Highly reversible extrinsic electrocaloric effects over a wide temperature range in epitaxially strained SrTiO3 films

Electrocaloric effects have been experimentally studied in ferroelectrics and incipient ferroelectrics, but not incipient ferroelectrics driven ferroelectric using strain. Here we use optimally oriented interdigitated surface electrodes to investigate extrinsic electrocaloric effects in low-loss epitaxial SrTiO3 films near the broad second-order 243 K ferroelectric phase transition created by biaxial in-plane coherent tensile strain from DyScO3 substrates. Our extrinsic electrocaloric effects are an order of magnitude larger than the corresponding effects in bulk SrTiO3 over a wide range of temperatures including room temperature, and unlike electrocaloric effects associated with first-order transitions they are highly reversible in unipolar applied fields. Additionally, the canonical Landau description for strained SrTiO3 films works well if we set the low-temperature zero-field polarization along one of the in-plane pseudocubic <100> directions. In future, similar strain engineering could be exploited for other films, multilayers and bulk samples to increase the range of electrocaloric materials for energy efficient cooling.

Association between high or low-quality carbohydrate with depressive symptoms and socioeconomic-dietary factors model based on XGboost algorithm: From NHANES 2007-2018

BACKGROUND

Depressive symptoms are a serious public mental health problem, and dietary intake is often considered to be associated with depressive symptoms. However, the relationship between the quality of dietary carbohydrates and depressive symptoms remains unclear. Therefore, this study aimed to investigate the relationship between high and low-quality carbohydrates and depressive symptoms and to attempt to construct an integrated model using machine learning to predict depressive symptoms.

METHODS

A total of 4982 samples from the National Health and Nutrition Examination Survey (NHANES) were included in this study. Carbohydrate intake was assessed by a 24-h dietary review, and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ9). Variance inflation factor (VIF) and Relief-F algorithms were used for variable feature selection.

RESULTS

The results of multivariate linear regression showed a negative association between high-quality carbohydrates and depressive symptoms (β: -0.147, 95 % CI: -0.239, -0.056, p = 0.002) and a positive association between low-quality carbohydrates and depressive symptoms (β: 0.018, 95 % CI: 0.007, 0.280, p = 0.001). Subsequently, we used the XGboost model to produce a comprehensive depressive symptom evaluation model and developed a corresponding online tool (http://8.130.128.194:5000/) to evaluate depressive symptoms clinically.

LIMITATIONS

The cross-sectional study could not yield any conclusions regarding causality, and the model has not been validated with external data.

CONCLUSIONS

Carbohydrate quality is associated with depressive symptoms, and machine learning models that combine diet with socioeconomic factors can be a tool for predicting depression severity.

High-entropy engineering with regulated defect structure and electron interaction tuning active sites for trifunctional electrocatalysis

High-entropy alloy nanoparticles (HEANs) possessing regulated defect structure and electron interaction exhibit a guideline for constructing multifunctional catalysts. However, the microstructure-activity relationship between active sites of HEANs for multifunctional electrocatalysts is rarely reported. In this work, HEANs distributed on multi-walled carbon nanotubes (HEAN/CNT) are prepared by Joule heating as an example to explain the mechanism of trifunctional electrocatalysis for oxygen reduction, oxygen evolution, and hydrogen evolution reaction. HEAN/CNT excels with unmatched stability, maintaining a 0.8V voltage window for 220 h in zinc-air batteries. Even after 20 h of water electrolysis, its performance remains undiminished, highlighting exceptional endurance and reliability. Moreover, the intrinsic characteristics of the defect structure and electron interaction for HEAN/CNT are investigated in detail. The electrocatalytic mechanism of trifunctional electrocatalysis of HEAN/CNT under different conditions is identified by in situ monitoring and theoretical calculation. Meanwhile, the electron interaction and adaptive regulation of active sites in the trifunctional electrocatalysis of HEANs were further verified by density functional theory. These findings could provide unique ideas for designing inexpensive multifunctional high-entropy electrocatalysts.

The impact of physical activity on household out-of-pocket medical expenditure among adults aged 45 and over in urban China: The mediating role of spousal health behaviour

Background

Increasing medical expenditure is viewed as one of the critical challenges in the context of population ageing. Physical activity (PA), as a primary prevention strategy for promoting health, is considered as an effective way to curb the excessive growth in medical expenditure. This study aimed to analyze the association between PA and the household out-of-pocket medical expenditure (HOPME) among Chinese urban adults aged 45 and over, and to explore the mediating role of spousal health behaviour.

Methods

This study analyzed a nationally longitudinal survey: 2014-2018 China Family Panel Studies (CFPS). Fixed effects regression model was applied to estimate the association between PA and annual HOPME. Sobel model was utilized to test the mediating effect.

Results

(1) PA was negatively associated with the annual HOPME among urban resident aged 45 and over in China. Exercising 1-5 times per week and maintaining the duration of each exercise session at 31-60 min were effective in reducing annual HOPME. (2) Spousal PA played a significant mediating role in the relationship between respondent's PA and annual HOPME. (3) The negative association between the respondent's PA and HOPME were found among women and those aged between 45 and 65, so was the mediating effect of spouse's PA.

Conclusion

Individual PA not only directly reduces HOPME but also indirectly contributes to this reduction by enhancing the PA levels of their spouses. To capitalize on these benefits, more actions should be taken to increase the availability of PA facilities, enhance the public awareness of PA's benefits, and encourage residents to consistently engage in regular PA.

Optimizing adjuvant treatment options for patients with glioblastoma

Background

This study focused on minimizing the costs and toxic effects associated with unnecessary chemotherapy. We sought to optimize the adjuvant therapy strategy, choosing between radiotherapy (RT) and chemoradiotherapy (CRT), for patients based on their specific characteristics. This selection process utilized an innovative deep learning method.

Methods

We trained six machine learning (ML) models to advise on the most suitable treatment for glioblastoma (GBM) patients. To assess the protective efficacy of these ML models, we employed various metrics: hazards ratio (HR), inverse probability treatment weighting (IPTW)-adjusted HR (HRa), the difference in restricted mean survival time (dRMST), and the number needed to treat (NNT).

Results

The Balanced Individual Treatment Effect for Survival data (BITES) model emerged as the most effective, demonstrating significant protective benefits (HR: 0.53, 95% CI, 0.48-0.60; IPTW-adjusted HR: 0.65, 95% CI, 0.55-0.78; dRMST: 7.92, 95% CI, 7.81-8.15; NNT: 1.67, 95% CI, 1.24-2.41). Patients whose treatment aligned with BITES recommendations exhibited notably better survival rates compared to those who received different treatments, both before and after IPTW adjustment. In the CRT-recommended group, a significant survival advantage was observed when choosing CRT over RT (p < 0.001). However, this was not the case in the RT-recommended group (p = 0.06). Males, older patients, and those whose tumor invasion is confined to the ventricular system were more frequently advised to undergo RT.

Conclusion

Our study suggests that BITES can effectively identify GBM patients likely to benefit from CRT. These ML models show promise in transforming the complex heterogeneity of real-world clinical practice into precise, personalized treatment recommendations.

Revealing the Orbital Interactions between Dissimilar Metal Sites during Oxygen Reduction Process

A FeCo/DA@NC catalyst with the well-defined FeCoN6 moiety is customized through a novel and ultrafast Joule heating technique. This catalyst demonstrates superior oxygen reduction reaction activity and stability in an alkaline environment. The power density and charge-discharge cycling of znic-air batteries driven by FeCo/DA@NC also surpass those of Pt/C catalyst. The source of the excellent oxygen reduction reaction activity of FeCo/DA@NC originates from the significantly changed charge environment and 3d orbital spin state. These not only improve the bonding strength between active sites and oxygen-containing intermediates, but also provide spare reaction sites for oxygen-containing intermediates. Moreover, various in situ detection techniques reveal that the rate-determining step in the four-electron oxygen reduction reaction is *O2 protonation. This work provides strong support for the precise design and rapid preparation of bimetallic catalysts and opens up new ideas for understanding orbital interactions during oxygen reduction reactions.

