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Background Health disparities across socioeconomic status (SES) remain a critical issue. Health empowerment, a promising strategy linked to improved health outcomes, remains under explored in terms of mitigating SES-related health disparities and its potential to counteract structural inequities. This study aims to evaluate how health empowerment varies across SES strata and its association with health outcomes to inform targeted health promotion strategies for mitigating health inequalities. Methods This study conducted a cross-sectional survey in five cities in Anhui Province via purposive sampling. Data on health empowerment (health literacy, health consciousness, and healthcare trust/fairness), health outcomes (self-rated health, chronic diseases), and SES were collected. Descriptive statistics, chi-square tests, and logistic regression were used for analysis. Results Among the 1,364 participants, chronic disease incidence showed a clear SES gradient (24.1% in the low SES group, 15.1% in the middle SES group, and 14.0% in the high SES group), whereas health literacy levels were lower in the low SES group when both median and upper quartile thresholds were used. High health literacy (using the upper quartile as the threshold) was linked to lower chronic disease prevalence in the low- and middle-SES groups and better self-rated health across all SES strata; health awareness was positively associated with self-rated health only in the middle- and high-SES groups, while perceived trust/fairness showing an inverse association with self-rated health in the low-SES group. Logistic regression confirmed that health literacy using the upper quartile as the threshold was associated with lower odds of chronic diseases in the low SES group (OR = 0.453, P  < 0.05), with both thresholds benefiting self-rated health across all SES groups. Conclusions This study confirms significant socioeconomic disparities in chronic disease incidence and health literacy, with higher health literacy levels showing a protective association against chronic diseases, particularly in the low-SES population. While health literacy is consistently associate with self-rated health across all socioeconomic strata, health awareness is associated with self-rated health only in middle- and high-SES groups, suggesting that structural barriers impede health behavior translation in vulnerable populations. The findings underscore the need for tiered health empowerment interventions targeting specific socioeconomic groups, with higher thresholds of health literacy potentially related to overcoming structural disadvantages in low-SES communities.

The recent outbreak of betacoronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which is responsible for the Coronavirus Disease 2019 (COVID-19) global pandemic, has created great challenges in viral diagnosis. The existing methods for nucleic acid detection are of high sensitivity and specificity, but the need for complex sample manipulation and expensive machinery slow down the disease detection. Thus, there is an urgent demand to develop a rapid, inexpensive, and sensitive diagnostic test to aid point-of-care viral detection for disease monitoring. In this study, we developed a clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR associated proteins (Cas) 12a-based diagnostic method that allows the results to be visualized by the naked eye. We also introduced a rapid sample processing method, and when combined with recombinase polymerase amplification (RPA), the sample to result can be achieved in 50 minutes with high sensitivity (1–10 copies per reaction). This accurate and portable detection method holds a great potential for COVID-19 control, especially in areas where specialized equipment is not available.

Background This study aims to investigate the direct associations among workplace violence, organizational climate, authentic leadership, and physicians’ job satisfaction, as well as the indirect pathways through job burnout, with the aim of offering potential preventive strategies. Methods Through a purposive sampling method, a total of 408 questionnaires were distributed to physicians in six tertiary-level hospitals in Anhui Province, and 399 valid questionnaires were returned. Structural equation modeling was used to test the proposed model. Results Although workplace violence did not directly influence physicians’ job satisfaction, it indirectly reduced it by exacerbating burnout. A positive organizational climate was shown to enhance job satisfaction directly and indirectly by mitigating job burnout. Authentic leadership directly enhanced job satisfaction and indirectly alleviated burnout by optimizing the organizational climate. Authentic leadership also indirectly enhanced job satisfaction by improving the organizational climate and alleviating job burnout. Conclusions This study confirms that workplace violence, authentic leadership and organizational climate influence physicians’ job satisfaction through both direct and burnout-mediated indirect pathways. Interventions and programs promoting a positive work environment could potentially reduce job burnout and increase job satisfaction among Chinese physicians of tertiary hospitals.

Background The development of medical education is rapidly evolving, with innovative teaching methods such as problem-based learning (PBL) and multidisciplinary treatment (MDT) combined with flipped classroom approaches gaining increasing attention in clinical medical education. However, the actual effectiveness of PBL combined with MDT and flipped classroom methods in the teaching of cardiovascular diseases has not been well studied. Considering that these which includedteaching methods can complement each other, this study explores the application and effectiveness of PBL combined with MDT and flipped classroom teaching method in the case-based teaching of acute coronary syndrome. Methods A total of 100 undergraduate clinical medicine students aged 20–21 years from Guangzhou Medical University were selected as research participants. They were randomly divided into two groups via a random number table: the experimental group (PBL combined with MDT and flipped classroom teaching), which included 50 students, and the control group (traditional teaching methods), which also included 50 students. After the clinical training, the theoretical examination scores and skill assessment results of the two groups were compared, and a questionnaire survey was conducted to evaluate teaching effectiveness. Results The theoretical examination scores and skill assessment results of the experimental group were significantly better than those of the control group ( P  < 0.05). The questionnaire survey revealed that the students in the experimental group outperformed those in the traditional teaching group in terms of learning motivation, theoretical learning outcomes, clinical thinking ability, literature retrieval skills, self-directed learning ability, practical ability, and classroom satisfaction, with statistically significant differences ( P  < 0.05). Conclusion The findings of this study suggest that the integration of PBL, MDT, and the flipped classroom teaching method may have a positive impact on the theoretical knowledge and clinical skills of undergraduate medical students in the context of acute coronary syndrome (ACS). However, due to the study’s limited sample size, short-term assessment period, and reliance on self-reported data, these results should be interpreted with caution.

