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Embryonic diapause is a common evolutionary adaptation observed across a wide range of organisms. Artemia is one of the classic animal models for diapause research. The current studies of Artemia diapause mainly focus on the induction and maintenance of the embryonic diapause, with little research on the molecular regulatory mechanism of Artemia embryonic reactivation. The first 5 h after embryonic diapause breaking has been proved to be most important for embryonic reactivation in Artemia. In this work, two high-throughput sequencing methods, ATAC-seq and RNA-seq, were integrated to study the signal regulation process in embryonic reactivation of Artemia at 5 h after diapause breaking. Through the GO and KEGG enrichment analysis of the high-throughput datasets, it was showed that after 5 h of diapause breaking, the metabolism and regulation of Artemia cyst were quite active. Several signal transduction pathways were identified in the embryonic reactivation process, such as G-protein-coupled receptor (GPCR) signaling pathway, cell surface receptor signaling pathway, hormone-mediated signaling pathway, Wnt, Notch, mTOR signaling pathways, etc. It indicates that embryonic reactivation is a complex process regulated by multiple signaling pathways. With the further protein structure analysis and RT-qPCR verification, 11 GPCR genes were identified, in which 5 genes function in the embryonic reactivation stage and the other 6 genes contribute to the diapause stage. The results of this work reveal the signal transduction pathways and GPCRs involved in the embryonic reactivation process of Artemia cysts. These findings offer significant clues for in-depth research on the signal regulatory mechanisms of the embryonic reactivation process and valuable insights into the mechanism of animal embryonic diapause. [ABSTRACT FROM AUTHOR]

In response to external threatening signals, animals evolve a series of defensive behaviors that depend on heightened arousal. It is believed that arousal and defensive behaviors are coordinately regulated by specific neurocircuits in the central nervous system. The ventral tegmental area (VTA) is a key structure located in the ventral midbrain of mice. The activity of VTA glutamatergic neurons has recently been shown to be closely related to sleep–wake behavior. However, the specific role of VTA glutamatergic neurons in sleep–wake regulation, associated physiological functions, and underlying neural circuits remain unclear. In the current study, using an optogenetic approach and synchronous polysomnographic recording, we demonstrated that selective activation of VTA glutamatergic neurons induced immediate transition from sleep to wakefulness and obviously increased the amount of wakefulness in mice. Furthermore, optogenetic activation of VTA glutamatergic neurons induced multiple defensive behaviors, including burrowing, fleeing, avoidance and hiding. Finally, viral-mediated anterograde activation revealed that projections from the VTA to the central nucleus of the amygdala (CeA) mediated the wake- and defense-promoting effects of VTA glutamatergic neurons. Collectively, our results illustrate that the glutamatergic VTA is a key neural substrate regulating wakefulness and defensive behaviors that controls these behaviors through its projection into the CeA. We further discuss the possibility that the glutamatergic VTA-CeA pathway may be involved in psychiatric diseases featuring with excessive defense.

Control of the directional bounce of droplets impacting solid surfaces is crucial for many agricultural and industrial applications. However, for the universal impact process of raindrops on plant leaves, little is known about how the highly coupled and complicated fluid–structure interaction controls the postimpact motion of droplets and endows the leaves with tenacious vitality. Here, we report a leaf‐like superhydrophobic cantilever to flexibly bounce droplets with well‐defined directionality and controllability. Through theoretical modeling and three‐dimensional fluid–solid coupling simulations, we find that the flexible cantilever significantly relieves the impacting forces of raindrops to reduce droplet fragmentation and enhance water repellency. The results further uncover the scaling relations of the droplet bouncing direction with respect to Weber number and cantilever stiffness. By this technique, the seemed disorganized postimpact movements of droplets are programmable and predictable, achieving the goal of where to point and where to hit automatically. This work advances the understanding of natural droplet impact phenomena, opens a new avenue for delicately controlling liquid motion in space with soft materials, and inspires a plethora of applications like soft robots to transport materials and energies, monitor plant growth as well as predict pathogen transmission in plants. [ABSTRACT FROM AUTHOR]

