Biosynthetic pathway of prescription cucurbitacin IIa and high-level production of key triterpenoid intermediates in engineered yeast and tobacco.

Cucurbitacin IIa is a triterpenoid isolated exclusively from Hemsleya plants and a non-steroidal anti-inflammatory drug that functions as the main ingredient of prescription Hemslecin capsules and tablets in China. Synthetic biology provides new strategies for production of such valuable cucurbitacins at a large scale; however, the biosynthetic pathway of cucurbitacin IIa has been unknown, and the heterologous production of cucurbitacins in galactose medium has been expensive and low yielding. In this study, we characterized the functions of genes encoding two squalene epoxidases (HcSE1-2), six oxidosqualene cyclases (HcOSC1-6), two CYP450s (HcCYP87D20 and HcCYP81Q59), and an acyltransferase (HcAT1) in cucurbitacin IIa biosynthesis by heterologous expression in Saccharomyces cerevisiae and Nicotiana benthamiana. We achieved high-level production of the key cucurbitacin precursor 11-carbonyl-20ß-hydroxy-Cuol from glucose in yeast via modular engineering of the mevalonate pathway and optimization of P450 expression levels. The resulting yields of 46.41 mg/l 11-carbonyl-20ß-hydroxy-Cuol and 126.47 mg/l total cucurbitacin triterpenoids in shake flasks are the highest yields yet reported from engineered microbes. Subsequently, production of 11-carbonyl-20ß-hydroxy-Cuol by transient gene expression in tobacco resulted in yields of 1.28 mg/g dry weight in leaves. This work reveals the key genes involved in biosynthesis of prescription cucurbitacin IIa and demonstrates that engineered yeast cultivated with glucose can produce high yields of key triterpenoid intermediates. We describe a low-cost and highly efficient platform for rapid screening of candidate genes and high-yield production of pharmacological triterpenoids.

Inquiry in uncertainty-nursing students' learning experience in challenge-based learning: A qualitative study.

BACKGROUND: Currently, nursing students face a significant lack of preparedness in efficiently addressing complex issues. The use of challenge-based learning, a student-centred situational learning method that utilizes practice scenarios to solve complex problems, can help alleviate the challenges in nurse education. However, there remains to be more extensive exploration on the application of challenge-based learning in nurse practice education. OBJECTIVES: This study aims to explore the learning experiences of nursing students in challenge-based learning to gain a deeper understanding of the ways and mechanisms through which challenge-based learning enhances specific learning abilities. DESIGN/METHODS: This study utilized a hermeneutic phenomenological design, employing semi-structured interviews and thematic analysis. SETTINGS: A university in Hunan, China, hosted the nursing skills competition based on the principles of challenge-based learning, targeting senior students from nursing schools in Hunan province. PARTICIPANTS: A total of 24 fourth-year students from six colleges, including one male and twenty-three female students. RESULTS: Two themes and seven sub-themes emerged from the study. Theme 1 Constructing a knowledge system in complex scenarios with sub-themes: Case-based education centred on comprehensive knowledge promotes knowledge linkage; Reverse reasoning promotes knowledge differentiation; Making mistakes helps finding the correct path of knowledge; Traps inspire identification of potential problems. Theme 2 Inquiry in uncertainty with sub-themes: Unexpected changes promote exploration of general principles; Combining knowledge with diverse case scenarios promotes flexible thinking; The uncertainty of knowledge fosters independent thinking. CONCLUSIONS: The complexity and variability inherent in challenging learning situations promote the construction of students' knowledge systems and the cultivation of an inquisitive spirit. The identification of these mechanisms contributes to the optimization of instructional environment design, the development of a culture of continuous learning and innovation, and effectively tackling complex issues within an ever-evolving global context.

Nerve Defect Treatment with a Capping Hydroxyethyl Cellulose/Soy Protein Isolate Sponge Conduit for Painful Neuroma Prevention.

