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Abstract Anaerobic digestion (AD) is an efficient technology for treating organic solid wastes, and the volatile fatty acids (VFAs) produced during AD have significant value due to their wide range of applications and higher added value compared to methane. This study investigated the long-term effects of high solid content and straw proportion in mixed substrates (straw, sludge, and food wastes) on VFAs production through semi-continuous reactors under thermophilic and mesophilic conditions. Results showed that both reactors achieved a maximum VFAs concentration of ~ 22 g/L as the straw proportion increased to 50%. Acetate (48.3 – 64.5%) was the main component of produced VFAs in both reactors, while butyrate and propionate production in thermophilic temperature were superior compared to mesophilic conditions. Microbial community analysis revealed that Defluviitoga plays a pivotal role in acidogenesis within both reactors; besides, unclassified Hungateiclostridiaceae and Caproiciproducen were found to be dominant in thermophilic reactor, while Lachnospiraceae_NK3A20_group and Rikenellaceae_RC9_gut_group were essential for VFAs production under mesophilic conditions. These findings provide valuable insights for the biotechnological exploration of acidogenic fermentation for large-scale mechanized production of VFAs from agricultural wastes.

Background There have been numerous intervention studies focusing on the development of preterm infants, but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants. The aspects and extent to which the home environment affects the early (18 months corrected age) neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit (NICU). It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study, 275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children’s Hospital. The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient (evaluated by the Gesell Developmental Scale) and the rate of developmental delays at 18 months corrected age.Results A total of 41.454% of the infants were extremely preterm. The developmental quotient scores at 18 months corrected age were in the middle of the scale. The language domain had the highest rate of developmental delay (46.182%), followed by the adaptive domain (37.091%). Multiple logistic regression analyses showed that compared with infants in supportive home environments, infants with moderate/unsupportive home environments had significantly elevated risks of development delay: 2.162-fold for global (odds ratio (OR) 2.162, 95% confidence interval (CI) 1.274 to 3.665, p=0.004), 2.193-fold for fine motor (OR 2.193, 95% CI 1.161 to 4.140, p=0.016), 2.249-fold for language (OR 2.249, 95% CI 1.336 to 3.786, p=0.002) and 2.042-fold for personal-social (OR 2.042, 95% CI 1.149 to 3.628, p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants. It is associated with higher developmental quotient scores and protects against neuropsychiatric delays. Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.

Abstract Constrained by a limited understanding of the structure and luminescence mechanisms of carbon dots (CDs), achieving precise enhancement of their photoluminescence (PL) performance without altering the emission wavelength and color remains a challenge. In this work, a deuterated CD is first achieved by simply replacing the reaction solvent from H2O to D2O. The substitution of D atoms for H atoms is not limited on the surface but also within the internal structure of CDs. Deuteration affects the formation of the π‐conjugated network structure by altering the content of sp2 carbon and sp3 carbon, ultimately inducing a reconstruction for energy level structure of CDs. Both the intrinsic state and surface state emission, including quantum yield, emission intensity and lifetime, are significantly enhanced after deuteration. It benefits from the reduction in non‐radiative transitions, since the lowered vibrational frequencies of D atoms and optimized local energy level distribution in CDs structure. The deuterated CDs are applied in the fabrication of white‐light‐emitting diodes to show their application potential. This work provides a highly versatile route for improving and controlling photoluminescence performance of CDs and has opportunities to guide the development of CDs for practical applications.

ImportanceUnderstanding treatment expectations of patients and their clinicians is of great importance in improving personalized medical services and enhancing patient safety systems.ObjectiveTo investigate treatment expectations of patients and their clinicians and compare differences between both, by using a pair of validated structured assessment tools covering three key aspects/dimensions of clinical interests.Design, setting, and participantsThis single-center cross-sectional study was conducted at Peking Union Medical College Hospital in China. The study enrolled patients aged 16 years and older receiving inpatient care and their clinicians. Patient recruitment was conducted from March 2023 to November 2023.AssessmentsIn addition to demographic and clinical characteristics, this study employed two validated structured assessment tools to evaluate treatment expectations among patients and their clinicians: the Hospitalized Patients’ Expectations for Treatment Scale-Patient version (HOPE-P) and its counterpart, the Hospitalized Patients’ Expectations for Treatment Scale-Clinician version (HOPE-C).ResultsA total of 233 patients (mean [SD] age, 52.3 [15.1] years; 108 [46.4%] female) along with their clinicians, who numbered 75 in total were enrolled in this study. The distribution of total scores for HOPE-P and HOPE-C displayed similar patterns, with most scores concentrated in the higher range (above 50% of the full score). The mean HOPE-P total score was higher than that of HOPE-C (mean [SD] score, 38.78 [4.86] vs 37.49 [4.32]; t = 3.12, P = 0.002). In Dimension 2, the HOPE-P score was higher than HOPE-C (23.67 [3.20] vs 21.72 [3.03]; t = 6.98, P < 0.001). However, in Dimensions 1 and 3, HOPE-P scored lower than HOPE-C (13.37 [2.44] vs 13.84 [1.73]; t = -2.384, P < 0.018; 1.74 [1.14] vs 1.94 [1.00]; t = -2.00, P = 0.047). Certain demographic and clinical characteristics led to variations in patients’ treatment expectations, including marital status, monthly family income, and smoking history.Conclusions and relevanceThis cross-sectional study revealed significant differences between patients’ and doctors’ treatment expectations. Notably, it highlighted the need for clinicians to focus on rationalizing patients’ expectations concerning treatment outcomes.Trial Registration Chinese Clinical Trial Registry IdentifierChiCTR2300075262.

Chloramphenicol is a widely used bactericide and highly effective antibiotic in aquaculture and livestock breeding. To protect human health, detecting chloramphenicol residues in animal-derived food products has become increasingly important. This review introduces the properties of chloramphenicol, the limit standards, and the hazards of residual chloramphenicol in animal-derived food products. Furthermore, it describes commonly used chloramphenicol detection methods. In addition, the review thoroughly analyzes and summarizes the advantages and disadvantages of different detection methods, outlining methods to improve the efficiency and precision of chloramphenicol detection to ensure the quality and safety of animal-derived food products. Finally, the prospects for developing advanced detection techniques and analytical methods are prospected.

Abstract The superior size and power scaling potential of ferroelectric-gated Mott transistors makes them promising building blocks for developing energy-efficient memory and logic applications in the post-Moore’s Law era. The close to metallic carrier density in the Mott channel, however, imposes the bottleneck for achieving substantial field effect modulation via a solid-state gate. Previous studies have focused on optimizing the thickness, charge mobility, and carrier density of single-layer correlated channels, which have only led to moderate resistance switching at room temperature. Here, we report a record high nonvolatile resistance switching ratio of 38,440% at 300 K in a prototype Mott transistor consisting of a ferroelectric PbZr0.2Ti0.8O3 gate and an RNiO3 (R: rare earth)/La0.67Sr0.33MnO3 composite channel. The ultrathin La0.67Sr0.33MnO3 buffer layer not only tailors the carrier density profile in RNiO3 through interfacial charge transfer, as corroborated by first-principles calculations, but also provides an extended screening layer that reduces the depolarization effect in the ferroelectric gate. Our study points to an effective material strategy for the functional design of complex oxide heterointerfaces that harnesses the competing roles of charge in field effect screening and ferroelectric depolarization effects.