Background: Immune microenvironment serves a vital role in glioma progression, and a large number of studies have found that tumor progression can be reduced to some extent by modulating the immune process in tumors. Materials and Methods: ImmuneScore of each sample in CGGA datasets were calculated with Estimate R package, and samples were grouped by median ImmuneScore values for differential analysis to obtain immune microenvironment differential genes. We further conducted survival analysis, ROC curve analysis, independent prognostic analysis, and clinical correlation analysis on glioma sample genes in CGGA to obtain glioma prognostic genes, and then identified their intersection with immune microenvironment DEGs by Venn tool. The GEPIA and UALCAN databases were used to verify the differential expression of intersecting genes in the glioma and normal brain and to identify our target gene. After validation of their prognostic value, we constructed a nomogram to calculate the risk score and to estimate the accuracy of prognostic model. We mined co-expression genes, enriched functions and pathways, and correlations to immune cell infiltration of unigene with an online database. Finally, we verified the differential expression of FCGBP in glioma by immunohistochemical staining. Results: We finally selected Fc fragment of IgG-binding protein (FCGBP) as our study gene. The prognostic values of FCGBP were validated by a series of analyses. Immunohistochemical staining showed that FCGBP expression increased in gliomas and was up-regulated with the progression of glioma grade. Conclusion: As a key unigene in glioma progression, FCGBP contributes to the regulation of immune microenvironment and has the potential to be a prognostic biomarker and immune targets. [ABSTRACT FROM AUTHOR]

Archaeal carotenoids, as novel bioactive compound, are stronger free radical scavenger. The effects of archaea Halorubrum carotenoids on skin coloration, antioxidative status and immune‐related genes expression of golden trout Oncorhynchus mykiss were investigated. In total, 420 fish (10.90 ± 0.06 g) were divided into three groups with four replicates, and fed with commercial diets containing 0 (Ctrl), 25 mg/kg (P25) and 50 mg archaeal carotenoids/kg feed (P50) for 8 weeks. Although no significant difference was observed on growth, the fish fed archaeal carotenoids had significantly higher yellowness and carotenoid content (p < 0.05) in skin. Compared with the Ctrl group, the total antioxidant capacity (T‐AOC) in serum was significantly enhanced in the P25 and P50 groups (p < 0.05), but no significant difference on lysozyme activity was obtained (p > 0.05). In liver, the catalase activity significantly decreased in the P50 group (p < 0.05), but T‐AOC and superoxide dismutase activity was not significantly regulated by archaeal carotenoids (p > 0.05). The significant improvement of liver glutathione peroxidase in P50 group was observed, while malondialdehyde content significantly decreased (p < 0.05). After ammonia exposure and Aeromonas hydrophilia challenge, higher survival was observed in the P25 and P50 groups, associating with reducing the expression of pro‐inflammation cytokines il‐1β, but enhancing the expression of anti‐inflammation cytokines tgf‐β and hsp70. However, ammonia stress and pathogenic challenge caused opposite trends in the expression of tnf‐α. Our study confirmed the beneficial role of archaeal carotenoids on skin coloration, antioxidative and immune systems of golden trout, and provided evidence for the potential application of this novel carotenoid in health management of aquaculture. [ABSTRACT FROM AUTHOR]

Author(s): Virgil Percec (corresponding author) [1]; Andrés E. Dulcey [1]; Venkatachalapathy S. K. Balagurusamy [1, 2]; Yoshiko Miura [1]; Jan Smidrkal [1]; Mihai Peterca [1, 2]; Sami Nummelin [1]; Ulrica [...]

