Fluoride-Free Synthesis of 2D Titanium Carbide (MXenes) Assisted by scCO2 -Based Ternary Solution.

2D MXene-Ti3 C2 Tx holds great promise in various electronic applications, especially for electromagnetic interference (EMI) shielding devices and supercapacitors. Ti3 C2 Tx synthesis typically involves the use of hazardous fluorine-containing chemicals that can result in the formation of inert fluoride functional groups on the surface of Ti3 C2 Tx , severely degrading its properties and posing a threat to the performance of electron transfer among electrical devices. Herein, a supercritical carbon dioxide-based ternary solution (scCO2 /DMSO/HCl) to produce fluoride-free Ti3 C2 Tx in mild conditions (via 0.5 m HCl, 20 MPa, 32 °C) is reported. The fluorine-free Ti3 C2 Tx films electrode presents an excellent gravimetric capacitance of 320 F g-1 at 2 mV s-1 in 1 m H2 SO4 . Besides, it is demonstrated that fluorine-free Ti3 C2 Tx films exhibit outstanding EMI shielding efficiency of 53.12 dB at 2.5 µm thickness. The findings offer a mild and practical approach to producing fluoride-free Ti3 C2 Tx and open opportunities for exploring MXenes' potential applications in various fields.

Biosensing of Cysteine through the Induction of Oxygen Vacancies in a Cu/Zr Heterostructure Prepared by Supercritical Antisolvent Technique.

There has been a growing emphasis on facile preparation of binary heterogeneous composite materials. Leveraging the eco-friendly efficiency of supercritical CO2 technology, we achieved precise control over the influencing factors of mass transfer, enabling the accurate modulation of the resulting product morphology and properties. In the current study, CuxO/ZrOy composite materials were prepared using this technology and calcined to obtain electrode materials for the detection of cysteine (Cys). Essential comprehensive characterization techniques were employed to elucidate the heterojunction. The resulting electrode demonstrated a linear response to Cys within a concentration range of 0.5 nM to 1 µM, featuring a high sensitivity of 1035 µA·cm-2·µM-1 and a low detection limit of 97.3 nM. Thus, establishing a novel avenue for nonenzyme-based electrochemical sensors tailored for biologically active Cys detection through the implementation of a heterogeneous structure.

The Role of Depression and Anxiety in the Relationship Between Arthritis and Cognitive Impairment in Chinese Older Adults.

BACKGROUND: Mental disorders and cognitive impairment are common in older patients with arthritis. While it is recognized that mental conditions may play a role in the connection between arthritis and cognitive impairment, the precise underlying relationship remains uncertain. METHODS: The data was derived from the baseline survey of the Guangdong Mental Health Survey in South China, involving a sample of 3,764 citizens aged 65 and older. An array of aspects were explored, including socio-demographics, lifestyle behaviors, self-reported chronic conditions, depression, anxiety, and cognitive impairment. Logistic regression analyses examined the association between arthritis and cognitive impairment after adjustment for potential confounders. Serial mediation models were used to examine whether depression or anxiety played a mediating role in the arthritis-cognitive impairment linkage. RESULTS: The prevalence rates of cognitive impairment and arthritis of the older adults were 28.9% and 12.1%, respectively. Compared to those without arthritis, participants with arthritis were at a higher risk of cognitive impairment (OR = 1.322, 95%CI: 1.022-1.709) after adjustment for socio-demographics, lifestyle behaviors, and mental health conditions. Serial mediation analyses indicated that depressive and anxiety symptoms co-played a serial mediating role in the association between arthritis and cognitive impairment (B1 = 0.025, 95%CI: 0.005-0.052; B2 = 0.050, 95%CI: 0.021-0.086). CONCLUSIONS: Arthritis may heighten cognitive impairment risk in Chinese older adults, and the relationship was potentially mediated by depressive and anxiety symptoms. Future interventions should be considered, integrating mental health assessments into arthritis care frameworks and being alert to possible cognitive impairment.

Knowledge of Alzheimer's disease and associated factors among adults in Zhuhai, China: a cross-sectional analysis.