Abstract Background For better disease management and improved prognosis, early identification of co-morbid depression in diabetic patients is warranted. the WHO-5 well-being index (WHO-5) has been used to screen for depression in diabetic patients, and its Chinese version (WHO-5-C) has been validated. However, its psychometric properties remain to be further validated in the type 2 diabetes patient population. The aim of our study was to examine the reliability and validity of the WHO-5-C in patients with type 2 diabetes mellitus. Methods The cross-sectional study was conducted on 200 patients from July 2014 to March 2015. All patients should complete the WHO-5-C, the Patient Health Questionnaire-9 (PHQ-9), the 20-item Problem Areas in Diabetes Scale (PAID-20), the Mini International Neuropsychiatric Interview (M.I.N.I), and Hamilton Rating Scale for Depression (HAM-D). Internal consistency of WHO-5 was revealed by Cronbach’s alpha, and constructive validity by confirmatory factor analysis (CFA). Relationship with PHQ-9, HAM-D, and PAID-20 was examined for concurrent validity, and ROC analysis was performed for criterion validity. Results The WHO-5-C presented satisfactory reliability (Cronbach’s alpha = 0.88). CFA confirmed the unidimensional factor structure of WHO-5-C. The WHO-5-C had significant negative correlation with HAM-D (r = -0.610), PHQ-9 (r = -0.694) and PAID-20 (r = -0.466), confirming good concurrent validity. Using M.I.N.I as the gold standard, the cut-off value of WHO-5-C was 42, with a sensitivity of 0.83 and specificity of 0.75. Conclusion The WHO-5-C holds satisfactory reliability and validity that is suitable for depression screening in type 2 diabetes patients as a short and convenient instrument.

IntroductionEarly detection of neuropsychiatric systemic lupus erythematosus (NPSLE) remains a challenge in clinical settings. Previous studies have found different autoantibodies as markers for NPSLE. This study aimed to describe the distribution of psychiatric syndromes in a group of patients with systemic lupus erythematosus (SLE) and to investigate the association between psychiatric syndromes and specific autoantibodies.MethodsThis retrospective study was conducted at a single medical center in China. We reviewed medical records of hospitalized patients with SLE who were consulted by psychiatrists due to potential mental disorders. Results of serum autoantibodies and general laboratory tests were collected. The correlation between clinical variables was examined. Binary logistic regression analyses were used to determine factors related to NPSLE and different psychiatric diagnoses.ResultsAmong the 171 psychiatric manifestations in 160 patients, 141 (82.4%) were attributed to SLE. Acute confusional state (ACS) had the highest prevalence (57.4%). Anti-cardiolipin (ACL) antibody (X2 = 142.261, p < 0.001) and anti-β2 glycoprotein I (-β2GP1) antibody (X2 = 139.818, p < 0.001) varied significantly between groups, with the highest positive rate found in patients with mood disorders (27.3% and 18.2%). SLE disease activity index – 2000 (SLEDAI-2K) score excluding item ACS and item psychosis was a predictor of NPSLE (OR 1.172 [95% CI 1.105 - 1.243]).ConclusionsDisease activity reflected by SLEDAI-2K score is a predictor for NPSLE. Antiphospholipid antibodies are associated with mood disorders in SLE. Further separate investigation of neuropsychiatric disorders is needed in order to better comprehend NPSLE’s pathological mechanism.

Let $ T_{1}, T_{2}, \dots, T_{k} $ be spanning trees of a graph $ G $. For any two vertices $ u, v $ of $ G $, if the paths from $ u $ to $ v $ in these $ k $ trees are pairwise openly disjoint, then we say that $ T_{1}, T_{2}, \dots, T_{k} $ are completely independent. Hasunuma showed that there are two completely independent spanning trees in any 4-connected maximal planar graph, and that given a graph $ G $, the problem of deciding whether there exist two completely independent spanning trees in $ G $ is NP-complete. In this paper, we consider the number of completely independent spanning trees in some Cartesian product graphs such as $ W_{m}\Box P_{n}, \ W_{m}\Box C_{n}, \ K_{m, n}\Box P_{r}, \ K_{m, n}\Box C_{r}, \ K_{m, n, r}\Box P_{s}, \ K_{m, n, r}\Box C_{s} $.

ObjectivePatient safety management systems in general hospitals require a comprehensive tool for assessing the expectations of inpatients across different wards. This study aimed to develop and psychometrically validate a new scale, the hospitalized patients’ expectations for treatment scale-clinician version (HOPE-C), to meet this requirement.MethodsWe interviewed 35 experts and 10 inpatients while developing the HOPE-C scale. The scale was initially designed with three dimensions: clinicians’ expectations regarding doctor-patient communication, clinicians’ expectations regarding treatment outcome, and clinicians’ expectations regarding disease management. We recruited 200 inpatients from a general hospital in China. At the same time, 51 clinicians were assigned to the enrolled patients who completed the HOPE-C to examine the reliability, validity, and psychometric characteristics of the questionnaire. We applied item analysis, assessed construct validity, evaluated internal consistency, and conducted a test-retest reliability analysis over 7 days.ResultsBoth exploratory and confirmatory analyses supported a 2-dimensional structure, comprising doctor-patient communication expectations and treatment outcome expectations, with favorable model fit parameters (root mean square residual [RMR] = 0.042, root mean square error of approximation [RMSEA] = 0.049, comparative fit index [CFI] = 0.989, Tucker-Lewis index [TLI] = 0.984). Item analysis demonstrated appropriate item design (r = 0.744–0.961). The scale exhibited strong internal consistency, with Cronbach’s α values of 0.884, 0.816, and 0.840 for the overall scale, the doctor-patient communication expectation subscale, and the treatment outcome expectation subscale, respectively. The 7-day test-retest reliability was 0.996 (p < 0.001).ConclusionOur findings suggest that the HOPE-C is a reliable and valid assessment tool for measuring the expectations of inpatients in general hospitals. It effectively identifies patients’ expectations concerning doctor-patient communication and treatment outcomes.

