Quantifying Imaging Agent Binding and Dissociation in 3-D Cancer Spheroid Tissue Culture Using Paired-Agent Principles.

Binding kinetics play an important role in cancer diagnosis and therapeutics. However, current methods of quantifying binding kinetics fail to consider the three-dimensional environment that drugs and imaging agents experience in biological tissue. In response, a methodology to assay agent binding and dissociation in 3-D tissue culture was developed using paired-agent molecular imaging principles. To test the methodology, the uptakes of ABY-029 (an IRDye 800CW-labeled epidermal growth factor receptor (EGFR)-targeted antibody mimetic) and IRDye-700DX carboxylate in 3-D spheroids were measured in four different human cancer cell lines throughout staining and rinsing. A compartment model (optimized for the application) was then fit to the kinetic curves of both imaging agents to estimate binding and dissociation rate constants of the EGFR-targeted ABY-029 agent. A statistically significant correlation was observed between apparent association rate constant (k3) and the receptor concentration experimentally and in simulations (r = 0.99, p < 0.05). A statistically significant difference was found between effective k3 (apparent rate constant of ABY-029 binding to EGFR) values for cell lines with varying levels of EGFR expression (p < 0.05), with no significant difference found between cell lines and controls for other fit parameters. Additionally, a similar binding affinity profile compared to a gold standard method was determined by this model. This low-cost methodology to quantify imaging agent or drug binding affinity in clinically relevant 3-D tumor spheroid models can be used to guide timing of imaging in molecular guided surgery and could have implications in drug development.

Effects of medical consortium policy on health services: an interrupted time-series analysis in Sanming, China.

Objectives: China has implemented reforms to enhance the operational efficiency of three-level medical services through medical consortiums (MCs). This study evaluated the impact of MCs reform on health services in Sanming, China. Methods: An interrupted time-series analysis (ITSA) was conducted to assess the impact of MCs on changes in health service levels and trends across the overall situation of MCs and different institutional types within MCs, including county hospitals and grassroots medical institutions. The evaluation focused on various indicators such as outpatient and emergency visits, inpatients, average length of stay, occupancy rate of hospital beds, and hospital bed turnover times. Monthly data were collected from April 2015 to June 2019 through reports on the Sanming Municipal Health Commission website and the Sanming public hospital management monitoring platform. Results: After the intervention of MCs reform, a significant increase was observed in the total number of inpatients (ß3 = 174.28, p < 0.05). However, no statistically significant change was observed in the total number of outpatient and emergency visits (ß3 = 155.82, p = 0.91). Additionally, the implementation of MCs reform led to an amplification in service volumes provided by county hospitals, with significant increases in the number of outpatient and emergency visits (ß3 = 1376.54, p < 0.05) and an upward trend in the number of inpatients (ß3 = 98.87, p < 0.01). However, no significant changes were observed under the MCs policy for grassroots medical institutions regarding the number of outpatient and emergency visits (ß3 = -1220.72, p = 0.22) and number of inpatients (ß3 = 75.42, p = 0.09). Conclusion: The Sanming MCs reform has achieved some progress in augmenting service volumes. Nevertheless, it has not led to an increase in service volumes at the grassroots medical institutions. There persists an insufficiency in the efficiency of services and a need for further improvement in primary healthcare. To address these concerns, it is imperative for county hospitals to offer targeted assistance that can enhance motivation among grassroots medical institutions. Besides the MCs should explore initiatives, including improved management of medical equipment, allocation of funding, and personnel resources.

Secular trends and urban-rural disparities in height of Chinese adolescents aged 18 years from 1985 to 2019.

OBJECTIVES: To examine the secular trends and urban-rural disparities in height of Chinese adolescents aged 18 years from 1985 to 2019. METHODS: Data were extracted from the Chinese National Surveys on Students' Constitution and Health from 1985 to 2019, and the heights of a total of 76 554 boys and 75 908 girls aged 18 years were measured. The Mann-Kendall trend test was used to analyze the secular trends in height. Changes in different periods and urban-rural disparities were tested by z-tests and calculating the ratios of the coefficient of variation (CV) of height. RESULTS: The height of Chinese boys and girls aged 18 years increased from 168.21 and 157.10 cm in 1985 to 172.15 cm and 160.11 cm in 2019, respectively, with a larger increase in rural areas. The secular trends in height were the largest for boys from 1995 to 2005 and for girls from 2014 to 2019, and the same results were observed in urban and rural areas. The urban-rural disparities for boys and girls decreased by 1.79 and 0.91 cm, respectively, with significant decreases for boys in all regions and for girls in the eastern region. The overall CVs of height increased by 0.13% and 0.25% for boys and girls, respectively, with the largest increase among rural girls. CONCLUSIONS: The height of Chinese adolescents aged 18 years continued to increase between 1985 and 2019. The urban-rural disparities narrowed, and inequalities within rural areas for girls increased.

