Heterogenous subtypes of health literacy among individuals with Metabolic syndrome: a latent class analysis.

Objective To explore the heterogenous subtypes and the associated factors of health literacy among patients with metabolic syndrome.Methods A cross-sectional study was conducted, and 337 patients with metabolic syndrome were recruited from Sir Run Run Shaw Hospital in Zhejiang Province from December 2021 to February 2022. The Social Support Questionnaire, Short version of the Health Literacy Scale European Questionnaire (HLS-EU-Q16), and MacArthur Scale of Subjective Social Status were used for investigation. Latent class analysis (LCA) was performed to explore the heterogenous subtypes of health literacy among Metabolic syndrome patients. Univariate analysis and logistic regression were used to identify the predictors of the latent classes.Results The findings of LCA suggested that three heterogeneous subtypes of health literacy among individuals with metabolic syndrome were identified: high levels of health literacy, moderate levels of health literacy, and low levels of health literacy. The multinomial logistic regression results indicated that compared with low levels of health literacy class, the high levels of health literacy class were predicted by age (OR 0.932, 95%CI[0.900-0.966]), socio-economic status (OR 1.185, 95%CI[1.058-1.328]), and social support (OR 1.065, 95%CI[1.012-1.120]). Compared with low levels of health literacy class, the moderate levels of health literacy class were predicted by age (OR 0.964, 95%CI[0.934-0.995]), socio-economic status (OR 1.118, 95%CI[1.006-1.242]), male (OR 0.229, 95%CI[0.092-0.576]).Conclusion The levels of health literacy among patients with metabolic syndrome can be divided into three heterogenous subtypes. The results can inform policy-makers and care professionals to design targeted interventions for different subgroups among patients with metabolic syndrome who are male, at older age, have less social support, and with disadvantaged socio-economic status to improve health literacy.

Consistency evaluation of exercise target heart rate determined by resting heart rate and anaerobic threshold in chronic heart failure patients.

PURPOSE: To evaluate the consistency on the target heart rate for exercise determined by simple target heart rate (sTHR) based on resting heart rate (HRrest) and heart rate at anaerobic threshold (HRAT) in cardiopulmonary exercise test (CPET) for patients with chronic heart failure. METHODS: This is a retrospective cohort study, in which CHF patients who underwent CPET in Tongji Hospital Cardiac Rehabilitation Center Affiliated to Tongji University from March 2007 to December 2018 were enrolled. The clinical data of the patients from the electronic medical record system, HRrest and HRAT measured by CPET were collected. Patients were further divided into subgroups according to gender, age (<60 years group and ≥ 60 years group), with or without beta-blocker therapy and subgroup of heart failure (heart failure with reduced, mid-range and preserved ejection fraction). The sTHR (HRrest plus 10, 15, 20, 25 and 30 bpm) and HRAT were all calculated in each patient. Paired t-test was used for the difference between the two methods, correlation analysis was shown by pearson analysis and intraclass correlation coefficient (ICC) was calculated for consistency test. RESULTS: A total of 547 CHF patients were enrolled, including 447 males (81.7%), aged 63 (56,69) years, with BMI of 25.2 (23.5,26.4) kg/m2 and LVEF of 45.0 (36.0, 52.0) %. The target heart rate determined by HRAT method was (93.59 ± 13.95) bpm, and its counterpart determined by HRrest plus 20 bpm (HRrest+20) was (93.16 ± 7.69) bpm. There was no significant difference between the two methods (P>0.05). However, it was statistically different between HRrest plus 10, 15, 25, 30 bpm and HRAT respectively (P<0.001). And HRrest+20 was positively correlated with HRAT (r = 0.418, P<0.001). Therefore, HRrest+20 below was regarded as sTHR. The ICC of the consistency test between sTHR and HRAT was 0.523,95%CI 0.435-0.596 (P < 0.001) in all patients (n = 547). In patients with beta-blocker therapy (n = 464), the ICC of sTHR and HRAT consistency test was 0.534,95%CI 0.441-0.612, P < 0.001; The ICC of the consistency test between sTHR and HRAT of patients without beta-blocker therapy (n = 83) was 0.407,95%CI 0.083-0.616, P < 0.05. In the sinus rhythm group (n = 466), the ICC of sTHR and HRAT consistency test was 0.527,95%CI 0.433-0.606, P < 0.001; The ICC of the consistency test between sTHR and HRAT of atrial fibrillation patients in group (n = 81) was 0.482,95%CI 0.195-0.667, P < 0.05.The ICC of the consistency test between sTHR and HRAT was 0.501,95%CI 0.338-0.623 (P < 0.001) in patients under 60 years old (n = 195); The ICC of the consistency test between sTHR and HRAT in patients ≥60 years old (n = 352) was 0.533,95%CI 0.424-0.621, P < 0.001. In the male group (n = 447), the ICC of sTHR and HRAT consistency test was 0.577,95%CI 0.491-0.649, P < 0.001; The ICC of the consistency test between sTHR and HRAT of female patients in group (n = 100) was 0.344,95%CI 0.025-0.559, P < 0.05. The ICC of sTHR and HRAT consistency test in HFrEF group (n = 170) was 0.395,95%CI 0.181-0.553, P < 0.01; The ICC values of the consistency test between sTHR and HRAT was 0.543, 95%CI 0.405-0.649 (P < 0.001) in patients with HFmrEF (n = 222); In HFpEF group (n = 155), the ICC of sTHR and HRAT consistency test was 0.620,95%CI 0.478-0.723, P < 0.001. CONCLUSION: The exercise target heart rate calculated by HRrest is consistent with that determined by HRAT in patients with CHF. For primary hospitals without CPET, exercise prescription equivalent to AT intensity for patients with CHF can be determined by HRrest. However, the target heart rate calculated by HRrest can't replace that determined by HRAT in this patient cohort completely.