Painful neuroma, as one of the complications of nerve injury from disease or trauma, results in instinctive neuropathic pain that adversely affects a patient's quality of life. To intercept neuroma development, capping strategies have been performed as effective therapies. Nonetheless, the most appropriate biocompatible material to shield the nerves is an urgent clinical requirement. Herein, a compatible hydroxyethyl cellulose (HEC)/soy protein isolate (SPI) sponge capping conduit (HSSC) is used to prevent neuroma in vivo. Following capping on the sciatic nerve stump in vivo, the behavior of the rats and the structure of tissues are compared through histological assessment and autotomy scoring. The HSSCs gained a dismal autotomy score and enhanced the amelioration, where inflammatory invasions and overdeposition of collagen are defeated. The expression of myelin growth linked genes (Krox20, MPZ, and MAG) in the HSSC group at the eighth week was almost 2 times higher than that of the no capping group. The HSSC conduit served as a physical barrier to repress the infiltration of inflammation as well as provided an optimum microenvironment for facilitating nerve rejuvenation and intercepting neuroma development during nerve amelioration.

Composite Hydrogel Conduit Incorporated with Platelet-Rich Plasma Improved the Regenerative Microenvironment for Peripheral Nerve Repair.

Peripheral nerve regeneration and functional recovery remain major challenges in clinical practice. Nerve guidance conduits (NGCs) which can regulate the regenerative microenvironment are beneficial for peripheral nerve repair. Platelet-rich plasma (PRP) can secrete multiple growth factors to regulate the regenerative microenvironment. However, current administration methods of PRP are rapidly activated followed by the burst release of growth factors, causing low therapeutic efficiency in vivo. To overcome these disadvantages, a composite nerve conduit was fabricated by incorporating PRP into a gelatin methacrylate (GelMA) and sodium alginate (SA) hydrogel. The GelMA/SA-3/PRP-20 NGCs possess optimal mechanical properties, degradation rate, and superior biological performance. Importantly, GelMA/SA-3/PRP-20 NGCs achieved the sustained release of two major growth factors (VEGF-A, PDGF-BB) from PRP. Moreover, the GelMA/SA-3/PRP-20 NGCs significantly promoted the migration of Schwann cells and the neovascularization of endothelial cells in vitro. While bridging 10 mm rat sciatic nerve defects, the GelMA/SA-3/PRP-20 NGCs promoted axonal regeneration and functional recovery of peripheral nerves. Therefore, the GelMA/SA-3/PRP-20 NGCs could regulate the regenerative microenvironment by sustained release of growth factors from PRP and shed new light on the clinical application of PRP in peripheral nerve repair.

Development of a food preservative from sea buckthorn together with chitosan: Application in and characterization of fresh-cut lettuce storage.

The purpose was to create a novel composite food preservative for fresh-cut lettuce using flavonoids and chitosan from sea buckthorn leaves (SBL). Sea buckthorn leaves were extracted with ethanol as the extraction solvent and ultrasonic-assisted extraction to obtain flavonoid from sea buckthorn leaf crude (FSL), and then the FSL was secondarily purified with AB-8 resin and polyamide resin to obtain flavonoid from sea buckthorn leaf purified (FSL-1). Different concentrations of FSL-1 and chitosan were made into a composite preservative (FCCP) by magnetic stirring and other methods, containing 1% chitosan preservative (CP) alone, 0.5-2 mg/ml of FSL-1 and 1% chitosan composite preservative (FCCP-1, FCCP-2, FCCP-3, and FCCP-4), and the FSL-1 concentrations were analyzed the effect of FSL-1 concentration on the physicochemical properties of the composite preservatives, including their film-forming ability, antioxidant capacity and ability to prevent bacterial growth, was analyzed. To further investigate the effect of the combined preservatives on fresh-cut lettuce, different FCCPs were applied to the surface was stored at 4°C for 7 days. Then the changes in weight loss, hardness, browning index, total chlorophyll content, SOD and MDA were analyzed. It was used to assess the physicochemical indicators of fresh-cut lettuce throughout storage. According to the results of Fourier transform infrared spectroscopy, FSL-1 and chitosan interacted to form hydrogen bonds, and the contact angle and viscosity of FCCP increased on both horizontal glass and polystyrene plates, indicating the good film-forming properties of the composite preservation solution. With the diameter of the antibacterial zone of Staphylococcus aureus, Escherichia coli, Salmonella typhimurium, and Listeria monocytogenes being (21.39 ± 0.22), (17.43 ± 0.24), (15.30 ± 0.12), and (14.43 ± 0.24) mm, respectively. It was proved that the antibacterial activity of FCCP became stronger with the increase of FSL-1 concentration and had the best antibacterial effect on S. aureus. The complex preservative showed the best scavenging effect on ferric reducing antioxidant capacity, DPPH radicals (96.64%) and 2,2'-Azinobis- (3-ethylbenzthiazoline-6-sulphonate) (ABTS) radicals (99.42%) when FSL-1 was added at 2 mg/ml. When fresh-cut lettuce was coated with FCCP for the same storage time, various indicators of lettuce such as weight loss, hardness, browning index, SOD activity and MDA content were better than the control group showing good potential in fresh-cut vegetables and fruits preservation. FCCP holds great promise for food safety quality and shelf-life extension as a new natural food preservative. The waste utilization of sea buckthorn leaves can greatly improve his utilization and economic benefits.

