What's the preferences of medical staff for providing health education service? - A discrete choice experiment in Beijing, China.

OBJECTIVE: To quantify medical staff preferences for providing health education service in hospitals. METHODS: This study took medical staff in the department of internal medicine of hospitals in Beijing, China as the research subjects, and designed a discrete choice experiment (DCE) to investigate the health education service provision preferences of them. Through various methods, 8 attributes and corresponding levels were determined. An online survey was conducted among the medical staff of the sample hospitals from May to June 2023. Participants' preferences were analyzed using conditional logit and mixed logit models. RESULTS: Finally, 831 respondents completed the questionnaire, among which 600 cases passed the consistency test. All the attributes included in this study had an impact on medical staff' health education service preferences (P < 0.001). The most important one with the greatest impact on the health education service delivery behavior of the respondents was "department working atmosphere-encouraging health education" (ß = 4.062, P < 0.001). CONCLUSION: In this study, the departmental work atmosphere and performance bonuses emerged as crucial factors influencing the engagement of medical staff in health education work. PRACTICAL IMPLICATIONS: Hospitals should prioritize measures to improve the health education working atmosphere in departments to increase the enthusiasm of medical staff to provide services.

Protocol to detect OLA1 polyubiquitination by Aurora A in vivo and in vitro.

Aurora A is a critical kinase that functions in centrosome maturation and bipolar spindle assembly. On the other hand, Aurora A has E3 ubiquitin ligase activity and polyubiquitinates Breast cancer gene 1 (BRCA1)-interacting protein Obg-like ATPase 1 (OLA1), targeting it for proteasomal degradation. Here, we present a protocol to detect OLA1 ubiquitination. We describe steps for recovering frozen cells and protein purification. We then detail assays for both in vivo and in vitro ubiquitination of OLA1 by Aurora A. For complete details on the use and execution of this protocol, please refer to Fang et al.1.

Knockout of Brca1-interacting factor Ola1 in female mice induces tumors with estrogen suppressible centrosome amplification.

Obg-like ATPase 1 (OLA1) is a binding protein of Breast cancer gene 1 (BRCA1), germline pathogenic variants of which cause hereditary breast cancer. Cancer-associated variants of BRCA1 and OLA1 are deficient in the regulation of centrosome number. Although OLA1 might function as a tumor suppressor, the relevance of OLA1 deficiency to carcinogenesis is unclear. Here, we generated Ola1 knockout mice. Aged female Ola1+/- mice developed lymphoproliferative diseases, including malignant lymphoma. The lymphoma tissues had low expression of Ola1 and an increase in the number of cells with centrosome amplification. Interestingly, the proportion of cells with centrosome amplification in normal spleen from Ola1+/- mice was higher in male mice than in female mice. In human cells, estrogen stimulation attenuated centrosome amplification induced by OLA1 knockdown. Previous reports indicate that prominent centrosome amplification causes cell death but does not promote tumorigenesis. Thus, in the current study, the mild centrosome amplification observed under estrogen stimulation in Ola1+/- female mice is likely more tumorigenic than the prominent centrosome amplification observed in Ola1+/- male mice. Our findings provide a possible sex-dependent mechanism of the tumor suppressor function of OLA1.

The global value of freshwater lakes.

Lakes face threats from human activities like unsustainable development, population growth and industrial technologies. These challenges impact the ecosystem services of lakes. Research has assessed the monetary value of services from freshwater biomes annually. This article reviews these values, estimating lakes' global ecosystem services to be within the region of USD 1.3-5.1 trillion annually. Their natural asset value is estimated at USD 87-340 trillion, comparable to the monetary value of global real estate, assuming a relatively high social discount rate to account for future increased standards of living. Considering environmental degradation, future generations may experience a lower living standard. Using a 0.1% discount rate, recognizing potential harm and aligning with indigenous values raises the lakes' value to USD 1300-5100 trillion, which is at least equal to the global monetary value of wealth created. This valuation is shared by all as a collective asset, unlike the skewed distribution of created wealth.

