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Abstract Background How to mobilize nurses students' learning initiative, reduce the incidence of academic procrastination, and improve their social adaptability is a key factor in lowering nursing brain drain and improving nursing quality. Objective To explore the mediating role of resilience in the correlation between social adaptability and academic procrastination of undergraduate nursing students. Methods This study is a cross-sectional survey. The researchers conducted an electronic questionnaire survey of 962 nursing undergraduates in Guanzhong District, Shaanxi Province from November 2022 to April 2023, and adopted the intention sampling method. And make the following assumptions: (1) There is a significant negative correlation between academic procrastination and social adaptability. (2) Academic procrastination can directly affect the social adaptability of undergraduate nursing students, and it has a significant negative predictive effect. (3) Resilience can directly affect academic procrastination and social adaptability. At the same time, resilience plays an intermediary role between the two. In this study, the Aitken procrastination scale, the resilience scale, and the social adaptability diagnostic scale were used to evaluate undergraduate nursing students. SPSS27.0 software is used to analyze the data statistically, and the Hayes PROCESS Macro method is used to test the model. Results The study's findings are as follows: 1) Academic procrastination significantly and negatively impacts social adaptability (c = -0.292, t = -6.407, p < 0.001). 2) Even when accounting for resilience, academic procrastination still significantly predicts lower social adaptability (c′= -0.204, t = -4.338, p < 0.001). 3) The Bootstrap method test of percentile bias correction indicates that resilience serves as a significant mediator between academic procrastination and social adaptability. Bootstrap SE = 0.018, 95% CI = (-0.124, -0.055). The indirect effect contributes to 29.79% of the total effect. Conclusion Resilience not only directly affects the academic procrastination and social adaptability of nursing students, but also partially intermediate the relationship between academic procrastination and social adaptability.

The persistence, bioaccumulation, and toxicity of perfluorinated and polyfluoroalkyl substances (PFASs), along with their concentrations in the environment and humans, have attracted global attention. However, so far, there have been seldom reports providing a systematical review in the entire field of PFASs research. Therefore, this study summarizes 14,112 relevant publications (2005–2022) and conducts bibliometric analysis using Vosviewer and CiteSpace. The findings offer insights into global PFASs research trends, assisting scientists in establishing their research directions. Unlike traditional literature reviews, this article presents a new method for data collection and analysis that achieves quantitative visualization of the information from the past 18 years in the field of PFASs. Results show a significant increase in global PFASs publications, with China leading in publication output and the US in international collaborations. Author Kurunthachalam Kanna has the highest publication records. Document co-citation clustering and key line analysis identifies four major research areas and landmarks, while betweenness centrality analysis reveals developmental processes. Citation burst analysis finds that PFASs toxicity and monitoring have been hot areas, suggesting the need for greater attention towards the types and levels of PFASs in various environmental media and the removal processes of PFASs responsible for pollution, which may emerge as future research hotspots.

Abstract Background An aging population has contributed to an increasing prevalence of functional limitations among older adults. Family support plays a crucial role in toileting and bathing assistance. Yet, the relationship between availability of family care resources and such actual assistance remains insufficiently explored. Our study aims to describe availability of family care resources and identify the association between availability of family care resources and toileting assistance or bathing assistance. Methods This study employed a cross-sectional analysis of data from the 2018 National Survey of the China Health and Retirement Longitudinal Study (CHARLS). The availability of family care resources was assessed using measurements of spouse availability, adult child availability, and living arrangement. Bathing assistance and toileting assistance were measured based on self-reported receipt of such assistance. Descriptive statistics were used to depict the overall and subgroup situation of availability of family care resources. Multivariable logistic models were employed to investigate the relationship between availability of family care resources and the receipt of toileting assistance or bathing assistance. Results Among the sample of older adults with functional limitations, 69% had a spouse, 63% had at least one adult child, and 80% resided with family members. Among those with bathing disability, 13% reported lacking bathing assistance, and among those with toileting disability, 54% reported lacking toileting assistance. Participants with 1-2 adult children had lower odds of receiving toileting assistance (OR: 0.28, 95% CI: 0.09, 0.91, p= 0.034) compared to those with three or more adult children. Spouse availability and living arrangement did not exhibit statistically significant associations with toileting assistance. Participants without a spouse had lower odds of receiving bathing assistance (OR: 0.27, 95% CI: 0.09-0.78, p= 0.016) in comparison to those with a spouse; however, adult child availability and living arrangement did not display statistically significant associations with bathing assistance. Conclusion The present findings suggest a gap in family commitment when it comes to assisting older adults with functional limitations in bathing/toileting. To address this, policymakers are encouraged to prioritize the implementation of proactive mechanisms for identifying family caregivers, alongside incentives to enhance their engagement in practical caregiving activities. Furthermore, it is crucial to emphasize the prioritization of affordable and easily accessible formal toileting/bathing assistance options for older adults who lack sufficient family care resources.

Abstract Background The informal caregivers of adult patients with β-thalassemia major (β-TM) bear not only physical but also emotional and economic pressures of providing care. This study is the first to evaluate the caregiver burden by Zarit Burden Interview (ZBI) of adult patients with β-TM in mainland China and to identify predictors of caregiver burden. Methods In this cross-sectional study, we conducted an online survey with snowball sampling covering seven provinces between September 1, 2021, and January 31, 2022, of patients aged ≥ 18 years with β-TM and their informal caregivers. Caregiver burden was assessed using the ZBI. Data on patient demographics, disease and therapy characteristics, and informal caregivers’ demographic characteristics were collected and analysed using independent t-tests, analysis of variance, Spearman’s correlation and multiple linear regression. Results Of 75 included patients, more than half (50.7%) were male. The mean patient age was 24.69 ± 5.59 years. The mean age of the informal caregivers was 50.60 ± 9.16 years, with women (74.7%) being predominant. The ZBI score was 38.00 ± 17.02. Multiple linear regression analysis showed that patients with interrupted blood transfusion therapy and informal caregivers required to care of others were positively associated with caregiver burden (p

ObjectivesThe purpose of this study was to determine the structural features and transferability of the multidrug-resistance (MDR) plasmid, and resistance phenotypes for the tested antimicrobials in foodborne Vibrio parahaemolyticus.MethodsPlasmids were isolated from a V. parahaemolyticus strain of seafood origin, then sequenced using the Illumina NovaSeq 6000 and PacBio Sequel II sequencing platforms to obtain the complete genome data. Characterization of the MDR plasmid pVP52-1, including determination of antimicrobial resistance genes (ARGs), plasmid incompatibility groups, and transferability, was carried out.ResultsV. parahaemolyticus strain NJIFDCVp52 contained two circular chromosomes and two circular plasmids (pVP52-1 and pVP52-2). Plasmid typing indicated that pVP52-1 belonged to the incompatibility group IncA/C2 and the sequence type pST3. pVP52-1 carried 12 different ARGs, an IS110-composite transposon consisting of aac(6′)-Ib-cr, qnrVC1, aac(6′)-Ib, dfrA14, and the IS26-mphA-IS6100 unit flanked by inverted sequences of IS5075 and IS4321. pVP52-2 carried no ARGs. A plasmid elimination assay showed that only pVP52-1 and its ARGs were lost, the loss of resistance to several antimicrobials, causing a change from the ampicillin-ampicillin/sulbactam-cefazolin-cefoxitin-ceftazidime-cefotaxime-imipenem-trimethoprim/sulfamethoxazole resistance pattern to the ampicillin resistance pattern. In accordance, a conjugation transfer assay showed that only pVP52-1 and its ARGs were horizontally transferred, leading to increased antimicrobial resistance in Escherichia coli strain EC600, causing a change from the ampicillin-nalidixic acid resistance pattern to the ampicillin-ampicillin/sulbactam-cefazolin-cefoxitin-ceftazidime-cefotaxime-imipenem-nalidixic acid-chloramphenicol-tetracycline-trimethoprim/sulfamethoxazole-azithromycin resistance pattern. Further transferability experiments revealed that pVP52-1 could be transferred to other enterobacterial strains of E. coli and Salmonella.DiscussionThis study emphasizes the urgent need for continued surveillance of resistance plasmids and changes in antimicrobial resistance profiles among the V. parahaemolyticus population.

In the age of digitization, digital transformation has emerged as a crucial pathway for companies to achieve sustainable development. In a sample of 24,103 firm-year observations from 3,508 listed companies in China's A-share market between 2007 and 2020, we investigate the relationship between corporate digital transformation and financing constraints based on dynamic capability theory. The proportion of intangible assets dedicated to digital technology is employed as a measure of the degree of digital transformation, and the SA index is utilized to assess the level of financing constraints. The findings demonstrate that digital transformation plays a significant role in alleviating financing constraints. In addition, greater institutional ownership leads to a pronounced negative correlation between digital transformation and financing constraints. From the perspective of dynamic capability theory, this study provides empirical evidence supporting research on economic consequences associated with digital transformation. Our results may contribute towards government formulation and implementation of policies promoting digital transformation to create a supportive external environment for businesses. Companies must seize opportunities associated with digital transformation to mitigate financing constraints.

