Groundwater pollution risk, health effects and sustainable management of halocarbons in typical industrial parks.

As important chemical raw materials and organic solvents, halogenated hydrocarbons not only play an important role in economic development, but are also the main source of environmental pollution. This study proposed an improved groundwater risk assessment model system, aimed at identifying and treating contaminants at leak sites. Groundwater ubiquity score (GUS) was used to evaluate the leachability of organic pollutants. The entropy-weighted water quality index (EWQI) method was used to assess the comprehensive quality of groundwater at the site. An improved groundwater health risk assessment model was constructed to analyze the health risks of groundwater. The sources of organic pollutants were identified based on the positive matrix factorization (PMF) model. Self-organizing mapping (SOM) and the K-means algorithm were integrated to classify and manage pollution source areas. The results showed that groundwater in the study area was strongly affected by human activities. The pollution source was located in a factory near S05. Different organic pollutants were highly leachable and had high potential to contaminate surrounding groundwater. 1,2-dichloropropane and 1,2,3-trichloropropane caused the largest range of contamination. The groundwater pollution index in the study area was high, and 72% of the monitoring points were non-drinkable. Both the carcinogenic and non-carcinogenic indexes of groundwater far exceeded the international standard limits and had a great impact on human health. 1,2,3-trichloropropane and 1,2-dichloropropane were major non-carcinogenic risk factors. The leakage of pollutants and pesticide solvents were the main causes of groundwater pollution. Cluster areas III and II were areas with significant pollution impacts and needed to be monitored intensively. Most areas were cluster I, with relatively low risk. This study can provide technical support for groundwater pollution risk assessment and management in similar industrial parks.

Radial basis point interpolation for strain field calculation in digital image correlation.

In order to extract smooth and accurate strain fields from the noisy displacement fields obtained by digital image correlation (DIC), a point interpolation meshless (PIM) method with a radial basis function (RBF) is introduced for full-field strain calculation, which overcomes the problems of slow calculation speed and unstable matrix inverse calculation of the element-free Galerkin method (EFG). The radial basis point interpolation method (RPIM) with three different radial basis functions and the moving least squares (MLS) and pointwise least squares (PLS) methods are compared by analyzing and validating the strain fields with high-strain gradients in simulation experiments. The results indicate that the RPIM is nearly 80% more computationally efficient than the MLS method when a larger support domain is used, and the efficiency of the RPIM is nearly 26% higher than that of the MLS method when a smaller support domain is used; the strain calculation accuracy is slightly lower than that of the MLS method by 0.3-0.5%, but the stability of the calculation is significantly improved. In contrast with the PLS method, which is easily affected by the noise and the size of the strain calculation window, the RPIM is insensitive to the displacement noise and the size of the support domain and can obtain a similar calculation accuracy. The RPIM with multiquadric (MQ) radial basis functions performs well in balancing the computational accuracy and efficiency and is insensitive to shape parameters. The application cases show that the method can effectively compute the strain field at the crack tip, validating its applicability to the study of the plastic region at the crack tip. In conclusion, the proposed RPIM-based method provides an accurate, practical, and robust approach for full-field strain measurements.

Identification of C1q/TNF-related protein 4 as a novel appetite-regulating peptide that reduces food intake in Siberian sturgeon (Acipenser baerii).

