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This study evaluated the learning effects and examined the participants' perceptions of an interprofessional shared decision-making (IP-SDM) training program.This mixed-method study used a quasi-experimental pretest-posttest design in the quantitative phase and semi-structured interviews in the qualitative phase. The 6-week curriculum design, based on Kolb's experiential learning cycle, consisted of two simulated objective structured clinical examinations with standardized patients and blended teaching methods through various course modules.A total of 39 multidisciplinary healthcare personnel completed the 6-week training program, and 32 of them participated in qualitative interviews. The IP-SDM training program effectively improved the SDM process competency of the participants from the perspectives of the participants, standardized patients, and clinical teachers. The interviews illustrated how the curriculum design enhanced learning; the effectiveness results indicated improvements in learners' attitude, knowledge, skills, and teamwork.This IP-SDM training program improved multidisciplinary healthcare personnel's competency, self-efficacy, and intention to engage in IP-SDM.Applying Kolb's experiential learning cycle and blended teaching methods to develop and implement the IP-SDM training program can improve multidisciplinary healthcare personnel's knowledge, attitude, skills, and teamwork in IP-SDM.

Aromatic carboxylic acids (ACAs) may be as transformed key metabolites via gut microbiome for playing better pharmacological effects. However, it's rare to achieve high-specificity, high-sensitivity, and high-throughput detection simultaneously, especially, for tracing trace ACAs in gut microbiome. In this work, firstly, a novel dual-template and double-shelled molecularly imprinted 96-well microplates (DDMIPs) was designed and amplified signal for p-hydroxybenzoic acid (PBA) and 3,4,5-trimethoxycinnamic acid (TMA). Additionally, the DDMIPs and a stable isotope labeling derivatization (SILD) method combined with the ultra-high performance liquid chromatography triple quadrupole tandem mass spectrometry (UHPLC-TQ MS) was firstly stepwise integrated, achieving high-effective, high-sensitive, and high-throughput study of gut microbiome metabolism. The whole strategy showed lower limits of detections (LODs) up to 1000 folds than the traditional method, and revealed a more real metabolism-time profile of PBA and TMA by 3-step signal amplification. The platform also laid the foundation for fast, simple, high-selective, high-effective, and high-throughput metabolism and pharmacological research.

In wind and solar power generation systems, the MPPT algorithm is often used to quantify renewable energy production power, if the light or wind changes suddenly in the algorithm search process, it is possible that the iterative algorithm will not be able to track to the maximum power point or fall into turbulence, and frequent restart of the relevant algorithm will also bring a large energy loss. In view of this situation. For the purpose of further analysis the effect of power output characteristics on the tracking ability of the system, and to enhance the reliability and energy utilization of renewable energy generation system. This manuscript studies an optimal control method for a wind–solar storage complement device designed using power prediction. The article establishes the simulation model of each subsystem separately, and the wavelet packet neural network is used to build a power prediction model. An MPPT optimal control strategy is proposed. This control strategy combines the hysteresis loop comparison-based P&O algorithm in single-peak MPPT and the improved firefly algorithm in multi peak MPPT. The dynamic tracking ability, speed and single peak value and multi peak optimization capability of the algorithm are guaranteed. And the simulation analysis of the control strategy is executed by MATLAB, and the findings demonstrate the efficacy of the optimum control technique proposed in this article. This algorithm has also been shown to outperform traditional intelligent algorithms in terms of tracking efficiency and stability

We present a definition of stochastic Hamiltonian process on finite graph via its corresponding density dynamics in Wasserstein manifold. We demonstrate the existence of stochastic Hamiltonian process in many classical discrete problems, such as the optimal transport problem, Schrodinger equation and Schrodinger bridge problem (SBP). The stationary and periodic properties of Hamiltonian processes are also investigated in the framework of SBP.