Background: Glioma is one of the most common malignancies in the central nervous system and has limited effective therapeutic options. Therefore, we sought to identify a suitable target for immunotherapy. Materials and Methods: We screened prognostic genes for glioma in the CGGA database and GSE43378 dataset using survival analysis, receiver operating characteristic (ROC) curves, independent prognostic analysis, and clinical correlation analysis. The results were intersected with immune genes from the ImmPort database through Venn diagrams to obtain likely target genes. The target genes were validated as prognostically relevant immune genes for glioma using survival, ROC curve, independent prognostic, and clinical correlation analyses in samples from the CGGA database and GSE43378 dataset, respectively. We also constructed a nomogram using statistically significant glioma prognostic factors in the CGGA samples and verified their sensitivity and specificity with ROC curves. The functions, pathways, and co-expression-related genes for the glioma target genes were assessed using PPI networks, enrichment analysis, and correlation analysis. The correlation between target gene expression and immune cell infiltration in glioma and the relationship with the survival of glioma patients were investigated using the TIMER database. Finally, target gene expression in normal brain, low-grade glioma, and high-grade glioma tissues was detected using immunohistochemical staining. Results: We identified TNFRSF12A as the target gene. Satisfactory results from survival, ROC curve, independent prognosis, and clinical correlation analyses in the CGGA and GSE43378 samples verified that TNFRSF12A was significantly associated with the prognosis of glioma patients. A nomogram was constructed using glioma prognostic correlates, including TNFRSF12A expression, primary-recurrent-secondary (PRS) type, grade, age, chemotherapy, IDH mutation, and 1p19q co-deletion in CGGA samples with an AUC value of 0.860, which illustrated the accuracy of the prognosis prediction. The results of the TIMER analysis validated the significant correlation of TNFRSF12A with immune cell infiltration and glioma survival. The immunohistochemical staining results verified the progressive up-regulation of TNFRSF12A expression in normal brain, low-grade glioma, and high-grade glioma tissues. Conclusion: We concluded that TNFRSF12A was a viable prognostic biomarker and a potential immunotherapeutic target for glioma. [ABSTRACT FROM AUTHOR]

Background and Objectives: Guizhi-Shaoyao-Zhimu decoction (GSZD) is often applied to control rheumatoid arthritis (RA), gout, osteoarthritis, etc. In this study, bioinformatic analysis and experimental verification were used to uncover the integral mechanism profile of GSZD against RA. Materials and Methods: The chemical compositions of GSZD were identified by UPLC-QTOF-MS/MS. MH7A cell model was established to screen active compounds in GSZD, and potential targets of these compounds were predicted through online database retrieval. The differential expression genes (DEGs) in synovial tissue of RA patients and normal controls were retrieved from the GEO database. DEGs and the predicated compounds targets were overlapped, and the overlapped genes were subsequently enriched by GO and KEGG analysis. The pathways with significant enrichments were further experimentally verified. Results: A total of 19 constituents were identified from GSZD, and 11 compounds showed obviously antiproliferative effects on MH7A cells with IC50 < 100 μg/mL. Bioinformatic analysis indicated that IL-1β, IL-6, MAPK8, JAK2, CXCL8, and CASP3 were the main targets of GSZD, and the integral pharmacological mechanisms profile of GSZD might be related to anti-inflammation and proapoptosis. GSZD can promote the loss of mitochondrial membrane potential (MOMP) and induce apoptosis in MH7A cells. Furthermore, in vitro experiments showed GSZD can not only downregulate mRNA expressions of IL-1β (p< 0.05), IL-6 (p< 0.05), MMPs (p< 0.05) and CCL5 (p< 0.05) but also inhibit the nuclear transcription of NF-κB. GSZD also reduced the expressions of Bcl-2 (p< 0.05), JAK2 (p< 0.05), STAT-3 (p< 0.05), whereas increase Bax (p< 0.05), Caspase-3 (p< 0.05) and caspase-9 (p< 0.05). Conclusion: Collectively, inducing synovial fibroblast apoptosis and inhibiting inflammatory response are two important ways for GSZD to RA, and our study proved bioinformatic analysis combined with experimental verification is a feasible method to explore the drug targets and mechanism of actions of TCMs. [ABSTRACT FROM AUTHOR]

