Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients.

BACKGROUND: Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease (COPD) patients and reduce the quality of life of patients, but also affect the treatment effect and long-term prognosis. Therefore, it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression. AIM: To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents. METHODS: In this retrospective study, 60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group. The control group was given routine nursing, and the observation group was given comprehensive assessment. Clinical symptoms, quality of life [COPD assessment test (CAT) score], anxiety and depression Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were compared between the two groups. RESULTS: CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge, and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge. The average score was 22.1 (P < 0.05). In the observation group, HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge, and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge. The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge, and from an average of 14.1 at admission to an average of 11.8 at discharge. CONCLUSION: The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients' clinical symptoms and quality of life, and can effectively reduce patients' anxiety and depression.

A mild deprotection of isopropylidene ketals from 2-deoxyglycosides using AcOH/H2O/DME: An efficient regioselective deprotection of terminal isopropylidene ketals.

This paper describes a mild and efficient catalytic deprotection method for isopropylidene ketals and benzylidene acetals using AcOH/H2O/DME(1,2-Dimethoxyethane). The method effectively removes ketal and acetal protecting groups from 2-deoxyglycosides which are prone to hydrolysis under acidic conditions. Moreover, it enables the selective removal of the terminal ketal over an internal one.

DMAP-promoted oxidative functionalization of α-amino ketones via oxygen delivery from water/alcohols.

This paper shows a novel oxidative functionalization of α-amino ketones to yield the corresponding α-ketoamides and α-acylimidates. The reaction proceeds via oxygen delivery from water/alcohols in conjunction with an electron acceptor and 4-dimethylaminopyridine (DMAP). Mechanistic study indicates that DMAP exhibits a dual function of nucleophilic catalysis and proton abstraction.

TFA-Promoted Cascade Sulfonylation/Rearrangement/Cyclization of 1,5-Diynols and Sodium Sulfinates to Construct Sulfonylated Benzo[b]fluorenes.

A novel conversion of 1,5-diynols into sulfonylated benzo[b]fluorenes is reported by a TFA-promoted cascade cyclization with sodium sulfinates under mild conditions. This strategy provides an efficient and practical approach for accessing various sulfonated benzo[b]fluorenes in moderate to excellent yields under metal-free conditions. On the basis of the control experimental results and density functional theory calculations, a possible cascade transformation mechanism consisting of the dehydration of propargylic alcohols, sulfonylation, allenylation, and Schmittel-type cyclization is proposed. It is worth noting that TFA played an important role in this cascade cyclization, which promoted C-SO2R bond cleavage in a propargylic sulfone intermediate to form allenyl sulfones, followed by Schmittel-type cyclization to give the target product.

Perceptions of community mental health services among culturally diverse adult Singaporeans with major depressive disorder: A descriptive qualitative study.

Persons with major depressive disorder (PMDDs) often experience pernicious ramifications on the biopsychosocial aspects of their health. While community mental health services (CMHSs) in Singapore are increasingly leveraged to meet the escalating demand for mental healthcare, shortcomings such as a substantial treatment gap and the lack of holistic, culturally sensitive care have been highlighted. Of note, the perspectives of the service users, which have hardly been studied in the literature, are crucial to our understanding of their needs to continuously improve CMHSs. Accordingly, this qualitative descriptive study explored the perceptions and experiences of community-dwelling adults with major depressive disorder in their use of CMHSs in Singapore. Seventeen adults with major depressive disorder purposefully sampled from a CMHS provider were interviewed through a semi-structured guide between October and November 2021. Data analysis via Braun and Clarke's six-step thematic framework yielded five themes corresponding to three different phases: pre-CMHS encounter ((i) procrastination to seek help and (ii) factors influencing CMHS utilization); intra-CMHS encounter ((iii) incongruous perceptions of the impacts on biopsychosocial health and (iv) differing perceptions and experiences of culturally sensitive care); and post-CMHS encounter ((v) enhancing CMHSs for PMDDs based on end-users' experiences). Our findings underscore the need to improve the delivery of personalized mental healthcare services, use of settings- and culturally-specific anti-stigma strategies, and nationwide mental health literacy in symptom recognition and awareness of help-seeking resources.

