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This study aimed to determine the trajectories of perinatal depression and their relationship with length of hospital stay (LOS), hospitalization costs, and adverse maternal and infantile outcomes. This longitudinal observational study included 525 participants. Perinatal depressive symptoms were assessed at four waves (from the first trimester to the postpartum period). LOS, hospitalization costs, and adverse maternal (sleep, fatigue, anxiety, perceived stress, and memory problems) and infantile outcomes of participants were obtained from medical records and self‐reported questionnaires. Trajectories of perinatal depressive symptoms were explored with latent class growth analysis. Associations between trajectories and adverse maternal and infant outcomes were explored with multiple linear regression and binary logistic regression models. The participants' average age was 29.6 ± 3.9 years. Five heterogeneous developmental trajectories of perinatal depressive symptoms were identified as follows: high‐level (7.05%), moderate‐increasing (12%), remission (15.05%), moderate‐level (37.14%), and low‐level (28.76%). The average LOS was 5.78 ± 2.13 days, and the average hospitalization costs were 12,695.27 ± 5457.51 yuan. Compared with the trajectory of low‐level depressive symptoms, the LOS, hospitalization costs, and likelihood of adverse outcomes of women with high‐level and moderate‐increasing depressive symptom trajectories increased. The findings capture the heterogeneity of perinatal depression in Chinese women. Women in the moderate‐increasing and high‐level trajectory groups had longer LOS, more hospitalization costs, and poor birth outcomes. Elucidating the trajectories of perinatal depression and their relationship with maternal and infant health outcomes provides important insights into the development of person‐centred care planning for women during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Menaquinone-7 (MK-7), a multipotent vitamin K2, possesses a wide range of biological activities, a precise curative effect and excellent safety. A simple and rapid LC-APCI-MS/MS method for the determination of MK-7 in human plasma with single liquid–liquid extraction (LLE) extraction and 4·5-min analysis time has been developed and validated. Four per cent bovine serum albumin (BSA) was used as surrogate matrix for standard curves and endogenous baseline subtraction. This method was reproducible and reliable and was used to analyse of MK-7 in human plasma. The endogenous circadian rhythm and bioavailability of MK-7 were investigated in two randomised single-dose, open, one-way clinical trials (Study I and Study II). A total of five healthy male subjects were enrolled in Study I and 12 healthy male subjects in Study II. Single-dose (1 mg) of MK-7 was given to each subject under fasting condition, and all eligible subjects were given a restricting VK2 diet for 4 d prior to drug administration and during the trial. The experiment results of Study I demonstrated that endogenous MK-7 has no circadian rhythm in individuals. Both studies showed MK-7 are absorbed with peak plasma concentrations at about 6 h after intake and has a very long half-life time. [ABSTRACT FROM AUTHOR]

Translation as a bridge between different cultures has received significant attention in recent years, especially with the rise of globalization and the increasing communication between nations. Translation has become a crucial tool for connecting people, promoting cross-cultural understanding, and facilitating international trade, academic exchange, and outbound tourism. With the advancement of information technology, research on improving English translation algorithms has become a hot topic. This is due to the complexities and variability of language, where words can have different meanings in different contexts. To address the issue of semantic coherence in current English translation proofreading systems, this paper proposes a semantic ontology translation model that utilizes fuzzy mapping to translate English and selects the most semantically appropriate translation using a decision function. The contributions of this research are twofold. Firstly, it provides a new approach to English translation proofreading by incorporating semantic ontology and fuzzy mapping. Secondly, it demonstrates the effectiveness of this approach through the improved efficiency and accuracy of English proofreading. The key findings of this study show that the proposed semantic ontology translation model can significantly improve the semantic coherence of English translation proofreading. This makes this article different from other studies by offering a unique solution to the problem of semantic coherence in English translation proofreading. [ABSTRACT FROM AUTHOR]

Background: There is limited knowledge on the yield of performing capture-based targeted ultradeep sequencing on bronchoalveolar lavage (BAL) specimens from advanced nonsmall cell lung cancer (NSCLC) patients. This study aimed to evaluate gene variations and performance characteristics in BAL and tissue specimens using targeted sequencing. Methods: This cohort study retrospectively enrolled 20 patients with advanced NSCLC. The variant detection percentage, correlation of tumor mutation burden (TMB), and allele frequency heterogeneity (AFH) were compared between paired BAL and tissue samples. A three-tiered system was also applied for the interpretation of gene variants according to the guidelines. Results: No statistical difference was observed in variant detection between BAL and tissue samples (P =.591 for variant tier and P =.409 for variant type). In general, BAL achieved higher detection rates in tier I variants (96.2% vs 84.6%) and gene fusions (75% vs 50%) compared with tissue samples; tissue samples had better variants detection rates for other variants, such as tier II (89.6% vs 76.0%), tier III (87.1% vs 72.6%), single nucleotide variant (SNV, 89.6% vs 76.5%), insertion/deletion/duplication (InDel, 74.6% vs 69.8%) and copy number variation (CNV, 93.8% vs 43.8%). Besides, there were significant correlations of TMB (R 2 = 0.96, P <.001) and AFH (R 2 = 0.87, P <.001) between BALs and paired tissues. Conclusions: The findings demonstrate that BAL may serve as a supplement in liquid biopsy for mutation detection and for routine utilization in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Some research found that elevated plasma cell-free DNA (cfDNA) concentrations and poor prognosis are associated in non-small cell lung cancer (NSCLC). However, more studies need to be carried out to verify this conclusion. Therefore, this study investigated the relationship between cfDNA concentration and treatment outcomes including prognosis in patients with advanced NSCLC. Methods: We retrospectively collected medical records and cfDNA data from 160 patients with advanced NSCLC. Progression-free survival (PFS) were calculated using the Kaplan-Meier method and were compared between groups using the log rank test. Cox regression analysis was used for estimating the independent predictors of PFS. And we used logistic regression to evaluate the relationship between baseline biomarkers and efficacy. In our study, BT1 cfDNA, BT2 cfDNA, and BT3 cfDNA were defined as cfDNA concentration before the first treatment (baseline cfDNA concentration), cfDNA concentration before the second treatment, and cfDNA concentration before the third treatment, respectively. Results: Patients with low cfDNA (BT1 cfDNA < 15 (ng/mL)) were reported a significantly prolonged median progression-free survival (mPFS) compared with patients with patients with high cfDNA (BT1 cfDNA ≥ 15(ng/mL)) (mPFS: 14.6 vs. 8.3 months, P = 0.002), as well as patients with neutrophil/lymphocyte ratio (NLR)<2.98 (mPFS: 13.1 vs. 7.9 months, P = 0.023). In addition, Cox proportional hazards regression analysis identified independent indicators associated with PFS including BT1 cfDNA ≥ 15 (ng/mL), NLR ≥ 2.98 and extrapulmonary metastasis. The best cut-off value for BT3 cfDNA for predicting disease progression is 41.46 (ng/mL) (Area Under the Curve (AUC): 0.652, 95%CI: 0.516–0.788), achieving 90.7% sensitivity and 37.5% specificity for the prediction of disease progression. BT3 cfDNA (OR = 6.08, 95% CI: 1.94–19.57, P = 0.002) was an independent factor for disease progression in patients with advanced NSCLC. Conclusions: BT1 cfDNA may be a biomarker to assess the prognosis of advanced NSCLC. Patients with advanced NSCLC with lower cfDNA and NLR before treatment had a better prognosis. Increased BT3 cfDNA concentration was an independent factor of disease progression in advanced NSCLC patients. These findings may assist in identifying high-risk patients and guiding treatment strategies. [ABSTRACT FROM AUTHOR]