Half‐smooth tongue sole Cynoglossus semilaevis is a high‐value marine fish species. The intensive farming of this flatfish species has been suffered from disease outbreak. Poly‐β‐hydroxybutyrate (PHB) is a carbon storage compound accumulated by a wide variety of prokaryotes and is considered biocontrol agent applied in aquaculture. In this study, the dietary effect of PHB‐accumulating Halomonas (HM.PHB) was investigated on survival, growth, resistance on Vibrio anguillarum and intestine microbial composition of C. semilaevis juveniles. Halomonas was fermented, which contained 76% PHB on cell dry weight. The fish juveniles were fed formulated feeds containing 1% HM.PHB, 3% HM.PHB and 5% HM.PHB, and 3% particle PHB (Par.PHB) and 3% Halomonas containing no PHB (HM) for 6 weeks. The basal feed feeding was considered as the control. The results revealed that both Halomonas‐PHB and particle PHB significantly improved the survival and growth of the juveniles than the control (p <.05), while HM was in between. When challenged with V. anguillarum, the survival rate in 1% HM.PHB, 3% HM.PHB and 5% HM.PHB was significantly improved than the control. Moreover, the increased intestine fold, epithelium height and surface were also observed in 3% HM.PHB. PCoA based on high‐throughput sequencing of 16S rRNA gene fragment indicated that dietary Halomonas‐PHB and particle PHB modified and stabilized the intestine microbial community of the fish. Our study demonstrated that Halomonas‐PHB is an effective feed additive for C. semilaevis juvenile culture. The outcome of this study facilitates the application of Halomonas‐PHB in C. semilaevis and other marine fish aquaculture. [ABSTRACT FROM AUTHOR]

Directing a liquid droplet after or upon impacting a solid is crucial in many biological, sustainable, environmental, and engineering applications. Despite significant progress in the translational motion of droplets on surfaces, a fundamental dynamic understanding of directional bouncing of an impinging droplet needs to be developed and improved. Here, we investigate the projectile motion of a droplet after impacting the superhydrophobic interfaces with various roughness gradients at room temperature. The results reveal that an initial oblique velocity and the reactive force generated in intrinsic gyration (seesaw effect) engender the preferential bouncing motion of a droplet towards a region with lower roughness. An arbitrary planar force is used to describe the basic mechanical model. New anti-gravity pendulum dynamics are deduced and demonstrated by tuning the model and adjusting the substrate gradient and the impact position. The direction of droplet transport is also flexibly adjusted by changing the structural parameter and the inclined angle of the substrate. This acts as a tri-directional rectifier and might be useful for creating a miniature musical fountain. This work advances the understanding of directed droplet transportation and also provides a promising approach to delicately control liquid motion by actuating a force model upon a designed interface. [ABSTRACT FROM AUTHOR]

Neurodegenerative diseases are neurological diseases that are characterized by neuronal degeneration and apoptosis; they threaten populations around the world and place a great burden on the social economy. Unfortunately, the drugs currently used to treat neurodegenerative diseases have obvious side effects, making them much less effective. Therefore, discovery of new safe and effective drugs is urgently needed. Zanthoxylum bungeanum Maxim. (ZBM) has a long medicinal history in China and can also be used as food. ZBM contains many types of chemical components, of which amides are the most abundant. In preparing this review, we searched and integrated the relevant literature in PubMed, Web of Science, Elesvier, Wliey and Springer using the keywords "ZBM", "amide", "physicochemical properties", and "neurodegenerative diseases". It was found that the amides that are present in ZBM (AZB), although structurally unstable, are the likely material basis for an irritating sensation in the mout,. In addition, AZB can play a therapeutic role in Alzheimer's disease, Parkinson's and depression by exerting antioxidant and anti-inflammatory effects. The main targets of AZB are the TRPV1, TRPA1 and PI3K/AKT signalling pathways. This review will discuss the physical and chemical properties of AZB and its use in the treatment of neurodegenerative diseases to provide a reference for the development of ZBM for use in the treatment of neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

Introduction: Cell-free protein microarrays represent a special form of protein microarray which display proteins made fresh at the time of the experiment, avoiding storage and denaturation. They have been used increasingly in basic and translational research over the past decade to study protein-protein interactions, the pathogen-host relationship, post-translational modifications, and antibody biomarkers of different human diseases. Their role in the first blood-based diagnostic test for early stage breast cancer highlights their value in managing human health. Cell-free protein microarrays will continue to evolve to become widespread tools for research and clinical management. Areas covered: We review the advantages and disadvantages of different cell-free protein arrays, with an emphasis on the methods that have been studied in the last five years. We also discuss the applications of each microarray method. Expert commentary: Given the growing roles and impact of cell-free protein microarrays in research and medicine, we discuss: 1) the current technical and practical limitations of cell-free protein microarrays; 2) the biomarker discovery and verification pipeline using protein microarrays; and 3) how cell-free protein microarrays will advance over the next five years, both in their technology and applications. [ABSTRACT FROM PUBLISHER]

