Latent Profile Analysis of Medication Beliefs in Patients with Type 2 Diabetes in the Hospital-Home Transition and Comparison with Medication Adherence.

Background: The treatment of Type 2 Diabetes Mellitus (T2DM) is a protracted and arduous process. Medication, being a universally crucial therapeutic measure, underscores the significance of medication adherence in managing the disease effectively. Medication beliefs have emerged as a significant predictor of adherence, attracting considerable scholarly attention in recent years. However, there remains a paucity of research utilizing individual-centered approaches to explore medication beliefs among the T2DM population during the hospital-home transition, leaving the relationship between these beliefs and medication adherence unclear. Purpose: To investigate latent categories of medication beliefs among patients with T2DM during the transition from hospital to home, and to analyze variations in medication adherence across these categories of patients. Patients and methods: Between August 2022 and September 2023, this study selected 304 patients with a pre-discharge diagnosis of T2DM as study subjects from a tertiary hospital in Dongguan City. The patients' profiles were assessed comprehensively via the Sociodemographic and Clinical Characteristics Questionnaire, alongside the Chinese version of Beliefs about Medicines Questionnaire-Specific and Morisky Medication Adherence Scale-8. The present study conducted latent profile analysis using Mplus 7.4 software and analyzed the influencing factors of different medication belief categories and their differences in medication adherence using SPSS 26.0 software. Results: The medication beliefs of 304 patients were rated at 3.36±5.24 points, while medication adherence scored 6.23±1.56 points. The medication beliefs were classified into four categories: moderate necessity - low to moderate concern group (40.13%), high necessity - low concern group (9.54%), moderate necessity - moderate to high concern group (19.08%), and moderate necessity - high concern group (31.25%). Age, monthly per capita household income, and place of residence emerged as influential factors for the four categories. Moreover, the disparity in medication adherence among these categories demonstrated statistical significance (P < 0.001). Conclusion: The medication beliefs of patients were classified into four distinct categories, and variations in medication adherence were evident across these categories. The high necessity - low concern group demonstrated the highest medication adherence scores, while the moderate necessity - high concern group exhibited the lowest scores. Healthcare providers are advised to tailor personalized medication belief enhancement programs based on patients' homogeneous beliefs, addressing specific issues encountered by each category. This approach aims to ensure optimal medication adherence across diverse medical and social environments, effectively improving patient prognosis and enhancing quality of life.

The roles of pyroptosis in genitourinary diseases.

Pyroptosis, a form of programmed cell death distinct from apoptosis and necrosis, is thought to be closely associated with the pathogenesis of diseases. Recently, the association between pyroptosis and urinary diseases has attracted considerable attention, and a comprehensive review focusing on this issue is not available. In this study, we reviewed the role of pyroptosis in the development and progression of benign urinary diseases and urinary malignancies. Based on this, pyroptosis has been implicated in the development of urinary diseases. In summary, this review sheds light on future research directions and provides novel ideas for using pyroptosis as a powerful tool to fight urinary diseases.

Evidence of pre-approval clinical trial supporting the granted conditional approval for novel cancer drugs in China between 2015 and 2022.

Background: Accelerated approval (AA) of novel anticancer drugs based on surrogacy has attracted considerable concern globally. China National Medical Products Administration (NMPA) also established a similar conditional approval (CA) program to accelerate the approval of novel drugs to address unmet medical needs. This cross-sectional study aimed to evaluate the pre-approval clinical trial evidence and potential challenge of cancer drugs receiving CA in China from policy implementation to 2022. Methods: The cancer drugs (initial and supplemental indications) granted CA between January 1, 2015 and December 31, 2022 using the public database of the NMPA were analyzed. The characteristics of the cancer drugs received CA were described. Primary efficacy endpoints and safety derived from the pre-approval clinical trial, including response rates (RR), progression-free survival (PFS), overall survival (OS), treatment-related serious adverse events (SAE) and Grade ≥3 adverse events (AEs) were quantitatively estimated by meta-analysis. Besides, the correlation between the surrogate endpoints and OS was estimated by the reported trial-level correlation analysis. Findings: The NMPA approved 72 cancer indications (56 new molecular entities) with CA between 2015 and 2022. 34 indications (47%) were also approved by the FDA or EMA. 74% (53/72) of cancer indications were based on a single-arm trial design while 26% (19/72) for randomized controlled trials. The pooled RR was 0.50 (95% CI: 0.45-0.55, I2 = 96%) with significant differences across cancer types and targets while the pooled hazard risk was 0.39 (95% CI: 0.28-0.53, I2 = 89%) for PFS and 0.67 (95% CI: 0.61-0.73, I2 = 0%) for OS. The pooled treatment-related SAE and Grade ≥3 AEs from single-arm designs resulted in 15% and 25%, respectively. In randomized controlled trials, the pooled treatment-related SAE and Grade ≥3 AEs observed in CA drugs and the control groups were comparable. Surrogate endpoints were widely used as the primary efficacy endpoints in the pre-approval pivotal clinical trials with 75% (54/72) for RR, 10% (7/72) for PFS, and 4% (3/72) for others. Of these, 27% (17/63) of the surrogate endpoints reported a trial-level correlation with OS; three reported high correlation (r ≥ 0.85), two reported moderate correlation (0.70 ≤ r < 0.85) and 12 reported low correlation (r < 0.70). Interpretation: The majority of novel cancer drugs that received CA were based on RR designed for single-arm trials. The reported correlations of treatment effect between the surrogate endpoints and OS used for CA were limited. Our findings highlighted that the introduction of OS or quality of life based on RCT in confirmatory clinical trials as much as feasible was essential to ensure the clinical benefits for patients. Funding: This study was supported by postdoctoral fellowship from Tsinghua-Peking Joint Centers for Life Sciences (CLS).