[Objectives] To understand the effects of exposure to different LED lights on the growth, development and reproduction of Spodoptera litura. [Methods] Larvae, pupae and adults of S. litura were randomly assigned to different LED light treatment groups: L1, L2, P1, P2, A1 and A2, whereas those assigned to the control group were kept under a photoperiod of 14L 10D. [Results] Exposure to LED light had no significant effect on the pupation rate compared to the control group (P>0.05). The adult eclosion rate of the P1 group (66.2%) was significantly lower than that of the L1 and L2 groups (P<0.05). The L1 group had a significantly shorter larval (♀: 15.8 d, ♂: 16.4 d) and female pupal, periods (9.8 d, P<0.05) than the control group. The P1 and P2 groups had a significantly longer male pupal period (11.9 and 11.8 d, respectively, P<0.05). With the exception of female pupae in L2 group, all treatment groups had significantly lower pupal weights (P<0.05) than the control group. Adult male longevity in the P2 group (7.5 d) was significantly less than that of the control group (12.2 d, P<0.05), and the pre-oviposition period of the A2 group (3.4 d) was significantly longer than in the L2 and A1 groups (P<0.05). Females in the L1, P1 and P2 groups laid fewer eggs per female than those in the control group (P<0.05). [Conclusion] Exposure to different LED lights during the scotophase has significant effects on the growth, development and reproduction of S. litura. These effects vary with developmental stage and the type of LED light. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is one of the most frequently diagnosed cancers. Polo-like kinase 1 (PLK1), a member of the serine/threonine kinase PLK family, is the most investigated and essential in the regulation of cell cycle progression, including chromosome segregation, centrosome maturation and cytokinesis. However, the nonmitotic role of PLK1 in CRC is poorly understood. In this study, we explored the tumorigenic effects of PLK1 and its potential as a therapeutic target in CRC. Methods: GEPIA database and immunohistochemistry analysis were performed to evaluate the abnormal expression of PLK1 in CRC patients. MTT assay, colony formation and transwell assay were performed to assess cell viability, colony formation ability and migration ability after inhibiting PLK1 by RNAi or the small molecule inhibitor BI6727. Cell apoptosis, mitochondrial membrane potential (MMP) and ROS levels were evaluated by flow cytometry. Bioluminescence imaging was performed to evaluate the impact of PLK1 on CRC cell survival in a preclinical model. Finally, xenograft tumor model was established to study the effect of PLK1 inhibition on tumor growth. Results: First, immunohistochemistry analysis revealed the significant accumulation of PLK1 in patient-derived CRC tissues compared with adjacent healthy tissues. Furthermore, PLK1 inhibition genetically or pharmacologically significantly reduced cell viability, migration and colony formation, and triggered apoptosis of CRC cells. Additionally, we found that PLK1 inhibition elevated cellular reactive oxygen species (ROS) accumulation and decreased the Bcl2/Bax ratio, which led to mitochondrial dysfunction and the release of Cytochrome c, a key process in initiating cell apoptosis. Conclusion: These data provide new insights into the pathogenesis of CRC and support the potential value of PLK1 as an appealing target for CRC treatment. Overall, the underlying mechanism of inhibiting PLK1-induced apoptosis indicates that the PLK1 inhibitor BI6727 may be a novel potential therapeutic strategy in the treatment of CRC. [ABSTRACT FROM AUTHOR]

Background: Lymphangioleiomyomatosis (LAM) is a female‐predominant interstitial lung disease, characterized by progressive cyst formation and respiratory failure. Clinical treatment with the mTORC1 inhibitor rapamycin could relieve partially the respiratory symptoms, but not curative. It is urgent to illustrate the fundamental mechanisms of TSC2 deficiency to the development of LAM, especially mTORC1‐independent mechanisms. Glutaredoxin‐1 (Glrx), an essential glutathione (GSH)‐dependent thiol‐oxidoreductase, maintains redox homeostasis and participates in various processes via controlling protein GSH adducts. Redox signalling through protein GSH adducts in LAM remains largely elusive. Here, we demonstrate the underlying mechanism of Glrx in the pathogenesis of LAM. Methods: 1. Abnormal Glrx expression in various kinds of human malignancies was identified by the GEPIA tumour database, and the expression of Glrx in LAM‐derived cells was detected by real‐time quantitative reverse transcription (RT‐qPCR) and immunoblot. 2. Stable Glrx knockdown cell line was established to evaluate cellular impact. 3. Cell viability was determined by CCK8 assay. 4. Apoptotic cell number and intracellular reactive oxygen species (ROS) level were quantified by flow cytometry. 5. Cox2 expression and PGE2 production were detected to clarify the mechanism of Bim expression modulated by Glrx. 6. S‐glutathionylated p65 was enriched and detected by immunoprecipitation and the direct regulation of Glrx on p65 was determined. 7. The xenograft animal model was established and photon flux was analyzed using IVIS Spectrum. Results: In LAM, TSC2 negatively regulated abnormal Glrx expression and activation in a mTORC1‐independent manner. Knockdown of Glrx increased the expression of Bim and the accumulation of ROS, together with elevated S‐glutathionylated proteins, contributing to the induction of apoptotic cell death and inhibited cell proliferation. Knockdown of Glrx in TSC2‐deficient LAM cells increased GSH adducts on nuclear factor‐kappa B p65, which contributed to a decrease in the expression of Cox2 and the biosynthesis of PGE2. Inhibition of PGE2 metabolism attenuated phosphorylation of ERK, which led to the accumulation of Bim, due to the imbalance of its phosphorylation and proteasome degradation. In xenograft tumour models, knockdown of Glrx in TSC2‐deficient LAM cells inhibited tumour growth and increased tumour cell apoptosis. Conclusions: Collectively, we provide a novel redox‐dependent mechanism in the pathogenesis of LAM and propose that Glrx may be a beneficial strategy for the treatment of LAM or other TSC‐related diseases. [ABSTRACT FROM AUTHOR]

Pre-trained language models achieve high performance on machine reading comprehension task, but these models lack robustness and are vulnerable to adversarial samples. Most of the current methods for improving model robustness are based on data enrichment. However, these methods do not solve the problem of poor context representation of the machine reading comprehension model. We find that context representation plays a key role in the robustness of the machine reading comprehension model, dense context representation space results in poor model robustness. To deal with this, we propose a Multi-task machine Reading Comprehension learning framework via Contrastive Learning. Its main idea is to improve the context representation space encoded by the machine reading comprehension models through contrastive learning. This special contrastive learning we proposed called Contrastive Learning in Context Representation Space(CLCRS). CLCRS samples sentences containing context information from the context as positive and negative samples, expanding the distance between the answer sentence and other sentences in the context. Therefore, the context representation space of the machine reading comprehension model has been expanded. The model can better distinguish between sentence containing correct answers and misleading sentence. Thus, the robustness of the model is improved. Experiment results on adversarial datasets show that our method exceeds the comparison models and achieves state-of-the-art performance. [ABSTRACT FROM AUTHOR]

