Health behavior inventory - short form: a Chinese validation study using classical test theory and item response theory.

BACKGROUND: It is imperative to use a validated tool to measure and understand health behavior as it greatly impacts health status. It has been demonstrated that the Health Behavior Inventory - Short Form (HBI-SF) is valid in several countries. The purpose of this study was to translate the HBI-SF into Chinese and test its psychometric properties. METHODS: This study employed a two-phase methodology. The phase one entailed the cross-cultural adaptation of the HBI-SF, while the subsequent phase evaluated the psychometric properties of the scale. This evaluation encompassed classical test theory (CTT) and item response theory (IRT) tests to assess reliability and validity. It involved 1058 participants, of whom 1036 completed the questionnaire successfully. Out of these, 518 were analyzed for CTT, along with 518 for IRT. RESULTS: The S-CVI was found to be 0.935, while the I-CVI ranged from 0.889 to 1.000. The results of the confirmatory factor analysis suggested the goodness-of-fit indices for the four-factor model was acceptable. Regarding the subscales, the average variance extracted (AVE) and Heterotrait-Monotrait Ratio of Correlations (HTMT) matrix also met the cutoff values (AVE > 0.5 and HTMI < 0.85). Furthermore, the internal consistency and composite reliability indices of all factors were greater than 0.7. Infit and/or outfit values indicated that all items fitted the Rasch model. The Wright map revealed that the average person measures for the participants (mean = - 0.994, SD = 0.430) were comparatively lower than the average item measures (mean = 0.000, SD = 0.257). The person separation reliability values for the four factors ranged from 0.600 to 0.746, indicating an acceptable level of reliability. Two items showed differential item functioning. CONCLUSIONS: The findings derived from both CTT and IRT analyses demonstrate favorable levels of reliability and validity for the Chinese version of the HBI-SF.

Ferrate (VI) oxidation of sulfamethoxazole enhanced by magnetized sludge-based biochar: Active sites regulation and degradation mechanism analysis.

Developing non radical systems for antibiotic degradation is crucial for addressing the inefficiency of conventional radical systems. In this study, novel magnetic-modified sludge biochar (MASBC) was synthesized to significantly enhance the oxidative degradation of sulfamethoxazole (SMX) by ferrate (Fe (VI)). In the Fe (VI)/MASBC system, 90.46% of SMX at a concentration of 10 µM and 49.34% of the total organic carbon (TOC) could be removed under optimal conditions of 100 µM of Fe (VI) and 0.40 g/L of MASBC within 10 min. Furthermore, the Fe (VI)/MASBC system was demonstrated with broad-spectrum removal capability towards sulfonamides in single or mixture. Quenching experiments, EPR analyses, and electrochemical experiments revealed that direct electron transfer (DET) and •O2- were mainly responsible for the removal of SMX, with functional groups (e.g., -OH, C=O) and Fe-O (redox of Fe (III)/Fe (II)) acting as the active sites, while the probe experiments showed that Fe (IV)/Fe (V) made a minor contribution to the degradation of SMX. Benefiting from the DET, the Fe (VI)/MASBC system exhibited a wide pH adaptation range (e.g., from 5.0 to 10.0) and strong anti-interference ability. The N atoms and their neighboring atoms in SMX were the prior degradation sites, with the cleavage of bond and ring opening. The degradation products showed low or non-toxicity according to ECOSAR program assessment. The removal of SMX remained within a reasonable range of 71.33%-90.46% over five consecutive cycles. Also, the Fe (VI)/MASBC system was demonstrated to be effectively applied for successful SMX removal in various water matrices, including ultrapure water, tap water, lake water, Yangtze River water, and wastewater. Therefore, this study offered new insights into the mechanism of Fe (VI) oxidation and would contribute to the efficient treatment of organic pollutants.

Efficient degradation of sulfadiazine by UV-triggered electron transfer on oxalic acid-functionalized corn straw biochar for activating peroxyacetic acid: Performance, mechanism, and theoretical calculation.