Relationship between occupational coping self-efficacy and health-related productivity loss in ICU nurses： path analysis of perceived social support / 四川精神卫生

BackgroundCompared with absenteeism， health-related productivity loss has a long-lasting negative effect， and poses a greater harm and loss. The health-related productivity loss is mediated by self-efficacy， and perceived social support has been shown to have an impact on health-related productivity loss， whereas the interaction mechanism among the three remains unclear. ObjectiveTo investigate the status of perceived social support， occupational coping self-efficacy and health-related productivity loss among ICU nurses， and to test the mediation role of perceived social support in the relationship between occupational coping self-efficacy and health-related productivity loss. MethodsFrom September to November， 2021， purposive sampling technique was adopted to select 468 ICU nurses in 8 tertiary hospitals in Sichuan Province. Subjects were assessed using self-made general information questionnaire， Perceived Social Support Scale （PSSS）， Occupational Coping Self Efficacy Scale for Nurses （OCSE-N） and Stanford Presenteeism Scale-6 （SPS-6）. Pearson correlation analysis was used to examine the correlation among variables. Amos 24.0 was utilized to test the mediation role of perceived social support in the relationship between occupational coping self-efficacy and health-related productivity loss. ResultsA total of 415 ICU nurses completed the valid questionnaire survey. ICU nurses scored （63.13±11.62） on PSSS， （22.24±6.15） on OCSE-N， and （16.83±4.24） on SPS-6. Health-related productivity loss was detected in 279 ICU nurses （67.23%）. Correlation analysis denoted that PSSS total score was positively correlated with OCSE-N total score （r=0.348， P<0.05）， and negatively correlated with SPS-6 total score （r=-0.274， P<0.05）. OCSE-N total score was negatively correlated with SPS-6 total score （r=-0.421， P<0.05）. The direct effect value of occupational coping self-efficacy on health-related productivity loss was -0.401， and perceived social support showed a mediation role in the relationship between occupational coping self-efficacy and health-related productivity loss （the indirect effect value was -0.052， accounting for 11.48% of the total effect）. ConclusionThe occupational coping self-efficacy of ICU nurses may affect the health-related productivity loss through the action path of perceived social support.［Funded by Scientific Research Project of Sichuan Provincial Health Commission （number， 19PJ042）］

Electrochemical Arene Radical Cation Promoted Spirocyclization of Biaryl Ynones: Access to Alkoxylated Spiro[5,5]trienones.

Herein, a novel electrochemical arene radical cation promoted dearomative spirocyclization of biaryl ynones with alcohols is described, providing a conceptually novel transformation mode for producing diverse alkoxylated spiro[5,5]trienones. The catalyst- and chemical-oxidant-free spirocyclization protocol features broad substrate scope and high functional group tolerance. Mechanistic studies reveal that the generation of arene radical cation via anodic single-electron oxidation is crucial, with sequential 6-endo-dig cyclization, dissociation of hemiketal, anodic oxidation, and nucleophilic attack of alcohols.

NBS-mediated bromination and dehydrogenation of tetrahydro-quinoline in one pot: scope and mechanistic study.

A facile and general approach was developed for the efficient construction of functionalized bromoquinolines by the dehydrogenation of tetrahydroquinolines using NBS as the electrophile and as oxidant. The cascade transformation proceeded with good functional group tolerance under metal-free conditions with a short reaction duration. Various tetrahydroquinolines bearing either electron-rich or electron-deficient groups at different positions were successfully converted into the corresponding target products in moderate to high yields under mild conditions. It is worth noting that the obtained polybromoquinolines could further undergo classic metal-catalyzed cross-coupling reactions with good regioselectivity. The Sonagashira coupling reaction occurred regioselectively in the C-6 position of the obtained products followed by a Suzuki coupling reaction to give multifunctionalized quinolines. The mechanism indicated that electrophilic bromination/radical dehydrogenation sequences occurred in one pot.

Cascade Cyclization of 1,5-Diynols and (RO)2P(O)SH to Construct Benzo[b]fluorenyl S-Alkyl Phosphorothioates under Catalyst-Free Conditions.