The bacterial storage compound poly-β-hydroxybutyrate (PHB) is a potential bio-control agent in aquaculture. It has been reported that PHB benefit to the survival and growth, and improve their immunity of aquatic animals. However, the cellular and molecular regulation mechanisms of PHB in immunity process remain unclear. This study investigated the immune mechanism of hemocytes regulated by Halomonas -PHB (PHB-HM) and PHB monomer 3-HB. Red claw crayfish Cherax quadricarinatus was used as the experimental animal in cytological study. Fluorescence microscopy and flow cytometry (FCM) analysis indicated that PHB-HM labeled with fluorescein isothiocyanate (FITC) could be engulfed by granulocytes (Gs) and semi-granulocytes (SGs) upon in vitro incubation. Transmission electron microscopy (TEM) further showed the ongoing degradation of PHB granules inside Gs and SGs after the injection of PHB-HM into crayfish sinus, but phagocytosis of PHB-HM by hyalinocyte (H) was not observed. Therefore, Gs and SGs are considered the main effector cells of cellular immunity induced by PHB-HM, and SGs likely played a particular important role in this process. To study the biosafety and molecular mechanism of PHB monomer 3-HB, hemocyte viability and expression of the related genes were determined after being exposed to 0–1 mg/mL of 3-HB, and Vibrio parahaemolyticus (VP) was used as the pathogenic bacterium. The results confirmed that 3-HB had no toxic effect on hemocytes by means of cell viability assay, and supplementation with 1 mg/mL of 3-HB suppressed the growth rate of VP in TSB medium. Moreover, injection of 3-HB into the blood sinus of crayfish remarkably improved the phagocytic rate of Gs and SGs on VP. Furthermore, transcriptome assay was designed to illuminate the molecular mechanism of 3-HB regulation using red swamp crayfish Procambarus clarkii as experimental animals. RNA-seq analysis and qRT-PCR verification revealed that the microtubule and cytoskeleton-related genes were high expressed 3 h after 3-HB injection, indicating both genes might involve in building up the innate immunity. In summary, bacterial storage PHB could be phagocytosed by main effector blood cells and likely to be degraded within the cells. 3-HB helped the crayfish resistant to pathogens through improving phagocytosis, suppressing the growth of pathogenic bacteria, and increasing the expression of microtubule-related genes. The findings in this work provide cytological and molecular evidence which will facilitate the application of PHB and 3-HB as immune-control agents in farming of aquatic animals. • Granular cells (Gs) and Semi-Granular cells (SGs) were considered the main effector cells of cellular immunity induced by PHB-HM. • PHB granules were degraded in hemocytes of crayfish. • 3-HB remarkably improved the phagocytic rate of Gs and SGs on Vibrio parahaemolyticus. • 3-HB induced the microtubule and cytoskeleton-related genes which might involve in building up the innate immunity. [ABSTRACT FROM AUTHOR]

BackgroundIntegrated care enhanced with information technology has emerged as a means to transform health services to meet the long-term care needs of patients with chronic diseases. However, the feasibility of applying integrated care to the emerging “three-manager” mode in China remains to be explored. Moreover, few studies have attempted to integrate multiple types of chronic diseases into a single system. ObjectiveThe aim of this study was to develop a coordinated telehealth system that addresses the existing challenges of the “three-manager” mode in China while supporting the management of single or multiple chronic diseases. MethodsThe system was designed based on a tailored integrated care model. The model was constructed at the individual scale, mainly focusing on specifying the involved roles and responsibilities through a universal care pathway. A custom ontology was developed to represent the knowledge contained in the model. The system consists of a service engine for data storage and decision support, as well as different forms of clients for care providers and patients. Currently, the system supports management of three single chronic diseases (hypertension, type 2 diabetes mellitus, and chronic obstructive pulmonary disease) and one type of multiple chronic conditions (hypertension with type 2 diabetes mellitus). A retrospective study was performed based on the long-term observational data extracted from the database to evaluate system usability, treatment effect, and quality of care. ResultsThe retrospective analysis involved 6964 patients with chronic diseases and 249 care providers who have registered in our system since its deployment in 2015. A total of 519,598 self-monitoring records have been submitted by the patients. The engine could generate different types of records regularly based on the specific care pathway. Results of the comparison tests and causal inference showed that a part of patient outcomes improved after receiving management through the system, especially the systolic blood pressure of patients with hypertension (P

