Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study

BACKGROUND

Among people living with HIV (PLHIV) on antiretroviral therapy (ART), the mortality of immunological non-responders (INRs) is higher than that of immunological responders (IRs). However, factors associated with immunological non-response following ART are not well documented.

METHODS

We obtained data for HIV patients from the National Free Antiretroviral Treatment Program database in China. Patients were grouped into IRs (CD4 cell count ≥ 350 cells/μl after 24 months' treatment), immunological incomplete responders (ICRs) (200-350 cells/μl) and INRs (< 200 cells/μl). Multivariable logistic regression was used to assess factors associated with immunological non-response.

RESULTS

A total of 3900 PLHIV were included, among whom 2309 (59.2%) were IRs, 1206 (30.9%) ICRs and 385 (9.9%) INRs. In multivariable analysis, immunological non-response was associated with being male (2.07, 1.39-3.09), older age [40-49 years (vs. 18-29 years): 2.05, 1.29-3.25; 50-59 years: 4.04, 2.33-7.00; ≥ 60 years: 5.51, 2.84-10.67], HBV co-infection (1.63, 1.14-2.34), HCV co-infection (2.01, 1.01-4.02), lower CD4 + T cell count [50-200 cells/μl (vs. 200-350 cells/μl): 40.20, 16.83-96.01; < 50 cells/μl: 215.67, 85.62-543.26] and lower CD4/CD8 ratio (2.93, 1.98-4.34) at baseline. Compared with patients treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) based regimens, those receiving protease inhibitors (PIs) based regimens were less likely to be INRs (0.47, 0.26-0.82).

CONCLUSIONS

We found a sizable immunological non-response rate among HIV-infected patients. Being male, older age, coinfection with HBV and HCV, lower CD4 + T cell count and lower CD4/CD8 ratio are risk factors of immunological non-response, whereas PIs-based regimens is a protective factor.

Self-encapsulated ionic fibers based on stress-induced adaptive phase transition for non-contact depth-of-field camouflage sensing

Ionically conductive fibers have promising applications; however, complex processing techniques and poor stability limit their practicality. To overcome these challenges, we proposed a stress-induced adaptive phase transition strategy to conveniently fabricate self-encapsulated hydrogel-based ionically conductive fibers (se-HICFs). se-HICFs can be produced simply by directly stretching ionic hydrogels with ultra-stretchable networks (us-IHs) or by dip-drawing from molten us-IHs. During this process, stress facilitated the directional migration and evaporation of water molecules in us-IHs, causing a phase transition in the surface layer of ionic fibers to achieve self-encapsulation. The resulting sheath-core structure of se-HICFs enhanced mechanical strength and stability while endowing se-HICFs with powerful non-contact electrostatic induction capabilities. Mimicking nature, se-HICFs were woven into spider web structures and camouflaged in wild environments to achieve high spatiotemporal resolution 3D depth-of-field sensing for different moving media. This work opens up a convenient route to fabricate stable functionalized ionic fibers.

Spatial spillover effect of environmental factors on the tuberculosis occurrence among the elderly: a surveillance analysis for nearly a dozen years in eastern China

BACKGROUND

In many areas of China, over 30% of tuberculosis cases occur among the elderly. We aimed to investigate the spatial distribution and environmental factors that predicted the occurence of tuberculosis in this group.

METHODS

Data were collected on notified pulmonary tuberculosis (PTB) cases aged ≥ 65 years in Zhejiang Province from 2010 to 2021. We performed spatial autocorrelation and spatial-temporal scan statistics to determine the clusters of epidemics. Spatial Durbin Model (SDM) analysis was used to identify significant environmental factors and their spatial spillover effects.

RESULTS

77,405 cases of PTB among the elderly were notified, showing a decreasing trend in the notification rate. Spatial-temporal analysis showed clustering of epidemics in the western area of Zhejiang Province. The results of the SDM indicated that a one-unit increase in PM2.5 led to a 0.396% increase in the local notification rate. The annual mean temperature and precipitation had direct effects and spatial spillover effects on the rate, while complexity of the shape of the greenspace (SHAPE_AM) and SO2 had negative spatial spillover effects.

CONCLUSION

Targeted interventions among the elderly in Western Zhejiang may be more efficient than broad, province-wide interventions. Low annual mean temperature and high annual mean precipitation in local and neighboring areas tend to have higher PTB onset among the elderly.