Preparation of rambutan-like Co0.5Ni0.5Fe2O4 as anode for high-performance lithium-ion batteries.

NiFe2O4 is a kind of promising lithium ion battery (LIB) electrode material, but its commercial applications have been limited due to the electronic insulation property and large volume expansion during the conversion reaction process, which results in rapid capacity decrease and poor cycling stability. We synthesized rambutan-like Co0.5Ni0.5Fe2O4 using the self-templating solvothermal method. The special structure of Co0.5Ni0.5Fe2O4 which was formed by the assembly of numerous nanosheets could effectively buffer the volume change during the charging and discharging process. Partial substitution of Ni with Co. in NiFe2O4 leads to Co0.5Ni0.5Fe2O4, the coexisting of both nickel and cobalt components is expected to provide more abundant redox reactions. The specific capacity of the rambutan-like Co0.5Ni0.5Fe2O4 as an anode material for LIB could reach 963 mA h g-1 at the current density of 500 mA g-1 after 200 cycles, confirming that the as-synthesized material is a promising candidate for LIBs.

A light-trapping structure based on BiO3 nano-islands with highly crystallized sputtered silicon for thin-film solar cells.

Silicon films with light-trapping structures are fabricated based on Bi2O3 nano-islands, which are obtained by annealing Bi nano-islands in the air at 400 °C. The topography exhibits the maximum altitude of over 600 nm and the root-mean-square roughness of 150 nm, with the lateral size of single island of about 1 µm. Highly crystallized sputtered silicon, realized by Cu-induced crystallization, is used to be a light-absorbing layer. Reflectivity of the samples with different thickness of silicon has been studied to reveal the light-trapping efficiency. The average reflectivity under AM1.5 illumination spectrum is 12% when silicon is 480 nm thick and the reflectivity for the long wavelength region between 800 nm and 1100 nm is less than 10% when the silicon is 1.2 µm thick. This is a promising low-cost structure for crystallized silicon thin-film solar cells with high efficiency.

A method of calculating the bearing capacity of sand pile composite foundations in a mucky soil layer considering consolidation.

In engineering practice, the measured bearing capacity of a sand pile composite foundation in a mucky soil layer is much larger than the design value. Based on the sand pile construction and the load application process, a method of calculating the bearing capacity of the foundation based on the effective stress was proposed. Cavity diameter expansion in sand pile construction was simplified into a planar problem, and the cavity expansion theory was used to establish the expression of the rate of displacement and the horizontal stress increase. Based on the e-p curve and the calculation of the degree of consolidation, the relationships between the horizontal and vertical effective stress and the void ratio were obtained. According to the close relationship between the bearing capacity of the foundation in a mucky soil layer and the water content, an expression describing the relationships between the bearing capacity of the foundation, effective stress, void ratio, and water content was established. For the temporary engineering foundation treatment project, which needs a high bearing capacity but allows large foundation deformation, the design of sand pile composite foundations uses these relationships to take the consolidation effect of mucky soil into consideration, thereby reducing the replacement rate and lowering the construction cost.