Emerging findings point to a role for C1q/TNF-related protein 4 (CTRP4) in feeding in mammals. However, it remains unknown whether CTRP4 regulates feeding in fish. This study aimed to determine the feeding regulation function of CTRP4 in Siberian sturgeon (Acipenser baerii). In this study, the Siberian sturgeon ctrp4 (Abctrp4) gene was cloned, and Abctrp4 mRNA was shown to be highly expressed in the hypothalamus. In the hypothalamus, Abctrp4 mRNA decreased during fasting and reversed after refeeding. Subsequently, we obtained the AbCTRP4 recombinant protein by prokaryotic expression and optimized the expression and purification conditions. Siberian sturgeon (81.28 ± 14.75 g) were injected intraperitoneally using 30, 100, and 300 ng/g Body weight (BW) AbCTRP4 to investigate its effect on feeding. The results showed that 30, 100, and 300 ng/g BW of the AbCTRP4 significantly reduced the cumulative food intake of Siberian sturgeon at 1, 3, and 6 h. Finally, to investigate the potential mechanism of CTRP4 feeding inhibition, 300 ng/g BW AbCTRP4 was injected intraperitoneally. The findings demonstrated that AbCTRP4 treatment for 1 h significantly promoted the mRNA levels of anorexigenic peptides (pomc, cart, and leptin) while suppressing the mRNA abundances of orexigenic peptides (npy and agrp).In addition, the jak2/stat3 pathway in the hypothalamus was significantly activated after 1 h of AbCTRP4 treatment. In conclusion., this study confirms the anorexigenic effect of CTRP4 in Siberian sturgeon.

Development of a self-assessment tool to evaluate the readiness of pharmacy departments for internship training in China: a two-phase study.

OBJECTIVES: Internships in the pharmacy departments of training hospitals represent a crucial stage in the professional development of pharmacy students. However, the quality of internship training varies significantly across training hospitals in China, and there is a lack of standardized readiness evaluation tools. Therefore, the purpose of this study was to develop a self-assessment tool to evaluate the preparedness of training hospitals for providing internship training. METHODS: This study employed an exploratory mixed-methods approach and was conducted in two phases. In the first phase, during 2021, focus groups were conducted with 16 interns from three tertiary hospitals in Henan Province. In 2022, 14 preceptors from tertiary hospitals in various provinces were interviewed either one-on-one or in focus groups. The interview data were analyzed using thematic analysis to compile a set of self-assessment indicators for internship training readiness. Subsequently, the initial draft of the self-assessment tool for internship training readiness was developed by integrating the indicators derived from the interviews and literature review. In the second phase, the Delphi method was utilized. In 2023, the experts participated in two rounds of correspondence (21 experts in the first round and 19 in the second round), and consensus was reached on the indicators of the self-assessment tool after the two rounds. Meanwhile, these experts assessed the current status of internship training in training hospitals across China. RESULTS: The qualitative findings of the first phase included five themes and 22 sub-themes, which were integrated with the indicators derived from the literature review to develop an initial indicator framework for the second phase. This initial framework comprised five domains and 37 items. The second phase involved two rounds of expert surveys, with effective response rates of 90.48% and 89.47%, respectively. Ultimately, the self-assessment tool for evaluating the readiness of pharmacy departments in training hospitals for internships included five dimensions and 35 secondary indicators: (1) organizational structure, (2) training content, (3) training mode, (4) effectiveness evaluation, and (5) emergency management. Additionally, experts assessed the readiness of pharmacy departments in Chinese training hospitals for internships, yielding varied results. Emergency management preparedness scored the highest, followed by organizational structure and training content preparation. However, the modes of internship training and the evaluation of training effectiveness received lower scores. CONCLUSION: The developed tool provides a comprehensive self-assessment checklist for the pharmacy departments of training hospitals and possesses the potential to enhance the development of more effective internship training programs.

Nurses' self-regulation after engaging in end-of-life conversations with advanced cancer patients: a qualitative study.

BACKGROUND: Self-regulation is crucial for nurses who engage in in-depth end-of-life conversations with advanced cancer patients, especially in cultural contexts featuring death taboos. An improved understanding of the self-regulation process of nurses can help them address negative emotions and promote self-growth more effectively. Therefore, this study aimed to explore nurses' self-regulation process after end-of-life conversations with advanced cancer patients. METHODS: This study employed a descriptive, qualitative approach. Seventeen nurses from four hospitals and a hospice unit in mainland China were interviewed between September 2022 and June 2023. Data were collected through face-to-face semistructured interviews. A thematic analysis method was used to analyse the data following the guidance of regulatory focus theory. RESULTS: Three main themes were developed: self-regulation antecedents include personality, experience, and support; promotion or prevention is a possible self-regulation process for nurses; both self-exhaustion and self-growth may be the outcomes of self-regulation, as did seven subthemes. Personality tendencies, life experience, and perceived support may affect nurses' self-regulation, thereby affecting their self-regulation outcomes. CONCLUSIONS: Nurses exhibit different self-regulatory tendencies and self-regulation outcomes. The provision of peer support and counselling support to nurses is highly important with regard to achieving good self-regulation outcomes.