Association between the weight-adjusted waist index and the odds of type 2 diabetes mellitus in United States adults: a cross-sectional study

Objective

To examine the association between the weight-adjusted waist index (WWI) and the odds of type 2 diabetes mellitus(T2DM)among U.S. adults.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) spanning six years (2007-2018) were utilized, encompassing 31001 eligible participants. Weighted multivariate logistic regression models and smoothed fit curves were employed to assess the association between WWI and the odds of T2DM, as well as dose-response relationships in the overall population and the odds of T2DM in various subgroups.

Results

In the fully adjusted continuous model, each one-unit increase in WWI was associated with a 1.14-fold increase in the odds of T2DM within the entire study population (2.14 [1.98,2.31], P < 0.0001). In the fully adjusted categorical model, when using the lowest tertile of WWI (T1) as the reference group, the second tertile (T2) and the third tertile (T3) were associated with a 0.88-fold (1.88 [1.64,2.17], P < 0.0001) and a 2.63-fold (3.63 [3.11,4.23], P < 0.0001) increase in the odds of T2DM. These findings indicated a positive correlation between WWI values and the odds of T2DM, aligning with the results of the smoothed-fitted curves. In the analysis of subgroups, in addition to maintaining consistency with the overall population results, we found interactions between age and hypertension subgroups.

Conclusion

In conclusion, WWI was found to be positively associated with the odds of T2DM in U.S. adults.

Sex differences in patients with COVID-19 after bariatric surgery: a multicenter cross-sectional study

Objectives

This multicenter, cross-sectional study aimed to investigate whether sex differences persist among patients who have undergone bariatric surgery and tested positive for the coronavirus disease (COVID-19).

Methods

We conducted a multicenter cross-sectional study via an online electronic questionnaire to collect data. Categorical data were presented as absolute and relative frequencies. Data for continuous variables were expressed as mean and standard deviation (SD) or median [interquartile range (IQR)]. We employed ordered logistic regression to assess whether females had higher odds of an increased self-reported duration of the most severe symptom compared to males. Using a modified Poisson regression model with robust standard errors to assess the differences in clinical characteristics among COVID-19 cases.

Results

Statistical analysis revealed significant differences in the prevalence rates of various comorbidities. Among participants who reported their temperature during COVID-19 infection, more than half engaged in vitamin supplementation and regular exercise, while 4.2% remained asymptomatic. The probability of females experiencing a longer duration of severe symptoms increased compared to males [adjusted Odds Ratio (aOR) = 1.92, 95% confidence interval (CI) 1.73-2.12]. In the multivariate mixed-effects Poisson regression analysis, compared to males, females exhibited a lower prevalence rate of asymptomatic infection [adjusted prevalence ratio (aPR 0.40, 95% CI 0.28-0.58), lower prevalence of infection without therapeutic medication use (aPR 0.76, 95% CI 0.70-0.82), and lower prevalence of multiple infections (aPR 0.39, 95% CI 0.20-0.74)].

Conclusion

This cross-sectional study indicates the persistence of sex differences among patients with COVID-19 who have undergone bariatric surgery. Further research is needed to explore the underlying factors contributing to this disparity.

Liquid crystal based sensor for antimony ions detection using poly-adenine oligonucleotides

Antimony is highly toxic and a key water pollutant, which needs to be monitored closely. To date, however, most analytical methods for antimony detection are quite limited because they are complicated, expensive, and not suitable for real-time monitoring of antimony. In this study, a label-free and rapid method for antimony ions (Sb3+) detection is developed based on liquid crystals and a 10-mer poly-adenine oligonucleotide as a specific recognition probe for the first time. The working principle is based on the binding of the oligonucleotide to Sb3+, which weakens the interaction between the oligonucleotide and cationic surfactants. As a result, the event induces a planar-to-homeotropic orientational change of liquid crystals and a bright-to-dark optical change under crossed polars. This liquid crystal-based optical sensor exhibits a rapid response to Sb3+ in 10 s, a detection range between 20 nM and 5 μM, and a detection limit at 6.7 nM calculated from 10-mins assay time. It also shows good selectivity against other metal ions including Ag+, Cd2+, Cu2+, Fe3+, K+, Mg2+, Mn2+, Na+, Pb2+, and Zn2+. Moreover, this system can be used to detect Sb3+ in aqueous solutions with different pH or ionic strengths. This simple, fast, and low-cost liquid crystal-based sensing approach with high sensitivity and selectivity has a high potential for detecting Sb3+ in natural environments and industrial wastewater.

