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The research attention is increasingly directed towards the effective integration of the 17 United Nations Sustainable Development Goals (SDGs) within the limitations of the real world and amidst intersectoral conflicts. In light of the inextricable relationship between irrigation and energy, the objective of this study is to identify potential avenues for achieving the SDG6 and SDG7 goals of enhancing water use efficiency in agriculture and eradicating energy poverty, respectively. Utilizing data from 30 Chinese provinces from 2002 to 2017, this study explores the dynamic influence of energy poverty on agricultural water efficiency with a system generalized method of moments methodology. The findings suggest that energy poverty may greatly reduce agricultural water efficiency. The heterogeneity study shows that when agricultural water efficiency grows, the negative impacts of energy poverty continue to fade. Based on an assessment of various processes, results suggest that non-farm employment and cropping structure modification is a prominent conduit via which energy poverty negatively influences agricultural water efficiency.

ObjectivesTo explore the lived experiences of patients with symptomatic osteoporosis on a patient-reported outcomes (PROs) programme for symptom management and quality of life (QoL) improvement.DesignThis is a qualitative phenomenological study.SettingParticipants14 active participants in the PROs programme were recruited and interviewed through semi-structured face-to-face interviews. Colaizzi’s seven-step method was employed for thematic analysis.ResultsFour overarching themes and two sub-themes emerged, including (1) varied perceptions of the PROs programme, where some participants found it beneficial for tracking symptoms while others cited challenges such as technological barriers and lack of actionable outcomes; (2) PROs as a tool for enhancing communication and facilitating appointments by enabling more efficient doctor–patient interactions and quicker scheduling; (3) emotional support provided by regular doctor–patient communication, with sub-themes of fostering a sense of belonging and offering psychological comfort; and (4) limitations of remote communication, highlighting challenges in addressing complex medical needs and providing immediate solutions for medication adjustments.ConclusionsPROs programmes facilitate symptom tracking, enhance communication and provide emotional support for patients with osteoporosis. However, limitations such as technological barriers and reliance on remote communication must be addressed. Ethical considerations, including potential over-reporting of symptoms to expedite care, require careful management. Future research should include patients who discontinue participating in the PROs programme prematurely and the perspectives of healthcare providers to provide a more balanced, comprehensive understanding.

The nutritional quality and yield of oats ( Avena sativa ) are often compromised by plant diseases such as red leaf, powdery mildew, and leaf spot. Sugars Will Eventually be Exported Transporters (SWEETs) are newly identified sugar transporters involved in regulating plant growth and stress responses. However, the roles of SWEET genes in biotic stress responses remain uncharacterized in oats. In this study, 13 AsSWEET genes were identified across nine chromosomes of the oat genome, all of which were predicted to contain seven transmembrane regions. Phylogenetic analysis revealed four clades of AsSWEET proteins, with high homology to SWEET proteins in the Poaceae family. Collinearity analysis demonstrated strong relationships between oat and Zea mays SWEETs. Using subcellular localization prediction tools, AsSWEET proteins were predicted to localize to the plasma membrane. Promoter analysis revealed cis-acting elements associated with light response, growth, and stress regulation. Six AsSWEET proteins were predicted to interact in a network centered on AsSWEET1a and AsSWEET11. Gene expression analysis of two oat varieties, ‘ForagePlus’ and ‘Molasses’, indicated significant expression differences in several AsSWEET genes following infection with powdery mildew or leaf spot, including AsSWEET1a , AsSWEET1b , AsSWEET2b , AsSWEET3a , AsSWEET11 , and AsSWEET16 . These SWEET genes are potential candidates for disease resistance in oats. This study provides a foundation for understanding the regulatory mechanisms of AsSWEET genes, particularly in response to powdery mildew and leaf spot, and offers insights for enhancing oat molecular breeding.

An unexpected surge of osteoporosis outpatients occurred after COVID-19 lockdown was lifted in China. To confirm the observation and identify possible reasons driving patients care seeking behaviors post-pandemic, we compared the outpatient volumes at the osteoporosis clinic in January through May, 2019–2022 and surveyed seven osteoporosis specialists across China to validate the phenomenon before devising an online questionnaire to collect patients’ characters and physical activity levels. Univariate and binary logistic regression analyses were calculated to identify predictors of post-lockdown care-seeking. We received 480 valid responses, including 397 (82.7%) patients having visited the clinic after lockdown and 83 (17.3%) having not. Four significant predictors were identified, including being female, experiencing pain, aggravating symptoms, and heightened anxiety during lockdown ( P  < 0.05). Both groups experienced lower physical activity levels during lockdown, which however was not a significant predictor ( P  = 0.317). The surge in osteoporosis outpatient visits after COVID-19 lockdown suggests vast latent demand for osteoporosis care accumulated during the pandemic. Four significant factors predict post-lockdown outpatient care-seeking, including being female, experiencing pain and aggravating symptoms, and heightened anxiety levels. Though physical activity levels decrease d during lockdown, it failed to predict care-seeking. This demonstrates resilience of osteoporosis patients to resume regular care despite disruption and stress the substantial backlog of unmet healthcare needs.

