Assessment of sulfamethoxazole removal by three wetland plant species under hydroponic conditions: uptake, accumulation, and physiological responses.

Plants play a crucial role as a removal pathway in constructed wetlands, demonstrating the ability to absorb and tolerate antibiotics from wastewater. However, the specific contribution of plants in this regard has not yet to be sufficiently established. To gain a more comprehensive insight into the associated processes, we selected three common wetland plant species, Canna indica L. (C. indica), Cyperus alternifolius L. (C. alternifolius), and Thalia dealbata Fraser (T. dealbata), to evaluate their capacity for uptake, accumulation, and physiological response in the removal of sulfamethoxazole (SMX) at varying initial concentrations (10, 30, 100, and 300 µg/L) under hydroponic conditions. The results showed that SMX removal was more efficient at lower concentrations (10 and 30 µg/L) than at higher concentrations (100 and 300 µg/L). Moreover, plant systems were found to consistently outperform unplanted systems in SMX removal. Among the assessed species, C. indica was identified as being relatively effective in the removal of SMX, whereas the performance of C. alternifolius was notably less pronounced. A positive correlation was observed between the concentration of SMX in the plant tissues and that in the external aqueous medium. However, plant tissue residues contributed only a minor fraction to the overall removal of SMX. Wetland plants absorb SMX through their roots, and we accordingly detected significantly higher concentrations in submerged plant tissues. Furthermore, we also detected reductions in net photosynthetic rates indicative of potential phytotoxicity, which is associated with the accumulation of antibiotic in the shoot tissues. Accumulation of SMX in the roots and rhizomes was also found to be associated with the development of shorter roots, with this effect becoming more pronounced with an increase in the concentration of exogenous SMX. However, despite these adverse effects, plants can detoxify antibiotics via the glutathione pathway. Of the assessed plant species, C. indica was identified as the most SMX tolerant, as indicated by Km and Vmax values, with C. alternifolius being the least tolerant. Our findings in this study reveal the potential value of wetland plants in the sequestration of antibiotics and provide evidence for the underlying mechanisms of action. These findings could make an important contribution to the implementation of phytoremediation in antibiotic-contaminated water.

Three wetland plants with fibrous root systems, namely Canna indica, Cyperus alterniflius, and Thalia dealbata, were selected to investigate the removal efficiencies of sulfamethoxazole in the hydroponic system by different emergent plants, quantify the contribution of uptake and accumulation for sulfamethoxazole in plant tissues, and assess the physiological responses of plants and their effect on the removal of sulfamethoxazole. The knowledge obtained from this study shows the potential use of wetland plants for removing antibiotics and the inherent mechanisms, which will be useful for the application of phytoremediation in antibiotic contaminated water.

Associations Between Sociodemographic Variables, Social Determinants of Health, and Diabetes: Findings From a Congregational Health Needs Assessment.

PURPOSE: To examine associations between sociodemographic variables, social determinants of health (SDOHs) and diabetes using health needs assessment data. DESIGN: Cross-sectional study. SETTING: Faith-based communities in the Mid-South U.S. SAMPLE: Of the 378 churches, 92 participated in the study (24% response rate); N = 828 church leaders and members completed the survey. MEASURE: The Mid-South Congregational Health Survey assessed perceived health-related needs of congregations and the communities they serve. ANALYSIS: Generalized linear mixed modeling examined the associations between sociodemographic variables (age, sex, race/ethnicity, educational level), SDOHs (affordable healthcare, healthy food, employment), and diabetes. RESULTS: Individuals with less education had lower odds of reporting all SDOHs as health needs compared to individuals with more education (ORrange = .59-.63). Men had lower odds of reporting diabetes as a health need or concern compared to women (OR = .70; 95% CI = .50, .97). African Americans had greater odds of reporting diabetes as a health need compared to individuals in the 'Other' race/ethnicity category (OR = 3.91; 95% CI = 2.20, 6.94). Individuals who reported affordable healthcare (OR = 2.54; 95% CI = 1.73, 3.72), healthy food (OR = 2.24; 95% CI = 1.55, 3.24), and employment (OR = 3.33; 95% CI = 2.29, 4.84) as health needs had greater odds of reporting diabetes as a health need compared to those who did not report these SDOHs as needs. CONCLUSIONS: Future studies should evaluate strategies to merge healthcare and faith-based organizations' efforts to address SDOHs impacting diabetes.

