Differences in influencing mechanism of clinicians' adoption behavior for liver cancer screening technology between the leading and subordinate hospitals within medical consortiums.

BACKGROUND: Medical consortiums have been extensively established to facilitate the integration of health resources and bridge the technical gap among member institutions. However, some commonly appropriate technologies remain stagnant in subordinate hospitals, although they have been routinely applied in leading hospitals. Besides, the mechanism underlying differences in clinicians' adoption behavior at different levels of institutions was unknown. Therefore, this study aimed to investigate the differences in influencing mechanisms of clinicians' hepatic contrast-enhanced ultrasound technology (CEUS) utilization behavior between leading and subordinate hospitals within medical consortiums, thus providing clues for expanding effective and appropriate technologies within integrated care systems. METHODS: A self-designed scale was developed based on the theory of planned behavior (TPB). A multistage sampling method was applied to investigate clinicians who were aware of CEUS and worked in liver disease-related departments within the sampled medical institutions. The final sample size was 289. AMOS 24.0 software was used to construct multi-group structural equation modeling (SEM) to validate the hypotheses and determine the mechanism of hepatic CEUS utilization. RESULTS: It revealed that behavioral intention significantly influenced adoption behavior, regardless of whether it was in leading hospitals or subordinate hospitals (ß = 0.283, p < 0.001). Furthermore, behavioral attitude (ß = 0.361, p < 0.001) and perceived behavioral control (ß = 0.582, p < 0.001) exerted significant effects on adoption behavior through behavioral intention. However, in leading hospitals, subjective norm had a significant positive effect on behavioral intention (ß = 0.183, p < 0.01), while it had a significant negative impact on behavioral intention in the subordinate hospitals (ß = -0.348, p < 0.01). CONCLUSION: To effectively translate the adoption intention into actual behavior, it is recommended to elucidate the demand and facilitators involved in the process of health technology adoption across leading and subordinate hospitals. Additionally, bolstering technical support and knowledge dissemination within subordinate hospitals while harnessing the influential role of key individuals can further enhance this transformative process.

Alterations in gut microbiome associated with severity of atopic dermatitis in infants.

BACKGROUND: Atopic dermatitis (AD) often arises in infancy, and gut microbial dysbiosis is associated with the development of AD. However, less is known about specific changes in early-life gut microbiome associated with AD and AD severity. This study aims to reveal the gut microbial composition and function profiles associated with the severity of AD in infants. METHODS: Sixty-two infants (mean [SD] age, 4.7[1.9] months) with different severities of AD were enrolled and divided into three groups (mild, moderate and severe) according to the Scoring Atopic Dermatitis (SCORAD) index. The profiles of gut microbial composition and function were analysed by sequencing 16S ribosomal RNA amplicons. Quality of life on children and the family was evaluated using published questionnaires. RESULTS: Decreased levels of Clostridium sensu stricto, Collinsella and increased level of Parabacteroides presented in the severe AD group compared with the mild AD group after adjusting potential confounders (p < 0.05). There were strong positive correlations between the Scoring Atopic Dermatitis (SCORAD) index and the relative abundance (RA) of Bacteroides and functional pathways for metabolism of sphingolipids and glycosphingolipids (p < 0.05). The SCORAD index was negatively correlated with the RA of Clostridium sensu stricto (p < 0.05), and was also positively correlated with the index of quality of life on children and the family (p < 0.05). CONCLUSION: Discrepancies in gut microbial composition and functional pathways were observed in infants with mild-to-severe AD. Alterations in butyrate-producing bacteria (Clostridium sensu stricto), sphingolipid-producing bacteria (Parabacteroides, Bacteroides), and related functional pathways were associated with the severity of AD infants.

Behavioral deviations: healthcare-seeking behavior of chronic disease patients with intention to visit primary health care institutions.

