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Abstract Background Women with a history of gestational diabetes mellitus (GDM) are 12-fold more likely to develop type 2 diabetes (T2D) 4–6 years after delivery than women without GDM. Similarly, GDM is associated with the development of common mental disorders (CMDs) (e.g. anxiety and depression). Evidence shows that holistic lifestyle interventions focusing on physical activity (PA), dietary intake, sleep, and mental well-being strategies can prevent T2D and CMDs. This study aims to assess the effectiveness of a holistic lifestyle mobile health intervention (mHealth) with post-GDM women in preventing T2D and CMDs in a community setting in Singapore. Methods The study consists of a 1-year randomised controlled trial (RCT) with a 3-year follow-up period. Post-GDM women with no current diabetes diagnosis and not planning to become pregnant will be eligible for the study. In addition, participants will complete mental well-being questionnaires (e.g. depression, anxiety, sleep) and their child’s socio-emotional and cognitive development. The participants will be randomised to either Group 1 (Intervention) or Group 2 (comparison). The intervention group will receive the “LVL UP App”, a smartphone-based, conversational agent-delivered holistic lifestyle intervention focused on three pillars: Move More (PA), Eat Well (Diet), and Stress Less (mental wellbeing). The intervention consists of health literacy and psychoeducational coaching sessions, daily “Life Hacks” (healthy activity suggestions), slow-paced breathing exercises, a step tracker (including brisk steps), a low-burden food diary, and a journaling tool. Women from both groups will be provided with an Oura ring for tracking physical activity, sleep, and heart rate variability (a proxy for stress), and the “HAPPY App”, a mHealth app which provides health promotion information about PA, diet, sleep, and mental wellbeing, as well as display body mass index, blood pressure, and results from the oral glucose tolerance tests. Short-term aggregate effects will be assessed at 26/27 weeks (midpoint) and a 1-year visit, followed by a 2, 3, and 4-year follow-up period. Discussion High rates of progression of T2D and CMDs in women with post-GDM suggest an urgent need to promote a healthy lifestyle, including diet, PA, sleep, and mental well-being. Preventive interventions through a holistic, healthy lifestyle may be the solution, considering the inextricable relationship between physical and psychological health. We expect that holistic lifestyle mHealth may effectively support behavioural changes among women with a history of GDM to prevent T2D and CMDs. Trial status The protocol study was approved by the National Healthcare Group in Singapore, Domain Specific Review Board (DSRB) [2023/00178]; June 2023. Recruitment began on October 18, 2023. Trial registration ClinicalTrials.gov NCT05949957. The first submission date is June 08, 2023.

Objective In this study, inbred BALB/c mice infected with the pneumonia virus of mice (PVM) were used to establish an animal model of viral pneumonia, and the changes in the pro-inflammatory alarmin molecule, high mobility group box 1 protein (HMGB1), during PVM infection were observed, as well as the in vivo intervention effects of the HMGB1 inhibitor, glycyrrhizic acid (GA), on PVM-induced lung injury.Methods Three-week-old female BALB/c mice were randomly divided into three groups, each consisting of 6 mice. One group, uninfected by PVM, served as the control group (Control). The other two groups were inoculated intranasally with PVM at a dose of 1×104 50% tissue culture infective dose (TCID50)/25 μL, and subsequently treated with GA saline solution (GA group) or plain saline solution (normal saline, NS group) via gavage for 15 consecutive days. During this period, changes in body weight and appearance were monitored in each group. At the end of the experiment, lung tissue samples were collected from all groups. The distribution of PVM and HMGB1 proteins in the lung tissues was analyzed using hematoxylin-eosin staining and immunohistochemistry. The expression levels of HMGB1 and its Toll-like receptor 4 (TLR-4), advanced glycosylation end-product-specific receptor (AGER), and inflammatory cytokines such as interleukin (IL)-1β, IL-2, and tumor necrosis factor-α (TNF-α) in lung tissues of mice were measured using real time fluorescence quantitative PCR.Results Compared with the Control group, the NS group showed a significant weight loss after 6 days (P

