Effect of biosurfactants on the transport of polyethylene microplastics in saturated porous media.

Microplastic (MP) pollution has become a significant global environmental issue, and the potential application of biosurfactants in soil remediation has attracted considerable attention. However, the effects of biosurfactants on the transport and environmental risks of MPs are not fully understood. This study investigated the transport of polyethylene (PE) in the presence of two types of biosurfactants: typical anionic biosurfactant (rhamnolipids) and non-ionic biosurfactant (sophorolipids) using column experiments. We explored the potential mechanisms involving PE surface roughness and the influence of dissolved organic matter (DOM) on PE transport in the column under the action of biosurfactants, utilizing the Wenzel equation and fluorescence analysis. The results revealed that both the concentration of biosurfactants and the surface roughness of PE were advantageous for the adhesion of biosurfactants to the PE surface, thereby enhancing the mobility of PE in the column. The proportion of hydrophobic substances in various DOM sources is a critical factor that enhances PE transport in the column. However, the biosurfactant-mediated enhancement of PE transport was inhibited by the biosurfactant-DOM mixture. This was mainly due to DOM occupying the adhesion sites of biosurfactants on PE surfaces. Moreover, the mobility of PE in the presence of sophorolipids is higher than that in the presence of rhamnolipids because the combined hydrophobic and electrostatic forces between PE and sophorolipids create synergistic effects that improve PE stability. Additionally, the mobility of PE increased with rising pH and decreasing ionic strength. These findings provide a more comprehensive understanding of MP transport when using biosurfactants for soil remediation.

NDR1/FBXO11 promotes phosphorylation-mediated ubiquitination of ß-catenin to suppress metastasis in prostate cancer.

Background: Prostate cancer progression hinges on ß-catenin's stability and activity, a key factor in epithelial-mesenchymal transition (EMT) and metastasis. This study delves into NDR1-dependent phosphorylation's impact on ß-catenin via FBXO11, an E3 ubiquitin ligase, in prostate cancer cells. Methods: Human prostate cancer cell lines underwent various in vitro assays, including real-time PCR, Western blotting, immunoprecipitation, immunofluorescence, and protein stability assays, to explore ß-catenin's interactions and post-translational modifications. NDR1 modulation's in vivo efficacy was assessed using a nude mice lung metastasis model. Small-molecule screening identified a potential NDR1 activator, aNDR1, tested for its effects on metastasis via in vitro and in vivo assays. Results: NDR1 phosphorylated ß-catenin at Ser33/37, facilitating its interaction with FBXO11. This led to FBXO11-mediated ubiquitination and cytoplasmic degradation of ß-catenin, while the NDR1-FBXO11 complex impeded ß-catenin nuclear translocation by inducing JNK2 ubiquitination. Thus, NDR1 and FBXO11 jointly regulate ß-catenin activity in prostate cancer cells through dual phosphorylation-driven ubiquitination, potentially suppressing EMT. Reduced NDR1 expression inhibited FBXO11 and ß-catenin phosphorylation, diminishing ß-catenin and JNK2 ubiquitination, promoting EMT and enhancing prostate cancer cell metastasis. The inhibitory effects of aNDR1 on prostate cancer metastasis were validated. Conclusion: The NDR1/FBXO11 axis outlines a non-canonical ß-catenin degradation pathway crucial in regulating EMT and prostate cancer cell metastasis. NDR1 activation, particularly with aNDR1, could offer a promising therapeutic avenue against prostate cancer metastasis.

Effect of cerebrospinal dual-site magnetic stimulation on freezing of gait in Parkinson's disease.

Addressing levodopa-unresponsive freezing of gait (FOG) in Parkinson's disease (PD) presents a significant challenge. A randomized double-blinded trial evaluated the effects of repetitive transcranial magnetic stimulation (rTMS) in conjunction with transcutaneous magnetic spinal cord stimulation among 57 PD individuals experiencing levodopa-unresponsive FOG. Patients were randomized to receive dual-site stimulation involving bilateral primary motor cortex of the lower leg (M1-LL) and the lumbar spinal cord, single-site stimulation targeting bilateral M1-LL alone, or sham stimulation for 10 sessions. Low-frequency rTMS induced remarkable improvements in FOG, gait, and motor functions compared to sham at 1 day and 1 month postintervention. Notably, the dual-site protocol demonstrated superior efficacy in mitigating FOG and improving gait compared to the single-site approach, which correlated with a pronounced increase in short-interval intracortical inhibition of the abductor pollicis brevis. These findings underscore the potential of the cerebrospinal dual-site regimen as a promising approach for levodopa-unresponsive FOG and gait in PD.

