Long-term survivals of immune checkpoint inhibitors as neoadjuvant and adjuvant therapy in dMMR/MSI-H colorectal and gastric cancers.

BACKGROUND: The long-term survival benefit of immune checkpoint inhibitors (ICIs) in neoadjuvant and adjuvant settings is unclear for colorectal cancers (CRC) and gastric cancers (GC) with deficiency of mismatch repair (dMMR) or microsatellite instability-high (MSI-H). METHODS: This retrospective study enrolled patients with dMMR/MSI-H CRC and GC who received at least one dose of neoadjuvant ICIs (neoadjuvant cohort, NAC) or adjuvant ICIs (adjuvant cohort, AC) at 17 centers in China. Patients with stage IV disease were also eligible if all tumor lesions were radically resectable. RESULTS: In NAC (n = 124), objective response rates were 75.7% and 55.4%, respectively, in CRC and GC, and pathological complete response rates were 73.4% and 47.7%, respectively. The 3-year disease-free survival (DFS) and overall survival (OS) rates were 96% (95%CI 90-100%) and 100% for CRC (median follow-up [mFU] 29.4 months), respectively, and were 84% (72-96%) and 93% (85-100%) for GC (mFU 33.0 months), respectively. In AC (n = 48), the 3-year DFS and OS rates were 94% (84-100%) and 100% for CRC (mFU 35.5 months), respectively, and were 92% (82-100%) and 96% (88-100%) for GC (mFU 40.4 months), respectively. Among the seven patients with distant relapse, four received dual blockade of PD1 and CTLA4 combined with or without chemo- and targeted drugs, with three partial response and one progressive disease. CONCLUSION: With a relatively long follow-up, this study demonstrated that neoadjuvant and adjuvant ICIs might be both associated with promising DFS and OS in dMMR/MSI-H CRC and GC, which should be confirmed in further randomized clinical trials.

Research progress in the development of 3D skin models and their application to in vitro skin irritation testing.

Toxicological assessment of chemicals is crucial for safeguarding human health and the environment. However, traditional animal experiments are associated with ethical, technical, and predictive limitations in assessing the toxicity of chemicals to the skin. With the recent development of bioengineering and tissue engineering, three-dimensional (3D) skin models have been commonly used as an alternative for toxicological studies. The skin consists of the subcutaneous, dermis, and epidermis. All these layers have crucial functions such as physical and biological protection and thermoregulation. The epidermis is the shallowest layer protecting against external substances and media. Because the skin is the first contact point for many substances, this organ is very significant for assessing local toxicity following skin exposure. According to the classification of the United Nations Global Harmonized System, skin irritation is a major potentially hazardous characteristic of chemicals, and this characteristic must be accurately assessed and classified for enhancing chemical safety management and preventing and reducing chemical accidents. This review discusses the research progress of 3D skin models and introduces their application in assessing chemical skin irritation.

Combined use of Donepezil and Memantine increases the probability of five-year survival of Alzheimer's disease patients.

BACKGROUND: Alzheimer's disease (AD) is the most common neurodegenerative disease. Studying the effects of drug treatments on multiple health outcomes related to AD could be beneficial in demonstrating which drugs reduce the disease burden and increase survival. METHODS: We conducted a comprehensive causal inference study implementing doubly robust estimators and using one of the largest high-quality medical databases, the Oracle Electronic Health Records (EHR) Real-World Data. Our work was focused on the estimation of the effects of the two common Alzheimer's disease drugs, Donepezil and Memantine, and their combined use on the five-year survival since initial diagnosis of AD patients. Also, we formally tested for the presence of interaction between these drugs. RESULTS: Here, we show that the combined use of Donepezil and Memantine significantly elevates the probability of five-year survival. In particular, their combined use increases the probability of five-year survival by 0.050 (0.021, 0.078) (6.4%), 0.049 (0.012, 0.085), (6.3%), 0.065 (0.035, 0.095) (8.3%) compared to no drug treatment, the Memantine monotherapy, and the Donepezil monotherapy respectively. We also identify a significant beneficial additive drug-drug interaction effect between Donepezil and Memantine of 0.064 (0.030, 0.098). CONCLUSIONS: Based on our findings, adopting combined treatment of Memantine and Donepezil could extend the lives of approximately 303,000 people with AD living in the USA to be beyond five-years from diagnosis. If these patients instead have no drug treatment, Memantine monotherapy or Donepezil monotherapy they would be expected to die within five years.