BACKGROUND: This study aimed to assess the public knowledge regarding Alzheimer's Disease (AD) in Zhuhai, China, focusing on identifying knowledge gaps and the influence of demographic and health factors. METHODS: A cross-sectional study was conducted in Zhuhai, China, from October to November 2022. A total of 1986 residents from 18 communities were selected employing stratified multi-stage equi-proportional sampling. Questionnaires covering general information and the Alzheimer's Disease Knowledge Scale (ADKS) were investigated face-to-face. Ordinal multiclass logistic regression was applied to assess the relationship between AD awareness and demographic and health characteristics. RESULTS: The average ADKS score was 18.5 (SD = 3.36) in Zhuhai. The lowest awareness rates were observed in the "Symptoms" and "Caregiving" subdomains of ADKS, with rates of 51.01% and 43.78%, respectively. The correct rates for the 30 ADKS questions ranged from 16.62 to 92.6%, showing a bimodal pattern with clusters around 80% and 20%. Women (OR = 1.203, 95% CI: 1.009-1.435), individuals aged 60 years or older (OR = 2.073, 95% CI: 1.467-2.932), those living in urban areas (OR = 1.361, 95% CI: 1.117-1.662), higher average monthly household income per capita (OR = 1.641, 95% CI: 1.297-2.082), and without any neurological or mental disorders (OR = 1.810, 95% CI: 1.323-2.478) were more likely to have higher levels of awareness about Alzheimer's disease. CONCLUSIONS: Adults in Zhuhai show a limited knowledge of AD, particularly in the 'Symptoms' and 'Caregiving' subdomains. Upcoming health campaigns must focus on bridging the knowledge gaps in different subdomains of AD, especially among subgroups with lower awareness, as identified in our study.

U-shaped association between sleep duration and subjective cognitive complaints in Chinese elderly: a cross-sectional study.

BACKGROUND: Subjective cognitive decline (SCD) may be the early screening signal to distinguish susceptible population with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Subjective cognitive complaints (SCCs) have been proved strongly associated with SCD. This study aimed to explore the association between sleep duration and SCCs in the Chinese elderly. METHODS: We conducted a cross-sectional study involving 688 participants aged 60 years and older in Guangdong Province, China. SCCs were assessed by the Subjective Cognitive Decline questionnaire 9 (SCD-Q9), which contained 9 items with two dimensions, including the overall memory function and time comparison (OMTC) and daily activity ability (DAA). Restricted cubic splines and generalized additive model (GAM) were used to fit the association between sleep duration and SCD-Q9 score. RESULTS: There were significant U-shaped associations between sleep duration and overall score of SCD-Q9 (EDF = 3.842, P < 0.001), as well as the OMTC dimension (EDF = 4.471, P < 0.001) in the age- and gender-adjusted GAM. The lowest points on the overall score of SCD-Q9 and OMTC score were observed in those sleeping 8 h per night. After further adjusting for other demographic characteristics, lifestyle behaviors, hypertension and diabetes, the U-shaped associations between sleep duration and the overall score of SCD-Q9 (EDF = 3.575, P = 0.004), sleep duration and the OMTC score (EDF = 4.478, P = 0.010) were still found. The daily activity ability (DAA) score was also non-linear associated with sleep duration both in the age- and gender-adjusted GAM (EDF = 2.314, P < 0.001) and further adjusted GAM (EDF = 2.080, P = 0.010). CONCLUSIONS: Both longer sleep duration (> 8 h) and shorter duration (< 8 h) were linked to worse SCCs. Future studies should explore the protective effect of managing sleep duration on SCD and its progression to dementia.

Nanoarchitectured prototypes of mesoporous silica nanoparticles for innovative biomedical applications.