Revealing Hydrogen Bond Effect in Rechargeable Aqueous Zinc-Organic Batteries.

The surrounding hydrogen bond (H-bond) interaction around the active sites plays indispensable functions in enabling the organic electrode materials (OEMs) to fulfill their roles as ion reservoirs in aqueous zinc-organic batteries (ZOBs). Despite important, there are still no works could fully shed its real effects light on. Herein, quinone-based small molecules with a H-bond evolution model has been rationally selected to disclose the regulation and equilibration of H-bond interaction between OEMs, and OEM and the electrolyte. It has been found that only a suitable H-bond interaction could make the OEMs fully liberate their potential performance. Accordingly, the 2,5-diaminocyclohexa-2,5-diene-1,4-dione (DABQ) with elaborately designed H-bond structure exhibits a capacity of 193.3 mAh g-1 at a record-high mass loading of 66.2 mg cm-2 and 100 % capacity retention after 1500 cycles at 5 A g-1. In addition, the DABQ//Zn battery also possesses air-rechargeable ability by utilizing the chemistry redox of proton. Our results put forward a specific pathway to precise utilization of H-bond to liberate the performance of OEMs.

Stable Lithium Oxygen Batteries Enabled by Solvent-diluent Interaction in N,N-dimethylacetamide-based Electrolytes.

In the pursuit of next-generation ultrahigh-energy-density Li-O2 batteries, it is imperative to develop an electrolyte with stability against the strong oxidation environments. N,N-dimethylacetamide (DMA) is a recognized solvent known for its robust resistance to the highly reactive reduced oxygen species, yet its application in Li-O2 batteries has been constrained due to its poor compatibility with the Li metal anode. In this study, a rationally selected hydrofluoroether diluent, methyl nonafluorobutyl ether (M3), has been introduced into the DMA-based electrolyte to construct a localized high concentration electrolyte. The stable -CH3 and C-F bonds within the M3 structure could not only augment the fundamental properties of the electrolyte but also fortify its resilience against attacks from O2 - and 1O2. Additionally, the strong electron-withdrawing groups (-F) presented in the M3 diluent could facilitate coordination with the electron-donating groups (-CH3) in the DMA solvent. This intermolecular interaction promotes more alignments of Li+-anions with a small amount of M3 addition, leading to the construction of an anion-derived inorganic-rich SEI that enhances the stability of the Li anode. As a result, the Li-O2 batteries with the DMA/M3 electrolyte exhibit superior cycling performance at both 30 °C (359th) and -10 °C (120th).

Reconfiguring the Hydrogen Networks of Aqueous Electrolyte to Stabilize Iron Hexacyanoferrate for High-Voltage pH-Decoupled Cell.

Prussian blue analogs (PBAs) are promising insertion-type cathode materials for different types of aqueous batteries, capable of accommodating metal or non-metal ions. However, their practical application is hindered by their susceptibility to dissolution, which leads to a shortened lifespan. Herein, we have revealed that the dissolution of PBAs primarily originates from the locally elevated pH of electrolytes, which is caused by the proton co-insertion during discharge. To address this issue, the water-locking strategy has been implemented, which interrupts the generation and Grotthuss diffusion of protons by breaking the well-connected hydrogen bonding network in aqueous electrolytes. As a result, the hybrid electrolyte enables the iron hexacyanoferrate to endure over 1000 cycles at a 1 C rate and supports a high-voltage pH-decoupled cell with an average voltage of 1.95 V. These findings provide insights for mitigating the dissolution of electrode materials, thereby enhancing the viability and performance of aqueous batteries.

