Factors associated with patients' healthcare-seeking behavior and related clinical outcomes under China's hierarchical healthcare delivery system.

Introduction: The hierarchical healthcare delivery system is an important measure to improve the allocation of medical resources and promote equitable distribution of basic medical and health services. It is one of the key factors in the success or failure of China's medical reform. This study aims to analyze the factors influencing patients' healthcare-seeking behaviors, including socioeconomic and clinical outcomes, under China's hierarchical healthcare delivery system, and to provide potential solutions. Methods: Patients receiving outpatient treatment in the past 14 days and inpatient care in the past 1 year were investigated. The multivariate logistic regression was used to analyze the influencing factors of patient's medical treatment behavior selection, and to compare whether the clinical outcomes of primary medical institutions and grade A hospitals are the same. Results: Nine thousand and ninety-eight person-times were included in the study. Of these, 4,538 patients were outpatients, 68.27% of patients were treated in primary medical institutions; 4,560 patients were hospitalized, 58.53% chose to be hospitalized in grade A hospitals. Provinces and cities, urban and rural areas, occupation, education level, medical insurance type, income, whether there are comorbid diseases, and doctors' medical behavior are the factors affecting the choice of medical treatment behavior. Patients who choose primary medical institutions and grade A hospitals have different control levels and control rate for the blood pressure, blood lipids, blood glucose. Conclusion: Under the hierarchical diagnosis and treatment system, the patients' choice of hospital is mainly affected by their level of education, medical insurance types, and the inpatients are also affected by whether there are comorbid conditions. Clinical outcomes of choosing different levels of hospitals were different.

Seed germination and seedling growth response of Leymus chinensis to the allelopathic influence of grassland plants.

Allelopathy has a profound impact on the germination and growth of plants, influencing the establishment of plant populations and shaping community ecological patterns. However, the allelopathic potential of many grassland species remains poorly understood. In this study, we prepared aqueous extracts from 17 herbaceous plants to investigate their allelopathic effects on the seed germination and seedling growth of Leymus chinensis, a dominant grassland species. Our results revealed that the response of L. chinensis to allelopathic compounds was dependent on the specific plant species, extract concentration, and target plant organ. Notably, Fabaceae plants exhibited a stronger allelopathic potential than Poaceae, Asteraceae, and other plant families. Moreover, we observed that root growth of L. chinensis was more sensitive to allelopathy than shoot growth, and seed germination was more affected than seedling growth. Generally, the germination of L. chinensis was strongly inhibited as the donor plant extract concentration increased. The leachate of Fabaceae plants inhibited the seedling growth of L. chinensis at concentrations ranging from 0.025 to 0.1 g mL-1. On the other hand, the leachate from other families' plants exhibited either inhibitory or hormetic effects on the early growth of L. chinensis, promoting growth at 0.025 g mL-1 and hindering it at concentrations between 0.05 and 0.1 g mL-1. These findings highlight the significant allelopathic potential of grassland plants, which plays a critical role in establishing plant populations and associated ecological processes. In addition, they shed light on the coexistence of other plants with dominant plants in the community.

Evaluation of an algorithm-guided photoplethysmography for atrial fibrillation burden using a smartwatch.

BACKGROUND: Wearable devices based on the PPG algorithm can detect atrial fibrillation (AF) effectively. However, further investigation of its application on long-term, continuous monitoring of AF burden is warranted. METHOD: The performance of a smartwatch with continuous photoplethysmography (PPG) and PPG-based algorithms for AF burden estimation was evaluated in a prospective study enrolling AF patients admitted to Beijing Anzhen Hospital for catheter ablation from September to November 2022. A continuous Electrocardiograph patch (ECG) was used as the reference device to validate algorithm performance for AF detection in 30-s intervals. RESULTS: A total of 578669 non-overlapping 30-s intervals for PPG and ECG each from 245 eligible patients were generated. An interval-level sensitivity of PPG was 96.3% (95% CI 96.2%-96.4%), and specificity was 99.5% (95% CI 99.5%-99.6%) for the estimation of AF burden. AF burden estimation by PPG was highly correlated with AF burden calculated by ECG via Pearson correlation coefficient (R2 = 0.996) with a mean difference of -0.59 (95% limits of agreement, -7.9% to 6.7%). The subgroup study showed the robust performance of the algorithm in different subgroups, including heart rate and different hours of the day. CONCLUSION: Our results showed the smartwatch with an algorithm-based PPG monitor has good accuracy and stability in continuously monitoring AF burden compared with ECG patch monitors, indicating its potential for diagnosing and managing AF.

