Dual-Carbon Phase-Encapsulated Prelithiated SiOx Microrod Anode for Lithium-Ion Batteries.

Among silicon-based anode family for Li-ion battery technology, SiOx, a nonstoichiometric silicon suboxide holds the potential for significant near-term commercial impact. In this context, this study mainly focuses on demonstrating an innovative SiOx@C anode design that adopts a pre-lithiation strategy based on in situ pyrolysis of Li-salt of silsesquioxane trisilanolate without the need for lithium metal or active lithium compounds and creates dual carbon encapsulation of SiOC nanodomains by simply one-step thermal treatment. This ingenious design ensures the pre-lithiation process and pre-lithiation material with high-environmental stability. Moreover, phenyl-rich organosiloxane clusters and polyacrylonitrile polymers are expected to serve as internal and external carbon source, respectively. The formation of an interpenetrating and continuous carbon matrix network would not only synergistically offer an improved electrochemical accessibility of active sites but also alleviate the volume expansion effect during cycling. As a result, this new type of anode delivered a high reversible capacity, remarkable cycle stability as well as excellent high-rate capability. In particular, the L2-SiOx@C material has a high initial coulomb efficienc of 80.4% and, after 500 cycles, a capacity retention as high as 97.5% at 0.5 A g-1 with a reversible specific capacity of 654.5 mA h g-1.

Modulation of Crystal Growth of an Energetic Metal-Organic Framework on the Surfaces of Graphene Derivatives for Improved Detonation Performance.

Energetic materials are a special class of energy materials composed of C, H, O, and N. Their safety always deteriorates with increasing energy. Regulating the properties of energetic materials to meet application requirements is one of the focuses of research in this field. Energetic metal-organic frameworks (EMOFs) are good candidates as primary explosives to replace lead azide (LA) and other explosives containing toxic metal elements. However, safety remains the biggest concern in applications. In this paper, crystal morphology modulation of EMOF was carried out by stepwise coordination of metal ions and energetic ligands on surfaces of graphene oxide (GO) and amino-functionalized graphene oxide (AGO). Two energetic composite materials, Cu-AFTO@GO and Cu-AFTO@AGO, were successfully synthesized and also the EMOF (Cu-AFTO). The structures and morphologies of these materials were fully characterized. The thermal decomposition behaviors, mechanical sensitivity, and electrostatic discharge sensitivity were investigated in detail. The electric ignition ability of EMOF and two composite materials was tested. This study shows that it is possible to reduce the diameter of EMOF crystals from hundreds of microns to tens of nanometers by a stepwise coordination method. The high electrical conductivity and sensitivity-reducing effect of GO and/or AGO allow the nanosized EMOF crystals to have a lower ignition threshold and lower sensitivity.

Developing a scale measuring the doctor-patient relationship in China from the perspective of doctors.

OBJECTIVES: The doctor-patient relationship is usually measured in line with patient needs and demands. This study aimed to develop a scale measuring such a relationship from the perspective of doctors. METHODS: A draft scale was developed and adapted to the hospital context of China based on several existing scales, with an intention to measure how medical doctors view and manage their relationship with patients beyond episodic clinical encounters. Two rounds of Delphi consultations involving 14 experts were conducted to seek their consensus on the inclusion and descriptions of items. This resulted in a 19-item scale measuring four domains of the relationship. The scale was validated through a survey of 1,712 medical doctors selected from 27 public hospitals in Heilongjiang province of China. The internal consistency of the scale was assessed using Cronbach's α coefficients of the four domains. Confirmatory factor analyses were performed to test the construct validity of the scale. Linear regression analyses were performed to assess the known-group validity of the scale. RESULTS: The scale measures four domains. The Cronbach's α of the scale reached an acceptable level, ranging from 0.61 to 0.78 for its four domains. Good fitness of data into the four-domain structure of the scale was confirmed by the confirmatory factor analysis. Known-group differences were demonstrated in the regression analyses. CONCLUSION: The doctor-patient relationship scale developed in this study is a psychometrically valid tool assessing how medical doctors view and manage their relationship with patients in the hospital setting in China.

Activation of Autophagy Induces Monocrotaline-Induced Pulmonary Arterial Hypertension by FOXM1-Mediated FAK Phosphorylation.

