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Acrylamide is widely found in various types of fried foods and cigarettes, and is not only neurotoxic and carcinogenic, but also has many potential toxic effects. The current assessment of acrylamide intake through dietary questionnaires is confounded by a variety of factors, which poses limitations to safety assessment. In this review, we focus on the levels of AAMA, the urinary metabolite of acrylamide in humans, and its association with other diseases, and discuss the current research gaps in AAMA and the future needs. We reviewed a total of 25 studies from eight countries. In the general population, urinary AAMA levels were higher in smokers than in nonsmokers, and higher in children than in adults; the highest levels of AAMA were found in the population from Spain compared with the general population from other countries. In addition, AAMA is associated with several diseases, especially cardiovascular system diseases. Therefore, AAMA, as a biomarker of internal human exposure, can reflect acrylamide intake in the short term, which is of great significance for tracing acrylamide-containing foods and setting the allowable intake of acrylamide in foods.

Successful adaption to the increasing demands of the healthcare system involves self-directed learning (SDL) approach, which contributes to professional values and academic and clinical performance. Although many factors are related to SDL, research examining the association between internal factors such as loneliness, mindfulness and optimism with self-directed learning is limited.This study aims to examine the association between loneliness, mindfulness, and optimism with self-directed learning.A cross-sectional design was conducted, and study participants included 568 nursing students from higher education institutes in North, East and South China from May 2020 to October 2020. Data collection instruments included socio-demographics, the self-directed learning scale, the loneliness scale, the Five Facet Mindfulness Questionnaire, and the Life Orientation Test. Hierarchical multiple regression and moderation analyses were used to analyze the data.Findings indicated that loneliness was negatively related to SDL, whereas mindfulness and optimism showed a positive relationship to SDL. Optimism did not significantly moderate the relationship between loneliness and SDL, and between optimism and self-directed learning.The findings suggest that incorporating training programs for reducing loneliness and improving mindfulness and optimism into curricular and extracurricular activities on campuses may help increase SDL.

The progression of breast cancer is closely related to obstructive sleep apnea-hypopnea syndrome (OSAHS). Low concentrations of cannabinoids promote tumor proliferation. However, the role of cannabinoid receptors (CBs) in chronic intermittent hypoxia (CIH)-induced breast cancer has not been reported. The migration and invasion of breast cancer cell lines (MCF-7 and T47D) were measured by scratch assay and transwell assay. Gene and protein expressions were analyzed by qPCR and western blotting. Tumor xenograft mice model were established to evaluate the function of CBs. We observed that chronic hypoxia (CH) and CIH increased CBs expression and promoted migration and invasion in breast cancer. Mice grafted with MCF-7 exhibited obvious tumor growth, angiogenesis, and lung metastasis in CIH compared with CH and control. In addition, CIH induced CBs expression, which subsequently activated insulin-like growth factor-1 receptor (IGF-1R)/AKT/glycogen synthase kinase-3β (GSK-3β) axis. Knockdown of CBs alleviated CIH-induced migration and invasion of breast cancer in vitro. Furthermore, CIH exaggerated the malignancy of breast cancer and silencing of CBs suppressed tumor growth and metastasis in vivo. Our study contributed to understanding the role of CIH in breast cancer development modulation., Graphical abstract, The role of CBs in CIH-induced breast cancer remains unknown. In this study, we found that CIH induced CBs expression via activating IGF-1R/AKT/GSK-3β signaling. CBs knockdown inhibited CIH-induced progression of breast cancer. Our study revealed that CBs might be a new therapeutic strategy for breast cancer.

Background Many students solving quantitative problems in science struggle to apply mathematical instruction they have received to novel problems. The few students who succeed often draw on both their mathematical understanding of the equation and their scientific understanding of the phenomenon. Understanding the sensemaking opportunities provided during instruction is necessary to develop strategies for improving student outcomes. However, few studies have examined the types of sensemaking opportunities provided during instruction of mathematical equations in science classrooms and whether they are organized in ways that facilitate integration of mathematical and scientific understanding. This study uses a multiple case study approach to examine the sensemaking opportunities provided by four different instructors when teaching the same biological phenomenon, population growth. Two questions are addressed: (1) What types of sensemaking opportunities are provided by instructors, and (2) How are those sensemaking opportunities organized? The Sci-Math Sensemaking Framework, previously developed by the authors, was used to identify the types of sensemaking. Types and organization of sensemaking opportunities were compared across the four instructors. Results The instructors provided different opportunities for sensemaking of equations, even though they were covering the same scientific phenomenon. Sensemaking opportunities were organized in three ways, blended (previously described in studies of student problem solving as integration of mathematics and science resources), and two novel patterns, coordinated and adjacent. In coordinated sensemaking, two types of sensemaking in the same dimension (either mathematics or science) are explicitly connected. In adjacent sensemaking, two different sensemaking opportunities are provided within the same activity but not explicitly connected. Adjacent sensemaking was observed in three instructors’ lessons, but only two instructors provided opportunities for students to engage in blended sensemaking. Conclusions Instructors provide different types of sensemaking opportunities when teaching the same biological phenomenon, making different resources available to students. The organization of sensemaking also differed with only two instructors providing blended sensemaking opportunities. This result may explain why few students engage in the successful strategy of integrating mathematics and science resources when solving quantitative problems. Documentation of these instructional differences in types and organization of sensemaking provides guidance for future studies investigating the effect of instruction on student sensemaking.