A cadaveric breast cancer tissue phantom for phase-contrast X-ray imaging applications.

BACKGROUND: As mammography X-ray imaging technologies advance and provide elevated contrast in soft tissues, a need has developed for reliable imaging phantoms for use in system design and component calibration. In advanced imaging modalities such as refraction-based methods, it is critical that developed phantoms capture the biological details seen in clinical precancerous and cancerous cases while minimizing artifacts that may be caused due to phantom production. This work presents the fabrication of a breast tissue imaging phantom from cadaveric breast tissue suitable for use in both transmission and refraction-enhanced imaging systems. METHODS: Human cancer cell tumors were grown orthotopically in nude athymic mice and implanted into the fixed tissue while maintaining the native tumor/adipose tissue interface. RESULTS: The resulting human-murine tissue hybrid phantom was mounted on a clear acrylic housing for absorption and refraction X-ray imaging. Digital breast tomosynthesis was also performed. CONCLUSION: Both attenuation-based imaging and refraction-based imaging of the phantom are presented to confirm the suitability of this phantom's use in both imaging modalities.

Unintended consequences: Disrupting microbial communities of Nilaparvata lugens with non-target pesticides.

Insects are frequently exposed to a range of insecticides that can alter the structure of the commensal microbiome. However, the effects of exposure to non-target pesticides (including non-target insecticides and fungicides) on insect pest microbiomes are still unclear. In the present study, we exposed Nilaparvata lugens to three target insecticides (nitenpyram, pymetrozine, and avermectin), a non-target insecticide (chlorantraniliprole), and two fungicides (propiconazole and tebuconazole), and observed changes in the microbiome's structure and function. Our results showed that both non-target insecticide and fungicides can disrupt the microbiome's structure. Specifically, symbiotic bacteria of N. lugens were more sensitive to non-target insecticide compared to target insecticide, while the symbiotic fungi were more sensitive to fungicides. We also found that the microbiome in the field strain was more stable under pesticides exposure than the laboratory strain (a susceptible strain), and core microbial species g_Pseudomonas, s_Acinetobacter soli, g_Lactobacillus, s_Metarhizium minus, and s_Penicillium citrinum were significantly affected by specifically pesticides. Furthermore, the functions of symbiotic bacteria in nutrient synthesis were predicted to be significantly reduced by non-target insecticide. Our findings contribute to a better understanding of the impact of non-target pesticides on insect microbial communities and highlight the need for scientific and rational use of pesticides.

Redox and Near-Infrared Light-Responsive Nanoplatform for Enhanced Pesticide Delivery and Pest Control in Rice: Construction, Efficacy, and Potential Mechanisms.

The brown planthopper, Nilaparvata lugens (Stål), is a major rice pest in various Asian countries, causing significant negative impacts on rice yield and quality. In this study, we developed a novel nanoplatform (NIT@MON@CuS) for pesticide delivery that responds to redox and near-infrared light stimuli. The nanoplatform consisted of CuS nanoparticles with mesoporous organic silica (MON), loaded with nitenpyram (NIT). With an average size of 190 nm and a loading efficiency of 22%, NIT@MON@CuS exhibited remarkable thermal response in the near-infrared region, demonstrating excellent photothermal conversion ability and stability. In vitro release kinetics demonstrated the rapid release of nitenpyram under near-infrared light and glutathione conditions, facilitating a satisfactory temperature increase and accelerated drug release. The NIT@MON@CuS-treated group exhibited a higher mortality of N. lugens, increasing from 62 to 88% compared to the group treated with nitenpyram technical after 96 h. Bioassay revealed that NIT@MON@CuS significantly enhanced nitenpyram toxicity by more than 1.4-fold against both laboratory insecticide-resistant and field strains of N. lugens. Furthermore, RT-qPCR results demonstrated that MON@CuS had the capability to reduce P450 gene expression, thereby improving the sensitivity of N. lugens to insecticides. These findings suggest that MON@CuS holds great potential as an intelligent pest control platform, offering a sustainable and efficient approach to protect crops against pests.