Development of a low-cost and accurate carrier screening method for spinal muscular atrophy in developing countries.

Heterozygous carriers of the survival of motor neuron 1 (SMN1) gene deletion in parents account for approximately 95% of neonatal spinal muscular atrophy cases. Given the severity of the disease, professional organizations have recommended periconceptional spinal muscular atrophy carrier screening to all couples, regardless of race or ethnicity. However, the prevalence of screening activities in mainland China remains suboptimal, mainly attributed to the limitations of the existing carrier screening methods. Herein, we aimed to develop a low-cost, accessible, and accurate carrier screening method based on duplex droplet digital PCR (ddPCR), to cover a wider population in developing countries, including China. The receiver operating characteristic curve was used to determine the cut-off value of SMN1 copy numbers. Performance validation was conducted for linearity, precision, and accuracy. In total, 482 cases were considered to validate the concordance between the developed ddPCR assay and multiplex ligation-dependent probe amplification. Linear correlations were excellent between the expected concentration of the reference gene and the observed values (R2 > 0.99). Both the intra- and inter-assay precision of our ddPCR assays were less than 6.0%. The multiplex ligation-dependent probe amplification and ddPCR results were consistent in 480 of the 482 cases (99.6%). Two cases with multiplex ligation-dependent probe amplification, suggestive of two copies of SMN1 exon 7, were classified into three copies by ddPCR analysis. The overall correct classification of the samples included in our ddPCR assay was 100%. This study demonstrates that an appropriate cut-off value is an important prerequisite for establishing a semi-quantitative method to determine the SMN1 copy numbers. Compared to conventional methods, our ddPCR assay is low-cost, highly accurate, and has full potential for application in population spinal muscular atrophy carriers screening.

Predictors of Adolescents' Transition Through the Stages of Change for Quitting E-Cigarettes: Findings From the Population Assessment of Tobacco and Health Study.

PURPOSE: To identify predictive factors associated with US adolescents' transition through the stages of change for potentially quitting e-cigarettes using the Trans-theoretical model of behavior change. DESIGN: Prospective cohort study. SETTING: United States. SUBJECTS: We utilized data from adolescents (12-17 years) in Wave 3 of the Population Assessment of Tobacco and Health study who used e-cigarettes exclusively over the past 30 days (n = 177) and were followed up with in Wave 4. MEASURES: Outcome variables were 3 transition categories: those who remained stagnant, those who progressed, and those who regressed in their stage of quitting e-cigarettes. Predictor variables were socio-demographics, e-cigarette harm perception, e-cigarette use at home or by important people, social norms, e-cigarette and anti-tobacco advertisements, and e-cigarette health warnings. ANALYSIS: Weighted-adjusted multinomial regression analysis was performed to determine the association between predictor and outcome variables. RESULTS: From Wave 3 to Wave 4, 19% of adolescents remained stagnant; 73.3% progressed; and 7.7% regressed. Adolescents were less likely to progress in their stage of change if they perceived nicotine in e-cigarettes to be "not at all/slightly harmful" (AOR = .26 [95% CI: .25, .27], P < .001); reported important people's use of e-cigarettes (AOR = .18 [95% CI: .05, .65, P = .009); and "rarely" noticed e-cigarette health warnings (AOR = .28 [95% CI: .08, .98, P = .054). CONCLUSION: Intervention efforts must target specific predictive factors that may help adolescents quit e-cigarettes.

ErbB4 promotes M2 activation of macrophages in idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is the most common and fatal diffuse fibrotic lung disease accompanied by macrophage M2 activation. ErbB4 is involved in and affects the process of inflammation. In this study, we determined that the mRNA level and protein expression of ErbB4 and M2 cytokine members were increased in the serum of IPF patients. In mouse alveolar macrophage MH-S cells, after knocking down ErbB4 by siRNA, the mRNA level and protein expression of M2 activator induced by interleukin (IL)-4 were decreased compared with the control group. Activating by ErbB4 agonist neuromodulatory protein (NRG)-1, IL-4-induced M2 program was promoted. Mechanistically, treated with NRG-1 in MH-S cells, the phosphorylation level of Akt did not change, while the phosphorylation level of ERK increased. Using SCH772984 to inhibit ERK pathway, the increasing IL-4-induced M2 activation by NRG-1 was inhibited, and the high level of M2 activator protein expression and mRNA expression was restored. Collectively, our data support that ErbB4 and M2 programs are implicated in IPF, and ErbB4 participates in the regulation of M2 activation induced by IL-4 through the ERK pathway.