Abstract Objective This study aims to describe the preference for primary healthcare (PHC) and investigate associated factors among homebound residents in both rural and urban areas of China. It provides valuable insights to facilitate the rational allocation of healthcare resources and promote the utilization of PHC. Methods In this nationally representative cross-sectional study, we utilized the most recent data (2020) from the China Family Panel Studies (CFPS). Participants were recruited from 25 provincial-level administrative regions in both rural and urban areas of China. Homebound patients were asked to provide details about their individual characteristics, variables related to family caregiving, and preferences for PHC. Multivariable logistic models were used to analyze potential factors associated with preference for PHC. Estimates of association were reported as odds ratios (OR) and their 95% confidence intervals (CI). Results The study found that 58.43% of rural patients reported a preference for PHC, while 42.78% of urban patients favored PHC. Compared to rural participants who did not received inpatient care in the past year, those who received inpatient care in the past year had 67% lower odds of choosing PHC (OR:0.33, 95% CI:0.19–0.59); Compared to rural participants who did not received family caregiving when ill, those who received family caregiving when ill had 59% lower odds of choosing PHC (OR: 0.41, 95% CI:0.21–0.77). Correspondingly, Compared to urban participants who did not received inpatient care in the past year, those who had received inpatient care in the past year had 75% lower odds of choosing PHC (OR: 0.25, 95% CI: 0.10–0.56); Compared to urban participants who did not received family caregiving when ill, those who received family caregiving when ill had 73% lower odds of choosing PHC (OR: 0.27, 95% CI: 0.11–0.63); Compared to urban participants who with agricultural Hukou, those with Non-agricultural Hukou had 61% lower odds of choosing PHC (OR: 0.39, 95% CI:0.18–0.83); Compared to urban participants living in the eastern part of mainland China, those living in the central part of China had 188% higher odds of choosing PHC (OR: 2.88, 95% CI: 1.14–7.29). Conclusion Policymakers should focus on tailoring PHC to vulnerable populations and prioritizing family-based public health strategies for enhancing homebound patients’ perceptions of PHC. Furthermore, further study is needed on whether the Hukou registration system affects the barriers that homebound patients experience in choosing healthcare providers.

Sustainable development has become a corporate goal all over the world, and innovation as a crucial prerequisite for sustainable development has attracted much attention. This study investigates the relationship between the business environment and corporate innovation in Chinese A-share listed enterprises from 2017 to 2020. We use a complex indicator to measure the business environment and use multiple regression models to conduct the analysis. The findings suggest that a favorable business environment promotes corporate innovation by reducing financing constraints and environmental uncertainty. Compared to non-state-owned enterprises, the positive impact of the business environment on corporate innovation is enhanced in state-owned enterprises. Concentrated ownership enhances the positive impact of a favorable business environment on corporate innovation. Our study provides a new analytical perspective on the relationship between the business environment and corporate innovation in the context of China.

Spermatogenesis is the production of spermatozoa by the testes, a process that is associated with reproduction in males. Amphioctopus fangsiao is an economically important species from the northern coast of China, and little research has been done on spermatogenesis in this species. In this study, we performed transcriptome analysis of testis and other somatic tissues. The maturing stage of testis development was selected, in which the emergence of spermatozoa was observed. A total of 15,773 differentially expressed genes were identified, including 8,922 upregulated genes and 6,851 downregulated genes. GO and KEGG enrichment analyses were performed to explore the functions of genes related to spermatogenesis, and the interactions between genes were examined by constructing protein interaction networks. Pathways and genes related to spermatogenesis were identified, including the oxytocin signaling pathway, the calcium signaling pathway, the FOXO signaling pathway, the DNAH family, and other key genes. The expression levels of 25 key genes were verified by qRT-PCR. The results for spermatogenesis-related genes will provide insights into the processes of spermatogenesis and testis development in A. fangsiao.

Glyphosate, ranked as one of the most widely used herbicides in the world, has raised concerns about its potential disruptive effects on sex hormones. However, limited human evidence was available, especially for children and adolescents. The present study aimed to examine the associations between exposure to glyphosate and sex hormones among participants aged 6–19 years, utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2016. Children and adolescents who had available data on urinary glyphosate, serum sex steroid hormones, including testosterone (TT), estradiol (E2) and sex hormone binding globulin (SHBG), and covariates were selected. Additionally, the ratio of TT to E2 (TT/E2) and the free androgen index (FAI), which was calculated using TT/SHBG, were also included as sex hormone indicators. Survey regression statistical modeling was used to examine the associations between urinary glyphosate concentration and sex hormone indicators by age and sex group. Among the 964 participants, 83.71% had been exposed to glyphosate (>lower limit of detection). The survey regression revealed a marginally negative association between urinary glyphosate and E2 in the overall population, while this association was more pronounced in adolescents with a significant trend. In further sex-stratified analyses among adolescents, a significant decrease in E2, FAI, and TT (p trend

Abstract Background Loneliness is one of the major health problems among older adults. Among this population, home and community-based services (HCBS) have become increasingly popular. Despite its health benefits, little is known about the relationship between HCBS use and loneliness in older people with functional limitations. We aim to explore the characteristics of loneliness among older people with functional limitations and examine the association between HCBS use and loneliness in China. Methods We used a cross-sectional data from the 2018 China Health and Retirement Longitudinal Study, which includes a nationally representative sample of Chinese residents aged 65 and older with functional limitations. Logistic regression models were used to examine the associations between HCBS use and loneliness, and we further used propensity score matching to address potential sample selection bias. Result In China, 46% of older people with functional limitations felt lonely and only 22% of older people with functional limitations reported using HCBS in 2018. Compared with participants who did not receive HCBS, those who received HCBS were less likely to report loneliness (OR = 0.81, 95% CI = 0.63, 0.99, p = 0.048), and the results remained significant after addressing sample selection bias using propensity score matching. Conclusion Our results showed that loneliness was common among Chinese older people with functional limitations, and the proportion of HCBS use was low. There was robust evidence to support that among older people with functional limitations, HCBS use was associated with decreased loneliness. Further policies should promote the development of broader HCBS use for older people with functional limitations to reduce their loneliness.