An Erythrocyte Membrane-Derived Nanosystem for Efficient Reversal of Endothelial Injury in Sepsis

Sepsis is caused by a disordered host immune in response to infection and endothelial cells perform a crucial role in boosting immunity reaction in the pathophysiology of sepsis and septic organ failure. The aim of this study is to construct a novel erythrocyte membrane-derived nanosystems to reverse endothelial damage in sepsis. Herein, an innovative nanometer calcium metal-organic framework (Ca-MOF) is generated for the first time by using chelidonic acid as a ligand and calcium chloride as an ion donor for anti-inflammation. Then, zoliflodacin is loaded into Ca-MOF (CMZ) to sterilize and nanoscale erythrocyte membrane vesicles are prepared by modification with a γ3 peptide on the surface (γ3-RM) for precise targeting. Finally, γ3-RM camouflages the nanocore CMZ, to form novel erythrocyte membrane-camouflaged nanoparticle γ3-RCMZ. The superior performance of novel nanosystem results from its suitable biocompatibility, nontoxicity, specific targeting, and anti-inflammatory and bactericidal effects. Its anti-inflammatory mechanism mainly involves inhibiting the Caspase1-nuclear factor kappa-B (Caspase1-NF-κB) pathway and oxidative stress reduction to alleviate endothelial damage. Moreover, the findings have revealed for the first time that the bactericidal drug zoliflodacin also has anti-inflammatory effects in vivo and in vitro. Therefore, the novel nanosystem (γ3-RCMZ) provides a new nanotherapy strategy for sepsis treatment.

From VIB- to VB-Group Transition Metal Disulfides: Structure Engineering Modulation for Superior Electromagnetic Wave Absorption

The laminated transition metal disulfides (TMDs), which are well known as typical two-dimensional (2D) semiconductive materials, possess a unique layered structure, leading to their wide-spread applications in various fields, such as catalysis, energy storage, sensing, etc. In recent years, a lot of research work on TMDs based functional materials in the fields of electromagnetic wave absorption (EMA) has been carried out. Therefore, it is of great significance to elaborate the influence of TMDs on EMA in time to speed up the application. In this review, recent advances in the development of electromagnetic wave (EMW) absorbers based on TMDs, ranging from the VIB group to the VB group are summarized. Their compositions, microstructures, electronic properties, and synthesis methods are presented in detail. Particularly, the modulation of structure engineering from the aspects of heterostructures, defects, morphologies and phases are systematically summarized, focusing on optimizing impedance matching and increasing dielectric and magnetic losses in the EMA materials with tunable EMW absorption performance. Milestones as well as the challenges are also identified to guide the design of new TMDs based dielectric EMA materials with high performance.

Effective early strategy to prevent olfactory and gustatory dysfunction in COVID-19: A randomized controlled trial

BACKGROUND

Olfactory and gustatory dysfunctions (OGDs) are key symptoms of COVID-19, which may lead to neurological complications, and lack of effective treatment. This may be because post-disease treatments may be too late to protect the olfactory and gustatory functions.

AIM

To evaluate the effectiveness of early use of saline nasal irrigation (SNI), corticosteroid nasal spray, and saline or chlorhexidine gluconate mouthwash for preventing OGDs in COVID-19.

DESIGN

This study was a double-blind randomized controlled trial.

METHODS

The study was conducted from May 5 to June 16, 2022. We recruited patients from three hospitals who were admitted with COVID-19 but without OGDs on the day of admission. Olfactory and gustatory functions were evaluated using the Taste and Smell Survey and the numerical visual analog scale. Participants were randomized to the saline, drug, or control groups. The control group received no intervention, saline group received SNI plus saline nasal spray and mouthwash, and the trial group received SNI plus budesonide nasal spray and chlorhexidine gluconate mouthwash. Participants were assessed again on the day of discharge.

RESULTS

A total of 379 patients completed the trial. The prevalence of OGDs was significantly lower in the saline (11.8%, 95% CI, 6.6-19.0%; P < 0.001) and trial (8.3%, 95% CI, 4.1-14.8%; P < 0.001) groups than in the control group (40.0%, 95% CI, 31.8-48.6%). Additionally, both interventions reduced the severity of OGDs.

CONCLUSIONS

We demonstrated effective strategies for preventing COVID-19-related OGDs, and the findings may guide early management of SARS-CoV-2 infection to reduce the incidence of COVID-19-related complications.

Association between depression and quality of life in older adults with type 2 diabetes: A moderated mediation of cognitive impairment and sleep quality

BACKGROUND

The acceleration of aging and the increase in life expectancy have resulted in an increasing number of older adults developing physical and mental comorbidities. We examined the association between depression and quality of life (QoL) using cognitive impairment (COI) as a mediator and sleep quality (SQ) as a moderator among older adults with type 2 diabetes.

METHODS

A total of 2646 participants from Weifang, Shandong, China completed the survey. Their depression, cognitive function, SQ, and QoL were assessed. PROCESS was used to investigate mediating and moderating effects.

RESULTS

COI mediated the association between depression and QoL (indirect effect = -0.1058, bootstrapped 95 % CI [-0.1417, -0.0725]). Moderated mediation analyses indicated that SQ moderated the first half of the pathway of depression's impact on QoL through COI (moderating effect = -0.1128, bootstrapped 95 % CI [-0.1981, -0.0348]). Depression negatively impacted cognitive function in participants with poor (vs. better) SQ.

LIMITATIONS

First, multiple assessment tools should be considered to increase objective assessment. Second, the cross-sectional design limited our ability to make causal inferences. Third, additional diabetes-related variables should be included to explore this relationship. Finally, the pathways of influence and mechanisms of action of COI in older adults should be explored further.

CONCLUSION

Depression could impair the QoL of older adults by aggravating their COI. Fortunately, improving patients' SQ may undermine this negative effect. These findings may play an integral role in promoting the psychiatric health of older adults with type 2 diabetes.

Association between the location of social medical insurance and social integration among China's elderly rural migrants: a nationwide cross-sectional study

BACKGROUND

Universal social medical insurance coverage is viewed as a major factor in promoting social integration, but insufficient evidence exists on the integration of elderly rural migrants (ERM), generally aged 60 years and above, in low- and middle-income countries. To address this problem, we explore the relationship between the location of social medical insurance (SMI), such as a host city, and social integration in the context of Chinese ERM.

METHODS

This study is based on data from the 2017 National Internal Migrant Dynamic Monitoring Survey in China. The study participants were Chinese ERM. An integration index was constructed to measure the degree of social integration in a multi-dimensional manner using a factor analysis method. This study used descriptive statistics and one-way analysis of variance to explore the differences in social integration between ERM with SMI from host cities and hometowns. Stepwise multiple linear regression analysis was used to test the correlation between SMI location and social integration level in the overall sample. Finally, the results were verified by propensity score matching.

RESULTS

It was found that 606 (18.2%) of the insured ERM chose host city SMI, while 2727 (81.8%) chose hometown SMI. The level of social integration was lower among ERM with hometown SMI (-1.438 ± 32.795, F = 28.311, p ≤ 0.01) than those with host city SMI (6.649 ± 34.383). Among the dimensions of social integration, social participation contributed more than other factors, with a contribution rate of 45.42%. Host city SMI increased the probability of the social integration index by 647% among ERM (k-nearest neighbor caliper matched (n = 4, caliper = 0.02), with a full sample ATT value of 6.47 (T = 5.32, SE = 1.48, p < 0.05)).

CONCLUSIONS

ERM with host city SMI have a higher social integration level than those with hometowns SMI. That is, host city SMI positively affects social integration. Policymakers should focus on the access of host city SMI for ERM. Removing the threshold of host city SMI coverage for ERM can promote social integration.