Identifying potential ferroptosis key genes for diagnosis and treatment of postmenopausal osteoporosis through competitive endogenous RNA network analysis

Objective

Postmenopausal osteoporosis (PMOP) is a common systemic metabolic bone disorder that is owing to the reduced estrogen secretion and imbalance of bone absorption and bone formation in postmenopausal women. Ferroptosis has been identified as a novel modulatory mechanism of osteoporosis. Nevertheless, the particular modulatory mechanism between ferroptosis and PMOP is still unclear. The objective of the current investigation was to detect potential biomarkers connected to ferroptosis in PMOP and discover its probable mechanism through bioinformatics.

Methods

We downloaded PMOP-related microarray datasets from the database of Gene Expression Omnibus (GEO) and obtained the differentially expressed genes (DEGs). Utilizing bioinformatics analysis, the DEGs were intersected with the ferroptosis dataset to obtain ferroptosis-connected mRNAs. Enrichment analysis employing KOBAS 3.0 was conducted to comprehend the biological functions and enrichment pathways of the DEGs. The generation of the protein-protein interaction (PPI) network was conducted with the aim of identifying central genes. Lastly, the coexpression and competitive endogenous RNA (ceRNA) networks were built using Cytoscape. With the help of external datasets GSE56815 to verify the reliability of the hub genes by plotting ROC curves.

Results

We identified 178 DE microRNAs (miRNAs), 138 DE circular RNAs (circRNAs), and 86 ferroptosis-related mRNAs. Enrichment analysis exhibited that mRNAs were primarily connected with the signaling pathways of PI3K/Akt, metabolism, mTOR, FoxO, HIF-1, AMPK, MAPK, ferroptosis, VEGF, and NOD-like receptors. Generation of the PPI network detected eight hub genes. The circRNA/miR-23b-3p/PTEN axis may relieve PMOP by inhibiting ferroptosis through targeting the pathway of PI3K/Akt signaling, which is a vital modulatory pathway for PMOP progression. Moreover, the ROC curves ultimately indicates that the four hub genes have greater diagnostic importance in PMOP samples in contrast to the normal group samples, which may be possible markers for PMOP diagnosis.

Conclusions

Bioinformatics analysis identified four hub genes, namely, PTEN, SIRT1, VEGFA, and KRAS, as potential biomarkers for PMOP diagnosis and management. Moreover, the circRNA/miR-23b-3p/PTEN axis may relieve PMOP by suppressing ferroptosis through targeting the pathway of PI3K/Akt signaling, providing a new avenue to explore the pathogenesis of PMOP.

Integrated virtual simulation and face-to-face simulation for clinical judgment training among undergraduate nursing students: a mixed-methods study

BACKGROUND

Virtual simulation and face-to-face simulation are effective for clinical judgment training. Rare studies have tried to improve clinical judgment ability by applying virtual simulation and face-to-face simulation together. This study aimed to evaluate the effect of an integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program on enhancing nursing students' clinical judgment ability and understanding of nursing students' experiences of the combined simulation.

METHODS

A sequential exploratory mixed-methods study was conducted in a nursing simulation center of a university in Central China. Third-year nursing students (n = 122) taking clinical training in ICUs were subsequentially assigned to the integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program arm (n = 61) or the face-to-face simulation-only arm (n = 61) according to the order in which they entered in ICU training. Clinical judgment ability was measured by the Lasater Clinical Judgment Rubric (LCJR). Focus group interviews were conducted to gather qualitative data.

RESULTS

Students in both arms demonstrated significant improvement in clinical judgment ability scores after simulation, and students in the integrated arm reported more improvement than students in the face-to-face simulation-only arm. The qualitative quotes provided a context for the quantitative improvement measured by the LJCR in the integrated arm. Most of the quantitative findings were confirmed by qualitative findings, including the domains and items in the LJCR. The findings verified and favored the effect of the combination of non-immersive virtual simulation and high-fidelity face-to-face simulation integrated program on enhancing nursing students' clinical judgment ability.

CONCLUSIONS

The integrated virtual simulation and face-to-face simulation program was feasible and enhanced nursing students' self-reported clinical judgment ability. This integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program may benefit nursing students and newly graduated nurses in the ICU more than face-to-face simulation only.