Pingwei Powder, a basic traditional Chinese medicine (TCM) prescription, was used for treating the chronic colitis, liver cirrhosis, and acute gastritis, etc. However, its systematic chemical characteristics has not been reported, which hinders the interpretation of its therapeutic mechanism, and quality control.To develop a powerful ultra high performance liquid chromatography tandem quadrupole-time-of-flight tandem mass spectrometry (UHPLC-Q-TOF-MS)-based method for the systematic chemical characterisation of Pingwei Powder, providing a basis for further research on pharmacological substance basis, and quality control of Pingwei Powder. UHPLC-Q-TOF-MS was used to detect a wide range of chemical substances in Pingwei Powder, and the obtained spectral data were imported into PeakView 1.2 software for data processing. Subsequently, the chemical substances in Pingwei Powder were identified by comparison with reference standards, literatures, and the built-in database of SCIEX OS 2.2 software. Finally, the chemical profile of Pingwei Powder was acquired, and 329 chemical components in Pingwei Powder were identified for the first time, mainly including flavonoids, terpenoids, organic acids, alkaloids, phenylpropanoids. Of note, 48 were from Atractylodis Rhizoma, 37 were from Magnoliae Officinalis Cortex, 72 were from Citri Reticulatae Pericarpium, 80 were from Glycyrrhizae Radix et Rhizoma, 32 were from Ginger, 60 were from Ziziphus jujuba. A scientifically efficient and credible method for obtaining the comprehensive chemical profile of Pingwei Powder based on UHPLC-Q-TOF-MS was developed for the first time, providing a basis for further research on pharmacological substance basis, and quality control of Pingwei Powder.

This review summarized the source, properties, as well as the harm of benzo-α-pyrene exposure to aquatic products. The commonly used instrumental analysis methods for the detection of benzo-α-pyrene were also discussed, and the future research direction of benzo-α-pyrene detection was prospected.

Abstract Background Although patient-centred medical services are widely recognized and accepted, how to define and evaluate them remains a controversial topic. Objectives This study attempts to evaluate the underlying structure of the Patient-Practitioner Orientation Scale (PPOS) with a homogenous population and clarify the connotation of patient-centredness. Methods In this cross-sectional study, 279 7th year Chinese medical students in were selected to examine the internal structure of the PPOS by means of internal consistency, exploratory, and confirmatory factor analyses. Results Both the two-factor model and the four-factor model showed acceptable internal consistency and structural validity. The four-factor model that endorsed the implicit attitude towards the doctor–patient relationship outperformed the two-factor model in terms of adaptability. Conclusions The PPOS has good psychometric attributes, as evaluated by Chinese medical students. This article attempts to explore patient-centredness from the perspective of implicit attitudes that affect the doctor–patient relationship and resummarizes the four factors. These four dimensions may suggest a deeper attitude towards the doctor–patient relationship, while “sharing information” or “caring about” the “patient” is the behaviour and preference expressed on the basis of these four attitudes, which is the result rather than the cause. Practice implications Understanding the underlying attitudes towards the doctor–patient relationship can help to construct a patient-centred medical service concept and improve the doctor–patient relationship in medical education courses and the system design of medical activities.

Abstract Background Fulminant myocarditis is a clinical syndrome associated with threatening dysrhythmia which temporary pacemaker can be used for life-saving support. As a method of physiological pacing, His bundle pacing (HBP) maintain better cardiac synchronization than traditional right ventricular (RV) pacing. Case presentation It’s a severe case of fulminant myocarditis in a 41-year-old patient who presented for recurrent arrhythmias with hemodynamic instability. Temporary His bundle pacing combined with optimal medical therapy and extracorporeal membrane oxygenators (ECMO) supported him through his critical period of hospitalization. Conclusions During 1-year follow up, the cardiac function recovery was obvious without any pacing related complications. Echocardiography showed better atrioventricular and intra-ventricular synchronization during HBP in DDD mode. This is the first reported case of temporary His-purkinje conduction system pacing used for severe fulminant myocarditis.

Abstract The device concept of ferroelectric-based negative capacitance (NC) transistors offers a promising route for achieving energy-efficient logic applications that can outperform the conventional semiconductor technology, while viable operation mechanisms remain a central topic of debate. In this work, we report steep slope switching in MoS2 transistors back-gated by single-layer polycrystalline PbZr0.35Ti0.65O3. The devices exhibit current switching ratios up to 8 × 106 within an ultra-low gate voltage window of $$V_{{{\mathrm{g}}}} = \pm \! 0.5$$ V g = ± 0.5 V and subthreshold swing (SS) as low as 9.7 mV decade−1 at room temperature, transcending the 60 mV decade−1 Boltzmann limit without involving additional dielectric layers. Theoretical modeling reveals the dominant role of the metastable polar states within domain walls in enabling the NC mode, which is corroborated by the relation between SS and domain wall density. Our findings shed light on a hysteresis-free mechanism for NC operation, providing a simple yet effective material strategy for developing low-power 2D nanoelectronics.

IntroductionPrevious research has revealed a bidirectional relationship between type 2 diabetes mellitus (T2DM) and major depressive disorder (MDD). A very limited proportion of patients with T2DM comorbid MDD received adequate psychiatric intervention. This study investigated the help-seeking behaviors of patients with T2DM comorbid with MDD during one-year follow-up.MethodsAt a medical center in China, a cohort of outpatients with T2DM were assessed and diagnosed for comorbid depression at baseline and after one year. The Mini International Neuropsychiatric Interview was used to diagnose MDD, while The Patient Health Questionnaire-9 (PHQ-9) and The Hamilton Depression Scale 17-item (HAMD-17) were used for depression assessment. Mental health help-seeking behaviors of patients during follow-up period were also evaluated.ResultsOut of the 203 patients with T2DM at baseline, 114 (56.2%) completed the follow-up. The prevalence of MDD in participants with T2DM was 12.8% at baseline and 22.8% at follow-up. Patients who completed the follow-up had a lower baseline PHQ-9 score (test statistic -2.068, p=0.039), HAMD-17 score (test statistic -2.285, p=0.022) than those who did not complete the follow-up. A total of 26 patients had comorbid MDD during the follow-up period, among which 8 patients (30.8%) voluntarily visited psychiatric clinics, while others did not seek assistance. The level of HbA1c at follow-up was higher in patients who sought help than in those who did not (8.1 ± 1.8% vs. 7.0 ± 0.7%), although the difference was not statistically significant.ConclusionVoluntary psychiatric help-seeking for Chinese patients with comorbid T2DM and MDD is uncommon. It is crucial to increase awareness of depression among patients and healthcare professionals alike.

BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, community medical workers, as the primary enforcers of community control measures, undertook many tasks with high exposure risk, resulting in severe psychological pressure, anxiety, depression and other psychological problems. Gender, type of workers, education, marital status, working years and other demographic factors were affect the mental state of medical workers. Community frontline medical workers gradually returned to normal work and life after the normalized management of COVID-19, but heavy work and high psychological pressure may continue to affect them. Thus, our research team used the same psychological questionnaire to investigate the psychological status of community frontline medical workers after the normalized management of COVID-19 compared with the COVID-19 period.MethodsThis was a cross-sectional study of community frontline medical workers in Sichuan, China, from February 6 to 17, 2023. Symptom Checklist-90 (SCL-90) and a self-designed questionnaire of demographic characteristics were provided to the participants point-to-point through a mobile network platform. Multiple logistic regression was used to analyze influencing factors related to community frontline medical workers’ psychology.ResultsA total of 440 valid questionnaires were statistically analyzed, including 192 (43.64%) from doctors and 248 (56.36%) from nurses. There were 222 (50.45%) participants who were SCL-90 positive. The median total SCL-90 score of medical workers was 105.0 (IQR 95.00–123.75), which was higher than that during the COVID-19 period. The doctor’s median SCL-90 score was 108.5 (IQR 96.00–136.25), and the positive item score was 16.5; the nurse’s median score was 104.0 (IQR 94.00–119.50), and the positive item score was 12.0. Bachelor’s degree education, no fixed contract and working years (10–19 years, 20–29 years, 30–39 years) were independent influencing factors for community frontline medical workers’ psychology.ConclusionAfter the normalized management of COVID-19, community frontline medical workers still suffered from psychological problems that were even more serious than those during COVID-19. Doctors were more likely to have psychological problems than nurses. In addition, the mental health status of community frontline medical workers was affected by education, type of contract and working years. Managers should pay attention to the mental health of these people.