PURPOSE: It has been shown that activation of autophagy promotes the development of pulmonary arterial hypertension (PAH). Meanwhile, forkhead box M1 (FOXM1) has been found to induce autophagy in several types of cancer. However, it is still unclear whether FOXM1 mediates autophagy activation in PAH, and detailed mechanisms responsible for these processes are indefinite. METHOD: PAH was induced by a single intraperitoneal injection of monocrotaline (MCT) to rats. The right ventricle systolic pressure (RVSP), right ventricular hypertrophy index (RVHI), percentage of medial wall thickness (%MT), α-smooth muscle actin (α-SMA) staining, and Ki67 staining were performed to evaluate the development of PAH. The protein levels of FOXM1, phospho-focal adhesion kinase (p-FAK), FAK, and LC3B were determined by immunoblotting or immunohistochemistry. RESULTS: FOXM1 protein level and FAK activity were significantly increased in MCT-induced PAH rats, this was accompanied with the activation of autophagy. Pharmacological inhibition of FOXM1 or FAK suppressed MCT-induced autophagy activation, decreased RVSP, RVHI and %MT in MCT-induced PAH rats, and inhibited the proliferation of pulmonary arterial smooth muscle cells and pulmonary vessel muscularization in MCT-induced PAH rats. CONCLUSION: FOXM1 promotes the development of PAH by inducing FAK phosphorylation and subsequent activation of autophagy in MCT-treated rats.

Failure Analysis for Overall Overturning of Concrete Single-Column Pier Bridges Induced by Temperature and Overloaded Vehicles.

Several overloaded-induced overturning incidents of girder bridges with single-column piers have occurred in recent years, resulting in significant casualties and economic losses. Temperature, in addition to overloading, may also play a role in exacerbating bridge overturning. To investigate the association between temperature and bridge overturning, an explicit finite element model (EFEM) of a three-span concrete curved continuous bridge considering nonlinearities was developed to simulate overall collapse. The effects of uniform and gradient temperatures on the overall overturning stability of curved and straight bridges were evaluated based on the EFEMs. Furthermore, the temperature-bridge coupling model and temperature-vehicle-bridge coupling model were utilized to examine how gradient temperature influences bridge overturning. The results show that the overall overturning collapse of a bridge follows four stages: stabilization, transition, risk and overturning. Variations in uniform temperature from -30 °C to 60 °C had a negligible effect on the ultimate vehicle weight for bridge overturning, with a variation of less than 1%. As the gradient temperature ranged from -30 °C to 60 °C, curved bridges show less than a 2% variation in ultimate vehicle weights, compared to a range of -6.1% to 11.7% for straight bridges. The torsion caused by positive gradient temperature in curved bridges can exacerbate bridge overturning, while negative gradient temperature in straight bridges can lead the girder to 'upward warping', facilitating girder separation from bearings. Monitoring the girder rotation angle and vertical reaction force of bearings can serve as important indicators for comparing the stability of bridges.

Comparison of Dynamic Amplification Factor of Deflection and Bending Moment of Highway Continuous Box-Girder Bridges by Mode Superposition.

There are differences between the dynamic deflection and bending moment (strain) in the same section of continuous girder bridges. However, the selection of the response for calculating dynamic amplification factors (DAFs), which are essential for bridge health monitoring and safety assessment, remains controversial. Modes may play a role in the relationship between the deflection DAF and the bending moment DAF in both numerical analysis and field tests. To investigate the distinctions between the DAFs of the deflection and bending moment in a continuous girder bridge, functional expressions of the DAFs were derived, taking into account multi-factor coupling under concentrated forces. The interaction effects of the mode and road surface condition (RSC), vehicle speed, bridge span length, and span number on the deflection DAF, the bending moment DAF, and the ratio of the deflection DAF to the bending moment DAF (RDM) of precast continuous box-girder bridges were analyzed using vehicle-bridge interaction. To ensure the accuracy of the DAF in numerical computations and experimental tests, two types of accuracy indexes and the corresponding cut-off modes were provided. Validation was conducted by performing dynamic load tests on two field bridges. The results indicate that different modes have a significant effect on the RDM of the mid-span section of a bridge. When considering multiple factors, the deflection DAF and bending moment DAF of the mid-span section increased rapidly with the considered modes and then stabilized. Statistically, the RDM of all nine bridges ranged from 1.00 to 1.12, indicating that the deflection DAF was greater than the bending moment DAF. The suggested cut-off modes can be utilized for efficient and accurate calculation of the DAF and response signal fidelity.