Shellfish are filter feeders that can accumulate toxic algae and their related toxins, increasing risk when consumed. Shellfish toxins can directly affect the physiological activities of marine organisms and threaten the stability of marine ecosystems. Ultimately, these toxins pass through the food chain and can endanger human health and economic security. Globally, shellfish poisoning incidents have occurred in many countries. The Bohai Sea is a semi-enclosed inland sea, where severe eutrophication of the seawater has occurred in recent years, leading to harmful algal blooms. To date, no simultaneous surveillance of diarrhetic shellfish poisonings (DSP) and paralytic shellfish poisonings (PSP) have been reported in the Tangshan shellfish culture area.To better understand shellfish toxin pollution in the shellfish culture areas of Tangshan and the dietary and health risks to residents, Mactra veneriformis, Ruditapes philippinarum, Rapana venosa, Crassostrea gigas, Cyclina sinensis, Meretrix meretrix, Mercenaria mercenaria, and Azumapecten farreri were collected for toxin monitoring from the Tangshan shellfish culture areas in Bohai Sea from October 2019 to September 2020. A total of 34 samples were collected for each shellfish species. Each sample weighed approximately 3 kg. All samples were transported to the laboratory on ice. In the laboratory, samples were flushed with tap water to remove sand and silt and shucked to collect the soft tissue. The tissue was thoroughly homogenized with a household blender, and approximately 50 g of tissue from each sample was stored at –20 ℃ until required for analysis. Five DSP including okadaic acid (OA), dinophysistoxin 1 (DTX1), dinophysistoxin 2 (DTX2), yessotoxin (YTX), and azaspiracid 1 (AZA1), and 14 PSP including saxitoxin (STX), neosaxitoxin (NEO), gonyautoxin 1/4 (GTX1/4), gonyautoxin 2/3 (GTX2/3), decarbamoylsaxitoxin (dcSTX), decarbamoylneosaxitoxin (dcNEO), decarbamoylgonyautoxin 2/3 (dcGTX2/3), gonyautoxin 5 (GTX5), gonyautoxin 6 (GTX6), and N-sulfocarbamoyl toxin 1/2 (C1/2) were tested using high performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS). The detection limit of the DSP method was 5 μg/kg, and the detection limit of the PSP method was 10–20 μg/kg.The DSP toxins were not detected in any of the samples. Several PSP toxins were detected, including saxitoxin (STX), gonyautoxin 1 (GTX1), gonyautoxin 2 (GTX2), and decarbamoylgonyautoxin 3 (dcGTX3). The GTX1 levels were the highest overall PSP toxin at 537.95 μg/kg in April. The results revealed positive rates of PSP for R. philippinarum, C. gigas, M. meretrix, and M. mercenaria, which were 11.76%, 47.06%, 5.90%, and 8.82%, respectively. Of the toxins tested, none were detected in the remaining samples. The highest PSP toxin levels in the positive samples from R. philippinarum, C. gigas, M. meretrix, and M. mercenaria were 414.26, 532.57, 452.77 and 195.46 μg STXeq/kg, respectively. We ranked the species in order of highest to lowest PSP toxin levels as: C. gigas > M. meretrix > R. philippinarum > M. mercenaria. In general, the toxin content of the shellfish in this area was lower than the EU limit of 800 μg STXeq/kg. The composition of shellfish toxins is related to many factors, including the sampling location and collection time. The toxin accumulation capacity by shellfish is also affected by many factors, including water pollution, salinity, light intensity, and most importantly, the species and density of the toxic algae in the surrounding waters.The ecological risk assessment methods used in this study were the risk quotient method (RQ) and the point assessment method. The RQ method is primarily used for semi-quantitative risk assessments to determine whether the pollutant concentrations have harmful effects. The point assessment model is a dietary exposure assessment tool. We applied risk quotient and point assessment methods to determine risk. There was no safety risk in the consumption of shellfish harvested from the Tangshan coastal study area during the study period. According to the point assessment method, at this specific time it was safe to consume the shellfish as the toxin levels were low. This analysis indicated that the safe single intake quantity of shellfish during months with high levels of shellfish-enriched toxins was reduced. As the toxin levels accumulating in different shellfish tissues can vary greatly, each sampled tissue was analyzed separately. The results indicate when there is a high accumulation of shellfish toxins present, consumers should restrict their consumption to a single serving rather than regularly consuming shellfish as part of their daily diet. The safety risk assessment results indicate that the seven shellfish species posed no food safety risk during the study period.This study provides a scientific basis for improving shellfish management practices to ensure shellfish are safe for consumption. This study analyzed the effects of toxin residues in shellfish species; different seasons and different locations vary in toxin content and components. We recommended consumers regulate their consumption to avoid potential poisoning events. This study provides social, economic, and ecological benefits in promoting green and healthy aquaculture of shellfish products, by ensuring the safety of shellfish products for consumer health. However, continuous long-term monitoring of both phytoplankton and biotoxins are recommended to ensure the development of the shellfish aquaculture industry and to support consumer health.

In recent years, with the scale and standardization of Stichopus japonicus mariculture, artificial reefs are increasingly used in S. japonicus farming to promote the development of the S. japonicus aquaculture industry. To provide shelter and improve the habitat environment for S. japonicus, three types of artificial reefs (box-shaped reef, triangular-shaped reef, and trapezoidal-shaped reef) were designed according to the ecological habitats of S. japonicus and the marine environment of Haizhou Bay (China) in the present study. After comprehensively comparing the three reef structures, we found that the trapezoidal-shaped reef has good permeability, a larger attachment area, and excellent anti-slip and anti-overturning properties. Further, the flow field characteristics surrounding a trapezoidal-shaped reef at different angles and flow velocities are investigated by three-dimensional numerical simulations. Then, the impact of the placement distance on the flow field surrounding the artificial reef combination was investigated. At the head-on angle θ = 0°, the upwelling volume increases as the flow velocity increases and then decreases, and the back eddy volume remains relatively constant. At the longitudinal spacing D = 4 L, the large slow-flow area surrounding the reef under this condition is more suitable for the S. japonicus habitat. In this study, the trapezoidal-shaped reef design is suitable and beneficial for S. japonicus aquaculture. Moreover, this study will contribute theoretical references to the design and arrangement of artificial reefs in coastal areas.

A paper-based surface enhancement of a Raman scattering substrate consisting of silver-nanowires stacked on glass-fiber filter paper was prepared. At the same time, the DNA-embedding molecule Eva Green was introduced as a signaling molecule for surface-enhanced Raman scattering (SERS) detection. Polymerase chain reaction (PCR) was used to amplify target genes and the method was developed into a rapid molecular diagnostic system. The total detection time of the developed detection method was 40 min, including 30 min of PCR amplification and 10 min of SERS measurement. After 30 PCR cycles, bacterial DNA with an initial concentration of 20 fg/μL and a bacterial suspension with an initial concentration of 7.2 × 101 CFUs/mL could be detected. When the enrichment culture time was 4 h, target bacteria with an initial contamination inoculation volume of 1.5 CFUs/mL could be detected in artificially contaminated samples. The method is fast and highly sensitive, and has not been applied to the detection of V. parahaemolyticus.

Abstract Background β-thalassaemia major poses a substantial economic burden, especially in adults. We aimed to estimate the economic burden of adult patients with β-thalassaemia major from a societal perspective using the real-world data. According to the clinical guideline, we also estimated the annual medical costs for patients with the same body weight and calculated the lifetime medical costs over 50 years in mainland China. Methods This was a retrospective cross-sectional study. An online survey with snowball sampling covering seven provinces was conducted. We extracted patient demographics, caregiver demographics, disease and therapy information, caring burden, and costs for adult patients diagnosed with β-thalassaemia major and their primary caregivers. In the real world, we estimated the annual direct medical cost, direct nonmedical cost, and indirect cost. In addition, we calculated the annual direct medical cost and lifetime direct medical cost by weight with discounted and undiscounted rates according to the clinical guideline. Results Direct medical costs was the main driver of total cost, with blood transfusion and iron chelation therapy as the most expensive components of direct medical cost. In addition, adult patients with β-thalassaemia major weighing 56 kg were associated with an increase of $2,764 in the annual direct medical cost using the real-world data. The undiscounted and discounted (5% discount rate) total lifetime treatment costs were $518,871 and $163,441, respectively. Conclusions Patients with β-thalassaemia major often encounter a substantial economic burden in mainland China. Efforts must be made to help policymakers develop effective strategies to reduce the burden and pevalence of thalassaemia.

Abstract Diatom is a common single‐cell microalgae with large species and huge biomass. Diatom biosilica (DB), the shell of diatom, is a natural inorganic material with a micro‐nanoporous structure. Its unique hierarchical porous structure gives it great application potential in drug delivery, hemostat materials, and biosensors, etc. However, the structural diversity of DB determines its different biological functions. Screening hundreds of thousands of diatom species for structural features of DB that meet application requirements is like looking for a needle in a seaway. And the chemical modification methods lack effective means to control the micro‐nanoporous structure of DB. The formation of DB is a typical biomineralization process, and its structural characteristics are affected by external environmental conditions, genes, and other factors. This allows to manipulate the micro‐nanostructure of DB through biological regulation method, thereby transforming the screening mode of the structure function of DB from a needle in a seaway to biofabrication mode. This review focuses on the formation, biological modification, functional activity of DB structure, and its application in biomaterials field, providing regulatory strategies and research idea of DB from the perspective of biofabrication. It will also maximize the possibility of using DB as biological materials.

BackgroundThe gut microbiota has emerged as an intriguing and potentially influential factor in regulating bone health. However, the causal effect of the gut microbiota on bone mineral density (BMD) appears to differ throughout various life stages.MethodsWe conducted a Mendelian randomization (MR) analysis to investigate the potential causal relationship between gut microbiota and BMD in five distinct age groups: 0–15, 15–30, 30–45, 45–60, and 60 years and older. The analysis employed three different methods, namely MR-Egger, weighted median, and Inverse-variance weighting, to ensure the robustness of our findings, a series of sensitivity analyses were also conducted, such as horizontal pleiotropy tests, heterogeneity tests, and leave-one-out sensitivity tests.ResultsIn the age group of 0–15 years, Eubacterium_fissicatena_group and Eubacterium_hallii_group were identified as risk factors for BMD. During the 15–30 age group, Phascolarctobacterium, Roseburia, and Ruminococcaceae_UCG_003 were found to be protective factors for BMD. In the 30–45 age group, Lachnospira genus demonstrated a protective effect on BMD, while Barnesiella and Lactococcus were identified as risk factors for BMD. Moving on to the 45–60 age group, Eubacterium_ventriosum_group, Lachnospiraceae_UCG_004, and Subdoligranulum were observed to be protective factors for BMD, while Eubacterium_coprostanoligenes_group, Fusicatenibacter, and Lactococcus were associated with an increased risk of BMD. In individuals aged 60 years and older, Fusicatenibacter and Ruminococcaceae_UCG_002 were also noted as risk factors for BMD. Conversely, Eubacterium_ruminantium_group, Ruminococcus_gauvreauii_group, Alistipes, and Coprococcus_3 were found to be protective factors for BMD, whereas Barnesiella and Sellimonas were identified as risk factors for BMD.ConclusionA robust causal relationship between gut microbiota and bone mineral density (BMD) exists throughout all stages of life, with Firmicutes phylum being the primary group associated with BMD across age groups. Gut microbiota linked with BMD primarily belong to the Firmicutes phylum across age groups. The diversity of gut microbiota phyla associated with BMD depicts relatively stable patterns during the ages of 0–45 years. However, for individuals aged 45 years and above, there is an observed increase in the number of gut microbiota species linked with BMD, and by the age of 60 years, a trend toward an increase in the Bacteroidetes phylum categories is proposed.