Correlation between inflammatory marker and lipid metabolism in patients with uterine leiomyomas.

Introduction: Obesity is a risk factor for the development of uterine leiomyoma (UL), and the inflammatory response plays a key role in the pathogenesis of UL. Our objective was to assess whether there was an independent relationship between inflammatory markers and triglycerides (TG) in patients with UL. Methods: 1,477 UL participants who were hospitalized at the Jining Medical University between January 2016 and December 2022 were included in this cross-sectional study. The independent and dependent variables measured at baseline were inflammatory markers and TG levels, respectively. The covariates were age, body mass index (BMI), UL and menstrual status. Based on the number of fibroids, the study population was divided into Single-group and Multiple-group. Results: Univariate and multiple regression analyses and stratified analyses revealed significant positive correlations between neutrophil-lymphocyte ratio and systemic immune inflammation index and TG, and significant negative correlations between monocyte-lymphocyte ratio and TG. Conclusion: The findings show a significant correlation between the inflammatory response and lipid metabolism levels in UL patients. This provides direction for further research into the pathophysiology of UL and also helps to formulate hypotheses for predictive models of UL.

Assessing soil microbes that drive fairy ring patterns in temperate semiarid grasslands.

BACKGROUND: Fairy rings occur in diverse global biomes; however, there is a critical knowledge gap regarding drivers of fairy rings in grassland ecosystems. Grassland fairy rings are characterized belowground by an expanding mycelial front and aboveground by vigorous vegetation rings that develop concentrically with each growing season. We evaluated fairy ring dynamics in a field study conducted in semiarid grasslands to elucidate above- and belowground interactions driving distinct vegetation patterns. We followed this initial field investigation with a complementary greenhouse experiment, using soils collected from specific fairy ring zones (inside, ring-edge, outside) to examine plant-soil-microbial interactions under controlled conditions. We selected Leymus chinensis (a dominant grass) as our model plant species to assess the role of diverse fairy ring microbial communities on plant growth and nutrition. RESULTS: In our field study, plants on the ring-edge produced greater shoot biomass with higher concentrations of N and P, compared to plants inside the ring or adjacent (outside) controls. Soil microbial community biomarkers indicate shifts in relative microbial biomass as fairy rings expand. Inside the ring, plant roots showed greater damage from pathogenic fungi, compared to outside or ring-edge. Our greenhouse experiment confirmed that inoculation with live ring-edge soil generally promoted plant growth but decreased shoot P concentration. Inoculation with soil collected from inside the ring increased root pathogen infection and reduced shoot biomass. CONCLUSION: We propose that soil microbial activity within ring-edges promotes plant growth via mobilization of plant-available P or directed stimulation. However, as the ring expands, L. chinensis at the leading edge may increase pathogen accumulation, resulting in reduced growth at the center of the ring in subsequent growing seasons. Our results provide new insights into the plant-soil-microbial dynamics of fairy rings in grasslands, helping to elucidate these mysterious vegetation patterns.

Effects of Nitrogen Forms on the Growth and Nitrogen Accumulation in Buchloe dactyloides Seedlings.

Buffalograss [Buchloe dactyloides (Nutt.) Engelm.] has become the most widely cultivated warm-season turfgrass in northern China because of its low-maintenance requirements. Nitrogen (N) can be applied to plants in a range of formulations. However, preference of nitrogen uptake and the effects of N form on plant growth and nitrogen accumulation has not been established in buffalograss. In this study, we evaluated the effects of different inorganic nitrogen forms (NO3--N, NH4+-N, and NO3--N: NH4+-N = 1:1) on growth and nitrogen accumulation in buffalograss seedlings. Results showed that supply of three N forms significantly increased buffalograss seedlings growth, biomass, and N contents of all plant organs compared with the seedlings receiving free nitrogen. Plants achieved better growth performance when they received nitrate as the sole N source, which stimulated stolon growth and increased the biomass of ramets, spacers, and aboveground and total plant biomass, and also allocated more biomass to ramets and more N to spacers. Meanwhile, those plants supplied with the treatment +NH4NO3 displayed a significantly greater N content in the ramet, 15N abundance, and 15N accumulation amount in all organs. These data suggest NO3--N supplied either singly or in mixture increased vegetative propagation and thus facilitates buffalograss establishment. However, applications of ammonium caused detrimental effects on buffalograss seedlings growth, but +NO3- could alleviate NH4+-induced morphological disorders. Thus, recommendations to increase vegetative propagation and biomass accumulation in buffalograss seedlings should consider increasing NO3--N in a fertility program and avoiding applications of nitrogen as NH4+-N.