Unpaired fundus image enhancement based on constrained generative adversarial networks.

Fundus photography (FP) is a crucial technique for diagnosing the progression of ocular and systemic diseases in clinical studies, with wide applications in early clinical screening and diagnosis. However, due to the nonuniform illumination and imbalanced intensity caused by various reasons, the quality of fundus images is often severely weakened, brings challenges for automated screening, analysis, and diagnosis of diseases. To resolve this problem, we developed strongly constrained generative adversarial networks (SCGAN). The results demonstrate that the quality of various datasets were more significantly enhanced based on SCGAN, simultaneously more effectively retaining tissue and vascular information under various experimental conditions. Furthermore, the clinical effectiveness and robustness of this model were validated by showing its improved ability in vascular segmentation as well as disease diagnosis. Our study provides a new comprehensive approach for FP and also possesses the potential capacity to advance artificial intelligence-assisted ophthalmic examination.

Effects of microcurrent therapy in promoting function and pain management of knee osteoarthritis: a systematic review and meta-analysis protocol.

INTRODUCTION: Microcurrent therapy (MCT) is a rising conservative treatment for patients with knee osteoarthritis (OA). Considering its potential benefits and convenience, MCT's application in those individuals with knee OA is capacious. However, no plausible clinical evidence has proved its unequivocal advantages in treating knee OA conservatively. The purpose of this study is to determine whether MCT is helpful in pain management and promoting function of knee OA and is safe in the treatment of knee OA in adult patients. METHODS AND ANALYSIS: We will search through MEDLINE, Embase, Cochrane Library, Web of Science and Google Scholar from inception to 15 March 2023. Original studies will include randomised controlled trials of patients treated with MCT. Two authors will independently screen, select studies, extract data and perform risk of bias assessment. Data consistently reported across studies will be pooled using random-effects meta-analysis. Heterogeneity will be evaluated using Cochrane's Q statistic and quantified using I2 statistics. Graphical and formal statistical tests will be used to assess for publication bias. ETHICS AND DISSEMINATION: Ethical approval will not be needed for this study as the data will be extracted from already published studies. The results of this review will be published in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER: CRD42022319828.

CG-3DSRGAN: A classification guided 3D generative adversarial network for image quality recovery from low-dose PET images.

Positron emission tomography (PET) is the most sensitive molecular imaging modality routinely applied in our modern healthcare. High radioactivity caused by the injected tracer dose is a major concern in PET imaging and limits its clinical applications. However, reducing the dose leads to inadequate image quality for diagnostic practice. Motivated by the need to produce high quality images with minimum 'low-dose', convolutional neural networks (CNNs) based methods have been developed for high quality PET synthesis from its low-dose counterparts. Previous CNNs-based studies usually directly map low-dose PET into features space without consideration of different dose reduction level. In this study, a novel approach named CG-3DSRGAN (Classification-Guided Generative Adversarial Network with Super Resolution Refinement) is presented. Specifically, a multi-tasking coarse generator, guided by a classification head, allows for a more comprehensive understanding of the noise-level features present in the low-dose data, resulting in improved image synthesis. Moreover, to recover spatial details of standard PET, an auxiliary super resolution network - Contextual-Net - is proposed as a second-stage training to narrow the gap between coarse prediction and standard PET. We compared our method to the state-of-the-art methods on whole-body PET with different dose reduction factors (DRF). Experiments demonstrate our method can outperform others on all DRF.Clinical Relevance- Low-Dose PET, PET recovery, GAN, task driven image synthesis, super resolution.

Functional validation of CYP304A1 associated with haedoxan A detoxification in Aedes albopictus by RNAi and transgenic drosophila.