BackgroundImproving the quality of life (QoL) of older adults is becoming an important global issue. However, very few studies have been focused on the relationship between socioeconomic status (SES) and QoL in older adults with hypertension. The purpose of this study is to investigate (a) the status of QoL and (b) the mediating effect of social capital in the relationship between SES and QoL, among rural older adults with hypertension in China.MethodsUsing multistage stratified random sampling, a face-to-face questionnaire survey was conducted among rural older adults with hypertension in Shandong province of China from June to July 2021. Three typical measures representing SES were used, namely, annual household income, educational level, and employment status. Individual social capital and QoL were assessed by the Resource Generator-China Scale (RG—China) and a 34-item simplified Patient Report Outcome (PRO)-specific scale for older adults with hypertension, respectively. A total of 950 rural older adults with hypertension were included in the analysis. The mediation model based on bootstrap analyses was employed to explore the relationship between SES and QoL and the mediating role of social capital in the SES-QoL nexus.ResultsThe sampled rural older adults with hypertension had an upper-middle level of QoL, and the average score was 132.57 ± 19.40. SES was positively correlated with both QoL and individual social capital; individual social capital was significantly positively correlated with QoL. Controlling for sociodemographic variables, SES was still significantly associated with individual social capital (β = 0.140, P < 0.001), and the higher the individual social capital, the better QoL (β = 0.153, P < 0.001). Individual social capital played a partially mediating role in the association between SES and QoL (indirect effect = 0.021, 95% CI: 0.010–0.038), which accounted for 9.38% of the total effect.ConclusionThis study provides evidence that the effect of SES on QoL was partially mediated by individual social capital among rural older adults with hypertension in China. The government should pay more attention to the rural older hypertensive population with lower SES and strive to reduce the negative impact of poor SES on their QoL, based on effective strategies including improving their individual social capital.

Summary: In China, older cancer survivors may show heterogeneity in financial toxicity (FT). We aimed to identify FT profiles among older Chinese cancer survivors and examine the association between FT profiles and individual characteristics. We used a latent profile analysis to categorize participants and a multinomial logistic regression to examine the associations. We identified three distinct FT profiles: high, moderate, and low. Participants aged 65–69 years, with a monthly household income ≥ 5,000 CNY and a high school education or above were more likely to be classified into the moderate than high FT profile, a monthly household income ≥ 5,000 CNY increased the likelihood of being in the low FT profile and living alone negatively affected the odds of being in the low FT profile. The findings identified heterogeneity in FT among this population, may help identify high-risk groups, and may enable early intervention.

Industrial and agricultural activities result in the direct release of contaminants into soil, which alters and destructs the habitats of soil biota. Clarifying the effects of soil contamination on soil organisms can provide a theoretical basis for the conservation of soil organisms. In this study, 3 nonmetal elements (total C, total N, total P), 5 light metal elements (total K, Ca, Mg, Al, Na), 5 heavy metal elements (Fe, Hg, Pb, Mn, Zn) and soil pH, and 18 morphological traits of carabid species were analysed to explore the responses of spatial variation of species diversity, community composition and morphometric traits to differences of soil chemical properties in four sites (Cement Plant, Coal Coking Plant, Village and Nature Reserve) in Gujiao City, the largest coking coal production city of China. In total, 1095 carabid beetles representing 59 species were recorded, with the greatest richness and activity abundance of ground beetles were found in Cement Plant and the largest species diversity was found in Coal Coking Plant, Nature Reserve contained carabid assemblages distinct from the other three sites. As for species distribution, 14 soil chemical properties could be associated with 43.2% of the observed variation, with soil Zn, N, Ca and Mn being the most important in explaining the spatial variation of the species. Changes in the type of economic activity had a significant influence on the 18 morphometric traits of carabid species, species of Coal Coking Plant and Nature Reserve had larger morphological traits than the other two sites. Variations in morphometric traits showed a significant correlation with soil chemical properties, especially body wide and profemora length, with 14 soil factors explaining more than 60% of their variance. Soil Mg, Mn, total N and pH value contributed the most in explaining morphometric traits variability of ground beetles. In summary, changes in soil chemical properties due to industrial and agricultural activities have led to carabid species diversity, community and morphometric traits changes. Soil health management is prerequisites that contribute to conserve soil biodiversity and function in industrial areas.

Abstract Across countries in the world, China has the largest population of childhood cancer survivors. Research and care for the childhood cancer survivor population in China is fragmented. We searched studies published in English or Chinese language between January 1, 2000 and June 30, 2021, which examined various aspects of childhood cancer survivorship in China. The existing China‐focused studies were largely based on a single institution, convenient samplings with relatively small sample sizes, restricted geographic areas, cross‐sectional design, and focused on young survivors in their childhood or adolescence. These studies primarily focused on the physical late effects of cancer and its treatment, as well as the inferior psychological wellbeing among childhood cancer survivors, with few studies examining financial hardship, health promotion, and disease prevention, or healthcare delivery in survivorship. Our findings highlight the urgent need for research and evidence‐based survivorship care to serve the childhood cancer survivor population in China.

BackgroundPediatric cancer patients in China often present at an advanced stage of disease resulting in lower survival and poorer health outcomes. One factor hypothesized to contribute to delays in pediatric cancer has been the online health information–seeking (OHIS) behaviors by caregivers. ObjectiveThis study aims to examine the association between OHIS behaviors by caregivers and delays for Chinese pediatric cancer patients using a mixed methods approach. MethodsThis study used a mixed methods approach, specifically a sequential explanatory design. OHIS behavior by the caregiver was defined as the way caregivers access information relevant to their children’s health via the Internet. Delays in pediatric cancer were defined as any one of the following 3 types of delay: patient delay, diagnosis delay, or treatment delay. The quantitative analysis methods included descriptive analyses, Student t tests, Pearson chi-square test, and binary logistic regression analysis, all performed using Stata. The qualitative analysis methods included conceptual content analysis and the Colaizzi method. ResultsA total of 303 pediatric cancer patient-caregiver dyads was included in the quantitative survey, and 29 caregivers completed the qualitative interview. Quantitative analysis results revealed that nearly one-half (151/303, 49.8%) of patients experienced delays in pediatric cancer, and the primary type of delay was diagnosis delay (113/303, 37.3%), followed by patient delay (50/303, 16.5%) and treatment delay (24/303, 7.9%). In this study, 232 of the 303 (76.6%) caregiver participants demonstrated OHIS behaviors. When those engaged in OHIS behaviors were compared with their counterparts, the likelihood of patient delay more than doubled (odds ratio=2.21; 95% CI 1.03-4.75). Qualitative analysis results showed that caregivers’ OHIS behaviors impacted the cancer care pathway by influencing caregivers’ symptom appraisal before the first medical contact and caregivers’ acceptance of health care providers’ diagnostic and treatment decisions. ConclusionsOur findings suggest that OHIS among Chinese pediatric caregivers may be a risk factor for increasing the likelihood of patient delay. Our government and society should make a concerted effort to regulate online health information and improve its quality. Specialized freemium consultations provided by health care providers via online health informatic platforms are needed to shorten the time for caregivers’ cancer symptom appraisal before the first medical contact.

