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Purpose Exploring novel mediators affecting the relationship between obesity and sleep-disordered breathing (SDB) is necessary. This study aimed to explore the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between body mass index (BMI) and SDB using data from the 2015–2018 National Health and Nutrition Examination Survey (NHANES) cycles. Methods Total 7639 participants were included. SDB was defined based on the self-reported frequency of snoring, snorting, or excessive daytime sleepiness. The BMI and NHHR were calculated based on height and weight measurements and laboratory data, respectively. Weighted multivariate logistic and linear regression analyses were conducted to examine the associations, and restricted cubic spline (RCS) analysis was used to assess dose–response relationships. Mediation analysis was performed to evaluate the NHHR’s role in the BMI–SDB association. Subgroup analyses were performed to assess differences across various populations. Results SDB symptoms were observed in 51.05% of participants. Higher BMI was significantly associated with increased SDB risk. RCS analysis revealed a nonlinear relationship between BMI and SDB. Subgroup analyses indicated a positive correlation between BMI and SDB was stronger among nonhypertensive participants. NHHR was positively associated with BMI and SDB. Mediation analysis showed that the NHHR explained 5.44–8.12% of the BMI–SDB association. Conclusions BMI is a critical factor in the risk of SDB, and the NHHR partially mediates this relationship. BMI and cholesterol levels should be managed to mitigate the SDB risk. Level of evidence Level V—cross-sectional observational study.

To efficiently, sustainably, and rapidly extract bioactive compounds, steam explosion (SE) technology was tried to use for the first time as a pretreatment of Potentilla discolor Bunge (PDB) stems. This study systematically investigated the effects of SE on stem structure, total phenolic content, composition and bioactivities. Macroscopic observation showed that SE-treated stems became darker and deeper in color. Microscopic analysis indicated a reduction in hemicellulose and lignin contents, while the basic skeletal structure remained intact, which facilitated the release of active compounds. This structural modification was directly linked to an enhancement in biological activity. Compared with the untreated group, total phenolic content in SE-treated stems increased 1.11–1.94 times. Correspondingly, antioxidant and hypoglycemic activities were enhanced by 1.35–7.19 times, demonstrating a clear relationship between the structural changes and the improved bioactivity. HPLC analysis showed specific changes in chemical composition, with increased levels of total phenolic content, particularly phenolic acids and flavonoids. Compositional analysis using Q Exactive HF LC-MS and standard comparison revealed that complex macromolecules, such as flavonoid glycosides and polyphenols, were hydrolyzed into smaller, more bioavailable molecules, such as quercetin. Overall, SE pretreatment represents a sustainable and effective approach for improving the extraction of bioactive compounds from PDB stems. These active compounds hold significant potential for applications in functional foods, nutraceuticals, and natural health products, offering an innovative strategy to enhance the bioavailability and bioactivity of plant-derived compounds.

Zinc-ion batteries (ZIBs) have recently attracted great interest and are regarded as a promising energy storage device due to their low cost, environmental friendliness, and superior safety. However, the development of suitable Zn-ion intercalation cathode materials remains a great challenge, resulting in unsatisfactory ZIBs that cannot meet commercial demands. Considering that spinel-type LiMn2O4 has been shown to be a successful Li intercalation host, spinel-like ZnMn2O4 (ZMO) is expected to be a good candidate for ZIBs cathodes. This paper first introduces the zinc storage mechanism of ZMO and then reviews the promotion of research progress in improving the interlayer spacing, structural stability, and diffusivity of ZMO, including the introduction of different intercalated ions, introduction of defects, and design of different morphologies and in combination with other materials. The development status and future research directions of ZMO-based ZIBs characterization and analysis techniques are summarized.

Background The medical and preventive integration(MPI) brings significant and substantial benefits to chronic disease management (CDM). Evaluating the effectiveness of MPI is curial to promote the high quality development of CDM. However, such a tool is not available in this field. We aimed to develop an evaluation index system for assessing the regional performance management level of MPI in the CDM and provide suggestions for improving quality construction of CDM at the county level. Methods The initial version of the performance evaluation index system was constructed based on literature analysis, panel discussions, and in-depth on-site interviews. The Delphi questionnaire was designed and 24 experts in the field of CDM were consulted in two rounds. The analytic hierarchy process method was employed to calculate the weight of indexes at the three levels. Results The MPI performance evaluation index system at the county level includes five first-level indexes, 20 s-level indexes, and 69 third-level indexes. Among the five first-level indicators, “integration quality” (0.2060) ranked first, followed by “integration inputs” (0.2010), “integration effectiveness” (0.1982), “integration outputs” (0.1975), and “integration mode” (0.1973). Conclusion The MPI performance evaluation indexes for CDM at the county level are scientific and reliable. This system can act as a useful tool for diversified subjects to find the loopholes and weak points in CDM. It also provides valuable experience for other national authorities to further improve their own CDM system by MPI evaluation. Strengths and limitations of this study This study complements the gaps in the field of MPI questionnaires in China, but the sample size is small, and it is recommended that reliability and validity tests be carried out in multiple regions of the country in later stages to increase the practicality of the questionnaire.