Alzheimer's disease is the most common type of dementia, affecting millions of people worldwide. In this study, we investigated the effects of two drugs commonly prescribed to people with Alzheimer's disease called Donepezil and Memantine to see whether they had an impact on when people died. We found that the combined use of Donepezil and Memantine significantly increased the probability of a person surviving five years compared to no drug treatment or treatment with Donepezil or Memantine alone. Our results suggest that the lives of many Alzheimer's patients in the USA who are currently on no drug treatment or just Donepezil or Memantine could be extended if they were treated with both drugs simultaneously.

Preparation of a (Ca,Sr,Ba)ZrO3 Crucible by Slip Casting for the Vacuum Induction Melting of NiTi Alloy.

Vacuum induction melting is a more energy-efficient process for the preparation of a titanium alloy with good homogeneity and low cost. But the crucial problem for this technology is in developing a crucible refractory with high stability. In the present work, a novel (Ca,Sr,Ba)ZrO3 crucible was prepared by slip casting and its performance in melting NiTi alloy was studied. The results showed that a single solid solution was formed with a homogeneous distribution of metal elements after sintering at 1500 °C. It was found that the total content of oxygen and nitrogen remaining in the TiNi alloy after melting in the (Ca,Sr,Ba)ZrO3 crucible was 0.0173 wt.%, which fulfills the ASTM standard on biomedical TiNi alloys. The good resistance of the (Ca,Sr,Ba)ZrO3 crucible to molten NiTi has a relationship with the sluggish diffusion effect of high-entropy ceramics. This study provides insights into the process of designing highly suitable crucible material for melting a NiTi alloy.

Long non-coding RNA (LncRNA) non-coding RNA activated by DNA damage (NORAD) knockdown alleviates airway remodeling in asthma via regulating miR-410-3p/RCC2 and inhibiting Wnt/ß-catenin pathway.

Background: Asthma is a chronic inflammatory disorder with high prevalence in childhood. Airway remodeling, an important structural change of the airways, is resulted from epithelial-mesenchymal transition. Long non-coding RNA non-coding RNA activated by DNA damage (NORAD) has been found to promote epithelial-mesenchymal transition in multiple cancers. This study aimed to analyze the role of NORAD in asthma, mainly focusing on epithelial-mesenchymal transition-mediated airway remodeling, and further explored the NORAD-miRNA-mRNA network. Methods: NORAD expression was analyzed in transforming growth factor-ß1-induced BEAS-2B human bronchial epithelial cells and ovalbumin-challenged asthmatic mice. The influences of NORAD on the epithelial-mesenchymal transition characteristics and Wnt/ß-catenin pathway activation were analyzed in vitro. The interactions between NORAD and miR-410-3p as well as miR-410-3p and regulator of chromosome condensation 2 were detected by dual-luciferase reporter assay and RNA pull-down assay. Rescue experiments using miR-410-3p antagonist and chromosome condensation 2 overexpression were used to confirm the mechanism of NORAD. Additionally, the role and mechanism of NORAD were further evaluated in asthmatic mice. Results: NORAD expression was elevated in both asthmatic models. Knockdown of NORAD impeded spindle-like morphology changes, elevated E-cadherin expression, decreased N-cadherin expression, suppressed cell migration, and inactivated the Wnt/ß-catenin pathway in transforming growth factor-ß1-stimulated BEAS-2B cells. NORAD acted as a sponge of miR-410-3p to regulate chromosome condensation 2 expression. Rescue assays demonstrated that silencing of NORAD ameliorated transforming growth factor-ß1-induced EMT via miR-410-3p/chromosome condensation 2/Wnt/ß-catenin axis. In vivo, knockdown of NORAD led to the reduction of inflammatory cell infiltration and collagen deposition, suppression of IL-4, IL-13, transforming growth factor-ß1 and immunoglobulin E production, decreasing of N-cadherin, chromosome condensation 2, ß-catenin and c-Myc expression, but increasing of E-cadherin and miR-410-3p expression. Conclusions: Silencing of NORAD alleviated epithelial-mesenchymal transition-mediated airway remodeling in asthma via mediating miR-410-3p/chromosome condensation 2/Wnt/ß-catenin pathway.