BackgroundMobile health (mHealth) technology is an increasingly recognized and effective method for disease management and has the potential to intervene in pulmonary function, exacerbation risk, and psychological status of patients with chronic obstructive pulmonary disease (COPD). ObjectiveThis study aimed to investigate the feasibility of an mHealth-based COPD management system designed for Chinese remote areas with many potential COPD patients but limited medical resources. MethodsThe system was implemented based on a tailored closed-loop care pathway that breaks the heavy management tasks into detailed pieces to be quantified and executed by computers. Low-cost COPD evaluation and questionnaire-based psychological intervention are the 2 main characteristics of the pathway. A 6-month prospective observational study at the community level was performed to evaluate the effect of the system. Primary outcomes included changes in peak expiratory flow values, quality of life measured using the COPD assessment test scale, and psychological condition. Acute exacerbations, compliance, and adverse events were also measured during the study. Compliance was defined as the ratio of the actual frequency of self-monitoring records to the prescribed number. ResultsA total of 56 patients was enrolled; 39 patients completed the 6-month study. There was no significant difference in the mean peak expiratory flow value before and after the 6-month period (366.1, SD 106.7 versus 313.1, SD 116.6; P=.11). Psychological condition significantly improved after 6 months, especially for depression, as measured using the Patient Health Questionnaire-9 scale (median 6.0, IQR 3.0-9.0 versus median 4.0, IQR 0.0-6.0; P=.001). The COPD assessment test score after 6 months of intervention was also lower than that at the baseline, and the difference was significant (median 4.0, IQR 1.0-6.0 versus median 3.0, IQR 0.0-6.0; P=.003). The median overall compliance was 91.1% (IQR 67%-100%). In terms of acute exacerbation, 110 exacerbations were detected and confirmed by health care providers (per 6 months, median 2.0, IQR 1.0-5.0). Moreover, 72 adverse events occurred during the study, including 1 death, 19 hospitalizations, and 52 clinic visits due to persistent respiratory symptoms. ConclusionsWe designed and validated a feasible mHealth-based method to manage COPD in remote Chinese areas with limited medical resources. The proposed closed-loop care pathway was effective at the community level. Proper education and frequent communication with health care providers may encourage patients’ acceptance and use of smartphones to support COPD self-management. In addition, WeChat might play an important role in improving patient compliance and psychological distress. Further research might explore the effect of such systems on a larger scale and at a higher evidence level.

BackgroundCOVID-19 is a global pandemic that is affecting more than 200 countries worldwide. Efficient diagnosis and treatment are crucial to combat the disease. Computer-interpretable guidelines (CIGs) can aid the broad global adoption of evidence-based diagnosis and treatment knowledge. However, currently, no internationally shareable CIG exists. ObjectiveThe aim of this study was to establish a rapid CIG development and dissemination approach and apply it to develop a shareable CIG for COVID-19. MethodsA 6-step rapid CIG development and dissemination approach was designed and applied. Processes, roles, and deliverable artifacts were specified in this approach to eliminate ambiguities during development of the CIG. The Guideline Definition Language (GDL) was used to capture the clinical rules. A CIG for COVID-19 was developed by translating, interpreting, annotating, extracting, and formalizing the Chinese COVID-19 diagnosis and treatment guideline. A prototype application was implemented to validate the CIG. ResultsWe used 27 archetypes for the COVID-19 guideline. We developed 18 GDL rules to cover the diagnosis and treatment suggestion algorithms in the narrative guideline. The CIG was further translated to object data model and Drools rules to facilitate its use by people who do not employ the non-openEHR archetype. The prototype application validated the correctness of the CIG with a public data set. Both the GDL rules and Drools rules have been disseminated on GitHub. ConclusionsOur rapid CIG development and dissemination approach accelerated the pace of COVID-19 CIG development. A validated COVID-19 CIG is now available to the public.