Most chromophores exhibit an aggregation-caused quenching (ACQ) effect, resulting in minimal or weak emission when incorporated into covalent organic frameworks (COFs). Consequently, the development of luminescent COFs, particularly those utilizing ACQ chromophores, presents both a compelling and formidable challenge. Herein, we report the construction of highly emissive ACQ chromophore-based COFs by an energy level matching strategy. This approach effectively modulates the electronic structures within the COFs, thereby suppressing intralayer charge transfer to ACQ chromophores, such as the imine linkage and dibenzo[g,p]chrysene unit, while simultaneously inhibiting interlayer charge transfer and non-radiative decay pathways. As a result, the undesired ACQ effect is mitigated, enabling the realization of highly emissive COFs. Notably, COF-BT-PhDBC demonstrates high brightness with a solid-state photoluminescence quantum yield of 14.7%, standing among the best ACQ chromophore-based COFs. Furthermore, COF-BT-PhDBC has been successfully utilized for in vivo three-photon fluorescence imaging of murine brain vasculature, achieving an impressive imaging depth of approximately 800 µm. As a result of aggregation-caused quenching (ACQ), many fluorophores show only weak emission when incorporated into covalent organic frameworks. Here, the authors report the development of emissive COFs from ACQ chromophores by an energy level matching strategy.

Introduction Community General Practitioners (CGPs) are crucial to primary healthcare worldwide. Their job satisfaction significantly impacts the quality and accessibility of healthcare. However, a comprehensive global perspective on this issue remains absent, necessitating this systematic review and meta-analysis. Methods This systematic review and meta-analysis sourced literature from PubMed, Web of Science, CNKI, and Wanfang, up to June 14, 2023. Of the 2,742 identified studies, 100 articles were selected for meta-analysis to assess satisfaction levels, and 97 studies were chosen for comparative analysis of influential factors. We employed both meta-analytic and comparative analytic methodologies, focusing on varying geographical, economic, and temporal contexts. Results The pooled rate and corresponding 95% confidence interval ( CI ) for job satisfaction among CGPs was 70.82% (95% CI : 66.62–75.02%) globally. Studies utilizing 5-point score scale obtained a random effect size of 3.52 (95% CI : 3.43–3.61). Diverse factors influenced satisfaction, with remuneration and working conditions being predominant. A noticeable decline in job satisfaction has been observed since the coronavirus disease 2019 outbreak, with satisfaction rates dropping from an average of 72.39% before 2009 to 63.09% in those published after 2020. Conclusions The downward trend in CGPs’ job satisfaction is concerning and warrants urgent attention from policymakers, especially in regions with an acute shortage of CGPs. The findings from this comprehensive review and meta-analysis provide essential insights for informed healthcare policy-making. It highlights the urgency of implementing strategies to enhance CGP satisfaction, thereby improving the effectiveness of primary healthcare systems globally.

Thermometric detectors are crucial in evaluating the condition of target objects spanning from environments to the human body. Optical-based thermal sensing tools have received extensive attention, in which the photon upconversion process with low autofluorescence and high tissue penetration depth is considered as a competent method for temperature monitoring, particularly in biomedical fields. Here, we present an optoelectronic thermometer via infrared-to-visible upconversion, accomplished by integrated light receiving and emission devices. Fully fabricated thin-film, microscale devices present temperature-dependent light emission with an intensity change of 1.5% °C−1 and a spectral shift of 0.18 nm °C−1. The sensing mechanism is systematically characterized and ascribed to temperature dependent optoelectronic properties of the semiconductor band structure and the circuit operation condition. Patterned device arrays showcase the capability for spatially resolved temperature mapping. Finally, in vitro and in vivo experiments implemented with integrated fiber-optic sensors demonstrate real-time thermal detection of dynamic human activity and in the deep brain of animals, respectively.A thermosensitive optoelectronic upconversion device based on integrated microscale LED and photodiode structures, with temperature dependent of spectral shift and intensity change.

