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The purpose of this study was to examine the impact of health education based on self-determination theory on hemodialysis knowledge, self-management, interdialytic weight gain and anxiety and depression in maintenance hemodialysis patients. The study is a quasi-randomized control trial, a total of 86 maintenance hemodialysis patients who met the inclusion criteria were included equally in the intervention and control groups. The control group received routine care, and the intervention group received health education based on self-determination theory. Three months after the intervention, the intervention effects were evaluated using the Hemodialysis Related Knowledge Scale, Self-Management Behavior Scale, Interdialytic Weight Gain, and Hospital Anxiety and Depression Scale. Three months after the intervention, the hemodialysis knowledge scores of the intervention group was higher than that of the control group and baseline; the scores of the intervention group in problem solving, partnership, emotional processing, executive self-care dimensions and the total self-management scores were higher than that of the control group and baseline; the interdialytic weight gain of the intervention group was lower than that of the control group and baseline; the anxiety and depression scores of the intervention group were lower than that of the control group and baseline. All these differences were statistically significant ( P  < 0.05). Health education based on self-determination theory can improve the hemodialysis knowledge level and self-management ability of maintenance hemodialysis patients, and reduce the interdialytic weight gain and anxiety and depression level.

ObjectivesPatients’ sense of gain experience (PSGE) is the comprehensive feeling throughout the treatment process, which is a critical benchmark for evaluating comprehensive medical and health system reform in China. This study aims to assess the current status of PSGE in public hospitals and identify important associated factors, providing evidence-based recommendations for improving healthcare services.DesignThis was a cross-sectional study conducted from October to November 2023.SettingA total of 14 public hospitals in Foshan, Guangdong Province, China.ParticipantsThere were 3223 responses, including 1592 from outpatients and 1631 from inpatients.Primary outcome measurePSGE was assessed across five domains: time accessibility, service accessibility, cost affordability, patient participation and efficacy predictability. Participants were also asked to provide an overall rating of the PSGE.ResultsThe overall score for PSGE was 4.47±0.53 (mean±SD), with service accessibility receiving the highest score (4.68±0.50) and affordability the lowest (4.17±0.86). Secondary hospitals scored an overall PSGE of 4.55±0.50, while tertiary hospitals scored 4.42±0.54. Key factors associated with PSGE were overall satisfaction (β=0.164, p<0.001), treatment satisfaction (β=0.187, p<0.001), satisfaction with medical reforms (β=0.149, p<0.001), patient loyalty (β=0.072, p=0.001) and hospital reputation (β=0.223, p<0.001).ConclusionsThis study found that patients reported a positive PSGE with service accessibility but reported a less positive PSGE with cost affordability. A tier-based disparity was evident, with secondary hospitals outperforming tertiary hospitals in overall PSGE outcome. Stronger PSGE was positively associated with higher scores in overall satisfaction, treatment satisfaction, satisfaction with medical reforms, patient loyalty and hospital reputation. Demographic and institutional factors, such as hospital level, patient type and household registration, were associated with the PSGE. Efforts can be focused on enhancing clinicians’ willingness and competence in discussing treatment costs during clinical encounters. It is essential for policymakers to address disparities in healthcare experiences among patient groups across hospital tiers to advance equitable, patient-centred systems.

ObjectivesThis study reports the life satisfaction of middle-aged and elderly patients who had a stroke in China, and explores its association with patients’ sociodemographic characteristics, health status, lifestyles and family relationship.DesignCross-sectional survey.Setting and participantsThe samples of this study were selected from the data of China Health and Retirement Longitudinal Study (CHARLS) in 2018, which covered 28 provinces, 150 countries/districts and 450 village/urban communities. 1154 patients who had a stroke aged 45 and over were included in this study as qualified samples.Outcome measuresDescriptive analysis was used to report sociodemographic characteristics, health status, lifestyles, family relationship and life satisfaction of middle-aged and elderly patients who had a stroke. χ2 analysis and binary logistic regression were used to analyse the factors influencing the life satisfaction of the patients who had a stroke.ResultsOverall, 83.1% of patients who had a stroke were satisfied with their lives, although only 8.7% rated their own health as being good. Patients who had a stroke who were male, elderly, married, living with their spouses and having a pension were more likely to report satisfaction with life (p<0.05). Self-rated health, health satisfaction, chronic lung disease, fall, pain, ability to work and family relationships were also significantly associated with life satisfaction (p<0.05). Patients who drank alcohol (86.8% vs 81.7%, p=0.041), had physical activity (84.4% vs 75.6%, p=0.004) and had social activity (85.3% vs 80.8%, p=0.041) were more satisfied with their lives than those who did not. Multivariable analysis confirmed that age, health satisfaction, physical pain, working ability, relationships with spouse and with children had significant effects on life satisfaction of patients who had a stroke (p<0.05).ConclusionsOur study indicates the importance of improving the overall health of patients who had a stroke and mediating factors, such as pain management, and work ability, spouse and children relationship in improving the life satisfaction of patients in the poststroke rehabilitation.