Chemical Derivatization and Paper Spray Ionization Mass Spectrometry for Fast Screening of Retinoic Acid in Cosmetics.

As a prescription drug, retinoic acid is listed as a banned cosmetic additive in the EU and China regulations. Currently, spectrophotometric methods, including thin-layer chromatography (TLC), high-performance liquid chromatography (HPLC), and HPLC-MS/MS, are commonly used for the determination of retinoic acid. As these conventional methods require complex pretreatment and are time-consuming, chemical derivatization combined with paper spray ionization mass spectrometry was developed for the fast detection of retinoic acid in cosmetics. N,N-dimethylpiperazine iodide (DMPI) was utilized as a derivatization reagent. Carboxylic acid in retinoic acid was derivatized to carry a positive charge and was subjected to mass spectrometry analysis. Results showed that compared with non-derivatized compounds, the detection limit was increased by about 50 times. The linearity in the range of 0.005-1 µg·mL-1 was good. The limit of detection (LOD) was 0.0013 µg·mL-1, and the limit of quantification (LOQ) was 0.0043 µg·mL-1. The recoveries of spiked samples were in the range of 95-105%, and the RSDs were below 5%. Derivatization and paper spray ionization MS render a quick, sensitive, and accurate method for the detection of retinoic acid in a complex matrix.

Dietary influences on urinary tract infections: unraveling the gut microbiota connection.

This study employs Mendelian randomization to investigate the causal relationships between dietary factors, gut microbiota, and urinary tract infections (UTIs). Our analysis revealed statistically significant associations, including high alcohol intake, cheese, and oily fish consumption with UTI risk, as well as links between UTI risk and specific gut microbiota, such as Prevotellaceae, Butyrivibrio, Anaerotruncus, and Dorea. Additionally, we observed associations with inflammatory markers, including C-Reactive Protein and Interleukin-6. Although the observed effects of these dietary factors on UTI risk are minimal and may limit their clinical relevance, these findings can still hold significant implications at the population level in public health. This research offers novel insights into the interplay between diet, gut microbiota, and UTI risk, laying a foundation for future studies. Further research is warranted to validate these associations and to explore the underlying mechanisms and their broader impact on public health.

Transport of reduced PBAT microplastics in saturated porous media: Synergistic effects of enhanced surface energy and roughness.

Microplastic (MP) pollution presents significant global environmental challenges, exacerbated by reduction aging processes in anoxic environments, thereby increasing environmental risks and potential threats to human health. However, the mechanisms underlying the transport of reduced MPs remain poorly understood. In this study, laboratory-scale column experiments were conducted to investigate the transport behavior of polybutylene adipate terephthalate (PBAT), a common biodegradable MPs, and its reduced products obtained through the aging process mediated by two typical reducing agents, NaBH4 and Na2S, under varying conditions (ionic strength (IS), divalent cations, and low molecular weight organic acids (LMWOAs)). The results indicated that reduction aging improved the hydrophilicity of PBAT by increasing the surface roughness (roughness factor increased from 1.300 to 1.642) and surface energy (from 51.80 to 107.03 mN m-1), thereby increasing the mobility of reduced PBAT (with recovery rate increased from 53.77 % to 63.18 %). Increased IS decreased the mobility of reduced PBAT by decreasing the surface negative charge density. Divalent cations inhibited the mobility of both pristine and reduced PBAT in porous media, with pristine PBAT, containing more oxygen functional groups, exhibiting stronger inhibition. Furthermore, LMWOAs promoted the retention of reduced PBAT in porous media, which was dependent on the type of LMWOAs. This study revealed the alterations in MPs properties caused by reduction aging and their effects on transport mechanisms, offering new insights into the transport behavior and environmental risks of reduced MPs.

Monocytes as an early risk factor for acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.