BACKGROUND: Insect cytochrome P450 monooxygenases play important roles in the detoxification metabolism of endogenous and exogenous compounds. Haedoxan A (HA) from Phryma leptostachya L. is a highly efficient natural pesticide used to control houseflies and mosquitos. CYP4C21 and CYP304A1 were previously demonstrated to be transcriptionally increased in Aedes albopictus in response to HA exposure, but their involvement in HA metabolism is unknown. RESULTS: Our data showed that CYP304A1 expression levels in A. albopictus were highest in third-instar larvae, and the expression level of CYP4C21 decreased significantly with the growth of instars, with the lowest occurring in the pupal stage. Compared with the control, the silencing of CYP304A1 and CYP4C21 genes by chitosan nanoparticle-mediated RNA interference could deplete 58.2% and 54.0% of the expression of corresponding genes, respectively. The bioassay data showed that knocking down the expression of CYP304A1 increased the mortality of A. albopictus when exposed to HA at LC30 and LC50 doses, but did not significantly increase mortality after silencing CYP4C21. Our data demonstrated that CYP304A1, but not CYP4C21, may be involved in HA detoxification. Moreover, the resistance ratio of CYP304A1 overexpressing flies was approximately 2-fold higher than that of the control line. The metabolized product of HA by CYP304A1 needs to be further confirmed by in vitro expression. CONCLUSION: This finding showed that inducibility was not always linked to detoxifying capabilities, and enhanced our understanding of the molecular basis of HA metabolic detoxification in A. albopictus. © 2022 Society of Chemical Industry.

Boron nitride nanoplate-based improvement of the specificity and sensitivity in loop-mediated isothermal amplification for Vibrio parahaemolyticus detection.

BACKGROUND: Nucleic acid testing based on DNA amplification is gradually entering people's modern life for clinical diagnosis, food safety monitoring and infectious disease prevention. Polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) are the most powerful techniques that have been the gold standard for quantitative nucleic acid analysis. However, the high nonspecific amplification rate caused by the formation of primer dimers, hairpin structures and mismatched hybridization severely restricts their real-world applications. It is highly desirable to explore a way for improving the specificity and sensitivity of PCR and LAMP assays. RESULTS: In this work, we demonstrated that a nanomaterial boron nitride nanoplate (BNNP), due to its unique surface properties, can interact with the main components of the amplification reaction, such as single stranded primers and Bst DNA polymerase, and increase the thermal conductivity of the solution. As a result, the presence of BNNPs dramatically improved the specificity of PCR and LAMP. And BNNPs maintained the specificity even after five rounds of PCR. Moreover, the sensitivity of LAMP was also enhanced by BNNPs, and the detection limit of BNNP-based LAMP was two orders of magnitude lower than that of classical LAMP. Then the BNNP-based LAMP was applied to detect Vibrio parahaemolyticus in contaminated seafood samples with high specificity and a 10-fold increase in sensitivity. SIGNIFICANCE: This is the first systematic demonstration of BNNPs as a promising additive to enhance the efficiency and fidelity of PCR and LAMP amplification reactions, thereby greatly expanding the application of nucleic acid detection in a wide range of laboratory and clinical settings.

First Report on Mesophyll Protoplast Isolation and Regeneration System for the Duboisia Species.

The Duboisia species, a group of plants native to Australia, have been historically valued for their pharmacological properties and have played a significant role in traditional medicine and pharmaceutical research. Persistent efforts are underway to enhance the efficacy of the active ingredient scopolamine, employing both conventional breeding methods and advanced biotechnology tools. The primary objective of this research was to establish a highly efficient method for isolating mesophyll protoplasts and facilitating their regeneration, thereby laying a robust foundation for the application of various advanced plant biotechnology tools in the pursuit of genetic enhancement. The mesophyll protoplast isolation process was developed for hybrid D. myoporoides × D. hopwoodii with careful optimisation of the following parameters: leaf strip size; incubation conditions; physical treatment; and enzyme concentration. The optimal parameters were combined in each individual step; the best enzyme concentration was determined to be 2% (w/v) cellulysin and 0.5% (w/v) macerase. Protoplast yield was found to be greatly affected by the enzyme concentrations. The isolated protoplasts were cultured at a density of 0.5 × 105 to best sustain the highest cell division (33.2%) and a microcalli induction frequency of 17.9%. After 40 days of culture in a modified KM8P medium at 25 °C in darkness, visible microcalli were transferred to a solidified Murashige and Skoog (MS) medium with 1 mg L-1 2,4-dichlorophenoxyacetic acid (2,4-D) for callus induction under a 16 h photoperiod. After 30 days of culture, compact organogenic calli were transferred into a solid MS medium with 6-benzylaminopurine (BA) alone or thidiazuron (TDZ) alone or in combination with BA or naphthalene acetic acid (NAA) for shoot regeneration. The maximum shoot regeneration frequency (63.3%) was observed in the medium with 1.5 mg L-1 TDZ alone. For the first time, a reliable protoplast isolation and regeneration system from mesophyll cells was established for Duboisia with high protoplast viability, successful microcalli formation, and intact plant regeneration. This innovation will significantly contribute towards the genetic enhancement of the Duboisia species.