BackgroundCognitive and motor dual-tasks play important roles in daily life. Dual-task interference impacting gait performance has been observed not only in healthy subjects but also in subjects with neurological disorders. Approximately 44–75% of Wilson’s disease (WD) patients have gait disturbance. According to our earlier research, 59.7% of WD patients have cognitive impairment. However, there are few studies on how cognition affects the gait in WD. Therefore, this study aims to explore the influence of cognitive impairment on gait and its neural mechanism in WD patients and to provide evidence for the clinical intervention of gait disturbance.MethodsWe recruited 63 patients who were divided into two groups based on their scores on the Addenbrooke’s cognitive examination III (ACE-III) scale: a non-cognitive impairment group and a cognitive impairment group. In addition to performing the timed up and go (TUG) single task and the cognitive and motor dual-task digital calculation and animal naming tests, the Tinetti Balance and Gait Assessment (POMA), Berg Balance Scale (BBS), and brain MRI severity scale of WD (bMRIsc-WD) were evaluated. The dual-task cost (DTC) was also computed. Between the two groups, the results of the enhanced POMA, BBS, and bMRIsc-WD scales, as well as gait performance measures such as TUG step size, pace speed, pace frequency, and DTC value, were compared.Results(1) Among the 63 patients with WD, 30 (47.6%) patients had gait disturbance, and the single task TUG time was more than 10 s. A total of 43 patients had cognitive impairment, the incidence rate is 44.4%. Furthermore, 28 (44.4%) patients had cognitive impairment, 39 (61.9%) patients had abnormal brain MRI. (2) The Tinetti gait balance scale and Berg balance scale scores of patients with cognitive impairment were lower than those of patients without cognitive impairment (p 0.05). However, regardless of cognitive impairment or not, the DTC2 values of number calculation tasks is higher than DTC1 of animal naming tasks in dt-TUG (p 0.05). Brain atrophy, the thalamus, caudate nucleus, and cerebellum were correlated with cognitive impairment (p

ObjectiveThis study aimed to identify the presence of psychiatric comorbidities as well as investigate the relationship between psychiatric interventions for mental symptoms and mortality in patients with systemic lupus erythematosus (SLE).MethodWe retrospectively evaluated the records of 160 inpatients with SLE who required psychiatric consultation for further therapeutic intervention from 2013 to 2020 in a tertiary general hospital. We collected clinical data, including diagnoses, medications, and mortality rate. We compared clinical characteristics among the diagnosis groups and correlations between variables.ResultsA total of 138 (86.3%) patients met the diagnostic criteria for at least one mental disorder, with the most common being delirium (54.4%). The average Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score significantly differed among the diagnosis groups (p = 0.003). The mortality rate among patients with delirium was significantly higher than that in the other patient groups (x2 = 12.967, p = 0.024). SLEDAI-2K score was not significantly correlated with mortality (r = 0.123, p = 0.087). Antipsychotics use was associated with mortality (odds ratio 0.053, p = 0.021).ConclusionAntipsychotic use may decrease death risk for patients with NPSLE. Early psychiatric consultation is necessary for patients with SLE who have developed or have suspected psychiatric symptoms in order to establish a comprehensive intervention plan.

ObjectivesA general expectation measurement of inpatients across wards is needed in the patient safety management systems of general hospitals. This study developed and psychometrically validated a new scale fulfilling the requirements above: the Hospitalized Patients’ Expectations for Treatment Scale-Patient version (HOPE-P). MethodsA total of 35 experts and ten inpatients were interviewed during the formulation of the HOPE-P scale, which was initially designed with three dimensions: doctor–patient communication expectations, treatment outcome expectations, and disease management expectancy. We recruited 210 inpatients from a general hospital in China and explored the reliability, validity, and psychometric characteristics of the questionnaire. Item analysis, construct validity, internal consistency and 7-day test–retest reliability analysis were applied.ResultsExploratory and confirmatory analyses supported a 2-dimension (doctor–patient communication expectation and treatment outcome expectation) structure with satisfactory model fit parameters (root mean square residual (RMR) = 0.035, a root-mean-square-error of approximation (RMSEA) = 0.072, comparative fit index (CFI) = 0.984, Tucker-Lewis index (TLI) = 0.970). Item analysis revealed an appropriate item design (r = 0.573–0.820). The scale exhibited good internal consistency, with Cronbach’s α of 0.893, 0.761, and 0.919 for the overall scale, the doctor–patient communication expectation subscale, and the treatment outcome expectation subscale, respectively. The 7-day test–retest reliability was 0.782 (p < .001).ConclusionOur results indicated that the HOPE-P is a reliable and valid assessment tool to measure the expectations of general hospital inpatients, with a strong capacity to recognize patients’ expectations regarding doctor–patient communication and treatment outcomes.

Microbes communicate with each other by Quorum sensing (QS) languages. Here the authors construct a QS database and the QS communication network to decipher intricate QSbased communications and form one of the key knowledge maps for human gut microbiota.

Diagnosing and treating secondary psychiatric symptoms with accuracy can be challenging in clinical settings. In this case study, we report on a female patient with Cushing’s disease who was misdiagnosed with anxiety disorder during her first psychiatric visit. Following initial ineffective psychiatric intervention, unexplained hypokalemia, and hypothyroidism, the patient visited the endocrinology clinic and was diagnosed with Cushing’s disease. During the medical and surgical procedures that followed, high doses of psychotropic medication were continued to treat persisting anxiety. After discharge, the patient developed autonomic dysfunction and impaired consciousness. Upon readmission, serotonin syndrome due to inappropriate psychiatric medication was diagnosed. The management of secondary psychiatric syndromes must be adapted to changes in the patient’s primary condition, which necessitates interdisciplinary collaboration in general hospital settings.