This study addressed the critical need for non-invasive monitoring of diabetes by proposing an acetone gas sensor based on hierarchical In _2 O _3 with atomic layer deposition (ALD)-deposited WO _3 nanoparticles. The sensor fabrication involved a carefully designed process, leveraging ALD to control WO _3 deposition, ensuring uniform distribution, and mitigating agglomeration. The resulting composite exhibited enhanced sensitivity, making it promising for detecting acetone, a key biomarker for diabetes. Material synthesis, including hydrothermal formation of In _2 O _3 hierarchy particles and ALD of WO _3 , was meticulously conducted. Comprehensive characterizations, involving SEM, TEM, EDX, XRD, XPS, and BET, validated the successful synthesis and deposition. The sensor’s response to varying acetone concentrations (50–2000 ppb) was systematically investigated, revealing a positive correlation. The In _2 O _3 /WO _3 –2 sensor exhibited the highest sensitivity, attributed to the catalytic properties of WO _3 . The proposed sensor presented a cost-effective, sensitive, and selective solution, paving the way for non-invasive diabetes monitoring.

Using sewage sludge to produce biochar-based adsorbents to remove phosphate (P) from water can be a sustainable and cost-effective method of waste management. However, the adsorption efficiency of sewage sludge biochar is not high. In this study, lanthanum-modified sludge-based biochar (La-SBBC) was synthesized by combining lanthanum nitrate with dewatered sludge. La-SBBC exhibited the highest removal efficiency of 99.06% for an initial P concentration of 15 mg/L at pH 3.0 with a dosage of 1.3 g/L. The maximum adsorption capacity of La-SBBC for P was 152.77 mg/g at 35 °C. The adsorption process followed the pseudo-second-order kinetic model (R2 ≥ 0.973) and the Freundlich isothermal adsorption model (R2 ≥ 0.928). Multilayer chemisorption was identified as the controlling process. The primary mechanisms of P adsorption by La-SBBC involved electrostatic interactions, precipitation, and inner sphere complexation. Thermodynamic analysis revealed that the adsorption process of La-SBBC was a spontaneous endothermic reaction. The fixed-bed experiment demonstrated that La-SBBC had significant practical utility. La-SBBC maintained 76.6% of the original P removal efficiency after six cycles. Therefore, La-SBBC can be used as a promising adsorbent for P in practical applications.

Plain English summary The majority of cancer cases and cancer mortality occur in older adults. Aging is a heterogenic process, which results in great diversity in older cancer patients concerning physical, psychological, and social status. There is limited information about the population characteristics and adverse health outcomes of older cancer patients in China, and the magnitude of this problem is unclear, creating challenges in understanding health disparities in geriatric cancer care. In this study, we have described the prevalence of frailty and explored the relationship between frailty and health-related quality of life (HRQoL). This study demonstrated that frailty, not being currently married, advanced cancer stage, and cancer site were significant factors influencing the lower HRQoL. Furthermore, frail individuals had a higher probability belonging to the lowest HRQoL quartile group. This study is considered as the first step in highlighting the importance of staging the aging and assessing quality of life among older cancer patients in China.

Abstract Background As erythropoietin (EPO) has been used to treat anemia in cancer patients, negative controversy has continued. Unfortunately, its effects on non‐small‐cell lung carcinoma (NSCLC) cell lines are uncertain and the phenomenon of inducing immune escape of tumor cells remains to be explored. This study aimed to provide an important basis for the application of exogenous EPO in the treatment of tumor‐associated anemia. Methods Cells were cultured in 1% O2, 5% CO2, and 94% N2 to simulate a hypoxic environment of the tumor. A549 cell line (lower expression EPOR) and NCI‐H838 cell line (higher expression EPOR) were treated with 2 and 8 U/ml recombinant human EPO (rhEPO). CCK‐8 method was used to determine the logarithmic growth phase of the cells and to detect cell proliferation. The expression levels of VEGF, HIF‐1α, and PD‐L1 were determined by western blot. One‐way ANOVA was used for statistical analysis between groups, with p

BackgroundFinancial hardship has been described as a patient’s economic experiencefollowing cancer-related treatment. Standardized patient-reported outcome measures(PROM) to assess this distress has not been well-studied, especially among older cancer survivors.ObjectiveThe aim of this study was to develop and validate PROM for assessing the financial hardship of older cancer survivors in China.MethodsItems were generated using qualitative interviews and literature review. Items were screened based on Delphi expert consultation and patients’ opinions. Item response theory (IRT) and classical test theory (CTT) were used to help reduce items. Retained items formed a pilot instrument that was subjected to psychometric testing. A cut-off score for the new instrument for predicting poor quality of life was identified by receiver operating characteristic (ROC) analysis.ResultsQualitative interviews and literature review generated 135 items, which were reduced to 60 items because of redundancy. Following Delphi expert consultation and patients’ evaluation, 24 items with high importance were extracted. Sixteen items were selected due to satisfactory statistical analysis based on CTT and IRT. Ten items were retained and comprised 2 domains after loadings in exploratory factor analysis (EFA). Internal consistency was satisfactory (α = 0.838). Test-retest reliability was good (intraclass correlation, 0.909). The ROC analysis suggested that the cut-off of 18.5 yielded an acceptable sensitivity and specificity.ConclusionsThe PROM for Hardship and Recovery with Distress Survey (HARDS) consists of 10 items that specifically reflect the experiences of financial hardship among older Chinese cancer survivors, and it also showed good reliability and validity in clinical settings.

Background: There is limited evidence on the effects of arsenic species and metabolic capacity on child neurodevelopment, particularly at low levels. Further, little is known about the critical window of exposure. Objective: To estimate the associations of arsenic exposure and arsenic metabolism in different pregnancy periods with neurodevelopment of two-year-old children. Methods: Concentrations of arsenobetaine (AsB), arsenite, arsenate, monomethyl arsenic acid (MMA), and dimethyl arsenic acid (DMA) in urine samples collected in three trimesters from 1006 mothers were measured using HPLC − ICPMS. Inorganic arsenic (iAs) was calculated as the sum of arsenite and arsenate. Total arsenic (tAs) was calculated as the sum of iAs, MMA and DMA. Child neurodevelopment was assessed with the Bayley Scales of Infant Development. Results: The geometric mean (GM) of SG-adjusted tAs in the first, second, third trimester was 16.37, 12.94, 13.04 μg/L, respectively. The mental development index (MDI) score was inversely associated with iAs and tAs. Compared to the 1st quartile, the MDI score decreased 0.43 (95%CI: −4.22, 3.36) for the 2nd, 6.50 (95%CI: −11.73, −1.27) for the 3rd, 5.42 (95%CI: −10.74, −0.10) for the 4th quartiles of iAs, and decreased 4.03 (95%CI: −7.90, −0.15) in the 4th quartile of tAs. In trimester-specific models, negative associations of DMA [−1.94 (95%CI: −3.18, −0.71)] and tAs [−1.61 (95%CI: −3.02, −0.20)] with the psychomotor development index (PDI) were only observed in 1st trimester. Conclusions: Our study found inverse associations between prenatal arsenic exposure, especially in early pregnancy, and neurodevelopment of children at two years old, even at low exposure levels.

Developing novel photoresponsive oxidase mimics is highly useful for environmental pollution monitoring and biological sensing. Herein, long-life room-temperature phosphorescent nitrogen-doped carbon quantum dots (P-NCDs) were synthesized from triethylenetetramine hexaacetic acid via a simple one-step hydrothermal method. The P-NCDs showed high photoresponsive oxidase-like activity. On this basis, a P-NCD-based photostimulated colorimetric sensing system was developed and used to detect Hg2+ in environmental and biological samples. P-NCDs under 365 nm UV lamp irradiation converted dissolved oxygen, via triplet excited state (T1) exciton transfer, to singlet oxygen (1O2), which then oxidized 3,3′,5,5′-tetramethylbenzidine (TMB), leading to a color changing reaction. Cysteine can suppress the catalysis of P-NCDs, and its specific complexation with Hg2+ can recover the oxidation activity of P-NCDs. Hence, efficient colorimetric Hg2+ detection with a linear range of 0.01–14 μM and a detection limit of 3.1 nM was achieved by detecting the color change of TMB. The feasibility of this strategy was validated through real sample analysis. Our study broadens the application scope of phosphorescent nanomaterials into colorimetric sensing.

Sperm storage is an important reproductive strategy in Amphioctopus fangsiao. Sperm can be stored in the oviducal glands up to eight months before fertilization. However, studies on the underlying storage mechanisms remain limited. In this study, the morphological structures of the oviductal glands and the changes adapted for sperm storage and fertilization were investigated by Hematoxylin eosin (HE) staining, transmission electron microscopy (TEM), and Alcian blue periodic acid Schiff (AB-PAS) staining. Results revealed that the nucleo-cytoplasmic ratio of the peripheral gland cells decreased and the eosinophilic secretory granules (glycoproteins) appeared in the cytoplasm and lumen during sperm storage. The cytoplasm of the central gland appeared vacuolated and AB pH 2.5 (+) secretions (acid mucins) were dispersed in the cells. These secretions may pass through the central cavity into the oviducts and be involved in zygote packaging. The spermathecae are composed of columnar epithelial ciliated cells with secretory functions. PAS (+) glycoproteins were found in the lumen, providing a microenvironment conducive to sperm survival. Cilia in the oviducts, central cavity, and spermathecae may help with sperm delivery, storage, and release, and egg transport. This study enhances our understanding of the biological reproduction process in A. fangsiao.