Background: Homologous Recombination Deficiency (HRD) is a predictive biomarker for ovarian cancer treated with PARP inhibitors or for breast cancer treated with first-line platinum-based chemotherapy. However, limited research is documented on platinum-based treatment prediction with HRD as a biomarker in ovarian cancer patients, especially in the Chinese population. Methods: We investigated the association between HRD status and the response of platinum-based chemotherapy in 240 Chinese HGSOC patients. Results: The Pt-sensitive patients showed higher HRD scores than Pt-resistant ones, but this was not significant(median: 42.6 vs. 31.6, p = 0.086). (Pt)-sensitive rate was higher in HRD + BRCAm tumors and in HRD + BRCAwt tumors (HRD + BRCAm: 97%, p = 0.004 and HRD + BRCAwt: 90%, p = 0.04) compared with 74% in the HRD-BRCAwt tumors. We also found Pt-sensitive patients tend to be enriched in patients with BRCA mutations or non-BRCA HRR pathway gene mutations (BRCA: 93.6% vs 75.4%, p < 0.001; non-BRCA HRR: 88.6% vs 75.4%, p = 0.062). Patients with HRD status positive had significantly improved PFS compared with those with HRD status negative (median PFS: 30.5 months vs. 16.8 months, Log-rank p = 0.001). Even for BRCAwt patients, positive HRD was also associated with better PFS than the HRD-negative group (median: 27.5 months vs 16.8 months, Log-rank p = 0.010). Further, we found patients with pathogenic mutations located in the DNA-binding domain (DBD) of BRCA1 had improved FPS, compared to those with mutations in other domains. (p = 0.03). Conclusions: The HRD status can be identified as an independent significance in Chinese HGSOC patients treated with first-line platinum-based chemotherapy. [ABSTRACT FROM AUTHOR]

Prenatal stress is a pressing issue. However, there is a lack of robust evidence for psychosocial interventions to manage this problem. This study aimed to examine the effectiveness of a mindfulness-based intervention on reducing prenatal stress compared to participation in health education groups. A randomized controlled trial was conducted in a prenatal clinic of comprehensive tertiary care from April to October 2017. A total of 108 pregnant women were randomly assigned to an intervention or a control group. Participants completed self-report measures of depression, anxiety, perceived stress, fatigue, positive and negative affect, and mindfulness before, immediately after, and 15 weeks after the 4-week intervention period. Generalized estimating equations were used to analyze the intervention outcomes. The results supported greater improvement in terms of perceived stress (Wald χ2=26.94, p<0.001), fatigue (Wald χ2=17.61, p<0.001), positive affect (Wald χ2=9.03, p = 0.011), negative affect (Wald χ2=11.37, p = 0.003), and mindfulness (Wald χ2=24.97, p<0.001) in the intervention group than in the control group. The self-help mindfulness intervention decreased prenatal stress and negative affect and improved positive affect and mindfulness. [ABSTRACT FROM AUTHOR]

Cytochrome P450 oxidoreductase deficiency (PORD) is a rare recessive disease with multiple clinical manifestations, which is usually diagnosed in neonates and children because of ambiguous genitalia or skeletal malformations. Moreover, the paucity of studies does not allow us to establish whether adult-onset PORD is associated with infertility. Here, we report clinical and laboratory findings in two phenotypically normal women diagnosed with PORD who underwent in vitro fertilization (IVF) and frozen embryo transfer (FET). We modified the gonadotropin stimulation protocol during controlled ovarian hyperstimulation (COH) and suggest the use of the vaginal 17β-estradiol route for endometrium preparation in hormone replacement therapy (HRT) cycles. We presume that PORD may be associated with infertility in several aspects, including disordered steroidogenesis, endometrium impairment, attenuation of drug metabolism, and the high risk of miscarriage. Our observations will help the early diagnosis and make a tailored approach to infertility management in adult-onset PORD. [ABSTRACT FROM AUTHOR]

The structure of English long sentences is generally complicated, with complicated logical levels, many parallel elements, many modifiers and conjunctions, and long post attributives. Moreover, pronouns in English long sentences often need to be judged according to the context. Complex English long sentences are very common in English and even run through the whole English article. The analysis results of these complex long sentences will seriously affect the quality and readability of machine translation. In this paper, HNC (hierarchical network of concepts) method is improved to realize the segmentation of long sentences, so as to simplify sentence patterns. According to the characteristics of professional literature, this paper puts forward a translation optimization method of professional literature combining HNC with statistics, which greatly improves the recognition efficiency of unknown words by extracting professional terms. The results show that the word segmentation method based on HNC and statistics proposed in this paper has achieved a good word segmentation effect in the open test environment, with an accuracy rate of 93.38% and a recall rate of 94.51%. The conclusion shows that our method can make full use of the knowledge of the source tree database, thereby improving the accuracy of the syntactic model on the target tree database. [ABSTRACT FROM AUTHOR]

The binding of tiamulin with calf thymus DNA was systematically investigated using multispectroscopy and molecular modelling techniques. For DNA, once tiamulin was added, viscosity (η) and melting temperature (Tm) both exhibited an uptrend. The fluorescence performance of the tiamulin–DNA complex did not change with the ionic strength changes. The binding constant (Ka) of tiamulin for single‐stranded DNA (ssDNA, 1.48 × 104 M−1) was obviously higher than that for double‐stranded DNA (dsDNA, 9.51 × 103 M−1) at 291 K. The helix structure became looser and the base stack force became stronger for DNA due to the presence of tiamulin as seen from circular dichroic (CD) spectra. The intercalation binding mode of tiamulin with DNA was disclosed. Molecular modelling also revealed tiamulin inserting into the base pairs with the lowest binding free energy of −18.73 kJ mol−1 using van der Waals forces as well as hydrogen bonds. [ABSTRACT FROM AUTHOR]

Optimal treatment for resectable esophageal squamous cell carcinoma (ESCC) is controversial, especially in the context of potential benefit of combining PD‐1 blockade with neoadjuvant therapy. This phase 2 study aimed to assess neoadjuvant camrelizumab plus chemotherapy in this population. Patients (clinical stage II‐IVA) received two cycles of neoadjuvant chemoimmunotherapy (NIC) with camrelizumab (200 mg on day 1) plus nab‐paclitaxel (260 mg/m2 in total on day 1 and day 8) and cisplatin (75 mg/m2 in total on days 1‐3) of each 21‐day cycle. Surgery was performed approximately 6 weeks after completion of NIC. Primary endpoint was complete pathologic response (CPR) rate in primary tumor. Secondary endpoints were objective response rate (ORR) per RECIST v1.1, 2‐year progression‐free survival (PFS) rate after surgery, PFS, overall survival (OS) and safety during NIC and perioperative period. Between 17 January 2020 and 8 December 2020, 56 patients were enrolled, and 51 received esophagectomy. Data cutoff date was 25 August 2021. The CPR rate was 35.3% (95% CI, 21.7%‐48.9%). NIC had an ORR of 66.7% (95% CI, 40.0%‐70.4%) and treatment‐related adverse events (TRAEs) of low severity (grade 1‐2, 75.0%; grade 3, 10.7%; grade 4‐5, no). No perioperative mortality occurred. Three (5.9%) patients had tumor recurrence and one (2.0%) patient died. The 2‐year PFS rate, median PFS and median OS had not been reached yet. Camrelizumab plus neoadjuvant chemotherapy in resectable ESCC demonstrates promising efficacy with acceptable toxicity, providing a feasible and effective option. Study is ongoing for long‐term survival analyses. [ABSTRACT FROM AUTHOR]