A gastric neuroendocrine carcinoma with good prognosis after chemotherapy combined with immunotherapy: A case report (CARE-compliant).

INTRODUCTION: Gastric neuroendocrine carcinoma (GNENs), as a highly malignant gastrointestinal tumor, is characterized by easy postoperative metastasis, and its prognosis has always been poor compared to other gastrointestinal tumors. Due to its rarity, there have been few case reports and studies on it. As of now, there is no clear diagnosis and treatment sequence and guidelines. In this report, we present a case of GNENs that underwent first-line treatment after surgery. The patient achieved an excellent prognosis and survival after a combination of chemotherapy resistance and immunotherapy. This report aims to provide valuable reference and guidance for the treatment of GNENs in the future. Therefore, we conducted a literature review on GNENs. PATIENT CONCERNS: A 61-year-old man was admitted to the hospital with complaints of upper abdominal distension and discomfort that had been persistent for 1 month. During the endoscopy examination, a 2.5 cm irregular deep mucosal defect was observed at the center of the gastric angle. The defect appeared covered with dirty moss, had a hard texture, and exhibited a tendency to bleed upon contact. DIAGNOSIS: Biopsy results confirmed the presence of a medium to poorly differentiated adenocarcinoma in the gastric horn. Subsequently, the patient underwent surgery, and the removed specimen was diagnosed as GNENs. INTERVENTION: Postoperative chemotherapy combined with immunotherapy. OUTCOME: The patient in this case achieved a good prognosis and extremely long survival [overall survival > 3 years+] after receiving first-line treatment, which included chemotherapy, drug resistance and immunotherapy, and is currently in good health condition. The tumor is not sensitive to the standard EP regimen for neuroendocrine carcinoma, but after being replaced with oxaliplatin based regimen combined with immunotherapy, partial response was obtained, indicating a synergistic effect between chemotherapy and immunity. After treatment, it remained stable for a considerable period of time. CONCLUSION: Immunotherapy, as a new mode of cancer treatment can provide new guidance and ideas for the treatment of GNENs.

Development and Mechanism Investigation of Novel Thioacetalized Indoles as Antiphytoviral Agents.

Potato virus Y (PVY) is a highly destructive pathogen that infects Solanum tuberosumvL., commonly known as potato, a crop that produces one of the most crucial food staples of the world. The PVY viral infection can considerably reduce the yield and quality of potatoes, thereby causing significant economic ramifications. Given the unsatisfactory performance of commercially available antiviral agents against PVY, we synthesized a series of novel indole-derived compounds followed by their bioevaluation and investigation of the mechanisms governing their anti-PVY activity. These indole-based derivatives contain dithioacetal as a key chemical moiety, and most of them exhibit promising anti-PVY activities. In particular, compound B2 displays remarkable in vivo protective and inactivating properties, with half-maximal effective concentration (EC50) values of 209.3 and 113.0 µg/mL, respectively, in stark contrast to commercial agents such as ningnanmycin (EC50 = 281.4 and 136.3 µg/mL, respectively) and ribavirin (EC50 = 744.8 and 655.4 µg/mL, respectively). The mechanism using which B2 enhances plant immune response to protect plants from PVY is elucidated using enzyme activity tests, real-time quantitative polymerase chain reaction (RT-qPCR), and proteomics techniques. This study aims to pave the way for developing candidate pesticides and related molecules using antiphytoviral activity.

A causal inference study: The impact of the combined administration of Donepezil and Memantine on decreasing hospital and emergency department visits of Alzheimer's disease patients.