Despite exceptional morphological and physicochemical attributes, mesoporous silica nanoparticles (MSNs) are often employed as carriers or vectors. Moreover, these conventional MSNs often suffer from various limitations in biomedicine, such as reduced drug encapsulation efficacy, deprived compatibility, and poor degradability, resulting in poor therapeutic outcomes. To address these limitations, several modifications have been corroborated to fabricating hierarchically-engineered MSNs in terms of tuning the pore sizes, modifying the surfaces, and engineering of siliceous networks. Interestingly, the further advancements of engineered MSNs lead to the generation of highly complex and nature-mimicking structures, such as Janus-type, multi-podal, and flower-like architectures, as well as streamlined tadpole-like nanomotors. In this review, we present explicit discussions relevant to these advanced hierarchical architectures in different fields of biomedicine, including drug delivery, bioimaging, tissue engineering, and miscellaneous applications, such as photoluminescence, artificial enzymes, peptide enrichment, DNA detection, and biosensing, among others. Initially, we give a brief overview of diverse, innovative stimuli-responsive (pH, light, ultrasound, and thermos)- and targeted drug delivery strategies, along with discussions on recent advancements in cancer immune therapy and applicability of advanced MSNs in other ailments related to cardiac, vascular, and nervous systems, as well as diabetes. Then, we provide initiatives taken so far in clinical translation of various silica-based materials and their scope towards clinical translation. Finally, we summarize the review with interesting perspectives on lessons learned in exploring the biomedical applications of advanced MSNs and further requirements to be explored.

Subjective cognitive decline symptoms and its association with socio-demographic characteristics and common chronic diseases in the southern Chinese older adults.

BACKGROUND: Subjective cognitive decline (SCD) may be the first symptomatic manifestation of Alzheimer's disease, but information on its health correlates is still sparse in Chinese older adults. This study aimed to estimate SCD symptoms and its association with socio-demographic characteristics, common chronic diseases among southern Chinese older adults. METHODS: Participants aged 60 years and older from 7 communities and 2 nursing homes in Guangzhou were recruited and interviewed with standardized assessment tools. Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure poor sleep quality, depression symptoms and anxiety symptoms. The SCD symptoms were measured by SCD questionnaire 9 (SCD-Q9) which ranged from 0 to 9 points, with a higher score indicating increased severity of the SCD. Participants were divided into low score group (SCD-Q9 score ≤ 3) and higher score group (SCD-Q9 score > 3). Chi-square tests and multivariate logistic regression analysis were used for exploring the influences of different characteristics of socio-demographic and lifestyle factors on SCD symptoms. Univariate and multivariate logistic regression analysis were applied to explore the association between SCD symptoms with common chronic diseases. RESULTS: A total of 688 participants were included in our analysis with a mean age of 73.79 (SD = 8.28, range: 60-101), while 62.4% of the participants were females. The mean score of the SCD-Q9 was 3.81 ± 2.42 in the whole sample. A total of 286 participants (41.6%) were defined as the low score group (≤3 points), while 402 participants (58.4%) were the high score group (> 3 points). Multivariate logistic regression analysis revealed that female (OR = 1.99, 95%CI: 1.35-2.93), primary or lower education level (OR = 2.58, 95%CI: 1.38-4.83), nursing home (OR = 1.90, 95%CI: 1.18-3.05), napping habits (OR = 1.59, 95%CI: 1.06-2.40), urolithiasis (OR = 2.72, 95%CI: 1.15-6.40), gout (OR = 2.12, 95%CI: 1.14-3.93), poor sleep quality (OR = 1.93, 95%CI: 1.38-2.71), depression symptoms (OR = 3.01, 95%CI: 1.70-5.34) and anxiety symptoms (OR = 3.11, 95%CI: 1.29-7.46) were independent positive related to high SCD-Q9 score. On the other hand, tea-drinking habits (OR = 0.64, 95%CI: 0.45-0.92), current smoking (OR = 0.46, 95%CI: 0.24-0.90) were independent negative related to high SCD-Q9 score. CONCLUSIONS: Worse SCD symptoms were closely related to common chronic diseases and socio-demographic characteristics. Disease managers should pay more attention to those factors to early intervention and management for SCD symptoms among southern Chinese older adults.

Three-Dimensional Bioprinting of Decellularized Extracellular Matrix-Based Bioinks for Tissue Engineering.

Three-dimensional (3D) bioprinting is one of the most promising additive manufacturing technologies for fabricating various biomimetic architectures of tissues and organs. In this context, the bioink, a critical element for biofabrication, is a mixture of biomaterials and living cells used in 3D printing to create cell-laden structures. Recently, decellularized extracellular matrix (dECM)-based bioinks derived from natural tissues have garnered enormous attention from researchers due to their unique and complex biochemical properties. This review initially presents the details of the natural ECM and its role in cell growth and metabolism. Further, we briefly emphasize the commonly used decellularization treatment procedures and subsequent evaluations for the quality control of the dECM. In addition, we summarize some of the common bioink preparation strategies, the 3D bioprinting approaches, and the applicability of 3D-printed dECM bioinks to tissue engineering. Finally, we present some of the challenges in this field and the prospects for future development.