Pedestrian guardrails (PGs) are common in high-density cities, but growing debate focuses on whether PGs provide pedestrian comfort and assure safety. The quasi-experimental condition, created by 2019–2020 Hong Kong protesters dismantling PGs the government later restored, allowed for a longitudinal study of how PGs impact pedestrian crossing behaviours at the intersection of Mong Kok Road and Sai Yeung Choi Street South. 6762 pedestrian behaviours were collected through video recording from periods before and after PG restoration; psychological factors linked to crossing behaviour were further investigated through a questionnaire. Per observations, crossing through the shortest route comprised most (25.24%) aberrant behaviours. PG restoration significantly reduced low-risk crossings but increased high-risk behaviours. Specifically, people aged 65+ were more likely to cross the road aberrantly to avoid grade-separated pedestrian crossings. The questionnaire results (N = 205) suggest pedestrians feel ambivalent about PGs. Taking shortcuts was the main reason for pedestrian misbehaviour (85.8% agreement rate). Additionally, pedestrians relied more on internal judgements of traffic situations than on external controls. Noticeably, PGs provided feelings of safety, despite not being designed to protect pedestrians from straying vehicles. These findings could inform designs for safe, comfortable pedestrian environments. [ABSTRACT FROM AUTHOR]

Background: As mean HbA1c provides incomplete information regarding glycemic variability, there has been considerable interest in the emerging association between glycemic variability and macrovascular events and with microvascular complications and mortality in adults with and without diabetes. However, the association between long-term glycemic variability, represented by visit-to-visit HbA1c variability, and functional limitations has not been clarified in previous literature. The present study aimed to explore the longitudinal association between long-term glycemic variability, represented by visit-to-visit HbA1c variability and functional limitations. Methods: This cohort study included adults aged over 50 years who participated in the 2006 to 2016 waves of the Health and Retirement Study. Physical functions, including mobility, large muscle function, activities of daily living (ADLs), and instrumental ADLs (IADLs), were assessed at baseline and every 2 years, and HbA1c levels were assessed at baseline and every 4 years. Visit-to-visit HbA1c variability was calculated using the HbA1c variability score (HVS) during the follow-up period. Generalized estimating equation models were used to evaluate the longitudinal association between HbA1c variability and functional limitations with adjustment for a series of confounders. Results: A total of 5,544 participants having three HbA1c measurements from 2006 to 2016, having two or more physical function measures (including one at baseline), and age over 50 years were included in this analysis. The mean age at baseline was 66.13 ± 8.39 years. A total of 916 (16.5%) participants had an HVS = 100, and 35.1% had an HVS = 50. The highest HVS category (HVS =100) was associated with increased functional status score (β = 0.093, 95% CI: 0.021–0.165) in comparison with the lowest HVS category (HVS = 0). Sensitivity analyses using the CV and SD of HbA1c as measures of variability showed similar associations between HbA1c variability and functional limitation. An incremental increase in HbA1c-CV (β = 0.630, 95% CI: 0.127–1.132) or HbA1c-SD (β = 0.078, 95% CI: 0.006–0.150) was associated with an increase in functional limitation in the fully adjusted model. Conclusions: HbA1c variability was associated with heightened difficulty in performing functional activities over time after adjusting for mean HbA1c levels and multiple demographics and comorbidities. This study provides further evidence regarding the detrimental effect of HbA1c variability and highlights the significance of steady glycemic control. [ABSTRACT FROM AUTHOR]

Owing to the abundance of raw material reserves and low cost, Na-ion batteries (NIBs) have successfully gained widespread attention from academic and industrial communities in the past few decades. However, the insufficient cathode energy density is still one of the critical bottlenecks restricting the development of NIBs. Following a strategy of introducing Li+ into the transition-metal (TM) layer to enhance the oxygen redox reaction, a novel layered cathode material P2-Na0.6Li0.11Fe0.27Mn0.62O2 (NLFMO) was designed and successfully synthesized. This NLFMO cathode not only delivers a large initial reversible capacity of 207.3 mA h g−1, but also shows a good cycling performance (104.2 mA h g−1 after 80 cycles) and rate capability (126.2 mA h g−1 at 1C). The ultrahigh capacity is contributed by both cationic (Fe3+/Fe4+ and Mn3+/Mn4+) and partially reversible anionic redox (O2−/On−) reactions, revealed by in situ X-ray absorption spectroscopy (XAS) and X-ray photoelectron spectroscopy (XPS) techniques. Moreover, no detrimental P2–O2 phase transition was observed in ex situ X-ray diffraction (XRD) patterns, confirming the high structural stability during Na+ deintercalation/intercalation processes. These results provide valuable information about the high-energy density layered cathode materials based on anionic redox reactions for NIBs. [ABSTRACT FROM AUTHOR]

Nowadays, unmanned aerial vehicles (UAVs) are widely used in many smart systems such as smart logistics, smart agriculture, and environmental monitoring systems. However, the limited computing capability and restricted battery lifetime of existing UAVs could significantly impact the quality of service (QoS) of UAV‐based smart systems and the quality of experience (QoE) of end users. Recently, Mobile Edge Computing (MEC) which provisions computing resources close to the mobile end devices has become a promising solution. However, since high‐speed UAV often flies through the signal range of the different edge nodes, the interruption of services in the MEC‐based UAV delivery system is a critical issue. A challenging question is when and how to perform dynamic task migration among the edge nodes to ensure service continuity. In this paper, we investigate the task migration issue for multiple UAVs in the MEC‐based UAV delivery system. Specifically, we propose an energy‐aware decision‐making strategy for the dynamic task migration named GAD to optimize the UAV energy consumption. Given the real‐time system status and QoS constraints, and through a dynamic two‐tier decision‐making mechanism, GAD can efficiently make the task migration decision from four candidate decisions, viz. No Migration, Data Migration Only, Cold Migration, and Live Migration. Experimental results based on a real‐world scenario show that our strategy can well outperform other baseline strategies in various metrics including the flying distances and the energy consumption of UAVs. [ABSTRACT FROM AUTHOR]