Environment and social support for smoking cessation among community smokers in Beijing, China.

INTRODUCTION: This study investigated the relationship between environment support, social support and smoking cessation, to provide suggestions for the construction of environment and social support for tobacco control. METHODS: This was a secondary analysis based on two cross-sectional surveys of adult smokers who participated in the six-month community smoking cessation intervention projects in Beijing. The study subjects were divided into a successful group (n=159) and an unsuccessful group (n=253). The status of the environment support, community tobacco exposure, and social support were compared between groups. A structural equation model (SEM) was established for Confirmatory Factor Analysis. RESULTS: The univariate analysis showed that there were differences in smoking cessation outcomes among smokers with different home tobacco regulations, workplace tobacco regulations and number of smokers in the family. Differences in 6-month smoking reduction were also found with different promotion levels of anti-tobacco messaging and the frequency of smoking events at home. The logistic regression analysis indicated that home tobacco regulations (OR=1.30; 95% CI: 1.00-1.69), workplace tobacco regulations (OR=1.27; 95% CI: 1.05- 1.54), and frequency of smoking events at home (OR=1.15; 95% CI: 1.02-1.29), were associated with smoking cessation. The results of the SEM showed that environment support (ß=0.39; 95% CI: 0.05-0.73, p=0.026) and social support (ß=0.37; 95% CI: 0.05-0.68, p=0.022) had influence on smoking cessation. CONCLUSIONS: Environment support and social support are related to smoking cessation. Attention should be paid to the smoking regulations at home and workplace, anti-tobacco messaging, and social support by the family. TRIAL REGISTRATION: The study was registered on the official website of the China Clinical Trial Registration Center. Identifier: ChiCTR1900024991.

The impact of COVID-19 prevention and control policy adjustment on anxiety, depression and coping behavior in China: a cross-sectional online survey, 21-28 December, 2022.

BACKGROUND: Following external situation reports, individuals perceive risks, experience different emotional reactions, and further change their behaviors. Therefor people's psychology will also be affected by adjustment of COVID-19 epidemic prevention and control policy, but it remains unknown what kind of coping behaviors will be produced due to psychology. This study defines coping behavior as "medical behavior and irrational consumption behavior after the adjustment of COVID-19 epidemic prevention and control policy in China", assesses the prevalence of negative emotions in the Chinese population after policy adjustments, and explores how negative emotions affect people's coping behaviors, conducts baseline research, provides references and suggestions for policy formulation. METHODS: A cross-sectional online survey was conducted during 21-28 December 2022, included sociodemographic characteristics, COVID-19 infection and irrational purchase behavior, psychological assessment, and opinion polling. Depression and anxiety status are assessed by PHQ-9 and GAD-7. The relationship between anxiety, depression and coping behavior was analyzed by Pearson χ2 test, Fisher's exact test and logistic regression. RESULTS: A total of 3995 infected participants were included in this study, of which 2363(59.1%) and 1194(29.9%) had depression and anxiety. There was a significant difference in clinical treatment and irrational purchase behavior between different level of depression and anxiety. Depression was a risk factor for self- medication (OR = 1.254), seeking professional treatment (OR = 1.215), using online services of medical institutions (OR = 1.320), large-scale purchases of medicines (OR = 1.154) and masks (OR = 1.096). Anxiety was a risk factor for seeking professional treatment (OR = 1.285) and large-scale purchases of masks (OR = 1.168). CONCLUSION: After the adjustment of COVID-19 epidemic prevention and control policy, patient risk perception can increase depression and anxiety. We found that associated with depression, COVID-19 patients are more likely to have medical behaviors such as self- medication, seeking professional treatment, using online services of medical institutions, and storage behaviors of medicines and masks; and anxiety associated with the coping behavior of patients to seek professional treatment and store masks in large quantities. We should improve people's mental health, and on the other hand, we should give people effective psychological education during the epidemic. Therefore, we should set up psychological outpatient clinics in community health institutions, expanding mental health screening and guidance; relying on the psychological outpatient clinic, establish groups of people with depression or anxiety to carry out COVID-19 health education and peer education, to reduce adverse drug reactions, avoid panic seeking professional treatment and irrational purchase behavior, and protect public mental health. TRIAL REGISTRATION: This study has been approved by the Medical Ethics Committee of Capital Medical University (2023SY086), and informed consent was obtained from the study subjects before the investigation.