[Source Analysis and Pollution Assessment of Soil Heavy Metals in Typical Geological High Background Area in Southeastern Chongqing].

In order to understand the pollution characteristics of soil heavy metals in typical geological high background areas in southeastern Chongqing, analyze its pollution sources, and put forward risk management and control suggestions, 211 topsoil samples (0-20 cm) were collected in Xinglong Town and Muye Township in the north of Youyang County, Chongqing City, and the contents of eight heavy metals (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) and the soil pH value in the surface soil were analyzed. Additionally, mathematical statistics, pollution load index (P), potential ecological risk index (RI), correlation analysis, and the positive matrix factorization (PMF) model were used to study the content and spatial distribution characteristics of heavy metals in the topsoil, and pollution assessment and source analysis of heavy metals were carried out. The results showed that the average concentrations of heavy metals in the surface soil all exceeded the soil background value in Chongqing, showing different levels of enrichment. Among them, the proportion of Cd exceeding the screening value in the "soil environmental quality risk control standard for soil contamination of agricultural land" (GB 15618-2018) was as high as 83.41%, the proportion of exceeding the control value was 7.58%, and the potential risk was relatively high. The evaluation results of the pollution load index method showed that the study area was slightly polluted as a whole, and the evaluation results of the potential ecological risk index showed that the overall ecological risk of the study area was relatively high. Among them, the contribution rates of heavy metals Hg, Cd, and As were 50.27%, 28.63%, and 11.70%, respectively. The PMF results showed that there were three main sources of heavy metals in the soil in the study area:natural parent material sources, agricultural sources, and mixed sources of industrial activities and traffic emissions, accounting for 40.49%, 29.12%, and 30.39%, respectively. The quantitative source analysis results of soil heavy metals in the study area have important reference significance for soil heavy metal pollution control in geologically high background areas.

Rising trend of childlessness in China: analysis of social and regional disparities with 2010 and 2020 census data.

INTRODUCTION: In recent decades, there has been a significant increase in childlessness. This paper analysed childlessness in China, specifically examining its socio and regional disparities. METHODS: With data from China's 2020 population census, supplemented with data from China's 2010 population census and 2015 inter-censual 1% population sample survey, we used a basic indicator of age-specific childlessness proportion, a decomposition method, and probability distribution models to analyse, fit and project childlessness. RESULTS: We presented age-specific childlessness proportions for women as a whole and by socioeconomic features, decomposition and projection results. The childlessness proportion increased markedly from 2010 to 2020, reaching 5.16% for women aged 49. The proportion is highest for city women, followed by township women, and is lowest among village women, at 6.29%, 5.50% and 3.72 % for women aged 49, respectively. The proportion for women aged 49 with high college education or above was 7.98%, and only 4.42% for women with junior high school education. The proportion also exhibits marked provincial discrepancies, and the total fertility rate is negatively correlated with childlessness at the province level. The decomposition results distinguished the different contribution of change in educational structure and change in childlessness proportion for subgroups to the total childlessness proportion change. It is projected that city women, women with high education will have higher childlessness proportion, and the proportion will further increase with the rapid increase in education level and urbanisation. CONCLUSIONS: Childlessness has risen to a relatively high level, and varies among women with different characteristics. This should be taken into consideration in China's countermeasures to reduce childlessness and curtail further fertility decline accordingly.

Assessment of the safety and probiotic characteristics of Lactobacillus salivarius CGMCC20700 based on whole-genome sequencing and phenotypic analysis.