Alzheimer's disease is the most common type of dementia that currently affects over 6.5 million people in the U.S. Currently there is no cure and the existing drug therapies attempt to delay the mental decline and improve cognitive abilities. Two of the most commonly prescribed such drugs are Donepezil and Memantine. We formally tested and confirmed the presence of a beneficial drug-drug interaction of Donepezil and Memantine using a causal inference analysis. We applied doubly robust estimators to one of the largest and high-quality medical databases to estimate the effect of two commonly prescribed Alzheimer's disease (AD) medications, Donepezil and Memantine, on the average number of hospital or emergency department visits per year among patients diagnosed with AD. Our results show that, compared to the absence of medication scenario, the Memantine monotherapy, and the Donepezil monotherapy, the combined use of Donepezil and Memantine treatment significantly reduces the average number of hospital or emergency department visits per year by 0.078 (13.8%), 0.144 (25.5%), and 0.132 days (23.4%), respectively. The assessed decline in the average number of hospital or emergency department visits per year is consequently associated with a substantial reduction in medical costs. As of 2022, according to the Alzheimer's Disease Association, there were over 6.5 million individuals aged 65 and older living with AD in the US alone. If patients who are currently on no drug treatment or using either Donepezil or Memantine alone were switched to the combined used of Donepezil and Memantine therapy, the average number of hospital or emergency department visits could decrease by over 613 thousand visits per year. This, in turn, would lead to a remarkable reduction in medical expenses associated with hospitalization of AD patients in the US, totaling over 940 million dollars per year.

Geospatial Analysis of Opioid Dispensing Patterns in California: A 2021 Real-World Study.

The misuse and abuse of opioids has become a serious public health threat in the United States. The state of California has been hit particularly hard by the opioid epidemic, with a noticeable increase in opioid-related fatalities and hospitalizations. This brief report paper aims to contribute to the growing literature by conducting a geospatial analysis of opioid dispensing patterns in California in 2021. The primary objective was to identify areas characterized by high-risk opioid dispending patterns and explore possible contributing factors. This retrospective study analyzed data from over 7 million records of opioid and benzodiazepine prescriptions dispensed by outpatient pharmacies in California in 2021. A series of generalized linear regression models was employed to assess the impact of neighborhood characteristics on opioid recipients and high-risk opioid dispensing. The study defined high-risk opioid dispensing behavior as: (1) multiple provider episodes, (2) overlapping opioid prescriptions for seven or more days, (3) overlapping opioid and benzodiazepine prescriptions for seven or more days, and (4) a high standardized dosage of opioid prescriptions per month. The study identified variables associated with high-risk opioid dispensing behaviors, including age, population density, income, and housing-related variables, as well as marital status and family-related variables. The study uncovered that there are noticeable disparities in opioid dispensing among different racial and ethnic groups within California. The findings indicated a correlation of high-risk dispensing indicators with certain demographic and socioeconomic factors. There was a substantial regional variation in opioid dispensing practices, with certain rural areas having higher rates of opioid prescriptions than urban areas.

PD-1/PD-L1 Inhibitor Plus Chemotherapy Versus PD-1/PD-L1 Inhibitor in Microsatellite Instability Gastrointestinal Cancers: A Multicenter Retrospective Study.

PURPOSE: To investigate the efficacy of PD-1/PD-L1 inhibitors plus chemotherapy versus anti-PD-1/PD-L1 monotherapy in advanced microsatellite instability (MSI)/mismatch repair-deficient (dMMR) gastrointestinal cancers. METHODS: We retrospectively recruited patients with MSI/dMMR gastrointestinal cancer who received anti-PD-1/PD-L1 with or without chemotherapy and compared objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) of PD-1/PD-L1 inhibitor plus chemotherapy (chemo-anti-PD-1/PD-L1 group) and PD-1/PD-L1 inhibitor alone (anti-PD-1/PD-L1 group). Propensity score-based overlap weighting analysis was conducted to adjust the baseline covariable imbalance. Sensitivity analysis was performed to confirm the stability of the results by propensity score matching and multivariable Cox and logistic regression models. RESULTS: A total of 256 patients were eligible, with 68 and 188 receiving chemo-anti-PD-1/PD-L1 and anti-PD-1/PD-L1, respectively. The chemo-anti-PD-1/PD-L1 group showed significant improvements versus the anti-PD-1/PD-L1 group in ORR (61.8% v 38.8%; P = .001), DCR (92.6% v 74.5%; P = .002), PFS (median PFS [mPFS], not reached [NR] v 27.9 months; P = .004), and OS (median OS [mOS], NR v NR; P = .014). After overlap weighting, the improvements tended to be more significant with chemo-anti-PD-1/PD-L1 versus anti-PD-1/PD-L1 in ORR (62.5% v. 38.3%; P < .001), DCR (93.8% v 74.2%; P < .001), PFS (mPFS, NR v 26.0 months; P = .004), and OS (mOS, NR v NR; P = .010). These results were solidified through sensitivity analysis. CONCLUSION: Chemo-anti-PD-1/PD-L1 is superior to anti-PD-1/PD-L1 in MSI/dMMR gastrointestinal cancers with improved efficacy.