Characteristics of a ceftadine/avibatam resistance KPC-33-producing Klebsiella Pneumoniae strain with capsular serotype K19 belonging to ST15.

OBJECTIVES: The aim of this study was to characterize the blaKPC-33 in a ST15-K19 ceftazidime-avibactam (CAZ-AVI)-resistant Klebsiella pneumoniae strain after the antibiotic CAZ-AVI was approved for use in Wuxi No. 2 People's Hospital, China. METHODS: Antimicrobial susceptibility testing was performed by the microdilution broth method. Whole genome sequencing (WGS) was performed using PacBio II and MiSeq sequencers. High-quality reads were assembled using the SOAPdenovo and GapCloser v1.12, and genome annotation was performed using the NCBI Prokaryotic Genome Annotation Pipeline (PGAP). Genomic characteristics were analysed by using bioinformatics methods. RESULTS: K. pneumoniae strain KPHRJ showed resistance to CAZ-AVI. WGS analysis showed that strain KPHRJ had one 5 536 506 bp chromosome (57.25% G+C content) and one plasmid (133 451 bp, G+C 54.29%). KPHRJ was classified as ST15 and K19 serotype. Resistome analysis showed that KPHRJ carries seven antimicrobial resistance genes (ARGs). WGS analysis and conjugation experiments demonstrated that the blaKPC-33 gene was carried by plasmid pKPHRJ, flanked by two copies of IS26 mobile elements (IS26-ISKpn27-blaKPC-33-ISKpn6-korC-TnAs1-tetR-tetA-Tn3-IS26). Besides these acquired resistance genes, mutations in porin protein-coding genes, such as OmpK36 and OmpK37, which may reduce susceptibility to the CAZ-AVI, were also identified from the genome. CONCLUSION: Here, we present the WGS of a CAZ-AVI resistant K. pneumoniae isolate, strain KPHRJ, with capsular serotype K19 and belonging to ST15. CAZ-AVI resistance is likely conferred by a KPC-2 variant, blaKPC-33 and mutations in porin-coding genes. We speculate that the approval of the CAZ-AVI in hospital could contribute to the emergence of these genomic features by providing a selective pressure leading to the emergence of CAZ-AVI resistant bacteria.

Prospective Exploratory Study of the Effects of Postoperative Endocrine Medication on the Endometrium in Breast Cancer Patients.