Acute graft-versus-host disease (aGVHD) is a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and contributes to high morbidity and mortality. However, our current understanding of the development and progression of aGVHD after allo-HSCT remains limited. To identify the potential biomarkers for the prevention and treatment of aGVHD during the early hematopoietic reconstruction after transplantation, we meticulously performed a comparative analysis of single-cell RNA sequencing data from post-transplant patients with or without aGVHD. Prior to the onset of aGVHD, monocytes in the peripheral blood of patients with aGVHD experienced a dramatic rise and activation on day 21 post-transplantation. This phenomenon is closely aligned with clinical cohort results obtained from blood routine examinations. Furthermore, in vitro co-culture experiments showed that peripheral blood monocytes extracted from patients with aGVHD approximately 21 days post-transplantation induced a significantly higher proliferation rate of allogeneic T cells compared to those from patients without aGVHD. Our study indicates that monocytes could be a crucial early clinical risk factor for the development of aGVHD, and this insight could potentially guide the timing of monitoring efforts, recommending assessments at the pivotal juncture of approximately day 21 post-transplantation, shedding fresh light on the significance of early hematopoietic regeneration in relation to the onset of aGVHD.

NDR1 mediates PD-L1 deubiquitination to promote prostate cancer immune escape via USP10.

Prostate cancer (PCa) is one of the most common male genitourinary system malignancies. Despite the significant benefits of anti-PD-L1 immune checkpoint inhibitor therapy in other cancers, the reasons for its poor therapeutic efficacy in prostate cancer (PCa) remain unclear.NDR1 plays an important role in innate immunity, but its role in tumor immunity and immunotherapy has not been investigated. The role of NDR1 in the immune microenvironment of PCa and the related mechanisms are unknown. Here, we found a positive correlation between NDR1 and PD-L1 expression in PCa. NDR1 significantly inhibits CD8 + T cell infiltration and function, thereby promoting immune escape in prostate cancer.More importantly, NDR1 inhibition significantly enhanced CD8 + T cell activation, which enhanced the therapeutic effect of anti-PD-L1. Mechanistic studies revealed that NDR1 inhibits ubiquitination-mediated PD-L1 degradation via the deubiquitinase USP10, upregulates PD-L1, and promotes PCa immune escape. Thus, our study suggests a unique PD-L1 regulatory mechanism underlying PCa immunotherapy failure. The significance of NDR1 in PCa immune escape and its mechanism of action were clarified, and combined NDR1/PD-L1 inhibition was suggested as an approach to boost PCa immunotherapy effectiveness.

The protective effect of glucose selenol on cadmium-induced testicular toxicity in male rat.

This study aimed to investigate the protective effects of glucose selenol on cadmium (Cd)-induced testicular toxicity. Twenty-four male Sprague-Dawley (SD) rats were randomly divided into four groups. Cd was administered orally at a dose of 40 mg/L or in combination with orally administered glucose selenol at doses of 0.15 mg/L and 0.4 mg/L for 30 days. The results showed that sperm quality decreased and testicular tissue was damaged in the Cd group; Glucose selenol significantly attenuated the negative effects by improving sperm quality and reducing testicular damage. Transcriptome sequencing analysis showed that Cd stress affected spermatogenesis, sperm motility, oxidative stress, blood-testis barrier and protein metabolism. Four clusters were obtained using the R Mfuzz package, which clustered highly expressed genes under different administrations, and 36 items were enriched. Notably, protein phosphorylation was enriched in the Cd group and is considered to play a key role in the response to Cd stress. We identified fifty-six target selenium (Se) and Cd co-conversion differentially expressed genes (DEGs), including three genes relating to spermatogenesis (Dnah8, Spata31d1b, Spata31d1c). In addition, the obtained DEGs were used to construct a protein-protein interaction network, co-processed with Se and Cd, and 5 modules were constructed. Overall, the analyses of rat testicular physiology and gene expression levels offer new insights into the reproductive toxicity of Cd in rats, and provide potential application prospects for glucose selenol in alleviating the impact of Cd-induced testicular damage.

Shared and distinct cortical morphometric alterations in five neuropsychiatric symptoms of Parkinson's disease.

