.

Molybdenum induces pancreatic ß-cell dysfunction and apoptosis via interdependent of JNK and AMPK activation-regulated mitochondria-dependent and ER stress-triggered pathways.

Molybdenum (Mo), a well-known toxic environmental and industrial pollutant, causes adverse health effects and diseases in humans and has received attention as a potential risk factor for DM. However, the roles of Mo in the mechanisms of the toxicological effects in pancreatic ß-cells are mostly unclear. In this study, the results revealed dysfunction of insulin secretion and apoptosis in the pancreatic ß-cell-derived RIN-m5F cells and the isolated mouse islets in response to Mo. These effects were accompanied by a mitochondria-dependent apoptotic signals including a decreased in the MMP, an increase in cytochrome c release, and the activation of caspase cascades and PARP. In addition, ER stress was triggered as indicated by several key molecules of the UPR. Furthermore, exposure to Mo induced the activation of ERK1/2, JNK, AMPKα, and GSK3-α/ß. Pretreatment with specific pharmacological inhibitors (in RIN-m5F cells and isolated mouse islets) of JNK (SP600125) and AMPK (Compound C) or transfection with si-RNAs (in RIN-m5F cells) specific to JNK and AMPKα effectively prevented the Mo-induced apoptosis and related signals, but inhibitors of ERK1/2 and GSK3-α/ß (PD98059 and LiCl, respectively) did not reverse the Mo-induced effects. Additionally, both the inhibitors and specific si-RNAs could suppress the Mo-induced phosphorylation of JNK and AMPKα each other. Taken together, these results suggest that Mo exerts its cytotoxicity on pancreatic ß-cells by inducing dysfunction and apoptosis via interdependent JNK and AMPK activation downstream-regulated mitochondrial-dependent and ER stress-triggered apoptosis pathways.

[Keap1-tat peptide attenuates oxidative stress damage in hippocampal CA1 region and learning and memory deficits following global cerebral ischemia].

OBJECTIVE: To design Keap1-tat peptide and explore its neuroprotective role on hipocampal CA1 neuron, as well as the effect on spacial learning and memory function following global cerebral ischemia. METHODS: Adult male Sprague Dawley (SD) rats were subjected to global cerebral ischemia (GCI) by four-vessel occlusion for 15 min and randomly divided into five groups: sham, sham+Keap1-tat, ischemia/reperfusion (I/R), Keap1-tat peptide- and vehicle-administrated groups. For Keap1-tat or vehicle groups, the rats were treated with Keap1-tat (30, 50, 100 µg in 5 µL 0.9% saline) or the same volume vehicle by intracerebroventricular injection (icv) 30 min prior to ischemia. Cresyl violet staining was used to observe the surviving neurons and 4-hydroxy-2-noneal (4-HNE) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) immunostaining were used to detect the change of markers response to oxidative stress in hippocampal CA1 region. The spatial learning and memory function of the rats was evaluated using Morris water maze. RESULTS: Compared with sham group, the number of surviving neurons in ischemia-reperfusion and vehicle groups significantly decreased in the hippocampal CA1 region (P<0.05), while administration of Keap1-tat significantly decreased the damage following GCI (P<0.05), and the dose of 50 µg existed the most effective neuroprotective role. Furthermore, immunostaining intensity of 4-HNE and 8-OHdG, markers of oxidative stress damage attenuated by Keap1-tat peptide as compared with vehicle group in CA1 region. Of significant interest, the time of finding underwater platform in Keap1-tat group animals was significantly short, and after removing the platform, the probe time of Keap1-tat group animals in the original quadrant where the platform was significantly increased compared with that of vehicle and I/R group animals (P<0.05). CONCLUSION: Keap1-tat peptide can effectively attenuate neuronal damage in hippocampal CA1 region and improve learning and memory function, which might bedue to the attenuation of oxidative stress caused by GCI.

Biological characteristics of Chinese precocious strain of eimeria acervulina and its immune efficacy against different field strains.

In this study, the biologic characteristics of one experimental precocious strain of Eimeria acervulina and seven field isolates from different geographic locations in China were compared, and the immune efficacy of two precocious strains against coccidiosis in chickens was assessed to explore their potential use as coccidiosis vaccines. All the different strains were purified by single oocyst separation and their monospecificity was confirmed using E acervulina-specific PCR assays. The average sizes of E. acervulina oocysts were 18.28-20.19 X 14.09-14.79 microm and the shape indexes were from 1.28 to 1.40. The prepatent periods ranged from 93 to 115 hr, except for the Heyuan precocious strain (HYP; 75 hr). Chickens infected with Huadu field strain (GHD) produced the highest oocyst output whereas HYP induced the lowest level. When inoculated with 50,000 sporulated oocysts or more, the average weight gains of infected chickens were reduced, with apparent clinical symptoms. To assess the immunogenicity of precocious strains HYP and Baoding (BDP), birds were orally immunized and challenged with seven different field strains of E. acervulina. Body weight gain, fecal oocyst output, and gut lesion scores were compared to evaluate their vaccine potential. The results showed that the average body weight gains of chickens in all the vaccinated and challenged groups were higher than those of nonvaccinated and challenged groups. In general, oocyst shedding was reduced 34.39%-95.31% and gut lesion scores decreased 31.03%-86.21% compared with unvaccinated and challenged control chickens. In summary, this study indicated that the precocious strains of E. acervulina could induce a protective immune effect with various responses against coccidiosis caused by different field strains.