An efficient and practical cascade cyclization of 1,5-diynols with (RO)2P(O)SH as the acid promoter and nucleophile under mild conditions was developed. A variety of highly substituted benzo[b]fluorenyl-containing S-alkyl phosphorothioates were successfully constructed in moderate to excellent yields. Furthermore, this protocol exhibited good functional group tolerance, a broad substrate scope, and potential practical applications, with water as the only byproduct. The reaction proceeded with allenyl thiophosphate as a key intermediate, followed by a Schmittel-type cyclization process to produce the target product.

Electrochemical 1,3-Alkyloxylimidation of Arylcyclopropane Radical Cations: Four-Component Access to Imide Derivatives.

Herein, a general electrochemical radical-cation-mediated four-component ring-opening 1,3-alkyloxylimidation of arylcyclopropanes, acetonitrile, carboxylic acids, and alcohols is described, providing a facile and sustainable approach to quickly construct structurally diverse imide derivatives from easily available raw materials in an operationally simple undivided cell. This metal-catalyst- and oxidant-free single-electron oxidation strategy offers a green alternative for the formation of highly reactive cyclopropane-derived radical cations, and this protocol features a broad functional group tolerance.

Pollen Morphology in Sorbus L. (Rosaceae) and Its Taxonomic Implications.

The genus Sorbus L. in the Rosaceae family is taxonomically challenging due to its morphological variation, polyploidy, and interspecific hybridization. In this study, we used scanning electron microscopy (SEM) to observe the pollen morphology of eighty species, representing six subgenera, in order to assess the differences within the genus Sorbus and its pollen characteristics. We conducted a cluster analysis on three qualitative and four quantitative characteristics. The results demonstrated that the pollen grains of the studied Sorbus species are isopolar and tricolporate. We identified five types of pollen shapes: suboblate, spheroidal, subprolate, prolate, and perprolate. The pollen ornamentation of the investigated species could be classified into five types: striate-perforate, striate, cerebroid-perforate, cerebroid, and foveolate. Interestingly, within the same subgenera, different species exhibited multiple types of characters. The cluster analysis indicated that all 80 species could be divided into six groups, with group B consisting exclusively of species from the subgenus Sorbus. Although pollen micro-morphologies alone do not provide sufficient evidence to establish the taxonomic relationships of the subgenera within Sorbus, they do offer valuable information for species-level taxonomic treatment.

Drug resistance related genes in lung adenocarcinoma predict patient prognosis and influence the tumor microenvironment.

Lung adenocarcinoma (LUAD) is the predominant type of non-small lung cancer (NSCLC) with strong invasive ability and poor prognosis. The drug resistance related genes are potentially associated with prognosis of LUAD. Our research aimed to identify the drug resistance related genes and explore their potential prognostic value in LUAD patients. The data used in this study were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Firstly, we screened drug resistance related genes in LUAD by differential gene analysis, univariate Cox regression and drug sensitivity analyses. Subsequently, we constructed a risk score model using LASSO Cox regression analysis, and verified whether the risk score can predict the survival of LUAD patients independent of other factors. Moreover, we explored the immune infiltration of 22 immune cells between high-risk and low-risk patients. Totally 10 drug-resistance positively related genes (PLEK2, TFAP2A, KIF20A, S100P, GDF15, HSPB8, SASH1, WASF3, LAMA3 and TCN1) were identified in LUAD. The risk score model of LUAD constructed with these 10 genes could reliably predict the prognosis of LUAD patients. 18 pathways were significantly activated in high-risk group compared with low-risk group. In addition, the infiltration proportion of multiple immune cells was significantly different between high-risk and low-risk groups, and the proportion of M1 phagocytes was significantly higher in the high-risk group compared with the low-risk group. The drug resistance related genes (PLEK2, TFAP2A, KIF20A, S100P, GDF15, HSPB8, SASH1, WASF3, LAMA3 and TCN1) could predict the prognosis of LUAD patients. Clarifying the roles and mechanisms of these 10 genes in regulating drug resistance in LUAD will help to improve individualized clinical treatment protocols and predict patient sensitivity to treatment.