Although observational studies have reported a positive association between obstructive sleep apnea syndrome (OSAS) and breast cancer (BC) risk, causality remains inconclusive. We aim to explore whether OSAS is associated with etiology of BC by conducting a two-sample Mendelian randomization (MR) study in a Chinese population and Asian population from the Breast Cancer Association Consortium (BCAC). We found a detrimental causal effect of OSAS on BC risk in the primary analysis of our samples (IVW OR, 2.47 for BC risk per log-odds increment in OSAS risk, 95% CI = 1.86-3.27; P = 3.6×10-10). This was very similar to results of the direct observational case-control study between OSAS and BC risk (OR = 2.80; 95% CI = 2.24-3.50; P =1.4×10-19). Replication in the Asian population of the BCAC study also supported our results (IVW OR, 1.33 for BC risk per log-odds increment in OSAS risk, 95% CI = 1.13-1.56; P = 0.0006). Sensitivity analyses confirmed the robustness of our findings. We provide novel evidence that genetically determined higher risk of OSAS has a causal effect on higher risk of BC. Further studies focused on the mechanisms of the relationship between OSAS and breast carcinogenesis are needed.

Objective: To analyze the liver injury and coagulation dysfunction in COVID-19 severe/critical type patients.The clinical data of 53 COVID-19 patients were collected from a single center in Wuhan from February 8, 2020 to March 25, 2020. The patients were divided into severe type group (38 patients) and critical type group (15 patients). The clinical characteristics, indexes of liver function, coagulation function and inflammatory markers were analyzed retrospectively. According to the degree of abnormal liver function in the process of diagnosis and treatment, the patients were divided into three groups: combined liver injury, mild abnormal liver function and normal liver function group. Statistical analysis was performed by using Student t test, Mann-Whitney U test, Kruskal-Wallis test and Chi-square test.Among the 53 patients, 29 were male (54.7%) and 24 were female (45.3%), the median age was 57(27－80) years old. The time from onset to admission was (11.5±7.7) days. The levels of AST, TBIL, DBIL, ALP, GGT, LDH, D-dimer, PCT and hsCRP in critical patients were higher than those in severe patients (P0.05). The levels of Alb in critical patients was lower than those in severe patients (P0.05). Among the 53 patients, 34 (64%) patients showed abnormal elevation of ALT, AST or TBIL, while 4 (7.5%) patients showed the criteria of COVID-19 with liver injury. After the patients were grouping according to the degree of liver dysfunction, the levels of ALP, GGT and D-dimer of the patients in the liver injury group were significantly higher than those in the normal liver function group, D-dimer levels of the patients in the liver injury group was significantly higher than those in the mild abnormal liver function group, while the levels of ALP and GGT in the mild abnormal liver function group were significantly higher than those in the normal liver function group, and the differences were statistically significant(P0.05).In this group, the patients with COVID-19 severe/critical type have a certain proportion of liver injury accompanied by significantly increased D-dimer levels, critical type patients have more severe liver function and coagulation dysfunction, which may promote the progression of COVID-19.重型/危重型新型冠状病毒肺炎患者合并肝脏损伤及凝血功能障碍的研究.分析重型及危重型新型冠状病毒肺炎（COVID-19）患者合并肝脏损伤及凝血功能障碍的情况.收集华中科技大学同济医学院附属同济医院中法新城院区山西队2020年2月8日至3月25日诊治的53例重型及危重型COVID-19患者的病历资料，将患者分为重型组（38例）和危重型组（15例），回顾性分析不同临床分型患者的临床特征及入院时肝功能、凝血功能及炎症指标的变化；将患者按诊疗过程中肝功能异常程度分为肝脏损伤组、肝功能轻度异常组以及肝功能正常组，比较各组患者相应时间节点碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（GGT）、降钙素原（PCT）、超敏C反应蛋白（hsCRP）、D-二聚体水平的变化。分析所有患者疾病转归。采用独立样本t检验、Mann-Whitney U检验、Kruskal-Wallis检验、卡方检验进行统计学分析.53例重型及危重型COVID-19患者中位年龄为57(27－80)岁，其中男性29例（54.7%），女性24例（45.3%）。起病至入院的时间为（11.5±7.7）d。危重型较重型患者AST、TBil、DBil、ALP、GGT、LDH、D-二聚体、PCT、hsCRP水平明显增高，而Alb水平明显降低（P0.05）。53例患者中，共有34例（64%）患者出现ALT、AST或TBil异常升高，4例（7.5%）符合COVID-19合并肝脏损伤。根据肝功能异常程度分组后，肝脏损伤组ALP、GGT、D-二聚体水平较肝功能正常组明显升高（P0.05），肝脏损伤组D-二聚体水平较肝功能轻度异常组明显升高（P0.05），肝功能轻度异常组ALP、GGT较肝功能正常组明显升高（P0.05）.本组患者中，7.5%的重型及危重型COVID-19患者合并肝脏损伤并伴有D-二聚体水平明显升高，危重型患者较重型患者存在更严重的肝脏损伤及凝血功能障碍，二者可能共同促进COVID-19的疾病进展.