Efficacy and Safety of Different Aerobic Exercise Intensities in Patients With Heart Failure With Reduced Ejection Fraction: Design of a Multicenter Randomized Controlled Trial (HF-EI Trial).

Background: Heart failure (HF) is one of the major causes of mortality worldwide, representing the terminal stage of several cardiovascular diseases. Exercise-based rehabilitation is a beneficial therapy for patients with chronic heart failure (CHF). However, there is a lack of specific guidance on clinical decision-making regarding optimal exercise intensity. It is necessary to optimize the clinical recommendations for HF exercises. We will evaluate the efficacy and safety of different aerobic exercise intensities in patients with heart failure with reduced ejection fraction (HFrEF): the HF-EI trial. This trial aims to assess the appropriate exercise intensity for patients with HFrEF. Methods: After a baseline assessment to determine the safety of exercise, 180 patients will be randomly assigned to supervised high-intensity exercise training (ET) group, supervised moderate intensity training (MIT) group, and control group at a ratio of 1:1:1. Patients randomly receiving high intensity training (HIT) undergo supervised ET (3 times/week, 30 min) for aerobic endurance at 70% peak oxygen consumption (peak VO2) intensity for 12 weeks. The MIT patients will perform supervised aerobic ET (3 times/week, 35-42 min) at the anaerobic threshold (AT) intensity for 12 weeks. The control group will continue to maintain their daily activities and will not receive ET. During the baseline and follow-up period, physical examination, laboratory tests, cardiology diagnostic tests, cardiopulmonary exercise tests (CPET), 6-min walk distance (6MWD), scale scores, exercise steps, medications, and clinical events will be monitored. Throughout the research, sport bracelets and patient diaries will be used to monitor and record overall physical activity, training courses, and compliance. Discussion: The HF-EI trial will evaluate the effects of different aerobic exercise intensities on peak VO2, quality of life (QoL), and clinical events among patients with HFrEF. The findings of this trial will provide a basis for formulating exercise prescriptions for patients with HFrEF. Clinical Trial Registration:http://www.chictr.org.cn/, identifier: ChiCTR2000036381.

A Model for the Prediction of Mortality and Hospitalization in Chinese Heart Failure Patients.

Background: Although many risk prediction models have been released internationally, the application of these models in the Chinese population still has some limitations. Aims: The purpose of the study was to establish a heart failure (HF) prognosis model suitable for the Chinese population. Methods: According to the inclusion criteria, we included patients with chronic heart failure (CHF) who were admitted to the Department of Cardiac Rehabilitation of Tongji Hospital from March 2007 to December 2018, recorded each patient's condition and followed up on the patient's re-admission and death. All data sets were randomly divided into derivation and validation cohorts in a ratio of 7/3. Least absolute shrinkage and selection operator regression and Cox regression were used to screen independent predictors; a nomogram chart scoring model was constructed and validated. Results: A total of 547 patients were recruited in this cohort, and the median follow-up time was 519 days. The independent predictors screened out by the derivation cohort included age, atrial fibrillation (AF), percutaneous coronary intervention (PCI), diabetes mellitus (DM), peak oxygen uptake (peak VO2), heart rate at the 8th minute after the cardiopulmonary exercise peaked (HR8min), C-reaction protein(CRP), and uric acid (UA). The C indexes values of the derivation and the validation cohorts were 0.69 and 0.62, respectively, and the calibration curves indicate that the model's predictions were in good agreement with the actual observations. Conclusions: We have developed and validated a multiple Cox regression model to predict long-term mortality and readmission risk of Chinese patients with CHF. Registration Number: ChicTR-TRC-00000235.

Computational characterization of halogen vapor attachment, diffusion and desorption processes in zeolitic imidazolate framework-8.