Reproductive hormones, organophosphate esters and semen quality: Exploring associations and mediation effects among men from an infertility clinic

Accumulating evidence indicates that organophosphate esters (OPEs) exposure may affect semen quality. As a crucial factor in male reproduction, reproductive hormones might be linked organophosphate esters (OPEs) exposure and semen quality. This study aimed to explore the mediating role of reproductive hormones on the association between OPEs exposure and semen quality. Five serum reproductive hormones, semen quality, and 16 urinary OPE metabolites were measured among 491 reproductive-aged men from a reproductive center. The associations of urinary OPE metabolites with reproductive hormones and semen quality were assessed using multivariable linear regression models, and the mediating role of reproductive hormones was evaluated by mediation analyses. We found that follicle stimulating hormone (FSH) was positively associated with diphenyl phosphate (DPHP) that in turn was negatively associated with sperm total count. In addition, inverse associations were exhibited between serum FSH and sperm concentration, sperm total count, total motility, and progressive motility (all Ptrend <0.05). Mediation analysis further showed that FSH mediated 13.7% of the inverse association of DPHP and sperm total count. Although further investigations are required, our results suggest that FSH was an intermediate mechanism in the associations between OPEs exposure and impaired semen quality.

A comprehensive review of advanced nasal delivery: Specially insulin and calcitonin

Peptide drugs through nasal mucous membrane, such as insulin and calcitonin have been widely used in the medical field. There are always two sides to a coin. One side, intranasal drug delivery can imitate the secretion pattern in human body, having advantages of physiological structure and convenient use. Another side, the low permeability of nasal mucosa, protease environment and clearance effect of nasal cilia hinder the intranasal absorption of peptide drugs. Researchers have taken multiple means to achieve faster therapeutic concentration, lower management dose, and fewer side effects for better nasal preparations. To improve the peptide drugs absorption, various strategies had been explored via the nasal mucosa route. In this paper, we reviewed the achievements of 18 peptide drugs in the past decade about the perspectives of the efficacy, mechanism of enhancing intranasal absorption and safety. The most studies were insulin and calcitonin. As a result, absorption enhancers, nanoparticles (NPs) and bio-adhesive system are the most widely used. Among them, chitosan (CS), cell penetrating peptides (CPPs), tight junction modulators (TJMs), soft NPs and gel/hydrogel are the most promising strategies. Moreover, two or three strategies can be combined to prepare drug vectors. In addition, spray freeze dried (SFD), self-emulsifying nano-system (SEN), and intelligent glucose reaction drug delivery system are new research directions in the future.

Is arterial spin labelling necessarily low perfusion for cavernous sinus venous malformation? A case of hyperperfusion cavernous sinus venous malformation

Generally, due to the complexity of the skull base structures, it is difficult to differentiate cavernous vascular malformation and meningioma in the cavernous sinus area using conventional imaging studies. Cavernous sinus venous malformation are characterized by increased capillary masses without a direct arterial supply, typically leading to low perfusion. On the other hand, meningiomas receive arterial blood supply to the tumour and often exhibit high perfusion. So, arterial spin labelling (ASL) can be helpful in distinguishing between the 2 tumour types. However, in our specific case of a cavernous sinus venous malformation, the ASL imaging showed hyperperfusion. Further analysis revealed that this hyperperfusion on ASL can occur when cavernous sinus venous malformation is associated with arteriovenous fistula malformation.

An electrochemical biosensor for detection of T4 polynucleotide kinase activity based on host-guest recognition between phosphate pillar[5]arene and methylene blue

T4 polynucleotide kinase (T4 PNK) is an important DNA repair-related enzyme that plays a crucial role in DNA recombination, replication and damage repair. Herein, an electrochemical biosensor was developed for detection of T4 PNK activity and inhibitor screening based on supramolecular host-guest recognition between phosphate pillar (Dumitrache and McKinnon, 2017) [5] arene (PP5) and methylene blue (MB). The water-soluble PP5 employed as the host for complexation of MB guest molecules. The substrate DNA with 5'-hydroxyl group was first self-assembled on the gold electrode surface through the chemical adsorption of the thiol group, which was phosphorylated in the presence of T4 PNK and adenosine triphosphate (ATP). TiO2 served as a bridge to link phosphorylated DNA and PP5 via the robust phosphate-Ti4+-phosphate chemistry. The immobilized PP5 captured the MB on electrode surface via the supramolecular host-guest recognition interaction, resulting in an enhanced electrochemical response signal. The electrochemical signal is proportional to the T4 PNK concentration in the range of 2 × 10-4 to 5 U mL-1 with a detection limit of 1 × 10-4 U mL-1. It was also successfully used for PNK inhibitor screening and PNK activity assay in HeLa cell lysates sample. The proposed strategy provides a novel sensing platform for kinase activity assay and inhibitor screening, holding a great potential in clinical diagnostics, inhibitor screening, and nucleotide kinase-target drug discovery.

