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BackgroundMobile health (mHealth) provides a new opportunity for disease prediction and patient health self-management. However, privacy problems in mHealth have drawn significant attention to patients’ online health information disclosure and to the possibility that privacy concerns may hinder mHealth development. ObjectivePrivacy calculus theory (PCT) has been widely used to understand personal information disclosure behaviors with the basic assumption of a rational and linear decision-making process. However, cognitive behavior processes are complex and mutual. In an attempt to gain a fuller understanding of information disclosure behavior, we further optimize a PCT-based information disclosure model by identifying the mutual relationship between costs (privacy concerns) and benefits. Social support, which has been proven to be a distinct and significant disclosure benefit of mHealth, was chosen as the representative benefit of information disclosure. MethodsWe examine a structural equation model that incorporates privacy concerns, health information disclosure intention in mHealth, and social support from mHealth, all at the individual level. ResultsA validated questionnaire was completed by 253 randomly selected participants. The result indicated that perceived health information sensitivity positively enhances patients’ privacy concern (beta path coefficient 0.505, P

BackgroundAn online health community (OHC) is a novel sharing channel through which doctors share professional health care knowledge with patients. While doctors have the authority to protect their patients’ privacy in OHCs, we have limited information on how doctors’ privacy protection choices affect their professional health care knowledge sharing with patients. ObjectiveWe examined the relationship between privacy protection and professional health care knowledge sharing in OHCs. Specifically, we examined the effects of privacy protection settings in an OHC on doctors’ interactive professional health care knowledge sharing and searching professional health care knowledge sharing (two dimensions of professional health care knowledge sharing). Moreover, we explored how such effects differ across different levels of disease stigma. MethodsWe collected the monthly panel data of 19,456 doctors from Good Doctor, one of the largest OHCs in China, from January 2008 to April 2016. A natural experimental empirical study with difference-in-difference analysis was conducted to test our hypotheses. The time fixed effect and the individual fixed effect were both considered to better identify the effects of a privacy protection setting on professional health care knowledge sharing. Additionally, a cross-sectional analysis was performed for a robust check. ResultsThe results indicate that the privacy protection setting has a significant positive effect on interactive professional health care knowledge sharing (β=.123, P

Abstract Background Opioid-reduced multimodal analgesia has been used clinically for many years to decrease the perioperative complications associated with opioid drugs. We aimed to assess the clinical effects of opioid-reduced anesthesia during thoracoscopic sympathectomy. Methods Surgical patients (n = 151) with palmar hyperhidrosis were randomly divided into control (Group C, 73 patients) and test (Group T, 78 patients) groups. All patients were administered general anesthesia using a laryngeal mask. In Group C, patients received propofol, fentanyl, and cisatracurium for anesthesia induction, and maintenance was achieved with propofol and remifentanil, along with mechanical ventilation during the operation. In Group T, anesthesia was induced with propofol, dezocine, and dexmedetomidine (DEX) and maintained with propofol, DEX, and an intercostal nerve block, along with spontaneous breathing throughout the operation. Perioperative complications related to opioid use include hypotension, bradycardia, hypertension, tachycardia, hypoxemia, nausea, vomiting, urine retention, itching, and dizziness were observed. To assess the impact of these complications, we recorded and compared vital signs, blood gas indices, visual analogue scale (VAS) scores, adverse events, and patient satisfaction between the two groups. Results Perioperative complications related to opioid use were similar between groups. There were no significant differences in the type of perioperative sedation, analgesia index, respiratory and circulatory indicators, blood gas analysis, postoperative VAS scores, adverse reactions, propofol dosage, postoperative recovery time, and patient satisfaction. Conclusions In minimally invasive surgeries such as thoracoscopic sympathectomy, opioid-reduced anesthesia was found to be safe and effective; however, this method did not demonstrate clinical advantages. Trial registration Chinese Clinical Trial Register: ChiCTR2100055005, on December 30, 2021.

Abstract Background Global antipsychotic usage, including off-label prescriptions, has increased in recent decades. However, trends in China, particularly for children and adolescents, remain unclear. This study explored these trends from 2016 to 2021 and identified factors associated with off-label prescriptions. Methods In this retrospective study, we analyzed on-label and off-label prescriptions based on drug information approved by the China National Medical Products Administration. To identify factors associated with off-label prescriptions, we conducted multivariate logistic regression analysis. Results Our study included 48,258 antipsychotic prescriptions, 52.4% (25,295) of which were prescriptions for males. Of these, 61.7% (29,813) were off-label. Over time, the number of antipsychotics and the percentage of off-label prescriptions for children and adolescents overall increased from 2016 to 2021. The use of atypical antipsychotics increased, whereas that of typical antipsychotics decreased. For off-label usage, all of the factors in our study were associated with off-label usage, including age, sex, year, region, department, reimbursement, antipsychotic type, drug expense, number of polypharmacy and diagnoses. Additionally, tiapride (15.8%) and aripiprazole (18.6%) were the most common typical and atypical antipsychotics, respectively. For pediatric diseases, common diagnoses included mood or affective disorders (31.7%) and behavioral and emotional disorders, with onset usually occurring in childhood and adolescence (29.1%). Furthermore, a depressive state was the most common diagnosis for which antipsychotic polypharmacy was used for treatment. Conclusion In this retrospective study, off-label antipsychotic prescriptions were common, with trends generally increasing among children and adolescents from 2016 to 2021. However, there is a lack of evidence supporting off-label usage, thus emphasizing the need for studies on the efficacy and safety of these treatments.