Predicting suicidal and self-injurious events in a correctional setting using AI algorithms on unstructured medical notes and structured data.

Suicidal and self-injurious incidents in correctional settings deplete the institutional and healthcare resources, create disorder and stress for staff and other inmates. Traditional statistical analyses provide some guidance, but they can only be applied to structured data that are often difficult to collect and their recommendations are often expensive to act upon. This study aims to extract information from medical and mental health progress notes using AI algorithms to make actionable predictions of suicidal and self-injurious events to improve the efficiency of triage for health care services and prevent suicidal and injurious events from happening at California's Orange County Jails. The results showed that the notes data contain more information with respect to suicidal or injurious behaviors than the structured data available in the EHR database at the Orange County Jails. Using the notes data alone (under-sampled to 50%) in a Transformer Encoder model produced an AUC-ROC of 0.862, a Sensitivity of 0.816, and a Specificity of 0.738. Incorporating the information extracted from the notes data into traditional Machine Learning models as a feature alongside structured data (under-sampled to 50%) yielded better performance in terms of Sensitivity (AUC-ROC: 0.77, Sensitivity: 0.89, Specificity: 0.65). In addition, under-sampling is an effective approach to mitigating the impact of the extremely imbalanced classes.

Rational design of HJH antimicrobial peptides to improve antimicrobial activity.

Antimicrobial peptides (AMPs) have attracted considerable interest in the past decade due to their advantages for tackling antibiotic resistance. They exhibit potential antimicrobial activity through unique cell membrane destruction mechanism based on their net charge, hydrophobic properties, and α-helix. In this work, a series of HJH peptides was rationally designed and synthesized. The antimicrobial activity and cytotoxicity assays indicated that HJH-5 and HJH-6 containing hydrophobic residues and helices displayed prominent antimicrobial activity and mild cytotoxicity, respectively. These peptides may be developed for combatting microbial infections.

Construction of Z-Scheme TiO2/Au/BDD Electrodes for an Enhanced Electrocatalytic Performance.

TiO2/Au/BDD composites with a Z-scheme structure was prepared by orderly depositing gold (Au) and titanium dioxide (TiO2) on the surface of a boron-doped diamond (BDD) film using sputtering and electrophoretic deposition methods. It was found that the introduction of Au between TiO2 and the BDD, not only could reduce their contact resistance, to increase the carrier transport efficiency, but also could improve the surface Hall mobility of the BDD electrode. Meanwhile, the designed Z-scheme structure provided a fast channel for the electrons and holes combination, to promote the effective separation of the electrons and holes produced in TiO2 and the BDD under photoirradiation. The electrochemical characterization elucidated that these modifications of the structure obviously enhanced the electrocatalytic performance of the electrode, which was further verified by the simulated wastewater degradation experiments with reactive brilliant red X-3B. In addition, it was also found that the photoirradiation effectively enhanced the pollution degradation efficiency of the modified electrode, especially for the TiO2/Au/BDD-30 electrode.

Immune Mechanism of Ethylicin-Induced Resistance to Xanthomonas oryzae pv. oryzae in Rice.

Ethylicin (ET) was reported to be promising in the control of rice bacterial leaf blight (BLB) caused by Xanthomonas oryzae pv. oryzae (Xoo). The detailed mechanism for this process remains unknown. Disclosed here is an in-depth study on the action mode of ET to Xoo. Through plant physiological and biochemical analysis, it was found that ET could inhibit the proliferation of Xoo by increasing the content of defense enzymes and chlorophyll in rice (Oryza sativa ssp. Japonica cv. Nipponbare). Label-free quantitative proteomic analysis showed that ET affected the rice abscisic acid (ABA) signal pathway and made the critical differential calcium-dependent protein kinase 24 (OsCPK24) more active. In addition, the biological function of OsCPK24 as a mediator for rice resistance to Xoo was determined through the anti-Xoo phenotypic test of OsCPK24 transgenic rice and the affinity analysis of the OsCPK24 recombinant protein in vitro and ET. This study revealed the molecular mechanism of ET-induced resistance to Xoo in rice via OsCPK24, which provided a basis for the development of new bactericides based on the OsCPK24 protein.