Nasal administration is a non-invasive method of drug delivery that offers several advantages, including rapid onset of action, ease of use, no first-pass effect, and fewer side effects. On this basis, nose-to-brain delivery technology offers a new method for drug delivery to the brain and central nervous system, which has attracted widespread attention. In this paper, the development status and trends of nasal drug delivery and nose-to-brain delivery technology are deeply analyzed through multiple dimensions: literature research, questionnaire surveys, and patent analysis. First, FDA-approved nasal formulations for nose-to-brain delivery were combed. Second, we collected a large amount of relevant information about nasal drug delivery through a questionnaire survey of 165 pharmaceutical industry practitioners in 28 provinces and 161 different organizations in China. Third, and most importantly, we conducted a patent analysis of approximately 700+ patents related to nose-to-brain delivery, both domestically and internationally. This analysis was conducted in terms of patent application trends, technology life cycle, technology composition, and technology evolution. The LDA topic model was employed to identify technological topics in each time window (1990–2023), and the five key major evolution paths were extracted. The research results in this paper will provide useful references for relevant researchers and enterprises in the pharmaceutical industry, promoting the further development and application of nasal drug delivery and nose-to-brain delivery technology.

River basin reservoir construction affects water and sediment transport processes in downstream reaches. The downstream impact of the Three Gorges Projects （TGP） has started to become apparent： （1） reduction in flood duration and discharge, and significant reduction in sediment load. Although there was some restoration in downstream sediment load, the total amount did not exceed the pre-impoundment annual average; （2） in 2003-2014 the d 〉 0.125 mm （coarse sand） load was restored to some degree, and to a maximum at Jianli Station, which was mainly at the pre-impoundment average. After restoration, erosion and deposition characteristics of the sediment was identical to that before impoundment. The degree of restoration during 2008-2014 was less than during 2003-2007; （3） after TGP im- poundment, there was some restoration in d 〈 0.125 mm （fine sand） sediment load, however, it was {ower than the pre-impoundment average; （4） due to riverbed compensation, the d 〉 0.125 mm sediment load recovered to a certain degree after impoundment, however, the total did not exceed 4400x104 t/y. This was mainly limited by flood duration and the average flow rate, and was less affected by upstream main stream, tributaries, or lakes. Restoration of d 〈 0.125 mm suspended sediment was largely controlled by upstream main stream, tributaries, and lakes, as well as by riverbed compensation. Due to bed armoring, riverbed fine suspended sediment compensation capability was weakened; （5） during 2003-2007 and 2008-2014, Yichang to Zhicheng and upper Jingjiang experienced coarse and fine erosion,lower Jingjiang experienced coarse deposition and fine erosion, Hankou to Datong had coarse deposition and fine erosion, and Chenglingji and Hankou was characterized by coarse deposition and fine sand erosion in 2003-2007, and coarse and fine erosion in 2008-2014. This difference was controlled by flood duration and number at Luoshan Station.

Effective recognition of viral infections and subsequent triggering of antiviral innate immune responses are essential for the host antiviral defense, which is tightly regulated by multiple regulators, including microRNAs （miRNAs）. A previous study showed that miR-4661 upregulates IL-IO expression in macrophages by antagonizing RNA-binding protein tristetraprolin-mediated IL-10 mRNA degradation. However, the ability of miR-4661 to regulate antiviral immune responses remains unknown. Here, we found that interferon-alpha （IFN-a） expression was repressed in Sendai virus （SeV）- and vesicular stomatitis virus （VSV）-infected macrophages and in dendritic cells transfected with miR-4661 expression. Moreover, multiple IFN-α species can be directly targeted by miR-4661 through their 3＇ untranslated region （3＇UTR）. This study has demonstrated that miR-4661 could directly target IFN-a expression to inhibit host antiviral innate immune response.