First-principles study on α/ß/γ-FeB6 monolayers as potential gas sensor for H2S and SO2.

CONTEXT: The adsorptions of toxic gases SO2 and H2S on 2D α/ß/γ-FeB6 monolayer were investigated using density functional theory calculations. To analyze the interaction between gas molecule H2S/SO2 and α/ß/γ-FeB6 monolayer, we calculated adsorption energy, adsorption distance, Mullikan charge, charge density difference, band structure, the density of states, work function, and theoretical recovery time. The adsorption energies show that H2S/SO2 is chemisorbed on α/ß-FeB6 while H2S/SO2 is physiosorbed on γ-FeB6 monolayer. As a result, γ-FeB6 has a short recovery time for H2S (5.71×10-8 s)/SO2 (1.94×10-5 s) due to modest adsorption. Therefore, γ-FeB6 may be a promising candidate for reusable H2S/SO2 sensors at room temperature. Although H2S is chemisorbed on α/ß-FeB6, as the working temperature rises to 500 K, the recovery time of α/ß-FeB6 for H2S can decrease to 1.13×10-1 s and 2.08×10-1 s, respectively, which are well within the detectable range. So, α/ß-FeB6 monolayer also may be a good candidate for H2S gas sensor. METHODS: Calculations were performed at GGA-PBE/DNP level using the Dmol3 module implemented in the Material Studio 2018 software package.

Towards ambient temperature operation of Li metal batteries using UV-Crosslinked single-ion electrospun electrolytes.

In spite of the fact that lithium metal batteries (LMBs) facilitate the diversification of energy storage technologies, their electrochemical reversibility and stability have long been constrained by side reactions and lithium dendrite problems. While single-ion conducting polymer electrolytes (SICPEs) possess unique advantages of suppressing Li dendrite growth, they deal with difficulties in practical applications due to their slow ion transport in general application scenarios at âˆ¼25 °C. In this study, we develop novel bifunctional lithium salts with negative sulfonylimide (-SO2N(-)SO2-) anions mounted between two styrene reactive groups, which is capable of constructing 3D cross-linked networks with multiscale reticulated ion nanochannels, resulting in the uniform and rapid distribution of Li+ ions in the crosslinked electrolyte. To verify the feasibility of our strategy, we designed PVDF-HFP-based SICPEs and the obtained electrolyte exhibits high thermal stability, outstanding Li+ transference number (0.95), pleasing ionic conductivity (0.722 mS cm-1), and broad chemical window (greater than5.85 V) at ambient temperature. As a result of the electrolyte structural merits, the Li||LFP cells displayed excellent cycling stability (96.4% reversible capacities after 300 cycles at 0.2C) without additional auxiliary heating. This ingenious strategy is expected to providing a new perspective for advanced performance and high safety LMBs.

Large-area 2D bismuth antimonide with enhanced thermoelectric properties via multiscale electron-phonon decoupling.

It is a challenge to obtain high thermoelectric efficiency owing to the conflicting parameters of the materials that are required. In this work, the composition-adjustable 2D bismuth antimonide (Bi100-xSbx) is synthesized using an e-beam evaporation system with homemade targets. Engineering multiscale defects is done to optimize the thermoelectric performance in the compound. Sb alloying introduces atomic defects, lattice distortion and increased grain boundary. They drastically decrease the thermal conductivity, with an ultralow value of ∼0.23 W m-1 K-1 obtained for the composition with x = 18. It is noticed that the atomic and nanoscale defects do not deteriorate the electrical conductivity (105 S m-1), and the value is even comparable to the bulk counterpart over a wide composition range (0 ≤ x ≤ 35). Annealing induces pore structure with microscale defects, which increase the Seebeck coefficient by 84% due to the energy barrier. The resultant ZT of 0.13 is enhanced by 420% in the annealed Bi82Sb18 when compared with the as-grown Bi. This work demonstrates a cost-effective and controllable way to decouple electrons and phonons in the thermoelectric field.

