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To evaluate the acceptability of self-administered acupressure for Knee osteoarthritis (KOA) among middle-aged and older adults. This is a mixed-method acceptability evaluation was embedded in a randomized controlled trial on self-administered acupressure for KOA. Participants received two 2-h training sessions on self-administered acupressure and were instructed to practice twice daily for 12 weeks. Quantitative data were collected using an acceptability questionnaire (n = 153) and acupressure logbooks (n = 157). Qualitative data were obtained through semi-structured interviews, including post-training (n = 13) and post-intervention focus groups (n = 13), and individual interviews with participants who dropped out (n = 5). Data were analysed using descriptive statistics and framework analysis based on the Theoretical Framework of Acceptability. The intervention had 91.7 % completion rate. Participants rated willingness to attend future sessions at 9.5/10 (SD=0.85). 57.8 % found technique education \"very helpful\" and 81.5 % followed the prescribed routine. Participants reported high overall acceptability of the self-administered acupressure training program, citing its practicality and potential benefits on knee pain, thigh strength, inflammation, and swelling. The minimal time and financial investment required were also appreciated. However, challenges related to personal efforts, time management, pressure from research monitoring, possible adverse events, and uncertainties with acupressure techniques were noted, leading to adherence issues. Participants expressed a need for continuous professional guidance. Self-administered acupressure is highly acceptable to middle-aged and older adults with KOA due to its potential benefits and merits of minimal time and cost. Future research should focus on optimizing intervention implementation by providing professional support and efficient monitoring to address identified challenges. •Self-administered acupressure is highly acceptable for managing knee osteoarthritis.•Adherence challenges arise from time management and acupressure techniques.•Continuous professional support is necessary to maintain effective practice.•Benefits reported include reduced knee pain and improved thigh strength.•The intervention requires minimal financial and time investment.

A gas sensor based on a ZnGa O (ZGO) thin film grown by metalorganic chemical vapor deposition operated under the different temperature from 25 °C to 300 °C is investigated in this study. This sensor shows great sensing properties at 300 °C. The sensitivity of this sensor is 22.21 as exposed to 6.25 ppm of NO and its response time is 57 s. Besides that, the sensitivities are 1.18, 1.27, 1.06, and 1.00 when exposed to NO (500 ppb), SO (125 ppm), CO (125 ppm), and CO (1500 ppm), respectively. These results imply that the ZGO gas sensor not only has high sensitivity, but also has great selectivity for NO gas. Moreover, the obtained results suggest that ZGO sensors are suitable for the internet of things(IOT) applications.

A gas sensor based on a ZnGa 2 O 4 (ZGO) thin film grown by metalorganic chemical vapor deposition operated under the different temperature from 25 °C to 300 °C is investigated in this study. This sensor shows great sensing properties at 300 °C. The sensitivity of this sensor is 22.21 as exposed to 6.25 ppm of NO and its response time is 57 s. Besides that, the sensitivities are 1.18, 1.27, 1.06, and 1.00 when exposed to NO 2 (500 ppb), SO 2 (125 ppm), CO (125 ppm), and CO 2 (1500 ppm), respectively. These results imply that the ZGO gas sensor not only has high sensitivity, but also has great selectivity for NO gas. Moreover, the obtained results suggest that ZGO sensors are suitable for the internet of things(IOT) applications.

Background Moxibustion is widely used in mainland China but rarely used in Hong Kong. This study was conducted among traditional Chinese medicine (TCM) practitioners in Hong Kong to collect and explore their experiences and views on the barriers to and possibilities of using moxibustion in Hong Kong. Methods This qualitative study was conducted via semi-structured individual interviews. Purposive sampling was employed to recruit 13 TCM practitioners who have clinically practiced in Hong Kong for 2 years or more. The interviews were audio-recorded and transcribed verbatim, and the data were subsequently analyzed using template analysis. Results Three main themes were identified as follows: (1) expectations of moxibustion use in Hong Kong, (2) barriers to moxibustion use in Hong Kong, and (3) possible solutions to enhance moxibustion use in Hong Kong. For the expectation of moxibustion use, the subthemes were (a) merits of moxibustion therapy, (b) effectiveness of moxibustion therapy, and (c) applicability of moxibustion in Hong Kong. For the barriers to moxibustion use in Hong Kong, the subthemes were (a) limits of moxibustion use in clinics, (b) limits of self-help use of moxibustion, and (c) limits of local TCM practitioners’ experience of practicing moxibustion. For the suggestions to enhance moxibustion use in Hong Kong, the subthemes were (a) improvements in moxibustion and its accessories, (b) clinic upgrade, (c) government support, and (d) promotion of self-administered moxibustion. Conclusion Moxibustion is anticipated to gain traction in Hong Kong due to its acceptability and feasibility for clinical and self-help applications, its broad applicability across diverse populations and medical conditions, and its suitability for the Hong Kong climate. Barriers to its clinical use in Hong Kong include strict fire safety regulations for buildings and high labor costs. The public’s lack of understanding of moxibustion practice and knowledge in managing potential adverse events limits its self-use. Moxibustion could be promoted in Hong Kong by improving moxa quality and moxibustion equipment, optimizing the layout and ventilation of clinics, refining government support, and popularizing self-administered moxibustion.