Computational simulation methods are used for characterizing the detailed attachment, diffusion and desorption of halogen vapor molecules in zeolitic imidazolate framework-8 (ZIF-8). The attachment energies of Cl2, Br2 and I2 are -55.2, -48.5 and -43.0 kJ mol-1, respectively. The framework of ZIF-8 is disrupted by Cl2, which bonds with Zn either on the surface or by freely diffusing into the cage. A framework deformation on the surface of ZIF-8 can be caused by the attachment of Br2, but only reorientation of the 2-methylimidazolate linkers (mIms) for I2. In diffusion, the halogen molecules have a tendency to vertically permeate the apertures of cages followed with swing effect implemented by the mIms. Larger rotation angles of mIms are caused by Br2 because of its stronger interaction with mIms than I2. A maximum of 7 Br2 or 5 I2 molecules can be accommodated in one cage. Br2 are clinging to the mIms and I2 are arranged as crystal layout in the cages, therefore in desorption processes molecules attached to the surface and free inside are desorbed while some remained. These results are beneficial for better understanding the adsorption and desorption processes of halogen vapors in the porous materials.

Impact of refractive index increment on the determination of molecular weight of hyaluronic acid by muti-angle laser light-scattering technique.

Hyaluronic acid (HA) is applied in a number of medical applications and HA of different molecular weight (Mw) are used in different pharmaceutical preparations. In determination of Mw by muti-angle laser light-scattering (MALS), refractive index increment (dn/dc) is an important parameter for accuracy. Herein, the influence of dn/dc on the Mw of HA in stroke-physiological saline solution is investigated by MALS in this work. Additionally, the Mw variation of HA in the manufacturing process of preparations is measured. It is shown that each HA sample corresponds to a specific value of dn/dc, which is varied from 1.38 to 1.74 L/g with the Mw increasing from 13.5 to 2840 kDa in solution. It is indicated by the results from both MALS approach and viscometry that appropriate dn/dc should be selected for Mw determination. In steam sterilization process of preparations at 121 °C, the Mw and conformation of HA can be accurately and rapidly determined by MALS. This work provides a precise method to determine the Mw of HA in the medical applications and preparation industries.

Catalysis effects of water molecules and of charge on intramolecular proton transfer of uracil.

In this work, the three most stable uracil isomers (U1, U2, and U3) and their neutral, positive, and negative charged multihydrates are chosen as research objects to investigate the tautomeric process between the most stable uracil, U1, and its two minor stable isomers, U2 and U3. By the study, deeper insight can be obtained regarding point mutations induced by uracil deformation. Toward the target, the activation energies of the intramolecular proton transfer (tautomeric process) as well as the catalysis effects of water molecules and of charges attached are investigated using density functional theory (DFT) calculations by means of the B3LYP exchange and correlation functions. Results reveal that water molecules hold a stronger catalysis effect on the proton transfer in these negative charged uracil hydrates than in the neutral counterparts. The optimal number of water molecules needed to catalyze the proton transfer is determined as two in the neutral hydrated systems, whereas it is three in the negative charged systems. Positive charge attachment, however, hinders the intramolecualr proton transfer of uracil, and the charge and the proton of uracil will transfer to the water clusters if water molecules are attached. Then the positive charged hydrates look more like U1a/b+[(H2O)n+H+] species in structure. Analysis reveals that it is the acceptance process of the last proton to determine the impossibility of proton transfer and result in the failure of tautomeric processes from cat-U1a-nw to cat-U2-nw and from cat-U1b-nw to cat-U3-nw. Detailed structural parameters and energy changes are discussed for the above different processes.

The prediction of intermolecular proton-transfer of guanine-cytosine base pair under the influence of fragments from decomposed MOFs.

Metal-organic frameworks (MOFs) can be decomposed into various fragments, including negative/positive charges, Zn+ or Cu2+ when used as drug delivery materials. To evaluate the safety of MOFs, different mechanisms of intermolecular proton-transfer in guanine-cytosine (GC) base pair under the influence of such fragments were investigated by density functional theory methods. In a vacuum, calculation results show that an excess electron assists proton transfer in the anionic GC radical, and a hole assists proton transfer in the cationic GC radical with small energy barriers. The mechanism for Zn+-GC transfer is that the located hole assists proton transfer from G to C. All proton-transfers of Cu2+-GC become spontaneous with stable proton-transferred structures, and the driving force is the Cu2+ due to its electrostatic and oxidative effects. However, in a micro-water environment, the average energy barrier of all proton-transfer processes increases by 2.8 kcal mol-1 because of the redistribution of charges. Water molecules play a very important role in buffering, and the influence of fragments on intermolecular proton-transfer processes of GC is reduced.

A differential photoelectrochemical hydrogen peroxide sensor based on catalytic activity difference between two zeolitic imidazolate framework surface coatings.