Neuropsychiatric symptoms (including anxiety, depression, apathy, impulse-compulsive behaviors and hallucinations) are among the most common non-motor features of Parkinson's disease. Whether these symptoms should be considered as a direct consequence of the pathophysiologic mechanisms of Parkinson's disease is controversial. Morphometric similarity network analysis and epicenter mapping approach were performed on T1-weighted images of 505 patients with Parkinson's disease and 167 age- and sex-matched healthy participants from Parkinson's Progression Markers Initiative database to reveal the commonalities and specificities of distinct neuropsychiatric symptoms. Abnormal cortical co-alteration pattern in patients with neuropsychiatric symptoms was in somatomotor, vision and frontoparietal regions, with epicenters in somatomotor regions. Apathy, impulse-compulsive behaviors and hallucinations shares structural abnormalities in somatomotor and vision regions, with epicenters in somatomotor regions. In contrast, the cortical abnormalities and epicenters of anxiety and depression were prominent in the default mode network regions. By embedding each symptom within their co-alteration space, we observed a cluster composed of apathy, impulse-compulsive behaviors and hallucinations, while anxiety and depression remained separate. Our findings indicate different structural mechanisms underlie the occurrence and progression of different neuropsychiatric symptoms. Based upon these results, we propose that apathy, impulse-compulsive behaviors and hallucinations are directly related to damage of motor circuit, while anxiety and depression may be the combination effects of primary pathophysiology of Parkinson's disease and psychosocial causes.

Identification and quantification of micro-nano-plastics in polypropylene-bottled injections.

Micro-nano-plastic (MNP) particles (p) in the environment can enter the human body and pose a potential threat to human health. However, it is unknown whether these substances are present in polypropylene (PP) plastic-bottled injections, which are used as high-frequency intravenous infusions to treat diseases. Therefore, the objective of this study was to identify and quantify insoluble MNP particles in 16 batches of injectable formulations within the validity period. Primarily, ethylene-propylene copolymer or P(E-P) micro-plastic (MP) particles (2-10 µm, 216 p/mL) were identified by micro-Raman spectroscopy, and nano-particles (<50 nm, 2.1 × 104 p/mL) similar to PP containing only carbon were detected by scanning electron microscopy-energy-dispersive X-ray spectroscopy (photoelectron). Furthermore, P(E-P) MP particles (1 × 103 to 1 × 105 ng/L) from the injections were enriched on the GF-B filter, and PP or P(E-P) nano-plastic (NP) particles (1 × 103 to 4 × 104 ng/L) enriched on the alumina film were detected by pyrolysis-gas chromatography/mass spectrometry. Finally, the total insoluble particles in injections were 6 × 104 to 1 × 107 p/mL (0.02-100 µm). Our findings are the first to identify and quantify MNPs in PP-bottled injections. Considering that they can enter the blood circulation, so whether cause disease remains to be investigated.

Latent Profile Analysis of Self-Stigma Among Individuals With Schizophrenia and Its Relationship With Illness Perception.

PURPOSE: To investigate self-stigma among individuals with schizophrenia, identify potential categories of self-stigma, and analyze the association between self-stigma categories and dimensions of disease perception. METHOD: Convenience sampling was used to select individuals with schizophrenia (N = 216) in psychiatric hospitals. A General Demographic Information Questionnaire, the Internalized Stigma of Mental Illness Inventory, and Brief Illness Perception Questionnaire were used for data collection. A latent profile analysis was performed on self-stigma characteristics of participants, and potential categories of influencing factors and their relationship with illness perception were examined. RESULTS: Participants were classified into three potential categories: low self-stigma-low resistance (19.4%), medium self-stigma (55.6%), and high self-stigma-high discrimination (25%). Compared with the low self-stigma-low resistance group, those with higher illness representation and illness understanding scores were more likely to be classified as medium self-stigma, and emotional representation was the strongest predictor for high self-stigma-high discrimination. CONCLUSION: Self-stigma among participants was mostly medium to high. Self-stigma of individuals with schizophrenia demonstrates group heterogeneity; therefore, nurses should formulate targeted interventions based on the characteristics of each category to achieve precise interventions and reduce self-stigma. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

The Hemagglutinin of Influenza A Virus Induces Ferroptosis to Facilitate Viral Replication.