Effects of High Pharmaceutical Concentrations in Domestic Wastewater on Membrane Bioreactor Treatment Systems: Performance and Microbial Community.

Despite pharmaceuticals being widely detected in water-bodies worldwide, what remain unclear are the effects of high pharmaceutical concentrations on the treatment efficiency of biological wastewater treatment processes, such as membrane bioreactor (MBR) systems. This study investigated the efficiency of MBR technology in the treatment of synthetic wastewater containing a mixture of five typical pharmaceuticals (ofloxacin, sulfamethoxazole, sulfamethylthiadiazole, carbamazepine and naproxen) with a total concentration of 500 µg/L. Both the control MBR (MBRc) without pharmaceutical dosing and the MBR operated with high influent pharmaceutical concentrations (MBRe) were operated under room temperature with the same hydraulic retention time of 11 h and the same sludge retention time of 30 d. The removal efficiency rates of total nitrogen and total phosphorus were 83.2% vs. 90.1% and 72.6% vs. 57.8% in the MBRc vs. MBRe systems, and both MBRs achieved >98% removal of organics for a 180-day period. The floc size decreased, and membrane fouling became more severe in the MBRe system. Microbial diversity increased in the MBRe system and the relative abundances of functional microbe differed between the two MBRs. Furthermore, the total relative abundances of genes involved in glycolysis, assimilating nitrate reduction and nitrification processes increased in the MBRe system, which could account for the higher organics and nitrogen removal performance. This work provides insights for MBR operation in wastewater treatment with high pharmaceutical concentrations.

Secular trends and spatial network effect on the height of Chinese adult adolescents from 1985 to 2019.

OBJECTIVES: To understand the distribution and secular trends of Chinese adult boys and girls and investigate their spatial network effects and determinants of spatial network effects. METHODS: Our study extracted data of 18-year-old boys and 17-year-old girls in China from the national students fitness and health survey reports in 1985, 2000, 2010, and 2019. A total of 89 839 participants were selected. The growth range and growth rate in each period were calculated. A neighborhood relationship network was created to share the common boundary. RESULTS: During the period 1985-2019, the average height of Chinese 18-year-old boys increased from 168.19 to 172.14 cm, and that of 17-year-old girls increased from 156.97 to 160.17 cm (all p trend <.05). Both boys and girls showed significant correlations in first- and second-level neighbors (all p < .05) with the most significant correlations in first-level neighbors (all p < .001). But there were no significant correlations in third-level neighbors. Height of girls and boys in each region was correlated with gross domestic product (GDP) per capita, urbanization rate, population density, longitude, and latitude. After controlling for factors with significance, only the initial regional height of girls in 2000 was positively correlated with first level neighborhood (p < .05). CONCLUSION: Since 1985, the heights of Chinese boys aged 18 and girls aged 17 have been increasing and the increases accelerated. Height is related to nearer neighbors. After controlling GDP per capita, urbanization rate, population density, longitude and latitude, the correlations has almost disappeared.

Integrated metabolome and transcriptome analyses provide insight into the effect of red and blue LEDs on the quality of sweet potato leaves.

Red and blue light-emitting diodes (LEDs) affect the quality of sweet potato leaves and their nutritional profile. Vines cultivated under blue LEDs had higher soluble protein contents, total phenolic compounds, flavonoids, and total antioxidant activity. Conversely, chlorophyll, soluble sugar, protein, and vitamin C contents were higher in leaves grown under red LEDs. Red and blue light increased the accumulation of 77 and 18 metabolites, respectively. Alpha-linoleic and linolenic acid metabolism were the most significantly enriched pathways based on Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. A total of 615 genes were differentially expressed between sweet potato leaves exposed to red and blue LEDs. Among these, 510 differentially expressed genes were upregulated in leaves grown under blue light compared with those grown under red light, while the remaining 105 genes were expressed at higher levels in the latter than in the former. Among the KEGG enrichment pathways, blue light significantly induced anthocyanin and carotenoid biosynthesis structural genes. This study provides a scientific reference basis for using light to alter metabolites to improve the quality of edible sweet potato leaves.