Background： Hepatitis B surfhce antigen （HBsAg） Ioss/seroconversion is considered to be the ideal endpoint of antiviral therapy and the ultimate treatment goal in chronic hepatitis B （CHB）. This study aimed to assess the patterns of ttBsAg kinetics in CHB patients who achieved HBsAg loss during the treatment of pegylated interferon （PEG-IFN） α-2a. Methods： A total of 150 patients were enrolled, composing of 83 hepatitis B envelope antigen （H BeAg）-positive and 67 HBeAg-negative patients. Patients were treated with PEG-IFN α-2a180 μg/week until HBsAg loss/seroconversion was achieved, which occurred within 96 weeks. Serum hepatitis B virus deoxyribonucleic acid and serological indicators （HBsAg, anti-HBs, HBeAg, and anti-HBe） were determined before and every 3 months during PEG-1FN α-2a treatment. Biochemical markers and peripheral blood neutrophil and platelet counts were tested every 1-3 months. Results： Baseline HBsAg levels were 2.5 ± 1.3 log IU/ml, and decreased rapidly at 12 and 24 weeks by 48.3%, and 88.3%, respectively. The mean time to HBsAg loss was 54.2 ± 30.4 weeks, though most patients needed extended treatment and 30.0% of HBsAg loss occurred during 72-96 weeks. Baseline HBsAg levels were significantly higher in HBeAg-positive patients （2.9 ± 1.1 log 1U/ml） compared with HBeAg-negative patients （2.0 ± 1.3 log I U/ml; t = 4.733, P 〈 0.001）, but the HBsAg kinetics were similar. Patients who achieved HBsAg loss within 48 weeks had significantly lower baseline HBsAg levels and had more rapid decline of HBsAg at 12 weeks compared to patients who needed extended treatment to achieve HBsAg loss. Conclusions： Patients with lower baseline HBsAg levels and more rapid decline during early treatment with PEG-IFN are more likely to achieve HBsAg loss during 96 weeks of treatment, and extended therapy longer than 48 weeks may be required to achieve HBsAg loss.

Background：Hepatitis B is an immune response-mediated disease.The aim of this study was to explore the differences of ratios of T-helper （Th） 2 cells to Thl cells and cytokine levels in acute hepatitis B （AHB） patients and chronic hepatitis B virus （HBV）-infected patients in immune-tolerance and immune-active phases.Methods：Thirty chronic HBV-infected patients in the immune-tolerant phase （IT group） and 50 chronic hepatitis B patients in the immuneactive （clearance） phase （IC group）,32 AHB patients （AHB group）,and 13 healthy individuals （HI group） were enrolled in the study.Th cell proportions in peripheral blood,cytokine levels in plasma,and serum levels of HBV DNA,hepatitis B surface antigen,and hepatitis B e antigen were detected.Results：The Th1 cell percentage and Th2/Th1 ratio in the HBV infection group （including IT,IC,and AHB groups） were significantly different from those in HI group （24.10% ± 8.66% and 1.72 ± 0.61 vs.15.16% ± 4.34% and 2.40 ± 0.74,respectively;all P 〈 0.001）.However,there were no differences in the Th1 cell percentages and Th2/Th1 ratios among the IT,IC,and AHB groups.In HBV infection group,the median levels of Flt3 ligand （Flt3L）,interferon （IFN）-γ,and interleukin （IL）-17A were significantly lower than those in HI group （29.26 pg/ml,33.72 pg/ml,and 12.27 pg/ml vs.108.54 pg/ml,66.48 pg/ml,and 35.96 pg/ml,respectively;all P 〈 0.05）.IFN-α2,IL-10,and transforming growth factor （TGF）-β2 median levels in hepatitis group （including patients in AHB and IC groups） were significantly higher than those in IT group （40.14 pg/ml,13.58 pg/ml,and 557.41 pg/ml vs.16.74 pg/ml,6.80 pg/ml,and 419.01 pg/ml,respectively;all P 〈 0.05）,while patients in hepatitis group had significant lower Flt3L level than IT patients （30.77 vs.59.96 pg/ml,P =0.021）.Compared with IC group,patients in AHB group had significant higher median level s of IL-1 0,TGF-β 1,and TGF-β2 （22.77 pg/ml,10,447.00 pg/ml,and 782.28 pg/ml vs.8.66 pg/ml,3755.50 pg/ml,and 482.87 pg/ml,respectively;all P 〈 0.05）.Conclusions：Compared with chronic HBV-infected patients in immune-tolerance phase,chronic HBV-infected patients in immune-active phase and AHB patients had similar Th2/Th 1 ratios,significantly higher levels of IFN-α2,IL-10,and TGF-β.AHB patients had significantly higher IL-10 and TGF-β levels than chronic HBV-infected patients in immune-active phase.