Biogeographic Patterns of Leaf Element Stoichiometry of Stelera chamaejasme L. in Degraded Grasslands on Inner Mongolia Plateau and Qinghai-Tibetan Plateau.

Plant leaf stoichiometry reflects its adaptation to the environment. Leaf stoichiometry variations across different environments have been extensively studied in grassland plants, but little is known about intraspecific leaf stoichiometry, especially for widely distributed species, such as Stellera chamaejasme L. We present the first study on the leaf stoichiometry of S. chamaejasme and evaluate its relationships with environmental variables. S. chamaejasme leaf and soil samples from 29 invaded sites in the two plateaus of distinct environments [the Inner Mongolian Plateau (IM) and Qinghai-Tibet Plateau (QT)] in Northern China were collected. Leaf C, N, P, and K and their stoichiometric ratios, and soil physicochemical properties were determined and compared with climate information from each sampling site. The results showed that mean leaf C, N, P, and K concentrations were 498.60, 19.95, 2.15, and 6.57 g kg-1; the average C:N, C:P, N:P, N:K and K:P ratios were 25.20, 245.57, 9.81, 3.13, and 3.21, respectively. The N:P:K-ratios in S. chamaejasme leaf might imply that its growth is restricted by K- or K+N. Moreover, the soil physicochemical properties in the S. chamaejasme-infested areas varied remarkably, and few significant correlations between S. chamaejasme leaf ecological stoichiometry and soil physicochemical properties were observed. These indicate the nutrient concentrations and stoichiometry of S. chamaejasme tend to be insensitive to variations in the soil nutrient availability, resulting in their broad distributions in China's grasslands. Besides, different homeostasis strength of the C, N, K, and their ratios in S. chamaejasme leaves across all sites were observed, which means S. chamaejasme could be more conservative in their use of nutrients improving their adaptation to diverse conditions. Moreover, the leaf C and N contents of S. chamaejasm were unaffected by any climate factors. However, the correlation between leaf P content and climate factors was significant only in IM, while the leaf K happened to be significant in QT. Besides, MAP or MAT contribution was stronger in the leaf elements than soil by using mixed effects models, which illustrated once more the relatively weak effect of the soil physicochemical properties on the leaf elements. Finally, partial least squares path modeling suggested that leaf P or K contents were affected by different mechanisms in QT and IM regions, suggesting that S. chamaejasme can adapt to changing environments by adjusting its relationships with the climate or soil factors to improve its survival opportunities in degraded grasslands.

Disparities in Secondary Prevention between Stroke and Coronary Heart Disease in China: Cross-Sectional Community-Based Study, 2014-2016.

BACKGROUND: Health care quality and insurance coverage have improved with economic development in China, but the burden of cardiovascular diseases (CVDs) continues to increase with ongoing gaps in prevention. We aimed to compare the uptake of secondary CVD prevention between stroke and coronary heart disease (CHD) patients in China. METHODS: In a cross-sectional community-based survey of 47,841 adults (age ≥45 years) in 7 regions of China between 2014 and 2016, we identified those with a history of stroke or CHD to quantify disparities in conventional secondary CVD prevention strategies in multivariable logistic regression models. RESULTS: There were 4,105 and 1,022 participants with a history of stroke and CHD, respectively. Compared to participants with CHD, those with a history of stroke were significantly less likely to be taking blood-pressure-lowering (39.7% vs. 53%), lipid-lowering (13.7% vs. 36.8%), and antiplatelet (20.8% vs. 50.6%) agents, at least one (48.9% vs. 70.8%) or all 3 recommended medicines (6.1% vs. 24.0%), and were less likely to achieve a lipid-cholesterol target (30.3% vs. 44.0%). Participants with a history of stroke achieved less optimal secondary prevention goals for medication use, either from any (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.44-0.66) or all 3 medications (aOR 0.27, 95% CI 0.20-0.36), as well as better blood pressure (aOR 0.81, 95% CI 0.66-0.98) and low-density lipoprotein cholesterol (aOR 0.34, 95% CI 0.27-0.43) levels of control. There were no significant differences in weight, smoking, or physical activity between the groups. CONCLUSION: Stroke patients had lower use of secondary CVD-preventive medication and achieved lower levels of risk factor control than those of CHD patients in China. Nationwide disease-specific strategies, and better education of participants and health care providers, may narrow these gaps.