Dynamics of Phyllosphere Microbiota and Chemical Parameters at Various Growth Stages and Their Contribution to Anaerobic Fermentation of Pennisetum giganteum.

This work evaluated the dynamic changes of phyllosphere microbiota and chemical parameters at various growth stages of Pennisetum giganteum and their effects on the bacterial community, cooccurrence networks, and functional properties during anaerobic fermentation. P. giganteum was collected at two growth stages (early vegetative stage [PA] and late vegetative stage [PB]) and was naturally fermented (NPA and NPB) for 1, 3, 7, 15, 30, and 60 days, respectively. At each time point, NPA or NPB was randomly sampled for the analysis of chemical composition, fermentation parameter, and microbial number. In addition, the fresh, 3-day, and 60-day NPA and NPB were subjected to high-throughput sequencing and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional prediction analyses. Growth stage obviously affected the phyllosphere microbiota and chemical parameters of P. giganteum. After 60 days of fermentation, NPB had a higher lactic acid concentration and ratio of lactic acid to acetic acid but a lower pH value and ammonia nitrogen concentration than NPA. Weissella and Enterobacter were dominant in 3-day NPA and Weissella was dominant in 3-day NPB, while Lactobacillus was the most abundant genus in both 60-day NPA and NPB. The complexity of bacterial cooccurrence networks in the phyllosphere decreased with P. giganteum growth. The ensiling process further decreased the complexity of bacterial networks, with the simplest bacterial correlation structures in NPB. There were great differences in the KEGG functional profiles of PA and PB. Ensiling promoted the metabolism of lipid, cofactors, vitamins, energy, and amino acids but suppressed the metabolism of carbohydrates and nucleotides. Storage time had a greater influence than growth stage on bacterial community diversity, cooccurrence networks, and functional profiles of P. giganteum silage. Differences in bacterial diversity and functionality of P. giganteum silage caused by growth stage appear to be offset by long-term storage. IMPORTANCE The phyllosphere microbiota consists of various and complex microbes, including bacteria with crucial relevance to the quality and safety of fermented food and feed. It initially derives from soil and becomes specific to its host after interaction with plants and climate. Bacteria associated with the phyllosphere are highly abundant and diverse, but we know little about their succession. Here, the phyllospheric microbiota structure was analyzed within the growth of P. giganteum. We also evaluated the effects of phyllosphere microbiota and chemical parameter changes on the anaerobic fermentation of P. giganteum. We observed remarkable differences in bacterial diversity, cooccurrence, and functionality of P. giganteum at various growth stages and storage times. The obtained results are important for understanding the fermentation mechanism and may contribute to high-efficient production without additional cost.

Design and experiment of a combined peeling machine for water chestnut.