Living experiences of people with advance cancer with low socioeconomic status: A systematic review of qualitative evidence.

BACKGROUND: The number of patients with advanced cancer is rapidly increasing, and the subgroup of this population with low socioeconomic status has suffered more disease burden than others. However, there is no recent qualitative synthesis of primary research studies into advanced cancer patients with low socioeconomic status. OBJECTIVE: To synthesise qualitative research findings into advanced cancer patients' experiences with low socioeconomic status, and then to help provide targeted and effective strategies to improve their quality of life. DESIGN: A systematic review and meta-synthesis of qualitative evidence (PROSPERO: CRD42021250423). DATA SOURCES: PubMed, Web of Science Core Collection (ISI Web of Science), Cochrane Library, Embase, OVID LWW, CINAHL Complete (EBSCO), PsycINFO (EBSCO) and MEDLINE (ISI Web of Science), China National Knowledge Infrastructure (CNKI), WangFang, and Vip databases were systematically searched from their original dates to July 2022. Qualitative data were appraised using the Joanna Briggs Institute (JBI) qualitative assessment. FINDINGS: The findings were synthesised into the following three analytical themes: (1) multi-dimensional disease distresses; (2) barriers in coping with disease distresses; and (3) strategies for dealing with disease distresses. CONCLUSIONS: Patients with advanced cancer with low socioeconomic status experienced complicated and interactional distresses, unique life barriers, and a wide range of adaptation strategies. These findings will provide a comprehensive perspective to promote individual-centred health care systems and services to help these vulnerable people deal with the challenges of disease and improve their quality of life.

In Situ Electrochemical Activation of Hydroxyl Polymer Cathode for High-Performance Aqueous Zinc-Organic Batteries.

The slow reaction kinetics and structural instability of organic electrode materials limit the further performance improvement of aqueous zinc-organic batteries. Herein, we have synthesized a Z-folded hydroxyl polymer polytetrafluorohydroquinone (PTFHQ) with inert hydroxyl groups that could be partially oxidized to the active carbonyl groups through the in situ activation process and then undertake the storage/release of Zn2+ . In the activated PTFHQ, the hydroxyl groups and S atoms enlarge the electronegativity region near the electrochemically active carbonyl groups, enhancing their electrochemical activity. Simultaneously, the residual hydroxyl groups could act as hydrophilic groups to enhance the electrolyte wettability while ensuring the stability of the polymer chain in the electrolyte. Also, the Z-folded structure of PTFHQ plays an important role in reversible binding with Zn2+ and fast ion diffusion. All these benefits make the activated PTFHQ exhibit a high specific capacity of 215 mAh g-1 at 0.1 A g-1 , over 3400 stable cycles with a capacity retention of 92 %, and an outstanding rate capability of 196 mAh g-1 at 20 A g-1 .

The Perceived Role of Occupational Therapists in Climate Change.

Introduction. In 2022, the World Health Organization (WHO) predicted that climate change would cause thousands of additional deaths per year from malnutrition, malaria, diarrhea, and heat stress alone between the years of 2030 and 2050. With such health consequences and environmental changes, climate change is impacting human occupations globally. However, there is a gap in the literature regarding the occupational therapists' role in climate change, particularly in the Canadian context. Objectives. Our research aimed to explore what is the perceived role of occupational therapists in climate change and climate action from the perspective of Canadian occupational therapists and international experts. Methods. This qualitative study used interpretive description methodology. We recruited 12 occupational therapists, including 4 research experts in the field. We conducted semi-structured interviews with each participant. Data were analyzed thematically. Results. This study uncovered three themes that focused on the complex interconnections between climate challenges and climate actions that occupational therapists are wrestling with personally, clinically, and professionally. Specifically, this study emphasized the importance of supporting individual occupational therapists with their personal challenges, integrating climate actions into clinical practices, and incorporating climate change and climate justice into occupational therapy curricula and professional advocacy. Conclusions. The environment, including the planet's ecosystem, is a fundamental component in many models of occupational therapy practice. This research provides a rich understanding in the themes of occupational therapists' perceptions of climate change and climate actions, particularly within a Canadian context.