Hollow Tobacco Mosaic Virus Coat Protein Assisted Self-Assembly of One-Dimensional Nanoarchitectures.

Herein, an efficient strategy to fabricate well-organized one-dimensional (1D) inorganic nanostructures is demonstrated by utilizing the hollow tobacco mosaic virus coat protein (TMVCP) as a restrictive template. Considering the advantages of the unique hollow structure and the dynamic self-assembly attribute of TMVCP, foreign nano-objects are successfully encapsulated and conveniently assembled into highly organized 1D chainlike structures in the cavity of the TMVCP multimer (TMV disk). Different kinds of functional nanoparticles, such as gold nanoparticles (AuNPs) and silver sulfide quantum dots (Ag2S QDs), are used to demonstrate the successful construction of ordered 1D nanochains in high yields. Notably, binary nanochains of such different kinds of nanoparticles are also constructed through co-assembling the TMV disk-coated AuNPs and Ag2S QDs. Further, the TMV-assisted AuNP nanochains are grown into the 1D nanowires through in situ Au deposition owing to the spatial confinement of the TMVCP cavity. Together, our findings indicate that the TMV-assisted self-assembly approach, resulting in higher yields and better controllability over the other reported studies based on directly mineralizing the metal architectures in the TMV nanorods, provides enormous potential toward the fabrication of highly complex hybrid-metal nanostructures.

The Assessment of Sleep Quality in Patients Following Valve Repair and Valve Replacement for Infective Endocarditis: A Retrospective Study at a Single Center.

BACKGROUND The aim of this study was to measure sleep quality among patients who underwent infective endocarditis (IE) surgery and identify the risk factors involved in sleep disorders. MATERIAL AND METHODS In this study, we used actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleep Scale (ESS) to determine the clinical characteristics of sleep disorders in 116 patients with IE who were in rehabilitation after surgery. RESULTS Our results showed that 46 (39.7%) patients had sleep efficiency over 85%, while 70 (60.3%) patients had sleep efficiency below 85%. The correlation analysis showed that sleep efficiency was related to the duration of the disease, with a longer duration leading to lower sleep efficiency (P=0.031). The sleep efficiency of patients with IE following surgery was also affected by alcohol consumption; however, surprisingly, patients with "heavy" alcohol consumption had higher sleep efficiency (P=0.030). We found a significant correlation between sleep efficiency and postoperative interleukin-6 (IL) levels, C-reactive protein (CRP) levels, and preoperative erythrocyte sedimentation rate (P<0.05). No significant correlation was found between brain natriuretic peptide levels and sleep efficiency, PSQI score, or ESS score. Postoperative hemoglobin (Hb) level was associated with sleep efficiency (R=0.194, P=0.036), but there was no statistically significant correlation between the PSQI and ESS scores. Postoperative alanine transaminase (ALT) showed a significant negative correlation with sleep efficiency (R=-0.27, P=0.003). CONCLUSIONS We found a high prevalence of sleep disorders in patients with IE along with an increase in inflammatory factors, including postoperative IL-6, CRP, ALT, and Hb levels.

Role of supercritical carbon dioxide (scCO2) in fabrication of inorganic-based materials: a green and unique route.

In recent times, the supercritical carbon dioxide (scCO2) process has attracted increasing attention in fabricating diverse materials due to the attractive features of environmentally benign nature and economically promising character. Owing to these unique characteristics and high-penetrability, as well as diffusivity conditions of scCO2, this high-pressure technology, with mild operation conditions, cost-effective, and non-toxic, among others, is often applied to fabricate various organic and inorganic-based materials, resulting in the unique crystal architectures (amorphous, crystalline, and heterojunction), tunable architectures (nanoparticles, nanosheets, and aerogels) for diverse applications. In this review, we give an emphasis on the fabrication of various inorganic-based materials, highlighting the recent research on the driving factors for improving the quality of fabrication in scCO2, procedures for production and dispersion in scCO2, as well as common indicators utilized to assess quality and processing ability of materials. Next, we highlight the effects of specific properties of scCO2 towards synthesizing the highly functional inorganic-based nanomaterials. Finally, we summarize this compilation with interesting perspectives, aiming to arouse a more comprehensive utilization of scCO2 to broaden the horizon in exploring the green/eco-friendly processing of such versatile inorganic-based materials. Together, we firmly believe that this compilation endeavors to disclose the latent capability and universal prevalence of scCO2 in the synthesis and processing of inorganic-based materials.