Characterization of the intergenic spacer rDNAs of two pig nodule worms, Oesophagostomum dentatum and O. quadrispinulatum.

The characteristics of the intergenic spacer rDNAs (IGS rDNAs) of Oesophagostomum dentatum and O. quadrispinulatum isolated from pigs in different geographical locations in Mainland China were determined, and the phylogenetic relationships of the two species were reconstructed using the IGS rDNA sequences. The organization of the IGS rDNA sequences was similar to their organization in other eukaryotes. The 28S-18S IGS rDNA sequences of both O. dentatum and O. quadrispinulatum were found to have variable lengths, that is, 759-762 bp and 937-1128 bp, respectively. All of the sequences contained direct repeats and inverted repeats. The length polymorphisms were related to the different numbers and organization of repetitive elements. Different types and numbers of repeats were found between the two pig nodule species, and two IGS structures were found within O. quadrispinulatum. Phylogenetic analysis showed that all O. dentatum isolates were clustered into one clade, but O. quadrispinulatum isolates from different origins were grouped into two distinct clusters. These results suggested independent species and the existence of genotypes or subspecies within pig nodule worms. Different types and numbers of repeats and IGS rDNA structures could serve as potential markers for differentiating these two species of pig nodule worms.

Eco-friendly dredging methods of changing fluvial landforms for enhancing hydraulic habitat quality and river corridor continuum.

Hydraulic habitat connectivity, including the longitudinal continuum respect and lateral flood pulse, is critical for fish survival and organism dispersal. Inappropriate and excessive dredging for prevent flooding may harm river ecosystems. The main objective of this study is to evaluate whether eco-friendly dredging presented by changing local river landforms incorporating the concept of nature-based solutions could grow fish habitat quality for improving river continuity and achieving flood control effects. By combining various mathematical models and empirical formulas and verifying them with the data obtained through field surveys, we explore the interconnections of hydrology, river morphology, and the habitat dynamics of four endemic fishes in an alluvial river. The relationship between habitat structure, flood risk, and river topography, flow discharge was presented as the reference for developing the proper river dredging approaches. The results reveal that the primary habitat defects were lack of high-quality habitat, unsatisfied habitat diversity, deficiency in refugia, and disconnectivity. Longitudinal disconnectivity was induced due to shallow water depth, while lateral disconnectivity is primarily caused by fast flow velocity, suggesting different and specific dredging methods were instructed. We recommend that the corresponding eco-friendly dredging schemes for longitudinal and lateral suitable habitat linkages increase fish habitat quality and river corridor continuity. The win-win strategy for enhancing the connection between suitable habitats sustains a more beneficial aquatic corridor and simultaneously achieves alluvial flood disaster risk reduction.

Lappulaeffusa (Boraginaceae), a new species from Xinjiang, China.

Lappulaeffusa D.H.Liu & W.J.Li, a new species of Boraginaceae from Xinjiang, China, is described and illustrated in this study. The new species is morphologically similar to Lappulahimalayensis and L.tadshikorum. However, it can be distinguished from the compared species by several characteristics, such as: stem single, erect, frequently branched at middle and above, densely spreading hispid, hairs discoid at base; corolla white or blue; fruit compressed, heteromorphic nutlets with two rows of marginal glochids, nutlets acute ovoid, disc narrowly ovate-triangular. The diagnosis of the new species is supported with comprehensive investigation including photographs, detailed description, notes on etymology, distribution and habitat, conservation status, as well as comparisons with morphologically similar species.

The Clinical Investigation on Varicocele and Sperm Quality in the Tibet an Plateau of China: A Prospectively Planned Retrospective Cohort Study.

Varicoceles are a common cause of male infertility, affecting up to 35% of men undergoing fertility evaluations. This study aims to investigate the potential influence of altitude and residence time on the occurrence of varicoceles, as well as on sperm quality and sterility in plateau areas. A total of 168 patients with varicocele were enrolled in the study, and the study population was divided into groups based on their direct exposure to different high altitudes due to their living locations. The internal diameter in Quiet breath (Dr), internal diameter in Valsalva maneuver (Dv), reflux peak value, and reflux time are gradually increased accompanied with altitude elevation and residence time extension. The number of cases above 4,500 m also increased with the severity of varicocele, and the altitude of clinical types was higher than that of subclinical types of varicocele. Especially above 4,500 m, the Dv, Dr, reflux peak value, and reflux time all increased with the severity of varicocele. The severity of varicocele was positively correlated with the residence time in plateau area. Patients with residence time of more than 1 year had higher values of Dr, Dv, differentiation time, reflux peak value, and reflux time than those with residence time of less than 1 year. Compared to 3,650 m, patients with varicocele in 4,500 m also have worse semen quality. Both altitude and residence time are strongly positively related to the severity and incidence rate of varicocele in plateau areas.