Lactic acid bacteria are generally regarded as alternatives to antibiotics in livestock and poultry farming, especially Lactobacillus strains, which are safe and have probiotic potential. Although Lactobacillus salivarius has long been proposed to be a probiotic, the understanding of the roles of this species is still in its infancy. Here, a strain of L. salivarius CGMCC20700 isolated from the intestinal mucosa of Yunnan black-bone chicken broilers was investigated in the context of its safety and probiotic characteristics by whole-genome sequencing in parallel with phenotypic analysis. Whole-genome sequencing results showed that L. salivarius CGMCC20700 has a single scaffold of 1,737,577 bp with an average guanine-to-cytosine (GC) ratio of 33.51% and 1,757 protein-coding genes. The annotation of Clusters of Orthologous Groups (COG) classified the predicted proteins from the assembled genome as possessing cellular, metabolic, and information-related functions. Sequences related to risk assessment, such as antibiotic resistance and virulence genes, were identified, and the strain was further confirmed as safe according to the results of antibiotic resistance, hemolytic, and acute oral toxicology tests. Two gene clusters of antibacterial compounds and broad-spectrum antimicrobial activity were identified using genome mining tools and antibacterial spectrum tests. Stress resistance genes, active stressor removal genes, and adhesion related genes that were identified and examined with various phenotypic assays (such as stress tolerance tests in acids and bile salts and auto aggregation and hydrophobicity assays). The strain showed a high survival rate in the presence of bile salts and under acidic conditions and exhibited significant auto aggregation capacity and hydrophobicity. Overall, L. salivarius CGMCC20700 demonstrated excellent safety and probiotic potential at both the genomic and physiological levels and can be considered an appropriate candidate probiotic for livestock and poultry farming.

The value of 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance whole-body scans and local enhancement scans in the preoperative staging and resectability assessment of pancreatic adenocarcinoma.

Background: In addition to contrast-enhanced multiphase computed tomography (CT) and magnetic resonance imaging (MRI), integrated positron emission tomography (PET)/magnetic resonance (MR) is increasingly being used for the preoperative evaluation of pancreatic cancer. The purpose of this study was to explore the value of hybrid 18F-fluorodeoxyglucose (18F-FDG) PET/MR imaging in preoperative assessment and treatment decision-making. Methods: A retrospective data collection (of imaging, clinical, and pathological information) was conducted on patients who underwent 18F-FDG PET/MR with clinically diagnosed or suspected pancreatic cancer from March 2018 to March 2022 in Ruijin Hospital. The data of 76 patients were initially included, with 1 of the 76 patients eventually being excluded due to a misdiagnosis of inflammatory disease. Of the 75 patients, 38 underwent pancreatic tumor resection and 10 underwent laparoscopic exploration. The accuracy of 18F-FDG PET/MR for pancreatic cancer staging and the assessment of pancreatic resectability was evaluated based on pathological results, intraoperative findings, and documented final clinical stages of illness. The adjustments to patient treatment plans were also analyzed before and after 18F-FDG PET/MR examination. Results: The accuracy of clinical tumor node metastasis (TNM) staging of pancreatic cancer by 18F-FDG PET/MR was 73.3% (55/75). The area under the curve (AUC) of 18F-FDG PET/MR for diagnosing the advanced stage (III-IV) versus the nonadvanced stage (I-II) of disease was 0.922 [95% confidence interval (CI): 0.852-0.993]. The treatment regimen of 20.0% (15/75) of patients was impacted. The accuracy of the evaluation of the resectability of pancreatic cancer with 18F-FDG PET/MR was 91.9% (34/37). With the surgical and pathological results being used as a reference, the overall accuracy of preoperative 18F-FDG PET/MR for T staging was 62.2%, and the AUC for diagnosing T4 versus T1-3 was 0.872 (95% CI: 0.660-1.000). Conclusions: 18F-FDG PET/MR performs well in diagnosing advanced pancreatic cancer and thus may impact the treatment decisions for a considerable number of patients. 18F-FDG PET/MR has a high level of accuracy in evaluating the resectability of pancreatic cancer before surgery.

Monitoring Longitudinal Trends and Assessment of the Health Risk of Shigella flexneri Antimicrobial Resistance.