BackgroundFrontline healthcare workers (FHWs) experienced psychological stress and heavy workload during COVID-19 pandemic. This study examined the psychological symptoms and occupational burnout of FHWs in a fever clinic during different periods of the pandemic.MethodsA cross-sectional survey of FHWs in the fever clinic of a tertiary hospital was carried out during both the outbreak period and regular period of COVID-19. Psychological measurement instruments including Generalized Anxiety Disorder 7-item, the 9-Question Patient Health Questionnaire, the Maslach Burnout Inventory-Human Service Survey, and the General Self-Efficacy Scale were used to evaluate anxiety, depression, burnout, and self-efficacy, respectively. The correlation between clinical variables was explored.ResultsA total of 162 participants were involved in this study, including 118 FHWs during the outbreak period (Group 1) and 44 FHWs during the regular period (Group 2). Anxiety symptoms were more prevalent in Group 2 (x2 = 27.477) while depressive symptoms were significantly more prevalent in Group 1 (x2 = 69.538). Burnout rate was higher in Group 2 (x2 = 29.526). Self-efficacy was higher in Group 1 (t = 3.194). Burnout was positively correlated with anxiety symptoms (r2 = 0.424) and negatively correlated with self-efficacy (r2 = −0.312).ConclusionAnxiety, depressive symptoms and burnout were prevalent in FHWs during different periods of the COVID-19 pandemic. There is a tendency to be less depressed, but more anxious and burned out over time, although the severity of the pandemic is decreasing. Self-efficacy may be an important factor in protecting FHWs from occupational burnout. Support and intervention plans for FHWs should be made at the institutional level.

Abstract The van der Waals magnets CrX3 (X = I, Br, and Cl) exhibit highly tunable magnetic properties and are promising candidates for developing novel two‐dimensional (2D) spintronic devices such as magnetic tunnel junctions and spin tunneling transistors. Previous studies of the antiferromagnetic CrCl3 have mainly focused on mechanically exfoliated samples. Controlled synthesis of high quality atomically thin flakes is critical for their technological implementation but has not been achieved to date. This work reports the growth of large CrCl3 flakes down to monolayer thickness via the physical vapor transport technique. Both isolated flakes with well‐defined facets and long stripe samples with the trilayer portion exceeding 60 µm have been obtained. High‐resolution transmission electron microscopy studies show that the CrCl3 flakes are single crystalline in the monoclinic structure, consistent with the Raman results. The room temperature stability of the CrCl3 flakes decreases with decreasing thickness. The tunneling magnetoresistance of graphite/CrCl3/graphite tunnel junctions confirms that few‐layer CrCl3 possesses in‐plane magnetic anisotropy and Néel temperature of 17 K. This study paves the path for developing CrCl3‐based scalable 2D spintronic applications.

BackgroundHyperlactatemia is a prognostic marker among patients with ST-segment elevation acute myocardial infarction (STEMI). However, the predictive value of lactate and the dynamic change associated with acute kidney injury (AKI) among patients with STEMI, remain poorly understood. We aimed to compare single lactate values at admission (Lacadm) and 12 h after admission (Lac12h) with lactate clearance (LC) 12 h after admission for AKI prediction in patients with STEMI.MethodsA total of 1,784 patients with STEMI were included. The study endpoint was AKI occurrence during hospitalization. The predictive value of lactate levels measured at admission and 12 h after admission and LC for AKI prediction was determined using multivariate logistic regression analyses and compared with receiver operator characteristic (ROC) curve analysis.ResultsOverall, AKI was observed in 353 (19.8%) patients. In multivariate logistic regression analyses, Lacadm ≥ 4.3 mmol/L (OR: 1.53; 95% CI: 1.01–2.30), Lac12h ≥ 2.1 mmol/L (OR: 1.81; 95% CI: 1.36–2.42), and LC ≥ −7.5% (OR: 0.40; 95% CI: 0.30–0.53) were the independent predictive factors for AKI after adjusting for confounders. ROC curve analysis results revealed that Lac12h (0.639; 95% CI: 0.616–0.661) exhibited a significantly higher area under the curve (AUC) than those of Lacadm (0.551; 95% CI: 0.527–0.574) and LC (0.593; 95% CI: 0.570–0.616) in the prediction of AKI. LC (△AUC = 0.037, p < 0.001) and Lac12h (△AUC = 0.017, p = 0.029) enhanced the discrimination capacity of Mehran Risk Score (MRS) for AKI among patients undergoing emergency coronary angiography.ConclusionLac12h is more effective for AKI prediction among patients with STEMI than Lacadm and LC. Furthermore, Lac12h and LC enhance the prediction capacity of MRS for AKI among patients after emergency coronary angiography.

Circular RNA (circRNA) is a newly discovered class of noncoding RNAs that plays key regulatory role in pathological development, including the regulation of several solid tumors. However, the effects of circRNA expression on oral squamous cell carcinoma (OSCC) remain unclear. With the use of high-throughput RNA sequencing data on eight paired oral cancer and adjacent healthy tissues, we observed that circRNA derived from the gene encoding pleckstrin homology domain-interacting protein (circPHIP) was highly expressed in OSCC. Additionally, circPHIP was highly expressed in other OSCC-related cell lines and was associated with tumor metastasis, TNM stage, and human papilloma virus infection status. The inhibition of circPHIP expression reduced OSCC cell migration, invasion, and proliferation. We found that circPHIP could adsorb microRNA (miR)-142-5p and upregulate the expression of PHIP and alpha-actinin 4 (ACTN4), both of which are potential oncogenes closely related to OSCC prognosis. The inhibition of miR-142-5p or overexpressing PHIP or ACTN4 reversed the circPHIP depletion-induced attenuation of OSCC malignancy. In conclusion, circPHIP is overexpressed in OSCC and enhances its malignancy via an miR-142-5p/PHIP-ACTN4/AKT serine/threonine kinase 1 signaling axis. Therefore, circPHIP may represent a novel target for treating OSCC.

Cryptococcosis is frequently found in immunosuppressed patients. It is also a significant opportunistic infection in non-immunocompromised individuals. In this study, we present a rare case of membranous nephropathy (MN) with pulmonary cryptococcosis. A 33-year-old man with MN was referred to our hospital because of dyspnea and weakness for 1 week. Before the above symptoms occurred, the dose of Cyclosporin A was increased again for relapse of MN. Multiple massive or patchy high-density shadows were present on computed tomography of the lung. Initially the patient underwent empirical anti-bacterial therapy, which turned out to be ineffective. As the results of serum cryptococcal latex agglutination tests were positive, the administration of anti-fungal drugs was prescribed. The results of fungal culture and pathologic examination of the lung tissue revealed the findings consistent with Cryptococcus neoformans. The patient was successfully treated with voriconazole followed by fluconazole with satisfactory result. Therefore, in patients with chronic kidney disease, lung lesions with poor bactericidal effects of cephalosporins need further examination to make sure whether there is pulmonary cryptococcosis. Early diagnosis and treatment might contribute to good results. It is a problem worthy of consideration that whether immunosuppressive agents need to be discontinued or not during antifungal therapy.