Background Nursing and medical students are suffering from high rates of depressive symptoms. Mental health benefits students’ learning, growth and professional development. Exploring psychological resources to prevent depression is emphasized recently, and self-compassion is shown to be inversely associated with depressive symptoms. However, the mechanism through which self-compassion contributes to decreased depressive symptoms is limited. Therefore, this study aimed to explore and examine a model detailing the potential paths between self-compassion and depressive symptoms. Methods A cross-sectional study was conducted and convenient sampling was used. Among the 1800 nursing and medical students targeted from two universities in East and North China, 1341 completed the questionnaires, and 1127 valid questionnaires were analyzed comprising 566 and 561 from medical and nursing students, respectively. Data in May 2020 and July 2020 were collected through Patient Health Questionnaire, self-compassion scale, resilience scale, Life Orientation Test and Perceived Stress Scale. Then, path model analysis was conducted to analyze the data. Results Finally, this study included 1125 valid questionnaires after excluding two extremes of study variables. Participants consisted of 50.2% medical students and 49.8% nursing students. The model showed an acceptable fit to the data. After controlling for the demographics, self-compassion was directly and indirectly associated with decreased depressive symptoms by increasing resilience and optimism and reducing perceived stress among nursing and medical students. Resilience and optimism were directly and indirectly associated with decreased depressive symptoms by reducing perceived stress among nursing students and indirectly associated with decreased depressive symptoms among medical students. Conclusions The study provides evidence that self-compassion significantly influences the decrease in depressive symptoms by increasing resilience and optimism and reducing perceived stress. These findings suggested that programs enhancing students’ self-compassion, resilience, and optimism simultaneously can help decrease depressive symptoms and improve mental health in education and healthcare institutes. These findings may facilitate the designing of educational programs for preventing depressive symptoms and promoting mental health among nursing and medical students.

Scientific ideas are often expressed as mathematical equations. Understanding the ideas contained within these equations requires making sense of both the embedded mathematics knowledge and scientific knowledge. Students who can engage in this type of blended sensemaking are more successful at solving novel or more complex problems with these equations. However, students often tend to rely on algorithmic/procedural approaches and struggle to make sense of the underlying science. This deficit may partly be the fault of instruction that focuses on superficial connections with the science and mathematics knowledge such as defining variables in the equation and demonstrating step-by-step procedures for solving problems. Research into the types of sensemaking of mathematical equations in science contexts is hindered by the absence of a shared framework. Therefore, a review of the literature was completed to identify themes addressing sensemaking of mathematical equations in science. These themes were compiled into nine categories, four in the science sensemaking dimension and five in the mathematics sensemaking dimension. This framework will allow for comparison across studies on the teaching and learning of mathematical equations in science and thus help to advance our understanding of how students engage in sensemaking when solving quantitative problems as well as how instruction influences this sensemaking.

Electrical field can tailor the lattice structure and morphology of manganese oxides during their synthesis and improve their supercapacities. Manganese oxides as Hausmannite Mn 3 O 4 nanoparticles and/or Bernessite δ-MnO 2 nanolayers, were synthesized under electric field by titration of MnSO 4 ·H 2 O and H 2 O 2 solution into dilute NaOH solution at 90 °C. The sample without electric field has the main phase as Mn 3 O 4 and some of δ-MnO 2 . When a high electric field is applied, the percentage of δ-MnO 2 in the samples increases with the electric field rapidly. A pure δ-MnO 2 sample is obtained when an applied electric field above 0.6 kV·cm −1 . The supercapacity is improved in the samples synthesized with high electric field, in which the main phase is the δ-MnO 2 . However, the deterioration of the properties is observed in the pure δ-MnO 2 sample. Therefore, synthesis under the electric field can tailor the crystalline structure of manganese oxides to improve the supercapacity respectively.

Topramezone is a new, highly selective herbicide of pyrazole structure for the post-emergence control of broadleaf and grass weeds in corn. In this study, the effects of topramezone on C. vulgaris, especially in relation to the cell growth, oxidative stress, cell morphology and photosynthetic activity were assessed. Results showed that topramezone treatment was detrimental to C. vulgaris growth during the 24-96h of exposure. The changes in cells pigments content and relative transcript of photosynthesis-related genes, which implies that topramezone disrupted the photosynthetic system. Moreover, topramezone induced membrane permeability in a significant proportion of cells with a maximum damage rate of 40.40%, and morphology of cells was more complicated than the control group. TEM images also revealed that topramezone compromised the integrity of the cells. The data corroborated topramezone induced ROS triggered oxidative stress, leading to an increase of MDA. These results suggested that topramezone could have significant effects on growth and physiological functions in algae species, and we supposed that this herbicide affected all of these parameters and the observed effects can be explained by the generation of oxidative stress. This research helps to understand how topramezone affects C. vulgaris and provides a scientific basis for applications of topramezone in aquatic environment.