BACKGROUND: Although primary health care (PHC) has been proven to be effective in preventing and treating chronic diseases, the visits rate of PHC institutions is still not ideal. Some patients initially express a willingness to visit PHC institutions but end up seeking health services at non-PHC institutions, and the reasons for this behavior remain unclear. Therefore, the objective of this study is to analyze the factors that contribute to behavioral deviations among chronic disease patients who originally intended to visit PHC institutions. METHODS: Data were collected from a cross-sectional survey among chronic disease patients with original intention to visit PHC institutions in Fuqing City, China. The analysis framework was guided by Andersen's behavioral model. Logistic regression models were employed to analyze the factors affecting the behavioral deviations among chronic disease patients with a willingness to visit PHC institutions. RESULTS: A total of 1,048 individuals were finally included and about 40% of the participants with the original willingness to seek care from PHC institutions finally chose non-PHC institutions in their subsequent visits. The results of logistic regression analyses indicated that at the predisposition factor level, older participants (aOR60-69 = 0.602, P < 0.01; aOR70-75 = 0.475, P < 0.01) were less likely to have behavioral deviations. At the enabling factor level, compared to those covered by Urban Employee Basic Medical Insurance (UEBMI) and not reimbursed, those covered by Urban-Rural Resident Basic Medical Insurance (URRBMI) (aOR = 0.297, P < 0.01), and those answering that reimbursement from medical institutions was convenient (aOR = 0.501, P < 0.01) or very convenient (aOR = 0.358, P < 0.001) were less likely to have behavioral deviations. At the need factor level, participants who visited PHC institutions due to illness last year (aOR = 0.348, P < 0.001) and with polypharmacy (aOR = 0.546, P < 0.01) were less likely to have behavioral deviations compared to those without the visit of PHC institutions and not taking polypharmacy, respectively. CONCLUSIONS: The deviations between the original willingness of PHC institution visits and subsequent behavior among chronic disease patients were associated with a number of predisposing, enabling, and need factors. Developing the health insurance system, strengthening the technical capacity of PHC institutions, and steadily developing a new concept of orderly healthcare-seeking behavior among chronic disease patients, will help promote their access to PHC institutions as well as improve the effectiveness of the tiered medical system for chronic disease care.

The natural occurring RRR-α-Tocopherol and synthetic α-Tocopherol stereoisomers in maternal plasma, cord plasma and breast milk among six regions of China.

The study aimed to investigate RRR-α-Tocopherol and synthetic α-Tocopherol stereoisomers in maternal plasma, cord plasma and breast milk from different regions of China, providing a reference for further guidance on maternal diet and the potential need to supplement mothers with vitamin E. Two hundred and twenty-one sample sets from maternal plasma, cord plasma and three stages of milk (colostrum: 1-5 d after delivery; transitional milk: 10-15 d; mature milk: 40-45 d) were collected longitudinally in six regions of Shanghai, Guangzhou, Tianjin, Chengdu, Lanzhou and Changchun. α-Tocopherol and the stereoisomers were determined by HPLC with a fluorescence detector. The RRR configuration accounted for more than 80 % of α-Tocopherol in maternal plasma, cord plasma and breast milk. Overall, there were regional differences both in α-Tocopherol and RRR. There were significant correlations between α-Tocopherol and RRR in maternal plasma, cord plasma and milk (P < 0.001). As well as negative correlations among α-Tocopherol, RRR and weight-related indicators, which refer to pre-gestation weight and BMI, pre-delivery weight and BMI and pregnancy weight gain, in almost all of samples. This study suggested that RRR-α-Tocopherol was the dominant configuration of α-Tocopherol and the main active form of vitamin E in the early life, guiding the rational supplement of pregnant women and the addition of α-Tocopherol in infant formula milk powder.

Redox properties of nano-sized biochar derived from wheat straw biochar.

Nano-sized biochar (NBC) has received increasing attention due to its unique physicochemical characteristics and environmental behaviour, but an understanding of its redox properties is limited. Herein, the redox properties of NBC derived from wheat straw were investigated at two pyrolysis temperatures (400 and 700 °C). These NBC materials were prepared from bulk-biochar by grinding, ultrasonication and separation treatments. The resulting NBC had average particle sizes of 78.8 ± 1.9 and 122.0 ± 2.1 nm after 400 and 700 °C treatments, respectively. The physicochemical measurements demonstrated that both the NBC prepared at 400 °C (NBC-400) and the NBC prepared at 700 °C (NBC-700) were enriched in carboxyl and phenolic oxygen-content groups. Electrochemical analyses showed that both NBC-400 and NBC-700 were redox active and had an electron transfer capacity (ETC) of 196.57 µmol-1 gC -1 and 363.47 µmol-1 gC -1, respectively. On the basis of its redox activity of NBC, the NBC was capable of mediating the reduction of iron and manganese minerals as well as the degradation of methyl orange (MO) by sulfide. The NBC-700 could stimulate these reactions better than the NBC-400 due to its higher redox activity. Meanwhile, the NBC was more active in stimulating these reactions than bulk-biochar. Our results highlight the importance of size in evaluating the redox reactivity of biochar and related environmental processes and improve our understanding of the redox properties of biochar.