Shigella flexneri infection is the main cause of diarrhea in humans worldwide. The emergence of antimicrobial resistance (AMR) of S. flexneri is a growing public health threat worldwide, while large-scale studies monitoring the longitudinal AMR trends of isolates remain scarce. Here, the AMR gene (ARG) profiles of 717 S. flexneri isolates from 1920 to 2020 worldwide were determined. The results showed that the average number of ARGs in isolates has increased significantly, from 19.2 ± 2.4 before 1970 to 29.6 ± 5.3 after 2010. In addition, mobile genetic elements were important contributors to ARGs in S. flexneri isolates. The results of the structural equation model showed that the human development index drove the consumption of antibiotics and indirectly promoted the antibiotic resistance. Finally, a machine learning algorithm was used to predict the antibiotic resistance risk of global terrestrial S. flexneri isolates and successfully map the antibiotic resistance threats in global land habitats with over 80% accuracy. Collectively, this study monitored the longitudinal AMR trends, quantitatively surveilled the health risk of S. flexneri AMR, and provided a theoretical basis for mitigating the threat of antibiotic resistance.

Automated Assessment of Photoreceptor Visibility in Adaptive Optics Split-Detection Images Using Edge Detection.

Purpose: Adaptive optics scanning laser ophthalmoscopy (AOSLO) is a high-resolution imaging modality that allows measurements of cellular-level retinal changes in living patients. In retinal diseases, the visibility of photoreceptors in AOSLO images is affected by pathology, patient motion, and optics, which can lead to variability in analyses of the photoreceptor mosaic. Current best practice for AOSLO mosaic quantification requires manual assessment of photoreceptor visibility across overlapping images, a laborious and time-consuming task. Methods: We propose an automated measure for quantification of photoreceptor visibility in AOSLO. Our method detects salient edge features, which can represent visible photoreceptor boundaries in each image. We evaluate our measure against two human graders and two standard automated image quality assessment algorithms. Results: We evaluate the accuracy of pairwise ordering (PO) and the correlation of ordinal rankings (ORs) of photoreceptor visibility in 29 retinal regions, taken from five subjects with choroideremia. The proposed measure had high association with manual assessments (Grader 1: PO = 0.71, OR = 0.61; Grader 2: PO = 0.67, OR = 0.62), which is comparable with intergrader reliability (PO = 0.76, OR = 0.75) and outperforms the top standard approach (PO = 0.57; OR = 0.46). Conclusions: Our edge-based measure can automatically assess photoreceptor visibility and order overlapping images within AOSLO montages. This can significantly reduce the manual labor required to generate high-quality AOSLO montages and enables higher throughput for quantitative studies of photoreceptors. Translational Relevance: Automated assessment of photoreceptor visibility allows us to more rapidly quantify photoreceptor morphology in the living eye. This has applications to ophthalmic medicine by allowing detailed characterization of retinal degenerations, thus yielding potential biomarkers of treatment safety and efficacy.

Short-term Assessment of Subfoveal Injection of Adeno-Associated Virus-Mediated hCHM Gene Augmentation in Choroideremia Using Adaptive Optics Ophthalmoscopy.

Importance: Subretinal injection for gene augmentation in retinal degenerations forcefully detaches the neural retina from the retinal pigment epithelium, potentially damaging photoreceptors and/or retinal pigment epithelium cells. Objective: To use adaptive optics scanning light ophthalmoscopy (AOSLO) to assess the short-term integrity of the cone mosaic following subretinal injections of adeno-associated virus vector designed to deliver a functional version of the CHM gene (AAV2-hCHM) in patients with choroideremia. Design, Setting, and Participants: This longitudinal case series study enrolled adult patients with choroideremia from February 2015 to January 2016 in the US. To be included in the study, study participants must have received uniocular subfoveal injections of low-dose (5 × 1010 vector genome per eye) or high-dose (1 × 1011 vector genome per eye) AAV2-hCHM. Analysis began February 2015. Main Outcomes and Measures: The macular regions of both eyes were imaged before and 1 month after injection using a custom-built multimodal AOSLO. Postinjection cone inner segment mosaics were compared with preinjection mosaics at multiple regions of interest. Colocalized spectral-domain optical coherence tomography and dark-adapted cone sensitivity was also acquired at each time point. Results: Nine study participants ranged in age from 26 to 50 years at the time of enrollment, and all were White men. Postinjection AOSLO images showed preservation of the cone mosaic in all 9 AAV2-hCHM-injected eyes. Mosaics appeared intact and contiguous 1 month postinjection, with the exception of foveal disruption in 1 patient. Optical coherence tomography showed foveal cone outer segment shortening postinjection. Cone-mediated sensitivities were unchanged in 8 of 9 injected and 9 of 9 uninjected eyes. One participant showed acute loss of foveal optical coherence tomography cone outer segment-related signals along with cone sensitivity loss that colocalized with disruption of the mosaic on AOSLO. Conclusions and Relevance: Integrity of the cone mosaic is maintained following subretinal delivery of AAV2-hCHM, providing strong evidence in support of the safety of the injections. Minor foveal thinning observed following surgery corresponds with short-term cone outer segment shortening rather than cone cell loss. Foveal cone loss in 1 participant raises the possibility of individual vulnerability to the subretinal injection.

