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BackgroundRecent evidence of the effectiveness of mobile phone–based diabetes management systems is generally based on studies conducted in tertiary hospitals or professional diabetes clinics. ObjectiveThis study aimed to evaluate the clinical efficacy and applicability of a mobile phone–based glucose-monitoring and feedback system for the management of type 2 diabetes mellitus (T2DM) in multiple primary care clinic settings. MethodsIn this multicenter, cluster-randomized controlled, open trial, 13 primary care clinics in Seoul and other large cities in South Korea were voluntarily recruited. Overall, 150 (9 clinics) and 97 (4 clinics) participants with T2DM were assigned to the intervention and control groups, respectively (2:1 allocation). Every month, participants in both groups attended face-to-face physicians’ consultation for the management of diabetes in the clinic. For the intervention group, participants were required to upload their daily self-monitoring of blood glucose (SMBG) results using the mobile phone app in addition to outpatient care for 3 months. The results were automatically transmitted to the main server. Physicians had to check their patients’ SMBG results through an administrator’s website and send a short feedback message at least once a week. At baseline and 3 months, both groups had anthropometry and blood tests, including hemoglobin A1c (HbA1c), and responded to questionnaires about treatment satisfaction and compliance. ResultsAt 3 months, participants in the intervention group showed significantly more improvement in HbA1c (adjusted mean difference to control −0.30%, 95% CI −0.50 to −0.11; P=.003) and fasting plasma glucose (−17.29 mg/dL, 95% CI −29.33 to −5.26; P=.005) than those in the control group. In addition, there was significantly more reduction in blood pressure, and the score regarding treatment satisfaction and motivation for medication adherence increased more in the intervention group than in the control group. In the subgroup analyses, the effect on glycemic control was more significant among younger patients and higher baseline HbA1c levels. ConclusionsThe mobile phone–based glucose-monitoring and feedback system was effective in glycemic control when applied in primary care clinic settings. This system could be utilized effectively with diverse institutions and patients. Trial RegistrationClinical Research Information Service (CRIS) https://tinyurl.com/tgqawbz

Research highlights: The increasing rates of mental health disorders during the COVID-19 pandemic have popularized the notion of access to natural environments as a solution, leading to a surge in demand for urban green spaces. The concentration of natural volatile organic compounds (NVOCs) in forests, resulting from plant metabolism, plays a crucial role in forest-based healing and ecosystem health. Background and objectives: This study aimed to investigate how tree spacing influences NVOC concentrations within forest ecosystems using passive samplers, thereby enhancing the understanding of optimal forest management practices to promote human health benefits. Methods: We employed passive samplers to investigate tree spacing effects on NVOC concentrations. We placed passive samplers among trees in the study area to measure NVOC concentrations in individual trees and analyzed the relationship between NVOC concentration and tree spacing and structure. Results: A multiple regression analysis using distance decay models showed that a tree spacing of 2.7–3 m had a significant impact on NVOC concentrations. These findings provide a better understanding of how tree structure, tree spacing, and microclimate within the forest influence NVOC concentration. Conclusion: These findings have important implications for forest management and the design of forest landscapes to promote human health and well-being by considering the spatial distribution of NVOC concentrations. [ABSTRACT FROM AUTHOR]

The preadipocyte factor 1 (Pref-1) is involved in the proliferation and differentiation of various precursor cells. However, the intracellular signaling pathways that control these processes and the role of Pref-1 in the pancreas remain poorly understood. Here, we showed that Pref-1 induces insulin synthesis and secretion via two independent pathways. The overexpression of Pref-1 activated MAPK signaling, which induced nucleocytoplasmic translocation of FOXO1 and PDX1 and led to the differentiation of human pancreatic ductal cells into β-like cells and an increase in insulin synthesis. Concurrently, Pref-1 activated Akt signaling and facilitated insulin secretion. A proteomics analysis identified the Rab43 GTPase-activating protein as a downstream target of Akt. A serial activation of both proteins induced various granular protein syntheses which led to enhanced glucose-stimulated insulin secretion. In a pancreatectomised diabetic animal model, exogenous Pref-1 improved glucose homeostasis by accelerating pancreatic ductal and β-cell regeneration after injury. These data establish a novel role for Pref-1, opening the possibility of applying this molecule to the treatment of diabetes.

Conventional gas chromatography-mass spectrometry (GC-MS) analysis methods for measuring the concentration of phytoncides in forests are limited because of the need for an extended human presence in forests, the risk of errors, and contamination. To overcome these issues, this study introduces real-time measurement devices and selected ion flow tube mass spectrometry (SIFT-MS) as potential replacements. This study was conducted in the Hongneung Experimental Forest between 19 and 21 November 2019. A correlation analysis and independent samples t-test were performed to compare the GC-MS and SIFT-MS techniques. The diurnal patterns and trends in the phytoncide concentrations analyzed using the GC-MS and SIFT-MS methods were similar, suggesting the potential replacement of GC-MS with SIFT-MS. While both methods revealed similar major components in the daytime nonvolatile organic compounds (NVOCs), with pinenes comprising approximately half of the total percentage, the 24 h SIFT-MS analysis indicated reduced proportions of pinenes and benzaldehyde, along with the detection of more diverse NVOC compounds at night. Additionally, the studies indicated that GC-MS exhibited slightly higher selectivity, resulting in the detection of fewer NVOC compounds with SIFT-MS. The correlation analysis between the microclimate indicators and phytoncide measurement methods revealed differences: GC-MS with a mini pump showed positive correlations with fine dust and industrially derived VOCs, while the 24 h real-time measurements exhibited strong negative correlations. Consequently, while the GC-MS and SIFT-MS methods exhibited both similarities and differences in phytoncide concentrations, an independent samples t-test, confirming no statistically significant differences between the two methods, suggests the suitability of adopting SIFT-MS over GC-MS for phytoncide collection and analysis in forest environments. Nevertheless, this study contributes to the literature by comparing outdoor phytoncide levels using the GC-MS and SIFT-MS methodologies. These findings, which show that the methods are closely aligned, can guide future researchers in considering SIFT-MS equipment for phytoncide studies, offering a more accessible and efficient option with real-time capabilities. [ABSTRACT FROM AUTHOR]