Although experimental data suggest that Selective serotonin reuptake inhibitors (SSRIs) may improve motor recovery after stroke, the results from clinical studies are conflicting. Six international electronic databases (Cochrane, PubMed, Embase, Web of Science, CINAHL, and PsycINFO) and four Chinese electronic databases (CBM, CNKI, WanFang Data, and VIP) were systematically searched up to April 2021. Co-primary outcomes were motor function and tolerability. Secondary outcomes included disability, neurological function, continuous depression scores, and adverse events. 25 randomized controlled trials including 4777 participants were identified. Pooled analyses found SSRIs significantly improved motor function [standardized mean differences (SMD), 0.72; 95% CI, 0.46 to 0.99], disability (SMD, 0.79; 95% CI, 0.51 to 1.06), neurological function (SMD, −0.58; 95% CI, −0.77 to −0.39) and continuous depression scores (SMD, −0.36; 95% CI, −0.70 to −0.02). SSRIs were associated with increased seizure (risk ratio, 9.00; 95% CI, 1.69 to 47.91) and gastrointestinal side effects (risk ratio, 2.26; 95% CI, 1.56 to 3.28), but similar risk of all-cause discontinuations when compared with the control group (risk ratio, 1.11; 95% CI, 0.79 to 1.56). SSRIs are effective and well-tolerated to promote motor recovery after stroke, but may increase the risk of seizures and gastrointestinal adverse effects. [ABSTRACT FROM AUTHOR]

To assess the toxicity of residual marbofloxacin from animal‐derived food, the interaction characteristics of marbofloxacin to bovine/human serum albumins (BSA/HSA) were explored using spectroscopic methods combined with molecular modelling. According to fluorescence spectra and time‐resolved fluorescence spectra measurements, quenching of BSA/HSA fluorescence induced by marbofloxacin was characterized as static quenching. A 1:1 ground‐state complex of marbofloxacin to BSA/HSA was formed with binding constant (Ka) 1.66 × 104/9.74 × 103 M−1 at 291 K. The location of marbofloxacin binding at site I within BSA/HSA was clarified by site marker competitive experiments. Molecular modelling demonstrated that the binding region for marbofloxacin to BSA and HSA were at site I with the lowest binding free energies of −22.86 and −21.60 kJ mol−1, respectively. Hydrogen bonds and van der Waals forces were dominantly involved in the spontaneous binding. Nonradiation energy transferred from BSA and HSA to marbofloxacin, due to the close distance (r0) between marbofloxacin and Trp residues of BSA (4.28 nm) and HSA (3.34 nm). As explained by circular dichroism (CD) spectra, an increased BSA/HSA α‐helix structure was observed after binding to marbofloxacin. Ultraviolet–visible (UV–vis) and Fourier transform infrared (FT‐IR) spectra suggested that conformation of the two proteins was altered by marbofloxacin. [ABSTRACT FROM AUTHOR]

Background: Mindfulness‐based interventions (MBIs) can alleviate psychological distress in patients with cancer. However, face‐to‐face MBIs may be inconvenient for patients. Therefore, guided self‐help interventions may be more accessible. The authors investigated the effects of a guided self‐help MBI for depression, anxiety, and sleep disorder symptoms in patients with breast cancer and explored the potential underlying mechanisms. Methods: One hundred forty‐four postoperative patients with breast cancer were randomly assigned to an intervention group (6‐week guided self‐help MBI; n = 72) or a wait‐list control group (routine treatment; n = 72). Self‐reported depression, anxiety, sleep disorder symptoms, and rumination and worry as potential mediators were assessed at baseline and postintervention. Outcomes were then assessed at 1‐month and 3‐month follow‐up. The intervention's effects over time and the potential mediating effect were analyzed using generalized estimating equations. The trial was registered at the Chinese Clinical Registry (ChiCTR‐IOR‐16008073). Results: Significant improvements in depression and sleep disorder symptoms occurred in the intervention group compared with wait‐list controls, and the improvements were maintained at 1‐month and 3‐month follow‐up. Changes in rumination and worry mediated the intervention's effects on changes in depression and sleep disorder symptoms. Conclusions: A guided self‐help MBI reduced depressive and sleep disorder symptoms by mitigating rumination and worry in patients with breast cancer. These findings support benefits of this accessible psychological intervention in oncology and provide insight into possible mechanisms of action. The current research contributes to discovering effective and widely accessible means for people with physical health conditions and may remove barriers that otherwise would have precluded participation in face‐to‐face psychological interventions. A guided self‐help intervention based on mindfulness reduces rumination and worry and improves depression and sleep disorder, which are symptoms in patients with breast cancer. As a guided self‐help intervention, participants face fewer barriers to treatment compared with face‐to‐face interventions using the same techniques. [ABSTRACT FROM AUTHOR]

Tumor mutation burden (TMB) serves as an effective biomarker predicting efficacy of mono-immunotherapy for non-small cell lung cancer (NSCLC). Establishing a precise TMB predicting model is essential to select which populations are likely to respond to immunotherapy or prognosis and to maximize the benefits of treatment. In this study, available Formalin-fixed paraffin embedded tumor tissues were collected from 499 patients with NSCLC. Targeted sequencing of 636 cancer related genes was performed, and TMB was calculated. Distribution of TMB was significantly (p < 0.001) correlated with sex, clinical features (pathological/histological subtype, pathological stage, lymph node metastasis, and lympho-vascular invasion). It was also significantly (p < 0.001) associated with mutations in genes like TP53 , EGFR , PIK3CA , KRAS , EPHA3 , TSHZ3 , FAT3 , NAV3 , KEAP1 , NFE2L2 , PTPRD , LRRK2 , STK11 , NF1 , KMT2D , and GRIN2A. No significant correlations were found between TMB and age, neuro-invasion (p = 0.125), and tumor location (p = 0.696). Patients with KRAS p.G12 mutations and FAT3 missense mutations were associated (p < 0.001) with TMB. TP53 mutations also influence TMB distribution (P < 0.001). TMB was reversely related to EGFR mutations (P < 0.001) but did not differ by mutation types. According to multivariate logistic regression model, genomic parameters could effectively construct model predicting TMB, which may be improved by introducing clinical information. Our study demonstrates that genomic together with clinical features yielded a better reliable model predicting TMB-high status. A simplified model consisting of less than 20 genes and couples of clinical parameters were sought to be useful to provide TMB status with less cost and waiting time. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to explore the levels and associations among depressive symptoms, perceived stress, and proinflammatory cytokines (interleukin-1β, interleukin-6, and tumor necrosis factor-α) in treatment-naïve patients with breast cancer. Methods: A cross-sectional study with one case and two control groups. Patients with breast cancer, matched patients with depression, and matched healthy women completed questionnaires and blood collection between May 2015 and March 2017. Data were analyzed using the general linear model and linear regression model. Results: The severity of depressive symptoms and perceived stress among patients with breast cancer was significantly higher than that in healthy controls and lower than those in patients with depression. Interleukin-1β was lower in patients with breast cancer than the other two groups. Perceived stress was independently and positively associated with depressive symptoms in patients with breast cancer. There were no significant associations between cytokines and depressive symptoms. Conclusion: Women with breast cancer experienced increased perceived stress prior to anticancer treatment, which was a strong contributor to severe symptoms of depression. Results emphasize the need to screen and identify patients with high perceived stress shortly after the disclosure of the diagnosis of breast cancer. Further research in larger sample is needed to investigate the relationship between proinflammatory cytokines and depressive symptoms. [ABSTRACT FROM AUTHOR]