Axiomatic characterization is the foundation of L-fuzzy rough set theory: the axiom sets of approximation operators guarantee the existence of L-fuzzy relations or L-fuzzy coverings that reproduce the approximation operators. Axiomatic characterizations of approximation operators based on L-fuzzy coverings have not been fully explored, although those based on L-fuzzy relations have been studied thoroughly. Focusing on three pairs of widely used L-fuzzy covering-based approximation operators, we establish an axiom set for each of them, and their independence is examined. It should be noted that the axiom set of each L-fuzzy covering-based approximation operator is different from its crisp counterpart, with an either new or stronger axiom included in the L-fuzzy version.

A reliable in vitro regeneration procedure for Populus tomentosa is a prerequisite for its trait improvement through genetic transformation. We established a systematic protocol for indirect regeneration of P. tomentosa using in vitro petioles of Chinese poplar cultivar ‘fasta-3’. A high frequency of callus induction (>97 %) was obtained from isolated petioles cultured on the modified 1/2MS basal medium supplemented with 0.5 mg/L ZT and 1.0 mg/L NAA, and the tested calli were subsequently plated on 1/2MS basal medium supplemented with 0.25 mg/L BA, 0.25 mg/L ZT, 0.25 mg/L NAA, 0.01 mg/L TDZ, and 0.5 mg/L KT for efficient regeneration of shoots after being cultured for 6 weeks. The regenerated shoots were vigorously rooted on the tested media supplemented with 1.0 mg/L IBA and 0.5 mg/L NAA. These results can facilitate genetic transformation of P. tomentosa for trait improvements in future.

Aim This study aimed to explore how social support (external factor), optimism (internal factor) and their interaction associated with diabetes‐related self‐care activities (DRSCA) over 3 months among people with type 2 diabetes mellitus (T2DM). Design Both questionnaire‐based and telephone‐based survey were used. The data were collected face to face, the first time by questionnaire and the second time by telephone. Methods One hundred and fifty‐five patients completed valid survey questionnaires (response rate was about 70% in the first and 62% in the second round). The association of social support and optimism with subsequent DRSCA was examined after adjusting for demographics and disease information. Results Based on results, optimism was significantly associated with subsequent DRSCA. In the dimensions of social support, objective social support and support use were significantly associated with subsequent DRSCA. The results showed that the mediation of optimism between the dimensions of social support and DRSCA was not significant after controlling for covariates. The results also indicated that social support and optimism played directly an important role in improving diabetes‐related self‐care activities.

Objective The aim of this analysis was to perform a meta-analysis evaluating gender difference of delayed healing risk in patients with venous leg ulcers. Methods We searched the PubMed and Web of Knowledge from their inception to 4 July 2015. The meta-analysis of pooled odds ratio and 95% confidence interval for venous leg ulcers healing risk were calculated. Results Twelve studies with 4453 patients were included in the meta-analysis. The pooled odds ratio for healing rate stratified by gender was 1.055 (95% CI 0.955–1.165; Z = 1.05, p = 0.292) by fix-effects model. The Begg's test (z = 2.67, p = 0.007), the Egger's test (t = 4.00, p = 0.003), and asymmetric funnel plot suggested there was significant publication bias. Subgroup analysis showed the pooled odds ratios were 1.048 (95% CI 0.945–1.162; Z = 0.88, p = 0.376) in prospective studies and 1.439 (95% CI 0.757–2.736; Z = 1.11, p = 0.266) in retrospective studies. Sensitivity analyses by only pooled adjusted odds ratios showed the pooled odds ratio was 1.049 (95% CI 0.946–1.163; Z = 0.91, p = 0.365), which indicated the results of meta-analysis were robust. Meta-regression analysis showed the healing rate odds ratio stratified by gender was not related with healing rate (t = 0.73, p = 0.484). Conclusion Our meta-analysis indicates that no gender difference existed for delayed healing in venous leg ulcers. Our results may be also useful in developing a risk score for failure of venous leg ulcers to heal.

Let A be a factor. For A, B ∈ A, define by [A, B]* = AB − BA* the skew Lie product of A and B. In this article, it is proved that a map Φ: A → A satisfies Φ([[A, B]*, C]*) = [[Φ(A), B]*, C]* + [[A, Φ(B)]*, C]* + [[A, B]*, Φ(C)]* for all A, B, C ∈ A if and only if Φ is an additive *-derivation.