A comparative study on deep learning models for text classification of unstructured medical notes with various levels of class imbalance.

BACKGROUND: Discharge medical notes written by physicians contain important information about the health condition of patients. Many deep learning algorithms have been successfully applied to extract important information from unstructured medical notes data that can entail subsequent actionable results in the medical domain. This study aims to explore the model performance of various deep learning algorithms in text classification tasks on medical notes with respect to different disease class imbalance scenarios. METHODS: In this study, we employed seven artificial intelligence models, a CNN (Convolutional Neural Network), a Transformer encoder, a pretrained BERT (Bidirectional Encoder Representations from Transformers), and four typical sequence neural networks models, namely, RNN (Recurrent Neural Network), GRU (Gated Recurrent Unit), LSTM (Long Short-Term Memory), and Bi-LSTM (Bi-directional Long Short-Term Memory) to classify the presence or absence of 16 disease conditions from patients' discharge summary notes. We analyzed this question as a composition of 16 binary separate classification problems. The model performance of the seven models on each of the 16 datasets with various levels of imbalance between classes were compared in terms of AUC-ROC (Area Under the Curve of the Receiver Operating Characteristic), AUC-PR (Area Under the Curve of Precision and Recall), F1 Score, and Balanced Accuracy as well as the training time. The model performances were also compared in combination with different word embedding approaches (GloVe, BioWordVec, and no pre-trained word embeddings). RESULTS: The analyses of these 16 binary classification problems showed that the Transformer encoder model performs the best in nearly all scenarios. In addition, when the disease prevalence is close to or greater than 50%, the Convolutional Neural Network model achieved a comparable performance to the Transformer encoder, and its training time was 17.6% shorter than the second fastest model, 91.3% shorter than the Transformer encoder, and 94.7% shorter than the pre-trained BERT-Base model. The BioWordVec embeddings slightly improved the performance of the Bi-LSTM model in most disease prevalence scenarios, while the CNN model performed better without pre-trained word embeddings. In addition, the training time was significantly reduced with the GloVe embeddings for all models. CONCLUSIONS: For classification tasks on medical notes, Transformer encoders are the best choice if the computation resource is not an issue. Otherwise, when the classes are relatively balanced, CNNs are a leading candidate because of their competitive performance and computational efficiency.

Sortase A-mediated cyclization of novel polycyclic RGD peptides for ανß3 integrin targeting.

Cyclic arginine-glycine-aspartic (RGD) peptides that specifically bind to integrin ανß3 have been developed for drug delivery, tracers, and imaging for tumor diagnosis and treatment. Herein, a series of polycyclic RGD peptides containing dual, tri, and tetra rings were designed and synthesized through sortase A-mediated ligation. An in vitro test on cell adhesion inhibition indicated that the RGD peptide containing tricylic structure exhibited outstanding potency and selectivity for ανß3 integrin.

Heavy Mn-doped CsPbBr3nanocrystals synthesized by high energy ball milling with high stability.

CsPbX3(X = Cl, Br, I) semiconductor nanocrystals (NCs) have excellent optical and photoelectric properties, and are potential core materials for various photoelectric devices. However, the toxicity of Pb and instability have been the key limitations to application of NCs. Herein, using MnBr2and MnBr2·4H2O as manganese sources, heavy Mn-doped CsPbBr3(Mn:CsPbBr3) NCs are synthesized by high-energy ball grinding, which avoids high temperature, a large number of polar solvents and atmosphere protection required in traditional liquid phase methods. However, when MnBr2·4H2O is used as the raw material, infinite solid solution doping can be achieved, and the synthesized Mn:CsPbBr3NCs show smaller particle size, stronger PL intensity and stability. The reason is that presence of crystal water plays a similar role to wet milling in the ball milling process, and can promote the passivation effect of oleylamine (OAm) on nanocrystal defects and the connection between them. In addition, a simple, easy-operating and beneficial to commercial production method for the preparation of Mn:CsPbBr3NCs/EVA flexible films is proposed, which can effectively improve the stability of Mn:CsPbBr3NCs. This study is expected to provide an effective way for the synthesis and stability improvement of CsPbX3NCs doped with different ions.