Background Hepatocellular Carcinoma (HCC) is a matter of great global public health importance; however, its current therapeutic effectiveness is deemed inadequate, and the range of therapeutic targets is limited. The aim of this study was to identify early growth response 1 (EGR1) as a transcription factor target in HCC and to explore its role and assess the potential of gene therapy utilizing EGR1 for the management of HCC. Methods In this study, both in vitro and in vivo assays were employed to examine the impact of EGR1 on the growth of HCC. The mouse HCC model and human organoid assay were utilized to assess the potential of EGR1 as a gene therapy for HCC. Additionally, the molecular mechanism underlying the regulation of gene expression and the suppression of HCC growth by EGR1 was investigated. Results The results of our investigation revealed a notable decrease in the expression of EGR1 in HCC. The decrease in EGR1 expression promoted the multiplication of HCC cells and the growth of xenografted tumors. On the other hand, the excessive expression of EGR1 hindered the proliferation of HCC cells and repressed the development of xenografted tumors. Furthermore, the efficacy of EGR1 gene therapy was validated using in vivo mouse HCC models and in vitro human hepatoma organoid models, thereby providing additional substantiation for the anti-cancer role of EGR1 in HCC. The mechanistic analysis demonstrated that EGR1 interacted with the promoter region of phosphofructokinase-1, liver type (PFKL), leading to the repression of PFKL gene expression and consequent inhibition of PFKL-mediated aerobic glycolysis. Moreover, the sensitivity of HCC cells and xenografted tumors to sorafenib was found to be increased by EGR1. Conclusion Our findings suggest that EGR1 possesses therapeutic potential as a tumor suppressor gene in HCC, and that EGR1 gene therapy may offer benefits for HCC patients.

Objective To evaluate maternal–fetal outcomes and therapeutic efficacy in Takayasu arteritis (TA)-complicated pregnancies through integrated retrospective analysis and meta-analytic synthesis. Methods A dual-design study was conducted: (1) retrospective analysis of 20 pregnancies (17 patients) at West China Second Hospital (2012–2024), stratifying TA phases (acute/prolonged/stable); (2) systematic review with random-effects meta-analysis of 16 studies (568 pregnancies globally). Clinical data encompassed maternal–fetal profiles, TA-specific variables, laboratory metrics (hematologic/coagulation parameters), and therapies (glucocorticoids /immunosuppressants /antihypertensives). Outcomes were compared against normative standards using t-tests, Wilcoxon, chi-square, and meta-regression. Results Among 20 pregnancies (median maternal age 28.5 years), 50% had at least one obstetric complication, with arterial stenosis (80%) and hypertension (40%) predominant. Meta-analysis revealed 42.6% adverse outcomes: gestational hypertension (26.1%), fetal growth restriction (17.7%), and preterm delivery (13.6%). Hematological analysis ( n  = 20) showed elevated WBC, PCT, TT, fibrinogen, urinary protein, and ALT (all P  < 0.05), alongside reduced PT, albumin, and bilirubin ( P  < 0.05). Regarding the analysis results of inflammatory indicators, CRP (prepartum) (95%CI = 0.969–1.034, OR = 1.001), CRP (postpartum) (95%CI = 0.920–1.217, OR = 1.058), and ESR (95%CI = 0.952–1.101, OR = 1.024) showed no statistically significant association with pregnancy outcomes. Neither pre-pregnancy nor gestational glucocorticoids (prednisone vs methylprednisolone) or immunosuppressants significantly reduced complications (all RR 95% CI crossed 1; P  > 0.05). Antihypertensive therapy showed no correlation with preeclampsia ( P  > 0.05). Conclusion TA significantly elevates maternal–fetal risks, driving hypertension, growth restriction, and preterm birth via vasculopathic-inflammatory pathways. Postpartum hypercoagulability (↑fibrinogen, ↓prothrombin time) necessitates multidisciplinary coagulation monitoring and mandatory thromboprophylaxis.

Salt lake brine contains abundant rubidium resources; however, the separation of rubidium from brine with a high K content remains a significant challenge in metallurgical processes and materials science. In this study, PAN-KCuFC-PEG particles were synthesized by phase transformation, using hydrophilic polyacrylonitrile (PAN) as the skeleton structure, potassium cupric ferricyanide (KCuFC) as the active component and water-soluble polymer polyethylene glycol (PEG) as the pore regulator. Characterization revealed that the addition of PEG increased the pore volume of PAN-KCuFC-PEG by 63% and the BET surface area by 172%. KCuFC powder was uniformly dispersed in PAN-KCuFC-PEG, and its crystal structure remained stable after loading. In static adsorption experiments, the maximum adsorption capacity of PAN-KCuFC-PEG for Rb+ reached 190 mg/g. The adsorption behavior followed a pseudo-second-order kinetic model, with the rate jointly controlled by external diffusion, intraparticle diffusion, and chemical reaction. In the column experiment, PAN-KCuFC-PEG was used to adsorb Qarhan Salt Lake brine (K: 26,000 mg/L, Rb: 65 mg/L). NH4Cl was employed for elution and desorption of PAN-KCuFC-PEG. During the adsorption–desorption process, the separation factor between Rb and K reached 160, the desorption rate reached 96.6%, and the overall yield was 68.3%. The enrichment and separation of Rb were successfully achieved.