Synergistic Reduction of Arsenic Uptake and Alleviation of Leaf Arsenic Toxicity in Maize (Zea mays L.) by Arbuscular Mycorrhizal Fungi (AMF) and Exogenous Iron through Antioxidant Activity.

Arbuscular mycorrhizal fungi (AMF) play key roles in enhancing plant tolerance to heavy metals, and iron (Fe) compounds can reduce the bioavailability of arsenic (As) in soil, thereby alleviating As toxicity. However, there have been limited studies of the synergistic antioxidant mechanisms of AMF (Funneliformis mosseae) and Fe compounds in the alleviation of As toxicity on leaves of maize (Zea mays L.) with low and moderate As contamination. In this study, a pot experiment was conducted with different concentrations of As (0, 25, 50 mgꞏkg-1) and Fe (0, 50 mgꞏkg-1) and AMF treatments. Results showed that under low and moderate As concentrations (As25 and As50), the co-inoculation of AMF and Fe compound significantly increased the biomass of maize stems and roots, phosphorus (P) concentration, and P-to-As uptake ratio. Moreover, the co-inoculation of AMF and Fe compound addition significantly reduced the As concentration in stem and root, malondialdehyde (MDA) content in leaf, and soluble protein and non-protein thiol (NPT) contents in leaf of maize under As25 and As50 treatments. In addition, co-inoculation with AMF and Fe compound addition significantly increased the activities of catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD) in the leaves of maize under As25 treatment. Correlation analysis showed that stem biomass and leaf MDA content were very significantly negatively correlated with stem As content, respectively. In conclusion, the results indicated that the co-inoculation of AMF and Fe compound addition can inhibit As uptake and promote P uptake by maize under low and moderate As contamination, thereby mitigating the lipid peroxidation on maize leaves and reducing As toxicity by enhancing the activities of antioxidant enzymes under low As contamination. These findings provide a theoretical basis for the application of AMF and Fe compounds in the restoration of cropland soil contaminated with low and moderate As.

Photoalkylation/-arylation of ortho-Diketones with Unactivated Organic Halides.

A new method for conducting a reductive alkylation/arylation of 1,2-diketones using visible light and unactivated organic halides is presented in this article. This technique does not require a photocatalyst and employs Et3N, a tertiary amine, as a promoter. This amine aids in generating a ketyl radical and an α-aminoalkyl radical, which engages in a C-X bond activation via a halogen atom transfer process (XAT). This approach's success hinges on utilizing Et3N as the promoter. This article's mild and straightforward protocol allows for significantly expanding organic halide substrates, including primary, secondary, and aromatic organic halides and various functional groups.

Synthesis of gem-dibromo 1,3-oxazines by NBS-mediated electrophilic cyclization of propargylic amides.

We present a highly efficient and practical method for synthesizing gem-dibromo 1,3-oxazines through 6-endo-dig cyclization of propargylic amides, using N-bromosuccinimide (NBS) as an electrophilic source. The metal-free reaction can be conducted under mild conditions with good functional group compatibility, delivering excellent yields of the desired products. Mechanistic studies suggest that the reaction proceeds via a double electrophilic attack by NBS on the propargylic amide substrate.

[Sludge Biochar Modified by B-doped and Its Adsorption Behavior and Mechanism of 1,2-DCA in Water].