Abstract Quinoa (Chenopodium quinoa Willd.), an Andean crop, is a facultative halophyte food crop recognized globally for its high nutritional value and plasticity to adapt to harsh conditions. We conducted a genome-wide association study on a diverse set of quinoa germplasm accessions. These accessions were evaluated for the following agronomic and biochemical traits: days to 50% flowering (DTF), plant height (PH), panicle length (PL), stem diameter (SD), seed yield (SY), grain diameter (GD), and thousand-grain weight (TGW). These accessions underwent genotyping-by-sequencing using the DNBSeq-G400R platform. Among all evaluated traits, TGW represented maximum broad-sense heritability. Our study revealed average SNP density of ≈ 3.11 SNPs/10 kb for the whole genome, with the lowest and highest on chromosomes Cq1B and Cq9A, respectively. Principal component analysis clustered the quinoa population in three main clusters, one clearly representing lowland Chilean accessions, whereas the other two groups corresponded to germplasm from the highlands of Peru and Bolivia. In our germplasm set, we estimated linkage disequilibrium decay to be ≈ 118.5 kb. Marker-trait analyses revealed major and consistent effect associations for DTF on chromosomes 3A, 4B, 5B, 6A, 7A, 7B and 8B, with phenotypic variance explained (PVE) as high as 19.15%. Nine associations across eight chromosomes were also found for saponin content with 20% PVE by qSPN5A.1. More QTLs were identified for PL and TGW on multiple chromosomal locations. We identified putative candidate genes in the genomic regions associated with DTF and saponin content. The consistent and major-effect genomic associations can be used in fast-tracking quinoa breeding for wider adaptation across marginal environments.

ObjectiveTo provide a scientific basis to establish further prevention and control strategies， the epidemiological characteristics of foodborne disease outbreaks from 2012 to 2021 in Jiangxi Province was analyzed.MethodsDescriptive analysis was conducted using foodborne disease outbreak data obtained from the Foodborne Disease Outbreak Reporting System for Jiangxi Province from 2012 to 2021.ResultsFrom 2012 to 2021， a total of 1 285 cases， 7，222 illnesses， and 48 deaths due to foodborne disease outbreaks occurred in Jiangxi Province. The case fatality rate was 0.66% （48/7 222）. Further， the mortality rates were found to statistically significantly differ among the different years （P≤0.001）. The number of foodborne disease outbreaks tended to increase within the 10 years， and most incidents occurred from May to September. Among the 768 confirmed single etiologic agents， poisonous mushroom was the cause of most incidents （50.78%； 390/768） and deaths （93.75%； 45/48）. Microbiological agents were responsible for most illnesses （49.41%； 2 266/4 586）. Salmonella and Vibrio parahaemolyticus were identified as the main pathogenic bacteria. Foodborne disease outbreaks mainly occurred among families and in catering services， with families having the largest number of incidents （64.75%； 832/285） and deaths （95.83%； 46/48）. Notably， the main pathogenic factor was poisonous mushrooms. Catering services were associated with the largest number of illnesses （51.77%； 3 739/7 222）， with microbiological agents as the main pathogenic factor.ConclusionPoisonous mushrooms caused the most deaths and mainly affected families. Microbial pathogenic factors were the main pathogenic factors in places offering catering services and schools. Rural families should be educated on the harm associated with the consumption of wild mushroom. Moreover， the supervision and management of food safety and health education should be promoted to reduce the incidence of foodborne disease and death.

Abstract Background A new concept of HER2‐low has emerged in recent years. However, the prognostic value and the relapse pattern of HER2‐low is unclear. Methods Our study included patients diagnosed with HER2‐negative/hormone receptor‐positive breast cancer to explore the differences in survival outcomes between the HER2‐low group and the HER2‐zero group. More importantly, we explored different recurrence patterns, including the comparison of metastatic sites and recurrence time curve between the two groups. Results A total of 797 patients with hormone receptor‐positive breast cancer were analyzed. Similar disease‐free survival (DFS) was observed between the HER2‐low group and HER2‐zero group (HR 0.84, 95% CI: 0.61–1.16, p = 0.290). There was also no significant difference in OS between the HER2‐low group and the HER2‐zero group (HR 0.77, 95% CI: 0.46–1.28, p = 0.310). When IHC 1+ and 0 were taken as a group, the IHC 2+ group had significantly better DFS than the IHC 1+ and 0 group in some subgroups. The risk of bone metastasis in patients with HER2 IHC 1+ and 0 was significantly higher than that of patients with HER2 IHC 2+ (12.7% vs. 4.7%, p