Background： Plasmacytoid dendritic cells （pDCs） and cytokines play an important role in occurrence and recovery of hepatitis B virus （HBV） infection. The aim of this study was to explore the frequency and function ofpDC and serum cytokine network profiles in patients with acute or chronic HBV infection. Methods： The healthy individuals （HI group）, hepatitis B envelope antigen （HBeAg）-positive chronic HBV patients in immune tolerance （IT） phase （IT group）, HBeAg-positive chronic HBV patients （CHB group）, and acute HBV patients （AHB group） were enrolled in this study. The frequency of cluster of differentiation antigen 86 （CD86） ＋ pDC and the counts of CD86 molecular expressed on surface ofpDC were tested by flow cytometer. The quantitative determinations ofcytokines, including Fins-like tyrosine kinase 3 ligand （FIt-3L）, interferon （1FN）-α2, IFN-γ, interleukin （IL）-17A, IL-6, IL-10, transforming growth factor （TGF）-β1 and TGF-β2, were performed using Luminex multiplex technology. Results： In this study, there were 13 patients in HI group, 30 in IT group, 50 in CHB group, and 32 in AHB group. Compared with HI group, HBV infected group （including all patients in IT, CHB and AHB groups） had significantly higher counts of CD86 molecular expressed on the surface ofpDC （4596.5 ± 896.5 vs. 7097.7 ± 3124.6; P 〈 0.001）. The counts of CD86 molecular expressed on the surface of pDC in CriB group （7739.2 ±4125.4） was significantly higher than that of IT group （6393.4 ± 1653.6, P=0.043）. Compared with IT group, the profile of cytokines of FIt-3L, IFN-γ, and IL-17A was decreased, IFN-α2 was significantly increased （P =0.012） in CH B group. The contents of IL-10, TGF-{31, and TGF-132 in AHB group were significantly increased compared with IT and CHB groups （all P 〈 0.05）. Conclusions： This study demonstrated that the function of pDC was unaffected in HBV infection. The enhanced function of pDC and IFN-α2 might involve triggering the immune response from IT to hepatitis active phase in H BV infection. Acute patients mainly presented as down-regulation of the immune response by enhanced IL-10 and TGF-β.

Introduction Few studies have investigated the predictors of the treatment response after attending sleep hygiene education (SHE). We aimed to explore the patient characteristics associated with a response to SHE for insomnia. Methods A secondary analysis was conducted to pool the data of two randomized controlled trials for insomnia (Trial registration number ClinicalTrials.gov: #NCT04227587; NCT03623438), in which the subjects in the comparison group had attended two 2-hour sessions (total 4 hours) of small-group based SHE. We examined the association of sociodemographic variables, clinical characteristics, baseline sleep-wake variables, and Sleep Hygiene Practice Scale (SHPS) items to the treatment response. Subjects with a reduction in insomnia severity index (ISI) scores of ≥ 6 points from baseline to week 8 were classified as responders. Factors were compared between responders and non-responders and by univariate and multivariate logistic regression analysis. Results A total of 170 subjects with insomnia disorder who had received the SHE program were included and 42 (24.7%) of them were classified as responders. At 8 weeks after baseline, the subjects showed a 2.88 points reduction in ISI total score, 11.5 minutes reduction in sleep onset latency, 10.4 minutes reduction in waketime after sleep onset, 20.3 minutes increase in total sleep time, and 4.42% increase in sleep efficiency. Univariate logistic regression analysis has identified 12 potential predictors for SHE responders, including age, gender, baseline sleep parameters, and SHPS items. In the multivariate logistic regression analysis, age, ever tried exercise for improving sleep, and baseline ISI score remained significant predictors of SHE treatment response (age, adjusted OR 0.88, 95%CI 0.79, 0.97, p = 0.011; ever tried exercise for improving sleep, adjusted OR 11.0, 95%CI 1.16, 104.9, p = 0.037; baseline ISI score, adjusted OR 1.59, 95%CI 1.15, 2.19, p = 0.005). Conclusion Lower age, higher baseline ISI score, and ever-tried exercise for improving sleep were shown to predict the response of SHE. Our findings inform individuals who have insomnia to select the treatment for chronic insomnia in the future. Support (if any) The RCTs were supported by the Research Grants Council, General Research Fund (NCT04227587, Project no.: 15100419), and Health and Medical Research Fund (NCT03623438, Project no.: 19200171).