Multiple heart-cutting two-dimensional liquid chromatography/charged aerosol detector assay of ginsenosides for quality evaluation of ginseng from diverse Chinese patent medicines

For quality control of Chinese patent medicines (CPMs) containing the same herbal medicine or different herbal medicines that have similar chemical composition, current ″one standard for one species″ research mode leads to poor universality of the analytical approaches unfavorable to discriminate easily confused species. Herein, we were aimed to elaborate a multiple heart-cutting two-dimensional liquid chromatography/charged aerosol detector (MHC-2DLC/CAD) approach to quantitatively assess ginseng from multiple CPMs. Targeting baseline resolution of 16 ginsenosides (noto-R1/Rg1/Re/Rf/Ra2/Rb1/Rc/Ro/Rb2/Rb3/Rd/Rh1/Rg2/Rg3/Rg3(R)/24(R)-p-F11), experiments were conducted to optimize key parameters and validate its performance. A Poroshell 120 EC-C18 column and an XBridge Shield RP18 column were separately utilized in the first-dimensional (1D) and the second-dimensional (2D) chromatography. Eight consecutive cuttings could achieve good separation of 16 ginsenosides within 85 min. The developed MHC-2DLC/CAD method showed good linearity (R2 > 0.999), repeatability (RSD < 6.73%), stability (RSD < 5.63%), inter- and intra-day precision (RSD < 5.57%), recovery (93.76-111.14%), and the limit of detection (LOD) and limit of quantification (LOQ) varied between 0.45-2.37 ng and 0.96-4.71 ng, respectively. We applied it to the content determination of 16 ginsenosides simultaneously from 28 different ginseng-containing CPMs, which unveiled the ginsenoside content difference among the tested CPMs, and gave useful information to discriminate ginseng in the preparation samples, as well. The MHC-2DLC/CAD approach exhibited advantages of high specificity, good separation ability, and relative high analysis efficiency, which also justified the feasibility of our proposed ″Monomethod Characterization of Structure Analogs″ strategy in quality evaluation of diverse CPMs that contained different ginseng.

Persulfate promoted carbamoylation of N-arylacrylamides and N-arylcinnamamides with 4-carbamoyl-Hantzsch esters

Carbamoyl-Hantzsch esters were used as carbamoyl radical precursors for oxidative carbamoylation of N-arylacrylamides and N-arylcinnamamides in the presence of inexpensive persulfates. This protocol can be applied to a broad range of substrates with various functional groups, providing a variety of 3,3-disubstituted oxindoles and 3,4-disubstituted dihydroquinolin-2(1H)-ones in moderate to good yields via an intermolecular addition/cyclization process.

Highly Stable, Mechanically Enhanced, and Easy-to-Collect Sodium Alginate/NZVI-rGO Gel Beads for Efficient Removal of Cr(VI)

Nanoscale zero-valent iron (NZVI) is a material that is extensively applied for water pollution treatment, but its poor dispersibility, easy oxidation, and inconvenient collection limit its application. To overcome these drawbacks and limit secondary contamination of nanomaterials, we confine NZVI supported by reduced graphene oxide (rGO) in the scaffold of sodium alginate (SA) gel beads (SA/NZVI-rGO). Scanning electron microscopy showed that the NZVI was uniformly dispersed in the gel beads. Fourier transform infrared spectroscopy demonstrated that the hydrogen bonding and conjugation between SA and rGO allowed the NZVI-rGO to be successfully embedded in SA. Furthermore, the mechanical strength, swelling resistance, and Cr(VI) removal capacity of SA/NZVI-rGO were enhanced by optimizing the ratio of NZVI and rGO. Interestingly, cation exchange may drive Cr(VI) removal above 82% over a wide pH range. In the complex environment of actual Cr(VI) wastewater, Cr(VI) removal efficiency still reached 70.25%. Pseudo-first-order kinetics and Langmuir adsorption isotherm are preferred to explain the removal process. The mechanism of Cr(VI) removal by SA/NZVI-rGO is dominated by reduction and adsorption. The sustainable removal of Cr(VI) by packed columns could be well fitted by the Thomas, Adams-Bohart, and Yoon-Nelson models, and importantly, the gel beads maintained integrity during the prolonged removal. These results will contribute significant insights into the practical application of SA/NZVI-rGO beads for the Cr(VI) removal in aqueous environments.

Identification of potential hub genes linked to immune and metabolic alterations in postoperative systemic inflammatory dysregulation

Background

Postoperative systemic inflammatory dysregulation (PSID) is characterised by strongly interlinked immune and metabolic abnormalities. However, the hub genes responsible for the interconnections between these two systemic alterations remain to be identified.

Methods

We analysed differentially expressed genes (DEGs) of individual peripheral blood nucleated cells in patients with PSID (n = 21, CRP > 250 mg/L) and control patients (n = 25, CRP < 75 mg/L) following major abdominal surgery, along with their biological functions. Correlation analyses were conducted to explore the interconnections of immune-related DEGs (irDEGs) and metabolism-related DEGs (mrDEGs). Two methods were used to screen hub genes for irDEGs and mrDEGs: we screened for hub genes among DEGs via 12 algorithms using CytoHubba in Cytoscape, and also screened for hub immune-related and metabolic-related genes using weighted gene co-expression network analysis. The hub genes selected were involved in the interaction between changes in immunity and metabolism in PSID. Finally, we validated our results in mice with PSID to confirm the findings.

Results

We identified 512 upregulated and 254 downregulated DEGs in patients with PSID compared with controls. Gene enrichment analysis revealed that DEGs were significantly associated with immune- and metabolism-related biological processes and pathways. Correlation analyses revealed a close association between irDEGs and mrDEGs. Fourteen unique hub genes were identified via 12 screening algorithms using CytoHubba in Cytoscape and via weighted gene co-expression network analysis. Among these, CD28, CD40LG, MAPK14, and S100A12 were identified as hub genes among both immune- and metabolism-related genes; these genes play a critical role in the interaction between alterations in immunity and metabolism in PSID. The experimental results also showed that the expression of these genes was significantly altered in PSID mice.

Conclusion

This study identified hub genes associated with immune and metabolic alterations in patients with PSID and hub genes that link these alterations. These findings provide novel insights into the mechanisms underlying immune and metabolic interactions and new targets for clinical treatment can be proposed on this basis.

The Impact of Self-Efficacy on Nurses' Well-Being: Does Digital Competence Matter?

PURPOSE

Drawing on person-environment fit theory and social cognitive theory, this study aimed to examine how self-efficacy affects nurses' workplace well-being via person-job fit and the moderating role of digital competence.

METHODS

A two-wave survey was conducted to collect data. Data were collected from six hundred and ninety-five nurses at three Chinese hospitals between May 2022 and September 2022. We employed hierarchical regression analysis and bootstrapping to analyze the data.

RESULTS

Self-efficacy positively influenced person-job fit (β = .55, p < .001), which positively affected nurses' workplace well-being (β = .32, p < .001). Person-job fit mediated the effect of self-efficacy on nurses' workplace well-being. Additionally, digital competence strengthened the positive impact of self-efficacy on person-job fit (β = .12, p < .001).

CONCLUSION

Recruiting nurses with both self-efficacy and digital competence benefits hospitals. It is critical for nurses to improve their digital competence for achieving person-job fit and attaining workplace well-being in the post-coronavirus disease 2019 (COVID-19) era.