Although the National Comprehensive Cancer Network and the Chinese Society of Clinical Oncology guidelines recommend comprehensive genomic profiling of lung adenocarcinoma, it has not been widely applied in Chinese hospitals. This observational study aimed to determine real-world evidence of whether comprehensive genomic profiling can benefit the survival of patients with lung cancer. We investigated the frequency of genomic alterations, treatment strategies, and clinical outcomes in 233 patients with advanced non-small cell lung carcinoma who were routinely screened using a 508-gene panel. The most prevalent drivers were mutations of EGFR (51%), KRAS (9%), PIK3CA (7%), ALK (7%), MET (6%), and BRAF (5%). Mutations in tumor suppressor genes included TP53, KEAP1, RB1, PTEN, and APC. Median overall survival (OS) was significantly shorter among patients harboring KRAS (mutant, n = 17; WT, n = 154) and TP53 (mutant, n = 103; WT n =68) mutations (11.3 vs. 24.0 months; P = 0.16 and 18.7 vs. 28.7 months; P = 0.018, respectively). The OS was longer among patients with tumors harboring EGFR (P = 0.069) and ALK (P = 0.51) mutations. Most patients (65.4%) with the driver gene-positive (EGFR, ALK, and ROS1) tumors were received TKI treatment, whereas those with driver gene wild tumors (53.1%) chose platinum-based therapy. Univariate and multivariate analyses associated a shorter OS among patients with tumors harboring concomitant TP53 and EGFR mutations. These findings provide additional evidence from real-world on the potential importance of targeted therapies as a treatment option in NSCLC patients harboring clinically actionable mutation. [ABSTRACT FROM AUTHOR]

This study investigated the association between diabetes complications, diabetes distress, and depressive symptoms in patients with type 2 diabetes mellitus. A total of 600 patients with type 2 diabetes mellitus were included in this study. Data were collected using the Diabetes Distress Scale and the nine-item Patient Health Questionnaire. The results showed that both diabetes complications and diabetes distress were positively associated with depressive symptoms, and diabetes distress attenuated the association between diabetes complications and depressive symptoms. The Sobel test confirmed the mediating effect of diabetes distress. Patients with both diabetes complications and diabetes distress had a higher risk of depressive symptoms than those with diabetes complications or diabetes distress alone. This study indicates that the positive association between diabetes complications and depressive symptoms is persistent and mediated by diabetes distress, and the comorbidity of diabetes complications and diabetes distress has an additive interaction effect on depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Blood glucose monitoring is essential in diabetic care and management. Monitoring using glucometers in home and in laboratories by professionals in certain health institutes were the common methods of blood glucose monitoring in clinical practice. This study aimed to characterize the profiles of blood glucose monitoring in the view of the discrepancy in methods and frequency conducted by the patients with type 2 diabetes mellitus (T2DM) in China, and to explore factors influencing the profiles. Methods: A cross-sectional, community-based study was conducted in Shandong province, China, with a multi-stage stratified sampling. A total of 2166 T2DM patients completed the structured questionnaires about the real-world status of blood glucose monitoring and other questions composed of demographic and clinical characteristic as well as the diabetes-related cognitive scales. Latent profile analysis (LPA) was used to identify the underlying profiles of blood glucose monitoring based on self-reported frequency of blood glucose monitoring through different methods. Univariate and multivariate logistic regression were used to analyze the characteristics of the profiles and to explore the factors associated with it. Results: Among the 2166 participants, the mean frequency of blood glucose monitoring was 2.77 times (standard deviation: 7.67) per month. LPA indicated that five-class model was the best solution for classifying the latent groups of blood glucose monitoring: Class 1 "Low frequency in all", Class 2 "High frequency in hospitals", Class 3 "High frequency in primary health institutes", Class 4 "High frequency in pharmacies", and Class 5 "High frequency in self-monitoring". The proportions of the patients in class 1, class 2, class 3, class 4, and class 5 were 88.1% (n=1909), 1.3% (n=28), 3.1% (n=67), 6.1% (n=133) and 1.3% (n=29), respectively. Multivariate logistic regression showed that participants who had higher income (OR: 1.58, 95% CI: 1.04∼ 2.41, p< 0.05), had diabetes complication(s) (OR=1.37, 95% CI: 1.03∼ 1.02, p=0.03) and had a good knowledge of blood glucose control (OR=1.59, 95% CI: 1.17∼ 2.16, p< 0.01) were more likely to have high frequency of blood glucose monitoring (in class 2, 3, 4, 5), and the rural patients were less likely to had high frequency of blood glucose monitoring (OR=0.47, 95% CI: 0.35∼ 0.63, p< 0.01). Conclusion: Low frequency dominates the characteristics of the profiles of blood glucose monitoring among T2DM patients in China, though distinct blood glucose monitoring groups can be identified by LPA. Educational and financial supports were recommended to increase the frequency of blood glucose monitoring in patients with T2DM, focusing on the patients with low socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: Differences in genomic profiling and immunity-associated parameters between germline BRCA and non- BRCA carriers in TNBC with high tumor burden remain unexplored. This study aimed to compare the differences and explore potential prognostic predictors and therapeutic targets. Methods: The study cohort included 21 consecutive TNBC cases with germline BRCA1/2 mutations and 54 non- BRCA carriers with a tumor size ≥ 2 cm and/or ≥1 affected lymph nodes. Differences in clinicopathological characteristics and genomic profiles were analyzed through next-generation sequencing. Univariate Kaplan–Meier analysis and Cox regression model were applied to survival analysis. Immunohistochemistry was used to confirm the consistency between CCNE1 amplification and cyclin E1 protein overexpression. Results: The cohort included 16 and five patients with germline BRCA1 and BRCA2 mutations, respectively. Patients with germline BRCA1/2 mutations were diagnosed at a significantly younger age and were more likely to have a family history of breast and/or ovarian cancer. Six non- BRCA carriers (11.11%) carried germline mutations in other cancer susceptibility genes, including five mutations in five homologous recombination repair (HRR) pathway genes (9.26%) and one mutation in MSH3 (1.85%). Somatic mutations in HRR pathway genes were found in 22.22 and 14.29% of the non- BRCA and BRCA carriers, respectively. PIK3CA missense mutation (p = 0.046) and CCNE1 amplification (p = 0.2) were found only in the non- BRCA carriers. The median tumor mutation burden (TMB) was 4.1 Muts/Mb, whereas none of the cases had high microsatellite instability (MSI). BRCA status did not affect disease-free survival (DFS, p = 0.15) or overall survival (OS, p = 0.52). CCNE1 amplification was an independent risk factor for DFS in non- BRCA carriers with TNBC (HR 13.07, 95% CI 2.47–69.24, p = 0.003). Consistency between CCNE1 amplification and cyclin E1 protein overexpression was confirmed with an AUC of 0.967 for cyclin E1 signal intensity. Conclusions: We found differences in genetic alterations between germline BRCA and non- BRCA carriers with TNBC and a high tumor burden. TMB and MSI may not be suitable predictors of TNBC for immune checkpoint inhibitors. Notably, CCNE1 amplification is a novel potential prognostic marker and therapeutic target for non- BRCA carriers with TNBC. Cyclin E1 may be used instead of CCNE1 to improve clinical applicability. [ABSTRACT FROM AUTHOR]