Mingmu Xiaoyao granules regulate the PI3K/Akt/mTOR signaling pathway to reduce anxiety and depression and reverse retinal abnormalities in rats.

Objective: To investigate the effects of Mingmu Xiaoyao granules (MMXY) on the morphology and function of the retina and the mechanism of PI3K/Akt/mTOR pathway-related proteins in rats with anxiety and depression induced by chronic unpredictable mild stress (CUMS). Methods: Fifty-two male Sprague Dawley rats were randomly allocated to either a control (n = 14) or a simulated CUMS group (n = 38). The CUMS model was established successfully at 4 weeks. Six rats in each group were randomly selected to be sacrificed and their retinas isolated for histological examination. At 5 weeks, rats in the CUMS group were randomly allocated to the following groups: Model (CUMS + pure water), MMXY-H (CUMS + MMXY 7.2 g/kg/d), MMXY-L (CUMS + MMXY 3.6 g/kg/d), and CBZ (CUMS + Carbamazepine 20 mg/kg/d), with eight rats in each group. All rats were given the relevant intervention once a day. At 12 weeks, sucrose preference and open field tests were performed to evaluate the anxiety and depression status of rats. In live rats, optical coherence tomography angiography was used to measure retinal thickness and blood flow, while electroretinograms (ERGs) and visual evoked potentials (VEPs) were used to evaluate retinal function. The next day, the specimens were sacrificed for serological, histological, immunofluorescence, Western blot and transmission electron microscopy examinations to explore the mechanism of MMXY in CUMS rats. Results: MMXY improved the anxiety and depression-like behavior of rats. Results of optical coherence tomography angiography showed that MMXY improved retinal inner thickness and blood flow in CUMS rats. MMXY improved the amplitude of a- and b-waves in the scotopic and photopic ERG, as well as N2 and P2 peak time and amplitude in the flash-VEP in CUMS rats. Retinal histological staining and transmission electron microscopy showed that MMXY reversed retinal morphology and ultrastructure in CUMS rats. MMXY reduced the expression of Beclin1 and LC3I/II proteins, regulated the PI3K/Akt/mTOR pathway, inhibited autophagy, and had a protective effect on the retina in CUMS rats. Conclusion: MMXY may effectively improve retinal morphology and function as well as anxiety and depression-like behaviors in CUMS rats by regulating the PI3K/Akt/mTOR signaling pathway.

Analysis of aerobic exercise influence on intraocular pressure and ocular perfusion pressure in patients with primary open-angle glaucoma: A randomized clinical trial.

Purpose: To investigate the change pattern of ocular perfusion pressure (OPP) and intra-ocular pressure (IOP) after short-term and long-term aerobic exercise. Methods: In this prospective, single-masked, randomized clinical trial, 123 patients with a primary open angle glaucoma that locally used prostaglandin analog alone were randomly divided into the exercise and control groups. In the short-term study, all individuals underwent a cycling exercise at moderate intensity (20% Wmax for 10 minutes) and high intensity (60% Wmax for 5 minutes). During the long-term study, the exercise group is characterized by regular jogging exercise lasting for 30 minutes during 6: 00-10: 00 in the morning for 3 months, with the exercise frequency of at least 20 times per month, and with the intensity reflected by the target heart rate. The control group is designed as a group with irregular exercise. Results: After short-term aerobic exercise, IOP significantly decreased, whereas the ocular perfusion pressure (OPP) significantly increased. The decreasing amplitude of IOP is related to the baseline of IOP, the intensity of exercise, gender, and so on. After 3 months of long-term exercise, the changes in the IOP level of the exercise group indicated a decreasing trend. Conclusion: The significant decrement of IOP and the increment of OPP suggest that aerobic exercise is beneficial for patients with primary open-angle glaucoma and appropriate aerobic exercise is appropriate in treating glaucoma patients. Trial registration: ChiCTR, ChiCTR-TRC-10001055. Registered one October 2010-Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj = 8483.

Attitudes of medical professionals towards patient-centredness: a cross-sectional study in H City, China.

