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Patient-centered communication (PCC) is a key indicator of healthcare quality and is critical to patient-centered care. The purpose of this study is to examine the trends in PCC over the past decade and determine if differences in PCC by subpopulation remain METHODS: We used nationally representative survey data from the Health Information National Trends Study (HINTS) to examine PCC. We conducted trend and multivariate regression analyses to understand the changes of PCC scores and differences in PCC by key sociodemographic groups.PCC reported among adults minimally increased with the largest increases in participants involved in making decisions regarding their healthcare. Participants who were non-Hispanic Black, older, had less than a high school education, or rural residents reported more positive perceptions of PCC CONCLUSION: Our findings indicate improvements to PCC over time. These findings also indicate that differences in patients' perceptions of PCC continue to persist and it's possible that personal expectations may influence a person's perception of the quality of PCC experienced PRACTICE IMPLICATIONS: This study highlights the continued need for provider education in patient emotional support and providing patients with the skills and resources to engage in high quality PCC.

This paper studies the adaptive distributed event-triggered fault-tolerant consensus problem for a class of multi-agent systems with time delays and external disturbance. The communication faults between the agent and its neighbours are considered, and a fault-tolerant control mechanism is designed to overcome the communication faults. Moreover, a distributed event-triggered mechanism is constructed based on the distributed errors, and hence the communication burden can be reduced. Combining the Lyapunov stability theorem with the Lyapunov-Krasovskii function, it verifies that the consensus tracking errors are bounded with the guaranteed security performance, and the time delays phenomenon can also be compensated. Finally, the effectiveness and utility of the proposed control method are fully validated by two simulation examples.

Objective To assess effect of licochalcone A (LicA) on amyloid-β (Aβ) peptide fragment 25–35–induced nerve injury and reveal the potential molecular mechanisms involved. Methods Viability of SH-SY5Y cells was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay after treatment with Aβ25–35 and/or LicA, following which apoptosis was detected by flow cytometry and Hoechst staining. Then, reactive oxygen species, glutathione, and superoxide dismutase were measured with flow cytometry and spectrophotometry. The ultrastructure of mitochondria was examined by transmission electron microscopy, and the biomarker proteins of autophagy, apoptosis, and phosphoinositide 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) signaling pathway were measured with Western blotting. Results LicA improved cell viability and decreased lactate dehydrogenase leakage remarkably in Aβ25–35–induced injury in SH-SY5Y cells. After treatment with LicA, reactive oxygen species, glutathione, and superoxide dismutase levels in cells all were significantly decreased, which indicated that LicA has an antioxidative effect on Aβ25–35-induced oxidative injury. LicA could also significantly reduce Aβ25–35–induced autophagy in SH-SY5Y cells. In the cells injured by Aβ25–35, LicA prevented the transformation from light chain protein 3-I to light chain protein 3-II and reduced the levels of proteins GRP78, GRP94, CHOP, and Bax, but increased the levels of antiapoptotic protein and phosphorylation of PI3K, Akt, and mTOR. These effects of LicA were restored or suppressed by mTOR inhibitor rapamycin or PI3K inhibitor LY294002. Conclusions LicA protects SH-SY5Y cells against Aβ25–35–induced injury, wherein suppressed autophagy and activated PI3K/Akt/mTOR signaling pathway are involved, and mTOR-dependent autophagy at least plays some role.

This paper investigates the problem of adaptive tracking control for multi-agent systems subject to output constraint and unknown hysteresis. Different from most existing results that use the barrier Lyapunov function and integral barrier Lyapunov function to solve the output constraint problem, the transformation technique is introduced in this paper, which can convert the original system to a constrained or completely unconstrained system. The difficulty caused by unknown Bouc-Wen hysteresis is solved via the Nussbaum gain technique. The continuous unknown function is estimated by using the radial basis function neural networks. The tracking differentiator is utilized to overcome the difficulty of “explosion of complexity”. By using the Lyapunov stability theory, it is indicated that all signals of the closed-loop system are semi-globally uniformly ultimately bounded, and the tracking error converges to a small neighborhood of the origin. Eventually, the feasibility of the designed approach is demonstrated by some simulation results.