Quantifying imaging agent binding and dissociation in 3D cancer spheroid tissue culture using paired-agent principles.

Binding kinetics play an important role in cancer diagnosis and therapeutics. However, current methods of quantifying binding kinetics fail to consider the three-dimensional environment that drugs and imaging agents experience in biological tissue. In response, a methodology to assay agent binding and dissociation in 3D tissue culture was developed using paired-agent molecular imaging principles. To test the methodology, the uptakes of ABY-029 (an IRDye 800CW-labeled epidermal growth factor receptor (EGFR)-targeted antibody-mimetic) and IRDye 700DX-carboxylate in 3D spheroids were measured in four different human cancer cell lines throughout staining and rinsing. A compartment model (optimized for the application) was then fit to the kinetic curves of both imaging agents to estimate binding and dissociation rate constants of the EGFR targeted ABY-029 agent. A linear correlation was observed between apparent association rate constant (k3) and the receptor concentration experimentally and in simulations (r=0.99, p<0.05). Additionally, a similar binding affinity profile compared to a gold standard method was determined by this model. This low-cost methodology to quantify imaging agent or drug binding affinity in clinically relevant 3D tumor spheroid models, can be used to guide timing of imaging in molecular guided surgery and could have implications in drug development.

Secular trends and sociodemographic determinants of thinness, overweight and obesity among Chinese children and adolescents aged 7-18 years from 2010 to 2018.

Background: Most studies have focused on overweight/obesity and its secular trend, with insufficient studies on the factors influencing thinness and trends recently. To examine the trends of prevalence and sociodemographic determinants of thinness, overweight, and obesity among Chinese children and adolescents aged 7 to 18 years from 2010 to 2018. Methods: This study was based on cross-sectional data of 11,234 children and adolescents aged 7 to 18 years from the Chinese Family Panel Studies (CFPS) in 2010, 2014, and 2018, including anthropometric and sociodemographic characteristics variables. The nutritional status of each individual was determined according to China and WHO criteria. The demographic characteristics of different subgroups were tested by chi-square, and log-binomial regression was used to analyze the trend of prevalence and the relationship between sociodemographic characteristics and different nutritional statuses. Results: After adjusting for age, from 2010 to 2018, the overall prevalence of thinness decreased, and the prevalence of overweight increased in Chinese children and adolescents. The overall prevalence of obesity declined in boys and increased in girls, but in adolescents aged 16-18 years, it increased significantly. Log-binomial regression analysis showed that among all subjects, time (years), 16-18 years were negatively associated with thinness, while 13-15 years, walking to school, large family size, and paternal age at childbirth older than 30 years old were positively associated with thinness; 10-12/13-15/16-18 years, boarding at school, medium and large family sizes, and mother's education at junior middle school/junior high school and above were negatively associated with overweight/obesity, while time (years), boys were positively associated with overweight/obesity in the multivariate model by adjusting for the statistically significant factors (all p < 0.05). Conclusion: Chinese children and adolescents are facing a double burden of malnutrition. Future public health policies and interventions should prioritize high-risk groups specifically young age groups, boys, larger family sizes and so on.

The insecticidal activity and mechanism of tebuconazole on Nilaparvata lugens (Stål).

BACKGROUND: Previous studies have shown that fungicides have insecticidal activity that can potentially be used as an insecticide resistance management strategy in the brown planthopper Nilaparvata lugens (Stål). However, the mechanism that induces mortality of N. lugens remains elusive. RESULTS: In the present study, the insecticidal activities of 14 fungicides against N. lugens were determined, of which tebuconazole had the highest insecticidal activity compared with the other fungicides. Furthermore, tebuconazole significantly inhibited the expression of the chitin synthase gene NlCHS1; the chitinase genes NlCht1, NlCht5, NlCht7, NlCht9, and NlCht10; and the ß-N-acetylhexosaminidase genes NlHex3, NlHex4, NlHex5 and NlHex6; it significantly suppressed the expression of ecdysteroid biosynthetic genes as well, including SDR, CYP307A2, CYP307B1, CYP306A2, CYP302A1, CYP315A1 and CYP314A1 of N. lugens. Additionally, tebuconazole affected the diversity, structure, composition, and function of the symbiotic fungi of N. lugens, as well as the relative abundance of saprophytes and pathogens, suggesting that tebuconazole reshapes the diversity and function of symbiotic fungi of N. lugens. CONCLUSION: Our findings illustrate the insecticidal mechanism of tebuconazole, possibly by inhibiting normal molting or disrupting microbial homeostasis in N. lugens, and provide an important rationale for developing novel insect management strategies to delay escalating insecticide resistance. © 2023 Society of Chemical Industry.