Atomically dispersed copper sites on titanium zirconium oxide accelerate the simultaneous oxidative removal of organic carbon and ammonia from landfill leachate

Landfill leachate is a refractory wastewater. Low-temperature catalytic air oxidation (LTCAO) has shown considerable potential for leachate treatment owing to its green and simple operation, but the simultaneous removal of chemical oxygen demand (COD) and ammonia from leachate remains challenging. Herein, TiZrO₄ @Cu_SA hollow spheres with high-loading single-atom Cu were synthesized using isovolumic vacuum impregnation and co-calcination methods, and the catalyst was applied to the LTCAO treatment of real leachate. Consequently, the removal rate of UV₂₅₄ reached 66% at 90 °C within 5 h, while that for COD was 88%. Simultaneously, the NH₃/NH₄⁺ (33.5 mg/L, 100 wt%) in the leachate was oxidized to N₂ (88.2 wt%), NO₂^--N (11.0 wt%), and NO₃^--N (0.3 wt%) owing to the effect of free radicals. The single-atom Cu co-catalyst in TiZrO₄ @Cu_SA exhibited a localized surface plasmon resonance effect at the active center, which could quickly transfer electrons to O₂ in water to form O₂^.- with a high activation efficiency. The degradation products were determined and the deduced pathway was as follows: the bonds joining benzene rings were first broken, and then the ring structure was further opened to produce acetic acid and other simple organic macromolecules, which were finally mineralized to CO₂ and H₂O.

Global, Regional, and National Burden of Pancreatic Cancer, 1990-2019: Results from the Global Burden of Disease Study 2019

Aims

Pancreatic cancer (PC) is a malignant tumor with a strong invasive nature and low survival rate. We aimed to estimate the PC burden at the global, regional, and national levels in 204 countries from 1990 to 2019.

Methods

Detailed data, including the incidence, death, and disability-adjusted life years (DALYs), were analyzed from the Global Burden of Diseases Study 2019.

Results

Globally, there were 530,297 (486,175-573,635) incident cases and 531,107 (491,948-566,537) deaths from PC in 2019. The age-standardized incidence rate (ASIR) was 6.6 (6-7.1), and the age-standardized mortality rate (ASMR) was 6.6 (6.1-7.1) per 100,000 person-years. PC caused 11,549,016 (10,777,405-12,338,912) DALYs, with an age-standardized rate of 139.6 (130.2-149.1) per 100,000 person-years. There were increases in estimated annual percentage changes (EAPCs) of ASIR (0.83; 0.78-0.87), ASMR (0.77; 0.73-0.81), and age-standardized DALYs rate (ASDR) (0.67; 0.63-0.71). The global number of incident cases increased by 168.7%, from 197,348 (188,604-203,971) to 530,297 (486,175-573,635); the number of deaths increased by 168.2% from 198,051 (189,329-204,763) to 531,107 (491,948-566,537); and total DALYs increased by 148.5% from 4,647,207 (4,465,440-4,812,129) to 11,549,016 (10,777,405-12,338,912). East Asia and China recorded the highest number of incident cases, deaths, and DALYs. The proportion of deaths was attributable to smoking (21.4%), elevated fasting glucose (9.1%), and high BMI (6%).

Conclusions

Our study updated the epidemiological trends and risk factors for PC. PC remains a major hazard to the sustainability of health systems worldwide, with an increasing incidence rate and mortality from 1990 to 2019. More targeted strategies are required to prevent and treat PC.

Enhanced methane production from the co-digestion of food waste and thermally hydrolyzed sludge filtrate

Although many technologies can be applied to sewage sludge (SS) and food waste (FW) treatment, high investment and operational costs, high land occupation, and the "not-in-my-backyard" effect pose many challenges in practice. Thus, it is important to develop and utilize low-carbon or negative-carbon technologies to tackle the carbon problem. This paper proposes a method of anaerobic co-digestion of FW and SS, thermally hydrolyzed sludge (THS), or THS filtrate (THF) to enhance their methane potential. Compared to the co-digestion of SS with FW, the methane yield of the co-digestion of THS and FW was 9.7-69.7% higher, and that of the co-digestion of THF and FW was 11.1-101.1% higher. The synergistic effect was weakened with the addition of THS but enhanced with the addition of THF, potentially owing to the change in humic substances. Filtration removed most humic acids (HAs) from THS but retained fulvic acids (FAs) in THF. Moreover, THF produced 71.4% of the methane yield of THS, although only 25% of the organic matter permeated from THS to THF. This indicated that hardly biodegradable substances remained in the dewatering cake and were removed from anaerobic digestion systems. The results indicate that the co-digestion of THF and FW is an effective way to enhance methane production.

Regulated High-Spin State and Constrained Charge Behavior of Active Cobalt Sites in Covalent Organic Frameworks for Promoting Electrocatalytic Oxygen Reduction

A novel type of covalent organic frameworks has been developed by assembling definite cobalt-nitrogen-carbon configurations onto carbon nanotubes using linkers that have varying electronic effects. This innovative approach has resulted in an efficient electrocatalyst for oxygen reduction, which is understood by a combination of in situ spectroelectrochemistry and the bond order theorem. The strong interaction between the electron-donating carbon nanotubes and the electron-accepting linker mitigates the trend of charge loss at cobalt sites, while inducing the generation of high spin state. This enhances the adsorption strength and electron transfer between the cobalt center and reactants/intermediates, leading to an improved oxygen reduction capability. This work not only presents an effective strategy for developing efficient non-noble metal electrocatalysts through reticular chemistry, but also provides valuable insights into regulating the electronic configuration and charge behavior of active sites in designing high-performance electrocatalysts.

Role of ALOX5 in non-small cell lung cancer: A potential therapeutic target associated with immune cell infiltration

OBJECTIVES

The efficacy of immunotherapy for lung cancer is closely related to immune cell infiltration. Arachidonic acid 5-lipoxygenase (ALOX5) can activate inflammatory responses and trigger various cell death patterns; however, the relevance of ALOX5 to immune cell infiltration in lung cancer is unclear. The expression of ALOX5 in non-small cell lung cancer (NSCLC) is analyzed using an online database to explore the correlation between ALOX5 and immune cell infiltration in NSCLC and its relationship with prognosis.

METHODS

Differences in ALOX5 expression in NSCLC and normal lung tissues were analyzed by online databases such as TIMER, GEPIA and HPA; the UALCAN database was used to reveal the relationship between ALOX5 and clinical features; Kaplan-Meier database was applied to explore the prognostic value of ALOX5; GeneMANIA and String Website was used to explore genes and proteins associated with ALOX5 expression, respectively; the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were used to analyze ALOX5 differential genes which were picked up through the TCGA database; GSEA software was applied to predict the signal pathways that ALOX5 may be involved in; and the TIMER database was used to analyze the effect of ALOX5 expression on the level of immune cell infiltration.

RESULTS

Compared with the normal lung tissues, the ALOX5 expression was low in NSCLC tissues (P<0.05), and which affected the prognosis of lung cancer patients. The expression level of ALOX5 was related to clinical features such as sex, age, metastasis, and pathological staging in NSCLC patients (all P<0.05). The gene interaction network analysis found that the genes interacting with ALOX5 mainly included the genes related to lipid oxidation and pro-inflammatory mediators such as coactosin like protein 1 (COTL1), leukotriene C4 synthase (LTC4S), and prostaglandin endoperoxide synthase 2 (PTGS2), and the protein-protein interaction analysis results were consistent. GO and KEGG analysis found that ALOX5 was involved in the biological process of activation of immune cell function and was involved in immune response function pathways. The GSEA analysis showed that ALOX5 may activate immune responses and mediate immune-related prognosis by affecting the cytokine-cytokine receptor interactions, natural killer-mediated cytotoxicity, and T cell receptor signaling pathways. The ALOX5 mRNA expressions in lung adenocarcinoma and lung squamous cell carcinoma were positively correlated with the tumor infiltration immune cells (B cells, CD8+ T cells, CD4+ T cells, etc.) (all P<0.05), and the ALOX5 mRNA expression was positively correlated with the expression of classic T cell immune checkpoint inhibitor genes (P<0.001).

