OBJECTIVE: Exploring the formation and aggregation of human islet amyloid polypeptide (hIAPP) (amylin) fibers is significant for promoting the prevention and treatment of type II diabetes mellitus (T2DM). Flavones in pomelo peel have visible biological activity in the anti-diabetes aspect. The present study aimed to investigate the effects of five flavones [naringin (NRG), narirutin (NRR), nobiletin (NOB), sinensetin (SIN), and neohesperidin (NHP)] in pomelo peel on peptide aggregation and explore its possible mechanisms. The cell viability of flavones against peptide aggregation was also evaluated. METHODS: The thioflavin T (ThT) assay and transmission electron microscopy (TEM) were used for evaluating the inhibition and disaggregation of flavones on peptide aggregation. The interaction mechanism was analyzed by endogenous fluorescence, molecular dynamics (MD) simulations, ultraviolet spectroscopy (UV) and isothermal titration calorimetry (ITC) experiments. The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) and immune assays were performed to characterize the cell viability of flavones against peptide aggregation. RESULTS: The five flavones showed a decrease in fluorescence intensity, fiber number and size under incubation with different molar ratios of hIAPP. The compounds can bind to the aromatic tyrosine (Tyr) residueTyr 37, resulting in the intrinsic fluorescence quenching of the peptides. Five flavones can form hydrogen bonds with hIAPP, which is likely to be based on their phenolic hydroxyl structure. They showed strong binding affinity with peptides. The reaction system of NRG and NRR observed an exothermic reaction, and the others were endothermic reactions. The absorption peaks of the compounds with hIAPP changed and showed hypochromic effects, indicating that there may be π-π stacking interaction. Flavones noticeably increased the cell viability in the presence of amyloid peptides and reduced the absorption intensity induced by peptide oligomers. CONCLUSION A total of five flavones in pomelo peel have inhibitory and depolymerization effects on amyloid fibrils, and can significantly protect cells from the toxic effect of hIAPP and reduce the production of toxic oligomers.

Objective To investigate the patterns of changes in biochemical factors(IL-1β and TGF-β1)and biophysical factors within the periodontal ligament microenvironment at different stages of periodontitis development.Methods Periodontitis models at different stages of development(early and late stages)were constructed in rats.The changes in the periodontal ligament microenvironment were determined by detecting biochemical factors((IL-1β and TGF-β1)and changes in periodontal ligament stiffness.Results Regarding biochemical factors,the growth factor TGF-β1 was at a high level in the early stage of periodontitis,while the inflammatory factor(IL-1β was slightly increased compared to the normal state,but expressed at a low level.As the inflammation progressed,the expression of TGF-β1 was suppressed and significantly decreased in the late stage of periodontitis(late stage:11.34±2.91 vs.early stage:20.41±2.64,P＜0.01).In contrast,the expression of(IL-1βsignificantly increased(late stage:18.77±3.36 vs.early stage:8.24±1.47,P＜0.01).Regarding biophysical factors,the stiffness of the periodontal ligament and the expression of the key protein integrin αv β3 in the mechanical signaling pathway gradually decreased with the development of periodontitis.Additionally,the osteogenic differentiation capacity of stem cells significantly decreased in the late stage of periodontitis(late stage:12.47±2.83 vs.early stage:21.15±4.38,P＜0.05).Conclusion TGF-β1 may play a role in promoting periodontal tissue repair and maintaining physiological stability in normal and early stages of periodontitis,while the increased expression of(IL-1β in the late stage of periodontitis may inhibit the osteogenic differentiation of stem cells,leading to bone loss.Biophysical factors,including matrix stiffness and integrin αvβ3 expression,gradually decrease with the progression of periodontitis,potentially affecting bone tissue repair.

Reporting guidelines are structured checklists for researchers to follow when reporting spe-cific types of studies.As researches conducted in real-world settings to address practical issues,implementa-tion research has stringent requirements for the replicability of result and the transparency of reporting,making its reporting guidelines particularly important.This paper systematically introduces the reporting guidelines in the field of implementation science,outlines their classification systems and scopes of applica-tion,and focuses on explaining the core characteristics and functions of five key reporting guidelines,inclu-ding the Standards for Reporting Implementation Studies(StaRI),Reporting guidelines for implementation and operational research,the Template for Intervention Description and Replication(TIDieR),the Frame-work for Reporting Adaptations and Modifications-Enhanced(FRAME),and recommendations for specifying and reporting implementation strategies.Furthermore,combined with the PEDALs research paradigm in im-plementation science,this paper further clarifies the specific application pathways for reporting guidelines and discusses directions for refinement,aiming to provide references for researchers to select appropriate reporting guidelines.