Stepwise and Controllable Synthesis of Mesoporous Heterotrimetallic Catalysts Based on Predesigned Al4 Ln4 Metallocycles

The motivation for making heterometallic compounds stemmed from their emergent synergistic properties and enhanced capabilities for applications. However, the atomically precisely controlled synthesis of heterometallic compounds remains a daunting challenge of the complications that arise when applying several metals and linkers. Herein, a stepwise and controlled method is reported for the accurate addition of second and third metals to homometallic aluminum macrocycles based on the synergistic coordination and hard-soft acid-base theory. These heterometallic compounds showed a good Lewis acid catalytic effect, and the addition of hetero-metals significantly improved the catalytic effect and rate, among that the conversion rate of compound AlOC-133 reached 99.9% within half an hour. This method combines both the independent controllability of stepwise assembly with the universality of one-step methods. Based on the large family of clusters, the establishment of this method paves the way for the controllable and customized molecular-level synthesis of heterometallic materials and creates materials customized for preferential application.

Metal ion and hydrogen bonding synergistically mediated carboxylated lignin/cellulose nanofibrils composite film

In order to alleviate the resource and environmental problems caused by plastic film materials, the development of biodegradable cellulose-based films is crucial. Inspired by the strengthening mechanism of cellulose-lignin network from wood, carboxylated lignin (CL) was isolated using maleic acid (MA) pretreatment catalyzed by metal chlorides. Compared with pure MA, the presence of metal ions yielded CL with high carboxyl content (0.34 mmol/g), small size and good dispersibility. CL was then composited with CNF to prepare various CL/cellulose nanofibrils (CNF) composite films. When the addition of ferric chloride was 0.3 mmol/g maleic acid, the corresponding composite films exhibited highest tensile strength (180.0 MPa), Young's modulus (13.0 GPa) and excellent ultraviolet blocking rate (97.0 %). Meanwhile, the interaction forces measured by atomic force microscope showed that the binding between CNF and various CLs (276-406 nN) was higher than that between pure CNFs (202 nN), verifying that CL enhanced the mechanical properties of composite films. In summary, this work constructs a super-strong network between CL and CNF synergistically mediated by metal ion crosslinking and hydrogen bonding, which can be a promising alternative to replace conventional plastics in multiple areas.

Hydrogel and Nanomedicine-Based Multimodal Therapeutic Strategies for Spinal Cord Injury

Spinal cord injury (SCI) is a severe neurodegenerative disease caused by mechanical and biological factors, manifesting as a loss of motor and sensory functions. Inhibition of injury expansion and even reversal of injury in the acute damage stage of SCI are important strategies for treating this disease. Hydrogels and nanoparticle (NP)-based drugs are the most effective, widely studied, and clinically valuable therapeutic strategies in the field of repair and regeneration. Hydrogels are 3D flow structures that fill the pathological gaps in SCI and provide a microenvironment similar to that of the spinal cord extracellular matrix for nerve cell regeneration. NP-based drugs can easily penetrate the blood-spinal cord barrier, target SCI lesions, and are noninvasive. Hydrogels and NPs as drug carriers can be loaded with various drugs and biological therapeutic factors for slow release in SCI lesions. They help drugs function more efficiently by exerting anti-inflammatory, antioxidant, and nerve regeneration effects to promote the recovery of neurological function. In this review, the use of hydrogels and NPs as drug carriers and the role of both in the repair of SCI are discussed to provide a multimodal strategic reference for nerve repair and regeneration after SCI.

Association between visit-to-visit lipid variability and risk of ischemic heart disease: a cohort study in China

AIMS

To explore the associations between visit-to-visit lipid variability and risk of ischemic heart disease (IHD) in a population-based cohort in China.

METHODS

We evaluated lipid variability in 30,217 individuals from the Yinzhou Health Information System who had ≥3 recorded lipid measurements during 2010-2014. We used various indicators including standard deviation (SD), coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV) to quantify the variability in triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

Overall, a total of 1305 participants with IHD were identified during the follow-up of 194,421 person-years. Subjects in Q4 had a 21% elevated risk of IHD (HR = 1.21, 95% CI: 1.03-1.41) for LDL-C variability (CV) compared with the reference (Q1). The HRs for Q4 vs Q1 were 1.21 (95% CI: 1.04-1.42) for HDL-C variability, and 1.28 (95% CI: 1.10-1.50) for TC variability. However, no association was observed between triglycerides variability and risk of IHD.