Do sleep and psychological factors influence musculoskeletal pain among nurses?

BACKGROUND: The physical factors associated with musculoskeletal pain in nursing personnel have been largely investigated, although the role of sleep and psychological factors resulting in musculoskeletal pain has not been addressed thoroughly. OBJECTIVE: This study aimed to explore the prevalence of musculoskeletal pain and investigate how sleep and psychological factors influence musculoskeletal pain in a nursing group. METHODS: Nordic standard questionnaires were distributed to 230 female nurses. Chi-square tests were performed to assess the associations between sleep problems, psychological problems, and musculoskeletal pain symptoms. Binary logistic regression analysis was also conducted to identify the primary factors influencing the prevalence of musculoskeletal pain. RESULTS: The highest prevalence of pain was observed in the lower back, neck, and shoulders, whereas the lowest prevalence of pain was observed in the ankles, feet, elbows, and hips/buttocks. Chi-square analysis and binary logistic regression showed that sleep duration, sleep onset time, and sleep quality all significantly contributed to the development of neck and upper back pain. With regard to the psychological factors, only occupational pride and stress had a significant effect on pain; in contrast, family support did not show any significant influence. CONCLUSION: Compared with other body regions, musculoskeletal pain in the lower back, neck, and shoulders requires more attention and preventive interventions. Special efforts should be made to shift the workday system of the nursing group because of the strong correlation between sleep problems and pain. Incentives other than penalty mechanisms should be considered seriously in nursing to boost occupational pride and relieve job stress.

Use of physical restraints and its associated risk factors in the aged care facilities: A multicentre cross-sectional study.

AIMS AND OBJECTIVES: To investigate the use of physical restraints in aged care facilities(ACFs)and analyse its associated risk factors. BACKGROUND: Physical restraints have been widely used in ACFs worldwide, but they can cause physical and mental harm to older people. It is important to regulate the use of physical restraint. DESIGN: A cross-sectional observational and correlational multicentre study. METHODS: By convenience sampling method, we selected eight ACFs in four representative regions of Hunan province, China, for this study. The ACF-related information was obtained by interviewing the managers and reviewing records. We conducted investigation and observation on the elderly in the ACFs to understand the use of physical restraints at three different times: 9:30-11:30, 16:00-18:00 and 19:30-21:30 on a working day. The STROBE checklist was followed for this cross-sectional study. RESULTS: This study found that the utilisation rate of physical restraints was 23.2%. The critical risk factors affecting the use of physical restrains include the following: (1) the ratio of nursing staff to the elderly residents; (2)whether there is a dementia care unit at the facility; (3) the number of elderly residents in each room; (4) the elderly residents' age, degree of education, marital status, care dependence and cognitive impairment; (5) whether the elderly has suffered from a stroke or senile dementia; (6) whether the elderly carries medical catheters. CONCLUSION: There is a lack of standardisation in the use of physical restraints in ACFs of central China. Chinese ACFs should develop guidelines and reduction measures to standardise the use of physical restraints, basing on the key factors affecting the use of physical restraints. RELEVANCE TO CLINICAL PRACTICE: The use of physical restraints in ACFs is threatening the safety of the elderly residents. Understanding the implementation of physical restraint in ACFs can provide reference for reducing the use of physical restraint.