Various individual characteristics may affect medication adherence; however, few studies have investigated the effect of interrelationships among these various individual characteristics on medication adherence. This cross-sectional study explored the interrelationships among risk factors for medication adherence and established a predictive model of low medication adherence among older adults with hypertension. Convenience sampling was used to recruit 300 older adults with hypertension. The following parameters were recorded: demographic and disease characteristics, health beliefs, self-efficacy, social support, and medication adherence of antihypertensive drugs. Classification and regression tree (CART) analysis was performed to develop a predictive model of low medication adherence. The CART model revealed that health belief, disease duration, self-efficacy, and social support interacted to contribute to various pathways of low medication adherence. The predicted accuracy of the model was validated with a low misclassification rate of 26%. The proposed classification model can help identify risk cases with low medication adherence. Suitable health education programs based on these risk factors to manage and improve medication adherence for older adults with hypertension could be considered.

Organic adhesives (e.g. epoxy resin) have been widely used in the near-surface-mounted (NSM) fibre reinforced polymer (FRP) strengthening system for reinforced concrete (RC) structures. However, the drawbacks of the organic adhesives in terms of high-temperature resistance and compatibility with concrete urge the development of inorganic adhesives (e.g. cement-based and alkali-activated materials). Moreover, a premature debonding of NSM FRPs from concrete substrate adversely affects the performance of strengthened RC structures, as well as the efficiency of NSM FRPs. Various anchorage strategies have been consequently proposed to improve the bond between the NSM FRPs and the concrete. This paper presents an overview on the bond behaviour between inorganic adhesive based NSM FRPs and concrete. Flexural strengthening of RC beams with inorganic adhesive based NSM FRPs, and the anchorage strategies for NSM FRPs are also summarized. Different from epoxy-based adhesives, the bond strength of inorganic adhesive based NSM FRPs decreases as the groove dimension increases. The RC beams strengthened by inorganic adhesive based NSM FRPs tend to fail due to an intermediate crack debonding of FRPs, which is probably caused by the low deformation capacity of inorganic adhesives. Anchorage strategies, such as adding external wrapping FRP fabrics or internal additional ribs, could significantly enhance the strengthening efficiency and the constructability of NSM FRPs. In the end, recommendations for future studies on the use of inorganic adhesive based NSM FRPs for structural strengthening are outlined.

Objectives An increased risk of thyroid cancers in patients with acromegaly has been addressed by numerous studies. However, the differences between patients with papillary thyroid cancer (PTC) with and without acromegaly remain to be clarified. We compared the clinical–pathologic data and genetic alterations of PTC between the 2 groups. Patients and Methods Four patients with PTC and acromegaly and 32 age-matched patients with PTC without acromegaly were retrieved retrospectively from the hospital recordings. Mutational analysis was determined by direct sequencing. Insulin-like growth factor-1 receptor and insulin Rβ expression were analyzed by immunohistochemistry in acromegaly group. Results The prevalence of multifocality involved in bilateral lobes in the acromegaly group was significantly increased (P = 0.017). The presence of bilateral lymph node metastasis showed the increasing trend even though without a significant difference because of the limited number of PTC patients in acromegaly group (P = 0.053). There was no significant difference in other factors, such as sex, tumor size in maximum diameter, lymph node metastasis, extrathyroidal extension, and TNM stage. Two (50%) PTCs in acromegalic group and 25 (78.12%) PTCs in the nonacromegalic group were detected to harbor BRAF600E mutation, and no patient was identified to have NRAS codon 61, KRAS codon 61/12/13 mutation. Insulin-like growth factor-1 receptor and insulin Rβ immunostaining showed low positive to positive in PTC cells and negative in adjacent normal tissues in patients with acromegaly. Conclusions Multifocality involved in 2 lobes is more common in patients with PTC and acromegaly, which shows more aggressive behaviors. BRAF mutation is not uncommon in patients with PTC and acromegaly.

The superhydrophobic ZnO@stearic acid (ZnO@STA) nanoarrays have been prepared and synchronously introduced plentiful oxygen vacancies by using hydrothermal method on the Zn substrate. After UV–Visible light irradiation, the superhydrophobic ZnO@STA surface is transformed into the superhydrophilic surface, which is mainly attributed to the excitation of electron-hole pairs and reaction with the adsorbed O2 and H2O from air to form hydroxyl radicals on the ZnO@STA surface, and not photodegradation of STA. Also, the introduced defect energy levels of oxygen vacancies make more electron-hole pairs excited by visible light. Continuing to further heat the ZnO@STA surface, the photoinduced hydroxyl radicals are desorbed from the ZnO@STA surface, making the photoinduced superhydrophilic surface revert to the original superhydrophobic surface. And the reverse wetting transition can be accelerated through the increase of heating temperature. Moreover, the ZnO@STA nanorod array surface also exhibits excellent cycle stability of reversible switch between superhydrophobicity and superhydrophilicity.