OBJECTIVES: Patient-centred communication improves patient experiences and patient care outcomes. This study aimed to assess the preference of medical professionals in China towards patient-centred communication under the context of the deteriorating doctor-patient relationship. METHODS: A cross-sectional survey of medical professionals was conducted in January and February 2018 in H City of Heilongjiang province, the northeast of China. The Chinese-Revised Patient-Practitioner Orientation Scale (CR-PPOS) was adopted to measure the individual preference of respondents towards patient-centredness in clinical communication. Multivariate logistic regression models were established to identify the sociodemographic (gender, age, marital status and educational attainment) and work experience (years of working, seniority, satisfaction with income, daily workload and perceived doctor-patient relationship) predictors of the preference towards patient-centredness. PATIENT AND PUBLIC INVOLVEMENT: Not applicable. RESULTS: A total of 618 valid questionnaires were returned. The CR-PPOS demonstrated acceptable reliability and validity. Overall, a low level of preference towards patient-centredness in clinical communication was found. Relatively higher scores on 'caring for patients' (20.42±4.42) was found compared with those on 'information/responsibility sharing' (15.26±4.21). Younger age, higher educational attainment, lower daily workload and a perception of harmonious doctor-patient relationship were associated with a higher preference towards patient-centredness in clinical communication. CONCLUSIONS: A low level of preference towards patient-centredness in clinical communication was found in medical professionals in the northeast of China, which may further jeopardise the efforts to improve doctor-patient relationship.

Knockin of the G275E mutation of the nicotinic acetylcholine receptor (nAChR) α6 confers high levels of resistance to spinosyns in Spodoptera exigua.

Spinosyns, including spinosad and spinetoram, act on the insect central nervous system, gradually paralyzing or destroying the target insect. Spinosad resistance is associated with loss-of-function mutations in the nicotinic acetylcholine receptor (nAChR) α6 subunit in a number of agricultural pests. Using gene editing, nAChR α6 has been verified as a target for spinosyns in five insect species. Recently, a point mutation (G275E) in exon 9 of nAChR α6 was identified in spinosad-resistant strains of Thrips palmi and Tuta absoluta. To date, no in vivo functional evidence has been obtained to support that this mutation is involved in spinosyn resistance in lepidopteran pests. In this study, the G275E mutation was introduced into the nAChR of Spodoptera exigua using clustered regularly interspaced short palindromic repeats (CRISPR) / CRISPR-associated protein 9 (Cas9) gene-editing technology. Reverse transcriptase-polymerase chain reaction and sequencing confirmed that this mutation was present in exon 9 of the nAChR transcripts in the edited 275E strain. The results of bioassays showed that the 275E strain was highly resistant to spinosad (230-fold) and spinetoram (792-fold) compared to the unedited background strain, directly confirming that the G275E mutation of the nAChR α6 subunit confers high levels of spinosyn resistance in S. exigua. Inheritance analysis showed that the resistance trait is autosomal and incompletely recessive. This study employs a reverse genetics approach to validate the functional role played by the G275E mutation in nAChR α6 of S. exigua in spinosyns resistance and provides another example of the use of CRISPR/Cas9 gene-editing technology to confirm the role played by candidate target site mutations in insecticide resistance.

Functional validation of nicotinic acetylcholine receptor (nAChR) α6 as a target of spinosyns in Spodoptera exigua utilizing the CRISPR/Cas9 system.

BACKGROUND: The beet armyworm, Spodoptera exigua, is a serious agricultural pest that is primarily controlled using chemical insecticides. Recently, resistance to the insecticide spinosad has been described in S. exigua field populations. To date, there has been no functional evidence proving the involvement of the nicotinic acetylcholine receptor (nAChR) α6 mutation in spinosad resistance in S. exigua. RESULTS: In this study, using the CRISPR/Cas9 genome-editing system, a homozygous strain (Seα6-KO) with approximately 1760-bp deletion within Seα6 in S. exigua causing a premature truncation of Seα6 was successfully constructed. Insecticide bioassays showed that Seα6-KO exhibited 373-fold higher resistance to spinosad and 850-fold higher resistance to spinetoram compared to WH-S strain with the same genetic background but showed no significant change in susceptibility to emamectin benzoate and chlorantraniliprole. Genetic analysis revealed that Seα6-KO is inherited as an incompletely recessive trait. CONCLUSION: The results clearly demonstrated the functional role of Seα6 in resistance to spinosyn insecticides and provide an example of using genome editing to verify a target premature truncation associated with resistance.