Disease burden of primary gallbladder and biliary tract cancers associated with body mass index in 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017.

OBJECTIVE: To investigate the incidence of primary gallbladder and biliary tract cancer, mortality and disability-adjusted life years (DALY) of the global burden from 1990 to 2017. METHODS: Data of 195 countries and territories from 1990 to 2017 were extracted from the Global Health Data Exchange. The age-standardized incidence rate (ASIR) and estimated annual percentage change (EAPC) were employed to quantify trends in the incidence of primary gallbladder and biliary tract cancer. The age-standardized death rate (ASDR), age-standardized DALY and their corresponding EAPC were used to evaluate mortality trends. RESULTS: The global incidence of primary gallbladder and biliary tract cancer rose by 75.9% from 119 900 cases in 1990 to 210 900 cases in 2017. The highest ASIR was observed in Chile (10.8 per 100 000 in 2017), followed by Japan and South Korea. Regions with the highest social development index (SDI) quintile also had the highest death cases associated with primary gallbladder and biliary tract cancer in 2017 (60 100, 95% UI 55 800-62 700). A high body mass index (BMI) was found to be closely related to age-standardized deaths and age-standardized DALY in most of the regions analyzed. CONCLUSIONS: Primary gallbladder and biliary tract cancer remains a serious threat to global public health, especially in high-SDI countries. The ASDR and age-standardized DALY decreased from 1990 to 2017. A high BMI may be associated with this cancer burden.

DMPP reduces nitrogen fertilizer application rate, improves fruit quality, and reduces environmental cost of intensive apple production in China.

In China, excessive application of nitrogen (N) fertilizer is common in intensive apple production. To resolve issues of benefit reduction and environmental pollution caused by excessive N, a two-year trial was conducted in an apple orchard with a split-plot design, in which the main factor was the N level (500, 400, 300, and 200 kg N ha-1 year-1, expressed as TN, TN80%, TN60%, and TN40%, respectively) and the deputy factor was whether or not to add 3,4-dimethylpyrazole phosphate (DMPP, expressed as +D). The effects of N reduction combined with DMPP on soil N transformation, fruit quality, economic benefits, and environmental effects were investigated. The results showed that DMPP reduced the production of nitrate and its vertical migration by inhibiting the abundance of AOB amoA and decreased N2O emission by reducing nirKC1 levels. Moreover, N reduction combined with DMPP improved N use efficiency (26.67-49.35%) and reduced N loss rate (15.25-38.76%). Compared with TN, TN60% + D increased the content of anthocyanin and soluble sugar by 21.15% and 13.09%, respectively, and decreased environmental costs caused by NH3 volatilization and N2O emission by 33.84%, while maintaining yield and N utilization rate at relatively high levels. Considering the agronomic, economic and environmental benefits, on the basis of traditional N application rate, 40% N reduction combined with DMPP (TN60% + D) could ensure target yield, corresponding quality and economic benefits, maintain soil N fertility, and reduce the risk of N losses to the environment. The present research could provide references for green, efficient, and sustainable development of apple production.

Chinese version of the chronic urticaria quality of life questionnaire: cultural adaptation, factor analysis, assessment of reliability and validity.