Objective: This study aimed to investigate the pathological effects of long-term postoperative endocrine medication on the endometrium in breast cancer patients. Methods: Data of 99 patients with primary breast cancer who underwent hysteroscopy and obtained endometrial biopsy from 1 June 2018 to 31 December 2021 at the Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital were prospectively collected. Results: Hysteroscopy was performed followed by endometrial histopathological examination in 99 breast cancer patients, including 44 taking tamoxifen (TAM), 26 taking other endocrine drugs, and 29 not taking endocrine drugs. The endometrial thickness in the TAM group was significantly higher than that in the other endocrine drug groups and the group not taking endocrine drugs (p=0.017). The receiver operating characteristic curves for the abnormal premenopausal endometrial thickening were plotted in this study; an endometrial thickness of 15.5 mm seen on ultrasound could be used as the most accurate ultrasound diagnostic threshold for the diagnosis of abnormal premenopausal endometrial hyperplasia, with an area under the curve of 0.888 (95% CI: 0.716, 1.000), a sensitivity of 100%, and a specificity of 75%, which was consistent with the results of our previous retrospective study. An endometrial thickness of ≥5 mm in postmenopausal women with breast cancer taking TAM was still used as the cut-off value for routine ultrasound diagnosis of abnormal postmenopausal endometrial hyperplasia. Conclusion: An ultrasound endometrial thickness (proliferative phase) of >15 mm in premenopausal patients can be used as the most accurate ultrasound diagnostic threshold for the diagnosis of abnormal endometrial hyperplasia. After menopause, an ultrasound endometrial thickness of ≥5 mm is still used as the criterion for diagnosing abnormal endometrial hyperplasia. Older patients should be monitored for signs of vaginal bleeding and fluid discharge, and hysteroscopy should be performed if necessary to ascertain the endometrial condition.

Aurora A polyubiquitinates the BRCA1-interacting protein OLA1 to promote centrosome maturation.

The BRCA1-interacting protein Obg-like ATPase 1 (OLA1) functions in centriole duplication. In this study, we show the role of the mitotic kinase Aurora A in the reduction of centrosomal OLA1. Aurora A binds to and polyubiquitinates OLA1, targeting it for proteasomal degradation. NIMA-related kinase 2 (NEK2) phosphorylates the T124 residue of OLA1, increases binding of OLA1 to Aurora A and OLA1 polyubiquitination by Aurora A, and reduces centrosomal OLA1 in G2 phase. The kinase activity of Aurora A suppresses OLA1 polyubiquitination. The decrease in centrosomal OLA1 caused by Aurora A-mediated polyubiquitination promotes the recruitment of pericentriolar material proteins in G2 phase. The E3 ligase activity of Aurora A is critical for centrosome amplification induced by its overexpression. The results suggest a dual function of Aurora A as an E3 ubiquitin ligase and a kinase in the regulation of centrosomal OLA1, which is essential for proper centrosome maturation in G2 phase.

Mechanism of community quitters' psychological traits on their smoking cessation effects: Based on a study of community intervention.

INTRODUCTION: We study the relationship between psychological traits of smokers and their smoking cessation effects, and provide more scientific evidence for smoking cessation intervention. METHODS: The study was conducted as a nested case-control study. Smokers who participated in the community smoking cessation intervention projects in Beijing in 2018-2020, were selected as the research participants and divided into two groups: a successful smoking cessation and unsuccessful smoking cessation group, according to their smoking cessation effects at 6 months. Psychological traits of quitters including smoking abstinence self-efficacy, willingness to quit smoking, and trait coping style, were compared between the two groups, and a structural equation model was established for confirmatory factor analysis to analyze their mechanisms. RESULTS: There were differences in smoking cessation results between the successful smoking cessation group and the unsuccessful smoking cessation group in terms of smoking abstinence self-efficacy and willingness to quit smoking. Willingness to quit smoking (OR=1.06; 95% CI: 1.008-1.118) is a risk factor, while smoking abstinence self-efficacy in habit/addiction situations (OR=0.77; 95% CI: 0.657-0.912) is a protective factor. The results of the structural equation model showed that smoking abstinence self-efficacy (ß=0.199, p=0.002) and trait coping style (ß= -0.166, p=0.042) could influence smoking cessation effects. The structural equation model was well fitted, which showed that smoking abstinence self-efficacy (ß=0.199, p=0.002) and trait coping style (ß= -0.166, p=0.042) might have influenced the effect of smoking cessation among smokers. CONCLUSIONS: Willingness to quit smoking has a positive impact on the smoking cessation effect, while smoking abstinence self-efficacy in habit/addiction situations and negative trait coping style have a negative impact. Smoking abstinence self-efficacy and trait coping styles can significantly affect smoking cessation outcomes.