Dual-task walking is a good paradigm to measure the walking ability of stroke patients in daily life. It allows for a better observation of brain activation under dual-task walking to assess the impact of the different tasks on the patient when combining with functional near-infrared spectroscopy (fNIRS). This review aims to summarize the cortical change of the prefrontal cortex (PFC) detected in single-task and dual-task walking in stroke patients. Six databases (Medline, Embase, PubMed, Web of Science, CINAHL, and Cochrane Library) were systematically searched for relevant studies, from inception to August 2022. Studies that measured the brain activation of single-task and dual-task walking in stroke patients were included. The main outcome of the study was PFC activity measured using fNIRS. In addition, a subgroup analysis was also performed for study characteristics based on HbO to analyze the different effects of disease duration and the type of dual task. Ten articles were included in the final review, and nine articles were included in the quantitative meta-analysis. The primary analysis showed more significant PFC activation in stroke patients performing dual-task walking than single-task walking ( = 0.340, = 0.02, = 7.853%, 95% = 0.054-0.626). The secondary analysis showed a significant difference in PFC activation when performing dual-task walking and single-task walking in chronic patients ( = 0.369, = 0.038, = 13.692%, 95% = 0.020-0.717), but not in subacute patients ( = 0.203, = 0.419, = 0%, 95% = -0.289-0.696). In addition, performing walking combining serial subtraction ( = 0.516, < 0.001, = 0%, 95% = 0.239-0.794), obstacle crossing ( = 0.564, = 0.002, = 0%, 95% = 0.205-0.903), or a verbal task ( = 0.654, = 0.009, = 0%, 95% = 0.164-1.137) had more PFC activation than single-task walking, while performing the n-back task did not show significant differentiation ( = 0.203, = 0.419, = 0%, 95% = -0.289-0.696). Different dual-task paradigms produce different levels of dual-task interference in stroke patients with different disease durations, and it is important to choose the matching dual-task type in relation to the walking ability and cognitive ability of the patient, in order to better improve the assessment and training effects. https://www.crd.york.ac.uk/prospero/, identifier: CRD42022356699.

Glioblastoma (GBM) is the most aggressive malignant brain tumor. Due to the infiltration and heterogeneity of GBM, the obstruction of the blood-brain barrier (BBB) and the unique immunosuppressive mechanism, it is hard to achieve significant effects of GBM treatment. Here, a kind of chemotactic nanomotor that loaded with glucose oxidase (GOx) and carboxylated cisplatin (Pt(IV)) prodrug on the L-arginine-derived polymer is proposed. The nanomotors are driven by catalysis of glucose decomposition and the positive chemotaxis towards the GBM microenvironment where inducible nitric oxide synthase and reactive oxygen species are highly expressed. This facilitates the BBB crossing and GBM targeting of the nanomotors. In addition, the released nitric oxide (NO) during propulsion as well as the loaded GOx and Pt(IV) can exert combined NO/starvation/chemotherapy. Meanwhile, it is able to induce and enhance the immune response through multiple pathways, thus better coping with the complexities of GBM treatment.

Abstract Background: Although repetitive transcranial magnetic stimulation (rTMS) has been extensively studied in patients with Alzheimer's disease (AD), the clinical evidence remains inconsistent. The purpose of this meta-analysis was to evaluate the effects of rTMS on global cognitive function in patients with AD. Methods: An integrated literature search using 4 databases (PubMed, Web of Science, Embase, and Cochrane Library) was performed to identify English language articles published up to October 6, 2021. We pooled Mini-Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-Cog) scores using a random-effects model via RevMan 5.4 software. We calculated estimates of mean differences (MD) with 95% confidence intervals (CI). The primary outcomes were pre-post treatment changes in global cognition as measured using MMSE and ADAS-Cog immediately after rTMS treatment, and the secondary outcome was duration of cognitive improvement (1-1.5 and ≥3 months). Results: Nine studies with 361 patients were included in this meta-analysis. The results showed that rTMS significantly improved global cognitive function immediately following rTMS treatment ( [MD] 1.85, 95% confidence interval [CI] 1.57 to 2.12, p 0.05) or adverse effect rate (p > 0.05) between the rTMS and control groups. Conclusions: Repetitive TMS is a potentially effective treatment for cognitive impairment in AD that is safe and can induce long-lasting effects. Our results also showed that ADAS-cog and MMSE differed in determination of global cognitive impairment.