Secular trends in physical fitness of rural Chinese children and adolescents aged 7-18 years from 1985 to 2019.

The main purpose of the study was to evaluate the secular trends in physical fitness of Chinese rural children and adolescents aged 7-18 from 1985 to 2019. The speed, muscular strength, explosive power fitness, cardiorespiratory fitness, and flexibility were investigated by National Survey on Students' Constitution and Health in 1985, 2000, 2010 and 2019. During the period 1985-2000, the physical fitness of Chinese rural children and adolescents improved except for flexibility, and almost all of them reached the maximum increase rate. During the period 2000-2010, in addition to the improvement of flexibility, other fitness showed downward trends, and the decline ranges were large. During the period 2010-2019, the speed of boys rebounded, flexibility, explosive power and muscular strength continued to decrease. Meanwhile, speed, flexibility and muscular strength in girls rebounded, and the explosive power continued to decline. From 2000 to 2019, the body mass index increase accelerated. This study shows that some components of physical fitness of Chinese rural children and adolescents have shown positive trends in recent years, especially for girls and adolescents aged 13-15 years. However, it may also imply inequality between sexes and ages, which provides a reference for the focus of the country's physical fitness and health monitoring and intervention measures.

Weighted Gene Co-Expression Network Analysis to Explore Hub Genes of Resveratrol Biosynthesis in Exocarp and Mesocarp of 'Summer Black' Grape.

Resveratrol is a polyphenol compound beneficial to human health, and its main source is grapes. In the present study, the molecular regulation of resveratrol biosynthesis in developing grape berries was investigated using weighted gene co-expression network analysis (WGCNA). At the same time, the reason for the resveratrol content difference between grape exocarp (skin) and mesocarp (flesh) was explored. Hub genes (CHS, STS, F3'5'H, PAL, HCT) related to resveratrol biosynthesis were screened with Cytoscape software. The expression level of hub genes in the exocarp was significantly higher than that in the mesocarp, and the expressions of the hub genes and the content of resveratrol in exocarp peaked at the maturity stage. While the expression levels of PAL, CHS and STS in the mesocarp, reached the maximum at the maturity stage, and F3'5'H and HCT decreased. These hub genes likely play a key role in resveratrol biosynthesis. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis further indicated that resveratrol biosynthesis was related to flavonoid biosynthesis, phenylalanine metabolism, phenylpropanoid biosynthesis, and stilbene biosynthesis pathways. This study has theoretical significance for exploring genes related to resveratrol biosynthesis in the exocarp and mesocarp of grapes, and provides a theoretical basis for the subsequent function and regulatory mechanism of hub genes.

Effectiveness of an integrative programme in reducing hypertension incidence among the population at risk for hypertension: A community-based randomized intervention study in Shanghai, China.