Gestational diabetes (GDM), defined as glucose intolerance during pregnancy, affects one in six pregnancies globally and significantly increases a woman’s lifetime risk of type 2 diabetes mellitus (T2DM). Being a relatively young group, women with GDM are also at higher risk of developing diabetes related complications (e.g., cardiovascular disease, non-alcoholic fatty liver disease) later in life. Children of women with GDM are also likely to develop GDM and this perpetuates a cycle of diabetes, escalating our current pandemic of metabolic disease. The global prevalence of GDM has now risen by more than 30% over the last two decades, making it an emerging public health concern. Antepartum management of maternal glucose is unable to fully mitigate the associated lifetime cardiometabolic risk. Thus, efforts may need to focus on improving care for women with GDM during the postpartum period where prevention or therapeutic strategies could be implemented to attenuate progression of GDM to DM and its associated vascular complications. However, strategies to provide care for women in the postpartum period often showed disappointing results. This has led to a missed opportunity to halt the progression of impaired glucose tolerance/impaired fasting glucose to DM in women with GDM. In this review, we examined the challenges in the management of women with GDM after delivery and considered how each of these challenges are defined and could present as a gap in translating evidence to clinical care. We highlighted challenges related to postpartum surveillance, postpartum glucose testing strategies, postpartum risk factor modification, and problems encountered in engagement of patients/providers to implement interventions strategies in women with GDM after delivery. We reasoned that a multisystem approach is needed to address these challenges and to retard progression to DM and cardiovascular disease (CVD) in women with GDM pregnancies. This is very much needed to pave way for an improved, precise, culturally sensitive and wholistic care for women with GDM.

Let $ O_{K} = \mathbb{Z}[i] $. For each positive integer $ n $, denote $ \xi_{K}(n) $ as the number of integral ideals whose norm divides $ n $ in $ O_{K} $. In this paper, we studied the distribution of ideals whose norm divides $ n $ in $ O_{K} $ by using the Selberg-Delange method. This is a natural variant of a result studied by Deshouillers, Dress, and Tenenbaum (often called the DDT Theorem), and we found that the distribution function was subject to beta distribution with density $ \sqrt{3}/(2\pi\sqrt[3]{u^{2}(1-u)}) $.

Background: Personalised care and support planning (CSP) is a person-centred approach for the care of people living with long-term conditions. Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) adapts the Year of Care Partnerships (YOCP) approach to CSP in the UK for people living with diabetes at Singapore polyclinics. Polyclinics are multi-storey primary care hubs that provide affordable, multidisciplinary, comprehensive, and high-throughput public health care for the multi-ethnic, multilingual Singapore population. Aim: To explore the experience of PACE-D-enrolled people living with diabetes with personalised CSP at Singapore polyclinics. Design & setting: Qualitative interviews of people living with diabetes who experienced personalised CSP at National University Polyclinics (NUP) in Singapore between July 2020 and November 2021. Method: PACE-D-enrolled people living with diabetes who experienced personalised CSP were purposively sampled. In-depth semi-structured interviews were recorded, transcribed, and analysed using Braun and Clarke’s reflexive thematic analysis. Results: Fifty-two patients participated in the study. Four main themes were identified. Theme 1 was the importance of the care-planning letter. Patients reported that the CPL prompted reflection and patient preparation for CSP conversations. Theme 2 was the role of the programme coordinator. PACE-D programme coordinators amplified self-management by playing advocate and confidant beyond administrative duties. Theme 3 was the value of the personalised CSP conversation. CSP providers were perceived as partners in care, with more time to listen compared with usual consultations. Patient engagement was affected by language confidence. Theme 4 was agency in self-management. With adequate time and support, patients increased in confidence and agency both in CSP engagement and diabetes self-management. Conclusion: While language confidence may affect patient engagement, personalised CSP shows promise for strengthening patient engagement and self-management among people living with diabetes at Singapore polyclinics.

CH4 has become the most attractive fuel for solid oxide fuel cells due to its wide availability, narrow explosion limit range, low price, and easy storage. Thus, we present the concept of on-cell reforming via SOFC power generation, in which CH4 and CO2 can be converted into H2 and the formed H2 is electrochemically oxidized on a Ni-BZCYYb anode. We modified the porosity and specific surface area of a perovskite reforming catalyst via an optimized electrostatic spinning method, and the prepared LCMN nanofibers, which displayed an ideal LaMnO3-type perovskite structure with a high specific surface area, were imposed on a conventional Ni-BZCYYb anode for on-cell CH4 reforming. Compared to LCMN nanoparticles used as on-cell reforming catalysts, the NF-SOFC showed lower ohmic and polarization resistances, indicating that the porous nanofibers could reduce the resistances of fuel gas transport and charge transport in the anode. Accordingly, the NF-SOFC displayed a maximum power density (MPD) of 781 mW cm−2 and a stable discharge voltage of around 0.62 V for 72 h without coking in the Ni-BZCYYb anode. The present LCMN NF materials and on-cell reforming system demonstrated stability and potential for highly efficient power generation with hydrocarbon fuels.