CONCLUSIONS

The ALOX5 gene expression in NSCLC is significantly downregulated, and which can affect NSCLC prognosis and immune cell infiltration levels. ALOX5 gene may be a potential biomarker of NSCLC prognosis associated with immune cell infiltration.

Alterations in smell or taste in individuals infected with SARS-CoV-2 during periods of Omicron variant dominance

OBJECTIVES

To characterize the prevalence, severity, correlation with initial symptoms, and role of vaccination in patients with COVID-19 with smell or taste alterations (STAs).

METHODS

We conducted an observational study of patients infected with SARS-CoV-2 Omicron admitted to three hospitals between May 17 and June 16, 2022. The olfactory and gustatory functions were evaluated using the taste and smell survey and the numerical visual analog scale at two time points.

RESULTS

The T1 and T2 time point assessments were completed by 688 and 385 participants, respectively. The prevalence of STAs at two time points was 41.3% vs 42.6%. Furthermore, no difference existed in the severity distribution of taste and smell survey, smell, or taste visual analog scale scores between the groups. Patients with initial symptoms of headache (P = 0.03) and muscle pain (P = 0.04) were more likely to develop STAs, whereas higher education; three-dose vaccination; no symptoms yet; or initial symptoms of cough, throat discomfort, and fever demonstrated protective effects, and the results were statistically significant.

CONCLUSION

The prevalence of STAs did not decrease significantly during the Omicron dominance, but the severity was reduced, and vaccination demonstrated a protective effect. In addition, the findings suggest that the presence of STAs is likely to be an important indicator of viral invasion of the nervous system.

Remove humic acid from water quickly using only oxygen and sulfite at nickel cobalt spinel catalyst

The typical refractory organic pollutant, humic acid (HA), causes many water and wastewater treatment obstacles. In this study, a novel method was proposed to degrade HA based on the low-temperature (<100 °C) catalytic air oxidation technology (LTCAO) using the NiCo-spinel (NCO) as a catalyst and the sulfite as a promoter. Sulfite enhanced the quantity of mineralized HA to 2.4 times that without sulfite assistance, and the removal rate of total organic carbon reached 93.1% within 60 min at 90 °C. HA gradually degrades into small organic molecules and is mineralized through interfacial reactions and radical paths. Sulfite plays a triple role in these reactions. Sulfite sulfonated HA destroyed its pseudomicellar structure, making HA easily oxidized. Sulfite also coordinated with NCO and promoted the internal electronic hopping conduction of NCO because of the fast electron transfer between SO₃^2- and the h⁺sites, thus accelerating the electron transfer between HA and O₂ mediated by NCO. In addition, the coordinated SO₃^2- was activated to form the radical ∙SO₃^-, which strengthened the oxidation of HA. This study supports a simple and green method for efficiently cleaning water and wastewater rich in HA.

[Formation of professor Mao Xiejun's thoughts on stomatological education]

Professor Mao Xiejun wrote a report about dental education of China in 1935. From 1948 to 1950, he published three articles containing the educational idea of "developing dentistry into stomatology". When he served as the director of the Faculty of Dentistry of Peking University Medical School in July 1950, he proposed to rename the Faculty of Dentistry into the Faculty of Stomatology,which were approved by the Ministry of Health and the Ministry of Education of the People's Republic of China in one month. The Chinese Medical Association established the Society of Stomatology the next year. Later, dentistry was successively changed into stomatology, and medical content was integrated into dental education, which was of great significance and far-reaching influence. During the developments of the thought of stomatological education in China, Professor Mao Xiejun evidently played a pivotal role. In this paper, the formation process of the thoughts of stomatological education related to professor Mao Xiejun's contribution is elucidated through studying the archives, personal letters, and historical documents, so as to enrich the researches on the history of stomatology in China and to facilitate better understanding and promoting the development of stomatology.

Removal of Hexavalent Chromium in Aqueous Solution by Cellulose Filter Paper Loaded with Nano-Zero-Valent Iron: Performance Investigation and Numerical Modeling

Cr(VI) pollution in water bodies is very harmful to human health and the environment. Therefore, it is necessary to remove Cr(VI) from water. In this study, the composite (FP-nZVI) was prepared by loading nano-zero-valent iron (nZVI) onto cellulose filter paper (FP) using a liquid-phase reduction method to improve the dispersibility and oxidation resistance of nZVI. In batch experiments, the effects of iron loading of FP-nZVI, initial concentration of Cr(VI), temperature, and pH on Cr(VI) removal were particularly investigated. The maximum removal rate of 98.6% was achieved at 25 °C, pH = 5, initial concentration of Cr(VI) of 20 mg/L, and FeCl₃·6H₂O solution concentration of 0.8 mol/L. The removal of Cr(VI) by FP-nZVI conformed to a pseudo-second-order kinetic model and Langmuir isotherm model. The mechanism of Cr(VI) removal was a multi-step removal mechanism, involving adsorption, reduction, and coprecipitation. Column experiments investigated the effect of flow rate (1 mL/min, 3 mL/min, and 5 mL/min) on Cr(VI) removal. We found that increasing flow rate slightly decreased the removal rate of Cr(VI). The transport of Cr(VI) in composite porous media was simulated using HYDRUS-1D, and the results show that the two-site model can well simulate the reactive transport of Cr(VI). This study may provide a useful reference for the remediation of groundwater contaminated with Cr(VI) or other similar heavy metals using FP-nZVI.

Influence of Dust Layers in Connecting Pipes on Explosion Propagation Characteristics of Flake Aluminum Powder in Cylindrical Interconnected Vessels

Aluminum dust explosion has become an important type of dust explosion accident. In the present work, an interconnected system is established to study the influence of accumulated dust layers in connecting pipes on explosion propagation characteristics. A high-precision computational fluid dynamics (CFD) method is applied to study the overpressure and flame development of aluminum powder explosion under the central ignition condition of two cylindrical vessels with a volume ratio of 1:5. The results show that pressure build-up in the secondary container is mainly due to the oscillating pressure wave. Moreover, compared with the ignition container, the thickness of the dust layer has a more obvious enhancement effect on the peak overpressure for the secondary container. When the ignition occurs in a large container, the dust layer is lifted in the connecting pipe under the action of the precursor pressure wave. After the jet flame enters the connecting pipe, the lifted aluminum dust participates in the explosion reaction, which significantly increases the explosion intensity. With the participation of the accumulated dust layer, the maximum overpressure of the explosion of flake aluminum dust in the interconnected system is higher than 30 bar, and the jet flame velocity is increased by 3 times. The present work can provide reference for the safety design of process equipment involving dust.

Relationship Between Physical Exercise and Cognitive Impairment Among Older Adults with Type 2 Diabetes: Chain Mediating Roles of Sleep Quality and Depression

Objective

Although physical exercise has been shown to boost physical, psychological, and psychiatric conditions in older adults, there is a relative lack of research on the mechanisms involved in this process for older adults with type 2 diabetes mellitus (T2DM). We thus evaluated whether sleep quality and depression mediated the relationship between physical exercise and cognitive impairment in older adults with T2DM by focusing on the exercise-physiology-psychology and psychiatry connection.

Methods

Self-reported data were collected from 2646 older adults with T2DM in Weifang, Shandong, China. Regression and bootstrap analyses were conducted to explore the chain mediator model including physical exercise, cognitive impairment, sleep quality, and depression.

Results

Engaging in physical exercise (coefficient = -0.6858, p < 0.001), high levels of sleep quality (coefficient = -0.3397, p = 0.015), and low levels of depression (coefficient = 0.3866, p < 0.001) were significantly associated with a low level of cognitive impairment. Sleep quality and depression mediated the chain effect between physical exercise and cognitive impairment (total effect = -1.0732, 95% CI [-1.3652, -0.7862]; direct effect = -0.6858, 95% CI [-0.9702, -0.3974]; indirect effect = -0.3875, 95% CI [-0.5369, -0.2521]).