Water chestnut is a characteristic aquatic vegetable in China, and its demand for peeling fresh fruit is increasing rapidly. Aiming at the existing problems of high labor intensity and low efficiency of manual peeling, a combined water chestnut peeling machine was designed, which used a rotary knife to remove bud and root, and a differential friction belts to remove side peel. The performance of the peeling machine was tested with water chestnut from Xiaogan, Hubei Provence. Under the conditions of 200 g feeding mass and 10 r/min rotation speed, the single factor test was carried out with cutting speed as the influencing factor and the cutting rate of bud and root as the evaluation index. The results showed that the cutting rate of fresh fruit of water chestnut bud and root were 79.04% and 83.77% respectively when the cutting speed of rotary knife was 1.2 m/s. In the differential friction belts, high and low linear velocities were taken as the influencing factors, and the side peel removal rate was used as the evaluation index. The side peel removal rate was 84.93% at the high-speed linear velocity of 2.1 m/s and the low-speed linear velocity of 1.58 m/s. The performance of the whole machine was evaluated, and the results showed that the working loss of the combined water chestnut peeling machine was 43.03% and the comprehensive peeling rate was 77.43%, which reached the design requirements. This study can provide a reference for the research and development of water chestnut peeling device.

SARS-CoV-2 proteins monitored by long-range surface plasmon field-enhanced Raman scattering with hybrid bowtie nanoaperture arrays and nanocavities.

The identification of biomacromolecules by using surface-enhanced Raman scattering (SERS) remains a challenge because of the near-field effect of traditional substrates. Long-range surface plasmon resonance (LRSPR) is a special type of surface optical phenomenon that provides higher electromagnetic field enhancement and longer penetration depth than conventional surface plasmon resonance. To break the limit of SERS detection distance and obtain a SERS substrate with increased enhancement ability, a bowtie nanoaperture array was sandwiched between two symmetric dielectric environments. Then, an Au mirror was inserted to form a metal-insulator-metal configuration. Finite-difference time-domain simulations revealed that numerous hybrid modes can be provided by this novel configuration (denoted as long-range SERS [LR-SERS] substrate). In particular, the LRSPR mode can be excited and reach the maximum value through the regulation of the polarizations of the incident light and the geometrical parameters of the LR-SERS substrate. The optimized LR-SERS substrate was then applied to detect SARS-CoV-2 spike (S) and nucleocapsid (N) proteins. This substrate displayed ultralow detection limits of ∼9.2 and ∼11.3 pg mL-1 for the S and N proteins, respectively. Moreover, with the help of principal component analysis and receiver operating characteristic methods, our fabricated sensors exhibited excellent selectivity and hold great potential for the diagnosis of SARS-CoV-2 proteins in real samples.

Study on path planning of mechanized harvesting of ratoon rice in the first season based on the capacitated arc routing problem model.

The stubble crushing caused by the harvester during the first season of ratoon rice harvesting will directly affect the grain yield of the ratoon season. In this work, a harvester path planning method for quadrilateral fields to address the harvester driving path problem of the first season of ratoon rice mechanized harvesting is proposed. This research first analyzes the operational characteristics and requirements of ratoon rice first-season mechanized harvesting, and then models the mechanized harvesting process of ratoon rice in the first season as a capacitated arc routing problem (CARP) considering the fact that the harvester cannot complete the full-coverage harvesting operation at one time due to the limitation of grain bin volume. The genetic algorithm (GA) with strong global search capability is used to solve it, and the selection and variation links of the algorithm are improved. The path planning method proposed in this article can dynamically find the optimal harvester travel route according to the specific conditions of the field and the parameters of harvester implements. The simulation test shows that the CARP method performs better in terms of harvesting path length and crushed area compared to the conventional rectangular detour and foldback reciprocating harvesting paths. The degree of optimization of this method is influenced by various factors such as the width of the cutting table, the turning radius of the harvester, and the size of the grain bin capacity. This research provides a more efficient and flexible path planning method to improve the efficiency of ratoon rice first-season mechanized harvesting operations and optimize the harvester's operating path, which can well meet the operational requirements.

Design and test of smashing and scattering device of double-channel feeding ratoon rice harvester.

Since it is requested that the smashed straw should not be scattered onto the stubble in the first season harvest, a smashing and scattering device matched with the first season harvester of ratoon rice was designed in this paper to smash and scatter the straw into the rolling area. The main structural parameters affecting the straw scattering performance were determined by theoretical analysis of the deflecting performance of the straw deflector. EDEM software was used to simulate and analyze the straw scattering situation under the action of the deflector. Taking the qualified rate of straw scattering as the performance index, the optimal parameter combination of the straw deflector was determined by L27 (313) orthogonal test, and the operating performance of the device was verified by bench test and field comparison test. The test results show that: The optimal parameter combination was 45° between the straw deflector and the vertical direction, 200 mm height difference between straw deflector and outlet, 0° inclination angle of inner deflector and 35° inclination angle of outer deflector. The qualified rate of straw scattering was 72.2% in the corresponding simulation test, 93.6% in the bench test and 95.2% in the field test, which could meet the demand of first season harvest of ratoon rice.