Ferroptosis is a novel form of cell death caused by the accumulation of lipid peroxides in an iron-dependent manner. However, the precise mechanism underlying the exploitation of ferroptosis by influenza A viruses (IAV) remains unclear. The results demonstrate that IAV promotes its own replication through ferritinophagy by sensitizing cells to ferroptosis, with hemagglutinin identified as a key trigger in this process. Hemagglutinin interacts with autophagic receptors nuclear receptor coactivator 4 (NCOA4) and tax1-binding protein 1 (TAX1BP1), facilitating the formation of ferritin-NCOA4 condensates and inducing ferritinophagy. Further investigation shows that hemagglutinin-induced ferritinophagy causes cellular lipid peroxidation, inhibits aggregation of mitochondrial antiviral signaling protein (MAVS), and suppresses the type I interferon response, thereby contributing to viral replication. Collectively, a novel mechanism by which IAV hemagglutinin induces ferritinophagy resulting in cellular lipid peroxidation, consequently impairing MAVS-mediated antiviral immunity, is revealed.

Effects of an online mindfulness-based cognitive therapy for caregivers of children with allergic rhinitis.

The incidence of allergic rhinitis in children is high across the world, as well as in China. Allergic rhinitis in children has serious impact on physical and mental health of the children. At the same time, the caregivers of allergic rhinitis children have heavy burden of care, and their mental problems are severe. It is necessary to implement timely psychological intervention for the caregivers of allergic rhinitis children. Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective psychological therapy, and the effect of online intervention can be comparable to the traditional face-to-face intervention program. This study focused on the mental health status in the main caregivers of children with allergic rhinitis, and conducted a modified online MBCT intervention on the caregivers, in order to improve their adverse mental state, meanwhile, improve the quality of care they provide. The results show that online MBCT intervention is applicable to the main caregivers of children with allergic rhinitis, and can effectively reduce caregiver burden, relieve anxiety and depression, and improve the level of mindfulness in the caregivers.

Zinc-finger CCHC-type containing protein 8 promotes RNA virus replication by suppressing the type-I interferon responses.

Host cells have evolved an intricate regulatory network to fine tune the type-I interferon responses. However, the full picture of this regulatory network remains to be depicted. In this study, we found that knock out of zinc-finger CCHC-type containing protein 8 (ZCCHC8) impairs the replication of influenza A virus (IAV), Sendai virus (Sev), Japanese encephalitis virus (JEV), and vesicular stomatitis virus (VSV). Further investigation unveiled that ZCCHC8 suppresses the type-I interferon responses by targeting the interferon regulatory factor 3 (IRF3) signaling pathway. Mechanistically, ZCCHC8 associates with phosphorylated IRF3 and disrupts the interaction of IRF3 with the co-activator CREB-binding protein (CBP). Additionally, the direct binding of ZCCHC8 with the IFN-stimulated response element (ISRE) impairs the ISRE-binding of IRF3. Our study contributes to the comprehensive understanding for the negative regulatory network of the type-I interferon responses and provides valuable insights for the control of multiple viruses from a host-centric perspective.IMPORTANCEThe innate immune responses serve as the initial line of defense against invading pathogens and harmful substances. Negative regulation of the innate immune responses plays an essential role in avoiding auto-immune diseases and over-activated immune responses. Hence, the comprehensive understanding of the negative regulation network for innate immune responses could provide novel therapeutic insights for the control of viral infections and immune dysfunction. In this study, we report that ZCCHC8 negatively regulates the type-I interferon responses. We illustrate that ZCCHC8 impedes the IRF3-CBP association by interacting with phosphorylated IRF3 and competes with IRF3 for binding to ISRE. Our study demonstrates the role of ZCCHC8 in the replication of multiple RNA viruses and contributes to a deeper understanding of the negative regulation system for the type-I interferon responses.

Corrigendum: Human IL-17 and TNF-α additively or synergistically regulate the expression of proinflammatory genes, coagulation-related genes, and tight junction genes in porcine aortic endothelial cells.

[This corrects the article DOI: 10.3389/fimmu.2022.857311.].