Cross-Sectional Online Survey on Depression and Anxiety Among the Population Infected or Non-Infected with COVID-19 - China, December 2022.

What is already known about this topic?: The psychological impact of the large-scale infection of the population resulting from the end of lockdown measures in China during the coronavirus disease 2019 (COVID-19) pandemic is unknown. What is added by this report?: Among all participants, 55.7% had depression symptoms, with a significant difference between the infected and non-infected groups, and 30.1% had anxiety. Those who were young, unvaccinated, had lower incomes, and experienced chronic diseases were more likely to experience negative emotions. What are the implications for public health practice?: Government officials should take into account the effect of policies on public sentiment during similar public health events and implement tailored community interventions to address any negative sentiment.

An intervention study on a hospital-community integrated management model of tobacco dependence based on a community intervention trial.

Objective: To assess the effect of the hospital-community integrated management model of tobacco dependence on smoking cessation among community residents compared with a brief smoking cessation intervention. Methods: Our study recruited 651 smokers who were willing to quit in 19 communities in Beijing and conducted a 6-month smoking cessation intervention. The control group receiving a brief smoking cessation intervention and the pilot group receiving an integrated smoking cessation intervention. Intention-to-treat analysis (ITT) and generalized estimating equations were used to assess the effects of the integrated intervention and smoking cessation medication on average number of cigarettes smoked per day (ACSD) and smoking cessation rate. Results: Simple effects analysis showed that smokers taking medication had significantly lower ACSD than those not taking medication at follow-up, the control group reduced smoking by 3.270, 4.830, and 4.760 cigarettes in the first, third and sixth months, respectively, while the pilot group reduced by 6.230, 5.820, and 4.100 cigarettes. The integrated intervention significantly reduced ACSD among medication-taking smokers at 1st month (reduced by 3.420, P < 0.05) and 3rd month (reduced by 2.050, P < 0.05), but had no significant effect among non-medication taking smokers. The 3rd month smoking cessation rate among medication-taking smokers was 27.0%, which was significantly higher than the smokers with brief smoking cessation intervention. Conclusion: The integrated hospital-community intervention can significantly promote smoking cessation among smokers taking medication, but the issue of payment for medication and additional labor compensation for medical staff should be addressed before its popularization.

Needs and views on healthy lifestyles for the prevention of dementia and the potential role for mobile health (mHealth) interventions in China: a qualitative study.

OBJECTIVES: Over the coming decades, China is expected to face the largest worldwide increase in dementia incidence. Mobile health (mHealth) may improve the accessibility of dementia prevention strategies, targeting lifestyle-related risk factors. Our aim is to explore the needs and views of Chinese older adults regarding healthy lifestyles to prevent cardiovascular disease (CVD) and dementia through mHealth, supporting the Prevention of Dementia using Mobile Phone Applications (PRODEMOS) study. DESIGN: Qualitative semi-structured interview study, using thematic analysis. SETTING: Primary and secondary care in Beijing and Tai'an, China. PARTICIPANTS: Older adults aged 55 and over without dementia with an increased dementia risk, possessing a smartphone. Participants were recruited through seven hospitals participating in the PRODEMOS study, purposively sampled on age, sex, living area and history of CVD and diabetes. RESULTS: We performed 26 interviews with participants aged 55-86 years. Three main themes were identified: valuing a healthy lifestyle, sociocultural expectations and need for guidance. First, following a healthy lifestyle was generally deemed important. In addition to generic healthy behaviours, participants regarded certain specific Chinese lifestyle practices as important to prevent disease. Second, the sociocultural context played a crucial role, as an important motive to avoid disease was to limit the care burden put on family members. However, time-consuming family obligations and other social values could also impede healthy behaviours such as regular physical activity. Finally, there seemed to be a need for reliable and personalised lifestyle advice and for guidance from a health professional. CONCLUSIONS: The Chinese older adults included in this study highly value a healthy lifestyle. They express a need for personalised lifestyle support in order to adopt healthy behaviours. Potentially, the PRODEMOS mHealth intervention can meet these needs through blended lifestyle support to improve risk factors for dementia and CVD. TRIAL REGISTRATION NUMBER: ISRCTN15986016; Pre-results.

