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Difficult or even non-healing diabetic foot ulcers (DFU) are a global medical challenge. Although current treatments such as debridement, offloading, and infection control have resulted in partial improvement in DFU, the incidence, amputation, and mortality rates of DFU remain high. Therefore, there is an urgent need to find new or more effective drugs. Numerous studies have shown that oxidative stress plays an important role in the pathophysiology of DFU. The nuclear factor erythroid 2-related factor (Nrf2) signaling pathway and the advanced glycated end products (AGEs)-receptor for advanced glycation endproducts (RAGE), protein kinase C (PKC), polyol and hexosamine biochemical pathways play critical roles in the regulation of oxidative stress in the body. Targeting these pathways to restore redox balance can control and alleviate the occurrence and development of DFU. Natural biologics are a major source of potential drugs for these relevant targets, and their antioxidant potential has been extensively demonstrated. Here, we discussed the pathophysiological mechanism of oxidative stress in DFU, and identifiled natural biologics targeting these pathways to accelerate DFU healing, in order to provide a new or potential direction for clinical treatment, nursing and related basic research of DFU.

Aims To synthesize evidence about the impact of Internet and phone-based diabetes education and management on metabolic control, self-management behavior changes, and psychological effects among children and adolescents with type 1 diabetes mellitus (T1DM). Background Internet and mobile technologies were commonly used to improve diabetes management among children and adolescents with type 1 diabetes mellitus. The effectiveness of new technology-based diabetes education and management has previously not been synthesized. Methods PubMed, EBSCO, Cochrane Library, Web of Science, Joanna Briggs Institute Library, and the Chinese databases CNKI and Wanfang were searched from 1989 to March 2020. Two reviewers independently selected randomized controlled trials (RCTs), in English and Chinese, which compared an intervention group of new technology-based diabetes education and management with a control group of usual care. The primary outcomes were metabolic control, such as glycated hemoglobin (HbA1c), and secondary outcomes consisted of behavior changes and psychological effects, such as self-efficacy and quality of life. Results A total of 23 RCTs with 1,824 participants met the inclusion criteria. The meta-analysis showed that phone calls could significantly reduce HbA1c (MD = -.17; 95% CI [-.33, -.01]; I2 = 0%) in children and adolescents with T1DM. New technology-based diabetes education and management could significantly improve self-efficacy (SMD = 0.37; 95% CI [.07, .67]; I2 = 0%). No benefits on behavior changes and quality of life were identified. Linking evidence to action New technology-based diabetes education has potential benefits for children and adolescents with T1DM, such as improving metabolic control through phone calls and increasing their self-efficacy of diabetes management. Well-designed RCTs with larger sample sizes and longer intervention duration should be conducted, especially in developing countries.

Benzoquinone (BQ) is a desirable cathode for aqueous rechargeable batteries because of its high theoretical capacity and low cost. However, its application is seriously hindered by the high solubility of its discharge product in electrolytes, leading to rapid capacity decay. Here, we report a highly pyridine- and pyrrole-N-doped carbon cloth (NCC) with hierarchical pores as a promising host to anchor BQ and its discharge products. The resultant cathode (BQ-NCC) exhibits an ultrahigh initial capacity of 489 mA h gBQ−1 (excluding the capacity contribution of NCC) at 0.1 A g−1 and a long cycle life with a high capacity retention of 90.4% at 0.5 A g−1 after 500 cycles. Furthermore, a pouch-type cell with a capacity of ∼0.23 A h delivers an energy density of 136.1 W h kg−1 based on the total mass of BQ-NCC and Zn foil. Our study provides a novel strategy to construct high-performance aqueous Zn-ion batteries for potential practical applications.

Li-organic batteries (LOBs) are promising advanced battery systems because of their unique advantages in capacity, cost, and sustainability. However, the shuttling effect of soluble organic redox intermediates and the intrinsic dissolution of small-molecular electrodes have hindered the practical application of these cells, especially under high operating temperatures. Herein, a cross-linked membrane with abundant negative charge for high-temperature LOBs is prepared via electrospinning of poly(vinyl alcohol) containing halloysite nanotubes (HNTs). The translocation of negatively charged organic intermediates can be suppressed by the electronic repulsion and the cross-linked network while the positively charged Li