A simple, rapid, and reliable method is reported for the determination of Mg, Ca, Cr, Mn, Fe, Ni, Cu, Zn, and Pb in biodiesel by inductively coupled plasma-mass spectrometry (ICP-MS). To overcome problems related to the organic matrix in the direct introduction of the samples, a new extraction approach was investigated. The method was based on emulsion breaking, in which metals were transferred from the biodiesel to an acidic aqueous phase after formation and breaking of a water–oil emulsion prepared by mixing biodiesel with aqueous Triton X-114 and HNO3. The pretreatment conditions were studied in detail. The dynamic reaction cell mode was used for the determination of Mg, Ca, Cr, and Fe by ICP-MS to eliminate interferences. The limits of detection and quantification for Mg, Ca, Cr, Mn, Fe, Ni, Cu, Zn, and Pb were from 0.007835 to 0.1896 µg/L and 0.02612 to 0.6320 µg/L, respectively. This method was validated by comparison with a well-established strategy of sample dilution and fortification.

Summary Background The subjective well-being (SWB) of nursing and medical students is a very important component in the training of future nurses and doctors, as well-being enables them to be more productive. Objectives The study examined the effects of peer caring and resilience on SWB as well as the mediating and moderating effects of resilience in the relationship between peer caring and SWB. Design A cross-sectional survey design was used. Settings A university and an affiliated hospital in China. Participants The convenience sample consisted of 426 nursing students and 336 medical students. Methods Questionnaires comprising peer caring measurement, a resilience scale and a well-being scale were used in the spring of 2014. Results Students participate in the study showed low SWB. There was a significant difference between nursing students and medical students in peer caring, but not in SWB and resilience. The mediating effects of resilience on the relationship between peer caring and SWB were examined. As hypothesized, resilience mediated the relationship between peer caring and SWB partly for nursing students (SE = 0.022, 95% CI = 0.041–0.128) and fully for medical students (SE = 0.023, 95% CI = 0.067–0.161). Resilience did not statistically significantly moderate the peer caring-SWB relationship for nursing students (β = 0.092, p = 0.057) but did so for medical students (β = 0.108, p Conclusion Peer caring and resilience improved the SWB of both nursing students and medical students. In addition, resilience improved SWB through peer caring for both nursing students and medical students, and higher resilience in medical students enhanced the positive effects of peer caring on SWB. Therefore, educators should promote peer caring and resilience in order to improve students' SWB.

Fascinating super paramagnetic uniqueness of iron oxide particles at nano-scale level make them extremely useful in the state of the art therapies, equipments, and techniques. Cobalt ferrite (CoFe2 O4 ) magnetic nanoparticles (MNPs) are extensively used in nano-based medicine and electronics, results in extensive discharge and accumulation into the environment. However, very limited information is available for their endocrine disrupting potential in aquatic organisms. In this study, the thyroid endocrine disrupting ability of CoFe2 O4 NPs in Zebrafish larvae for 168-h post fertilization (hpf) was evaluated. The results showed the elevated amounts of T4 and T3 hormones by malformation of hypothalamus pituitary axis in zebrafish larvae. These elevated levels of whole body THs leads to delayed hatching, head and eye malformation, arrested development, and alterations in metabolism. The influence of THs disruption on ROS production and change in activities of catalase (CAT), mu-glutathione s-transferase (mu-GST), and acid phosphatase (AP) were also studied. The production of significantly higher amounts of in vivo generation of ROS leads to membrane damage and oxidative stress. Presences of NPs and NPs agglomerates/aggregates were also the contributing factors in mechanical damaging the membranes and physiological structure of thyroid axis. The increased activities of CAT, mu-GST, and AP confirmed the increased oxidative stress, possible DNA, and metabolic alterations, respectively. The excessive production of in vivo ROS leads to severe apoptosis in head, eye, and heart region confirming that malformation leads to malfunctioning of hypothalamus pituitary axis. ROS-induced oxidative DNA damage by formation of 8-OHdG DNA adducts elaborates the genotoxicity potential of CoFe2 O4 NPs. This study will help us to better understand the risk and assessment of endocrine disrupting potential of nanoparticles. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 2068-2080, 2016.

Fang-Fang Zhao,1,2 Riitta Suhonen,1,3 Jouko Katajisto,4 Helena Leino-Kilpi1,5 1Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland; 2School of Nursing Science, Nantong University, Nantong, People’s Republic of China; 3Turku University Hospital and City of Turku, Welfare Division, Turku, Finland; 4Department of Mathematics and Statistics, University of Turku, Turku, Finland; 5Turku University Hospital, Turku, Finland Purpose: Many people with type 2 diabetes (T2DM) do not sustain sufficient diabetes-related self-care activities (DRSCA) in their daily lives. To provide additional information about the positive influence of DRSCA, this study was conducted to examine whether DRSCA were associated with reduced perceived stress, anxiety, and fatigue among people with T2DM and to explore the level of DRSCA, perceived stress, anxiety, and fatigue and their association with background information. Patients and methods: This study was a cross-sectional survey including 251 participants aged 18years and older recruited from two hospitals in the eastern part of China. The study utilized self-report questionnaires that consisted of background information, DRSCA, perceived stress, anxiety, and fatigue. Hierarchical multiple regression analysis was conducted to explore the association of DRSCA with perceived stress, anxiety, and fatigue while adjusting for background information. Results: The results indicated that the level of self-care activities, stress, and fatigue was around middle level. The prevalence of anxiety was 19%. A high level of DRSCA was likely to reduce perceived stress but was not linked to anxiety and fatigue. Women were more susceptible to stress and anxiety, and people who had diabetes for >5years were more likely to have anxiety. The background information included diabetes duration, standardized diabetes education, and high social support, all of which are factors that may influence DRSCA. Conclusion: The findings suggest that improving the level of DRSCA might effectively reduce perceived stress. The potential benefits of DRSCA can provide both motivational and evaluative data for self-care programs. In addition, the findings show that DRSCA were not linked to anxiety and fatigue, which implies that their positive influence on anxiety and fatigue may be offset by the load of frequent DRSCA. It is suggested that helping patients to make tailored plans to integrate DRSCA into their daily lives is needed. Meanwhile, in the background information, it is suggested that standardized diabetes education and high social support can benefit DRSCA; in improving psychological health, more attention should be paid to women and patients with diabetes duration >5years. Keywords: diabetes, self-care, adherence, benefits, negative feelings