Chronic urticaria is a common skin disorder that contributes profound impact on patients' quality of life (QoL). However, the cause of the disease is not clear, and the treatment still faces challenges. To better evaluate the effectiveness of treatment, an effective questionnaire survey on quality of life is needed. For the first time in Italy, a new questionnaire for chronic spontaneous urticaria, the chronic urticaria quality of life questionnaire (CU-Q2oL), has been developed. The purpose of this study was to develop and verify the Chinese version of the chronic urticaria quality of life questionnaire (CU-Q2oL). Three hundred and twenty-eight chronic urticaria patients were prospectively recruited and evaluated by the translated Chinese version of CU-Q2oL along with the Dermatology Life Quality Index (DLQI). Factor analysis, internal consistency, convergent validity, sensitivity to change and known-group validity were determined. Multiple linear regressions were used to determine the predicting factors of CU-Q2oL results. Factor analysis revealed a six-dimensional structure, and five of the six scales showed good internal consistency. Convergent validity and know-group validity showed good correlations. It was found to distinguish well between patients with different levels of urticaria activity and those to be sensitive to change in the Chinese CU-Q2oL. Disease severity was highly significantly predictive of the CU-Q2oL score on all scales. The CU-Q2oL Chinese version is a valid, reliable and sensitive instrument. It can be widely adopted to evaluate treatment outcomes and be applied in clinical research in Chinese patients.

Green Space and Health in Mainland China: A Systematic Review.

Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, as well as a range of co-benefits (e.g., increasing resilience to climate change). No systematic review has so far determined the degree of association between green space and health outcomes in China. This review was conducted to address this gap. Five electronic databases were searched using search terms on green space, health, and China. The review of 83 publications that met eligibility criteria reports associations indicative of various health benefits from more green space, including mental health, general health, healthier weight status and anthropometry, and more favorable cardiometabolic and cerebrovascular outcomes. There was insufficient evidence to draw firm conclusions on mortality, birth outcomes, and cognitive function, and findings on respiratory and infectious outcomes were inconsistent and limited. Future work needs to examine the health benefits of particular types and qualities of green spaces, as well as to take advantage of (quasi-)experimental designs to test greening interventions within the context of China's rapid urbanization and economic growth.

Cost-Benefit Analysis of Using A Single Dose of Tranexamic Acid in Degenerative Lumbar Scoliosis Patients Undergoing Long-Segment Spinal Fusion Surgery: A Retrospective Study.

BACKGROUND Degenerative lumbar scoliosis (DLS) patients undergoing posterior long-segment spinal fusion surgery often require perioperative blood transfusions, and previous studies have reported that increased complications and additional costs accompany these transfusions. One method for decreasing transfusions is the administration of tranexamic acid (TXA). We sought to evaluate the costs and benefits of preoperative administration of 1 g of intravenous TXA, without maintenance, in DLS patients undergoing long-segment spinal fusion surgery. MATERIAL AND METHODS Patients who received TXA (TXA group) were compared with patients who did not receive TXA (NTXA group) with regard to blood loss, units of packed red blood cells (PRBC) transfused, hemostasis costs, and perioperative complications. The benefits and costs were estimated through analysis of the spending on NTXA and TXA patients, and were compared. The difference between the cost per patient in the 2 groups was designated as the net cost-benefit. Then, both groups were substratified into non-osteotomy and osteotomy subgroups for further analysis. RESULTS Of the 173 patients who met the inclusion criteria, 54 TXA patients had significantly reduced perioperative blood loss and total hemostasis costs compared with NTXA patients (n=119). In the group without osteotomy (n=72), TXA (n=13) reduced perioperative blood loss but did not significantly decrease PRBC units and hemostasis costs. However, in patients undergoing osteotomy (n=101), a remarkable net cost savings of ¥648.77 per patient was shown in the TXA group (n=41) (P<0.001). This was because patients undergoing osteotomy in the TXA group received fewer PRBC units (3.7 vs 5.7, P=0.001). CONCLUSIONS A single dose of TXA significantly decreased perioperative blood loss and total hemostasis costs for DLS patients undergoing osteotomy. Furthermore, TXA led to no additional net costs in patients without osteotomy.

Large-scale genomic analysis reveals the genetic cost of chicken domestication.