The interaction between DNA and furazolidone/furacillin was investigated using various analytical techniques including spectroscopy and electroanalysis and molecular modelling. With the aid of acridine orange (AO), the fluorescence lifetimes of DNA–AO, DNA–furazolidone/furacillin–AO remained almost the same, which proved that the ground state complex was formed due to furazolidone/furacillin binding with DNA. Circular dichroism spectra and Fourier transform infrared spectroscopy showed that the second structure of DNA changed. Viscosity experiments presented that relative viscosity of DNA was increased with the increasing concentrations of furazolidone and almost unchanged for furacilin. In addition, the results of melting temperature (Tm), ionic strength, site competition experiments, cyclic voltammetry, and molecular docking all proved the intercalation binding mode for furazolidone and groove binding mode for furacilin. The binding constants (Ka) obtained from Wolfe–Shimmer equation were calculated as 3.66 × 104 L mol−1 and 3.95 × 104 L mol−1 for furazolidone–DNA and furacilin–DNA, respectively. [ABSTRACT FROM AUTHOR]

Background: Community-based diabetes management is known to be an important strategy for global diabetes control. In China, community-based diabetes management care, including regular blood glucose tests and guidance on medicine use, dietary control, and physical exercise provided by primary health institutions (PHIs), as one of the key contents of the national essential public health services (EPHS), was implemented since 2009 when the new round of health system reform was initiated. This study aimed to investigate the utilization of community-based diabetes management care services, and explore the factors influencing utilization from both patients' and providers' points of view.Methods: In total, 2520 type-2 diabetes mellitus (DM) patients registered for EPHS were selected from 63 PHIs in eight counties of Shandong province, China, using multi-stage stratified sampling. Of those, 2166 patients (response rate: 85.4%) completed face-to-face structured questionnaires on their utilization of community-based diabetes management care services. Further, 63 PHIs were surveyed on diabetes care delivery, and 444 primary healthcare providers were purposively sampled from those PHIs to measure their knowledge of diabetes management care delivery, using a self-developed questionnaire. Descriptive statistics were used to analyze the delivery and utilization of diabetes management care services. Multilevel logistic regression models were used to analyze the factors associated with patients' utilization of diabetes management services.Results: All 63 PHIs reported that all the required four diabetes management services were provided through EPHS. However, only 49.6% of the patients reported they fully used these services, with no statistically significant difference between urban and rural patients. Patients who had higher knowledge of diabetes and better self-efficacy in controlling the condition, were more likely to fully utilize diabetes management care. A larger number of PHI health staff per 1000 population was associated with better utilization of care.Conclusion: Although community-based diabetes management services are well available to Chinese DM patients under the framework of EPHS, the actual utilization of diabetes management services among the patients was poor. The size of the PHI workforce, patients' knowledge and self-efficacy in controlling diabetes, were important predictors of utilization, and could be enhanced to improve control of diabetes. [ABSTRACT FROM AUTHOR]

Background: Despite the great advance of protein structure prediction, accurate prediction of the structures of mainly β proteins is still highly challenging, but could be assisted by the knowledge of residue-residue pairing in β strands. Previously, we proposed a ridge-detection-based algorithm RDb2C that adopted a multi-stage random forest framework to predict the β-β pairing given the amino acid sequence of a protein. Results: In this work, we developed a second version of this algorithm, RDb2C2, by employing the residual neural network to further enhance the prediction accuracy. In the benchmark test, this new algorithm improves the F1-score by > 10 percentage points, reaching impressively high values of ~ 72% and ~ 73% in the BetaSheet916 and BetaSheet1452 sets, respectively. Conclusion: Our new method promotes the prediction accuracy of β-β pairing to a new level and the prediction results could better assist the structure modeling of mainly β proteins. We prepared an online server of RDb2C2 at http://structpred.life.tsinghua.edu.cn/rdb2c2.html. [ABSTRACT FROM AUTHOR]

Purpose: Patients with Type 2 diabetes (T2D) have increased risk of depression and anxiety. Evidence suggests that a heightened inflammatory state may contribute to this association. Females experience more depression and higher inflammation levels than males. This study compared associations of serum high-sensitivity C-reactive protein (hs-CRP) levels with symptoms of depression and anxiety between men and women with Type 2 diabetes mellitus (T2DM). Method: Cross-sectional data including demographic and disease characteristics, symptoms of depression and anxiety, clinical data, and laboratory values were collected from 392 patients with T2DM recruited from a general hospital in Shandong Province, China. We evaluated associations between serum hs-CRP level and symptoms of depression and anxiety in males and females separately using multiple linear regressions and χ2 tests for trend. Results: Sex moderated the association between serum hs-CRP level and symptoms of depression (B =.112 [ SE = 0.049]; p =.022) and anxiety (B =.137 [ SE = 0.053]; p =.011). Among females, hs-CRP level was positively associated with depression (B =.034, 95% confidence interval [CI] = [.006,.061]; p =.016, false discovery rate [FDR]-adjusted p =.020) and anxiety (B =.041, 95% CI [.011,.071], p =.007, FDR-adjusted p =.007). Positive trends indicated a higher prevalence of clinically significant symptoms of depression and anxiety in higher serum hs-CRP categories in females. No associations were found in males. Conclusion: Findings demonstrate that associations between serum hs-CRP level and symptoms of depression and anxiety in patients with T2D are sex-specific, with only females demonstrating a significant positive association. [ABSTRACT FROM AUTHOR]

Identification of deleterious variants in hereditary breast and ovarian cancer (HBOC) susceptibility genes allows for increased clinical surveillance and early detection, and could predict the response to poly (ADP‐ribose) polymerase (PARP) inhibitor in patients with advanced ovarian carcinomas. To determine the prevalence and clinical prediction factors for HBOC syndrome, 882 selected individuals underwent multigene panel testing for HBOC risk assessment during the period from January 2015 to March 2018. Overall, 176 deleterious mutations were observed in 19.50% (n = 172) of individuals. Twenty‐six of 176 mutations could not be retrieved in related public databases and were considered to be novel. Among patients with ovarian cancer, 115 deleterious mutations were identified in 429 patients (48.6%) with significant enrichment for a family history of breast or ovarian cancer syndrome (P <.05). In the breast cancer subgroup, 31 deleterious mutations were identified in 261 patients. Besides BRCA1 (8; 25.8%) and BRCA2 (11; 35.5%), the most frequently occurring genes, an additional 12 deleterious mutations (38.7%) were found in seven other susceptibility genes. Higher mutation incidence (57.9%) was observed in subjects with histories of breast and ovarian cancer. Our results highlighted the genetic heterogeneity of HBOC and the efficiency of a multigene panel in carrying out risk assessment. [ABSTRACT FROM AUTHOR]