Preparation and characterization of geraniol nanoemulsions and its antibacterial activity.

Geraniol nanoemulsions (G-NE) based on Tween 80 and medium chain triglyceride (MCT) as surfactant and co-surfactant, respectively, has been prepared by the spontaneous emulsification method. Its physical and chemical properties such as mean particle size, zeta potential, PDI, pH, viscosity, contact angle, appearance morphology, and stability (storage stability, thermal stability, centrifugal properties, acid-base stability, and freeze-thaw properties) of the droplet were analyzed. The results showed that the mean particle size of G-NE was 90.33 ± 5.23 nm, the PDI was 0.058 ± 0.0007, the zeta potential was -17.95 ± 5.85 mV and the encapsulation efficiency was >90%. The produced G-NE has been demonstrated to be fairly stable in long-term storage at 4°C, pH = 5 and high-speed centrifuges. Moreover, G-NE had a significant inhibition effect on Staphylococcus aureus, Escherichia coli, Salmonella typhimurium and Listeria monocytogenes (p < 0.05). The bacterial inhibition rates of G-NE at a concentration of 1 MIC were 48, 99, 71.73, and 99% after 12 h of action against these four foodborne pathogenic bacteria, respectively. Therefore, the results obtained indicated that nanoemulsification enhanced the stability and antibacterial activity of geraniol to some extent, which will promote the utilization of geraniol in food preservation.

Preparation of Solid Lipid Nanoparticles of Cinnamaldehyde and Determination of Sustained Release Capacity.

Natural plant essential oils cannot be applied on a large scale due to their high volatility, easy deactivation, etc. This study provides a new method to prepare a long-lasting, slow-release essential oil product by taking advantage of solid lipid nanoparticles, which will provide a scientific guideline for the future essential oil industry. In this article, solid lipid cinnamaldehyde nanoparticles were prepared using an ultrahigh-pressure homogenization method. SLN-CA with a particle size of 74 ± 5 nm, PDI of 0.153 ± 0.032, and zeta potential of -44.36 ± 2.2 mV was screened using an additional amount of cinnamaldehyde, the ratio of oil phase components, and the homogenization pressure and number of times as factors. Differential thermal analysis and spectroscopy demonstrated that cinnamaldehyde was successfully encapsulated inside the nanoparticles. The change in particle size of nanoparticles under different conditions and times was used as an indicator of stability. The stability of the finished nanoparticles was evaluated. The retention and slow-release ability of cinnamaldehyde were investigated using the concentration of cinnamaldehyde in nanoparticles as an indicator. The results showed that after 15 days, SLN-CA retained 52.36% of the concentration from 15 days prior. The bacterial inhibition test shows that SLN-CA can inhibit bacteria.

Cellular Antioxidant Properties of Ischnoderma Resinosum Polysaccharide.