Treatment of simulated textile sludge using the Fenton/Cl- system: The roles of chlorine radicals and superoxide anions on PAHs removal.

The main content of this work is to investigate the removal of polycyclic aromatic hydrocarbons (PAHs: phenanthrene, anthracene, and fluoranthene) from simulated sludge solid phase employing an Fenton/Cl- system under various Cl- contents and pH values. The steady-state concentrations of the hydroxyl, chlorine, and dichloride anion radicals ([·OH]ss, [·Cl]ss, and [Cl2·-]ss) in heterogeneous system were first measured using tert-butanol, nitrobenzene, and benzoic acid. The outcomes exhibited that increasing the Cl- content from 50 to 2000 mg/L (pH = 3.0) or raising the pH from 3.0 to 5.0 (1000 mg/L Cl-) caused [·OH]ss to continuously decrease and [Cl2·-]ss and the concentration of superoxide anions (HO2·/O2·-) to continuously increase. When the pH was 3.0 and the Cl- concentration was 1000 mg/L, [·Cl]ss had a maximum value of 9.27 × 10-14 M. Combining the results of PAH removal, radical quenching, and product analysis, it was found that ·Cl in the Fenton/Cl- system promoted the oxidative degradation of phenanthrene without forming chlorination byproducts. Furthermore, HO2·/O2·- was helpful in removing anthracene and fluoranthene. Under the environment of high Cl- content (≥1000 mg/L), PAHs could be removed more effectively by using HO2·/O2·-. This investigation underpins further study on the regulation of reactive species and the efficient degradation of target organic matter in Fenton/Cl- system, and provides a basis for studying the formation of chlorinated or toxic byproducts in the process of treating textile dyeing sludge by Fenton.

Marisediminitalea mangrovi gen. nov., sp. nov., isolated from marine mangrove sediment, and reclassification of Aestuariibacter aggregatus as Marisediminitalea aggregata comb. nov.

Strain GS-14T was isolated from a mangrove sediment sample collected at Beilun Estuary National Nature Reserve, Guangxi Province, PR China. Cells were Gram-stain-negative, strictly aerobic and rod-shaped with a polar flagellum. Optimal growth occurred in the presence of 3-6 % (w/v) NaCl, at pH 6-8 and at a temperature of 37 °C. The predominant polar lipids were phosphatidylglycerol and phosphatidylethanolamine. Ubiquinone 8 (Q-8) was the sole respiratory quinone. The major fatty acids (>10 % of the total fatty acids) were summed feature 3 (C16 : 1ω7c and/or C16 : 1ω6c) and C16 : 0. The DNA G+C content was 47.6 mol%. Phylogenetic analysis based on the 16S rRNA gene sequence indicated that strain GS-14T had the highest sequence similarity to Aestuariibacter aggregatus WH169T (96.63 %), Aliiglaciecola coringensis AK49T (96.56 %) and Alteromonas lipolytica JW12T (96.22 %). In addition, the OrthoANIu value and dDDH values calculated from the genomes of strain GS-14T and A. aggregatus WH169T were 79.5 and 21.9 %, respectively. Based on the polyphasic taxonomic results, strain GS-14T is considered to represent a novel species in a new genus, for which the name Marisediminitalea mangrovi gen. nov., sp. nov. is proposed. The type strain of Marisediminitalea mangrovi is GS-14T (=KCTC 72401T=MCCC 1K03622T). Because Aestuariibacter aggregatus WH169T clustered with strain GS-14T in the phylogenetic trees and was clearly separated from the two species within the genus Aestuariibacter, it is reclassified as a member of the genus Marisediminitalea as Marisediminitalea aggregata comb. nov. (type strain WH169T=CGMCC 1.8995T=LMG 25283T). The type species of the genus Marisediminitalea is Marisediminitalea aggregata gen. nov., comb. nov.