Catalysis operated on supported single metal atom is considered as one of the vital efforts for chemical and energy conversion. Despite the enormous amount of research on single transition metal (TM) enhanced graphdiyne (GDY) material, its modification with slightly depleted uranium remains unexplored. Herein, we conducted relativistic density functional theory (DFT) calculations for the accumulation of atomic uranium inside size-suitable GDY pore. The stability of graphdiyne-uranium (GDY-U) is corroborated in terms of short U–C bond distances (2.34–2.44 A), with local depletion of charge and greater U(5f)-C(p) molecular orbital overlap. The magnificent structural and electronic properties of GDY-U system qualify it for the investigation of hydrogen evolution reaction (HER). The HER performance of all exposed sites, including central metal atom and four dissimilarly coordinated acetylenic carbons has been examined and compared with that of pure GDY. As the overall HER interfacial descriptor, free energy change of the intermediate state (ΔGH∗) at the central metal surface of GDY-U was found to be most favorable (0.153 eV) amongst all sites and far superior to those of pure GDY. In addition to the uranium surface, the coordinated carbons also show improved HER activity, indicating the enhancement of the system upon metal insertion. The calculated ΔGH∗ of the GDY-U system here is comparable to some of the recently reported GDY-TM materials, suggesting that atomic uranium could be an exceptional alternative for applied common catalysts.

A series of novel phenylpyrazole carboxylic acid derivatives containing fluorine moiety, i.e., diamides 11, simple aryl-bearing amides 12 and acylthioureas 14 were successfully synthesized based on the key fluoro-containing phenylpyrazole acid intermediate. The new compounds were identified and confirmed by melting point, 1H NMR, 13C NMR and elemental analysis or HRMS. The bioassay results indicated that some of the compounds possessed excellent insecticidal activities towards oriental armyworm, diamondback moth and corn borer at low concentrations. For examples, compounds 11a, 11e−g and 14b exhibited remarkable larvicidal activities with LC50 values of 0.13 − 0.39 mg/L and 0.0002 − 0.0014 mg/L against oriental armyworm and diamondback moth, respectively, were comparable with those of the control chlorantraniliprole. Particularly, 11e were found superior to chlorantraniliprole in oriental armyworm tests (LC50: 0.23 mg/L vs. 0.26 mg/L); 11a, 11e, 11f and 14c in diamondback moth tests with LC50 values of 0.0002 mg/L, 0.0002 mg/L, 0.0008 mg/L and 0.0005 mg/L, respectively, were more effective than that of chlorantraniliprole. In addition, 12a also showed a promising insecticidal potential and development/optimization advantage. Compounds 11a, 11e–g, 12a, 14b and 14c could be considered as possible new leading structures for further study. The SAR investigation indicated that the compounds with fluorine motif (e.g., -F, -CF2H, -CF3) held apparently favorable insecticidal potentials, which provided useful guidance for further design/development of new phenylpyrazole-containing agrochemicals.

Sponge City (SC) projects offer an effective measure for coping with frequent occurrence of urban flooding as well as water shortage. In China, enormous demand for urban regeneration and short of capital has precipitated the growth of public–private capitalhip (PPP) mode for achieving urban sustainability. Generally, risk identification is perceived as a crucial step as to ensure the success of PPP mode. However, little attention has been paid to identify critical risks in Sponge City PPP projects for emerging countries, for example China. This paper aims to investigate the critical risk factors of Sponge City PPP projects in the context of China. The list of risk factors used for analysis are gathered from literature review, research group brainstorming, and expert interview. Decision-making trial and evaluation laboratory (DEMATEL) method is employed in the study to prioritize the risks and then analyze interdependence between them as to recognize critical risks. The research results show that inadequate supervision system (C1), government intervention (C2), immature law and regulations (C5), project fragmentation (C13), and unclear boundary of catchment area (C14) are the critical risk factors. The findings in this study can provide helpful references not only for the local government to adopt management measures for promoting sustainable SC projects, but also for private capital to effectively mitigate risks in future SC projects.