Background: We aimed to evaluate the effectiveness of a community-based integrative programme in reducing hypertension incidence among populations at high risk for hypertension in Shanghai, Eastern China. Methods: We conducted a cluster-randomized intervention trial with a total of 607 participants (intervention, n = 303; control, n = 304) between October 2019 and October 2020. A total of 605 participants (intervention, n = 302; control, n = 303) completed the follow-up survey. The intervention group received an integrative programme that included health education, physician follow-up, and self-management, while the control group received usual care only. We used questionnaires to investigate risk factors, knowledge, attitudes, and behaviours regarding hypertension prevention for all participants at baseline and follow-up. We measured the incidence of hypertension according to the predefined protocol based on the national definition during the four follow-ups (only applicable to the intervention group) and the physical examination at the end of the intervention/programme/study. The difference-in-difference (DID) effects of the intervention were estimated using Generalized Estimating Equations. Results: There were no significant differences in age group, gender, and educational level between intervention and control groups at baseline. The integrative programme reduced the incidence of hypertension in the intervention group compared to the control group (odds ratio (OR) = 0.27, 95% confidence interval (CI) = 0.12-0.61). The DID analysis found that the one-year intervention has improved the level of hypertension-related knowledge and attitudes regarding diagnostic criteria, complications of hypertension, and lifestyle modification (P < 0.05). The intervention was also associated with a 3.7% increase in the behaviour change rate of "not smoking" (OR = 2.50, 95% CI = 1.45-4.30) and a 34.8% increase in the rate of "monitoring blood pressure regularly" (OR = 29.61, 95% CI = 13.02-67.35). Conclusions: The integrative programme could reduce the risk for hypertension and improve the level of hypertension-related knowledge and attitudes, affecting the formation of healthy behaviours in high-risk populations. The community-based management for high-risk groups should be scaled up and incorporated into national hypertension control programmes, which may potentially reduce the substantial burden of hypertension and cardiovascular disease in China. Registration: ISRCTN registration number: ISRCTN74154693.

The evolution of mental health related policies in China: A bibliometric analysis, 1987-2020.

Background: Since 1987, the Chinese government has promoted public mental health by continuously implementing mental health related policies. This research attempts to reveal the distribution and characteristics of mental health related policies. In addition, it can help stakeholders evaluate whether the environment for policy implementation has improved and identify key points in the development of the overall mental health system. Methods: We used a bibliometric approach to analyze the evolution of mental health related policies in China from 1987 to 2020. A total of 239 mental health related policies were collected from Beida Fabao and official Internet websites of governmental departments. Co-wording, social networks, and citation analysis were applied to explore the evolutionary features of such policies. Results: The evolution of policy development showed that the number of mental health related policies in China has been increasing and their content has been enriched. Over time, mental health related policies not only gradually expanded its focus on common mental disorders, but also included an increasing number of keywords related to service provision, organization and administration. However, most policies were implemented independently by separate agencies and the number of policies jointly implemented by different agencies only accounted for 32.64% of all the policies implemented. The Ministry of Health (MOH) is at the core of the collaborative network associated with implementing mental health related policies in China. Conclusion: The environment associated with the implementation of mental health related policies in China is gradually improving. However, cross-sector collaboration among different agencies needs to be strengthened and financial support for related resources needs more attention. A clear division of responsibilities among various agencies and a sustainable financing mechanism are essential to the development and implementation of mental health related policies.

Risk prediction model of polypharmacy for community-dwelling elderly patients: An assessment tool for early detection.

Background: Polypharmacy has become a major and growing public health issue, with significant implications for health outcomes and expenditure on healthcare resources. In this study, a risk prediction model of polypharmacy represented by a nomogram for community-dwelling elderly patients based on the Chinese population was constructed. Methods: A cross-sectional study was conducted in Shanghai, China. The variables data affecting polypharmacy were fetched from the information system database of health government departments in Shanghai. The Least Absolute Shrinkage Selection Operator (LASSO) regression analysis was used to select the predictor variables, and multivariate logistic regression was used to establish the prediction model. A visual tool of the nomogram was established for predicting the risk of polypharmacy in the elderly population. In addition, the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to estimate the performance of the model. Results: A total of 80,012 elderly patients were included in this study. Eight variables, containing age, residential area, preferred medical institutions, number of visits to tertiary hospitals, number of visits to secondary hospitals, number of visits to community health centers, number of diagnoses, and main types of disease, were included in the risk prediction model of nomogram. The area under the curve (AUC) of the nomogram was 0.782 in both sets, demonstrating that the model has a good discriminant ability. The calibration chart shows that the prediction model fits well with the validation set. DCA results displayed that the threshold probabilities of the two sets in the prediction model reached up to 90%, implying that the model had a preferable application value. Conclusion: This study explored the risk factors for polypharmacy among the elderly in Shanghai, China, and applied the nomogram to establish a predictive model via eight variables, which provided an effective tool for early screening and timely prevention of polypharmacy. Family physicians or pharmacists could scientifically use the tool to closely observe community-dwelling elderly patients, decreasing the adverse health effects caused by medication for the elderly.

Health Status and Individual Care Needs of Disabled Elderly at Home in Different Types of Care.