Conclusion

Physical exercise may improve sleep quality in older adults with T2DM, alleviating depression and delaying the development of cognitive impairment. Physical exercise can enhance patients' ability to resist depression and cognitive impairment, and creating comfortable sleep environments can also reinforce the effects of this process. These findings have important implications for promoting healthy aging in older adults with T2DM.

Association between Participation of Children with Disabilities and the Child, Family, and Environmental Factors in Shanghai, China: A Cross-Sectional Study

Participation is essential to a child's health and well-being, whereas children with disabilities may lack the associated benefits because of physical restrictions. This study aims to examine the association between the participation of children with disabilities and the child, family, and environmental factors. A total of 433 children with disabilities aged 3-18 and their family caregivers were included. Three binary logistic regression models were respectively established to identify the significant factors associated with children's home, school, and community participation. Our main empirical results showed that among 433 children with disabilities, 44.3%, 47.6%, and 58.7% of them never or seldom participated in home, school, and community activities. Child and family factors were found to be dominantly associated with children's participation, and significant factors associated with the home, school, and community participation of children were different, including children's disability type, sleep problems and emotional stability, caregivers' education, mental HRQOL, rehabilitation belief, and number of children in the family. These results highlight that the participation of children with disabilities in mainland China urgently needs to be enhanced, and further research might be focused on validating the causal relationships between participation and significant child and family factors identified in this study.

Tunable electronic properties and related functional devices for ferroelectric In2Se3/MoSSe van der Waals heterostructures

In recent years, two-dimensional (2D) materials have attracted increasing attraction in a number of scientific research fields. In particular, ferroelectric materials with reversible spontaneous electric polarization and Janus transition metal dichalcogenides (TMDs) with intrinsic dipoles exhibit novel properties for many practical applications. Here, the electronic properties of van der Waals (vdW) heterostructures consisting of In₂Se₃ and MoSSe were investigated based on a first-principles approach. It was demonstrated that four studied In₂Se₃/MoSSe heterostructures exhibited obvious band gap (E _g) differences, ranging 0.13 to 0.90 eV for PBE (0.47 to 1.50 eV for HSE06) owing to the reversible spontaneous electric polarization of In₂Se₃ and different intrinsic dipole of MoSSe, and different band alignments of type-I or type-II could also be obtained. The energy bands of the four vdW heterostructures could be obviously regulated by varying degrees of vertical (horizontal) strain and vertical interface electric field, and the E _g varied from zero to 1.27 eV. Then, M4-based mechanical switching devices and ferroelectric diodes were designed based on the significant strain and electric field function. These results provide one possible mechanism for how the polarization direction regulates the physical properties of the system due to the different charges on the two surfaces of the out-of-plane polarized ferroelectric material, which may lead to different proximity effects on the face of the material.

An Anterior Cingulate Cortex-to-Midbrain Projection Controls Chronic Itch in Mice

Itch is an unpleasant sensation that provokes the desire to scratch. While acute itch serves as a protective system to warn the body of external irritating agents, chronic itch is a debilitating but poorly-treated clinical disease leading to repetitive scratching and skin lesions. However, the neural mechanisms underlying the pathophysiology of chronic itch remain mysterious. Here, we identified a cell type-dependent role of the anterior cingulate cortex (ACC) in controlling chronic itch-related excessive scratching behaviors in mice. Moreover, we delineated a neural circuit originating from excitatory neurons of the ACC to the ventral tegmental area (VTA) that was critically involved in chronic itch. Furthermore, we demonstrate that the ACC→VTA circuit also selectively modulated histaminergic acute itch. Finally, the ACC neurons were shown to predominantly innervate the non-dopaminergic neurons of the VTA. Taken together, our findings uncover a cortex–midbrain circuit for chronic itch-evoked scratching behaviors and shed novel insights on therapeutic intervention.

Education and development of rehabilitation therapy in China under the background of aging

The World Health Organization (WHO) estimates that about one-third of people worldwide currently have a need for rehabilitation. This demand is expected to increase in the coming years due to changes in population health and characteristics. For example, with the intensification of global aging, the rehabilitation needs of patients with chronic diseases and disabilities, postoperative dysfunction, and cognitive impairment continue to grow, and emergencies such as conflicts, disasters, and epidemics may lead to a surge in rehabilitation needs. Early and sustained rehabilitation could reduce complications, improve function, and reduce disability in affected populations, but rehabilitation services are often underestimated due to underfunding and poor short-term outcomes. WHO sees rehabilitation as an essential part of achieving universal health coverage and the Sustainable Development Goals. With the development of China's economy and society and the trend of an aging population, the demand for rehabilitation therapists is growing rapidly. Since the development of rehabilitation education in China at the beginning of this century, great progress has been made in both the training mode and the number of people trained, especially in the construction of higher education of rehabilitation in related colleges and universities. Through descriptive qualitative analysis, this study collected information from national policy documents and official websites of colleges and universities on policies concerning degree systems, cultivating goals and ideas, courses, education internationalization, continuing education in practice, standardized training after graduation, the number of colleges and universities with rehabilitation therapy related majors in China, and summarizes the current situation of the development of rehabilitation personnel education in Chinese colleges and universities. Judging from the results, during the development of rehabilitation education, China has continuously improved in terms of policy support, educational goals and concepts, the number and quality of institutions, degree systems, and internationalization, while gradually adapting to China's development status. This also provides direction and feasible suggestions for China to improve the rehabilitation education development system and formulate a national rehabilitation education plan in the future to deal with the challenge of aging.

Cortical pain induced by optogenetic cortical spreading depression: from whole brain activity mapping

BACKGROUND

Cortical spreading depression (CSD) is an electrophysiological event underlying migraine aura. Traditional CSD models are invasive and often cause injuries. The aim of the study was to establish a minimally invasive optogenetic CSD model and identify the active networks after CSD using whole-brain activity mapping.

METHODS

CSD was induced in mice by light illumination, and their periorbital thresholds and behaviours in the open field, elevated plus-maze and light-aversion were recorded. Using c-fos, we mapped the brain activity after CSD. The whole brain was imaged, reconstructed and analyzed using the Volumetric Imaging with Synchronized on-the-fly-scan and Readout technique. To ensure the accuracy of the results, the immunofluorescence staining method was used to verify the imaging results.

RESULTS

The optogenetic CSD model showed significantly decreased periorbital thresholds, increased facial grooming and freezing behaviours and prominent light-aversion behaviours. Brain activity mapping revealed that the somatosensory, primary sensory, olfactory, basal ganglia and default mode networks were activated. However, the thalamus and trigeminal nucleus caudalis were not activated.

CONCLUSIONS

Optogenetic CSD model could mimic the behaviours of headache and photophobia. Moreover, the optogenetic CSD could activate multiple sensory cortical regions without the thalamus or trigeminal nucleus caudalis to induce cortical pain.

SrB4O7:Sm2+ fluorescence improves the accuracy of temperature measurements in externally heated diamond anvil cells

The sample temperature in an externally heated diamond anvil cell (EHDAC) is generally measured by a thermocouple fixed to the pavilions of diamond anvils, ignoring the temperature difference between the thermocouple and the sample. However, the measured temperature depends strongly on the placement of the thermocouple, thus seriously reducing the accuracy of the temperature measurement and hindering the use of EHDAC in experiments requiring precise temperature measurements, such as high-pressure melting and phase-diagram investigations. In this study, the full width at half maximum (FWHM) of the 0-0 fluorescence line of strontium borate doped with bivalent samarium ions (SrBO₄:Sm²⁺, SBO) is found to be highly sensitive to temperature and responds extremely rapidly to small temperature fluctuations, which makes it an excellent temperature indicator. We propose herein a precise method to measure temperature that involves measuring the FWHM of the 0-0 fluorescence line of SBO. This method is used to correct the temperature discrepancy between the thermocouple and the sample in an EHDAC. These corrections significantly improve the accuracy of temperature measurements in EHDACs. The accuracy of this method is verified by measuring the melting point of tin at ambient pressure. We also use this method to produce a tentative elementary phase diagram of tin up to 109 GPa and 495 K. This method facilitates high-pressure, high-temperature experiments demanding accurate temperature measurements in various disciplines. The study also discusses, in general, the experimental approach to measuring temperature.