The prevalence of agranulocytosis and related death in clozapine-treated patients: a comprehensive meta-analysis of observational studies.

BACKGROUND: Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients. METHODS: A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model. RESULTS: Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3-0.6%) and 0.05% (95% CI 0.03-0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection. CONCLUSIONS: The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.

Frequency and correlates of violence against patients with schizophrenia living in rural China.

BACKGROUND: Violence against patients with schizophrenia is very common, however it is rarely studied in China, especially in primary health care institutions of rural areas. Therefore, we investigated the frequency of violence against patients with community-living schizophrenia in rural China and examined its associated factors and impact on quality of life (QoL) and social function. METHOD: A survey was conducted among 487 patients with schizophrenia living in rural communities. Data about violent victimization experiences in the past 6 months, demographic information, and clinical characteristics were collected by questionnaires. RESULTS: We found that 92 (18.9%) of 487 subjects experienced at least one type of violent event in the past 6 months. Logistic regression analysis suggested that a history of conducting dangerous behaviors(OR = 1.702, P = 0.02, 95%CI: 1.05-2.73), higher Brief Psychiatric Rating Scale (anxiety domain) score (OR = 1.15, P = 0.02, 95%CI: 1.01-1.304) and lower hospitalization rates (OR = 0.89, P = 0.04, 95%CI: 0.81-0.99) were significantly associated with violent victimization in patients with schizophrenia. Analysis of covariance showed the victims of violence tended to have worse social function in patients with schizophrenia living in rural communities of China (P = 0.04). CONCLUSIONS: Individuals with schizophrenia living in rural China had a high risk of being exposed to violence and violent victimization of patients with schizophrenia had adverse consequences for social function. More attention is needed for those patients experiencing violent events, because they are simultaneously possible to conduct dangerous behaviors.

Relationship between sleep duration and sociodemographic characteristics, mental health and chronic diseases in individuals aged from 18 to 85 years old in Guangdong province in China: a population-based cross-sectional study.

BACKGROUND: Sleep is vital for maintaining individual's physical and mental health. Prior studies have reported close relationships between sleep duration and chronic diseases. However, in China, the prevalence of aberrant sleep duration and the associations between sleep duration and chronic conditions still merit studying in Guangdong province. This study aimed at examining the relationship between sleep duration and multiple dimensions of sociodemographic characteristics, mental health and chronic diseases in Guangdong province in China, with a large population-based data of individuals aged from 18 to 85 years old. METHODS: This study aimed at analyzing the sociodemographic and clinical characteristics of the population in Guangdong province. Multistage stratified cluster sampling was applied for this study. 13,768 participants from Guangdong province were interviewed with standardized assessment tools, including Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Basic socio-demographic information, mental health and chronic diseases information were collected. Self-reported sleep duration was classified as three types: short (< 7 h), normative (7-9 h) and long (≥9 h). RESULTS: The mean sleep duration was 6.75 ± 1.11 h. Short sleepers had a higher prevalence of chronic diseases, including anemia (6.2%, p = 0.024), gout (2.8%, p = 0.010), hyperlipidemia (3.9%, p = 0.003) and low back pain (5.6%, p = 0.020) than other types of sleeper. Multinomial logistic regression analysis revealed that short sleepers were more likely to have low income level, have depressive symptoms, be ex- or current drinkers and be overweight. Anemia, hyperlipidemia and low back pain were all risk factors for short sleep, while malignant tumor was risky for long sleep. CONCLUSIONS: Low income level, drinking status, being overweight, and chronic conditions may be associated with aberrant sleep duration in Guangdong province general population. Short sleepers have a higher risk of suffering from anemia, hyperlipidemia, and low back pain, while long sleepers are more likely to have malignant tumor. Health professionals should value the sleep patterns in general health care and attach importance to conduct further epidemiologic surveys to explore the relationship between sleep duration and health.