CONCLUSIONS

Higher variability in LDL-C, HDL-C, and TC levels was associated with an elevated risk of IHD, suggesting that lipid variability could be considered as an independent risk factor of IHD.

Advances of Smart Stimulus-Responsive Microneedles in Cancer Treatment

Microneedles (MNs) have emerged as a highly promising technology for delivering drugs via the skin. They provide several benefits, including high drug bioavailability, non-invasiveness, painlessness, and high safety. Traditional strategies for intravenous delivery of anti-tumor drugs have risks of systemic toxicity and easy development of drug resistance, while MN technology facilitates precise delivery and on-demand release of drugs in local tissues. In addition, by further combining with stimulus-responsive materials, the construction of smart stimulus-responsive MNs can be achieved, which can respond to specific physical/chemical stimuli from the internal or external environment, thereby further improving the accuracy of tumor treatment and reducing toxicity to surrounding tissues/cells. This review systematically summarizes the classification, materials, and reaction mechanisms of stimulus-responsive MNs, outlines the benefits and challenges of various types of MNs, and details their application and latest progress in cancer treatment. Finally, the development prospects of smart MNs in tumor treatment are also discussed, bringing inspiration for future precision treatment of tumors.

The relationship between the oblique sagittal temporomandibular joint disc position and the volume surface area of the condyle in young TMD adults

The present study aims to compare the volume surface area of the condyle, the horizontal condylar axial angle and the disc-condyle angle between temporomandibular disorder (TMD) and asymptomatic volunteers, explore and analyze the relationship between the temporomandibular joint (TMJ) disc position in oblique sagittal plane and the volume surface area of the condyle in young adults with TMD symptoms. 84 young adult volunteers were received TMJ examination by Magnetic Resonance Imaging (MRI) and Cone Beam Computed Tomography (CBCT). TMD and asymptomatic volunteers were 42 each. MRI was used to assess the position of TMJ disc in the oblique sagittal plane with the condyle apex method. CBCT data were used for three-dimensional (3D) reconstruction of condyle and the measurements of the horizontal condylar axial angle and the volume surface area of the condyle. The condylar volume surface area of the TMD group was smaller than that of the asymptomatic group (p < 0.05), the disc condyle angle was larger than that of the asymptomatic group (p < 0.05), and no significant difference was found in the horizontal condylar axial angle (p > 0.05). In terms of correlation, the volume surface area of the condyle were negatively correlated with the position of the articular disc in TMD patients (p < 0.05). This significant negative correlation suggests that the possibility of disc displacement can be considered when poor condylar morphology is found.

The combined impact of social networks and connectedness on anxiety, stress, and depression during COVID-19 quarantine: a retrospective observational study

Introduction

The COVID-19 pandemic and associated quarantine measures have precipitated a surge in mental health disorders, particularly depression and anxiety. Government policies and restrictions on physical activity have contributed to this phenomenon, as well as diminished subjective social connectedness and exacerbated objective social isolation. As two dimensions of social isolation, it is worth noting that subjectively perceived social connectedness serves as a protective factor for mental health, whereas the decline in the size of objectively evaluated social networks poses a significant risk. However, research investigating the combined influence of these two dimensions remains limited.

Methods

This study used an online survey to collect data to investigate the effects of objective social connectedness and objective social networks on anxiety, stress, and depression during COVID-19 quarantine. A total of 485 participants were analyzed using statistical methods, including paired t-test, Pearson correlation analysis, linear regression, cluster analysis, ANOVA, and moderated mediated.

Results

The study found that anxiety and depression scores increased during the quarantine, with age, education, and social connectedness scores associated with the increase. Pre-quarantine anxiety and depression levels were strongly correlated with mental health status during quarantine. Cluster analysis, respectively, revealed three clusters for those without increasing anxiety and depression scores. The study also found that objective social network influences the impact of subjective social connectedness on pre-quarantine mental health, which in turn affects anxiety and depression levels during quarantine.

Conclusion

The study identified that quarantine increased anxiety and depression, with age being protective, and education and subjective social connectedness as risk factors. The study also emphasizes the comprehensive impact of objective and subjective social isolation. Although individuals perceive the same degree of social connectedness, those with smaller social networks are more prone to developing symptoms of anxiety and depression, which are also more likely to worsen during quarantine.