Torularhodin Alleviates Hepatic Dyslipidemia and Inflammations in High-Fat Diet-Induced Obese Mice via PPARα Signaling Pathway.

Torularhodin is a ß-carotene-like compound from Sporidiobolus pararoseus, and its protective effect against high-fat diet (HFD)-induced hepatic dyslipidemia and inflammation was investigated. Compared to mice of C57BL/6J fed on HFD, the addition of Torularhodin into the HFD (HFD-T) significantly reduced body weight, serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and the inflammatory mediators of TNF-α, IL-6, IL-1ß, and lipopolysaccharide (LPS). A significant increase of high-density lipoprotein cholesterol (HDL-c), which is beneficial to cholesterol clearance, was also observed in HFD-T group. Proteomic analysis showed HDL-C-c is highly correlated with proteins (e.g., CPT1A and CYP7A1) involved in lipid ß-oxidation and bile acid synthesis, whereas the other phenotypic parameters (TC, TG, LDL, and inflammatory cytokines) are highly associated with proteins (e.g., SLC27A4) involved in lipid-uptake. The up-regulated anti-inflammation proteins FAS, BAX, ICAM1, OCLN, GSTP1, FAF1, LRP1, APEX1, ROCK1, MANF, STAT3, and INSR and down-regulated pro-inflammatory proteins OPTN, PTK2B, FADD, MIF, CASP3, YAP1, DNM1L, and NAMPT not only demonstrate the occurrence of HFD-induced hepatic inflammation, but also prove the anti-inflammatory property of Torularhodin. KEGG signaling pathway analysis revealed that the PPARα signaling pathway is likely fundamental to the health function of Torularhodin through up-regulating genes related to fatty acid ß-oxidation, cholesterol excretion, HDL-Cc formation, and anti-inflammation. Torularhodin, as a new food resource, may act as a therapeutic agent to prevent hepatic dyslipidemia and related inflammation for improved health.

Role of the gut microbiota in dietary patterns rich in torularhodin via OSA colon-targeted delivery.

Torularhodin is a carotenoid with various functions, and carotenoids can be used by the gut microbiota. However, the effect of torularhodin on the gut microbiota is not yet clear. In this study, an octenyl succinic anhydride (OSA) colon-targeted delivery system and an in vitro gut digestive system were used to explore the role of the gut microbiota in long-term dietary patterns rich in torularhodin. The results suggested that the gut microbiota was affected by the diet rich in torularhodin, mainly including Frisingicoccus, Butyricicoccus, Eubacterium, Bacteroides, Dialister, Lachnoclostridium, Streptococcus, and Ruminococcus torques. Torularhodin inhibited the growth of pathogenic bacteria belonging to Enterobacteriaceae and transformed beneficial bacteria Bifidobacterium and Bacteroides into dominant bacteria under long-term dietary patterns. The functional analysis of the gut microbiota showed that differential genes were mainly enriched in glycolysis/gluconeogenesis and pentose phosphate pathways. The metabolome results also demonstrated that torularhodin mainly regulated fructose-1,6-bisphosphatase in the abovementioned pathway. Finally, the interaction network revealed that the gut microbiota (Bacteroides, Lachnospiraceae, and Megasphaera), metabolites (D-glucose, citric acid, tartaric acid, and propionic acid), and metabolic functions (pyruvate metabolism, glycolysis/gluconeogenesis, and pentose phosphate pathway) might be the key factors regulating the effect of torularhodin on the gut microbiota-metabolite-metabolism. Therefore, this study explored the mechanism of "torularhodin-gut microbiota-metabolite-metabolism" cross-feeding based on the bioinformatics methods, providing a theoretical basis for optimizing the gut microecology of a torularhodin-rich diet.