Prevalence and associated risk factors of insomnia among pregnant women in China.

BACKGROUND: Insomnia is common during pregnancy but the prevalence and risk factors of insomnia in Chinese women during pregnancy is not well studied. This study aimed to examine the prevalence of insomnia and its risk factors in Chinese women during pregnancy. METHODS: In this cross sectional study, 436 Chinese pregnant women with Insomnia Severity Index (ISI) ≥ 8 were clinically assessed using the insomnia criteria based on the combination of DSM-IV (Diagnostic and Statistical Manual-4th Edition) and ICD-10 (International Classification of Dieases, 10th Edition). Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), Pregnancy Pressure Scale (PPS), Perceived physical discomfort level and number, Epworth Sleepiness Scale (ESS), and a general socio-demographic questionnaire were administered. RESULTS: The results showed that about 20% of the pregnant women met the strict diagnosis criteria of insomnia. Independent-samples t-test revealed that several risk factors were correlated with the group with insomnia (N = 84) compared to the group without insomnia (N = 352). Binary Logistic regression analysis found that more significant bed partner influence (OR = 1.92, 95% CI: 1.03-3.60), depressive symptoms (OR = 1.07, 95% CI: 1.00-1.14), daytime sleepiness (OR = 1.07, 95% CI: 1.01-1.14), subjective somatic discomfort (OR = 2.27, 95% CI: 1.11-4.65), kinds of somatic discomfort (OR = 1.14, 95% CI: 1.03-1.27) and later gestation (OR = 1.05, 95% CI: 1.01-1.09) were significantly associated with insomnia. CONCLUSION: In this cohort of Chinese pregnant women, about a fifth of women suffered from clinically significant insomnia. Measures to prevent the adverse effects of insomnia should be provided to pregnant women with depressive symptoms, Sleep disturbance of the bed partner, excessive daytime sleepiness and somatic discomfort, especially late in gestation.

Highly Porous Microcarriers for Minimally Invasive In Situ Skeletal Muscle Cell Delivery.

Microscale cell carriers have recently garnered enormous interest in repairing tissue defects by avoiding substantial open surgeries using implants for tissue regeneration. In this study, the highly open porous microspheres (HOPMs) are fabricated using a microfluidic technique for harboring proliferating skeletal myoblasts and evaluating their feasibility toward cell delivery application in situ. These biocompatible HOPMs with particle sizes of 280-370 µm possess open pores of 10-80 µm and interconnected paths. Such structure of the HOPMs conveniently provide a favorable microenvironment, where the cells are closely arranged in elongated shapes with the deposited extracellular matrix, facilitating cell adhesion and proliferation, as well as augmented myogenic differentiation. Furthermore, in vivo results in mice confirm improved cell retention and vascularization, as well as partial myoblast differentiation. These modular cell-laden microcarriers potentially allow for in situ tissue construction after minimally invasive delivery providing a convenient means for regeneration medicine.

Meta-analysis of adherence to highly active antiretroviral therapy in patients with HIV infection in China.

With the widespread implementation of antiretroviral therapy in many countries, the HIV/AIDS epidemic has declined. However, little is known about the prevalence of adherence rate to Highly Active Antiretroviral Therapy (HAART) in patients with HIV infection in China. This is the first meta-analysis of cross-sectional studies of treatment adherence (≥ 95%) to HAART in Chinese patients. Both English (PubMed, PsycINFO, EMBASE, and Web of Science) and Chinese (WanFang, CNKI, and SinoMed) databases were systematically and independently searched by three investigators. Studies with adherence rate estimates of HAART were included. Adherence rate estimates of each eligible study were extracted and pooled using the random-effects model. A total of 40 studies conducted in China were eligible and analyzed. The mean rate of ≥ 95% adherence to HAART was 81.1% (95%CI: 75.1%-88.0%, I2 = 97.3%) at one week, 80.9% (95%CI: 74.7%-85.9%, I2 = 96.6%) at one month, and 68.3% (95%CI: 46.1%-84.4%, I2 = 97.1%) at 3 months or longer. Subgroup analyses revealed that samples with no gender predominance, low education level, middle economic region, rural area, older age (42.3 years), and recent publication (2013 or later) were correlated to higher HAART adherence. The average rate of HAART adherence was relatively high in China, which indicates effective HIV/AIDS policy, prevention and control measures. However, the HAART adherence rate decreased over the study time period.