Objective To construct and validate a risk prediction model for malnutrition in non-di-alysis patients with stages 3 to 5 chronic kidney disease(CKD)based on Logistic regression(LR)and XGBoost algorithms,and to compare the predictive performance between the two models.Methods A total of 506 CKD patients were enrolled as study subjects.According to chronological order,they were divided into training set(n=404)and test set(n=102)at the ratio of 8 to 2.The training set was divided into case group and control group based on whether they were malnourished,with 202 cases in each group.The LR and XGBoost models were established,and the model efficacy was evaluated through the area under the receiver operating characteristic(ROC)curve(AUC),sensitivity,speci-ficity,GiViTI calibration curve band and clinical decision curve.Results The LR model identified age ≥60 years,disease of stage 5,reduced appetite,hypoalbuminemia,low prealbumin,low mid-arm muscle circumference and high perceived stress as independent risk factors for malnutrition among non-dialysis CKD patients,while physical activity was identified as a protective factor(P＜0.05).In the XGBoost model,the top five influential variables were serum albumin,appetite,physical activity,prealbumin and mid-arm muscle circumference.The AUC of the LR and XGBoost models in the train-ing set were 0.930 and 0.947 respectively,and those in the test set were 0.925 and 0.933.The pre-dictive ability of the latter was slightly higher(P＞0.05).The GiViTI calibration curve bands all showed good calibration capability.Conclusion The XGBoost model combined with shapley additive explanation performs better in identifying malnourished patients and guiding precise care.

Objective:To develop the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus to provide community healthcare workers with an assessment tool to measure proactive health behaviors in a multidimensional manner.Methods:Guided by the information-motivation-behavioral skills theory, a test version of the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus was developed through literature research, semi-structured interviews, Delphi expert consultation, and pre-survey. Convenience sampling was used to select 696 cases of type 2 diabetes mellitus high-risk people in the community of Lubei District, Tangshan City, from February to June 2024 for the item analysis, reliability and validity test. A total of 696 questionnaires were distributed and 664 valid questionnaires were recovered, with a valid recovery rate of 95.40%.Results:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus included four dimensions, including prevention knowledge, prevention motivation, prevention skills, and prevention behaviors, with a total of 38 items. Exploratory factor analysis extracted four common factors, with a cumulative variance contribution rate of 64.203%. Confirmatory factor analysis showed good model fit. The total Cronbach's α coefficient for the scale was 0.940, the half fold reliability coefficient was 0.964, and the test-retest reliability coefficient was 0.859.Conclusions:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus has good reliability and validity, which can be used to evaluate the proactive health behaviors in population at high-risk of type 2 diabetes mellitus.

Objective:To construct a questionnaire to measure parents′ behavioral and social drivers (BeSD) in administering rotavirus vaccine to their children, and to test the reliability and validity of the questionnaire.Methods:A questionnaire was constructed to investigate the BeSD of rotavirus vaccination among parents based on the WHO BeSD questionnaire. A survey was conducted among parents of children aged 0-3 years old in vaccination clinics from 15 community health service centers in Nanjing City of Jiangsu Province, Yuhuan and Kaihua Counties of Zhejiang Province, Anqing City of Anhui Province, and Yangpu District of Shanghai City from April to May in 2024. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to analyze the reliability (internal consistency reliability, combination reliability and split half reliability) and validity (structural validity, convergence validity and discriminative validity) of the questionnaire.Results:A total of 850 questionnaires were collected, of which 614 were valid, with an effective response rate of 72.20%. The EFA resulted in the refinement of the rotavirus vaccine BeSD questionnaire from 37 to 35 items (including 24 core items), and suggested a five-factor structure including the perceptions of vaccine, confidence in vaccine, social process of vaccination, motivation for vaccination, and practical problems of vaccination. The cumulative variance contribution rate reached 56.27%. The CFA confirmed an ideal five-factor model fit (GFI=0.82,CFI=0.86,PNFI=0.67,RMSEA=0.07). The AVE of each dimension was greater than 0.50. The AVE square root of each dimension of the questionnaire was greater than its correlation coefficient. The Cronbach′s α coefficient of the total questionnaire was 0.79.Conclusion:The developed BeSD questionnaire of rotavirus vaccine has good reliability and validity, and can be used to measure parents′ behavioral and social factors in administering rotavirus vaccine to their children.

Reporting guidelines are structured checklists for researchers to follow when reporting spe-cific types of studies.As researches conducted in real-world settings to address practical issues,implementa-tion research has stringent requirements for the replicability of result and the transparency of reporting,making its reporting guidelines particularly important.This paper systematically introduces the reporting guidelines in the field of implementation science,outlines their classification systems and scopes of applica-tion,and focuses on explaining the core characteristics and functions of five key reporting guidelines,inclu-ding the Standards for Reporting Implementation Studies(StaRI),Reporting guidelines for implementation and operational research,the Template for Intervention Description and Replication(TIDieR),the Frame-work for Reporting Adaptations and Modifications-Enhanced(FRAME),and recommendations for specifying and reporting implementation strategies.Furthermore,combined with the PEDALs research paradigm in im-plementation science,this paper further clarifies the specific application pathways for reporting guidelines and discusses directions for refinement,aiming to provide references for researchers to select appropriate reporting guidelines.