Assessing the Impact of Air Pollution on Inbound Tourism along the Yangtze River across Space and Time.

The prevalent air pollution along the Yangtze River Economic Belt (YREB) possesses a significant threat to the natural environment, which further affects nearby tourism destination development. The paper seeks to assess the impact of air pollution on tourism in this region through a 2002-2012 panel data of 31 prefecture-level cities, along with geographic information system (GIS) and cluster analyses. The results reveal that air pollution is negatively associated with the number of inbound tourists along the YREB. In general, when air pollution intensifies by 1%, the number of inbound tourists decreases by 1.171%. This impact is more evident when air pollution is more severe, in the long term, and in areas that are larger, more central, and with more tourism resources. The paper contributes to the literature by addressing common limitations in previous studies and providing a more comprehensive evaluation of air pollution's impact on inbound tourism in the YREB. Practical implications regarding public policies and development directions based on air pollution periods, regions, and tourism resource allocations are provided.

A Cost-Effectiveness Analysis of Comprehensive Smoking-Cessation Interventions Based on the Community and Hospital Collaboration.

Background: The prevalence of cigarette smoking in China is high and the utilization of smoking cessation clinics is very low. Multicomponent smoking cessation interventions involving community and hospital collaboration have the potential to increase the smoking cessation rate. However, the cost-effectiveness of this intervention model is unknown. Methods: We conducted a smoking cessation intervention trial in 19 community health service centers in Beijing, China. A cost-effectiveness analysis was performed from a societal perspective to compare three strategies of smoking cessation: no intervention (NI), pharmacological intervention (PI), and comprehensive intervention (CI) (PI plus online health promotion). A Markov model, with a time horizon of 20 years, was used to simulate the natural progression of estimated 10,000 male smokers. A cross-sectional survey was conducted to obtain data on costs and quality-adjusted life years (QALYs) by using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. Probabilistic sensitivity analysis was performed to explore parameters of uncertainty in the model. Results: A total of 680 participants were included in this study, including 283 in the PI group and 397 in the CI group. After 6 months of follow-up, the smoking cessation rate reached 30.0% in the CI group and 21.2% in the PI group. Using the Markov model, compared with the NI group, the intervention strategies of the PI group and the CI group were found to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of $535.62/QALY and $366.19/QALY, respectively. The probabilistic sensitivity analysis indicated that the CI strategy was always the most cost-effective intervention. Conclusion: CI for smoking cessation, based in hospital and community in China, is more cost-effective than PI alone. Therefore, this smoking cessation model should be considered to be implemented in healthcare settings.

Perception of Patient Safety and the Reporting System Between Medical Staffs and Patients in China: A Cross-Sectional Online Study.

OBJECTIVE: This study aimed to understand the perception of patient safety and the reporting system in public in China, and make further recommendations for the optimization of the reporting system of patient safety. METHODS: The following data were collected through an online questionnaire from medical staffs and patients: recognition of patient safety, comments on patient participation, comments on spontaneous reports, attitudes toward the principles of spontaneous reports, and willingness to participate. This information was presented with frequency and percentage with 95% confidence intervals (CIs). Spearman rank correlation was used to evaluate the association of those data. RESULTS: A total of 27,493 valid questionnaires were collected in this study. The participants who knew patient safety very well, regarded patients as an essential part to enhance patient safety, viewed spontaneous reports helpful, agreed on the 3 principles of voluntariness, anonymity, and nonpunishment of the reporter, and were willing to participate in reporting were accounted for 39.2% (95% CI, 38.6%-39.8%), 31.2% (95% CI, 30.7%-31.8%), 25.2% (95% CI, 24.7%-25.7%), 24.0% (95% CI, 23.5%-24.5%), and 19.9% (95% CI, 19.4%-20.4%), respectively. A moderate positive correlation was observed between comments on spontaneous reports and attitudes toward the principles of spontaneous reports (medical staffs versus patients, rs = 0.452 versus rs = 0.439; both, P < 0.01), as well as comments on patient participation and comments on spontaneous reports (medical staffs versus patients, rs = 0.410 versus rs = 0.460; both, P < 0.01). CONCLUSIONS: The awareness of patient safety may influence the choices of the other questions subsequently and may affect their voluntariness for safety reports ultimately. Pertinent measures, such as publicity of the relevant concept, simplification of the reporting procedures, and promotion of incentive mechanisms, should be adopted to promote the optimization of the reporting system.