Protective effectiveness of previous infection against subsequent SARS-Cov-2 infection: systematic review and meta-analysis.

Background: The protective effectiveness provided by naturally acquired immunity against SARS-CoV-2 reinfection remain controversial. Objective: To systematically evaluate the protective effect of natural immunity against subsequent SARS-CoV-2 infection with different variants. Methods: We searched for related studies published in seven databases before March 5, 2023. Eligible studies included in the analysis reported the risk of subsequent infection for groups with or without a prior SARS-CoV-2 infection. The primary outcome was the overall pooled incidence rate ratio (IRR) of SARS-CoV-2 reinfection/infection between the two groups. We also focused on the protective effectiveness of natural immunity against reinfection/infection with different SARS-CoV-2 variants. We used a random-effects model to pool the data, and obtained the bias-adjusted results using the trim-and-fill method. Meta-regression and subgroup analyses were conducted to explore the sources of heterogeneity. Sensitivity analysis was performed by excluding included studies one by one to evaluate the stability of the results. Results: We identified 40 eligible articles including more than 20 million individuals without the history of SARS-CoV-2 vaccination. The bias-adjusted efficacy of naturally acquired antibodies against reinfection was estimated at 65% (pooled IRR = 0.35, 95% CI = 0.26-0.47), with higher efficacy against symptomatic COVID-19 cases (pooled IRR = 0.15, 95% CI = 0.08-0.26) than asymptomatic infection (pooled IRR = 0.40, 95% CI = 0.29-0.54). Meta-regression revealed that SARS-CoV-2 variant was a statistically significant effect modifier, which explaining 46.40% of the variation in IRRs. For different SARS-CoV-2 variant, the pooled IRRs for the Alpha (pooled IRR = 0.11, 95% CI = 0.06-0.19), Delta (pooled IRR = 0.19, 95% CI = 0.15-0.24) and Omicron (pooled IRR = 0.61, 95% CI = 0.42-0.87) variant were higher and higher. In other subgroup analyses, the pooled IRRs of SARS-CoV-2 infection were statistically various in different countries, publication year and the inclusion end time of population, with a significant difference (p = 0.02, p < 0.010 and p < 0.010), respectively. The risk of subsequent infection in the seropositive population appeared to increase slowly over time. Despite the heterogeneity in included studies, sensitivity analyses showed stable results. Conclusion: Previous SARS-CoV-2 infection provides protection against pre-omicron reinfection, but less against omicron. Ongoing viral mutation requires attention and prevention strategies, such as vaccine catch-up, in conjunction with multiple factors.

Insufficient Plasma Melatonin and Its Association With Neuropsychiatric Impairments in Patients With T2DM.

Purpose: Type 2 diabetes mellitus (T2DM) is associated with multiple neuropsychiatric impairments, including cognitive dysfunction, and melatonin (MLT) plays a crucial role in maintaining normal neuropsychiatric functions. This study is aimed at investigating the change in plasma MLT levels and its association with neuropsychiatric impairments in T2DM patients. Methods: One hundred twenty-six T2DM patients were recruited, and their demographics and clinical data were collected. Apart from the plasma glycated hemoglobin (HbA1c) levels and other routine metabolic indicators, the plasma concentrations of MLT, C-reactive protein (CRP), Interleukin 6 (IL-6), soluble myeloid triggered receptor 1 (sTREM 1), and receptor 2 (sTREM 2) were measured. Moreover, the executive function and depressive tendency were evaluated via the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the Epidemiological Research Center Depression Scale (CES-D), respectively. Result: Compared with the low HbA1c group, the T2DM patients in the high HbA1c group presented lower plasma MLT levels but higher plasma concentrations of inflammatory biomarker levels, together with higher scores in the BRIEF-A and CES-D scales. Moreover, results of the Pearson correlation test showed that the plasma MLT levels were negatively correlated with the BRIEF-A and CES-D scores, as well as plasma concentrations of HbA1c and inflammatory indications, indicating that MLT may mediate their neuroinflammation and neuropsychiatric impairments. Furthermore, the ROC curve results indicated that plasma MLT levels have a predictive effect on executive impairment and depressive status in T2DM patients. Conclusion: MLT levels decreased in patients with T2DM and were associated with neuropsychiatric impairments and inflammatory status, and MLT might be developed as a therapeutic agent and predictive indicator for T2DM-associated executive impairment and depression status.