BackgroundMounting evidence suggests that there may be a causal relationship or common pathogenic pathway between inflammatory bowel disease (IBD) and dementia. However, inconsistent results have emerged from epidemiological studies. We therefore conducted this review to clarify the relationship between IBD and dementia.MethodsWe systematically searched PubMed, Web of Science, Embase, and Cochrane library to identify all studies exploring the relationship between IBD and dementia published as of September 2021. Risk estimates were pooled using both fixed and random-effects models.ResultsSix studies involving 2,334,472 subjects were included. Pooled results suggested that the risk of developing dementia significantly increased after IBD diagnosis (HR = 1.27, 95% CI: 1.10–1.47, P = 0.001), which did not vary by age, gender, dementia subtype, or IBD subtype. Whereas, the dementia incidence before IBD diagnosis and the comorbidity rate of dementia in IBD patients were similar to those without IBD (HR = 0.92, 95% CI: 0.68–1.25; 0.82, 95% CI: 0.64–1.06, respectively). However, current evidence was insufficient to establish a causal relationship.ConclusionThis study shows an unidirectional association between IBD and dementia; patients with IBD have an increased risk of dementia, and it may be beneficial to develop individualized dementia screening strategies for this population. Future research needs to further investigate whether effective therapies of IBD can reduce this risk and pathophysiological mechanisms of the association.

BackgroundRheumatoid arthritis (RA) and Parkinson's disease (PD) are two common chronic diseases worldwide, and any potential link between the two would significantly impact public health practice. Considering the current inconsistent evidence, we conducted a meta-analysis and systematic review to examine the risk of PD in patients with RA.MethodsTwo investigators (DL and XH) conducted a comprehensive search of PubMed, Embase, and Web of Science using medical subject headings terms combined with free words to identify relevant papers published from inception through December 31, 2021. All studies that explored the relationship between RA and PD were included for quantitative analysis and qualitative review. Random- and fixed-effects models were used to pool the risk ratios (RRs) of PD in patients with RA. The Newcastle-Ottawa scale was used to assess the quality of included studies. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guideline.ResultsFour population-based studies involving 353,246 patients and one Mendelian randomized study were included in our study. The pooled result showed a significantly reduced risk of PD in patients with RA than in the general population (RR = 0.74, 95% CI: 0.56-0.98, P = 0.034). No apparent effects of gender, age, region, follow-up time, or study design on PD risk were observed. Sensitivity analysis showed that pooled results were relatively stable, and no publication bias was detected. The Mendelian randomization study indicated a significant inverse association between RA and PD (genetic correlation: −0.10, P = 0.0033) and that each one standard deviation increase in the risk of RA was significantly associated with a lower risk of PD. Of note, the current study is limited by the relatively small number of included studies and unmeasured confounding factors, especially for RA-related anti-inflammatory agents.ConclusionsThis study supports that people with RA had a lower PD risk than those without RA. Further studies are needed to explore the underlying molecular mechanisms of the interaction between the two diseases.

This work proposes an approach to fabricate flexible transparent ultraviolet (UV)-shielding membrane by casting method, which uniformly disperses pristine zinc oxide nanoparticles (NPs) in low-density polyethylene (LDPE). The critical conditions for film fabrication, such as casting temperature, LDPE concentration in the solution, dissolution time, NP concentration, and post hot press cooling processes, are systematically studied. It is found that the casting temperature needs to be close to the melting temperature of LDPE, namely, 115°C, so that transparent film formation without cracks can be guaranteed. NP agglomerates are suppressed if the polymer concentration is controlled below 6%. For good dispersion of NPs, LDPE has to be swelled or unentangled enough in the solution (close to 200 h dissolution time), and then the NP agglomerates can be diminished due to the diffusion of the NPs into the polymer gel (322 h dissolution time). When the NPs are well-dispersed in the LDPE film, the film can completely shield UV light while allowing high transmissivity for the visible light. As the concentration of NPs in the film increases from 4 to 6%, the transmissivity of the film decreases, the tensile strength increases, and the tensile failure strain decreases.

Abstract Background The doctor-patient relationship in China has deteriorated in recent years, and poor doctor-patient communication is one of the main reasons. How to effectively carry out doctor-patient communication training originated from the West among Chinese medical students still to be studied. In the past decade, Peking Union Medical College has adopted clinical scenario drama to teach doctor-patient relationship and clinical communication skills. The aim of this study was to introduce clinical scenario dramas and evaluate its effectiveness in promoting doctor-patient relationships and clinical communication skills through students’ self-perceptions in Chinese medical students. Methods This study was a retrospective, self-controlled study and conducted from March 2009 to October 2018. Doctor-patient relationship and communication skills training were administered to all sixth-year medical students, which involved lectures and various clinical scenario dramas. The program totaled 24 h, of which each class session was 3 h, with 8 sessions in total. All students were requested to complete an anonymous 5 likert self-rating survey including self-confidence in using communication skills and self-perceived learning attitude and ability before and at the end of the course. In addition, they were requested to evaluate the curriculum after completion of the course. Results Clinical scenario dramas helped students improve their self-confidence in clinical communication skills except for psychosomatic history taking (p

Objective: To use systematic pharmacological strategies to explore the regulatory mechanisms of Ma Xing Shi Gan Decoction (MXSGD) against the coronavirus disease 2019 (COVID-19). Methods: Data on the compounds and targets of MXSGD were collected from the Traditional Chinese Medicene Systems Parmacology Database and Analysis Platform (TCMSP) and TCM Databases@Taiwan. Data on ACE2-related targets and the protein-protein interaction (PPI) were collected from the String database. The Cytoscape 3.7.2 was used to construct and analyze the networks. The DAVID platform was used for Gene Ontology (GO) and pathway enrichment analyses. Results: Data on 272 MXSGD targets and 21 SARS-CoV-2 potential targets were collected. Four networks were constructed and analyzed based on the data: (1) compound-target network of MXSGD; (2) MXSGD-SARS-CoV-2-PPI network; (3) cluster of MXSGD-SARS-CoV-2-PPI network; (4) Herb-Pathway-Target network. The core targets included AKT1, MAPK3, IL-6, TP53, VEGFA, TNF, CASP3, EGFR, EGF and MAPK1. The antiviral biological processes were inflammatory responses (inflammatory cells, inflammatory cytokines and their signaling pathways), immune responses (T cells, monocytes, B cells and other immune cells), immune factors (IFN-γ, TNF-α and so on), virus defense, humoral immunity and mucosal innate immune response. The antivirus-related signaling pathways included TNF, NOD-like receptor, FoxO, PI3K-AKT and Toll-like receptor signaling pathways. Conclusions: MXSGD can control disease progression by regulating multiple compounds and targets; it can reduce inflammation and balance immunity by regulating several proteins that interact with ACE2 and signaling pathways closely related to disease development.

The heterointerface between complex oxides and van der Waals materials presents a versatile platform for exploring new functionalities. Here, the authors report an unconventional nonlinear optical filtering effect resulting from the interfacial polar alignment between monolayer MoS2 and a ferroelectric oxide thin film.