Satisfaction of family physician team members in the context of contract system: A cross-sectional survey from Shandong Province, China

Background

Family physicians play a key role in responding to the growing demand for primary healthcare due to aging. The work attitude of family physician team members (FPTMs) impacts their work efficiency and quality. Knowing how satisfied they are with their jobs can help identify potential directions and entry points for incentives. The purpose of this study is to analyze the job satisfaction status and influencing factors of grassroots health service personnel after the implementation of the family physician contract system in China.

Methods

The study conducted a cross-sectional survey with 570 FPTMs in three prefecture-level cities in the Shandong Province. Satisfaction was measured using 30 items across seven dimensions. Responses were recorded on a 5-point Likert scale. Descriptive statistical analysis was used to analyze the general information and satisfaction of FPTMs. Multiple linear regression analysis was used to analyze the factors influencing job satisfaction.

Results

The overall job satisfaction among FPTMs was not high. Among the seven dimensions, interpersonal relationships had the highest satisfaction (4.10 ± 0.78), while workload had the lowest satisfaction (3.08 ± 0.56). The satisfaction levels of the three sample regions were different, and the results were opposite to their regional economic development levels. The results of the multifactor analysis showed that gender, income level, educational background, working years, daily working hours, number of training sessions per year and the proportion of performance pay had significant impact on overall job satisfaction.

Conclusions

The development of a family physician contract system has increased the workload of FPTMs. In addition to the implementation of the new policy, attention should be paid to the workload and working attitude of family physicians. The fundamental measures should focus on attracting more personnel to work at the grassroots level by accelerating education and training to solve the problem of insufficient health personnel at the grassroots level. Simultaneously, attention should be paid to the improvement of the medical staff's salary level and the need for self-promotion, such as training.

Preferential subcortical collateral projections of pedunculopontine nucleus-targeting cortical pyramidal neurons revealed by brain-wide single fiber tracing

The pedunculopontine nucleus (PPN) is a heterogeneous midbrain structure involved in various brain functions, such as motor control, learning, reward, and sleep. Previous studies using conventional tracers have shown that the PPN receives extensive afferent inputs from various cortical areas. To examine how these cortical axons make collateral projections to other subcortical areas, we used a dual-viral injection strategy to sparsely label PPN-targeting cortical pyramidal neurons in CaMKIIα-Cre transgenic mice. Using a high-speed volumetric imaging with on-the-fly-scan and Readout (VISoR) technique, we visualized brain-wide axonal projections of individual PPN-targeting neurons from several cortical areas, including the prelimbic region (PL), anterior cingulate area (ACA) and secondary motor cortex (MOs). We found that each PPN-projecting neuron had a unique profile of collateralization, with some subcortical areas being preferential targets. In particular, PPN-projecting neurons from all three traced cortical areas exhibited common preferential collateralization to several nuclei, with most neurons targeting the striatum (STR), lateral hypothalamic area (LHA) and periaqueductal gray (PAG), and a substantial portion of neurons also targeting the zona incerta (ZI), median raphe nucleus (MRN) and substantia nigra pars reticulata (SNr). Meanwhile, very specific collateralization patterns were found for other nuclei, including the intermediate reticular nucleus (IRN), parvicellular reticular nucleus (PARN) and gigantocellular reticular nucleus (GRN), which receive collateral inputs almost exclusively from the MOs. These observations provide potential anatomical mechanisms for cortical neurons to coordinate the PPN with other subcortical areas in performing different physiological functions.

Culture Supernatant of Enterococcus faecalis Promotes the Hyphal Morphogenesis and Biofilm Formation of Candida albicans

(1) Background: Enterococcus faecalis and Candida albicans are often isolated from infected root canals. The interaction between these two species is not clear enough. Therefore, the objective of this study was to investigate the effect of E. faecalis on the biofilm formation, hyphal morphogenesis and virulence gene expression of C. albicans. (2) Methods: We used the culture supernatant of E. faecalis (CSE) to treat the biofilms of C. albicans. Then, crystal violet staining and colony-forming unit (CFU) counting were performed to evaluate biofilm biomass. Scanning electron microscopy (SEM) and confocal laser scanning microscope (CLSM) were applied to observe fungal morphology. Subsequently, exopolymeric substances (EPS) production, cellular surface hydrophobicity (CSH) and adhesion force of biofilms were investigated by CLSM, water–hydrocarbon two-phase assay and atomic force microscopy (AFM), respectively. Finally, the expression of C. albicans virulence genes (ALS1, ALS3, HWP1 and EFG1) were measured by RT-qPCR assay. (3) Results: The exposure of CSE promoted the biofilm formation and hyphal morphogenesis of C. albicans, increased the EPS production, CSH and adhesion force of C. albicans biofilms, and increased the expression level of EFG1. (4) Conclusions: Our data indicated that CSE promoted the hyphal morphogenesis and biofilm formation of C. albicans.

Landscape of immune infiltration in entorhinal cortex of patients with Alzheimerʼs disease

Alzheimer’s disease (AD) is one of the most common neurodegenerative diseases and manifests as progressive memory loss and cognitive dysfunction. Neuroinflammation plays an important role in the development of Alzheimer’s disease and anti-inflammatory drugs reduce the risk of the disease. However, the immune microenvironment in the brains of patients with Alzheimer’s disease remains unclear, and the mechanisms by which anti-inflammatory drugs improve Alzheimer’s disease have not been clearly elucidated. This study aimed to provide an overview of the immune cell composition in the entorhinal cortex of patients with Alzheimer’s disease based on the transcriptomes and signature genes of different immune cells and to explore potential therapeutic targets based on the relevance of drug targets. Transcriptomics data from the entorhinal cortex tissue, derived from GSE118553, were used to support our study. We compared the immune-related differentially expressed genes (irDEGs) between patients and controls by using the limma R package. The difference in immune cell composition between patients and controls was detected via the xCell algorithm based on the marker genes in immune cells. The correlation between marker genes and immune cells and the interaction between genes and drug targets were evaluated to explore potential therapeutic target genes and drugs. There were 81 irDEGs between patients and controls that participated in several immune-related pathways. xCell analysis showed that most lymphocyte scores decreased in Alzheimer’s disease, including CD4⁺ Tc, CD4⁺ Te, Th1, natural killer (NK), natural killer T (NKT), pro-B cells, eosinophils, and regulatory T cells, except for Th2 cells. In contrast, most myeloid cell scores increased in patients, except in dendritic cells. They included basophils, mast cells, plasma cells, and macrophages. Correlation analysis suggested that 37 genes were associated with these cells involved in innate immunity, of which eight genes were drug targets. Taken together, these results delineate the profile of the immune components of the entorhinal cortex in Alzheimer’s diseases, providing a new perspective on the development and treatment of Alzheimer’s disease.

Impact of public health education on the health status of the older migrant population

Background

Due to an increasing aging population, China has experienced a rapid expansion in its internal older migrant population who face greater health risks and who have a relatively high demand for health education. Public health education is an important means of preventing diseases and promoting health. However, many studies have focused on the utilization, with few studies examining the impact of public health education on the health of the older migrant population in China.

Objectives

This study analyzed the impact of public health education on the health of the older migrant population in China.

Methods

Based on data obtained from the National Migrant Population Health and Family Planning Dynamic Monitor Survey (2018), logistic models and propensity score matching were used to analyze the impact of public health education on the health of the older migrant population.