Construction of ecological security pattern of arid area based on landscape ecological risk assessment: a case study of the Wu-Chang-Shi urban agglomeration.

The construction of ecological security pattern (ESP) holds paramount importance in ensuring regional environment sustainability. This study introduces an innovative approach to ESP construction grounded in landscape ecological risk (LER) assessment, with Wu-Chang-Shi urban agglomeration in Xinjiang, China, serving as a case study. Initially, LER within the area was evaluated using the LER Index (LERI) method. Subsequently, the Geodetector model was employed to discern the relationship between multi-source data and LER. Furthermore, ecological resistance and corridors were delineated utilizing the minimum cumulative resistance (MCR) model. Lastly, the corridors were optimized using the gravity model, finalizing the ESP construction. Study results reveal that LER was always fluctuating from 1990 to 2010, and tended to stabilize from 2010 to 2020. Factor detection underscores the predominant influence of land use on LER, followed by elevation and vegetation distribution. The ESP shows the imperative for improving connectivity of the natural areas that are fragmented by urban land, highlighting the great significance of the woodland-originating corridors. Finally, strategies are proposed to enhance woodland and water coverage, boost landscape diversity in nature reserves, and prioritize ecological conservation in corridor regions. In summation, the study furnishes a framework for analyzing arid regions in Eurasia. Furthermore, the research idea of evaluation-analysis-remodeling also offers insights into environmental management in developing areas with more diverse climate types.

Prediction of fruit characteristics of grafted plants of Camellia oleifera by deep neural networks.

BACKGROUND: Camellia oleifera, an essential woody oil tree in China, propagates through grafting. However, in production, it has been found that the interaction between rootstocks and scions may affect fruit characteristics. Therefore, it is necessary to predict fruit characteristics after grafting to identify suitable rootstock types. METHODS: This study used Deep Neural Network (DNN) methods to analyze the impact of 106 6-year-old grafting combinations on the characteristics of C.oleifera, including fruit and seed characteristics, and fatty acids. The prediction of characteristics changes after grafting was explored to provide technical support for the cultivation and screening of specialized rootstocks. After determining the unsaturated fat acids, palmitoleic acid C16:1, cis-11 eicosenoic acid C20:1, oleic acid C18:1, linoleic acid C18:2, linolenic acid C18:3, kernel oil content, fruit height, fruit diameter, fresh fruit weight, pericarp thickness, fresh seed weight, and the number of fresh seeds, the DNN method was used to calculate and analyze the model. The model was screened using the comprehensive evaluation index of Mean Absolute Error (MAPE), determinate correlation R2 and and time consumption. RESULTS: When using 36 neurons in 3 hidden layers, the deep neural network model had a MAPE of less than or equal to 16.39% on the verification set and less than or equal to 13.40% on the test set. Compared with traditional machine learning methods such as support vector machines and random forests, the DNN method demonstrated more accurate predictions for fruit phenotypic characteristics, with MAPE improvement rates of 7.27 and 3.28 for the 12 characteristics on the test set and maximum R2 improvement values of 0.19 and 0.33. In conclusion, the DNN method developed in this study can effectively predict the oil content and fruit phenotypic characteristics of C. oleifera, providing a valuable tool for predicting the impact of grafting combinations on the fruit of C. oleifera.

Prevalence of cancer-related cognitive impairment among patients with nasopharyngeal carcinoma: a cross-sectional study.