Study on life histroy traits of Stellera chamaejasme provide insights into its control on degraded typical steppe.

The increase of unpalatable Stellera chamaejasme plants has become commonplace in degraded grasslands of China, which can hinder the establishment and growth of palatable plants and have an impact on sustainable development of livestock production. Controlling S. chamaejasme is thus a necessary, yet usually problematic step towards the degraded grassland. Various measures have been implemented to control S. chamaejasme but relatively little is known about the growth and development of S. chamaejasme in degraded grassland. Therefore, focusing on the life history traits of S. chamaejasme can provide theoretical support underpinning its management. In this study, different age classes of S. chamaejasme plants were surveyed and studied from a degraded typical steppe in China, and the variation of the phenotypic traits, biomass increasement, biomass allocation, reserves and nutrient content were described. These analyses could be of great importance in identifying the management practices of S. chamaejasme that are most consistent with the development of S. chamaejasme in degraded grasslands. We found that most of the phenotypic traits and biomass of all organs increased by different patterns with age class. Like many other species, there has been three developmental phases in S. chamaejasme, however, previous researches only focus on the S. chamaejasme in the adult reproductive phase, therefore leading to a delay between the time of S. chamaejasme's seedling and the time when it begins to establish. Our findings demonstrate that S. chamaejasme mainly distributes the biomass to belowground part (RMF and SMF), which is conducive to the survival of S. chamaejasme on degraded grasslands, making mowing fail to eradicate S. chamaejasme in practice. Partial least squares path modeling suggested that nutrient content (N) played a key role in flowering of S. chamaejasme, but the indirect effect was greater than direct effect. The results from this study highlight that control efforts and the management of S. chamaejasme should not only focus on the S. chamaejasme individual in unreproductive phase, but also on the belowground part of plant in reproductive phase.

Cross-sectional association of meal skipping with lipid profiles and blood glucose in Chinese adults.

OBJECTIVES: There is an increasing trend of skipping meals, especially breakfast and dinner, in China. Previous studies on the association of meal skipping with lipid profiles and blood glucose have yielded inconsistent results. METHODS: A national representative survey of 47 841 adults (age ≥ 45 y) was conducted in China. Frequency of breakfast, lunch, and dinner consumption were assessed with a questionnaire. Blood triacylglycerols, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fasting blood glucose were measured using standard methods. Generalized linear models were used to estimate relative concentrations and 95% confidence intervals (CIs). RESULTS: Of 37 355 participants included in the analysis, the prevalence of skipping breakfast, lunch, and dinner was 9.06%, 0.67%, and 0.67%, respectively. Breakfast skippers are more likely to reside in rural areas, while lunch and dinner skippers tend to be urban residents. Compared with regular breakfast consumption, skipping breakfast was associated with 10.6% (95% CI, 8.3-12.9%) higher concentrations of triacylglycerols, 5.5% (95% CI, 4.7-6.3%) higher total cholesterol, 7.7% (95% CI, 6.5-8.9%) higher low-density lipoprotein cholesterol, 2.4% (95% CI, 1.5-3.4%) lower high-density lipoprotein cholesterol, and 1.6% (95% CI, 1.0-2.1%) lower fasting blood glucose. Significant linear trends were observed for days of skipping breakfast per week and biomarker concentrations. No association was found for lunch or dinner skipping. The higher triacylglycerols and lower high-density lipoprotein cholesterol associated with skipping breakfast were more evident in participants who were overweight or obese, and those who were physically inactive. CONCLUSIONS: Our findings suggest a worse lipid profile of breakfast skippers. Not skipping breakfast might benefit cardiovascular disease prevention in Chinese adults.