BackgroundHallux valgus (HV) is a common foot and ankle surgery disease. The correction of HV deformity relies on a highly challenging surgical treatment. Thus, widely adopted evidence-based clinical guidelines are still needed to guide the selection of the most appropriate interventions. Recently, the study of HV has been growing and scholars are increasingly paying particular attention to this area. However, bibliometric literature remains lacking. Therefore, this study aims to reveal the hotspots and future research trends in HV via bibliometric analysis to fill this knowledge gap.MethodsLiterature related to HV from 2004 to 2021 was retrieved from the Science Citation Index Expanded (SCI-expanded) of the Web of Science Core Collection (WoSCC). Quantitative and qualitative analyses of scientific data are performed using software such as CiteSpace, R-bibliometrix, and VOSviewer.ResultsA total of 1,904 records were identified for analysis. The United States had the most number of published articles and total citations. Thus, the United States has made an essential contribution to the field of HV. Meanwhile, La Trobe University in Australia was the most productive institution. Menz HB and Foot & Ankle International were the most influential authors and the most popular journals among researchers, respectively. In addition, “older people,” “chevron osteotomy,” “Lapidus,” and “hallux rigidus” have always been the hotspots of attention. Changes and developments in the surgery of HV have gained researchers' interest. Future research trends are more focused on “radiographic measurement,” “recurrence,” “outcome,” “rotation,” “pronation,” and “minimally invasive surgery.” Thus, focusing on these subject directions can facilitate academic progress and provide the possibility of better treatments for HV.ConclusionThis study summarizes the hotspots and trends in the field of HV from 2004 to 2021, which will provide researchers with an updated view of essential information and somehow guide future research.

This work studied the characteristics of leaf, rice straw, and sewage sludge (SS) co-composting with the aim of determining the best composting ratio by monitoring temperature changes, oxygen (O2) concentration, carbon dioxide (CO2) concentration, ammonia (NH3) concentration, hydrogen sulfide (H2S) concentration, pH, electrical conductivity (EC), heavy metal content, carbon-nitrogen ratio (C/N ratio), germination index (GI), moisture content (MC), and volatile solids (VS) content during the composting process. Three composting piles with the mixture ratios of 4:1:1 (Pile A), 5:1:1 (Pile B), and 6:1:1(Pile C) (SS: leaf: rice straw) were tested. According to the temperature, C/N ratio, germination index, MC, and VS, the level of compost maturity in Pile B with a 5:1:1 mixing ratio was higher than that in Piles A and C. The contents of heavy metals in the composts were shown to meet the grade A standard in CJ/T 309-2009 (2009), except Cu and Zn, which was within the grade B standard.

Nivolumab, the programmed cell death 1 inhibitor, is a kind of immune checkpoint inhibitor commonly used to treat advanced cancers. Unfortunately, such drugs often induce various immune-related adverse events involving different body systems, with psoriasis being one of the skin toxicities. We report the clinical features of an exacerbated psoriasis induced by using nivolumab after three days in a patient with stage IIIc gastric adenocarcinoma. At the same time, we searched 27 case reports published from 2015 to 2021 over the world and systematically summarized the clinical manifestation of a total of 44 cases with psoriasis caused or exacerbated by Nivolumab. Commonly traditional treatment could be useful, and small molecule drugs such as apremilast are effective among some patients. However, more studies are needed to evaluate the efficacy and safety of biologics or small molecule drugs in treating psoriasis induced by nivolumab.

BackgroundPatients with β-thalassemia major (β-TM), predominantly adult patients, are associated with physical, mental, and social problems, that result in decreased quality of life (QoL). However, there is a paucity of data on QoL and health status utility (HSU) among adult patients with β-TM in mainland China. Our study aimed to evaluate the QoL by short form 36 questionnaire (SF-36) of adult patients with β-TM in mainland China and to estimate their HSU by SF-6D. In addition, we aimed to identify predictors of HSU.MethodsIn this cross-sectional descriptive study, a total of 75 adult patients with β-TM were included by the snowball sampling method that applied involving seven provinces with a relatively high prevalence of thalassemia across mainland China between September 1, 2021 and January 31, 2022. The collected information included social-demographic characteristics, health conditions, treatment, social support (social support rating scale), caregiver burden (Zarit burden interview), and QoL (SF-36). HSU scores were calculated for each adult patient from their SF-36 responses using the SF-6D algorithm with Hong Kong's tariff. The frequency of participants' responses to the SF-6D for each item of the options was described. Mean HSU scores between different subgroups were calculated. Ordinary least squares (OLS) regression modeling was performed to identify factors associated with HSU.ResultsA total of 75 adult patients with β-TM were included in this study. The mean SF-36 score was 50.2 ± 10.70, of which physical and mental scores were 47.57 ± 11.28 and 52.85 ± 14.21, respectively. In addition, the mean SF-6D utility score was estimated to be 0.598 ± 0.112, ranging from 0.391 to 0.962. Univariate analyses showed that interruption of iron chelation treatment significantly affected HSU values (P = 0.038); diagnosis with comorbidity very slightly affected HSU values (P = 0.0996). In the multivariate analysis, diagnosis with comorbidity (P = 0.042) was significantly negatively associated with HSU values; the minimum pre-transfusion hemoglobin concentration (P = 0.047) and social support (P = 0.068) were positively associated with HSU values.ConclusionThis study presents poor QoL and HSU outcomes in Chinese adult patients with β-TM. The study also highlights the importance of social support and treatment compliance, which can increase hemoglobin content and reduce comorbidities, further to ensure the QoL of patients. These findings can be used for future clinical and economic studies.

BackgroundThis study aimed to compare the effectiveness and safety of the percutaneous first extensor compartment performed by acupotomy procedure with or without ultrasonic (US) guidance.MethodsThe percutaneous release was performed with an acupotomy on 40 wrists of cadavers, which was divided into US guidance operation and blind operation. Each arm was dissected and assessed regarding the amount of release and the extent of neurovascular and tendon injury. An analysis of finite biomechanical elements based on wrists specimen data is analyzed to observe the stress of the first extensor tendon compartment. A prospective study observed the pain visual analogue score(VAS) and Patient-Rated Wrist Evaluation (PRWEB) changes after the ultrasound guidance or blind acupotomy treatment in 30 dQD patients.ResultsThe success rate in the ultrasound-guided technique was 85%, and the blind technique was 70% in the cadaver study, both techniques without neurovascular injury. There was no statistically significant difference between the two groups in measuring the distance from the incision marks to the blood vessels and nerves (P > 0.05). According to the biomechanical analysis, the tendon friction rubs when the wrist is upright. When the wrist is flexed, the tendon and tendon sheath is stressed in the bone ridges. In this prospective study, both ultrasound guidance and blind acupotomy treatment achieved well improvements in pain and function (P 0.05).ConclusionBoth blind and US-guided percutaneous release by acupotomy of the first extensor tendon compartment can get a good result. US-guided techniques can improve the success rate during acupotomy operations, especially for beginners and followers.

ObjectiveThis study aimed to determine the safety and accuracy of ultrasound-guided acupotomy percutaneous loosening of the transverse carpal ligament.MethodsThe 100 upper limb specimens were equally divided into the ultrasound-guided acupotomy group (U) and the nonultrasound-guided acupotomy group (N). For the U group, we simulated ultrasound-guided acupotomy loosening of the transverse carpal ligament in a human specimen, and for the N group, we performed the loosening of the transverse carpal ligament through the same approach under nonultrasound-guided conditions. The safety and accuracy of the two methods were compared through measurement.ResultsIn the ultrasound-guided group, the injury rate of nerves, blood vessels and tendons caused by needle-knife release was 0%. In the non-ultrasound-guided group, the rate of nerve, blood vessel and tendon damage was 6 percent, 12 percent and 20 percent, respectively. χ2 test (Fisher exact test) was performed for the nerve and blood vessel damage rates in the two groups (PN > 0.05, PA

Background: Diabetic foot ulcer (DFU) is a severe chronic complication of diabetes, that can result in disability or death. Dracorhodin Perchlorate (DP) is effective for treating DFU, but the potential mechanisms need to be investigated. We aimed to explore the mechanisms underlying the acceleration of wound healing in DFU by the topical application of DP through the combination of metabolomics and network pharmacology.Methods: A DFU rat model was established, and the rate of ulcer wound healing was assessed. Different metabolites were found in the skin tissues of each group, and MetaboAnalyst was performed to analyse metabolic pathways. The candidate targets of DP in the treatment of DFU were screened using network pharmacology. Cytoscape was applied to construct an integrated network of metabolomics and network pharmacology. Moreover, the obtained hub targets were validated using molecular docking. After the topical application of DP, blood glucose, the rate of wound healing and pro-inflammatory cytokine levels were assessed.Results: The levels of IL-1, hs-CRP and TNF-α of the Adm group were significantly downregulated. A total of 114 metabolites were identified. These could be important to the therapeutic effects of DP in the treatment of DFU. Based on the network pharmacology, seven hub genes were found, which were partially consistent with the metabolomics results. We focused on four hub targets by further integrated analysis, namely, PAH, GSTM1, DHFR and CAT, and the crucial metabolites and pathways. Molecular docking results demonstrated that DP was well combined with the hub targets.Conclusion: Our research based on metabolomics and network pharmacology demonstrated that DP improves wound healing in DFU through multiple targets and pathways, and it can potentially be used for DFU treatment.