A novel method, based on extraction induced by emulsion breaking, is proposed for rapid simultaneous determination of iron, manganese, copper, and zinc in jet fuel by inductively coupled plasma-mass spectrometry. Several parameters affecting the extraction efficiency were investigated including the concentrations of nitric acid and emulsifying agents, centrifugal speed, and extraction time. The limits of detection for iron, manganese, copper, and zinc were 0.116, 0.028, 0.06, and 0.085 µg L−1, respectively. The accuracy of the method was tested by the analysis of spiked samples (recovery percentages between 90% and 107% were observed) and by comparison with a well-established method.

A home-made centrifugal microextraction tube (CMET) was developed and applied to cloud point extraction coupled with microwave-assisted back extraction and gas chromatographic separation of six phthalate esters (PAEs) from mineral water. All phthalate esters were entrapped in the micelles of the non-ionic surfactant Triton X-114 and removed from the bulk phase by centrifugation. The obtained surfactant-rich phase was treated with water-immiscible solvents, and the target analytes were back extracted by short-term microwave application and determined by GC-FID directly. The whole process was finished in the CMET. The proposed method demonstrated good performance concerning linearity (R2 = 0.9977-0.9998), precision (2.3–5.7%), the limits of detection and quantitation (LOD, 11.5-19.3 μg L−1; LOQ, 37.0-63.3 μg L−1), spiked recoveries (89.1–96.3%) and enrichment factor (71-85). The proposed method was successfully applied for the determination of trace amount of phthalate esters in mineral water. DBP and BBP were found in actual mineral water samples.

This paper reports, for the first time, rapid simultaneous multi-element determination of Mg, Cr, Ni, Cu and Pb in used lubricating oils after their extraction/preconcentration from samples using the novel extraction induced by emulsion breaking. The quantification of the metals of interest in the extracts was performed by ICP-MS using rhodium as an internal standard. First, in order to make it possible to prepare the emulsion, 4 mL of each oil sample was mixed with 1 mL of toluene. Then the diluted oil sample was emulsified with 1 mL of Triton X-114 acid solution. Once the extraction of the metals was completed, the emulsion was broken by centrifugation for 10 min at 6000 rpm. After that, the lower aqueous phase, containing the analytes that were extracted from oil, was collected for the determination by ICP-MS. Several parameters affecting the extraction efficiency of the procedure were investigated including the nature and concentration of the solvent used for sample dilution, the type and concentration of the surfactant, the concentration of HNO3, and the other operational conditions (extraction time, collection time and centrifugal speed). The limits of detection for Mg, Cr, Ni, Cu and Pb were 0.126, 0.058, 0.028, 0.078 and 0.009 μg L−1, respectively. The accuracy of the method was checked by application of a recovery test, by an analysis of standard reference materials (SRM 1084a and 1085b) and by comparison with the microwave digestion method.

In this meta-analysis, we aim to evaluate gender differences of lower extremity amputation risk in patients with diabetic foot. Systematic computerized searches of PubMed and Web of Knowledge were performed. The pooled odds ratio (OR) and 95% confidence interval (CI) for amputation risk were calculated. Twenty studies with 15 385 case (present amputation) and 438 760 control (absent amputation) patients were included in the meta-analysis. The pooled crude OR was 1.676 (95% CI 1.307-2.149; Z = 4.07, P = .000). In the retrospective study subgroup, the pooled OR was 1.708 (95% CI = 1.235-2.363; Z = 3.24, P = .001); in the prospective study subgroup, the pooled OR was 1.478 (95% CI = 1.189-1.838; Z = 3.51, P = .000). The pooled adjusted OR was 1.439 (95% CI = 1.238-1.671; Z = 4.76, P = .000). In retrospective study subgroup, the pooled OR was 1.440 (95% CI = 1.208-1.717; Z = 4.07, P = .000); in prospective study subgroup, the pooled OR was 1.478 (95% CI = 1.080-2.024; Z = 2.44, P = .015). No significant publication bias was found. Sensitivity analyses by omitting a heterogeneity study showed the results were robust. In conclusion, our meta-analysis indicates that men with diabetic foot have about one half increased amputation risk than women with diabetic foot. Men with diabetes should receive more complete follow-up and more adequate health education.