OBJECTIVE: To examine the prevalence of cancer-related cognitive impairment (CRCI) and its contributing factors in patients with nasopharyngeal carcinoma (NPC) and explore the relationship between various assessment methods. METHODS: A cross-sectional study was conducted with 367 patients with NPC between March 2022 and April 2024 at Chongqing University Cancer Hospital. The data gathered from the demographic questionnaire, Montreal Cognitive Assessment (MoCA), Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were analyzed using logistic regression. RESULTS: Out of 367 participants, males accounted for 271 (73.84%). There were 217 (59.13%) individuals aged between 35-55 years. Cognitive impairment incidence was 58.04% using MoCA and 47.98% using FACT-Cog. Years of education, work condition, age and time since diagnosis (≥ 11 months) were all significantly associated with cognitive impairment using MoCA, the strongest being time since diagnosis (≥ 11 months) (OR = 2.672, 95% CI = 1.191-5.997, P = 0.017). Gender, marital status (married), place of residence (township), place of residence (city), alcohol history, SAS and SDS were all significantly associated with FACT-Cog, the strongest being marital status (married) (OR = 4.100, 95% CI = 1.130-14.87, P = 0.032). CONCLUSION: Patients diagnosed with NPC exhibit susceptibility to CRCI. There was a weak correlation between some aspects of the subjective tests and the objective test scores. Advanced age and disease diagnosis longer than 10 months are associated with a heightened risk of objective cognitive impairment. Furthermore, residing in rural areas, female, married, alcohol history, SAS and SDS increases the likelihood of subjective cognitive impairment. These findings highlight the need to select appropriate assessment scales for different needs and take targeted interventions to address CRCI in patients with NPC.

Cross-sectional study on the impact of cardiac and hepatic iron overload, as measured by MRI T2*, on the quality of life in children with severe beta-thalassemia major.

A cross-sectional study to explore the correlation between cardiac and hepatic iron overload and its impact on the quality of life in children diagnosed with severe beta-thalassemia major (ß-TM). A cohort of 55 pediatric patients with ß-TM, diagnosed via genetic testing at the Affiliated Hospital of Guangdong Medical University from January 2015 to January 2022, was included in this study. The assessment of cardiac and hepatic iron overload was conducted using the magnetic resonance imaging T2* technique. The Chinese version of the Pediatric Quality of Life Inventory (PedsQL) 4.0. Pearson correlation analysis was utilized to assess the relationships between the cardiac and hepatic T2* values and between these T2* values and the total scores of PedsQL 4.0. Analysis showed no significant correlation between cardiac and hepatic T2* values. However, a significant relationship was observed between cardiac T2* values and PedsQL 4.0 total scores (r = 0.313, P < .05), indicating that cardiac, but not hepatic, iron overload is associated with the quality of life. This study highlights the absence of correlation between cardiac and hepatic iron overload levels and demonstrates a significant impact of cardiac iron overload on the quality of life in children with ß-TM. These findings suggest the need for a focused approach to cardiac health in managing ß-TM.

Exploring willingness to use adverse drug reaction reporting systems: a multicentre qualitative study in China based on the technology acceptance model and task-technology fit integration approach.

BACKGROUND: Adverse drug reaction (ADR) reporting systems are critical for monitoring and managing drug safety. However, various factors influence the willingness to use these systems. This study aimed to investigate the willingness to use ADR reporting systems through an integrated model of the Technology Acceptance Model (TAM) and Task-Technology Fit (TTF) theory, conducting a multicentre qualitative study from the user's perspective. METHODS: This study used qualitative research methods, including in-depth interviews with clinicians, nurses, pharmacists and administrators who reported ADRs through the National Adverse Drug Reaction Monitoring System (NADRMS) and the China Hospital Pharmacovigilance System (CHPS). The interviews were audio-recorded, transcribed verbatim and analysed using QDA Miner software for data management and thematic analysis. RESULTS: Eighteen healthcare workers from five healthcare organisations participated in the study. They found the ease of use and usefulness of the current NADRMS and CHPS to be acceptable. The essential technical requirements identified included accuracy, standardisation, timeliness and confidentiality. However, challenges such as inaccurate information capture, unstable interfacing with medical record systems, low reporting efficiency and lack of data sharing were highlighted. Overall, front-line healthcare workers exhibited a generally negative attitude towards using NADRMS and CHPS, driven more by necessity than preference. Factors influencing their willingness to use these systems included ease of use, practicality, risk perception and social impact, with varying attitudes and requirements observed between user groups. CONCLUSION: This study provides practical recommendations that can be readily implemented to enhance the effectiveness and sustainability of ADR reporting systems. While front-line users in China acknowledged the systems' ease of use and usefulness, they also noted significant gaps in technological adaptation. They expressed the need for improvements in data openness and sharing, accessibility and system intelligence.