BackgroundThe coronavirus disease (COVID-19) was discovered in China in December 2019. It has developed into a threatening international public health emergency. With the exception of China, the number of cases continues to increase worldwide. A number of studies about disease diagnosis and treatment have been carried out, and many clinically proven effective results have been achieved. Although information technology can improve the transferring of such knowledge to clinical practice rapidly, data interoperability is still a challenge due to the heterogeneous nature of hospital information systems. This issue becomes even more serious if the knowledge for diagnosis and treatment is updated rapidly as is the case for COVID-19. An open, semantic-sharing, and collaborative-information modeling framework is needed to rapidly develop a shared data model for exchanging data among systems. openEHR is such a framework and is supported by many open software packages that help to promote information sharing and interoperability. ObjectiveThis study aims to develop a shared data model based on the openEHR modeling approach to improve the interoperability among systems for the diagnosis and treatment of COVID-19. MethodsThe latest Guideline of COVID-19 Diagnosis and Treatment in China was selected as the knowledge source for modeling. First, the guideline was analyzed and the data items used for diagnosis and treatment, and management were extracted. Second, the data items were classified and further organized into domain concepts with a mind map. Third, searching was executed in the international openEHR Clinical Knowledge Manager (CKM) to find the existing archetypes that could represent the concepts. New archetypes were developed for those concepts that could not be found. Fourth, these archetypes were further organized into a template using Ocean Template Editor. Fifth, a test case of data exchanging between the clinical data repository and clinical decision support system based on the template was conducted to verify the feasibility of the study. ResultsA total of 203 data items were extracted from the guideline in China, and 16 domain concepts (16 leaf nodes in the mind map) were organized. There were 22 archetypes used to develop the template for all data items extracted from the guideline. All of them could be found in the CKM and reused directly. The archetypes and templates were reviewed and finally released in a public project within the CKM. The test case showed that the template can facilitate the data exchange and meet the requirements of decision support. ConclusionsThis study has developed the openEHR template for COVID-19 based on the latest guideline from China using openEHR modeling methodology. It represented the capability of the methodology for rapidly modeling and sharing knowledge through reusing the existing archetypes, which is especially useful in a new and fast-changing area such as with COVID-19.

BackgroundHealth education emerged as an important intervention for improving the awareness and self-management abilities of chronic disease patients. The development of information technologies has changed the form of patient educational materials from traditional paper materials to electronic materials. To date, the amount of patient educational materials on the internet is tremendous, with variable quality, which makes it hard to identify the most valuable materials by individuals lacking medical backgrounds. ObjectiveThe aim of this study was to develop a health recommender system to provide appropriate educational materials for chronic disease patients in China and evaluate the effect of this system. MethodsA knowledge-based recommender system was implemented using ontology and several natural language processing (NLP) techniques. The development process was divided into 3 stages. In stage 1, an ontology was constructed to describe patient characteristics contained in the data. In stage 2, an algorithm was designed and implemented to generate recommendations based on the ontology. Patient data and educational materials were mapped to the ontology and converted into vectors of the same length, and then recommendations were generated according to similarity between these vectors. In stage 3, the ontology and algorithm were incorporated into an mHealth system for practical use. Keyword extraction algorithms and pretrained word embeddings were used to preprocess educational materials. Three strategies were proposed to improve the performance of keyword extraction. System evaluation was based on a manually assembled test collection for 50 patients and 100 educational documents. Recommendation performance was assessed using the macro precision of top-ranked documents and the overall mean average precision (MAP). ResultsThe constructed ontology contained 40 classes, 31 object properties, 67 data properties, and 32 individuals. A total of 80 SWRL rules were defined to implement the semantic logic of mapping patient original data to the ontology vector space. The recommender system was implemented as a separate Web service connected with patients' smartphones. According to the evaluation results, our system can achieve a macro precision up to 0.970 for the top 1 recommendation and an overall MAP score up to 0.628. ConclusionsThis study demonstrated that a knowledge-based health recommender system has the potential to accurately recommend educational materials to chronic disease patients. Traditional NLP techniques combined with improvement strategies for specific language and domain proved to be effective for improving system performance. One direction for future work is to explore the effect of such systems from the perspective of patients in a practical setting.