Prevalence and factors associated with depressive and anxiety symptoms in a Chinese population with and without cardiovascular diseases.

BACKGROUND: Few data have reported the prevalence of depressive and anxiety symptoms in patients with cardiovascular disease (CVD) in China. Our study aimed to estimate the prevalence and related risk factors of these mental health symptoms. METHODS: A total of 47841 participants from seven regions of China were enrolled by a two-stage, stratified, community-based, clustering sampling strategy between 2014 and 2016. Data of sociodemographic status and medical history were collected through a standard questionnaire. The Center for Epidemiologic Studies Depression Scale and Zung's self-rating anxiety scale were used to screen depressive and anxiety symptoms. RESULTS: Among 47588 individuals who completed the self-report questionnaires, the weighted prevalence of depressive symptom was 2.9% and that of anxiety symptom was 1.5%. In females with heart failure (HF) and stroke, prevalence of either depressive and anxiety symptoms were 15.1% and 13.8%, respectively; while 9.4% and 8.4% for the male counterparts. Among patients with ≥ any 3 specific CVDs, the prevalence of having either depressive or anxiety symptoms were 13.1% and 6.8% for females and males, respectively. Younger age, female, unmarried, lower income, and disease history of atrial fibrillation, HF and stroke tend to link with higher risks of mental health symptoms. LIMITATIONS: Cross-sectional study. CONCLUSION: A high proportion of patients with CVD had depressive and anxiety symptoms. Screening for mental health symptoms is more important in higher-risk populations who are at younger age, being female, unmarried, with low income, and with diagnoses of atrial fibrillation, HF, and stroke.

B3GNT3 acts as a carcinogenic factor in endometrial cancer via facilitating cell growth, invasion and migration through regulating RhoA/RAC1 pathway-associated markers.

BACKGROUND: Aberrant expression of beta-1,3-N-acetylglucosaminyltransferase-3 (B3GNT3) has been frequently clarified in various cancers, however, its role in endometrial cancer (EC) has not been assessed in detail. PURPOSE: This study aimed to investigate the biological role of B3GNT3 in EC and simply explored the detailed mechanism. METHODS: The EC RNA-Seq dataset from TCGA database was applied to evaluate the expression of B3GNT3 and assess its role on prognostic value. HEC-1-A and KLE cell lines of EC were used to perform loss- and gain-of-function B3GNT3 assays respectively. Quantitative real-time PCR (qRT-PCR) and western blot were used to measure the mRNA and protein levels of indicated molecules respectively. Cell counting kit-8, clone formation tests, and Transwell assay served to determine the changes of proliferative, invasive and migratory abilities of EC cells after altering the expression of B3GNT3. RESULTS: B3GNT3 was found to be highly expressed in EC tissues compared to normal tissues according to the online public databases, which confirmed by the following qRT-PCR in 3 EC cell lines. Besides, high B3GNT3 expression presented a worse overall survival in EC patients as compared with low B3GNT3 expression group. Furthermore, functional experiments in vitro indicated that B3GNT3 could facilitate the cell growth, invasion and migration. Moreover, we found that downregulation of B3GNT3 significantly reduced the expression level of GTP-RhoA and GTP-RAC1, whereas upregulation of B3GNT3 presented the opposite results. CONCLUSION: The results of current study demonstrate that B3GNT3 acts as an oncogene that promotes EC cells growth, invasion and migration possibly through regulating the RhoA/RAC1 signaling pathway-related markers, suggesting that B3GNT3 may be a candidate biomarker for EC therapeutic intervention.

Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China.

OBJECTIVE: To determine AF prevalence and gaps in atrial fibrillation (AF) awareness and management in China. METHODS: We conducted a community-based survey of 47 841 adults (age ≥45 years) in seven geographic regions of China between 2014 and 2016. Participants underwent a structured questionnaire, a standard 12-lead ECG, physical examination and blood sampling. AF prevalence, defined by either ECG detection or self-report, was estimated according to sampling weights, non-response and age and sex distribution of the population. We used multivariable logistic regression to estimate associations among sociodemographic, clinical and geographic factors with the AF prevalence, awareness and treatment. RESULTS: The weighted AF prevalence was 1.8% (95% CI 1.7% to 1.9%), but varied from 0.9% to 2.4% across geographical regions and equates to being present in an estimated 7.9 (95% CI 7.4 to 8.4) million people in China. Among men and women, the AF prevalence increased from 0.8% and 0.6% in the age group 45-54 years to 5.4% and 4.9% in the age group ≥75 years, respectively. Proportions of people who were aware of having AF decreased overall from 65.3% in 45-54 year-olds to 53.9% in ≥75 year-olds and varied between sex (men 58.5%, women 68.8%) and residency status (urban 78.3%, rural 35.3%). Only 6.0% of patients with high-risk AF received anticoagulation therapy. CONCLUSIONS: AF prevalence is higher than previously reported in China, with low awareness and large treatment gaps. Large-scale efforts are urgently needed to reduce AF adverse consequences.