Improvement of the sensitivity and selectivity is important in the development of an analytical method. Herein, we propose a differential photoelectrochemical (PEC) sensor to hydrogen peroxide based on the catalytic activity difference between two zeolitic imidazolate framework (ZIF) surface coatings. In the sensing and reference photoelectrodes, ZIF-67 and ZIF-8 films were grown on the surface of carboxylated carbon nanotubes-graphite-like carbon nitride/TiO2 nanotube array, respectively. The molecular sieve effect of ZIF-8 and ZIF-67 coatings can prevent the diffusion of molecules with size larger than the pores in coating layers (e.g. ascorbic acid), improving the selectivity of the PEC sensor to H2O2. The sensing photoelectrode offers higher sensitivity to H2O2 than the reference one due to the excellent catalytic activity of ZIF-67. The interference from the surfaces of the sensing and reference photoelectrodes can be eliminated effectively by the differential strategy, enhancing further the selectivity, reliability and stability of the sensor. Under optimized conditions, the as-prepared differential PEC sensor was applied to the detection of H2O2 with limit of detection of 1.5 nM, exhibiting high sensitivity and anti-interference ability.

Do the fragments from decomposed ZIF-8 greatly affect some of the intramolecular proton-transfer of thymine? A quantum chemical study.

The intramolecular proton-transfer processes of thymine were investigated by the density functional theory method. It is shown that the mutation from keto (T) to enol (T') form is affected by zeolitic imidazolate framework-8 (ZIF-8) fragments such as single 2-methylimidazole neutral crystals (M), and negatively charged 2-methylimidazole ligands (M-). Results show that with the number (n) of water (w) molecules that assist proton-transfer increasing from 1 to 4, the order of the tautomeric energy barriers (in kcal mol-1) is T-2w (16.3) < T-1w (17.6) < T-3w (17.8) < T-4w (20.5). In the presence of M, the order of energy barrier is MT-2w (16.6) < MT-1w (17.7) < MT-3w (18.9) < MT-4w (20.8). M- has a catalysis effect on the energy barrier and the order is M-T-2w (14.4) < M-T-3w (15.2) < M-T-1w (16.3) < M-T-4w (16.8). The attachment of the M- fragment slightly promotes the proton-transfer processes in some instances. The characterization of the proton-transfer processes is helpful to understand the genotoxicity of ZIF-8 during drug delivery applications.

The influence of isolated and penta-hydrated Zn2+ on some of the intramolecular proton-transfer processes of thymine: a quantum chemical study.

Zinc cation (Zn2+) plays an important role in the chemistry of DNA base pairs. In this work, the influence of isolated and penta-hydrated Zn2+ on some of the intramolecular proton-transfer processes of thymine (T) is investigated by the density functional theory method. It is shown that the calculated binding energies between Zn2+ and T are exothermic in vacuum. Compared to T, Zn2+ increases the stability of tautomer T' by 28.7 kcal mol-1, promoting the intramolecular proton transfer of T. But in a micro-water environment, the attachment processes of Zn2+ to T hydrates, penta-hydrated Zn2+ to T, and penta-hydrated Zn2+ to T hydrates lead to the rearrangement of molecules and the redistribution of charges. The conventional T is still the most stable form and the influence of Zn2+ is much reduced and the proton transfer is thermodynamically unfavored. The detailed characterization is helpful to understand the genotoxicity of zinc ions.

Effect of the methylation of uracil and/or glycine on their mutual interaction.

In order to simulate the hydrogen bonding and proton transfer (PT) in protein-DNA/RNA interactions, a series of simplified models were employed and investigated in the gas phase. These models included various neutral, anionic and cationic glycine-uracil dimers, and their methylated derivatives generated by the mono- or dimethylation of glycine and/or uracil moieties of the dimer. The results reveal that the only process that can occur in the neutral complexes is a double-PT process leading to proton exchange between the two moieties (i.e., point mutation). The first methyl substitute can reduce the activation energy of the PT process and thus promote the isomerization of the two moieties; further methylation can reduce the isomerization in only some of the cases. In the anionic complexes, only the one-way PT (i.e., amino acid → nucleic acid base) process is energetically favorable, and this PT process is an interesting barrier-free one (BFPT), with the attached electron locating itself at the base moiety. Methylation will disfavor BFPT, but it cannot alter the nature of BFPT. In the cationic complexes, three different PT processes can occur. These processes can transform mutually by adjusting either or both of the methylated sites and methyl number, indicating that the methylation can regulate the dynamics of these PT processes.