In the past few years, a large number of laborers in China have withdrawn from the market, resulting in a slowing down in the growth rate of the current economy as well as the total economic volume. In this context, the total scale of pension income distribution will therefore enter a state of slow growth even if the level of pension income distribution has improved. In the long run, a “contradictory” phenomenon will inevitably appear between the slow growth of pension income distribution and the rapid growth of pension demand, that is, the level of pension income distribution will not be able to meet pension needs. Accordingly, this paper aims to identify the main factors that affect the level of pension income in China, and to discuss how to optimize the level of pension income. Results show that the growth rate of the dependency ratio of the elderly has been in negative numbers for a long time, which indicates a shortage of available labor in China, and on the other hand, it reflects the stabilization and deepening of China’s aging. What is more, there is a causal relationship between the growth rate of residents’ disposable income and the growth rate of the dependency ratio of the elderly and the growth rate of China’s pension fund expenditure. In addition, the impact of local fiscal revenue on pension fund expenditure is not significant, so there is no explanatory significance for this work.

Breast cancer is the most frequent cause of death from cancer in 12 regions of the world. Among the breast cancer subtypes, triple-negative breast cancer (TNBC) is the most aggressive, leading to an adverse prognosis. Thus, we aimed to identify the top 100 most cited articles regarding TNBC through bibliometric analyses, to explore their current impact and publication status. We searched TNBC-related articles from the Web of Science core database on September 19, 2021, and ranked them by citation in descending order. Information extracted from the top 100 most cited articles, included title, author, institution, country, year, publication, Journal Cited Rank, citation, Web of Science category, were extracted by two researchers independently. VOSviewer was used to analyze data, such as co-authoring institutions, and author cooperation. Descriptive statistical analysis of data was performed using Excel. Citations from the top 100 most cited articles ranged from 225 to 2753, and all were published after 2007. The top 100 most cited articles were published in 38 journals, with the Journal of Clinical Oncology published the most (n = 15), followed by Clinical Cancer Research (n = 11), Lancet Oncology(n = 6). Eric P. Winer from USA, who participated 12 articles, was the most frequently published author. The USA (n = 71) was the country with the most contributions to TNBC. The most prevalent topics included: clinical features, molecular subtypes, relevant influencing factors, exploration of treatment options and prognosis of TNBC. The leading institution was the Dana Farber Cancer Institute (n = 20) from the USA. This is the first bibliometric analysis on the TNBC 100 most cited article. We provided insights into the most cited articles on TNBC and listed a detailed description of their characteristics and trend, which provides ideas for further study.

How to achieve the continuous improvement of the environmental performance level of the power industry within the requirements of clean and low-carbon energy development is the fundamental requirement and inevitable choice for the construction of ecological civilization and sustainable development. From the perspective of environmental protection, based on the Data Envelopment Analysis (DEA) method and the internal mechanism of power system production and supply, the power industry environmental efficiency evaluation index system was constructed, and the two-stage Network Slack-based Measure (NSBM) model considering undesired output was used to calculate China’s 30 provinces and municipalities from 1998 to 2019. The environmental efficiency is divided into two links: power generation efficiency and transmission and distribution efficiency. The study found that, within the research interval, the overall environmental efficiency of China’s 30 provinces is low, and the differences between provinces and cities are large, but they have gradually developed in a better direction after 2015. The power generation efficiency of the first link in most provinces and municipalities is higher than the transmission and distribution efficiency of the second link, and the low transmission and distribution efficiency is an important reason for the low comprehensive level of environmental efficiency. The overall evolution trend of environmental efficiency in the six regions of China is roughly the same, but the regional differences are obvious, showing a trend of “high in the southeast and low in the northwest”. The economic and natural resource differences in different provinces and cities in each region have led to varying degrees of redundancy in five aspects, including investment in power assets, installed power generation capacity, and length of transmission lines, which seriously affect the environmental efficiency of the power industry. This research attempts to open the “black box” of the environmental efficiency conversion process of the power industry, which can provide directions and strategic suggestions for the improvement of the efficiency of the power industry in China.

Variability and factors influencing quality of life (QOL) in breast cancer patients having chemotherapy were examined in a longitudinal prospective cohort study in two teaching hospitals in China. Physical, mental, social/family, and functional QOL changed significantly over time with varying patterns. In addition, various factors influenced the QOL of breast cancer patients at each chemotherapy cycle. Health professionals should focus on critical time periods during chemotherapy, particularly at baseline and during the fourth and fifth cycles when the QOL in our sample was at the lowest point, and they should provide additional support to patients to ensure that chemotherapy is delivered in an optimal fashion.