Spatial Structure Design of Thioether-Linked Naphthoquinone Cathodes for High-Performance Aqueous Zinc-Organic Batteries.

Organic electrode materials (OEMs) have gathered extensive attention for aqueous zinc-ion batteries (AZIBs) due to their structural diversity and molecular designability. However, the reported research mainly focuses on the design of the planar configuration of OEMs and does not take into account the important influence of the spatial structure on the electrochemical properties, which seriously hamper the further performance liberation of OEMs. Herein, this work has designed a series of thioether-linked naphthoquinone-derived isomers with tunable spatial structures and applied them as the cathodes in AZIBs. The incomplete conjugated structure of the elaborately engineered isomers can guarantee the independence of the redox reaction of active groups, which contributes to the full utilization of active sites and high redox reversibility. In addition, the position isomerization of naphthoquinones on the benzene rings changes the zincophilic activity and redox kinetics of the isomers, signifying the importance of spatial structure on the electrochemical performance. As a result, the 2,2'-(1,4-phenylenedithio) bis(1,4-naphthoquinone) (p-PNQ) with the smallest steric hindrance and the most independent redox of active sites exhibits a high specific capacity (279 mAh g-1), an outstanding rate capability (167 mAh g-1 at 100 A g-1), and a long-term cycling lifetime (over 2800 h at 0.05 A g-1).

Clinical features of hand, foot and mouth disease caused by Coxsackievirus A6 in Xi'an, China, 2013-2019: A multicenter observational study.

PURPOSE: To investigate the clinical features of hand, foot, and mouth disease (HFMD) caused by coxsackievirus A6 (CVA6) and this work may help early diagnose of atypical HFMD. METHODS: From January 2013 to December 2019, a total of 7,208 patients with a clinical diagnosis of HFMD in Xi'an Children's Hospital, Xi'an Central Hospital, and Xi'an Jiaotong University Second Affiliated Hospital, were included in this observational study. The clinical data, specimens and follow-up results were collected. Real-time RT‒PCR was performed for the detection and typing of enterovirus nucleic acids. RESULTS: Of the 7,208 clinically diagnosed HFMD patients, 5,622 were positive for enterovirus nucleic acids, and the positive proportions of CVA6, enterovirus 71 (EV-A71), coxsackievirus A16 (CVA16), and other enteroviruses were 31.0% (1,742/5,622), 27.0% (1,518/5,622), 35.0% (1,968/5,622), and 7.0% (394/5,622), respectively. Based on the etiology, patients were divided into CVA6 group, EV-A71group, and CVA16 group. The mean age at onset was significantly higher in the CVA6 group (4.62±2.13 years) than in the EV-A71 group and CVA16 group (3.45±2.25 years and 3.35±2.13 years, respectively; both P < 0.05). The male/female ratio was 1.45 (1,031/711) in the CVA6 group and was not significantly different from the other two groups. The incidence of fever was significantly higher in the CVA6 group [82.5% (1,437/1,742)] than in the EV-A71 group [51.3% (779/1,518)] and the CVA16 group [45.9% (903/1,968)] (P < 0.05). In the CVA6 group, the rashes were more frequently on the trunk and elbows/knees and were significantly different from the other two groups (P < 0.05). The number of patients with two or more rash morphologies was significantly higher in the CVA6 group than in the other two groups (P < 0.05). The incidence of bullous rash in the CVA6 group [20.2%; n = 352] was higher than in the EV-A71 group [0.33%; n = 5] and CVA16 group [0.66%; n = 13] (P < 0.05). The incidence of neurological complications was significantly higher in the EV-A71 group [52.1% (791/1,518)] than in the CVA16 group [5.1% (100/1,968)] and the CVA6 group [0.8% (14/1,742)] (P < 0.05). In the follow-up period, 160 patients (9.2%) with CVA6 HFMD experienced onychomadesis, but no onychomadesis was observed in the EV-A71 and CVA16 groups. The average WBC count was significantly higher in the CVA6 group than in the CVA16 group (P < 0.05). The number of patients with increased CRP was significantly larger in the CVA6 group than in the CVA16 group but was significantly smaller than that in the EV-A71 group (P < 0.05). CONCLUSIONS: CVA6 has become one of the main pathogens of HFMD in the Xi'an area during 2013-2019. The main clinical manifestations were slightly different from those of HFMD caused by EV-A71 or CVA16, with a higher frequency of fever, diverse morphologies and diffuse distribution of rashes, fewer neurological complications and some onychomadesis.