A predominant polysaccharide isolated from Ischnoderma resinosum underwent evaluation for its capacity to scavenge free radicals and its potential antioxidant properties at a cellular-oriented level. This proved that Ischnoderma resinosum polysaccharide (IRP) remarkably curtailed AAPH-induced erythrocyte hemolysis through the inhibition of the generation of ROS (p < 0.05). Rather, it caused the restoration of intracellular antioxidant enzyme (SOD, GSH-Px, and CAT) activities at an acceptable pace and the silencing of intracellular MDA formation, as well as the rescaling of LDH leakage. Furthermore, a model of oxidative stress in HepG2 cells was established by adopting 400 µM of hydrogen peroxide, which suggested that IRP manifests promising antioxidant activity. Notably, after the intervention of IRP in the H2O2-induced HepG2 cells, there was a statistical elevation in cell survivability (p < 0.05). IRP diminished the morphological alterations in the nucleus and decreased the secretion of ROS (p < 0.05), with a dose-dependent abrogation of apoptosis (p < 0.05). Consequently, IRP, which was isolated and purified, was able to scavenge free radicals and possessed favorable antioxidant activity that could dampen the occurrence of oxidative stimulation and effectively alleviate the AAPH-induced erythrocyte hemolysis and H2O2-induced oxidative damage in HepG2 cells. This provides a basis and theoretical reference for the development and utilization of IRP as a natural antioxidant, with emphasis on the exploitation of environmentally friendly and cost-effective antioxidants.

Neuroprotection of Gastrodia elata polyphenols against H2O2-induced PC12 cell cytotoxicity by reducing oxidative stress.

It has been suggested that oxidative stress (OS) has a role in the development of aging and neurodegenerative disorders. Biological molecules are easily damaged by reactive oxygen species, which can ultimately result in necrotic or apoptotic cell death. Foods containing phytochemicals, such as phenolic compounds, may have potential preventive effects against several diseases, including alzheimer's disease (AD), according to epidemiological and in vitro research. Gastrodia elata is a well-known homology of medicine and food plant that has been used for centuries in China and other East Asian countries to treat central nervous system disorders. In this study, we focused on the potential of the extract, Gastrodia elata polyphenols (GPP), for the prevention and treatment of AD. H2O2 induced PC12 cell damage was used to simulate the oxidative stress of AD. The effects of GPP on the injury model were evaluated by cell survival rate, lactate dehydrogenase (LDH), lipid peroxidation (MDA), production of intracellular antioxidant enzymes, reactive oxygen species (ROS), mitochondrial membrane potential (MMP), cellular inflammation level and apoptosis level. The results showed that GPP pretreatment had a protective effect by increasing cell viability, reducing lactate dehydrogenase infiltration, decreasing MDA and increasing intracellular antioxidant enzymes, diminishing reactive oxygen species production and decreasing mitochondrial membrane potential, reducing cell inflammation and decreasing apoptosis. Accordingly, it is suggested that GPP possessed promising neuroprotective benefits which enabled the prevention or therapeutic implementation of AD along with serving as a reference towards the exploitation of functional foods or drugs derived from Gastrodia elata.

Protective Effect of Flavonoids from Mulberry Leaf on AAPH-Induced Oxidative Damage in Sheep Erythrocytes.

To evaluate the antioxidant activity of flavonoids extracted from Chinese herb mulberry leaves (ML), flavonoids from mulberry leaves (FML) were extracted and purified by using ultrasonic-assisted enzymatic extraction and D101 macroporous resin. Using LC-MS/MS-Liquid Chromatography with tandem mass spectrometry analysis, hesperidin, rutoside, hyperoside, cyanidin-3-o-glucoside, myricitrin, cyanidin, and quercetin were identified, and NMR and UV were consistent with the verification of IR flavonoid characteristics. The antioxidant activity of FML has also been evaluated as well as the protective effect on 2,2 0-azobis (2-amidinopropane) dihydrochloride (AAPH)-induced oxidative stress. The results showed that FML exhibited powerful antioxidant activity. Moreover, FML showed dose-dependent protection against AAPH-induced sheep erythrocytes' oxidative hemolysis. In the enzymatic antioxidant system, pretreatment with high FML maintained the balance of SOD, CAT, and GSH-Px; in the non-enzymatic antioxidant system, the content of MDA can be effectively reduced after FML treatment. This study provides a research basis for the development of natural products from mulberry leaves.

In situ synthesis of TiO2/NC on cotton fibers with antibacterial properties and recyclable photocatalytic degradation of dyes.