Cardiac hypertrophy is an adaptive cardiac response that accommodates the variable hemodynamic demands of the human body during extended periods of preload or afterload increase. In recent years, an increasing number of studies have pointed to a potential connection between myocardial hypertrophy and abnormal expression of non-coding RNAs. Circular RNA (circRNA), as one of the non-coding RNAs, plays an essential role in cardiac hypertrophy. However, few studies have systematically analyzed circRNA-related competing endogenous RNA (ceRNA) regulatory networks associated with cardiac hypertrophy. Therefore, we used public databases from online prediction websites to predict and screen differentially expressed mRNAs and miRNAs and ultimately obtained circRNAs related to cardiac hypertrophy. Based on this result, we went on to establish a circRNAs-related ceRNA regulatory network. This study is the first to establish a circRNA-mediated ceRNA regulatory network associated with myocardial hypertrophy. To verify the results of our analysis, we used PCR to verify the differentially expressed mRNAs and miRNAs in animal myocardial hypertrophy model samples. Our findings suggest that three mRNAs (Col12a1, Thbs1, and Tgfbr3), four miRNAs (miR-20a-5p, miR-27b-3p, miR-342-3p, and miR-378a-3p), and four related circRNAs (circ_0002702, circ_0110609, circ_0013751, and circ_0047959) may play a key role in cardiac hypertrophy.

Myocardial remodeling is one of the main lesions in the late stage of chronic heart failure and seriously affects the prognosis of patients. Continuous activation of the renin-angiotensin-aldosterone system (RAAS) contributes to the development of myocardial remodeling greatly, and angiotensin II (Ang II), its main constituent, can directly lead to cardiac remodeling through an inflammatory response and oxidative stress. Since Ang II-induced myocardial remodeling is closely related to inflammation, we tried to explore whether the anti-inflammatory drug oridonin (Ori) can reverse this process and its possible mechanism. Our study investigated that hypertrophy and fibrosis can be induced after being treated with Ang II in cardiomyocytes (H9c2 cells and primary rat cardiomyocytes) and C57BL/6J mice. The anti-inflammatory drug oridonin could effectively attenuate the degree of cardiac remodeling both in vivo and vitro by inhibiting GSDMD, a key protein of intracellular inflammation which can further activate kinds of inflammation factors such as IL-1β and IL-18. We illustrated that oridonin reversed cardiac remodeling by inhibiting the process of inflammatory signaling through GSDMD. After inhibiting the expression of GSDMD in cardiomyocytes by siRNA, it was found that Ang II-induced hypertrophy was attenuated. These results suggest that oridonin is proved to be a potential protective drug against GSDMD-mediated inflammation and myocardial remodeling.

Background It is important to maintain the psychological well-being of front-line healthcare staff during the coronavirus disease 2019 (COVID-19) pandemic. Aims To examine COVID-19-related stress and its immediate psychological impact on healthcare staff. Method All healthcare staff working in the fever clinic, from 20 January 2020 to 26 March 2020, of a tertiary general hospital were enrolled. Stress management procedures were in place to alleviate concerns about the respondents’ own health and the health of their families, to help them adjust their work and to provide psychological support via a hotline. Qualitative interviews were undertaken and the Sources of Distress and the Impact of Event Scale-Revised (IES-R) were administered. Results Among the 102 participants (25 males; median age 30 years, interquartile range (IQR) = 27–36), the median IES-R total score was 3 (IQR = 0–8), and 6 participants (6.0%) scored above the cut-off on the IES-R (≥20). Safety and security were acceptable or better for 92 (90.2%) participants. The top four sources of distress were worry about the health of one's family/others at 0.88 (IQR = 0.25–1.25), worry about the virus spread at 0.50 (IQR = 0.00–1.00), worry about changes in work at 0.50 (IQR = 0.00–1.00) and worry about one's own health at 0.25 (IQR = 0.25–0.75). There was a moderate correlation between the IES-R score and the Sources of Distress score (rho = 0.501, P = 0.001). Conclusions The stress levels of healthcare staff in the fever clinic during the COVID-19 epidemic were not elevated. Physio-psychosocial interventions, including fulfilment of basic needs, activation of self-efficacy and psychological support, are helpful and worth recommending in fighting COVID-19.

Since the outbreak of the coronavirus epidemic, the “virtual” telemedicine has become a critical substitute for patient-provider interactions. However, virtual encounters often face challenges in the care of patients in high-risk categories such as chronic kidney disease (CKD) patients. In this study, we explore the patient's satisfaction and the practical effects of a newly established telemedicine program on CKD patients' care during the COVID-19 pandemic. Based on a prior version of an online patient care platform established in 2017, we developed a customized and improved online telemedicine program designed to specifically address the challenges emerging from the pandemic. This included an online, smart phone-based strategy for triage and medical care delivery and psychological support. We invited a total of 278 CKD patients to join the new platform during the pandemic. The subjects in group A were patients utilizing our old online CKD system and were historical users registered at least 3 months before the pandemic. A pilot survey interrogating medical and psychological conditions was conducted. Feedback on the program as well as a psychological assessment were collected after 1 month. In total, 181 patients showed active responses to the program, with 289 person-time medical consultations occurring during the study. The virtual care program provided a rapid triage for 17% (30 out of 181) patients, with timely referral to in-patient medical encounters for their worsening medical conditions or severe psychological problems. Nearly all patients (97.4%) believed the program was helpful. The number of symptoms (OR 1.309, 95%CI 1.113–1.541; P = 0.001) and being enrolled during the pandemic (OR 3.939, 95% CI 1.174–13.221; P = 0.026) were associated with high stress. During the follow-up, the high-stress CKD group at baseline showed a significant decrease in avoidance score (6.9 ± 4.7 vs. 9.8 ± 1.9, P = 0.015). In conclusion, during the pandemic, we established an online telemedicine care program for CKD patients that provides a rapid triage function, effective CKD disease management, and potentially essential psychological support.

We report the experimental evidence of evolving lattice distortion in high quality epitaxial orthorhombic SrIrO3(001) thin films fully strained on (001) SrTiO3 substrates. Angle-resolved X-ray photoemission spectroscopy studies show that the surface layer of 5 nm SrIrO3 films is Sr–O terminated, and subsequent layers recover the semimetallic state, with the band structure consistent with an orthorhombic SrIrO3(001) having the lattice constant of the substrate. While there is no band folding in the experimental band structure, additional super-periodicity is evident in low energy electron diffraction measurements, suggesting the emergence of a transition layer with crystal symmetry evolving from the SrTiO3 substrate to the SrIrO3(001) surface. Our study sheds light on the misfit relaxation mechanism in epitaxial SrIrO3 thin films in the orthorhombic phase, which is metastable in bulk.