Geographic Information Systems (GIS), Global Positioning Systems (GPS), and remote sensing (RS) are revolutionizing obesity-related research. The primary applications of GIS have included visualizing obesity outcomes and risk factors, constructing obesogenic environmental indicators, and detecting geographical patterns of obesity prevalence and obesogenic environmental features. GPS was mainly used to delineate individual activity space and combined with other devices to measure obesogenic behaviors. RS has been understated for its role as important sources of data about natural and built environments. These spatial technologies, collectively called the 3S technologies, will be useful in measuring more facets of obesogenic environments and individual environmental exposure at finer levels and studying obesity etiology and interventions.

304 stainless steel (SS) was exposed to 325 °C water condition to simulate the operation condition of nuclear power reactor. The microstructural characteristics and corrosion behaviors of exposed 304 SS was investigated. Result shows that the exposed 304 SS surface form an oxide film, which consist of outer film and inner film. The outer film is composed of μm-size hematite and nm-size spinel oxide particles formed on top of the original metal surface. The continuous inner film contains Nano-crystalline spinel. Potentiodynamic polarization test results indicate that the corrosion behavior of 304 SS decrease with exposure time increasing. Because the quantity of pores on oxide film increase with exposure time increasing, and the corrosion behavior decrease. The oxide film gradually grows with exposure time. Finally, the formation and evolution mechanism of oxide film was proposed and the determining factors was discussed.

To investigate whether nuclear factor-kappa B1 (NFKB1) gene polymorphisms are associated with the outcomes of hepatitis C virus (HCV) infection in a Chinese high-risk population.In this case-control study, 984 HCV-uninfected controls, 221 infected individuals with spontaneous HCV clearance, and 456 with persistent HCV infection were enrolled. Rs28362491 and rs72696119 were genotyped using the ABI TaqMan allelic discrimination assay. The functional annotation of the identified single nucleotide polymorphisms (SNPs) were further evaluated by bioinformatics analysis.Significant differences were observed among the three groups (P 0.001) in terms of the frequency of rs28362491 SNP. In logistic regression analysis, rs28362491-ATTG deleted (D) was associated with a significantly increased risk of HCV infection compared to the major-type rs28362491-ATTG inserted (I) (dominant model: adjusted OR = 1.332, 95% CI = 1.059-1.674, P = 0.014; additive model: adjusted OR = 1.181, 95% CI = 1.021-1.367, P = 0.025), after adjusting for age, gender, and route of infection. Based on the in silico prediction, the RegulomeDB score for SNP rs28362491 was 3a, indicating that it can potentially regulate the transcription and expression of NFKB1 gene.NFKB1 rs28362491-D allele was functionally associated with the increased risk of susceptibility to HCV infection in the Chinese Han population.

We aimed to systematically examine Americans’ perceptions of fast food (FF) and how these perceptions might affect fast food consumption (FFC) and obesity risk. We searched PubMed and Google for studies published in English until February 17, 2017 that reported on Americans’ perceptions (defined as their beliefs, attitudes, and knowledge) regarding FF as well as those on their associations with FFC and obesity risk. Thirteen articles met inclusion criteria. Limited research has been conducted on these topics, and most studies were based on convenience samples. A 2013 nationally representative phone survey of about 2000 subjects showed that one-fifth of Americans thought FF was good for health, whereas two-thirds considered FF not good. Even over two-thirds of weekly FF consumers (47% of the total population) thought FF not good. Americans seem to have limited knowledge of calories in FF. Negative and positive FF perceptions were associated with FFC. Those who consumed less FF seemed more likely to view FF negatively. When Americans valued the convenience and taste of FF and preferred FF restaurants with kid's menus and play areas, they were likely to purchase more FF. Available research indicates neither perceived availability of FF nor Geographical Information System (GIS)-based FF presence in the neighborhood has significant associations with weekly FFC. No studies examined potential links between FF perceptions and obesity risk. Americans’ perceptions of FF and how they might associate with FFC and obesity risk are understudied. Considerable variation was observed in Americans’ perceptions and FFC.