BACKGROUND: Species domestication is generally characterized by the exploitation of high-impact mutations through processes that involve complex shifting demographics of domesticated species. These include not only inbreeding and artificial selection that may lead to the emergence of evolutionary bottlenecks, but also post-divergence gene flow and introgression. Although domestication potentially affects the occurrence of both desired and undesired mutations, the way wild relatives of domesticated species evolve and how expensive the genetic cost underlying domestication is remain poorly understood. Here, we investigated the demographic history and genetic load of chicken domestication. RESULTS: We analyzed a dataset comprising over 800 whole genomes from both indigenous chickens and wild jungle fowls. We show that despite having a higher genetic diversity than their wild counterparts (average π, 0.00326 vs. 0.00316), the red jungle fowls, the present-day domestic chickens experienced a dramatic population size decline during their early domestication. Our analyses suggest that the concomitant bottleneck induced 2.95% more deleterious mutations across chicken genomes compared with red jungle fowls, supporting the "cost of domestication" hypothesis. Particularly, we find that 62.4% of deleterious SNPs in domestic chickens are maintained in heterozygous states and masked as recessive alleles, challenging the power of modern breeding programs to effectively eliminate these genetic loads. Finally, we suggest that positive selection decreases the incidence but increases the frequency of deleterious SNPs in domestic chicken genomes. CONCLUSION: This study reveals a new landscape of demographic history and genomic changes associated with chicken domestication and provides insight into the evolutionary genomic profiles of domesticated animals managed under modern human selection.

Model-based assessment of replicability for genome-wide association meta-analysis.

Genome-wide association meta-analysis (GWAMA) is an effective approach to enlarge sample sizes and empower the discovery of novel associations between genotype and phenotype. Independent replication has been used as a gold-standard for validating genetic associations. However, as current GWAMA often seeks to aggregate all available datasets, it becomes impossible to find a large enough independent dataset to replicate new discoveries. Here we introduce a method, MAMBA (Meta-Analysis Model-based Assessment of replicability), for assessing the "posterior-probability-of-replicability" for identified associations by leveraging the strength and consistency of association signals between contributing studies. We demonstrate using simulations that MAMBA is more powerful and robust than existing methods, and produces more accurate genetic effects estimates. We apply MAMBA to a large-scale meta-analysis of addiction phenotypes with 1.2 million individuals. In addition to accurately identifying replicable common variant associations, MAMBA also pinpoints novel replicable rare variant associations from imputation-based GWAMA and hence greatly expands the set of analyzable variants.

A cone-beam computed tomographic study evaluating the efficacy of incisor movement with clear aligners: Assessment of incisor pure tipping, controlled tipping, translation, and torque.

INTRODUCTION: This retrospective clinical study aimed to evaluate the efficacy of different types of incisor movements with clear aligners in the sagittal plane. METHODS: Pretreatment and posttreatment cone-beam computed tomography (CBCT) scans were collected from 69 patients who underwent nonextraction treatment with clear aligners (Invisalign; Align Technology, San Jose, Calif). Integrated 3-dimensional models of the virtual incisor position (ClinCheck; Align Technology) and the posttreatment incisor position (from posttreatment CBCT scans) were superimposed over the pretreatment position (from pretreatment CBCT scans) using Mimics software (Materialise, Leuven, Belgium). On the basis of the location of the rotation center, incisors showing pure tipping (>10°), controlled tipping (>10°), translation (>1 mm), or torque (>10°) movements were selected. Efficacy was determined by comparing the predicted and achieved incisor movement, and differences with efficacy were analyzed using Kruskal-Wallis and Shapiro-Wilk tests (α = 0.05). RESULTS: In measurements for 231 incisors, the mean efficacy of incisor movements in the sagittal plane was 55.58%. The most and least predictable movements were pure tipping (72.48%) and torque (35.21%), respectively. Labial root movement was significantly more predictable than lingual root movement, and labial movement of the mandibular incisors was significantly easier than that of the maxillary incisors. The type of tooth movement achieved was different from the type designed. CONCLUSIONS: The efficacy of incisor movement in the sagittal plane using clear aligners varies with designed movement type, and labial root movement appears to be more accurate than the lingual root movement. The biomechanics of clear aligners remains to be further elucidated to achieve more predictable treatment results.