More than 30% of genes in higher eukaryotes are regulated by promoter-proximal pausing of RNA polymerase II (Pol II). Phosphorylation of Pol II CTD by positive transcription elongation factor b (P-TEFb) is a necessary precursor event that enables productive transcription elongation. The exact mechanism on how the sequestered P-TEFb is released from the 7SK snRNP complex and recruited to Pol II CTD remains unknown. In this report, we utilize mouse and human models to reveal methylphosphate capping enzyme (MePCE), a core component of the 7SK snRNP complex, as the cognate substrate for Jumonji domain-containing 6 (JMJD6)’s novel proteolytic function. Our evidences consist of a crystal structure of JMJD6 bound to methyl-arginine, enzymatic assays of JMJD6 cleaving MePCE in vivo and in vitro, binding assays, and downstream effects of Jmjd6 knockout and overexpression on Pol II CTD phosphorylation. We propose that JMJD6 assists bromodomain containing 4 (BRD4) to recruit P-TEFb to Pol II CTD by disrupting the 7SK snRNP complex.

A reliable and inexpensive pretreatment procedure in the determination of β2-agonists in pork was developped. The procedure used a nanocomposite of multiwalled carbon nanotubes (CNTs) functionalized with graphene (rGO) as the reversed dispersive sorbent. It was analyzed after purification by high-performance liquid chromatography, the extraction time and the properties of the nanocomposite were optimized. Under optimized conditions, present method has linear response over concentration range of 0.5–50 ng/mL in pork samples with a satisfactory detection limit close to 0.1 ng/mL. The precisions of the current method (coefficient of variation) are lower than 5%, while recoveries are more than 98.3%. The nanocomposite exhibited high adsorptivity, long-term storage stability, satisfactory anti-interfering activity and high selectivity toward β2-agonists compared with those of rGO and CNTs. Keywords: High-performance liquid chromatography, Graphene, Multiwalled carbon nanotube, Ractopamine, Salbutamol

A magnetic-based immunoassay (MBI) combined with biotin-streptavidin amplification was proposed for butyl benzyl phthalate (BBP) investigation and risk assessment. The values of LOD (limit of detection, IC10) and IC50 were 0.57 ng/mL and 119.61 ng/mL, with a detection range of 0.57–24,977.71 ng/mL for MBI. The specificity, accuracy and precision are well demonstrated. A total of 36 environmental water samples of urban sewage from Zhenjiang, China, were collected and assessed for BBP contamination. The results show that BBP-positive levels ranged from 2.47 to 89.21 ng/mL, with a positive rate of 77.8%. The health effects of BBP in the urban sewage were within a controllable range, and the ambient severity for health (ASI) was below 1.49. The highest value of AS for ecology (ASII) was 7.43, which indicates a potential harm to ecology. The entropy value of risk quotient was below 100, the highest being 59.47, which poses a low risk to the environment and ecology, indicating that there is a need to strengthen BBP controls. The non-carcinogenic risk of BBP exposure from drinking water was higher for females than that for males, and the non-carcinogenic risk from drinking-water and bathing pathways was negligible. This study could provide an alternative method for detecting BBP and essential information for controlling BBP contamination.

Here, we outline magnetoelectric (ME) device concepts based on the voltage control of the interface magnetism of an ME antiferromagnet gate dielectric formed on a very thin semiconductor channel with large spin-orbit coupling (SOC). The emphasis of the ME spin field-effect transistors (ME spin FET) is on an antiferromagnet spin-orbit read logic device and a ME spin-FET multiplexer. Both spin-FET schemes exploit the strong SOC in the semiconducting channel materials but remain dependent on the voltage-induced switching of an ME, so that the switching time is limited only by the switching dynamics of the ME. The induced exchange field spin polarizes the channel material, breaks time-reversal symmetry, and results in the preferential charge transport direction, due to the spin-orbit-driven spin-momentum locking. These devices could provide reliable room temperature operation with large on/off ratios, well beyond what can be achieved using magnetic tunnel junctions. All of the proposed device spintronic functionalities without the need to switch a ferromagnet, yielding a faster writing speed (~10 ps) at a lower cost in energy (~10 aJ), excellent temperature stability (operational up to 400 K or above), and requiring far fewer device elements (transistor equivalents) than CMOS.

Abstract Background Immunoglobulin G4-related sialadenitis (IgG4-RS) is a newly recognized immune-mediated systemic disease. Despite its good response to steroid therapy, its treatment protocol is not standardized and the long-term outcome is controversial. The study was conducted to determine the short-term and long-term outcomes of IgG4-RS patients treated with glucocorticoids and steroid-sparing immunosuppressive agents, to analyze secretory function, serological and radiological changes in salivary glands and to assess the usefulness of serum IgG4 level as an indicator of disease activity. Methods IgG4-RS patients who were treated for more than 3 months were enrolled. Serological tests, salivary gland function assessment and computed tomography (CT) were performed before treatment and during follow up. The treatment outcomes in the short and the long term were evaluated, and the relationship between serum IgG4 level and salivary gland volume was analyzed. Results Glucocorticoids were used in all 43 patients and steroid-sparing immunosuppressive agents in 38 patients (88.4%). The follow-up period was 24.6 ± 14.9 months. Clinical remission was achieved in all patients after induction therapy. During short-term observation, salivary gland secretion significantly increased, and the serum IgG4 levels, the volumes and CT values of submandibular and parotid gland decreased significantly (P

Abstract Background The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients. Methods This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical “interview about cognitive, affective, and behavioral features associated with somatic complaints” was used to operationalize the SSD criteria B. For comparison, DSM-IV somatoform disorders were assessed with the Mini International Neuropsychiatric Interview plus. Cohen’s к scores were given to illustrate the agreement of the diagnoses. Results A three-structure model of the interview, within which items were classified as respectively assessing the cognitive (B1), affective (B2), and behavioral (B3) features, was examined. According to percentages of screening-positive persons and the receiver operator characteristic (ROC) analysis, a cut-off point of 2 was recommended for each subscale of the interview. With the operationalization, the frequency of DSM-5 SSD was estimated as 36.5% in our sample, and that of DSM-IV somatoform disorders was 8.2%. The agreement between them was small (Cohen’s к = 0.152). Comparisons of sociodemographic features of SSD patients with different severity levels (mild, moderate, severe) showed that mild SSD patients were better-off in terms of financial and employment status, and that the severity subtypes were congruent with the level of depression, anxiety, quality of life impairment, and the frequency of doctor visits. Conclusions The operationalization of the diagnosis and severity specifications of SSD was valid, but the diagnostic agreement between DSM-5 SSD and DSM-IV somatoform disorders was small. The interpretation the SSD criteria should be made cautiously, so that the diagnosis would not became over-inclusive.

Abstract Background Our study aimed (1) to describe the proportion of psychological distress among Chinese outpatients at general hospitals, (2) to compare cognitive and behavioral characteristics of patients with different distress patterns, and (3) to investigate the discriminant function of the analyzed variables in indicating the affinity towards the different distress patterns. Methods This multicenter cross-sectional study was conducted at ten outpatient departments at Chinese general hospitals. The somatic symptom severity scale (PHQ-15), the nine-item depression scale (PHQ-9), and the seven-item anxiety scale (GAD-7) were employed to classify patients in terms of four distress patterns. Results A total of 491 patients were enrolled. Among them, the proportion of patients with high psychological distress was significantly higher within those with high somatic distress (74.5% vs. 25.5%, p