Objective Diabetes remission has emerged as an achievable treatment goal,shifting the focus of care from increasing medication use to restoring metabolic health.While clinical trials show that remission is possible in...Objective Diabetes remission has emerged as an achievable treatment goal,shifting the focus of care from increasing medication use to restoring metabolic health.While clinical trials show that remission is possible in controlled settings,evidence remains limited regarding its implementation in routine care within middle-income,rice-based dietary contexts.This study aims to explore healthcare provider experiences with implementing diabetes remission services in Thailand,focusing on dietary strategies,deprescription practices and patient management in routine care settings.Design Qualitative study using semi-structured,in-depth interviews,supplemented by structured questionnaires and programme documents.Setting Thirteen healthcare facilities across six Thai regions and two national-level professional or policy organisations.Participants 17 key informants purposively sampled for regional,institutional and professional diversity,including physicians,nurses,dietitians and national programme leaders.Data were collected and analysed iteratively until no new insights emerged.Thematic content analysis was conducted in QDA Miner Lite v3.0 with investigator triangulation.Result Five major themes emerged:key strengths,success factors,nutritional approaches and lifestyle modification,implementation challenges,and development strategies.Multidisciplinary teamwork,personalised care plans and regular monitoring facilitated service delivery.Culturally adapted dietary strategies,such as low-carbohydrate Thai-style meals and intermittent fasting,were widely used.Challenges included unclear clinical guidelines,limited staffing and technological disparities.Medication deprescription varied across sites due to the absence of standardised protocols.Healthcare providers emphasised the need for community engagement and policy support to enable scale-up.Real-world implementation of diabetes remission services is feasible but challenged by systemic constraints and contextual variability.Flexible,culturally tailored approaches,empowered care teams and supportive policy frameworks are essential for sustainability.展开更多
Semiconductor based photocatalysis that harvests renewable solar energy to produce green hydrogen has attracted widespread attention[1],known for its environmental friendliness,low opera-tional costs,and scalability.E...Semiconductor based photocatalysis that harvests renewable solar energy to produce green hydrogen has attracted widespread attention[1],known for its environmental friendliness,low opera-tional costs,and scalability.Extensive experimental and theoretical explorations have significantly advanced the development of pho-tocatalysts for overall water splitting at laboratory scale[2],by band structure engineering[3],heterostructure construction[4],active site design[5],and even micro-/macro-texture modulation[6,7].Preliminary demonstration and verification of its large-scale application have been accomplished using SrTiO_(3) as photocatalyst[8].However,this technology yet faces the great challenges in practical application,with solar-to-hydrogen conversion efficiency still lower than 2%,suffering from the thermodynamically and kinetically constrained water splitting reactions[9].Although some well documented strategies(e.g.,light concentration,exter-nal heat,and concentrated electrolytes)could overcome these pho-tocatalytic limitations to some extent[10],the introduced harsh reaction conditions would significantly compromise the durability of photocatalysts[11].For example,to realize the practical applica-tion of photocatalytic recycling and upgrading of plastic wastes into solar hydrogen,strong alkaline solutions containing mono-meric constituents should serve as feedstocks for photo-reforming[12],with photocatalysts exposed to the harsh alkaline condition and then suffering from degradation and inactivation.展开更多
文摘Objective Diabetes remission has emerged as an achievable treatment goal,shifting the focus of care from increasing medication use to restoring metabolic health.While clinical trials show that remission is possible in controlled settings,evidence remains limited regarding its implementation in routine care within middle-income,rice-based dietary contexts.This study aims to explore healthcare provider experiences with implementing diabetes remission services in Thailand,focusing on dietary strategies,deprescription practices and patient management in routine care settings.Design Qualitative study using semi-structured,in-depth interviews,supplemented by structured questionnaires and programme documents.Setting Thirteen healthcare facilities across six Thai regions and two national-level professional or policy organisations.Participants 17 key informants purposively sampled for regional,institutional and professional diversity,including physicians,nurses,dietitians and national programme leaders.Data were collected and analysed iteratively until no new insights emerged.Thematic content analysis was conducted in QDA Miner Lite v3.0 with investigator triangulation.Result Five major themes emerged:key strengths,success factors,nutritional approaches and lifestyle modification,implementation challenges,and development strategies.Multidisciplinary teamwork,personalised care plans and regular monitoring facilitated service delivery.Culturally adapted dietary strategies,such as low-carbohydrate Thai-style meals and intermittent fasting,were widely used.Challenges included unclear clinical guidelines,limited staffing and technological disparities.Medication deprescription varied across sites due to the absence of standardised protocols.Healthcare providers emphasised the need for community engagement and policy support to enable scale-up.Real-world implementation of diabetes remission services is feasible but challenged by systemic constraints and contextual variability.Flexible,culturally tailored approaches,empowered care teams and supportive policy frameworks are essential for sustainability.
基金supported by the National Natural Science Foun-dation of China(22432003,52225606,and 523B2070).
文摘Semiconductor based photocatalysis that harvests renewable solar energy to produce green hydrogen has attracted widespread attention[1],known for its environmental friendliness,low opera-tional costs,and scalability.Extensive experimental and theoretical explorations have significantly advanced the development of pho-tocatalysts for overall water splitting at laboratory scale[2],by band structure engineering[3],heterostructure construction[4],active site design[5],and even micro-/macro-texture modulation[6,7].Preliminary demonstration and verification of its large-scale application have been accomplished using SrTiO_(3) as photocatalyst[8].However,this technology yet faces the great challenges in practical application,with solar-to-hydrogen conversion efficiency still lower than 2%,suffering from the thermodynamically and kinetically constrained water splitting reactions[9].Although some well documented strategies(e.g.,light concentration,exter-nal heat,and concentrated electrolytes)could overcome these pho-tocatalytic limitations to some extent[10],the introduced harsh reaction conditions would significantly compromise the durability of photocatalysts[11].For example,to realize the practical applica-tion of photocatalytic recycling and upgrading of plastic wastes into solar hydrogen,strong alkaline solutions containing mono-meric constituents should serve as feedstocks for photo-reforming[12],with photocatalysts exposed to the harsh alkaline condition and then suffering from degradation and inactivation.