Objective To investigate the patterns of changes in biochemical factors(IL-1β and TGF-β1)and biophysical factors within the periodontal ligament microenvironment at different stages of periodontitis development.Methods Periodontitis models at different stages of development(early and late stages)were constructed in rats.The changes in the periodontal ligament microenvironment were determined by detecting biochemical factors((IL-1β and TGF-β1)and changes in periodontal ligament stiffness.Results Regarding biochemical factors,the growth factor TGF-β1 was at a high level in the early stage of periodontitis,while the inflammatory factor(IL-1β was slightly increased compared to the normal state,but expressed at a low level.As the inflammation progressed,the expression of TGF-β1 was suppressed and significantly decreased in the late stage of periodontitis(late stage:11.34±2.91 vs.early stage:20.41±2.64,P＜0.01).In contrast,the expression of(IL-1βsignificantly increased(late stage:18.77±3.36 vs.early stage:8.24±1.47,P＜0.01).Regarding biophysical factors,the stiffness of the periodontal ligament and the expression of the key protein integrin αv β3 in the mechanical signaling pathway gradually decreased with the development of periodontitis.Additionally,the osteogenic differentiation capacity of stem cells significantly decreased in the late stage of periodontitis(late stage:12.47±2.83 vs.early stage:21.15±4.38,P＜0.05).Conclusion TGF-β1 may play a role in promoting periodontal tissue repair and maintaining physiological stability in normal and early stages of periodontitis,while the increased expression of(IL-1β in the late stage of periodontitis may inhibit the osteogenic differentiation of stem cells,leading to bone loss.Biophysical factors,including matrix stiffness and integrin αvβ3 expression,gradually decrease with the progression of periodontitis,potentially affecting bone tissue repair.

Objective:To develop the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus to provide community healthcare workers with an assessment tool to measure proactive health behaviors in a multidimensional manner.Methods:Guided by the information-motivation-behavioral skills theory, a test version of the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus was developed through literature research, semi-structured interviews, Delphi expert consultation, and pre-survey. Convenience sampling was used to select 696 cases of type 2 diabetes mellitus high-risk people in the community of Lubei District, Tangshan City, from February to June 2024 for the item analysis, reliability and validity test. A total of 696 questionnaires were distributed and 664 valid questionnaires were recovered, with a valid recovery rate of 95.40%.Results:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus included four dimensions, including prevention knowledge, prevention motivation, prevention skills, and prevention behaviors, with a total of 38 items. Exploratory factor analysis extracted four common factors, with a cumulative variance contribution rate of 64.203%. Confirmatory factor analysis showed good model fit. The total Cronbach's α coefficient for the scale was 0.940, the half fold reliability coefficient was 0.964, and the test-retest reliability coefficient was 0.859.Conclusions:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus has good reliability and validity, which can be used to evaluate the proactive health behaviors in population at high-risk of type 2 diabetes mellitus.

Objective:To construct a questionnaire to measure parents′ behavioral and social drivers (BeSD) in administering rotavirus vaccine to their children, and to test the reliability and validity of the questionnaire.Methods:A questionnaire was constructed to investigate the BeSD of rotavirus vaccination among parents based on the WHO BeSD questionnaire. A survey was conducted among parents of children aged 0-3 years old in vaccination clinics from 15 community health service centers in Nanjing City of Jiangsu Province, Yuhuan and Kaihua Counties of Zhejiang Province, Anqing City of Anhui Province, and Yangpu District of Shanghai City from April to May in 2024. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to analyze the reliability (internal consistency reliability, combination reliability and split half reliability) and validity (structural validity, convergence validity and discriminative validity) of the questionnaire.Results:A total of 850 questionnaires were collected, of which 614 were valid, with an effective response rate of 72.20%. The EFA resulted in the refinement of the rotavirus vaccine BeSD questionnaire from 37 to 35 items (including 24 core items), and suggested a five-factor structure including the perceptions of vaccine, confidence in vaccine, social process of vaccination, motivation for vaccination, and practical problems of vaccination. The cumulative variance contribution rate reached 56.27%. The CFA confirmed an ideal five-factor model fit (GFI=0.82,CFI=0.86,PNFI=0.67,RMSEA=0.07). The AVE of each dimension was greater than 0.50. The AVE square root of each dimension of the questionnaire was greater than its correlation coefficient. The Cronbach′s α coefficient of the total questionnaire was 0.79.Conclusion:The developed BeSD questionnaire of rotavirus vaccine has good reliability and validity, and can be used to measure parents′ behavioral and social factors in administering rotavirus vaccine to their children.