In this study, catalytic activity and deactivation mechanism of a carbon-based solid-acid catalyst in the esterification of oleic acid and methanol were investigated. The experimental results showed that the S150-4 catalyst, prepared by sulphonating at 150 °C for 4 h, yielded the highest sulfonic acid density. The conversion yield reached 97.98% under the optimum esterification conditions (i.e. catalyst loading, 10 wt%; methanol/oleic acid molar ratio, 8:1; reaction temperature, 65 °C; reaction time, 8 h) and decreased to 79.19% after four cycles. In the first batch of esterification, the formation of sulfonic esters was the main reason for the deactivation of the catalyst, whereas the leaching of sulphur was the main contributor in the second to fourth batches. Therefore, it is believed that reducing the leaching of sulphur and the formation of sulfonic esters by changing the addition method of methanol is an effective method to extend the service life of the catalyst.

Scutellaria baicalensis Georgi (S. baicalensis) is a traditional Chinese medicine that has been used in the treatment of diabetes for centuries. Although it has curative effects on diabetic nephropathy (DN), the critical role and mechanisms of S. baicalensis in the prevention and management of DN have not been fully elucidated. Thus, in the current study, metabolomics was integrated with a network pharmacology approach to explore the mechanisms of S. baicalensis against DN. To illustrate the metabolic alterations regulated by S. baicalensis during DN progression, an untargeted serum metabolomics approach using ultra-high- performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) was developed. It revealed that 14 serum metabolic biomarkers identified in DN rats were partially reversed by S. baicalensis treatment, which was primarily involved in glycerophospholipid metabolism, arachidonic acid metabolism and retinol metabolism pathways, with 536 extended metabolite-target genes (M-T) interactions observed. Based on network pharmacology analysis, a total of 31 active compounds and 123 compound-target genes (C-T) interactions of S. baicalensis were identified. By integrating M-T with C-T co-network analysis, 18 shared genes were identified as hub targets against DN, including MAPK14, MPO, MMP9, FN1, NOS2 and CASP3, which primarily contributed to biological processes related to inflammatory responses. The molecular docking analysis further verified the interactions between the major active compounds and six predicted proteins encoded by the hub targets, indicating that S. baicalensis may function by targeting inflammatory responses process in DN. Overall, the current work yielded new insights into the molecular mechanisms of active compounds in the action of S. baicalensis against DN progression and suggested a strategy for clarifying the treatment mechanisms of traditional herbal medicines.

An efficient and practical route to various 3-alkoxylquinoxalin-2(1H)-ones through visible-light photocatalytic C(sp2)−H/O−H cross-dehydrogenation coupling of quinoxalin-2(1H)-ones and alcohols, employing ambient air as an oxidant at room temperature under metal-free conditions, was developed.

Radioresistance reduces the success of therapy for patients with ESCC. Enhancing our understanding of the cardinal principles of radioresistance may improve the response of patients to irradiation. MicroRNAs perform a key role in posttranscriptional regulation, which is linked with the response of tumors to irradiation. Here, we successfully constructed a radioresistant cell line model, ECA109R, from parental esophageal cancer cell line ECA109. We used RNA-Seq analysis and qRT-PCR to compare the miRNA expression profiles of the ECA109 and ECA109R cell lines. The results revealed that miR-450a-5p was downregulated in the radioresistant cells. Functional analysis indicated that miR-450a-5p increases cellular radiosensitivity and suppresses autophagy in ESCC cells. We utilized a luciferase reporter assay to identify the target gene, DUSP10, as an indispensable regulator of the p38 and SAPK/JNK signaling pathways. Upregulation or downregulation of DUSP10 expression could reverse the effects of miR-450a-5p overexpression or inhibition. Tumor xenograft experiments verified that miR-450a-5p overexpression could increase sensitivity to radiation therapy in vivo. In general, our findings indicate that miR-450a-5p is a latent radiosensitizer and may represent a potential novel therapeutic target for radioresistance in ESCC.