Off-site construction (OSC) has been a hot issue in the construction industry. However, high cost was an important factor that hinders the OSC development. This study attempts to explore how stakeholder collaborative management and OSC cost performance relate to each other. Semi-structured interviews were conducted to explore and verify the quantitative indicators that measure stakeholder collaborative management and cost performance. Interaction frequency, emotional intensity, familiarity, and reciprocity were selected as the metrics to measure stakeholder collaborative management. Unilateral cost and production cost of precast components were used to depict OSC cost performance. Meanwhile, social network analysis (SNA) was adopted to obtain density, network centralization and centrality to estimate the network relationship. This study attained the adjacency matrix by a survey, and then developed an OSC collaborative project management primary framework (OSCCPMPF) through SNA to explore the evolution process of collaboration among stakeholders. Hypotheses were developed. Then, multiple case studies were conducted. This study found that stakeholder collaborative management positively affects cost performance. Meanwhile, cost performance was the most important driver for stakeholder collaborative management. Network relationship had a positive impact on cost performance. Additionally, differential strategies can be adopted to promote the OSC development. The findings are useful for setting up a benchmark framework for cost management and project management mode in OSC.

F6NM martensitic stainless steel was exposed to 350 °C water condition for 500, 1500, and 2500 h to simulate pressurized water reactor (PWR) condition. The characterization and corrosion behavior of the oxide film were investigated. Results indicate that the exposed steel surface formed a double-layer oxide film. The outer oxide film is Fe-rich and contains two type oxide particles. However, the inner oxide film is Cr-rich, and two oxide films, whose thicknesses increase with increasing exposure time. The oxide film reduces the corrosion behavior because the outer oxide film has many crack and pores. Finally, the mechanism and factors affecting the formation of the oxide film were investigated.

The huge economic loss of citrus fruit after harvest called for safe and efficient preservatives, as chemically synthesized agents threatened the environment and human health. Herein a biocontrol fungus Chaetomium globosum QY-1 near the orchard in riparian area was identified to have antimicrobial, antioxidant and tyrosinase inhibition activity, which meets the requirements of an ideal preservative. Metabolite profiling based on bioassay-guided fractionation was carried out, and eight polyketones were determined by MS and NMR. The most abundant CheA exhibited strong inhibition to Penicillium digitatum, the main pathogen caused citrus fruit rot. Among these metabolites, Epicoccone and Epicoccolide B showed higher antioxidant activity, while Epicoccone and CheA had higher tyrosinase inhibitory activity. All the activities were close to or even better than the positive control (Vc; glutathione; Vc and arbutin; Bellkute), implying that the metabolites of C. globosum had comprehensive effects as natural preservatives.

Penicillium oxalicum has been used as a biocontrol fungus in agriculture for many years, but the antimicrobial substances are still uncertain. Herein, we isolated a linear peptide named Sanxiapeptin in the culture broth of Penicillium oxalicum SG-4 collecting from the Three Gorges riparian zone. Sanxiapeptin exhibited potent inhibitory effect on citrus green mold Penicillium digitatum, the main fungi responsible for postharvest decay. Sanxiapeptin was elucidated as composing of five amino acids, which were β-amino-α-methoxybutyric acid (Amoba), N-Me- l -Thr, d -Thr, N-Me- l -Val and l -Ser. By analyzing three chemically synthesized oligopeptides with similar structures, we found that the first amino acid of Amoba was crucial to the antifungal activity, as was the methylation of peptide bond. Sanxiapeptin may act as an antimicrobial agent by affecting the function of cell membranes or walls. The antimicrobial spectrum, safety and stability analysis supported that Sanxiapeptin was a promising antifungal agent for citrus preservation.