Ingenious use of autocatalytic hydrodeoxygenation for the separation and recovery of oil and iron from rolling oil sludge

This paper introduces a transformative hydrodeoxygenation process for the simultaneous recovery of oil and iron from hazardous rolling oil sludge (ROS). Leveraging the inherent catalytic capabilities of iron/iron oxide nanoparticles in the sludge, our process enables the conversion of fatty acids and esters into hydrocarbons under conditions of 4.5 MPa, 330 °C, and 500 rpm. This reaction triggers nanoparticle aggregation and subsequent separation from the oil phase, allowing for effective resource recovery. In contrast to conventional techniques, this method achieves a high recovery rate of 98.3% while dramatically reducing chemical reagent consumption. The reclaimed petroleum and iron-ready for high-value applications-are worth 3910 RMB/ton. Moreover, the process facilitates the retrieval of nanoscale magnetic Fe and Fe0 particles, and the oil, with an impressive hydrocarbon content of 87.8%, can be further refined. This energy-efficient approach offers a greener, more sustainable pathway for ROS valorization.

Methanogenic and methanotrophic communities determine lower CH4 fluxes in a subtropical paddy field under long-term elevated CO2

Clarifying the effects of elevated CO2 concentration (e[CO2]) on CH4 emissions from paddy fields and its mechanisms is a crucial part of the research on agricultural systems in response to global climate change. However, the response of CH4 fluxes from rice fields to long-term e[CO2] (e[CO2] duration >10 years) and its microbial mechanism is still lacking. In this study, we used a long-term free-air CO2 enrichment experiment to examine the relationship between CH4 fluxes and the methanogenic and methanotrophic consortia under long- and short-term e[CO2]. We demonstrated that contrary to the effect of short-term e[CO2], long-term e[CO2] decreased CH4 fluxes. This may be associated with the reduction of methanogenic abundance and the increase of methanotrophic abundance under long-term e[CO2]. In addition, long-term e[CO2] also changed the community structure and composition of methanogens and methanotrophs compared with short-term e[CO2]. Partial least squares path modeling analysis showed that long-term e[CO2] also could affect the abundance and composition of methanogens and methanotrophs indirectly by influencing soil physical and chemical properties, thereby ultimately altering CH4 fluxes in paddy soils. These findings suggest that current estimates of short-term e[CO2]-induced CH4 fluxes from paddy fields may be overestimated. Therefore, a comprehensive assessment of climate‑carbon cycle feedbacks may need to consider the microbial regulation of CH4 production and oxidation processes in paddy ecosystems under long-term e[CO2].

Favorable factors for the survival of ST-segment elevation myocardial infarction patients with medium- and high-risk thrombolysis in myocardial infarction scores

OBJECTIVE

ST-segment myocardial infarction (STEMI) is a time-sensitive emergency. This study screened the favorable factors for the survival of STEMI patients with medium- and high-risk thrombolysis in myocardial infarction (TIMI) scores.

METHODS

According to the TIMI scores at admission, 433 STEMI patients were retrospectively and consecutively selected and allocated into low-/medium-/high-risk groups, with their general information/blood routine/biochemical indicators/coagulation indicators documented. The factors influencing the in-hospital survival of STEMI patients were analyzed using univariate and multivariate logistic regression analyses. Moreover, the predictive value of favorable factors was analyzed by receiver operating characteristics (ROC) curve, and patients were assigned into high/low level groups based on the cut-off value of these factors, with their in-hospital survival rates compared.

RESULTS

The in-hospital survival rate of the medium-/high-risk groups was lower than that of the low-risk group. Emergency percutaneous coronary intervention (PCI), lymphocyte (LYM), total protein (TP), albumin (ALB), and sodium (Na) were independent favorable factors for in-hospital survival in the medium-/high-risk groups. Besides, LYM > 1.275 × 109/L, TP > 60.25 g/L, ALB > 34.55 g/L, and Na > 137.9 mmo1/L had auxiliary predictive value for the survival of STEMI patients with medium-/high-risk TIMI scores. Patients with high levels of LYM, TP, ALB, and Na exhibited higher in-hospital survival rates than patients with low levels.

CONCLUSION

For STEMI patients with medium- and high-risk TIMI scores, accepting emergency PCI and normal levels of LYM, TP, ALB, and Na were more conducive to in-hospital survival.