Fast screening of tyrosinase inhibitors from traditional Chinese medicinal plants by ligand fishing in combination with in situ fluorescent assay.

A simple and rapid method for screening of tyrosinase (TYR) inhibitors present in traditional Chinese medicines (TCMs) was developed by combining ligand fishing and the fluorescent enzymatic assay based on dopamine-functionalized carbon quantum dots (CQDs-Dopa). Ligands of the enzyme present in the TCM extractions were firstly adsorbed on the enzyme-modified magnetic beads, and then the beads were magnetically separated and subjected directly to the CQDs-Dopa-based fluorescent assay. Finally, compounds were desorbed from the "active" beads and identified with ultra-performance liquid chromatography-triple quadrupole mass spectrometry. A known natural TYR inhibitor quercetin was selected to assess the feasibility and quantification performance of this method, and good linearity in the range of 0.01-0.16 mM (R2 = 0.992) with a low detection limit of 0.004 mM was obtained. This method was then applied to screen TYR inhibitors present in Scutellaria baicalensis and Sophora flavescens. Six TYR inhibitors including baicalin (1), baicalein (2), wogonin (3), oroxylin A (4), kurarinone (5), and sophoraflavanone G (6) were found, among which 1-4 were firstly discovered in this work. This is the first report on the in situ assessment of the target compounds obtained by ligand fishing in the form of a mixture, which exhibited the combined advantages of specific extraction ability of ligand fishing and the high sensitivity of CQDs-based fluorescent assay, showing great potential for fast screening of enzyme inhibitors from TCMs.

pH regulation of the first phase could enhance the energy recovery from two-phase anaerobic digestion of food waste.

The effect of pH regulation in phase I on hydrolysis and acidogenesis rate, metabolites production, microbial community, and the overall energy recovery efficiency during two-phase anaerobic digestion (AD) of food waste (FW) was investigated. pH strongly affected the acidogenesis rate and the yield of the fermentation products. The highest acidogenesis efficiency (60.4%) and total volatile fatty acids (VFA)/ethanol concentration (12.4 g/L) were obtained at pH 8 during phase I. Microbial community analysis revealed that Clostridium IV was enriched at pH 8, relating to the accumulation of butyrate. Also, Clostridium sensu stricto played a crucial role in hydrogen production and was abundant at pH 6, resulting in the highest hydrogen yield (212.2 ml/g VS). In phase II, the highest cumulative methane yield (412.6 ml/g VS) was obtained at pH 8. By considering the hydrogen and methane production stages, the highest energy yield (22.8 kJ/g VS, corresponding to a 76.4% recovery efficiency) was generated at pH 8, which indicates that pH 8 was optimal for energy recovery during two-phase AD of FW. Overall, the results demonstrated the possibility of increasing the energy recovery from FW by regulating the pH in the hydrolysis/acidogenesis phase based on the two-phase AD system. PRACTITIONER POINTS: pH 8 was suitable for hydrolysis, acidogenesis, and methanogenesis. High hydrogen yields were obtained at pH 5-8 (about 200 ml/d). Clostridium sensu stricto might have played a crucial role in hydrogen production. High methane production (about 400 ml/g VS) was obtained at pH 7-9. pH 8 was optimal for energy recovery from FW with an efficiency of 76.4% (22.8 kJ/g VS).

Superhigh Electromagnetic Interference Shielding of Ultrathin Aligned Pristine Graphene Nanosheets Film.

Ultrathin, lightweight, high-strength, and thermally conductive electromagnetic interference (EMI) shielding materials with high shielding effectiveness (SE) are highly desired for next-generation portable and wearable electronics. Pristine graphene (PG) has a great potential to meet all the above requirements, but the poor processability of PG nanosheets hinders its applications. Here, efficient synthesis of highly aligned laminated PG films and nacre-like PG/polymer composites with a superhigh PG loading up to 90 wt% by a scanning centrifugal casting method is reported. Due to the PG-nanosheets-alignment-induced high electrical conductivity and multiple internal reflections, such films show superhigh EMI SE comparable to the reported best synthetic material, MXene films, at an ultralow thickness. An EMI SE of 93 dB is obtained for the PG film at a thickness of ≈100 µm, and 63 dB is achieved for the PG/polyimide composite film at a thickness of ≈60 µm. Furthermore, such PG-nanosheets-based films show much higher mechanical strength (up to 145 MPa) and thermal conductivity (up to 190 W m-1 K-1 ) than those of their MXene counterparts. These excellent comprehensive properties, along with ease of mass production, pave the way for practical applications of PG nanosheets in EMI shielding.