A new methodology is proposed in this study for active steering of a tram with independently rotating wheels (IRWs). This methodology has been developed specifically to improve the tram’s steering capability and to reduce wheel-rail wear. The tram is represented by a complex dynamic model with a diverse range of operating conditions, and traditional active steering methods cannot ensure that the tram can remain well-controlled throughout the entire range of operating conditions. The linear parameter-varying (LPV)- H ∞ control method proposed in this paper uses variable parameter theory to represent the nonlinearity, the parameter uncertainty, and the external force changes in the IRW. The LPV- H ∞ steering controller can not only ensure the robustness of the uncertain system, but also can balance the complexity and the performance of the controller. This allows the tram to offer good steering performance under various running conditions. The simulation results presented in this research show that application of the proposed control method improves the running performance of the tram and reduces the wheel-rail wear significantly on both straight and curved tracks when compared with the passive case.

Obesity is a risk factor for many serious health problems, associated with inflammation, hyperlipidemia, and gut dysbiosis. Prevention of obesity is especially important for human health. Tolypocladium sinense is one of the fungi isolated from Chinese caterpillar fungus, which is a traditional Chinese medicine with putative gut microbiota modulation effects. Here, we established a high-fat diet (HFD)-induced hyperlipidemia mice model, which was supplemented with lyophilized T. sinense mycelium (TSP) daily to evaluate its anti-obesity effects. The results indicated that TSP supplementation can effectively alleviate the inflammatory response and oxidative stress levels caused by obesity. TSP significantly prevented obesity and suppressed dyslipidemia by regulating the expression of lipid metabolism genes in the liver. TSP is also effective in preventing the HFD-induced decline in short-chain fatty acid (SCFA) content. Gut microbiota profiling showed that TSP supplementation reversed HFD diet-induced bacterial abundance and also altered the metabolic pathways of functional microorganisms, as revealed by KEGG analysis. It is noteworthy that, correlation analysis reveals the up-regulated gut microbiota (Lactobacillus and Prevotella_9) are closely correlated with lipid metabolism parameters, gene expression of liver lipid metabolism and inflammatory. Additionally, the role of TSP in the regulation of lipid metabolism was reconfirmed by fecal microbiota transplantation. To sum up, our results provide the evidence that TSP may be used as prebiotic agents to prevent obesity by altering the gut microbiota, alleviating the inflammatory response and regulating gene expression of liver lipid metabolism.

ObjectiveThe present study aimed to assess the efficacy and safety of ultrasound-guided percutaneous A1 pulley release using a needle knife.MethodsThe author performed percutaneous A1 pulley release in 84 cadaveric hands fixed with 10% formalin. The cadaveric hands were divided into three groups: 28 hands in each group (group U: ultrasound-guided needle knife pushing group, group N: non-ultrasound-guided needle knife pushing group, group T: classical needle knife operation puncture group). Percutaneous A1 pulley release was performed, the soft tissue was dissected layer by layer, and the relevant anatomical data were measured.ResultsThe injured cases were as follows: group U, 29 (20.7%); group N, 36 (25.7%); and group T, 28 (20.0%). There is no significant difference between different tissue injury types in different intervention methods. The missed release cases were as follows: group U, 8 (5.7%); group N, 4 (2.9%); and group T, 13 (9.3%). The percentage of released A1 pulley were as follows: group U, 71.4% ± 30.7%; group N, 66.0% ± 20.3%; and group T, 61.0% ± 30.4%. The percentage of released A1 pulley of the three groups were compared: group U > group N > group T, and there was statistical difference between the three groups. The full release rates of the three groups were compared: group U(31.4%) > group N(15.7%) > group T(13.6%), and there were significant difference in the full release of A1 pulley between group U and group T, group N.ConclusionBased on the cadaver specimen, the length and percentage of released A1 pulley is longer by ultrasound-guided percutaneous A1 pulley release using a needle-knife. and there was no statistical difference in the injury rate between the three techniques.Type of Study and Clinical RelevanceClinical anatomic study. To test the efficacy and safety of ultrasound-guided percutaneous A1 pulley release using a needle knife in cadaveric hands, and provide an anatomically based support in clinic.

Silicosis, the most common type of pneumoconiosis, exhibits a high incidence in workers who are chronically exposed to crystalline silica (CS). No specific remedy for cure as yet. The terpenoid oridonin exerts multiple modulatory functions in neoplasms and inflammations as a natural compound. In this study, we explored the effect of oridonin on silicosis and revealed the underlying molecular mechanism. An experimental silicosis mouse model was established to evaluate the effects of oridonin on pneumonia and pulmonary fibrosis. In addition, the impact of oridonin on alveolar macrophages (AMs) was examined in the MH-S cell line. Its molecular target, inducible nitric oxide synthase (iNOS), was identified by chemobiological means, and virus-mediated gene overexpression systems confirmed that oridonin directly restrained iNOS protein levels. Oridonin alleviated pneumonia and pulmonary fibrosis in silicosis mice with no obvious systemic toxicity. These effects were partially related to oridonin inhibition of CS-induced AMs injury and inflammation. Furthermore, oridonin suppressed iNOS enzymatic expression and activity by covalently binding to the Thr109 residue of the iNOS target. Thus, our results indicate oridonin as a potential iNOS enzymatic suppressor in experimental silicosis that attenuates pneumonia and pulmonary fibrosis progression, which provides a therapeutic avenue for silicosis prevention and treatment.

The photocatalytic performance of g-C3N4 materials prepared by different precursors for Rhodamine B (RhB) dye degradation was studied. Their crystal structure, morphologies, chemical compositions, functional groups, and optical and photoelectrochemical performances of prepared g-C3N4 were analysed and characterised using X-ray diffraction, scanning electron microscopy, X-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy, UV-Vis diffuse reflectance spectra, photoluminescence, and electrochemical workstations. The degradation of RhB dye in the presence of visible light and sunlight was utilised to assess the photocatalytic efficiency of the g-C3N4 photocatalyst. The results of the photocatalytic comparison experiment showed that the g-C3N4 photocatalyst prepared with urea as a precursor (UCN) has the best photocatalytic performance, achieving 99.61% removal in 40 min. In addition, the photocatalyst UCN can completely degrade 10 mg/L RhB dye within 20 min under sunlight, demonstrating its potential for practical applications under natural sunlight conditions. After four cycles, the degradation rate remains above 99%, demonstrating excellent stability and reusability. Due to its lower average pore number, larger BET-specific surface area and volume of pores, UCN provides more activity spaces and facilitates the adsorption of pollutant molecules, thereby enhancing photocatalytic activity. It was established through the active substance trapping studies that the main reactive species involved in the photocatalytic degradation process of RhB dye is •O2−. This study showed that g-C3N4 synthesised with urea as the precursor has better photocatalytic performance in the degradation of RhB dye.

Currently, the durability of cement-based composites is primarily influenced by the presence and transport of corrosive fluids. In structural concrete, various factors such as mechanical loads and drying shrinkage can lead to the formation of cracks, which adversely affect its transport properties. While there is some consensus regarding the impact of individual cracks on transportation, our understanding of crack networks remains relatively limited. Furthermore, the maintenance of stress within the concrete can alter its porosity and influence the opening and closing of cracks, thereby affecting its transport properties. Due to limitations in experimental methods, characterizing the geometry of crack networks poses a challenge. However, numerical modeling offers an efficient and practical approach to investigate the impact of cracks, particularly microcracks, on the diffusivity of concrete.