Factors associated with the willingness of older people to engage with long-term care services: A systematic review.

The ageing of the population has resulted in an increase in the demand for long-term care services for older people, but with limited resources, its challenges have also been highlighted. Although factors affecting the willingness of older people to engage with long-term care services have been widely reported, however, systematic review has not synthesised the evidence, and its associated factors remain unclear. This systematic review aims to study and synthesise the best available evidence on the potential factors related to the willingness of older people to engage with long-term care services. Eight electronic databases were comprehensively searched from inception to January 2021: the Cochrane Library, PubMed, Web of Science, CINAHL, Wanfang Database, China Knowledge Resource Integrated Database (CNKI), Weipu Database (VIP), and Chinese Biomedical Literature Database (CBM). The original literatures were screened according to selection criteria. Two researchers used 11-item checklist recommended by the Agency for Healthcare Research and Quality to evaluate the quality of the included literatures. And the review used narrative synthesis to integrate factors related to the willingness of older people to engage with long-term care services. In total, 7794 studies were screened and 35 studies were included in this review. Among them, 23 studies were rated as moderate quality and 12 was high quality. Data synthesis identified that age, education, number of children, living arrangements, the relationship with children, primary caregivers, place of residence, social support, household income, medical insurance, activities of daily living ability and spiritual comfort should all be taken into account when establishing the appropriate long-term care service model or formulating relevant policies. However, many factors remain undetermined and require more rigorous original literature support. And multiple areas can be also considered in the future studies, especially psychological factors.

Understanding charge storage in Nb2CTx MXene as an anode material for lithium ion batteries.

MXenes represent an emerging family of two-dimensional materials of transition metal carbides/carbonitrides terminated with functional groups like -O, -OH, and -F on the chemically active surface of MX slabs. As a member of the family, Nb2CTx exhibits superior lithium storage capacity over most of the other MXenes as anode materials in lithium-ion batteries (LIBs). However, an in-depth understanding of the charge storage mechanism is still lacking so far. Here, through combining complementary experiments and density functional theory calculations, we provide insights into the (de)lithiation process. Specifically, Nb2CTx with dominant -O functional groups stores charge as a result of changes in the oxidation states of both transition metals Nb and O, which is supported by Bader charge analysis showing a significant change in the oxidation states of Nb and O upon lithiation. As monitored by ex situ X-ray diffraction, the interlayer spacing of Nb2CTx changes slightly upon lithium ion (de)intercalation, corresponding to a volume change of only 2.3% with a near zero-strain feature. By coupling with a LiFePO4/C cathode, the full cell presents superior rate capability and cycling stability as well. The insights into the charge storage mechanism of Nb2CTx in this work provide useful guidance for the rational design of MXene-based anode materials for high-performance LIBs.

A highly durable CoOx/N-doped graphitized-nano-diamond electrocatalyst for oxygen reduction reaction.

Oxygen reduction reaction (ORR) occupies a pivotal position in fuel cell applications, and it is a challenge to obtain highly durable ORR catalysts. Herein, porous cobalt oxide microsphere growing at the surface of on nitrogen-doped graphitized-nano-diamond (CoOx/N-GND) was prepared using hydrothermal and subsequent heat treatment process. Porous cobalt oxide of high specific surface area could expose more surface Co2+that act as active sites than bulk one does. The doping of nitrogen also promotes the catalytic activity. Besides, nano-diamond (ND) ofsp3hybrid structure was used as an electronic conduction carriers of ultrahigh stability to improve the durability of catalytic composite. Prepared CoOx/N-GND shows a satisfactory half-wave potential of 0.82 V (versus RHE), which is close to that of Pt/C (0.85 V), an excellent methanol tolerance and a lower activity loss after 5000 cycles. These merits inspire the application of CoOx/N-GND as the cathode of Zn-air battery and the battery performance was evaluated in this work. In general, this work highlights an innovate approach to design and prepare highly durable catalyst.