Aims Parenting interventions in this review refer to supportive parenting training provided for parents or primary caregivers of children and adolescents with type 1 diabetes mellitus (T1DM). The review aimed to synthesize evidence about parenting interventions in parents or caregivers of children and adolescents with T1DM, and to evaluate the effect of interventions in reducing parents' or caregivers' psychological distress, helping them share diabetes management responsibility, seek social support, and improve their quality of life. Methods We searched PubMed, MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science from January 1978 to October 2018. Randomized controlled trials (RCTs) comparing an intervention group of parenting programs with a control group of usual care were included. The primary outcomes were stress, family responsibility and conflict, and social support. Secondary outcomes included other psychological index and quality of life. Pooled effect sizes of weighted mean difference (WMD) were calculated. Results A total of 17 RCTs with 962 participants met the inclusion criteria. Findings of the meta-analysis showed parenting interventions could significantly reduce parents' depression (WMD = -5.78, 95% CI: -6.23 to -5.33, I2 = 0%) and distress (WMD = -5.28, 95% CI: -10.31 to -.25, I2 = 0%), and help them ask for positive social support (WMD = .83, 95% CI: .03 to 1.64, I2 = 0%). No beneficial changes of other outcomes were found. Linking evidence to action Parents of children and adolescents with T1DM need support from the multidisciplinary team in health care, especially in mental health, family management of childhood diabetes, and social support. Parenting interventions may help parents reduce psychological distress and depression and assist them to ask for social support. Future research should include well-designed RCTs with large samples, appropriate measures with clear definitions, objective assessment, and separation of effects on mothers and fathers.

Pancreatic cancer is one of the most severe types of tumors, with a 5-year survival rate of less than 7%. The prognosis and treatment of pancreatic cancer are largely limited by the extent of tumor invasion and the presence of lymph node and distant metastases. Therefore, exploring the biological behavior of pancreatic cancer cells (PCCs) is extremely important for the understanding, diagnosis, and treatment of pancreatic cancer. Current studies have shown that pancreatic stellate cells (PSCs) regulate the biological behavior of PCCs, such as their proliferation, apoptosis, invasion, and migration, by remodeling the extracellular matrix. Though Hic-5 is an important gene in PSCs, no study has investigated the regulation of PCCs by Hic-5. Here, we demonstrate that Hic-5 expression is upregulated in pancreatic cancer and that siRNA transfection can effectively inhibit Hic-5 expression. Compared to the control group, Hic-5 inhibition significantly reduced proliferation, increased apoptosis, and reduced invasion and migration of PCCs. Moreover, the inhibition of Hic-5 expression simultaneously reduced matrix metalloproteinase-9 (MMP-9) expression. Statistical analysis revealed that Hic-5 expression was higher among the pancreatic cancer group than among the normal group and was negatively correlated with postoperative survival time among patients with pancreatic cancer. These results have important clinical significance for further exploring the molecular mechanism involved in Hic-5-mediated invasion and metastasis of pancreatic cancer and ameliorating the prognosis of patients with pancreatic cancer.

Introduction: The study investigated the risk factors of phlebitis associated with infusion by peripheral intravenous catheter (PIVC). Methodology: Hospitalized adults (n = 506) were placed with PIVCs by trained nurses. Rates of phlebitis were noted according to PIVC gauge, insertion site, and dwell time; and type and volume of infusion solution. Results: The development of phlebitis appeared to be significantly associated with the size of the outer diameter of the PIVC. The rate of phlebitis among patients given a hypertonic infusion solution was significantly higher; and also associated with infusion volume. There was no difference in phlebitis development among insertion sites, and dwell times among these sites were comparable. Conclusion: The risk of phlebitis increased with the PIVC size and volume of infusion solution, and use of a hypertonic solution. The recognition of risk factors and standardized intervention may reduce the occurrence of phlebitis associated with PIVC use.

Supplemental material, Supplementary_Material_cnr for Variability and Influencing Factors of QOL in Breast Cancer Patients Having Chemotherapy by Zhongping Ai, Xiaolan Gao, Silin Zheng and Changbi Lu in Clinical Nursing Research