The development of a performance evaluation index system for Chinese Centers for Disease Control and Prevention: a Delphi consensus study.

BACKGROUND: The performance evaluation of the Centers for Disease Control and Prevention (CDC) is crucial for enhancing the quality of public health services. With the ongoing reform of the CDC system in China, the existing performance evaluation system faces challenges. This study used the Delphi method to develop a new performance evaluation system for China's provincial, city, and county-level CDC. METHODS: Following the "Structure-Process-Outcome" model, assessment indicators were systematically collected. Indicators were modified and screened through two Delphi rounds based on CDC responsibilities, health development, and national policies. Twenty-four experts provided ratings and recommendations, and the research team evaluated questionnaire reliability, expert positivity, expert authority, and opinion consistency. RESULTS: The preliminary index system identified through the literature review and pre-survey included 11 primary, 30 secondary, and 64 tertiary indicators. After the first round of consultation, two secondary indicators and 11 tertiary indicators were removed and 22 tertiary indicators were added. After the second round of consultation, three secondary indicators and 11 tertiary indicators were removed and three tertiary indicators were added, at which point the p-value of the test for Kendall's coefficient of concordance W was < 0.001 and the coefficient of variation was within acceptable limits (< 0.25), so the consultation was concluded. The final index system included 11 primary, 25 secondary, and 67 tertiary indicators. CONCLUSIONS: This study responded to the CDC system reform by developing a comprehensive performance evaluation index system for provincial, city, and county-level CDC in China. The index system is both scientifically grounded and practical, serving as an effective tool for promoting the high-quality work of CDC organizations.

Association between the functional connectivity of ventral tegmental area-prefrontal network and pure apathy in Parkinson's disease: a cross-sectional study.

Background: Apathy, characterized by diminished goal-directed behaviors, frequently occurs in patients with Parkinson's disease (PD). The dopamine-releasing neurons of the ventral tegmental area (VTA) have been closely related to this behavioral disruption and project widely to the corticolimbic areas, yet their functional and structural connectivity in regard to other brain regions remain unknown in patients with PD and pure apathy (PD-PA). This study thus aimed to characterize the alterations of functional connectivity (FC) of the VTA and white matter structural connectivity in PD-PA. Methods: In this study, 29 patients with PD-PA, 37 with PD but not pure apathy (PD-NPA), and 28 matched healthy controls (HCs) underwent T1-weighted, resting state functional magnetic resonance imaging, and diffusion tensor imaging scans. Patients of this cross-sectional retrospective study were consecutively recruited from The First Affiliated Hospital of Nanjing Medical University between April 2017 and October 2021. Meanwhile, HCs were consecutively recruited from the local community and the Health Examination Center of our hospital. An analysis of covariance and a general linear model were respectively conducted to investigate the functional and structural connectivity among three groups. The tract-based spatial statistics (TBSS) approach was used to investigate the white matter structural connectivity. Results: Patients with PD-PA showed reduced FC of the VTA with the left medial superior frontal gyrus (SFGmed) when compared to the patients with PD-NPA [t=-3.67; voxel-level P<0.001; cluster-level family-wise error-corrected P (PFWE)<0.05]. Relative to the HCs, patients with PD-PA demonstrated reduced FC of the VTA with the left SFGmed (t=-4.98; voxel-level P<0.001; cluster-level PFWE<0.05), right orbital superior frontal gyrus (SFGorb) (t=-5.08; voxel-level P<0.001; cluster-level PFWE<0.05), and right middle frontal gyrus (MFG) (t=-5.08; voxel-level P<0.001; cluster-level PFWE<0.05). Moreover, the reductions in VTA FC with the left SFGmed were associated with severe apathy symptoms in patients with PD-PA (r=-0.600; P=0.003). However, a TBSS approach did not reveal any significant differences in fiber tracts between the three groups. Conclusions: This study identified reduced FC within the mesocortical network (VTA-SFGmed) of patients with PD-PA. These findings may provide valuable information for administering neuromodulation therapies in the alleviation of apathy symptoms in those with PD.