Studies consider the impact of financial support on agricultural technology adoption, but do not consider the role of the rapidly evolving Digital Financial Inclusion (DFI). This study analyzes the impact of DFI on farmers’ willingness to adopt agricultural technology (WTAAT) using data from the China Labor-force Dynamics Survey and the Digital Financial Inclusion Index of Peking University, China. The results show that DFI significantly increases farmers’ WTAAT, consistent with the results of robustness tests. Moreover, the analysis of moderating effects shows that the contribution of DFI to WTAAT increases with the level of financial market development. Finally, WTAAT is affected by DFI development among farmers who receive government subsidies, participate in production technology training, and have no local non-agricultural economy. Therefore, we propose policy recommendations for developing DFI in rural areas, improving the financial market environment, and increasing subsidies and technical training. Our study provides some empirical evidence for exploring the field of agricultural technology adoption from the perspective of DFI and also provides new ideas for combining the digital transformation of finance with sustainable agricultural development, enriching the development of research in this field, which may also provide policy insights for the development of agricultural modernization in China and other countries.

Background Informed decision-making is pivotal for end-of-life (EOL) care aligns with patients’ preferences, thereby enhancing the quality of dying. However, limited research has analyzed how individuals’ prior exposure to life-sustaining treatment (LST) shapes informed EOL choices. This study addresses this gap by investigating the impact of LST witnessed experiences on EOL decision-making among the elderly in China. Methods We conducted a cross-sectional analysis of primary data from 571 elderly residents in a public nursing home. Logistic regression and marginal effect analyses were performed to examine associations between LST witnessed experiences and informed EOL choices. LST witnessed experiences were categorized into five items: cardiopulmonary resuscitation (CPR), tracheal intubation, tube feeding, expensive antibiotics use, and hemodialysis. We assessed variations in marginal effects across these five LST items. Subgroup analyses evaluated differences stratified by education levels and monthly pension. Partial correlations analyses and interaction effect analyses were further employed to investigate the dual role of death taboo in mediating both LST witnessed experiences and informed EOL choices. Results Elderly individuals with LST witnessed experiences exhibited a higher demand for informed EOL care (OR = 1.551, 90% CI: 1.095 to 2.196, p < 0.05 ) compared to those without LST witnessed experiences. There was 7.5 percentage-point increase in the predicted probability of choosing informed EOL care (90% CI: 0.016 to 0.134, p < 0.05 ) associated with LST witnessed experiences. Specifically, witnessing CPR (incremental effect = 0.079, 90% CI: 0.003 to 0.155, p < 0.1 ) and tube feeding (incremental effect = 0.085, 90% CI: 0.020 to 0.150, p < 0.05 ) significantly influenced informed EOL choices. Subgroup analyses revealed that these effects were stronger among individuals with lower educational attainment and monthly pensions. Conclusions LST witnessed experiences were significantly associated with more informed EOL choices among the elderly, highlighting the role of firsthand medical experiences in shaping care preferences. To optimize EOL decision-making, targeted death education programs—particularly for socioeconomically disadvantaged groups with limited health literacy—are critical in clinical and community settings.

Ionizing radiation has been widely used in industry, medicine, military and agriculture. Radiation-induced skin injury is a significant concern in the context of radiotherapy and accidental exposure to radiation. The molecular changes at the single-cell level and intercellular communications during radiation-induced skin injury are not well understood. This study aims to illustrate this information in a murine model and human skin samples from a radiation accident using single-cell RNA sequencing (scRNA-Seq). We further characterize the functional significance of key molecule, which may provide a potential therapeutic target. ScRNA-Seq was performed on skin samples from a nuclear accident patient and rats exposed to ionizing radiation. Bioinformatic tools were used to analyze the cellular heterogeneity and preferential mRNAs. Comparative analysis was performed to identify dysregulated pathways, regulators, and ligand-receptor interactions in fibroblasts. The function of key molecule was validated in skin cells and in three mouse models of radiation-induced skin injury. 11 clusters in human skin and 13 clusters of cells in rat skin were depicted respectively. Exposure to ionizing radiation caused changes in the cellular population (upregulation of fibroblasts and endothelial cells, downregulation of keratinocytes). Fibroblasts and keratinocytes possessed the most interaction pairs with other cell lineages. Among the five DEGs common to human and rat skins, was highly expressed in fibroblasts, which mediated radiosensitivity by cell apoptosis and modulated crosstalk between macrophages, keratinocytes and endothelial cells in radiation-induced skin injury. In animal models, knock-out mice ( ) showed more severe injury after radiation exposure than wild-type counterparts in three models of radiation-induced skin injury with complex mechanisms. The study reveals a single-cell transcriptional framework during radiation-induced skin injury, which provides a useful resource to uncover key events in its progression. is a novel target in radiation-induced skin injury, which provides a potential therapeutic strategy against this disease.