A novel UV/oxalic acid functionalized corn straw biochar (OCBC)/peroxyacetic acid (PAA) system was built to degrade sulfadiazine from waters. 94.7 % of SDZ was removed within 30 min by UV/OCBC/PAA. The abundant surface functional groups and persistent free radicals (PFRs) on OCBC were responsible for these performances. Cyclic voltammetry (CV) and other characterization analysis revealed, under UV irradiation, the addition of OCBC served as electron donor, which might promote the reaction of electrons with PAA. The quenching and electron paramagnetic resonance (EPR) tests indicated that R-O•, 1O2 and •OH were generated. Theoretical calculations indicated sulfonamide bridge was vulnerable under the attacks of reactive species. In addition, high removal effect achieved by 5 reuse cycles and different real waters also suggested the sustainability of UV/OCBC/PAA. Overall, this study provided a feasible approach to remove SDZ with high mineralization efficiency, in addition to a potential strategy for resource utilization of corn straw.

Suppressing Wnt signaling of the blood‒tumor barrier to intensify drug delivery and inhibit lipogenesis of brain metastases.

Lipogenesis is often highly upregulated in breast cancer brain metastases to adapt to intracranial low lipid microenvironments. Lipase inhibitors hold therapeutic potential but their intra-tumoral distribution is often blocked by the blood‒tumor barrier (BTB). BTB activates its Wnt signaling to maintain barrier properties, e.g., Mfsd2a-mediated BTB low transcytosis. Here, we reported VCAM-1-targeting nano-wogonin (W@V-NPs) as an adjuvant of nano-orlistat (O@V-NPs) to intensify drug delivery and inhibit lipogenesis of brain metastases. W@V-NPs were proven to be able to inactivate BTB Wnt signaling, downregulate BTB Mfsd2a, accelerate BTB vesicular transport, and enhance tumor accumulation of O@V-NPs. With the ability to specifically kill cancer cells in a lipid-deprived environment with IC50 at 48 ng/mL, W@V-NPs plus O@V-NPs inhibited the progression of brain metastases with prolonged survival of model mice. The combination did not induce brain edema, cognitive impairment, and systemic toxicity in healthy mice. Targeting Wnt signaling could safely modulate the BTB to improve drug delivery and metabolic therapy against brain metastases.

In situ activation of peroxymonosulfate with bioelectricity for sulfamethoxazole sustainable removal.

Conventional electrochemical activation of peroxymonosulfate (PMS) is not very cost-effective and practical by the excessive input of energy. The electricity generated by photosynthetic microalgae fuel cells (MFCs) is utilized to activate PMS, which would achieve the combination of green bioelectricity and advanced oxidation processes for sustainable pollutants degradation. In this study, a novel dual-chamber of MFCs was constructed by using microalgae as anode electron donor and PMS as cathode electron acceptor, which was operating under both close-circuit and open-circuit conditions. Under close-circuit condition, 1-12 mM PMS in cathode was successfully in situ activated, where 32.00%-99.83% of SMX was removed within 24 h, which was about 1.21-1.78 times of that in the open-circuit of MFCs. Meanwhile, a significant increase in bioelectricity generation in MFCs was observed after the accumulation of microalgae biomass (4.65-5.37 mg/L), which was attributed to the efficient electron separation and transfer. Furthermore, the electrochemical analysis demonstrated that SMX or its products were functioned as electronic shuttles, facilitating the electrochemical reaction and altering the electrical capacitance. The quenching experiments and voltage output results reflected that complex active radical (SO4⋅-, ⋅OH, and 1O2) were involved in SMX removal. Seven degradation products of SMX were detected and S-N bond cleavage was the main degradation pathway. Predicted toxicity values calculated by ECOSAR program showed that all the products were less toxic or nontoxic. Finally, the density functional theory (DFT) calculations revealed that the O and N atoms on SMX were more susceptible to electrophilic reactions, which were more vulnerable to be attacked by reactive species. This study provided new insights into the activation of PMS by bioelectricity for SMX degradation, proposing the mechanisms for PMS activation and degradation sites of SMX.

Social determinants of health and their relation to suboptimal health status in the context of 3PM: a latent profile analysis.