Second Time-Scale Synthesis of High-Quality Graphite Films by Quenching for Effective Electromagnetic Interference Shielding.

Graphite film has many remarkable properties and intriguing applications from energy storage, electromagnetic interference (EMI) shielding, and thermal management to ultraviolet lithography. However, the existing synthesis methods require an extremely high processing temperature of ∼3000 °C and/or long processing time of typically hours. Here, we report an ultrafast synthesis of tens of nanometer-thick high-quality graphite films within a few seconds by quenching a hot Ni foil in ethanol. The vertical growth rate can reach over 64 nm s-1, which is more than 2 orders of magnitude higher than those of the existing methods. Moreover, the films show excellent electrical conductivity (∼2.6 × 105 S/m) and mechanical strength (∼110 MPa) comparable to or even better than those synthesized by chemical vapor deposition. As an example, we demonstrate the potential of these graphite films for effective EMI shielding, which show a record absolute shielding effectiveness of 481,000 dB cm2 g-1, outperforming all the reported synthetic materials.

An integrated strategy for ascertaining quality marker of Schisandra chinensis (Turcz.) Baill based on correlation analysis between depression-related monoaminergic metabolites and chemical components profiling.

Traditional Chinese Medicines (TCMs) have been widely used in orient countries for thousands of years, while their inconsistent quality and therapy issues have become increasingly serious as a result of the absence of effective methods for quality control. Therefore, it is necessary to develop a novel and specific evaluation system for TCMs' quality involved with not only composition but also bioactivity. In this study, we used Schisandra chinensis (Turcz.) Baill as an example and developed a novel integrated approach involved with various chemical analysis and data processing methods to explore its quality marker (Q-marker) underlying its anti-depressive effects. First, six bioactive lignans were identified and semi-quantified in rat brain samples via high resolution mass spectrometry. Then, the bioinformation analysis showed that all the six bioactive components could modulate various diseases relative to noradrenergic, dopaminergic and serotonergic pathways. Thus, the monoaminergic metabolites contained in these three pathways were selected to screen potential biomarkers of depression treated by S. chinensis based on target metabolomics using a rapid HPLC-MS/MS method. Finally, the correlation analysis between the six components and potential biomarkers was employed to uncover the Q-markers of S. chinensis. It is suggested that schisandrol A, schisandrin A, schisandrin C and gomisin N could be determined as Q-markers for S. chinensis. Thus, the integrated approach describing here for discovering Q-markers was expected to offer an alternative quality assessment strategy of herbal medicines for the first time.

Role of P2X7R in the development and progression of pulmonary hypertension.

BACKGROUND: Pulmonary arterial hypertension (PAH) is a devastating disease that lacks sufficient treatment. Studies have shown that the Nod-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome contributes to PAH pathogenesis, but the role of the upstream molecular P2X7 receptor (P2X7R) has remained unexplored. We investigated the role of P2X7R in the pathogenesis of PAH. METHODS AND RESULTS: PH was induced by a single subcutaneous injection of monocrotaline (MCT) (60 mg/kg) on left pneumonectomised Sprague-Dawley rats, as validated by significant increases in pulmonary artery pressure and vessel wall thickness. Marked P2X7R was detected by predominant PA immunostaining in lungs from PH rats. Western blot revealed a significant increase in the protein levels of P2X7R as well as NLRP3 and caspase-1 in the diseased lung tissue compared with normal tissue. The rats received A-740003 (a selective P2X7 receptor antagonist, 30 mg/kg) daily starting from 1 week before or 2 weeks after MCT injection. Consequently, A-740003 reversed the NLRP3 inflammasome upregulation, significantly decreased the mean right ventricular (RV) pressure and RV hypertrophy, and reversed pulmonary arterial remodelling 4 weeks after MCT injection, as both a pretreatment and rescue intervention. Notably, A-740003 significantly reduced macrophage and pro-inflammatory cytokine levels, as measured via bronchoalveolar lavage. The recruitment of macrophages as well as collagen fibre deposition in the perivascular areas were also reduced, as confirmed by histological staining. CONCLUSIONS: P2X7R contributes to the pathogenesis of PH, probably in association with activation of the NLRP3 inflammasome. Blockade of P2X7R might be applied as a novel therapeutic approach for the treatment of PAH.