BackgroundHypertension is a lifestyle-induced chronic disease that threatens the lives of patients. Control of hypertension requires patients to follow self-management regimes; unfortunately, however, patient compliance with hypertension self-management is low, especially in developing countries. Improvement of patient compliance is premised on meeting patient needs. Mobile health apps are becoming increasingly popular for self-management of chronic diseases. However, few mobile apps have been designed to meet patient needs for hypertension self-management. ObjectiveThe goal of this study was to develop a mobile health app to improve patient compliance with hypertension self-management and evaluate the effectiveness of the app in terms of patient compliance. MethodsThe goal-directed design method was applied to guide study design. We divided the study into 4 stages. Stages 1 to 3 comprised the development process. To improve the applicability of the goal-directed design method to chronic disease management, we extracted elements of user models concerned with patient compliance and defined a concrete process for user modeling. In stage 1, personas of hypertensive patients were built using qualitative and quantitative methods. Clustering methods based on questionnaire responses were used to group patients. Qualitative interviews were conducted to identify the needs of different groups. In stage 2, several functional modules were designed to meet the needs of different groups based on the results from stage 1. In stage 3, prototypes of functional modules were designed and implemented as a real app. Stage 4 was the deployment process, in which we conducted a pilot study to investigate patient compliance after using the app. Patient compliance was calculated through the frequency with which they took blood pressure measurements. In addition, qualitative interviews were conducted to learn the underlying reasons for the compliance results. ResultsIn stage 1, patients were divided into 3 groups based on 82 valid questionnaire responses. Eighteen patients from the different groups (7, 5, and 6 patients) were interviewed, and the needs of the groups were summarized as follows: improve self-management ability, enhance self-management motivation, and receive self-management support. In stages 2 and 3, 6 functional modules were designed and implemented based on specified needs, and the usability of the app was improved through usability tests. In stage 4, 143 patients were recruited to use different versions of the app for 2 months. Results show that patient compliance improved as functional modules were added (P

Abstract: Aiming at the disadvantages of the present electric parameters detection of power harmonics, a power system harmonic detection technique based on sliding-windows iterative of discrete Fourier transform (SWIDFT) and wavelet transform (WT) are proposed in this paper. Using SWIDFT to detect the fundament components and the total harmonic components and using WT to extract and separate the fundamental harmonic and the high order harmonic contents from the total harmonic components. Simulation results obtained by this algorithm reveal that the proposed method can detect harmonic signal precisely. Therefore, it provides an effective means for power system harmonic analysis and detection. [Copyright &y& Elsevier]

BackgroundChronic disease patients often face multiple challenges from difficult comorbidities. Smartphone health technology can be used to help them manage their conditions only if they accept and use the technology. ObjectiveThe aim of this study was to develop and test a theoretical model to predict and explain the factors influencing patients’ acceptance of smartphone health technology for chronic disease management. MethodsMultiple theories and factors that may influence patients’ acceptance of smartphone health technology have been reviewed. A hybrid theoretical model was built based on the technology acceptance model, dual-factor model, health belief model, and the factors identified from interviews that might influence patients’ acceptance of smartphone health technology for chronic disease management. Data were collected from patient questionnaire surveys and computer log records about 157 hypertensive patients’ actual use of a smartphone health app. The partial least square method was used to test the theoretical model. ResultsThe model accounted for .412 of the variance in patients’ intention to adopt the smartphone health technology. Intention to use accounted for .111 of the variance in actual use and had a significant weak relationship with the latter. Perceived ease of use was affected by patients’ smartphone usage experience, relationship with doctor, and self-efficacy. Although without a significant effect on intention to use, perceived ease of use had a significant positive influence on perceived usefulness. Relationship with doctor and perceived health threat had significant positive effects on perceived usefulness, countering the negative influence of resistance to change. Perceived usefulness, perceived health threat, and resistance to change significantly predicted patients’ intentions to use the technology. Age and gender had no significant influence on patients’ acceptance of smartphone technology. The study also confirmed the positive relationship between intention to use and actual use of smartphone health apps for chronic disease management. ConclusionsThis study developed a theoretical model to predict patients’ acceptance of smartphone health technology for chronic disease management. Although resistance to change is a significant barrier to technology acceptance, careful management of doctor-patient relationship, and raising patients’ awareness of the negative effect of chronic disease can negate the effect of resistance and encourage acceptance and use of smartphone health technology to support chronic disease management for patients in the community.