IntroductionSoft robotic gloves (SRGs) integrated with brain-computer interfaces (BCIs) have demonstrated potential in facilitating motor recovery after stroke by enabling active, intention-driven rehabilitation. Emerging evidence suggests that incorporating vibrotactile stimulation (VTS) into SRG-BCI systems may further enhance sensorimotor feedback. The objective of this study is to evaluate the therapeutic efficacy and underlying neural mechanisms of BCI-driven, intention-based glove activation compared with automated glove-assisted training, with VTS applied identically in both groups.Methods and analysisThis multicentre, single-blind, randomised controlled trial will involve 48 post-stroke patients within 1 week to 3 months after stroke onset, with stratification by time since stroke during randomisation. Participants will be randomly assigned to either the BCI-SRG group (n=24) or SRG group (n=24). Both groups will receive identical VTS. Patients in the BCI-SRG group will actively initiate movements of the SRG through motor imagery, while those in the SRG group will receive automated glove-assisted training without BCI control. The intervention will be administered 5 days per week for 4 weeks. The primary outcome measure is the Fugl-Meyer Assessment of Upper Extremity. Secondary outcome measures include Wolf Motor Function Test, International Classification of Functioning, Disability and Health Generic Set, Barthel Index, Modified Ashworth Scale, Semmes-Weinstein Monofilament Test, as well as event-related spectral perturbation and event-related desynchronisation. All assessments will be conducted at both baseline and post-intervention.Ethics and disseminationEthics approval of this study protocol has been obtained from the Ethics Committee of the First Affiliated Hospital with Nanjing Medical University (2025-SR-508). The findings will be disseminated through peer-reviewed journals, conference presentations and communication with scientific, professional and general public audiences.Trial registration numberChiCTR2500106951.

Drought stress severely compromises the physiological integrity and secondary metabolism of medicinal plants. This study integrated physiological, biochemical, and ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) analyses to investigate the effects of exogenous methyl jasmonate (MeJA) on drought-stressed Ilex rotunda seedlings. Drought reduced relative water content by 29% and chlorophyll by >50%, while elevating H2O2 (76%) and malondialdehyde (120%). MeJA application mitigated these impairments, reducing oxidative markers by 25% and enhancing non-enzymatic antioxidant capacity, as shown by a 74% increase in DPPH radical scavenging activity and a 141% rise in total phenolic content. Hierarchical clustering analysis (HCA), principal component analysis (PCA), and orthogonal partial least squares-discriminant analysis (OPLS-DA), and pathway mapping confirmed a significant reprogramming of the phenolic metabolome, particularly within phenylpropanoid and benzoate biosynthesis pathways. Drought + MeJA-treated plants exhibited a distinct and enriched profile compared to both well-watered control and drought-stressed groups. This reprogramming specifically elevated key hydroxycinnamates, including verbascoside and neochlorogenic acid (increased by 50% and 52%, respectively), while suppressing alternative phenolic branches. These findings demonstrate that MeJA orchestrates a shift from enzymatic scavenging to a potent metabolite-based antioxidant system, positioning it as an effective elicitor for enhancing drought resilience and enriching the high-value phytochemicals in I. rotunda.

Ilex verticillata (winterberry) is a valuable ornamental shrub increasingly threatened by leaf blight, a disease that compromises its aesthetic and economic value. While fungal pathogens like Alternaria alternata are known to cause leaf blight in horticultural crops, their role in I. verticillata and the host’s defense mechanisms have not been fully characterized. Our study investigated the pathogen-host interaction by identifying the causal agent and examining the physiological and molecular defense mechanisms of I. verticillata. Through morphological and multi-locus molecular analyses (ITS, TEF1-α, G3PDH, RPB2), A. alternata was confirmed as the primary pathogen, fulfilling Koch’s postulates. Pathogenicity assays revealed distinct disease progression stages, from necrotic lesions to tissue degradation. Transcriptomic profiling uncovered dynamic host responses, with early upregulation of pattern recognition receptors (PRRs) and transcripts encoding antioxidant enzymes (SOD, CAT), followed by downregulation of metabolic pathway genes. Phytohormone analysis highlighted intricate crosstalk, with salicylic acid (SA) peaking during mid-infection and jasmonic acid (JA) rebounding later, reflecting a coordinated defense strategy. Additionally, the oxidative stress marker malondialdehyde (MDA), an indicator of membrane lipid peroxidation, surged early, indicating membrane damage, while sustained induction of antioxidant enzymes suggested adaptive responses. The key finding was distinct phytohormone crosstalk, characterized by a mid-infection SA peak followed by a late JA rebound, alongside an early oxidative burst marked by MDA accumulation and sustained antioxidant enzyme activity. These findings provide a framework for understanding I. verticillata’s defense mechanisms and offer insights for developing targeted disease management strategies, such as resistant cultivar breeding or hormone-mediated interventions.