For the disabled, paying attention to their health status is the starting point to discovering their survival problems, while meeting their care needs is the end point to solving their survival problems. As the country with the largest number of disabled elderly in the world, how to ensure this group could obtain appropriate home care is a major public health issue facing China. Thus, we conducted a cross-sectional study from October to December 2020 to explore the basic characteristics and health status of disabled elderly in different types of care who are living at home in 37 streets in Shanghai, as well as the individual care needs and its relevance. We observed the significant differences in the number of diagnoses (p = 0.03), smoking (p = 0.009), drinking (p = 0.016), exercise (p = 0.001), activity of daily living (p < 0.0001), and the quality of life (p < 0.0001) across care types. The care needs of the disabled elderly are diversified, of which a vast majority of them have not been fully guaranteed. The urgent need for improving the identification accuracy of care needs of disabled elderly, as well as the development of elaborate and personalized care programs for them, is needed.

In-Situ Sludge Reduction Performance and Mechanism in Sulfidogenic Anoxic-Oxic-Anoxic Membrane Bioreactors.

The excess sludge generated from the activated sludge process remains a big issue. Sustainable approaches that achieve in situ sludge reduction with satisfactory effluent quality deserve attention. This study explored the sludge reduction performance of sulfidogenic anoxic-oxic-anoxic (AOA) membrane bioreactors. The dynamics of the microbial community and metabolic pathways were further analyzed to elucidate the internal mechanism of sludge reduction. Compared with the conventional anoxic-oxic-oxic membrane bioreactor (MBRcontrol), AOAS150 (150 mg/L SO42- in the membrane tank) and AOAS300 (300 mg/L SO42- in the membrane tank) reduced biomass production by 40.39% and 47.45%, respectively. The sulfide reduced from sulfate could enhance the sludge decay rate and decrease sludge production. Extracellular polymeric substances (EPSs) destruction and aerobic lysis contributed to sludge reduction in AOA bioreactors. The relative abundance of Bacteroidetes (phylum), sulfate-reducing bacteria (SRB, genus), and Ignavibacterium (genus) increased in AOA bioreactors compared with MBRcontrol. Our metagenomic analysis indicated that the total enzyme-encoding genes involved in glycolysis, denitrification, and sulfate-reduction processes decreased over time in AOAS300 and were lower in AOAS300 than AOAS150 at the final stage of operation. The excess accumulation of sulfide in AOAS300 may inactive the functional bacteria, and sulfide inhibition induced sludge reduction.

Rational medication management mode and its implementation effect for the elderly with multimorbidity: A prospective cohort study in China.

Background: As one of the countries with the most serious degree of aging, the incidence of potentially inappropriate drug use among the elderly is as high as 30. 4% in Chinese communities, and the lack of effective medication management and poor medication compliance at home are the main factors. Given these situations, we constructed a Rational Medication Management Mode based on family physician service, carried out an empirical research and evaluated the implementation effect. Methods: A prospective cohort study was conducted from September to December 2021 to analyze the implementation effect of the Rational Medication Management Mode by comparing the outcome indicators between the intervention group and control group. The primary outcome of this study was medication number and polypharmacy (taking 5 or more medications) at 90 days. The secondary outcomes included the situation for behavioral self-management and knowledge-belief-behavior of rational medication use. Results: A total of 618 elderly patients (309 in the intervention group and 309 in the control group) with multimorbidity were included in this study, those were all available at follow-up at 90 days. At 90 days, the number of medications was achieved by 3.88 (1.48), and patients with polypharmacy were reduced by 59.55% in the intervention group, having a significant difference compared with the control group (P < 0.001). Patients with medication reminders, intermittent medication and adverse drug reactions were achieved in 294 (95.15%), 47 (15.21%), and 51 (16.51%) respectively in the intervention group (P < 0.001). The knowledge, belief, behavior security and behavior compliance of rational medication use of elderly patients were all greatly improved in the intervention group at 90 days (P < 0.0001). Conclusion: The Rational Medication Management Mode based family physician service, which provides the support of manuals and pillboxes, can decrease the elderly patients' number of drugs with multimorbidity, reduce the incidence of polypharmacy, enhance behavioral self-management, increase the knowledge and belief of rational medication use, and improve the security and compliance of medication usage behavior. In order to provide a practical basis for rational medication management of elderly patients with multimorbidity under the background of long-term prescriptions in China.