Association of T66A polymorphism in CASQ2 with PR interval in a Chinese population.

OBJECTIVE: The aim of this study was to explore the relationship between arrhythmia-associated or electrocardiogram (ECG)-associated common variants and PR interval, QRS duration, QTcorrected, and heart rate in a Chinese cohort. METHODS: We studied the association between 26 single-nucleotide polymorphisms (SNPs) and digital ECG data from 379 unrelated Han Chinese individuals collected in an epidemiological survey in Beijing. All subjects were 45 years of age or older and were free of cardiovascular diseases and diabetes. The SNPs were genotyped in a multiplex panel using the Sequenom MassARRAY platform. RESULTS: Missense variant T66A (Thr66Ala, rs4074536) of the CASQ2 gene, which was previously reported to be associated with QRS complex in European populations, was significantly associated with PR interval prolongation in our sample (padjusted = 0.006, betaadjusted = 3.983 ms). A two-tailed t test showed that the CC genotype (n = 86) had a significantly longer PR interval (162.9 ± 19.4 ms) than the non-CC genotypes (n = 288, PR interval: 154.6 ± 20.9 ms), with a remarkable difference of 8.2 ms between the groups (p = 0.001). Interestingly, this association between T66A of CASQ2 and PR interval was more evident in females (padjusted = 0.007, betaadjusted = 5.723 ms) than in males (padjusted = 0.177, betaadjusted = 2.725 ms). In addition, rs3822714 in the HAND1 locus might be associated with QRS duration (padjusted = 0.034, betaadjusted = -2.268 ms). CONCLUSION: We identified a novel signal of an association between the CC genotype of T66A in CASQ2 and PR interval prolongation in a Chinese population, particularly in females. This association deserves further exploration given its possible effects on calcium handling in cardiac electrophysiology.

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Stellera chamaejasme is one of most common poisonous plant species in degraded grasslands of China. S. chamaejasme could dominate the community in some severely degraded grasslands, which is a serious threat to the sustainable development of animal husbandry in natural grasslands. In this study, S. chamaejasme population was divided into 10 age classes according to the number of branches. We investigated the age structure of S. chamaejasme population and population dynamic indices, and quantified the survival status of S. chamaejasme population by compiling a static life table, drawing a survival curve, conducting survival analysis. The age structure of S. chamaejasme population in the study area was growth type. The number of individuals in Ⅰ age class was sufficient but with relatively low survival rate. The population structure of S. chamaejasme was fitted the growing type. The development process of population was fluctuating. The number of individuals would drop sharply in Ⅱ and Ⅷ, indicating that these two age classes were the bottleneck period in the development of S. chamaejasme population. The survival curves of S. chamaejasme population was the Deevey-Ⅱ type. The results of survival analysis showed that the population had a sharp decrease in the early stage and was stable in the later stage, which was because the value of fx and λx of S. chamaejasme in Ⅰ or Ⅱ age class were the highest. In conclusion, sufficient young individuals (Ⅰ) was the basis for the expansion of S. chamaejasme population in the degraded typical steppe. The low transformation rate of young individuals to adults might be one of the reasons explaining why S. chamaejasme population could not expand rapidly in the early stage of grassland degradation. Therefore, it was suggested to intervene early when the number of S. chamaejasme was limited.

Crop Diversity at the Landscape Level Affects the Composition and Structure of the Vegetation-Dwelling Arthropod Communities in Naked Oat (Avena Chinensis) Fields.

