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General practitioners (GPs) play an important role in diabetes care in primary care as the "gatekeepers" of population health. The management of diabetes can slow its progression, reduce complications and improve patient outcomes, which requires effective communication and collaboration between patients and their doctors. GPs with good communication skills can help to build long-term care relationships with diabetes patients and help them develop effective self-management skills. This paper summarizes the design and development of diabetes communication skills training for GPs guided by research team with multiple theoretical frameworks, including evidence-based findings from systematic review, experiences and ideas of diabetes patients communicating with GPs based on qualitative studies, prioritization of training content for patient-doctor communication in GPs captured by mixed-methods research, in order to provide new ideas for high-quality diabetes management in primary care and inform the design of training programmes for GPs based on evidence and medical education frameworks.

Sepsis is a common and lethal syndrome. Long non-coding RNA (lncRNA) transcript predicting survival in AKI (TapSAKI) has recently been found to serve as an important regulator in sepsis. However, the underlying mechanism of TapSAKI in sepsis pathogenesis remains largely unknown. Our data demonstrated that lipopolysaccharide (LPS)-induced HK-2 cell injury by weakening cell viability and enhancing cell apoptosis and inflammation. TapSAKI was upregulated and miR-205 was downregulated in LPS-induced HK-2 cells. TapSAKI knockdown or miR-205 overexpression alleviated LPS-induced cytotoxicity in HK-2 cells. TapSAKI sequestered miR-205 via acting as a miR-205 sponge. Moreover, the mitigating effect of TapSAKI silencing on LPS-induced HK-2 cell injury was mediated by miR-205. Additionally, the interferon regulatory factor 3 (IRF3) signaling was involved in the regulation of the TapSAKI/miR-205 axis on LPS-induced HK-2 cell damage. Our current study suggested that TapSAKI silencing relieved LPS-induced injury in HK-2 cells at least in part by sponging miR-205 and regulating the IRF3 signaling pathway, highlighting a novel understanding for sepsis pathogenesis and a promising target for this disease treatment.

A flurry of studies over the past decade has shown that astrocytes play a more active role in neural function than previously recognized. Hippocampal slices prepared from young rodent pups have served as a popular model for studying the pathways by which astrocytes participate in synaptic transmission. It is, however, not known how well astrocytes tolerate traumatic injury and hypoxia, which are unavoidable when preparing acute slices. We here showed that astrocytes exhibit striking changes in expression of several receptors and structural proteins, including re-expression of the developmental marker nestin within 90 min following preparation of live vibratome slices. Moreover, immunoelectron microscopy showed a 2.7-fold loss of astrocytic processes in acute hippocampal slices prepared from glial fibrillary acidic protein-green fluorescent protein reporter mice. A sharp decrease in the number of mitochondria was also noted in acute slices, concurrently with an increase in mitochondrial size. Glycogen content decreased 3-fold upon slice preparation and did not recover despite stable recordings of field excitatory postsynaptic current. Analysis of Ca(2+) signaling showed that astrocytic responses to purine receptor and mGluR5 agonists differed in slice versus in vivo. These observations suggest that the functional properties and the fine structure of astrocytes in slices may be reflective of early stages of reactive gliosis and should be confirmed in vivo when possible.

Circulating tumor cells (CTCs) with different epithelial and mesenchymal phenotypes play distinct roles in the metastatic cascade. However, the influence of their phenotypic traits and chemotherapy on their transit and retention within capillaries remains unclear. To explore this, we developed a microfluidic device comprising 216 microchannels of different widths from 5 to 16 μm to mimic capillaries. This platform allowed us to study the behaviors of human breast cancer epithelial MCF-7 and mesenchymal MDA-MB-231 cells through microchannels under chemotherapy-induced stress. Our results revealed that when the cell diameter to microchannel width ratio exceeded 1.2, MCF-7 cells exhibited higher transit percentages than MDA-MB-231 cells under a flow rate of 0.13 mm/s. Tamoxifen (250 nM) reduced the transit percentage of MCF-7 cells, whereas 100 nM paclitaxel decreased transit percentages for both cell types. These differential responses were partially due to altered cell stiffness following drug treatments. When cells were entrapped at microchannel entrances, tamoxifen, paclitaxel, and high-flow stress (0.5 mm/s) induced a reduction in mitochondrial membrane potential (MMP) in MCF-7 cells. Tamoxifen treatment also elevated reactive oxygen species (ROS) levels in MCF-7 cells. Conversely, MMP and ROS levels in entrapped MDA-MB-231 cells remained unaffected. Consequently, the viability and proliferation of entrapped MCF-7 cells declined under these chemical and physical stress conditions. Our findings emphasize that phenotypically distinct CTCs may undergo selective filtration and exhibit varied responses to chemotherapy in capillaries, thereby impacting cancer metastasis outcomes. This highlights the importance of considering both cell phenotype and drug response to improve treatment strategies. [ABSTRACT FROM AUTHOR]

The strength of loess in seasonal frozen soil areas decreases evidently due to the freeze-thaw cycle, which even leads to some engineering and geological problems. Fibre reinforcement is very effective in improving the mechanical properties of soil. Triaxial tests under different water contents, freezing temperatures, and number of freeze-thaw cycles were carried out for fibre-reinforced loess to study the ability of fibre reinforcement to improve the resistance of loess to freeze-thaw damage; scanning electron microscopy (SEM) was also conducted. The effects of freeze and thaw deterioration and reinforcement were discussed by comparing the strength parameters under different test conditions, and the influence mechanism of freezing temperature, number of freeze-thaw cycles, and reinforcement on loess strength was explained. Results show that a lower freezing temperature indicates a more evident decrease in strength after thawing. Under the action of the first five freeze-thaw cycles, the degree of decrease is more prominent. The fibre reinforcement can reduce the fragmentation of aggregates in loess, thereby effectively restraining the deterioration effect of loess during freeze-thaw cycles. Finally, the strength parameter prediction model under different freeze-thaw cycles of reinforced loess is established, thereby providing theoretical support for engineering application and numerical simulation of fibre-reinforced loess. [ABSTRACT FROM AUTHOR]