Periodontal health: A national cross-sectional study of knowledge, attitudes and practices for the public oral health strategy in China.

AIM: To assess the status of periodontal health knowledge, attitudes and practices (KAP) among Chinese adults. MATERIALS AND METHODS: A cross-sectional study was conducted in a nationally representative sample of adults (N = 50,991) aged 20 years or older from ten provinces, autonomous regions, and municipalities. Percentages of Chinese adults with correct periodontal knowledge, positive periodontal attitudes, and practices were estimated. Multiple logistic regression analyses were used to examine the related factors. RESULTS: Less than 20% of Chinese adults were knowledgeable about periodontal disease. Very few (2.6%) of Chinese adults use dental floss ≥once a day and undergo scaling ≥once a year and visit a dentist (6.4%) in the case of gingival bleeding. Periodontal health KAP was associated with gender, age, body mass index, marital status, place of residence, education level, income, smoking status, and history of periodontal disease. CONCLUSIONS: Periodontal health KAP are generally poor among the Chinese adult population. Community-based health strategies to improve periodontal health KAP need to be implemented. Increasing knowledge of periodontal disease, the cultivation of correct practices in response to gingival bleeding, and the development of good habits concerning the use of dental floss and regular scaling should be public oral health priorities.

Psychotropic medication treatment patterns in community-dwelling schizophrenia in China: comparisons between rural and urban areas.

BACKGROUND: To date no study has compared more specifically the psychotropic medication treatment patterns for patients with schizophrenia living in community between rural and urban areas. This study examined the rural-urban differences of the use of psychotropic drugs among community-dwelling individuals with schizophrenia in China. METHOD: Data on 993 community-dwelling patients with schizophrenia (n = 479 in rural area and n = 514 urban area) were collected by interviews during 2013-2014, and 2015-2016 according to the diagnosis of DSM-IV or ICD-10. Data on patients' socio-demographic and clinical characteristics, prescriptions of psychotropic drugs were collected using a standardized protocol and data acquisition procedure. RESULTS: Multivariate analyses revealed that in comparison with the rural counterparts, the patients from the urban area were significantly more frequently prescribed antipsychotic polypharmacy, clozapine, and benzodiazepines, but the patients from the rural area had more frequently prescribed anticholinergics. CONCLUSIONS: Substantial variations in psychotropic medication treatment patterns for patients with schizophrenia living in community were found between rural and urban areas in China. Common use of antipsychotic polypharmacy, clozapine and benzodiazepines in urban area, and anticholinergics in rural area need to be further addressed.

The Prevalence of Sleep Disturbances and Sleep Quality in Older Chinese Adults: A Comprehensive Meta-Analysis.

Objective: This is a meta-analysis of the pooled prevalence of insomnia-specific sleep disturbances (sleep disturbances thereafter) and sleep quality in older Chinese adults. Method: Both English (PubMed, Embase and PsycINFO) and Chinese (Chinese National Knowledge Infrastructure [CNKI], WanFang and SinoMed) databases were systematically searched. Data extraction and quality assessment were independently performed by two investigators. Random-effects model was performed to pool the prevalence of sleep disturbances and sleep quality. Subgroup and meta-regression analyses were performed to explore the source of heterogeneity. Funnel plots, Egger's regression model, and Begg's test were used to assess publication bias. Results: A total of 47 studies were included. The pooled prevalence of sleep disturbances was 35.9% (95% CI: 30.6%-41.2%). Older adults in rural areas had higher prevalence of sleep disturbances than their counterparts in urban areas. Sleep quality was measured by the Pittsburgh Sleep Quality Assessment (PSQI) in all studies with available data. In the 27 studies with available data, the pooled mean PSQI total score was 6.64 (95% CI: 6.14-7.13). There was no significant difference between genders and between rural and urban areas. Compared to men, women had higher mean scores in sleep latency (Q = 23.62, p < 0.001), sleep efficiency (Q = 12.08, p = 0.001), and use of sleep-promoting medications (Q = 4.07, p = 0.044). Conclusion: Sleep disturbances are common in older Chinese adults, particularly in older women.