A simple hydrothermal method is successfully used to prepare the La2O3 film, and the accurate control of its surface structure is realized through the hydrothermal temperature and time from the sparsely dispersed compact microspheres to closely packed microsphere film, then from the hierarchical structure of the sparsely dispersed compact and flower-like microspheres accompanied with the discrete vertical-standing nanopetals to the hierarchical structure constituted by the closely packed compact microspheres and dense vertical-standing nanopetals. The XRD analysis shows the prepared film is mainly made of hexagonal La2O3 accompanied with some impurities of La(OH)2NO3, La(OH)3 and La2TiO5. Valuably, the prepared La2O3 film has high capacitance which can be modulated by surface structure, and achieves the maximum when the surface structure is hierarchical structure constituted by the closely packed compact microspheres and vertical-standing nanopetals. Eventually, the high capacitance leads to the electrowetting-on-dielectric (EWOD) responses with low voltage actuation below 8 V and wide contact angle modulation range of about 131°. The works are very beneficial to the design and preparation of supercapacitor and EWOD devices with high performance.

The chitin deacetylase produced by marine strain Nitratireductor aquimarinus MCDA3-3 (NaCDA) was purified by using ammonium sulfate precipitation, Q Sepharose, and Superdex column chromatography. The purified NaCDA showed 75-fold purity, 50 U/mg specific activity with 28.5% yield. The purified CDA molecular weight was about 36 kDa. The temperature and pH of the purified enzyme were suiting at 30 °C and 8.0, respectively. The NaCDA was highly stable for a wide range of temperature 4 °C–25 °C and pH 6.0–9.0. Besides, increased enzyme activity was observed by introducing metal ions mainly Sr2+, Mg2+, and Na+. The enzyme was founded inhibited by Co2+, Ba2+, and EDTA at the value of 1 mM concentrations. On the other hand, NaCDA was shown an active activity behavior toward glycol chitin and chitin oligomers with a degree of polymerization more than four, any polymer below the chain such as trimer and dimer significantly reduce in the activity rate, and inactive with N-acetylglucosamine. Interestingly, NaCDA showed a high activity rate against insoluble chitins and converting acetyls to deacetylated. The reduction of acetyls from 56.26% and 22.88% of acetyl groups from ɑ-chitin and β-chitin, respectively. Hence, the NaCDA would be applicable in production chitosan toward mass production.

Enrichment of trace bioactive constituents and metabolites from complex biological samples is challenging. This study presented a one-pot synthesis of magnetic polydopamine nanoparticles (Fe3O4@SiO2@PDA NPs) with multiple recognition sites for the magnetic dispersive solid-phase extraction (MDSPE) of ginsenosides from rat plasma treated with white ginseng. The extracted ginsenosides were characterized by combining an ultra-high-performance liquid chromatography coupled to a high-resolution mass spectrometry with supplemental UNIFI libraries. Response surface methodology was statistically used to optimize the extraction procedure of the ginsenosides. The reusability of Fe3O4@SiO2@PDA NPs was also examined and the results showed that the recovery rate exceeded 80% after recycling 6 times. Furthermore, the proposed method showed greater enrichment efficiency and could rapidly determine and characterize 23 ginsenoside prototypes and metabolites from plasma. In comparison, conventional methanol method can only detect 8 ginsenosides from the same plasma samples. The proposed approach can provide methodological reference for the trace determination and characterization of different bioactive ingredients and metabolites of traditional Chinese medicines and food., Graphical abstract Image 1, Highlights • The Fe3O4@SiO2@PDA NPs were synthesized through one-pot method. • The RSM was designed to promote the extraction of trace active ingredients. • The MDSPE, UPLC-MS and UNIFI software were integrated into an analytical platform. • The synergetic strategy was applied to enrich ginsenosides from rat plasma. • The synergetic strategy provided an easy, rapid and sensitive method for analytes.