The aim of the study was to explore the coping strategy and the effects of self-efficacy of Chinese undergraduate nursing students when they face the stress in clinical practice. Convenience sampling was used to recruit undergraduate nursing students in Mainland China who have practiced 3 months in hospitals in their final college year. Self-report questionnaires including demographics, Perceived Stress Scale, coping behaviour inventory and Generalized Self-Efficacy Scale were collected. The results showed that during clinical practice, assignments and workload were the most common stress to students; transference was the most frequently used coping strategy by students. Self-efficacy not only had a positive main effect in predicting the frequency of use of staying optimistic and problem solving strategies but also moderated the effects of stress from taking care of patients on transference strategy, as well as stress from assignments and workload on problem solving strategy. It is essential to bolster the students' self-efficacy to reduce stress and adopt positively the coping strategies during clinical practice.

Prior studies have shown that students have difficulty understanding the role of mutation in evolution and genetics. However, little is known about unifying themes underlying students’ difficulty with mutation. In this study, we examined students’ written explanations about mutation from a cognitive science perspective. According to one cognitive perspective, scientific phenomena can be perceived as entities or processes, and the miscategorization of processes as entities can lead to noncanonical ideas about scientific phenomena that are difficult to change. Students’ incorrect categorization of processes as entities is well documented in physics but has not been studied in biology. Unlike other scientific phenomena that have been studied, the word “mutation” refers to both the process causing a change in the DNA and the entity, the altered DNA, making mutation a relevant concept for exploration and extension of this theory. In this study, we show that, even after instruction on mutation, the majority of students provided entity-focused descriptions of mutation in response to a question that prompted for a process-focused description in a lizard or a bacterial population. Students’ noncanonical ideas about mutation occurred in both entity- and process-focused descriptions. Implications for conceptual understanding and instruction are discussed.

ObjectivesThe study aimed to examine the diabetes-related self-care activities (DRSCA) in association with positive health consisting of resilience, subjective well-being (SWB) and disease-related quality of life (DRQoL), and the associations of background information with resilience, SWB and DRQoL.DesignA cross-sectional study.MethodsA convenience sample of people with type 2 diabetes (T2DM) was recruited from two tertiary hospitals in eastern China. Self-reported survey data included DRSCA, resilience, SWB, DRQoL, and background information comprising demographics and social support. Data were analysed using hierarchical multiple regression analyses.ResultsTwo hundred and forty-six valid questionnaires were analysed. Among the components of positive health, hierarchical multiple regression analysis showed that DRSCA were significantly associated with improved SWB (β=0.140, p=0.020), but not with resilience and DRQoL after adjusting for background information. Participants with higher level of education had higher resilience and men had higher SWB than women. Social support (β=0.186, p=0.003) in Model 1 and resilience (β=0.298, pConclusionsThis study indicated an association between DRSCA and one component of positive health, namely SWB. This finding could help motivate patients to perform DRSCA and to improve SWB in people with T2DM. In addition, the fact that demographics, for example, gender, were associated with SWB and education was associated with resilience also needs to be accommodated when aiming to improve SWB and build resilience.Trial registration numberNCT02594748

The synergistic effects of mixtures of CdCl2, Ni (NO3)2, CuSO4, and ZnSO4 on photobacterium Q67 were predicted and evaluated by using models of concentration addition (CA), independent action (IA), effect summation (ES), ES with the exponent e (ESE), ES with the power of the number of components n (ESN), and integrated CA with IA based on multiple linear regression (MLR) model (ICIM). The effects of all mixtures were underestimated by CA, IA, ES, ESE, and ESN models, but were effectively predicted by the ICIM model.

Aim To synthesize the effects of theory-based self-management educational interventions on patients with type 2 diabetes (T2DM) in randomized controlled trials. Background Type 2 diabetes is a common chronic disease causing complications that put a heavy burden on society and reduce the quality of life of patients. Good self-management of diabetes can prevent complications and improve the quality of life of T2DM patients. Design Systematic review with meta-analysis of randomized controlled trials following Cochrane methods. Data resources A literature search was carried out in the MEDLINE, EMBASE, CINAHL, PSYCINFO and Web of Science databases (1980-April 2015). Review methods The risk of bias of these eligible studies was assessed independently by two authors using the Cochrane Collaboration's tool. The Publication bias of the main outcomes was examined. Statistical heterogeneity and random-effects model were used for meta-analysis. Results Twenty studies with 5,802 participants met the inclusion criteria. The interventions in the studies were based on one or more theories which mostly belong to mid-range theories. The pooled main outcomes by random-effects model showed significant improvements in HbA1c, self-efficacy and diabetes knowledge, but not in BMI. As for quality of life, no conclusions can be drawn as the pooled outcome became the opposite with reduced heterogeneity after one study was excluded. No significant publication bias was found in the main outcomes. Conclusion To get theory-based interventions to produce more effects, the role of patients should be more involved and stronger and the education team should be trained beyond the primary preparation for the self-management education program. This article is protected by copyright. All rights reserved.