Sludge biochar (BC600) and B-doped sludge biochar (BBC600) were prepared with the boric acid doping modified co-pyrolysis method using municipal sludge as precursors, and the materials were structurally characterized by SEM, BET, FTIR, and Zeta potential and static contact angle to investigate the adsorption behavior, mechanism of BC600 and BBC600 on 1,2-DCA in water, and the influencing factors. The results of structural characterization showed that the B element content, specific surface area, and pore volume of biochar increased by 76%, 48%, and 30%, respectively, after the B doping modification; the effect of B doping modification on the surface charge and hydrophobicity of biochar was not significant. The results of adsorption experiments showed that the adsorption of 1,2-DCA by BBC600 was better than that by BC600 due to the larger specific surface area and higher strength of oxygen-containing functional groups of BBC600; the pseudo-first-order kinetic equation could better describe the adsorption of 1,2-DCA by BC600, and the pseudo-second-order kinetic equation could better fit the adsorption of 1,2-DCA by BBC600. The intraparticle diffusion was not the only rate-limiting step affecting the adsorption rate; the biochar material was more dispersed and stable under alkaline conditions, and its oxygen-containing functional groups were deprotonated and had enhanced electron-donating ability, which was beneficial to the adsorption of 1,2-DCA. Humic acid (HA) showed a low concentration-promoting and high concentration-inhibiting effect on the adsorption of 1,2-DCA by BC600, whereas both low and high concentrations of HA showed an inhibitory effect on the adsorption of 1,2-DCA by BBC600. The adsorption of 1,2-DCA by BC600 was inhibited by both low and high concentrations of HA, and HA competed with 1,2-DCA for adsorption; Cl-, SO42-, and NO3- all inhibited the adsorption of 1,2-DCA by biochar, and the degree of inhibition ordered from small to large was Cl-

Synergetic Effect of Superabsorbent Polymer and CaO-Based Expansive Agent on Mitigating Autogenous Shrinkage of UHPC Matrix.

The hybrid use of a superabsorbent polymer (SAP) and expansive agent (EA) is beneficial for mitigating the autogenous shrinkage of ultra-high-performance concrete (UHPC) without compromising strength. However, the unclear mechanisms behind the synergetic effect of the two materials may hinder the more effective applications of this method. This study clarifies the interactions between SAP and CaO-based EA (CEA) in a UHPC matrix by quantifying the content and distribution of water and hydration products, underlining their influence on the strength and autogenous shrinkage evolution. The high strength of 135 MPa can be achieved in systems with a reasonable combination (S1E1, 0.1 wt%SAP, and 1 wt%CEA), and after 7 days, a 24% reduction in shrinkage was found in the same system, which is more effective than the use SAP or CEA alone at the same dose. The mitigating effect on the autogenous shrinkage of a UHPC matrix with hybrid materials at different stages depends on the competition between the water retention for self-desiccation and portlandite formation. With the continuing formation of hydration products, the microporosity of UHPC matrix under internal curing conditions at 28 d is considerably reduced, resulting in a more compact microstructure. This study also finds a suppressed crystallization pressure of growing portlandite in the extra space provided by emptied SAP, which explains the lost expansion of CEA.

Subarachnoid hemorrhage following wasp stings.

Three days after being stung by wasps in a rural area, a 60-year-old man was admitted to the emergency department with headaches. The physical examination showed that the patient was conscious, had moderate pain, had four head and back stings with local edema and erythema around the wounds, and had a stiff neck. Brain computed tomography upon admission revealed no abnormalities. Following lumbar puncture, the patient was diagnosed with subarachnoid hemorrhage (SAH) induced by wasp stings. No obvious aneurysms were found by either computed tomography angiography or three-dimensional rotational angiography. He received symptomatic treatment including antiallergy medication (chlorpheniramine and intravenous hydrocortisone), nimodipine for possible vasospasm, fluid infusion, and mannitol for intracranial pressure reduction and was discharged on the 14th day. This case of wasp sting-induced SAH is being reported to improve doctors' diagnostic abilities when encountering patients with wasp stings. It is important for emergency physicians to be aware that patients stung by wasps may develop rare complications such as SAH. Hymenoptera-induced SAH is an example of such a case.

Electrochemically enabled decyanative C(sp3)-H oxygenation of N-cyanomethylamines to formamides.

Selective oxygenation of C(sp3)-H bonds adjacent to nitrogen atoms is a highly attractive strategy for synthesizing various formamide derivatives while preserving the substrate skeletons. Herein, an environmentally benign electrochemically enabled decyanative C(sp3)-H oxygenation of N-cyanomethylamines using H2O as a carbonyl oxygen atom source is described, leading to the synthesis of a large class of formamides in good to excellent yields with a broad substrate scope under metal- and oxidant-free conditions. This electrochemical technology highlights the facile incorporation of N-formyl into some important bioactive molecules.