Exploring the influencing factors of adverse drug reaction reporting among medical personnel: a COM-B model-based study.

Background: This study aims to identify the factors that influence medical workers' enthusiasm for reporting adverse drug reactions (ADRs). Understanding these factors is essential to implement targeted interventions that can improve and refine pharmacovigilance systems. Methods: We adopted the Capability, Opportunity, Motivation, and Behavior model (COM-B) model as the theoretical framework and conducted qualitative research using in-depth interviews with clinicians, nurses, pharmacists, and administrators. 24 one-on-one interviews were conducted and audio-recorded. The interviews were transcribed verbatim, and subjected to thematic analysis to uncover the key factors affecting ADR reporting among medical staff. Results: The participation included 24 healthcare workers from six different healthcare organisations. Analysis revealed that decreased motivation to report ADRs was due to inadequate judgment or inconsistent judgment criteria within the capability domain, poor awareness of ADRs and deficient communication skills within the psychological domain, unclear responsibilities within the motivation domain, and limited or no access to necessary resources within the opportunity domain. Facilitators of ADR reporting included sufficient cognitive and operational abilities, spontaneous and incentivized motivation, clear responsibilities and role expectations, and robust social support. Conclusion: There is a critical need to develop comprehensive interventions that address the identified factors influencing ADR reporting. By improving the motivation of medical staff to report ADRs, the pharmacovigilance system can be significantly improved.

Truncated VZV gE Induces High-Titer Neutralizing Antibodies in Mice.

Backgrounds: A contemporary public health challenge is the increase in the prevalence rates of herpes zoster (HZ) worldwide. Methods: In this work, the gE gene structure was analyzed using bioinformatics techniques, and three plasmids of varying lengths, tgE537, tgE200, and tgE350, were expressed in Chinese hamster ovary (CHO) cells. These proteins were used to immunize BALB/c mice with Al/CpG adjuvant; ELISPOT and FCM were used to evaluate cellular immunity; and ELISA, VZV microneutralization, and FAMA assays were performed to detect antibody titers. Results: Target protein concentrations of 1.8 mg/mL for tgE537, 0.15 mg/mL for tgE200 and 0.65 mg/mL for tgE350 were effectively produced. The ability of the three protein segments to stimulate CD4+ and CD8+ T cells, as well as to cause lymphocytes to secrete IFN-γ and IL-4, did not significantly differ from one another. Both tgE537 and tgE350 were capable of generating VZV-specific antibodies and neutralizing antibodies, while tgE350 had the highest neutralizing antibody titer (4388). There was no equivalent humoral immune response induced by tgE200. Conclusions: The results of this investigation provide the groundwork for the creation of HZ recombinant vaccines using truncated proteins as antigens.