Background：Biliverdin （BV） has a protective role against ischemia-reperfusion injury （IRI）.However,the protective role and potential mechanisms of BV on lung IRI （LIRI） remain to be elucidated.Thus,we aimed to investigate the protective role and potential mechanisms of BV on LIRI.Methods：Lungs were isolated from Sprague-Dawley rats to establish an ex vivo LIRI model.After an initial 15 min stabilization period,the isolated lungs were subjected to ischemia for 60 min,followed by 90 min ofreperfusion with or without BV treatment.Results：Lungs in the I/R group exhibited significant decrease in tidal volume （1.44 ± 0.23 ml/min in I/R group vs.2.41 ± 0.31 ml/min in sham group;P 〈 0.001）,lung compliance （0.27 ± 0.06 ml/cmH2O in I/R group vs.0.44 ± 0.09 ml/cmH2O in sham group;P 〈 0.001;1 cmH2O=0.098 kPa）,and oxygen partial pressure （PaO2） levels （64.12 ± 12 mmHg in FR group vs.114 ± 8.0 mmHg in sham group;P 〈 0.001;1 mmHg =0.133 kPa）.In contrast,these parameters in the BV group （2.27 ± 0.37 ml/min of tidal volume,0.41 ± 0.10 ml/ cmH2O of compliance,and 98.7 ± 9.7 mmHg of PaO2） were significantly higher compared with the I/R group （P =0.004,P 〈 0.001,and P 〈 0.001,respectively）.Compared to the I/R group,the contents of superoxide dismutase were significantly higher （47.07 ± 7.91 U/mg protein vs.33.84 ± 10.15 U/mg protein;P =0.005） while the wet/dry weight ratio （P 〈 0.01）,methane dicarboxylic aldehyde （1.92 ± 0.25 nmol/mg protein vs.2.67 ± 0.46 nmol/mg protein;P 〈 0.001）,and adenosine triphosphate contents （297.05 ± 47.45 nmol/mg protein vs.208.09 ± 29.11 nmol/mg protein;P =0.005） were markedly lower in BV-treated lungs.Histological analysis revealed that BV alleviated LIRI.Furthermore,the expression of inflammatory cytokines （interleukin-1 β,interleukin-6,and tumor necrosis factor-α） was downregulated and the expression of cyclooxygenase-2,inducible nitric oxide synthase,and Jun N-terminal kinase was significantly reduced in BV group （all P 〈 0.01 compared to I/R group）.Finally,the apoptosis index in the BV group was significantly decreased （P 〈 0.01 compared to I/R group）.Conclusion：BV protects lung IRI through its antioxidative,anti-inflammatory,and anti-apoptotic effects.

Cancer cell dysregulations result in the abnormal regulation of cellular metabolic pathways. By simulating this metabolic reprogramming using constraint‐based modeling approaches, oncogenes can be predicted, and this knowledge can be used in prognosis and treatment. We introduced a trilevel optimization problem describing metabolic reprogramming for inferring oncogenes. First, this study used RNA‐Seq expression data of lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) samples and their healthy counterparts to reconstruct tissue‐specific genome‐scale metabolic models and subsequently build the flux distribution pattern that provided a measure for the oncogene inference optimization problem for determining tumorigenesis. The platform detected 45 genes for LUAD and 84 genes for LUSC that lead to tumorigenesis. A high level of differentially expressed genes was not an essential factor for determining tumorigenesis. The platform indicated that pyruvate kinase (PKM), a well‐known oncogene with a low level of differential gene expression in LUAD and LUSC, had the highest fitness among the predicted oncogenes based on computation. By contrast, pyruvate kinase L/R (PKLR), an isozyme of PKM, had a high level of differential gene expression in both cancers. Phosphatidylserine synthase 1 (PTDSS1), an oncogene in LUAD, was inferred to have a low level of differential gene expression, and overexpression could significantly reduce survival probability. According to the factor analysis, PTDSS1 characteristics were close to those of the template, but they were unobvious in LUSC. Angiotensin‐converting enzyme 2 (ACE2) has recently garnered widespread interest as the SARS‐CoV‐2 virus receptor. Moreover, we determined that ACE2 is an oncogene of LUSC but not of LUAD. The platform developed in this study can identify oncogenes with low levels of differential expression and be used to identify potential therapeutic targets for cancer treatment. Identifying differentially expressed genes is critical in exploring molecular mechanisms of cancers. A high level of differential gene expression is not an essential factor for tumorigenesis. We developed an optimization platform that can identify oncogenes with low levels of differential expression and potential therapeutic targets for cancer treatment. The platform was applied on LUAD and LUSC to illustrate its performance.