Background: Suboptimal health is identified as a reversible phase occurring before chronic diseases manifest, emphasizing the significance of early detection and intervention in predictive, preventive, and personalized medicine (PPPM/3PM). While the biological and genetic factors associated with suboptimal health have received considerable attention, the influence of social determinants of health (SDH) remains relatively understudied. By comprehensively understanding the SDH influencing suboptimal health, healthcare providers can tailor interventions to address individual needs, improving health outcomes and facilitating the transition to optimal well-being. This study aimed to identify distinct profiles within SDH indicators and examine their association with suboptimal health status. Method: This cross-sectional study was conducted from June 16 to September 23, 2023, in five regions of China. Various SDH indicators, such as family health, economic status, eHealth literacy, mental disorder, social support, health behavior, and sleep quality, were examined in this study. Latent profile analysis was employed to identify distinct profiles based on these SDH indicators. Logistic regression analysis by profile was used to investigate the association between these profiles and suboptimal health status. Results: The analysis included 4918 individuals. Latent profile analysis revealed three distinct profiles (prevalence): the Adversely Burdened Vulnerability Group (37.6%), the Adversity-Driven Struggle Group (11.7%), and the Advantaged Resilience Group (50.7%). These profiles exhibited significant differences in suboptimal health status (p < 0.001). The Adversely Burdened Vulnerability Group had the highest risk of suboptimal health, followed by the Adversity-Driven Struggle Group, while the Advantaged Resilience Group had the lowest risk. Conclusions and relevance: Distinct profiles based on SDH indicators are associated with suboptimal health status. Healthcare providers should integrate SDH assessment into routine clinical practice to customize interventions and address specific needs. This study reveals that the group with the highest risk of suboptimal health stands out as the youngest among all the groups, underscoring the critical importance of early intervention and targeted prevention strategies within the framework of 3PM. Tailored interventions for the Adversely Burdened Vulnerability Group should focus on economic opportunities, healthcare access, healthy food options, and social support. Leveraging their higher eHealth literacy and resourcefulness, interventions empower the Adversity-Driven Struggle Group. By addressing healthcare utilization, substance use, and social support, targeted interventions effectively reduce suboptimal health risks and improve well-being in vulnerable populations. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00365-5.

The effect of family health on suboptimal health status: The parallel mediation role of sleep quality and health behaviour.

Background: The prevalence of suboptimal health status has been increasing worldwide, posing a significant challenge to public health. Meanwhile, family health has been recognised as an important factor influencing individual health outcomes. However, the mechanisms through which family health affects suboptimal health status remain unclear. We aimed to investigate the parallel mediation role of sleep quality and health behaviour in the relationship between family health and suboptimal health status. Methods: We conducted a cross-sectional online survey with a sample of adults >18 years old from four provinces in China. The survey questionnaires queried their demographic characteristics, family health, suboptimal health status, sleep quality, and health behaviour. We assessed family health by the Family Health Scale-Short Form and suboptimal health status using the Suboptimal Health Status Questionnaire. We employed structural equation modelling to analyse the data and test the proposed mediation model. Results: we collected 4918 valid questionnaires. The mean age of the participants was 30.1 years (standard deviation = 12.5). The correlation analysis demonstrated a significant negative association between family health and suboptimal health status (r = -0.44; P < 0.001). The results of the parallel mediation analysis showed that family health had a significant indirect effect on suboptimal health status through both sleep quality (ß = -0.350; P < 0.001) and health behaviour (ß = -0.137; P < 0.001). The total indirect effect of family health on suboptimal health status through both sleep quality and health behaviour was also significant (ß = -0.569, P < 0.001). Conclusions: This study highlights the significance of family health as a predictor of suboptimal health status and suggests that sleep quality and health behaviour are parallel mediators in this relationship. By understanding the role of family health, sleep quality, and health behaviour, interventions can be targeted to improve overall health outcomes.

Nanomodulators targeting endothelial WNT and pericytes to reversibly open the blood-tumor barrier for boosted brain tumor therapy.

The blood-brain barrier (BBB)/blood-tumor barrier (BTB) impedes brain entry of most brain-targeted drugs, whether they are water-soluble or hydrophobic. Endothelial WNT signaling and neoplastic pericytes maintain BTB low permeability by regulating tight junctions. Here, we proposed nitazoxanide (NTZ) and ibrutinib (IBR) co-loaded ICAM-1-targeting nanoparticles (NI@I-NPs) to disrupt the BTB in a time-dependent, reversible, and size-selective manner by targeting specific ICAM-1, inactivating WNT signaling and depleting pericytes in tumor-associated blood vessels in breast cancer brain metastases. At the optimal NTZ/IBR mass ratio (1:2), BTB opening reached the optimum effect at 48-72 h without any sign of intracranial edema and cognitive impairment. The combination of NI@I-NPs and chemotherapeutic drugs (doxorubicin and etoposide) extended the median survival of mice with breast cancer brain metastases. Targeting BTB endothelial WNT signaling and tumor pericytes via NI@I-NPs could open the BTB to improve chemotherapeutic efficiency against brain metastases.