The expansion of agriculture and intensive mechanized production have resulted in the loss of habitats and biodiversity, which has led to the loss of ecological services such as the biological control of pests and diseases, and insect-borne pollination. Current studies mainly focus on the impact of small-scale crop diversity (such as intercropping) on ecological service but lack research on the effects of crop diversity at the landscape scale. In this study, vegetation-dwelling arthropods in naked oat (Avena chinensis) fields under different planting patterns were collected at different growth stages by standardized sweep netting sampling, and the differences in arthropod communities and temporal dynamics were analyzed. Taking this information as an example, the effects of crop diversity at the landscape scale caused by different planting patterns on arthropod communities were studied. It was found that herbivores were the most abundant functional group in the arthropod community in naked oat fields, accounting for 70.13% of the total abundance, followed by natural enemies, accounting for 23.45%, and, finally, other insects. The abundance and species richness of natural enemies in naked oat fields under diversified planting pattern were significantly higher than those under intensive planting pattern, while the abundance and species richness of herbivorous pests showed no significant difference between the two planting patterns. Planting patterns significantly affected the composition and structure of arthropod communities in naked oat fields. Significantly higher ratio of natural enemy to pest and more diverse natural enemies under the diversified planting pattern have shown better biological control potential and the significance of biodiversity protection.

Sex Differences in Primary and Secondary Prevention of Cardiovascular Disease in China.

BACKGROUND: Despite improvements in diagnostic and therapeutic interventions to combat cardiovascular disease (CVD) in recent decades, there are significant ongoing access gaps and sex disparities in prevention that have not been adequately quantified in China. METHODS: A representative, cross-sectional, community-based survey of adults (aged ≥45 years) was conducted in 7 geographic regions of China between 2014 and 2016. Logistic regression models were used to determine sex differences in primary and secondary CVD prevention, and any interaction by age, education level, and area of residence. Data are presented as adjusted odds ratios (ORs) and 95% CIs. RESULTS: Of 47 841 participants (61.3% women), 5454 (57.2% women) had established CVD and 9532 (70.5% women) had a high estimated 10-year CVD risk (≥10%). Only 48.5% and 48.6% of women and 39.3% and 59.8% of men were on any kind of blood pressure (BP)-lowering medication, lipid-lowering medication, or antiplatelet therapy for primary and secondary prevention, respectively. Women with established CVD were significantly less likely than men to receive BP-lowering medications (OR, 0.79 [95% CI, 0.65-0.95]), lipid-lowering medications (OR, 0.69 [95% CI, 0.56-0.84]), antiplatelets (OR, 0.53 [95% CI, 0.45-0.62]), or any CVD prevention medication (OR, 0.62 [95% CI, 0.52-0.73]). Women with established CVD, however, had better BP control (OR, 1.31 [95% CI, 1.14-1.50]) but less well-controlled low-density lipoprotein cholesterol (OR, 0.66 [95% CI, 0.57-0.76]), and were less likely to smoke (OR, 13.89 [95% CI, 11.24-17.15]) and achieve physical activity targets (OR, 1.92 [95% CI, 1.61-2.29]). Conversely, women with high CVD risk were less likely than men to have their BP, low-density lipoprotein cholesterol, and bodyweight controlled (OR, 0.46 [95% CI, 0.38-0.55]; OR, 0.60 [95% CI, 0.52-0.69]; OR, 0.55 [95% CI, 0.48-0.63], respectively), despite a higher use of BP-lowering medications (OR, 1.21 [95% CI, 1.01-1.45]). Younger patients (<65 years) with established CVD were less likely to be taking CVD preventive medications, but there were no sex differences by area of residence or education level. CONCLUSIONS: Large and variable gaps in primary and secondary CVD prevention exist in China, particularly for women. Effective CVD prevention requires an improved overall nationwide strategy and a special emphasis on women with established CVD, who have the greatest disparity and the most to benefit.

Ablation Versus Medical Therapy for Atrial Fibrillation in the Elderly: A Propensity Score-Matched Comparison.