Co-expression of diacylglycerol O-acyltransferase (DGAT1) and a lipid droplet-stabilizing protein called Cys-oleosin (collectively ‘HME’ technology) increases foliar lipid concentrations and plant biomass, which could elevate energy yields from perennial ryegrass (PR, Lolium perenne L.)-based pastures. Quantifying the feasible benefits of HME PR necessitates that herbage growth and energy density are quantified on a ground area basis under regular defoliation. We examined the translation, from spaced pots indoors to field canopies (swards), of the fatty acid (FA), gross energy (GE), and biomass enhancing traits associated with HME technology expression in PR. Under controlled indoor conditions in spaced pots, hemizygous HME seedlings with 32% higher leaf FA content (1.2%DW) than null controls exhibited a faster rate of leaf extension. These effects translated into a stable 0.2–0.5 kJ/gDW increase in herbage GE concentration, and a 6–10% herbage growth rate advantage when HME ‘miniswards’ were grown under moderate light competition (LAI 7–9) for five defoliation and regrowth cycles (harvests). However, subsequent growth in a dense canopy (LAI>10) eliminated this HME herbage growth advantage. In two field trials in the Midwest United States, hemizygous HME swards exhibited 25–34% (0.8–1%DW) higher end-of-season herbage FA content than null control swards, and 0.2–0.5 kJ/gDW higher end-of-season herbage GE. Herbage growth rates were generally similar for HME and null control swards across both field seasons. This thorough analysis of trait translation shows that the benefits of enhanced FA and GE translate to HME PR canopies grown in the field. The intrinsic growth advantage of HME PR may be diminished in field canopies such that yield benefits are realized only under limited conditions.

Research shows that a significant number of adolescents and young adults quit vaping or reduced the amount of nicotine consumed since the beginning of the COVID-19 pandemic. However, there is a lack of evidence on adolescent risk perceptions regarding the link between vaping and susceptibility to contracting COVID-19. This study examined the level of perceived COVID-19 risk due to vaping among at-risk adolescents. A sample (N = 1,251) of adolescents aged 13 to 17 and susceptible to future vaping were recruited through Qualtrics to participate in an online survey. More than two thirds of the sample (68.34%) reported that vaping would increase one’s risk of contracting COVID-19. Ordinal logistic regression showed that this risk perception was positively associated with perceived prevalence of vaping among peers (AOR = 1.186, 95%CI = 1.019–1.382) and prior exposure to vaping product advertising (AOR = 1.371, 95%CI = 1.221–1.539), and negatively associated with past 30-day vaping (AOR = 0.579, 95%CI = 0.406-0.825) and number of closest friends who vaped (AOR = 0.873, 95%CI = 0.779-0.978). Further analysis stratified by past 30-day vaping showed that, among those who vaped in the past 30 days, vaping-related covid risk perception was positively associated with susceptibility to future vaping (AOR = 1.562, 95%CI = 1.161–2.101) and sensation-seeking (AOR = 1.212, 95%CI = 1.003–1.463). These results are open to different interpretations because of the cross-sectional nature of the data. Additional research is needed to better understand the observed relationships and their implications for vaping prevention during the pandemic.

The explosive growth of green building (GB) research over the past few decades has posed great challenges for researchers to effectively grasp the holistic GB research status. This paper presents a text mining based method to identify the key research topics and trends from the existing abundant GB research publications. In total, 2421 articles are retrieved from the Web of Science core database. Subsequently, three mutually integrated text mining techniques, including the latent Dirichlet allocation (LDA) modeling, Word2vec, and community network analysis, are employed for knowledge discovery. Results show that the number of GB research topics increased from 1990 to 2020, while design optimization and energy efficient measures have always been the research hotspots. The identified research themes are further categorized into nine general research areas, including GB design, energy saving, GB rating system, life cycle evaluation, incentive and hindrances, post-occupancy evaluation, GB technologies, GB market, and management aspects of GB. Based on the revealed emerging research themes in recent ten years, three research directions are further proposed, such as green building market, employment of digital technologies, and safety risks in GB projects. This research provides an applicable quantitative method to efficiently identify the research topics from the extensive research publications and establishes a comprehensive knowledge framework of the GB research status at different stages.