PBPK-PD model for predicting morphine pharmacokinetics, CNS effects and naloxone antagonism in humans.

Morphine and morphine-6-glucuronide (M6G) produce central nervous system (CNS) effects by activating mu-opioid receptors, while naloxone is used mainly for the reversal of opioid overdose, specifically for the fatal complication of respiratory depression, but also for alleviating opioid-induced side effects. In this study we developed a physiologically-based pharmacokinetic-pharmacodynamic (PBPK-PD) model to simultaneously predict pharmacokinetics and CNS effects (miosis, respiratory depression and analgesia) of morphine as well as antagonistic effects of naloxone against morphine. The pharmacokinetic and pharmacodynamic parameters were obtained from in vitro data, in silico, or animals. Pharmacokinetic and pharmacodynamic simulations were conducted using 39 and 36 clinical reports, respectively. The pharmacokinetics of morphine and M6G following oral or intravenous administration were simulated, and the PBPK-PD model was validated using clinical observations. The Emax model correlated CNS effects with free concentrations of morphine and M6G in brain parenchyma. The predicted CNS effects were compared with observations. Most clinical observations fell within the 5th-95th percentiles of simulations based on 1000 virtual individuals. Most of the simulated area under the concentration-time curve or peak concentrations also fell within 0.5-2-fold of observations. The contribution of morphine to CNS effects following intravenous or oral administration was larger than that of M6G. Pharmacokinetics and antagonistic effects of naloxone on CNS effects were also successfully predicted using the developed PBPK-PD model. In conclusion, the pharmacokinetics and pharmacodynamics of morphine and M6G, antagonistic effects of naloxone against morphine-induced CNS effects may be successfully predicted using the developed PBPK-PD model based on the parameters derived from in vitro, in silico, or animal studies.

Short-term effects of ambient air pollution and cause-specific emergency department visits in Guangzhou / 中华疾病控制杂志

Objective To understand the relationship between the concentration of air pollutants and daily emergency department visits for different diseases (circulatory system disease, digestive system disease, nervous system disease and respiratory system disease) in Guangzhou, Guangdong Province. Methods The daily average concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2, carbon monoxide (CO) and PM2.5 and the daily maximum 8-hour concentrations of O3, the daily average temperature, the relative humidity and cause -specific emergency department visits of the four major diseases from 2015 to 2017 were collected in Guangzhou. Semi-parametric generalized additive model was used to analyze the relationship between the concentration of pollutants and daily cause-specific emergency department visits. Results The daily average concentrations of SO2, NO2, CO, O3 and PM2.5 during the study period were 13.24 μg /m3, 45.96 μg /m3, 0.97 mg /m3, 123.77 μg /m3 and 36.22 μg /m3, respectively. For circulatory system disease，the independently significant associations of SO2 with emergency department visits in single-pollutant models (2.91%, 95% CI: 1.00%-4.85%), and multipollutant models (4.39%, 95% CI: 1.22%-7.67%) were observed. Conclusion The ambient SO2 increases the risk of emergency department visits due to circulatory diseases in Guangzhou. Comprehensive prevention and control measures should be taken to reduce the emission of SO2.

Quality control of Shuanghuanglian preparations using an effect-constituent index / 药学学报

We established a quality evaluation method for Shuanghuanglian preparations based on an effect-constituent index (ECI), which is guided by the clinical efficacy of Shuanghuanglian and a dose-efficacy correlation. An HPLC method was used to establish the quantitative fingerprint of Shuanghuanglian from different manufacturers and to determine the content of 10 fingerprint components, including baicalin, chlorogenic acid, forsythin, galuteolin, wogonin, forsythoside A, luteolin, caffeic acid, baicalein, and scutellarin. Using Staphylococcus aureus as biological model, the potency of Shuanghuanglian preparations was determined by antibiotic microbial assay. Using the method of PLC-DA, the efficacious antibacterial components were screened by "dose-efficacy" correlation analysis. According to the antibacterial potency and content of the antibacterial ingredients, combined with the method of the custom weight coefficient, ECI was calculated and verified. The results show that the antibacterial ECI can facilitate evaluation of the efficacy of Shuanghuanglian based on the composition of its contents, providing a new method for the quality control of traditional Chinese medicine.