The impact of the physical form of torularhodin on its metabolic fate in the gastrointestinal tract.

Torularhodin is a fungal carotenoid with multiple health benefits. However, the relationship between its physical form and metabolic fate in the gastrointestinal tract (GIT), which is essential to its bioavailability and health efficacy, has rarely been studied. Thus, physical forms of torularhodin including nanoemulsion powder (T-EP), capsules of the T-EP by alginate (T-EPA), and solution in MCT oil (T-oil) were used in the study. T-EP was produced through OSA-starch-mediated torularhodin emulsification and spray drying whereas the T-EPA was alginate-based capsules of the T-EP particles that were entrapped in the network structure of the alginate matrix as observed by scanning electron microscopy (SEM). The oil digestibility in the simulated small intestine was decreased from T-EP (100%), T-oil (60%) to T-EPA (40%), and the bioaccessibilities were 27%, 15% and 12%, respectively. The in vivo study using mice revealed that the content of torularhodin gradually decreased along with the digestion time in both the stomach and small intestine while a significantly higher colonic accumulation was observed in T-EPA compared to T-oil and T-EP. In vitro fecal fermentation showed that propionate (32 mM) was the predominant metabolite produced by torularhodin in the physical form of T-EPA. Thus, the physical form of torularhodin is a significant contributing factor to its GIT metabolic fate, and a health outcome-oriented design of the physical form of torularhodin or other nutraceuticals is beneficial for the development of functional foods with enhanced health benefits.

Association Between Serum Vitamin A Levels and Recurrent Respiratory Tract Infections in Children.

To evaluate the association between serum vitamin A levels and the prevalence of recurrent respiratory tract infections (RRTIs) in children and adolescents and to provide evidence that would help decrease the prevalence of respiratory tract infections (RTIs) in children. This cross-sectional study included 8034 children and adolescents in Beijing aged 6 months to 17 years. RRTI and RTI symptoms were diagnosed according to the Clinical Concept and Management of Recurrent Respiratory Tract Infections in Children. Multivariate logistic regression models were used to evaluate the association between serum vitamin A levels and RRTIs after adjusting for potential confounders. Among the included children, 721 (8.97%) were diagnosed with vitamin A deficiency, whereas 3,073 (38.25%) were diagnosed with subclinical vitamin A deficiency. Only 28.8% (208/721) of children with vitamin A deficiency and 53.1% (1,631/3,073) of children with subclinical vitamin A deficiency had no RRTI and RTI symptoms, respectively. Compared with children with normal vitamin A levels, those with vitamin A deficiency and subclinical vitamin A deficiency had a greater risk for RRTIs, with an odds ratio (OR) of 6.924 [95% confidence interval (CI): 5.433-8.824] and 2.140 (95% CI: 1.825-2.510), respectively]. Vitamin A levels were also positively associated with RTI symptoms, with those having vitamin A deficiency and subclinical vitamin A deficiency showing an OR of 1.126 (95% CI: 0.773-1.640) and 1.216 (95% CI: 1.036-1.427), respectively. The present cross-sectional study found that low serum vitamin A levels were significantly associated with RRTI or RTI prevalence in children and adolescents.