Conductive cardiac patches can rebuild the electroactive microenvironment for the infarcted myocardium but their repair effects benefit by carried seed cells or drugs. The key to success is the effective integration of electrical stimulation with the microenvironment created by conductive cardiac patches. Besides, due to the concerns in a high re-admission ratio of heart patients, a remote medicine device will underpin the successful repair. Herein, we report a miniature self-powered biomimetic trinity triboelectric nanogenerator with a unique double-spacer structure that unifies energy harvesting, therapeutics, and diagnosis in one cardiac patch. Trinity triboelectric nanogenerator conductive cardiac patches improve the electroactivity of the infarcted heart and can also wirelessly monitor electrocardiosignal to a mobile device for diagnosis. RNA sequencing analysis from rat hearts reveals that this trinity cardiac patches mainly regulates cardiac muscle contraction-, energy metabolism-, and vascular regulation-related mRNA expressions in vivo. The research is spawning a device that truly integrates an electrical stimulation of a functional heart patch and self-powered e-care remote diagnostic sensor. Infarted myocardium hampers the synchronous electroactivity of the cardiac tissue. Here, the authors showcase a battery-free conductive cardiac patch made of reduced graphene and its therapeutic efficacy for cardiac repair.

Building operational energy consumption accounts for a significant share of global energy consumption, and it is crucial to promote renewable energy self-sufficiency and operational optimization for zero-carbon buildings. However, scheduling strategies relying on day-ahead forecasts have limitations, and ignoring the ambiguity of short-term source-load forecasts is prone to the risk of scheduling failures. To address this issue, this study proposes an intraday optimization method for zero-carbon buildings under the source-load fuzzy space, which innovatively constructs a fuzzy chance constraint model of Photovoltaic (PV) output and load demand, enforces energy self-sufficiency as a constraint, and establishes a multi-objective optimization framework with thermal comfort as the main objective and power adjustment balance as the sub-objective, so as to quantify the decision risk through intraday energy optimization. Experiments show that the proposed method quantifies the decision-maker’s risk preference through fuzzy opportunity constraints, balances conservatism and aggressive strategies, and improves thermal comfort while safeguarding energy independence, providing a risk-controllable scheduling paradigm for the decarbonized operation of buildings.

Boosting evidence indicated lipids play important roles in plants. To explore lipid function in cotton fiber development, the lipid composition and content were detected by untargeted and targeted lipidomics. Compared with rapid elongation fibers, the lipid intensity of 16 sub-classes and 56 molecular species decreased, while only 7 sub-classes and 26 molecular species increased in the fibers at the stage of secondary cell wall deposition. Unexpectedly, at the rapid elongation stage, 20 sub-classes and 60 molecular species increased significantly, while only 5 sub-classes and 8 molecular species decreased in the ligon lintless-1 (li-1) mutant compared with its wild-type Texas Maker-1 (TM-1). Particularly, campesteryl, sitosteryl, and total steryl ester increased by 21.8-, 48.7-, and 45.5-fold in the li-1 fibers, respectively. All the molecular species of sphingosine-1-P, phytoceramide-OHFA, and glucosylceramide increased while all sphingosine, phytosphingosine, and glycosyl inositol phospho ceramides decreased in the li-1 fibers. Similarly, the different expression genes between the mutant and wild type were enriched in many pathways involved in the lipid metabolism. Furthermore, the number of lipid droplets also increased in the li-1 leaf and fiber cells when compared with the wild type. These results illuminated that fiber cell elongation being blocked in the li-1 mutant was not due to a lack of lipids, but rather lipid over-accumulation (obesity), which may result from the disruption of sphingolipid and sterol metabolism. This study provides a new perspective for further studying the regulatory mechanisms of fiber development.

Furfural extraction oil (FEO) is rich in polycyclic aromatic hydrocarbons (PAHs) and is hard to convert under mild conditions. To address this upgrade challenge, this study proposed a co-aquathermolysis process with corn stalk and a Ni/Mo hydrofining catalyst. Key parameters, including reaction temperature, time, catalyst dosage, and corn stalk dosage, were systematically evaluated for their impact on upgrade performance. Under optimized conditions (oil-to-water mass ratio 2:1, 280 °C, 18 h, 8 wt% catalyst, 8 wt% corn stalk), a viscosity reduction rate of 19.96% was achieved, significantly exceeding the 12.69% rate obtained without corn stalk. Meanwhile, the average molecular weight decreased from 430.0 to 353.3 g·mol−1 and the aromatic ring index declined from 3.049 to 2.593. The H/C ratio increased to 1.568, and the sulfur content decreased to 0.09210%. 1H NMR analysis revealed that corn stalk promotes long-chain scission and inhibits aromatic condensation, leading to a reduced aromatic carbon fraction. A detailed hydrocarbon composition analysis corroborated the conversion of tricyclic and tetracyclic aromatic hydrocarbons to monocyclic and bicyclic aromatic hydrocarbons. These findings offer valuable insights for the modification of FEO via aquathermolysis and establish biomass utilization as a practical strategy for FEO upgrades.