Myostatin (MSTN) has long been recognized as a critical regulator of muscle mass. Recently, there has been increasing interest in its role in metabolism. In our study, we specifically knocked out MSTN in brown adipose tissue (BAT) from mice ([MSTN.sup.[DELTA]UCP1]) and found that the mice gained more weight than did controls when fed a high-fat diet, with progressive hepatosteatosis and impaired skeletal muscle activity. RNA-Seq analysis indicated signatures of mitochondrial dysfunction and inflammation in the MSTN-ablated BAT. Further studies demonstrated that Kruppel-like factor 4 (KLF4) was responsible for the metabolic phenotypes observed, whereas fibroblast growth factor 21 (FGF21) contributed to the microenvironment communication between adipocytes and macrophages induced by the loss of MSTN. Moreover, the MSTN/SMAD2/3-p38 signaling pathway mediated the expression of KLF4 and FGF21 in adipocytes. In summary, our findings suggest that brown adipocyte-derived MSTN regulated BAT thermogenesis via autocrine and paracrine effects on adipocytes or macrophages, ultimately regulating systemic energy homeostasis., Introduction Brown adipose tissue (BAT) plays a crucial role in whole-body energy balance and fuel metabolism, mediating nonshivering thermogenesis in mammals exposed to subthermoneutral temperatures (1). The abundance of mitochondria [...]

To analyze the impact of different regions, lactation times, and blood group genotypes on the oligosaccharide composition of healthy lactating mothers’ breast milk from representative regions of China, and to explore the compositional characteristics of oligosaccharides in Chinese human milk, in this longitudinal cohort study, the concentrations of 23 oligosaccharides in breast milk samples from 109 healthy mothers at three lactation stages in six cities in east, west, north and south China were analyzed by ultra-high performance liquid chromatography triple quadrupole tandem mass spectrometry (UPLC-MS-MS). Besides, the attribution of breast milk to blood group genotypes was investigated. The results showed that concentrations of total oligosaccharides and total fucosylated neutral oligosaccharides were significantly higher in samples from Kunming, Jinan and Shenzhen than those from Beijing, Baotou and Xining, and the concentrations of 3-fucosyllactose (3-FL), lactodifucotetraose (LDFT) and lacto-N-neodifucohexaose II (LNnDFH-II) were significantly lower in samples from Baotou than those from Shenzhen, Jinan and Beijing, respectively. The concentrations of eight neutral oligosaccharides and four acidic oligosaccharides showed a significant decreasing trend with lactation time, whereas 3-FL concentration increased significantly, and the concentrations of LDFT and LNnDFH-II also increased but not significantly. The concentrations of two monofucosylhexasaccharides were the highest in 1-month-old mature milk, and then remained unchanged or decreased slightly as lactation progressed. Based on oligosaccharide types, it was inferred that the major blood group genotype of lactating mothers was Se+Le+ for all the six cities. In this genotype, the concentrations of lacto-N-difucohexaose-II (LNDFH-II), LNDFH-I & LNnDFH-I, 6’-sialyllactose (6’-SL) and sialyllacto-tetrasaccharide c (LSTc) were higher and the concentrations of 18 other oligosaccharides were lower than in other genotypes. This study provides scientific theoretical guidance for precise estimation of the intake of breast milk oligosaccharides by infants and young children at the early life stage.

In addition to the significant role in physical activity, skeletal muscle also contributes to health through the storage and use of macronutrients associated with energy homeostasis. However, the mechanisms of regulating integrated metabolism in skeletal muscle are not well-defined. Here, we compared the skeletal muscle transcriptome from obese and lean control subjects in different species (human and mouse) and found that interferon regulatory factor 4 (IRF4), an inflammation-immune transcription factor, conservatively increased in obese subjects. Thus, we investigated whether IRF4 gain of function in the skeletal muscle predisposed to obesity and insulin resistance. Conversely, mice with specific IRF4 loss in skeletal muscle showed protection against the metabolic effects of high-fat diet, increased branched-chain amino acids (BCAA) level of serum and muscle, and reprogrammed metabolome in serum. Mechanistically, IRF4 could transcriptionally upregulate mitochondrial branched-chain aminotransferase (BCATm) expression; subsequently, the enhanced BCATm could counteract the effects caused by IRF4 deletion. Furthermore, we demonstrated that IRF4 ablation in skeletal muscle enhanced mitochondrial activity, BCAA, and fatty acid oxidation in a BCATm-dependent manner. Taken together, these studies, for the first time, established IRF4 as a novel metabolic driver of macronutrients via BCATm in skeletal muscle in terms of diet-induced obesity.

Effective and safe pharmacotherapies for central nervous system (CNS) disorders remain a major obstacle to human health worldwide. Nanotechnology offers promise in addressing this challenge by enabling the transport of large molecules across the blood–brain barrier (BBB) and the delivery of multiple drugs. Numerous studies have demonstrated the efficacy of nanodrugs in animal models of various CNS disorders, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis, stroke, lysosomal storage disease, and gliomas. Nanoparticles (NPs), tailor-made to enhance drug enrichment locally and promote extended drug release, can prevent neuronal death, decrease neurotoxicity, and inhibit tumor growth. In addition to drug delivery, gene therapy using nanotechnology has emerged as a potentially curative option for neurodegenerative diseases. In this review, we summarize how NPs have successfully crossed the BBB and specifically targeted different cells in various CNS disease models over the past decade. Although nanotechnology holds great promise, several drawbacks and challenges must be addressed before its effective implementation in the treatment of CNS diseases.