Objective To assess the effect of low-dose perioperatively continuous infusion of lidocaine on postoperative inflammation, immune function and quality of recovery in patients undergoing video-assisted thoracoscopic surgery (VATS). Methods Patients with lung cancer aged 18–65 years, undergoing elective VATS were randomized into lidocaine intervention (L) and standard care (C) groups. For patients in Group L, 1 mg/kg lidocaine was intravenously injected within approximately 10 min during the induction of anesthesia, followed by a continuous infusion of lidocaine at a rate of 1.5 mg/kg/h until the patient left the operating room. The postoperative analgesia plan included 2% lidocaine at 5 mg/kg. Group C was given an equal volume of normal saline as a control . The primary outcomes were plasma concentrations of tumor necrosis factor-α (TNF-α), interleukin-1(IL-1), and interleukin-6 (IL-6), along with T lymphocyte counts of CD3 + , CD4 + , CD8 + , and the CD4 + /CD8 + ratio before anesthesia induction (T1), and 24 h (T2) and 48 h (T3) postoperatively. Secondary outcomes included the visual analog scale (VAS) for pain at rest and during movement, Time to first post-operative rescue analgesia, Cumulative OME(the oral morphine equivalents) at 24 h, along with the frequency and severity of postoperative nausea and vomiting (PONV) within the initial 48-h after surgery. Results In Group C and Group L, compared with preoperative levels, the levels of CD3 + , CD4 + and the ratio of CD4 + /CD8 + were significantly decreased at 24 and 48 h postoperatively, while the levels of TNF-α, IL-1 and IL-6 were significantly increased ( P  < 0.05). Compared with Group C, in Group L, the levels of CD3 + , CD4 + and the ratio of CD4 + /CD8 + were significantly increased at 24 and 48 h postoperatively, while the levels of TNF-α, IL-1 and IL-6 were significantly decreased ( P  < 0.05).Additionally, the L group experienced less pain on the movement VAS, the decreased OME dosage and a lower rate of PONV within 48 h postoperatively than the C group ( P  < 0.05). Conclusion Intravenous infusion of lidocaine during the perioperative period was effective in reducing postoperative inflammatory response and the postoperative suppression of cellular immune function in the body, as well as significantly reducing the level of postoperative pain and the incidence of PONV in patients undergoing VATS. Highlights Continuous perioperative infusion of low-dose lidocaine improved postoperative analgesic effect and reduce the incidence of postoperative nausea and vomiting. Low-dose continuous infusion of lidocaine reduces postoperative inflammatory response. Low-dose continuous infusion of lidocaine during the perioperative period alleviates postoperative cellular immune suppression.

Caffeic acid O-methyltransferase (COMT) is a multifunctional enzyme involved in lignin biosynthesis and plays an important role in various primary and secondary metabolic pathways, including the plant stress response. In this study, we identified 37 AsCOMT genes from the oat ( Avena sativa ) whole-genome database, which are distributed across 11 chromosomes. Phylogenetic analysis grouped these genes into two major subfamilies, indicating that they are highly conserved during evolution and share close relationships with COMT genes from Zea mays and Oryza sativa . Cis-acting elements analysis revealed a rich presence of regulatory motifs related to plant hormone signaling and stress responses. Expression profiling of different oat varieties infected with powdery mildew and leaf spot disease showed significant upregulation or downregulation of several AsCOMT genes (e.g., AsCOMT14 , AsCOMT22 , AsCOMT24 , AsCOMT27 ). Moreover, disease-resistant oat varieties have higher lignin contents compared to susceptible varieties. Overexpression of AsCOMT23 and AsCOMT27 in tobacco leaves resulted in significantly increased lignin content, highlighting the potential of these genes in lignin biosynthesis. These results offer a preliminary exploration of the role of AsCOMT in both lignin synthesis and the plant stress response, laying the groundwork for further functional studies and potential applications in oat breeding.

Radiotherapy (RT) has been the standard of care for treating a multitude of cancer types. Radiation-induced gastric injury (RIGI) is a common complication of RT for thoracic and abdominal tumors. It manifests acutely as radiation gastritis or gastric ulcers, and chronically as chronic atrophic gastritis or intestinal metaplasia. In recent years, studies have shown that intracellular signals such as oxidative stress response, p38/MAPK pathway and transforming growth factor-β signaling pathway are involved in the progression of RIGI. This review also summarized the risk factors, diagnosis and treatment of this disease. However, the root of therapeutic challenges lies in the incomplete understanding of the mechanisms. Here, we also highlight the potential mechanistic, diagnostic and therapeutic directions of RIGI.