A cotton fabric/titanium dioxide-nanocellulose (TiO2-Cot.) flexible and recyclable composite material with highly photocatalytic degradation of dyes and antibacterial properties was synthesized. During the preparation process, nano-TiO2 particles were synthesized through an in situ strategy and grown on cotton fiber, and were wrapped with cellulose nanocrystals (NC). The prepared TiO2-Cot. was characterized by field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). The SEM and EDS results showed that nano-TiO2 particles were evenly distributed on the fiber surface. The prepared TiO2@Cot. has excellent photocatalytic efficiency of 95.68% for MB and 92.77% for AR under weak ultraviolet irradiation over 6 h. At the same time, it has excellent antibacterial activity against S. aureus and E. coli. The stability and reusability of the materials were also investigated.

The influence of effective communication, perceived respect and willingness to collaborate on nurses' perceptions of nurse-physician collaboration in China.

BACKGROUND: Nurse-physician collaboration is a critical prerequisite for high-quality care. Previous researchers have addressed multiple factors that influence collaboration. However, little of this research has explored the influence of interactional factors on nurses' perception of nurse-physician collaboration in China. AIMS: To examine the influence of interactional factors (effective communication, perceived respect and willingness to collaborate) on nurses' perception of nurse-physician collaboration. METHODS: A cross-sectional survey of 971 registered nurses in nine hospitals was conducted. An author-designed interactional factor questionnaire and the Nurse-Physician Collaboration Scale were used to collect data. Multiple regression analysis was used. RESULTS: Nurse-physician collaboration was identified as at a moderate level (mean = 3.93 ±â€¯0.68). Interactional factors (effective communication, perceived respect and willingness to collaborate) were identified as relatively moderate to high (mean = 4.03 ±â€¯0.68, mean = 3.87 ±â€¯0.75, mean = 4.50 ±â€¯0.59, respectively). The results showed that effective communication, perceived respect and willingness to collaborate explained 57.3% of the variance in nurses' perception of nurse-physician collaboration (Adjusted R2 = 0.573, F = 435.563, P < 0.001). Perceived respect (ß = 0.378) was the strongest factor relevant to nurses' perception of nurse-physician collaboration, second was effective communication (ß = 0.315), and the weakest factor among these three factors was willingness to collaborate (ß = 0.160). CONCLUSION: Nurses' perceptions of collaboration were relatively positive, mainly in Sharing of patient information; however, improvements need to be made regarding Joint participation in the cure/care decision-making process. Effective communication, perceived respect and willingness to collaborate significantly affect nurses' perception of nurse-physician collaboration, with perceived respect having greater explanatory power among the three interactional factors. It is necessary for hospital managers to develop strategies to build professional respect for nurses, facilitate effective nurse-physician communication and improve nurses' willingness to collaborate.

New lignans attenuating cognitive deterioration of Aß transgenic flies discovered in Acorus tatarinowii.

Five new lignan racemates, (±)-tatarinoid D-H (1-5), and three known analogues (6-8) were isolated from the rhizomes of Acorus tatarinowii. Their structures were established by 1D, 2D-NMR, HR-MS, IR and optical spectral data. Among them, 1 and 6-8 can alleviate the cognitive deterioration of Aß transgenic flies.

Bioactive Asarone-Derived Phenylpropanoids from the Rhizome of Acorus tatarinowii Schott.

Eight new (1a/1b, 2a, 3a, 4a/4b, and 5a/5b) and seven known (2b, 3b, and 6-10) asarone-derived phenylpropanoids, a known asarone-derived lignan (12), and four known lignan analogues (11 and 13-15) were isolated from the rhizome of Acorus tatarinowii Schott. The structures were elucidated via comprehensive spectroscopic analyses, modified Mosher's method, and quantum chemical calculations. Compounds 1-8 were present as enantiomers, and 1-5 were successfully resolved via chiral-phase HPLC. Compounds 1a/1b were the first cases of asarone-derived phenylpropanoids with an isopropyl C-3 side-chain tethered to a benzene core from nature. Hypoglycemic, antioxidant, and AChE inhibitory activities of 1-15 were assessed by the α-glucosidase inhibitory, ORAC, DPPH radical scavenging, and AChE inhibitory assays, respectively. All compounds except 3a showed α-glucosidase inhibitory activity. Compound 3b has the highest α-glucosidase inhibitory effect with an IC50 of 80.6 µM (positive drug acarbose IC50 of 442.4 µM). In the antioxidant assays, compounds 13-15 exhibited ORAC and DPPH radical scavenging activities. The results of the AChE inhibitory assay indicated that all compounds exhibited weak AChE inhibitory activities.