Purpose: To examine whether and how self-management and psychological resilience could moderate the relationships between symptoms and health-related quality of life (HRQoL) among hypertensive patients in China.Methods: This was a cross-sectional study of 220 participants recruited from January to May, 2018. Demographic and clinical information were obtained from medical records and by patient interview. The Chinese version of 17-item Hypertension-specific Symptom Scale, 21-item Self-Management Scale, and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) as well as Short Form 12 Health Survey (SF-12) were used to collect information in this research. The moderation effects of self-management and psychological resilience were explored using the PROCESS macro for SPSS.Results: Among all patients, 128 (58.2%) were female, 106 (48.2%) had a bachelor degree or higher, and 133 (60.5%) had moderate to severe Charlson Comorbidity Index. Both self-management and psychological resilience were negatively correlated to symptoms (r = - 0.259, p < 0.001; r = - 0.282, p < 0.001) but positively correlated to physical (r = 0.316, p < 0.001; r = 0.344, p < 0.001) and mental (r = 0.273, p < 0.001; r = 0.309, p < 0.001) HRQoL. After controlling for potential covariates, self-management could moderate the associations between symptoms and physical HRQoL (p = 0.041, ΔR2 = 0.010), while psychological resilience could moderate the relationships between symptoms and mental HRQoL (p = 0.02, ΔR2 = 0.010).Conclusions: For hypertension patients, HRQoL is dependent on the severity of symptoms, engagement of self-management behaviors, and psychological resilience, which should be carefully considered when to improve patients' HRQoL by health care providers. [ABSTRACT FROM AUTHOR]

Study Question: What is the effect of two guided self-administered interventions on psychological distress in women undergoing IVF or ICSI?Summary Answer: A brief mindfulness intervention significantly reduced depression and improved sleep quality, while the gratitude journal intervention showed no significant effect on any outcome variables.What Is Known Already: Mindfulness and gratitude journal interventions have been found to be beneficial in reducing negative affect and improving well-being. However, there are very few mental health professionals who implement such interventions in low- and middle-income countries. Therefore, two guided self-administered interventions for women with infertility were designed to help them cope with their psychological distress.Study Design, Size, Duration: A three-armed, randomized controlled trial was designed to evaluate the mindfulness and gratitude journal interventions for women undergoing IVF/ICSI. Between May 2016 and November 2017, at the reproductive center in a public hospital, 234 women were randomly assigned to the brief mindfulness group (BMG, n = 78), gratitude journal group (GJG, n = 78) or control group (CG, n = 78). The inclusion criteria were being a woman undergoing her first cycle of IVF, having at least junior middle school education and having no biological or adopted children.Participants/materials, Setting, Methods: Female infertility patients (n = 346) were approached, and 112 did not meet the inclusion criteria. All three randomized groups completed questionnaires on the day of down-regulation (T1), the day before embryo(s) transfer (T2), and 3 days before the pregnancy test (T3). The BMG completed four sessions and listened to a 20-minute audio daily, including guided mindfulness breathing and body scan. The GJG completed four sessions and wrote three gratitude journals daily. The CG received routine care. A generalized estimating equation was used in an intention-to-treat analysis. The primary outcome was depression. Secondary outcomes were anxiety, sleep quality, infertility-related stress, mindfulness and gratitude.Main Results and the Role Of Chance: Participants of the BMG showed decreased depression (mean difference (MD) = -1.69, [-3.01, -0.37], d = 0.44) and improved sleep quality (MD = -1.24, [-1.95, -0.39], d = 0.43) compared to the CG, but the effect was not significant for anxiety, Fertility Problem Inventory totals, mindfulness, gratitude scores or pregnancy rates. The BMG showed a significant reduction in depression and improvement in sleep quality between T1 and T2, a continuous significant reduction between T1 and T3 and no reduction between T2 and T3. There were no significant effects on any of the variables for the GJG.Limitations, Reasons For Caution: The inclusion criteria may result in bias because some participants with low education were excluded and only women with infertility were included. A low compliance rate occurred in the gratitude journals group. Moreover, men were not included in this study. Further research should consider including spouses of the target population.Wider Implications Of the Findings: The brief mindfulness intervention was beneficial in decreasing depression and improving sleep quality. Implementation of guided self-administered mindfulness could make the psychological counseling service more accessible for patients with infertility in resource-poor settings. The efficiency and feasibility of the gratitude journal intervention needs to be investigated further.Study Funding/competing Interest(s): This study was funded by the National Social Science Foundation (17BSH054). The authors have no conflicts of interest.Trial Registration Number: ChiCTR-IOR-16008452.Trial Registration Date: 9 May 2016.Date Of First Patient’s Enrolment: 15 May 2016. [ABSTRACT FROM AUTHOR]

Since molecular genotyping has been established for the Candida species, studies have found that a single Candida strain (endemic strain) can persist over a long period of time and results in the spread of nosocomial invasive candidiasis without general characteristics of horizontal transmissions. Our previous study also found the existence of endemic strains in a cancer center in Tianjin, China. In the current study, we performed further investigation on endemic and non-endemic Candida albicans strains, with the aim of explaining the higher morbidity of endemic strains. In an in vivo experiment, mice infected with endemic strains showed significantly shorter survival time and higher kidney fungal burdens compared to mice infected with non-endemic strains. In an in vitro experiment, the killing percentage of neutrophils to endemic strains was significantly lower than that to non-endemic strains, which is positively linked to the ratio of LC3B-II/I in neutrophils. An immunofluorescence assay showed more β-1,3-glucan exposure on the cell walls of non-endemic strains compared to endemic strains. After blocking the β-glucan receptor (CR3) or inhibiting downstream kinase (SYK) in neutrophils, the killing percent to C. albicans (regardless of endemic and non-endemic strains) and the ratio of LC3B-II/I of neutrophils were significantly decreased. These data suggested that the killing capability of neutrophils to C. albicans was monitored by β-1,3-glucan via CR3/SYK pathway-dependent LC3B-II accumulation and provided an explanation for the variable killing capability of neutrophils to different strains of C. albicans, which would be beneficial in improving infection control and therapeutic strategies for invasive candidiasis. [ABSTRACT FROM AUTHOR]

Executive impairments have been observed both in patients with schizophrenia and in their unaffected first-degree relatives. Very few studies have investigated neurocognitive subgroups in unaffected first-degree relatives and in healthy participants using data-driven methods. The study included a high-risk group consisting of 100 unaffected young offspring and siblings of patients with schizophrenia and 198 healthy controls, all aged between 9 and 23 years. Executive function, victimization, and emotional and behavioral problems of participants were assessed by a series of self-report scales. Neurocognitive subgroups were investigated using latent class analysis of executive function measures. Four neurocognitive clusters were identified: a good performance cluster, a good self-control cluster, a low self-control cluster, and a severe impairment cluster. Participants in severe impaired executive function cluster reported a significantly higher level of victimization and had more prominent emotional and behavioral problems than the good performance cluster. Neurocognitive differences between high-risk young people and healthy controls were driven by individuals who have severe and global, rather than selective, executive deficits. Our results may provide clues to an explanation of the mechanisms behind executive impairments in young individuals at genetic risk and help to identify new targets for early interventions. [ABSTRACT FROM AUTHOR]