BACKGROUND Whether ablation therapy reduces the risk of death and embolic events in elderly patients with atrial fibrillation (AF) remains unclear. MATERIAL AND METHODS AF patients ≥65 years old receiving either catheter ablation or non-ablation therapy at 2 tertiary and 2 non-tertiary hospitals in Beijing from November 2009 to December 2012 were enrolled. Patients were followed up every 6 months for information on treatment and clinical event occurrence. A propensity score matching algorithm produced comparable 2 groups of patients treated with ablation or non-ablation. Rates of a composite of all-cause death, non-fatal stroke, and peripheral embolism were the primary outcomes. Each composite component and major bleeding were the secondary outcomes. RESULTS There were 596 ablated patients and 1144 patients with non-ablation therapy enrolled. Propensity score algorithm matched 347 comparable pairs of patients. Patient characteristics variables were well balanced. During 523.5 and 497.5 patient-years follow-up, respectively, ablation therapy was associated with a significant lower risk of experiencing the primary composite outcome (hazard ratio [HR]=0.40; 95% confidence interval [CI]: 0.19-0.85), all-cause death (HR=0.13 95% CI: 0.04-0.43), and major bleeding (HR=0.23; 95% CI: 0.12-0.67), without apparent heterogeneity by age, sex, and AF type, and for risk score subgroups. CONCLUSIONS In this propensity-matched elderly sample, ablation therapy was associated with lower risk of composite outcome consisting of all-cause death, non-fatal stroke, and peripheral embolism, and therefore might be an alternative to conservative therapy.

High nutrient uptake efficiency and high water use efficiency facilitate the spread of Stellera chamaejasme L. in degraded grasslands.

BACKGROUND: Stellera chamaejasme L. is a poisonous plant widely distributes in degraded grasslands in China. The mechanism underlying its spread remains unknown. In some degraded grasslands, S. chamaejasme has gradually replaced previous dominant species, such as Leymus chinensis, Stipa krylovii, Artemisia eriopoda on typical steppes. Apart from its unpalatability by livestock, we hypothesized that the survival strategy (nutrient uptake and water use efficiency) of S. chamaejasme in degraded grasslands could be distinct from other coexisting species in the community. Recently, ecological stoichiometry has been suggested as a new approach for studying the demand for natural resources of plants in a changing world, and the leaf carbon isotopic composition (δ13C leaf) as a rapid and effective high throughput phenotyping method for water use efficiency (WUE), both of which can reveal the survival and adaptive strategies of plants. Therefore, in this study we aimed to fill the knowledge gap concerning ecological stoichiometry in the leaf, stem, and root of S. chamaejasme and its surrounding soil on grasslands with different degrees of degradation, and comparing the leaf nutrient content and δ13C of S. chamaejasme with the coexisting species (L. chinensis, S. krylovii, A. eriopoda) in the communities. Toward this goal, we conducted a field survey in which plants and soils were sampled from four different degraded grasslands on typical steppes in China. RESULTS: Our results showed that there is no significant difference of carbon content (C%) and nitrogen content (N%) in leaves of S. chamaejasme in different degraded grasslands, and all element contents and element ratios in stems did not differ significantly. Meanwhile, ecological stoichiometry of S. chamaejasme is distinct from the coexisting species, with low C%, high N% and phosphorus content (P%) in the leaf, indicating high nutrient uptake efficiency of S. chamaejasme in nutrient-poor environments like degraded grasslands. Additionally, S. chamaejasme showed significant higher WUE than other species. CONCLUSIONS: Our results indicated that high nutrient uptake efficiency and high WUE of S. chamaejasme might together contribute to the spread of S. chamaejasme in degraded grasslands.

Host Genotype and Precipitation Influence of Fungal Endophyte Symbiosis and Mycotoxin Abundance in a Locoweed.

Many plant endophytes produce mycotoxins, but how host genetic variation influences endophyte colonization and mycotoxin production under natural conditions is poorly understood. This interaction has not been fully considered in many previous studies which used controlled experiments with agronomic or model plant species. Here, we investigated this interaction in a naturally occurring forb (a locoweed species) Oxytropis ochrocephala, its symbiotic endophyte Alternaria oxytropis, and the mycotoxin swainsonine. Host genetic variation was characterized by microsatellite markers. Endophyte infection rate and swainsonine levels were determined by PCR and HPLC, respectively. Genetic markers defined two distinct host populations and revealed that host genetics were significantly correlated with geographical location, elevation, and precipitation. As the host diverged, symbiotic interactions were reduced or failed to produce detectable swainsonine in one host population. Host genotype and precipitation had a significant impact in shaping swainsonine production at the population level. This study highlights the effect of host genotype in influencing this interaction in locoweeds.