Familiarity of teaching skills among general practitioners transfer training trainers in China: a cross-sectional survey

BACKGROUND

The insufficient number of general practitioners (GPs) is a major challenge facing China's healthcare system. The purpose of the GP transfer training programme was to provide training for experienced doctors to transition to general practice. However, research on the competencies of GP transfer training trainers in teaching skills in China is limited. This cross-sectional study aimed to examine the baseline familiarity with teaching skills among Chinese GP transfer training trainers.

METHODS

An online survey was conducted among trainers who participated in the 2021 Sichuan Province General Practice Training Trainer Program. The survey collected data on participants' characteristics and familiarity with 20 skills in three essential teaching knowledge areas: the core functions of primary care (five questions), preparation for lesson plan (four questions), and teaching methods (11 questions).

RESULTS

In total, 305 participants completed the survey. Familiarity rates were generally low across all three essential teaching knowledge areas. No significant differences were observed in familiarity rates between the tertiary and secondary hospitals.

CONCLUSION

This study revealed gaps in the teaching skills of GP transfer training trainers in China. These results suggest the necessity for targeted training programs to enhance the teaching skills and competencies of trainers.

Ultrathick GeP Anode To Balance the Extreme Load and Compliance for High Areal Capacity Flexible Sodium-Ion Batteries

The ever-growing application of miniaturized electric devices calls for the manufacturing of energy storage systems with a high areal energy density. Thick electrode design is a promising strategy to acquire high areal energy density by enhancing active mass loading and minimizing inactive components. However, the sluggish reaction kinetics and poor electrode mechanical stability that are accompanied by the increased electrode thickness remain unsolved problems. Herein, for the first time, we propose a novel chemical cross-linking strategy to fabricate GeP thick electrodes with adjustable electrode thicknesses and active mass loadings for high areal capacity sodium-ion batteries (SIBs). The chemical cross-linking between carboxylic multiwalled carbon nanotubes (CNTs) and pyrolysis cellulose nanofibers (CNFs) forms a 3D network that encloses GeP nanoparticles, which guarantees fast charge transfer, efficient stress relief, and alleviated volume expansion/shrinkage of the electrode. The hierarchical porous structure generates numerous interconnected channels for unfettered Na+ diffusion, ensuring uncompromised reaction kinetics as the electrode thickness increases. As a result, the ultrathick 1031 μm GeP@C-CNTs-CNFs electrode featuring a mass loading of 18.3 mg cm-2 delivers an ultrahigh areal capacity of 10.58 mAh cm-2 accompanied by superior cycling stability, which outperforms all reported Ge-based electrodes (generally below 1.5 mAh cm-2). This work sheds insightful light on designing high areal capacity flexible thick electrodes for the applications of miniaturized electric devices.

Associations of blood pressure trajectories in early life with target organ damage in midlife : a 30-year cohort study

Hypertension is a pivotal factor in cardiovascular risk. However, the association of longitudinal blood pressure (BP) trajectories in the early life and cardiovascular risk assessed by target organ damage (TOD) in adulthood is poorly reported. The objective of this study was to identify the association between systolic BP, diastolic BP, and mean atrial pressure (MAP) trajectories early in life with a single or multiple TOD in later life. We identified BP trajectories from 6 to 45 year-old using group-based trajectory models among 2430 individuals in the Hanzhong Adolescent Hypertension Study and examined the relationship between BP trajectories and cardiovascular risk in later life. Four discrete long-term systolic BP, diastolic BP, and MAP trajectories were identified, namely, low stable, moderate stable, high stable (low increasing), and moderate increasing groups, based on the BP levels at baseline and in the 30-year follow-up. The carotid intima-media thickness were higher in persistently high or increasing trajectories in comparison to the low stable group. Individuals with deteriorative trajectories during early life were at an increased risk of suffering from a single TOD, including left ventricular hypertrophy (LVH) and carotid atherosclerosis (CA) in middle age (36-49 years old). Moreover, higher BP trajectories were correlated with the presence of combined TODs load stage which were assessed by CA, LVH, arteriosclerosis and subclinical renal damage (SRD). Higher longitudinal BP trajectories early in life were associated with increased cardiovascular risk in midlife, and identifying BP trajectories in early life can help screen individuals with TOD later. LVH, left Ventricular Hypertrophy; CA, carotid atherosclerosis; SRD, subclinical renal damage; TOD, target organ damage.