Pharmaceutical cocrystals are multicomponent systems in which at least one component is an active pharmaceutical ingredient and the others are pharmaceutically acceptable ingredients. Cocrystallization of a drug substance with a coformer is a promising and emerging approach to improve the performance of pharmaceuticals, such as solubility, dissolution profile, pharmacokinetics and stability. This review article presents a comprehensive overview of pharmaceutical cocrystals, including preparation methods, physicochemical properties, and applications. Furthermore, some examples of drug cocrystals are highlighted to illustrate the effect of crystal structures on the various aspects of active pharmaceutical ingredients, such as physical stability, chemical stability, mechanical properties, optical properties, bioavailability, sustained release and therapeutic effect. This review will provide guidance for more efficient design and manufacture of pharmaceutical cocrystals with desired physicochemical properties and applications.

Biochar-amended landfill cover soil (BLCS) can promote CH4 and O2 diffusion, but it increases rainwater entry in the rainy season, which is not conducive to CH4 emission reduction. Hydrophobic biochar–amended landfill cover soil (HLCS) was prepared to investigate the changes in CH4 emission reduction and biological characteristics, and BLCS was prepared as control. Results showed that rainwater retention time in HLCS was reduced by half. HLCS had a higher CH4 reduction potential, achieving 100% CH4 removal at 25% CH4 content of landfill gas, and its main contributors to CH4 reduction were found to be at depths of 10–30 cm (upper layer) and 50–60 cm (lower layer). The relative abundances of methane-oxidizing bacteria (MOB) in the upper and lower layers of HLCS were 55.93% and 46.93%, respectively, higher than those of BLCS (50.80% and 31.40%, respectively). Hydrophobic biochar amended to the landfill cover soil can realize waterproofing, ventilation, MOB growth promotion, and efficient CH4 reduction.

Gouty arthritis (GA), as a multifactorial disease, is characterised by intense pain, active inflammation symptoms, and swollen joints. It has utterly complex pathogenesis, of which the amount of research publications on GA has increased during the last few decades. A bibliometric analysis was carried out to investigate the trends, frontiers, and hot spots in global scientific output in GA research over the last decade. We retrieved the Science Citation Index Expanded (SCI-Expanded) of the Web of Science Core Collection (WoSCC) for publications and recorded information published from 2012 to 2021. we carried out the bibliometric analysis and visualisation analysis of the overall distribution of annual outputs, leading countries, active institutions, journals, authors, co-cited references, and keywords with the VOSviewer and CiteSpace. The impact and quality of papers were assessed using a global citation score (GCS). We retrieved 2052 articles and reviews in total. The annual number of publications (Np) related to GA research has increased during the latest decade. China published the most papers, and the USA achieved the highest H-index and number of citations (Nc). The League of European Research Universities (LERU) and Clinical Rheumatology (Clin Rheumatol) are the most productive institutions and periodicals. The total GCS of the paper written by Kottgen, A. in 2013 was 479, ranking the first. The most common keywords were “Gout,” “hyperuricemia,” and “gouty arthritis.” This research revealed that though there was a slight fluctuation in publications related to GA, the Np raised on the whole. China was an enormous creator, and the USA was an influential nation in this domain. The top three contributor authors were Dalbeth, N., Singh, JA., and Choi, HK. There were few investigations on the treatment of GA by Chinese medicine monomer, and the “mechanism,” “pathway”, “nf- kappa-b”, “injury”, “receptor”, and “animal model” were growing research hotspots. Our research illustrated the hotspots of research and development trends in the research field of GA during the last decade. Recognition of the most critical indicators (researchers, countries, institutes, and journals for the release of GA research), hotspots in the research field of GA can be helpful for countries, scholars, and policymakers in this field to understand GA better make decisions.

Physalis alkekengi L. calyx (PC) extract can relieve insulin resistance and has glycemic and anti-inflammatory effects; however, the potential mechanisms related to gut microbiota and metabolites remain elusive. This study aimed to understand how PC regulates gut microbiota and metabolites to exert anti-obesogenic effects and relieve insulin resistance. In this study, a high-fat high-fructose (HFHF)-diet-induced obesity C57BL/6J male mice model with glycolipid metabolism dysfunction was established, which was supplemented with the aqueous extract of PC daily for 10 weeks. The results showed that the PC supplementation could effectively cure the abnormal lipid metabolism and maintain glucose metabolism homeostasis by regulating the expression of adipose metabolic genes and glucose metabolism genes in the liver, thereby effectively alleviating the inflammatory response. PC treatment also increased the contents of fecal short-chain fatty acids (SCFAs), especially butyric acid. PC extract could restore the HFHF-disrupted diversity of gut microbiota by significantly increasing the relative abundance of Lactobacillus and decreasing those of Romboutsia, Candidatus_Saccharimonas, and Clostridium_sensu_stricto_1. The negative effects of the HFHF diet were ameliorated by PC by regulating multiple metabolic pathways, such as lipid metabolism (linoleic acid metabolism, alpha-linolenic acid metabolism, and sphingolipid metabolism) and amino acid metabolism (histidine and tryptophan metabolism). Correlation analysis showed that among the obesity parameters, gut microbiota and metabolites are directly and closely related. To sum up, this study suggested that PC treatment exhibited therapeutic effects by regulating the gut microbiota, fecal metabolites, and gene expression in the liver to improve glucose metabolism, modulate adiposity, and reduce inflammation.

A coupling model reflecting the interaction between freeze–thaw cycles (FTCs) and alkali–silica reactions (ASRs) is established from the microscale to the macroscale under the consideration of non-uniform environmental and mechanical conditions. At both material and structural levels with/without reinforcement, the deformation and damage patterns of specimens under single and coupled FTCs and ASRs were simulated by multiscale finite element analysis and partially verified by experiments. Furthermore, following different sources of damage actions, the remaining fatigue life of reinforced concentrate (RC) slabs under traffic loads was investigated. The results show that ASR-driven expansion is mainly governed by the arrangement of reinforcing bars, whereas FTC damage is mainly initiated from corners, edges, and surfaces of RC slab parts and closely relies on water supply. In addition, the severity of coupled damage (FTC and ASR) can be significantly greater than that of the sum of single ASR and FTC damage due to the gel-filling of pores and entrained air. Finally, in terms of the remaining fatigue life, the ASR could be occasionally beneficial for bridge decks under moving traffic loads due to gel-filled cracks and chemical prestressing. However, if cracks are empty or filled by condensed liquid water, the overall fatigue life will be significantly reduced.

This paper presents an adaptive backstepping sliding mode tracking control method for underactuated unmanned surface vehicle. The tracking controller is designed by combining backstepping and adaptive sliding mode control technology. The virtual control law is used to replace the control strategy of position error, and the position tracking control is transformed into velocity control, which can effectively avoid the input saturation and singular value problem existing in the design of traditional backstepping control law. The neural shunt model method is used to solve the differential explosion problem caused by virtual control law. The adaptive technology based on backstepping sliding mode theory is introduced to compensate the model uncertainty and time-varying disturbances of the system, and the robustness of the underactuated USV is enhanced by this method in the unknown environment. Based on the Lyapunov stability theory, it is proved that the control system error is ultimately uniformly bounded. The simulation results show that the proposed adaptive backstepping sliding mode tracking control method can achieve stable tracking in the case of system parameter uncertainty and time-varying disturbances, so it can be concluded that this method is reasonable and effective.

ObjectiveThis study aimed to examine the urban-rural disparities and associated factors of health care utilization among cancer patients in China.MethodsThis study used the data collected from a cross-sectional survey conducted in China. A total of 1,570 cancer survivors from three urban districts and five rural counties were selected by using a multistage stratified random sampling method. We measured health care utilization with the way of cancer diagnosis, the number of hospitals visited, and receiving alternative therapies. Chi-square test was used to examine the differences between urban and rural cancer patients. Binary logistic regression analysis was performed to explore the determinants of health care utilization.ResultsAmong 1,570 participants, 84.1% were diagnosed with cancer after developing symptoms, 55.6% had visited two and above hospitals, and 5.7% had received alternative therapies. Compared with urban cancer patients, rural ones were more likely to be diagnosed with cancer after developing symptoms (χ2 = 40.04, p < 0.001), while they were less likely to visit more than one hospital (χ2 = 27.14, p < 0.001). Residence area (urban/rural), health insurance type, household income, age at diagnosis, tumor site, stage of tumor, and survival years were significantly associated with health care utilization of cancer patients (p < 0.01).ConclusionsHealth care utilization was suboptimal among cancers patients in China. Rural cancer patients had less health care utilization including screenings and treatments than urban ones. Policymakers should implement specific strategies to ensure equitable utilization of cancer care. More attention should be paid to the disadvantaged groups and rural cancer patients. Prioritizing health resources allocation is needed to prevent, screen, and treat cancers in rural areas.