In this paper, the author successfully fabricated Mg-3Sr-xY alloys by melting-leaching reduction method using SF6 and N2 as protected gas. The microstructures of the Mg-3Sr-xY alloys were investigated in details，and the results showed that Mg-3Sr-xY alloys are composed of dendrite α-Mg and eutectic α-Mg and Mg17Sr2 and Mg24Y5 particulates, the second phases distribute in the α-Mg dendrites and interdendrites. The fiber microstructures form after thermal extrusion and the dynamic recrystallization occurs. In Mg-3Sr-xY alloy, the tensile strengths, the yield strengths and elongation rates increase firstly, reach the peak values, decrease with the increasing in Y content. Mg-3Sr-xY alloy have the best mechanics properties, including yield strengths and ultimate strengths and elongation rates and creep properties by the addition of 0.6%Y content. The tensile behaviors at elevated temperatures are accord to general laws for the metals at room temperature. The Mg-3Sr-xY alloys with 0.4-1.0% Y are of best creep limit. The dislocation sliding and climbing is the main creep mechanism for Mg-3Sr-0.6Y alloys.

Efficient selectivity for the supramolecular catalysis by cucurbit[8]uril (Q[8]) for the oxidation of aryl, allyl, and alkyl alcohols to corresponding aldehydes by o-Iodoxybenzoic acid (IBX) in aqueous solvent is reported. The relationship between the catalytic ability of Q[8] and the structure of the substrate has revealed that the catalyst prefers aryl and allyl alcohols to alkyl alcohols, and the conversions of most aryl and allyl alcohols have been increased by 30–50% in the presence of Q[8]. The catalytic selectivity suggests that the IBX oxidation proceeds via a stabilized α-Carbanion intermediate and the supramolecular catalysis should be mechanistically related to the electron density and reactivity of the α-Carbanion.

In this paper, the author successfully fabricated Mg-Sr and Mg-Sr-Y alloys by melting-leaching reduction method using SF6 and N2 as protected gas. The micro-structures of the alloys were investigated in details，and the results showed that dendrite α-Mg and eutectic α-Mg and Mg17Sr2 were the main phases in the Mg-Sr alloy, while Mg -Sr-Y alloys were composed of dendrite α-Mg and small eutectic α-Mg and Mg17Sr2 and tiny Mg24Y5. More eutectics were distributed around dendrite crystals in the Mg-Sr alloy, the Mg17Sr2 with aspect ratio of 6 : 1 were aligned and discontinuous lamellae, a Mg17Sr2 was irregular particles. The microstructures of Mg-Sr-Y alloy refined, Mg17Sr2 and tiny Mg24Y5 particles with size of 2-3μm distributed in the α-Mg dendrites and boundaries. The fomation and growth of both Mg24Y5 and Mg17Sr2 in the alloys were stated. It is obvious that the role of improving the heat-resistant Mg alloy of Mg24Y5 is more than Mg17Sr2.

Between 2008 and 2010, 19 strains of infectious bronchitis virus (IBV) were isolated from the vaccinated chicken flocks in Sichuan province, China. The S1 genes of the isolates were amplified and sequenced. Phylogenetic analysis revealed that the 19 isolates and 37 reference IBV strains can be grouped into eight genotypes. Although IBVs of Taiwan-I type, massachusetts type, and proventriculitis type were isolated, but most isolates were LX4 genotype. Homology analysis of the sequences of S1 genes of the 19 isolates and 37 reference IBV strains revealed that the identity of the nucleotides and amino acid sequences of the S1 genes between the 15 LX4-type isolates and other IBV strains were 71.9–99.3% and 72.1–99.1%, respectively, while those of the analyzed IBV of LX4 type were 96.0–99.9% and 94.3–99.8%, respectively. The results from this study and other published results in the GenBank database showed that isolates circulating in Sichuan province in recent years were mainly LX4 genotype, which is the predominant genotype circulated in China in recent years.

The Euler-Taylor-Galerkin flux-corrected transport (ETG-FCT) algorithm for the numerical solution of particle transport equations is described, based on the method developed by Lohner to solve conservation equations in fluid mechanics, and its application is extended to gas discharge problems. To improve the efficiency of computing and reduce numerical error, the nonuniform triangular mesh method is introduced, and the continuity equation is solved by ETG-FCT. The new contributions in this paper include the development of the ETG scheme and its application to rod-plate gap streamer discharge in 50~50% SF6/N2gas mixtures problems. Results are obtained: the spatial distributions of electron densities, positive ion densities, negative ion densities, photoelectron densities, and the electric field, respectively. The velocities of streamer propagations and the radius of streamer obtained from the proposed model are in good agreement with experimental and simulation results in literature. The results also prove that the ETG-FCT method is valid.