Results

The self-assessed health of China's older migrant population was good, and the acceptance rate of public health education was 40.81%. The public health status of the older migrant population receiving public health education significantly improved (p < 0.05). After correcting for endogeneity among the variables, public health education increased the probability of improving the older migrant population's self-assessed health by 5.4-6.1% (p < 0.01). Heterogeneity analysis found that public health education had a greater impact on the health of older men with an education level of middle school and below, and especially on the older migrant population in the eastern region of China.

Conclusions

Public health education positively affected the health status of the older migrant population. The characteristics and preferences of the older migrant population involving different genders, regions, and educational levels need to be considered, public health education needs to be standardized, and appropriate education methods need to be adopted that suit the older migrant population. Reference suggestions are provided for improving the health level of the older migrant population.

Complete mitochondrial genome sequence of Acer miaotaiense (Aceraceae)

Acer miaotaiense P. C. Tsoong is a rare and endangered tree endemic to the Qinling Mountains of China and is listed as a national third-class protected plant. In this study, we sequenced the complete mitochondrial genome of Acer miaotaiense using the Illumina Novaseq 6000 and Nanopore platforms. The total mitochondrial genome length is 819,227 bp and has 69 genes, including 41 protein-coding, 25 tRNA, and 3 rRNA genes. The genome nucleotide composition was asymmetric, with an overall G + C content of 45.7%. Phylogenetic analysis indicated that Acer miaotaiense is closely related to the congeneric Acer yangbiense.

Study on the Rehabilitation Therapist Estimation Under Institutional Perspective by Applying the Workload Indicators of Staffing Needs in the Aging Context

Background

The need for rehabilitation therapy has increased dramatically with the aging of the population, the prevalence of non-communicable diseases, and the increase in the number of disabilities. Rehabilitation therapists are crucial to provide high quality rehabilitation therapy; however, there is a significant shortage of these professionals in China. One of the effective strategies to address this challenge is using the norm of the workforce for rehabilitation therapy, which is an index for assessing the personnel required in a facility. This research aimed to create a rehabilitation therapist-required norm under institutional perspective in Shandong Province, China, based on the Workload Indicators of Staffing Needs (WISN) method, which was created by the World Health Organization (WHO) in 1998 to analyse staff utilization at various levels of the health care system.

Methods

We conducted descriptive and quantitative research from October to November 2020 in the rehabilitation department of a tertiary hospital in Weifang City, China. Focus groups, online interviews, and document reviews were conducted to gather data and calculations of the WISN method performed.

Results

Admission assessment, pre-treatment evaluation, rehabilitation therapy, post-treatment evaluation, and health education for patients were identified as the main priority group activities. Interviews and analysis of documents summarized five factors related to rehabilitation therapists' health service activities. In this study, the annual working time of each therapist was 1,776 h per year. The WISN method calculations showed that the norm of rehabilitation therapists in this tertiary hospital was 23 therapists. As the department had 13 therapists, there was a shortage of 10 therapists based on the WISN calculation, with a ratio of 0.57, which represented the actual compared to the ideal number of therapists.

Conclusion

Workload pressure was high for therapists in this tertiary hospital. This model revealed a demand for ten more therapists in the rehabilitation department. The WISN method can help hospital administrators in therapist workforce monitoring, including in regard to therapists. Therefore, the WISN method should be embraced as part of hospital human resource planning and recruitment strategies to meet increasing rehabilitation needs.

Incidence and Risk Factors for Hypoxia in Deep Sedation of Propofol for Artificial Abortion Patients

Background

Respiratory depression is a life-threatening adverse effect of deep sedation. This study aimed to investigate the factors related to hypoxia caused by propofol during intravenous anesthesia.

Methods

Three hundred and eight patients who underwent painless artificial abortion in the outpatient department of Shanghai Tenth People’s Hospital between November 1, 2019 and June 30, 2020 were divided into two groups according to whether the patients experienced hypoxia (SpO₂ < 95%). Preoperative anxiety assessments, anesthesia process, and operation-related information of the two groups were analyzed. The univariate analysis results were further incorporated into logistic regression analysis for multivariate analysis to determine the independent risk factors affecting hypoxia.

Results

Univariate analysis revealed that body mass index (BMI) (21.80 ± 2.94 vs. 21.01 ± 2.39; P = 0.038, 95% confidence interval (CI) = [−1.54, −0.04]), propofol dose (15.83 ± 3.21 vs. 14.39 ± 3.01; P = 0.002, CI = [−2.34, −0.53]), menopausal days (49.64 ± 6.03 vs. 52.14 ± 5.73; P = 0.004, CI = [0.79, 4.21]), State Anxiety Inventory score (51.19 ± 7.55 vs. 44.49 ± 8.96; P < 0.001, CI = [−9.26, −4.15]), and Self-rating Anxiety Scale score (45.86 ± 9.48 vs. 42.45 ± 9.88; P = 0.021, CI = [−6.30, −0.53]) were statistically significant risk factors for hypoxia during the operation. Logistic regression analysis showed that propofol dosage, menopausal days, and State Anxiety Inventory score were independent risk factors for hypoxia.

Conclusion

Patient anxiety affects the incidence of hypoxia when undergoing deep intravenous anesthesia with propofol. We can further speculate that alleviating patient anxiety can reduce the incidence of hypoxia.

Clinical Trial Registration

[http://www.chictr.org.cn], identifier [ChiCTR2000032167].

The Effect of Relaxation Therapy on Hypoxia During Intravenous Propofol Anesthesia in Patients With Pre-operative Anxiety: A Prospective Randomized Controlled Trial

Background

This study aimed to investigate the effect of relaxation therapy on hypoxia during intravenous propofol anesthesia in patients with pre-operative anxiety.

Methods

Two-hundred and eighty patients were randomly categorized in the experimental group (relaxation therapy group) and control group. The Spielberger State-Trait Anxiety Inventory (S-STAI) was administered 30 to 60 min pre-operatively to assess the patient's current anxiety status and select appropriate patients. Patients in the experimental group received pre-surgical relaxation therapy. Decrease in oxygen saturation during the procedure was recorded for each patient group, and the relevant data were compared between the two groups.

Results

The basic S-STAI scores of the experimental and control groups were 56.88 ± 2.91 and 57.27 ± 3.56, respectively (p = 0.331). The difference was not statistically significant. The incidence of hypoxia in the experimental group during painless artificial abortion [routine blood oxygen saturation (SpO₂) <95%, duration >15 s] decreased from 30 to 12.3%.

Conclusion

Relaxation therapy may effectively reduce the incidence of hypoxia during painless artificial abortion by using less dose of propofol. It may help patients relieve their anxiety and improve perioperative safety.

Trial Registration

Chinese Clinical Trial Registry (ChiCTR2000032109).

Doctor of Public Health-Crisis Management and COVID-19 Prevention and Control: A Case Study in China

In the fields of public health policy and public health care, advanced educational programs are an important strategy in dealing with public health crises. The COVID-19 pandemic has exposed the global need for skilled public health leaders and managers to address complex public health challenges, which requires the strengthening of public health education at the highest levels. This paper is a qualitative case study of a special educational program for doctors of public health in China. The program's educational objectives are in line with epidemic prevention and control. With the goal of developing the world's leading national public health management system, the Chinese government established an advanced academic program for public health crisis management. The program offers doctoral students a multidisciplinary degree based upon the theoretical knowledge of crisis management, supported by advanced training in the foundational concepts, theories, and practices of public health, and the study of basic medicine which provides the theoretical support for developing essential clinical skills. Program graduates develop the theoretical, practical, and leadership-related capabilities required for the management of national emergencies. The program introduced in this paper meets current epidemic prevention and control needs and should be considered by public health policy makers, leaders, and scholars in the discussion of advanced public health policy and health care education in China, including the development of an internationally recognized Doctor of Public Health program.