Determinants of patient loyalty to healthcare providers: An integrative review.

PURPOSE: Patient loyalty is key to business success for healthcare providers and also for patient health outcomes. This study aims to identify determinants influencing patient loyalty to healthcare providers and propose an integrative conceptual model of the influencing factors. DATA SOURCES: PubMed, CINAHL, OVID, ProQuest and Elsevier Science Direct databases were searched. STUDY SELECTION: Publications about determinants of patient loyalty to health providers were screened, and 13 articles were included. DATA EXTRACTION: Date of publication, location of the research, sample details, objectives and findings/conclusions were extracted for 13 articles. RESULTS OF DATA SYNTHESIS: Thirteen studies explored eight determinants: satisfaction, quality, value, hospital brand image, trust, commitment, organizational citizenship behavior and customer complaints. The integrated conceptual model comprising all the determinants demonstrated the significant positive direct impact of quality on satisfaction and value, satisfaction on trust and commitment, trust on commitment and loyalty, and brand image on quality and loyalty. CONCLUSION: This review identifies and models the determinants of patient loyalty to healthcare providers. Further studies are needed to explore the influence of trust, commitment, and switching barriers on patient loyalty.

Salen-Based Covalent Organic Framework.

The Salen unit represents one of the most important ligands in coordination chemistry. We report herein the first example of a Salen-based covalent organic framework (COF), in which both the construction of the COF structure and the functionalization with Salen moieties have been realized in a single step. Due to its structural uniqueness, the obtained COF material, Salen-COF, possesses high crystallinity and excellent stability. Based on this, a series of metallo-Salen-based COFs were prepared via metalation for further applications.

Factors associated with balance function in patients with knee osteoarthritis: An integrative review.

This integrative review is to identify the factors associated with balance function in patients with knee osteoarthritis and explore the relationship between these factors and balance function. Osteoarthritis commonly occurs in elderly people. Patients with knee osteoarthritis have balance impairment, and maintaining knee stability is important for such patients to prevent accidental injuries caused by falling. Therefore, it is important to clarify the factors related to balance function in patients with knee osteoarthritis. The PubMed, Science Direct, CINAHL, Ovid, ProQuest, CNKI, WanFang databases were searched, and relevant articles published up to December 2015 were included. Twenty articles were included in the analysis. Age, gender, dominant limb, foot length, knee alignment, diurnal variation, and meniscus tears were the non-modifiable factors, whereas body mass index, knee pain, muscle strength, joint range of motion, severity, and cognitive loading were the modifiable factors. Knee sleeve and custom-molded insoles showed protective effects against knee osteoarthritis.

Polyphenols from wolfberry and their bioactivities.

Nine new phenylpropanoids, one new coumarin, and 43 known polyphenols were isolated from wolfberry. Their structures were determined by spectroscopic analyses, chemical methods, and comparison of NMR data. Polyphenols, an important type of natural products, are notable constituents in wolfberry. 53 polyphenols, including 28 phenylpropanoids, four coumarins, eight lignans, five flavonoids, three isoflavonoids, two chlorogenic acid derivatives, and three other constituents, were identified from wolfberry. Lignans and isoflavonoids were firstly reported from wolfberry. 22 known polyphenols were the first isolates from the genus Lycium. This research presents a systematic study on wolfberry polyphenols, including their bioactivities. All these compounds exhibited oxygen radical absorbance capacity (ORAC), and some compounds displayed DPPH radical scavenging activity. One compound had acetylcholinesterase inhibitory activity. The discovery of new polyphenols and their bioactivities is beneficial for understanding the scientific basis of the effects of wolfberry.