Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Mechanical Modeling and Analysis of Stability Deterioration of Production Well During Marine Hydrate Depressurization Production

Different from oil and gas production,hydrate reservoirs are shallow and unconsolidated,whose mechanical properties deteriorate with hydrate decomposition.Therefore,the formations will undergo significant subsidence during depressurization,which will destroy the original force state of the production well.However,existing research on the stability of oil and gas production wells assumes the formation to be stable,and lacks consideration of the force exerted on the hydrate production well by formation subsidence caused by hydrate decomposition during production.To fill this gap,this paper proposes an analytical method for the dynamic evolution of the stability of hydrate production well considering the effects of hydrate decomposition.Based on the mechanical model of the production well,the basis for stability analysis has been proposed.A multi-field coupling model of the force state of the production well considering the effect of hydrate decomposition and formation subsidence is established,and a solver is developed.The analytical approach is verified by its good agreement with the results from the numerical method.A case study found that the decomposition of hydrate will increase the pulling-down force and reduce the supporting force,which is the main reason for the stability deterioration.The higher the initial hydrate saturation,the larger the reservoir thickness,and the lower the production pressure,the worse the stability or even instability.This work can provide a theoretical reference for the stability maintaining of the production well.

Single-base editing in IGF2 improves meat production and intramuscular fat deposition in Liang Guang Small Spotted pigs

Background Chinese indigenous pigs are popular with consumers for their juiciness,flavour and meat quality,but they have lower meat production.Insulin-like growth factor 2(IGF2) is a maternally imprinted growth factor that promotes skeletal muscle growth by regulating cell proliferation and differentiation.A single nucleotide polymorphism(SNP) within intron 3 of porcine IGF2 disrupts a binding site for the repressor,zinc finger BED-type containing 6(ZBED6),leading to up-regulation of IGF2 and causing major effects on muscle growth,heart size,and backfat thickness.This favorable mutation is common in Western commercial pig populations,but absent in most Chinese indigenous pig breeds.To improve meat production of Chinese indigenous pigs,we used cytosine base editor 3(CBE3)to introduce IGF2 intron3-C3071T mutation into porcine embryonic fibroblasts(PEFs) isolated from a male Liang Guang Small Spotted pig(LGSS),and single-cell clones harboring the desired mutation were selected for somatic cell nuclear transfer(SCNT) to generate the founder line of IGF2^(T/T) pigs.Results We found the heterozygous progeny IGF2^(C/T) pigs exhibited enhanced expression of IGF2,increased lean meat by 18%-36%,enlarged loin muscle area by 3%-17%,improved intramuscular fat(IMF) content by 18%-39%,marbling score by 0.75-1,meat color score by 0.53-1.25,and reduced backfat thickness by 5%-16%.The enhanced accumulation of intramuscular fat in IGF2^(C/T) pigs was identified to be regulated by the PI3K-AKT/AMPK pathway,which activated SREBP1 to promote adipogenesis.Conclusions We demonstrated the introduction of IGF2-intron3-C3071T in Chinese LGSS can improve both meat production and quality,and first identified the regulation of IMF deposition by IGF2 through SREBP1 via the PI3KAKT/AMPK signaling pathways.Our study provides a further understanding of the biological functions of IGF2and an example for improving porcine economic traits through precise base editing.

Classification and technical target of water electrolysis for hydrogen production

Continuous efforts are underway to reduce carbon emissions worldwide in response to global climate change.Water electrolysis technology,in conjunction with renewable energy,is considered the most feasible hydrogen production technology based on the viable possibility of large-scale hydrogen production and the zero-carbon-emission nature of the process.However,for hydrogen produced via water electrolysis systems to be utilized in various fields in practice,the unit cost of hydrogen production must be reduced to$1/kg H_(2).To achieve this unit cost,technical targets for water electrolysis have been suggested regarding components in the system.In this paper,the types of water electrolysis systems and the limitations of water electrolysis system components are explained.We suggest guideline with recent trend for achieving this technical target and insights for the potential utilization of water electrolysis technology.

Upcycling plastic wastes into value-added products via electrocatalysis and photoelectrocatalysis

Plastic,renowned for its versatility,durability,and cost-effectiveness,is indispensable in modern society.Nevertheless,the annual production of nearly 400 million tons of plastic,coupled with a recycling rate of only 9%,has led to a monumental environmental crisis.Plastic recycling has emerged as a vital response to this crisis,offering sustainable solutions to mitigate its environmental impact.Among these recycling efforts,plastic upcycling has garnered attention,which elevates discarded plastics into higher-value products.Here,electrocatalytic and photoelectrocatalytic treatments stand at the forefront of advanced plastic upcycling.Electrocatalytic or photoelectrocatalytic treatments involve chemical reactions that facilitate electron transfer through the electrode/electrolyte interface,driven by electrical or solar energy,respectively.These methods enable precise control of chemical reactions,harnessing potential,current density,or light to yield valuable chemical products.This review explores recent progress in plastic upcycling through electrocatalytic and photoelectrocatalytic pathways,offering promising solutions to the plastic waste crisis and advancing sustainability in the plastics industry.

Quantifying the agreement and accuracy characteristics of four satellite-based LULC products for cropland classification in China

Various land use and land cover(LULC)products have been produced over the past decade with the development of remote sensing technology.Despite the differences in LULC classification schemes,there is a lack of research on assessing the accuracy of their application to croplands in a unified framework.Thus,this study evaluated the spatial and area accuracies of cropland classification for four commonly used global LULC products(i.e.,MCD12Q1V6,GlobCover2009,FROM-GLC and GlobeLand30)based on the harmonised FAO criterion,and quantified the relationships between four factors(i.e.,slope,elevation,field size and crop system)and cropland classification agreement.The validation results indicated that MCD12Q1 and GlobeLand30 performed well in cropland classification regarding spatial consistency,with overall accuracies of 94.90 and 93.52%,respectively.The FROMGLC showed the worst performance,with an overall accuracy of 83.17%.Overlaying the cropland generated by the four global LULC products,we found the proportions of complete agreement and disagreement were 15.51 and 44.72% for the cropland classification,respectively.High consistency was mainly observed in the Northeast China Plain,the Huang-Huai-Hai Plain and the northern part of the Middle-lower Yangtze Plain,China.In contrast,low consistency was detected primarily on the eastern edge of the northern and semiarid region,the Yunnan-Guizhou Plateau and southern China.Field size was the most important factor for mapping cropland.For area accuracy,compared with China Statistical Yearbook data at the provincial scale,the accuracies of different products in descending order were:GlobeLand30,FROM-GLC,MCD12Q1,and GlobCover2009.The cropland classification schemes mainly caused large area deviations among the four products,and they also resulted in the different ranks of spatial accuracy and area accuracy among the four products.Our results can provide valuable suggestions for selecting cropland products at the national or provincial scale and help cropland mapping and reconstruction,which is essential for food security and crop management,so they can also contribute to achieving the Sustainable Development Goals issued by the United Nations.

Simulation of the Ecosystem Productivity Responses to Aerosol Diffuse Radiation Fertilization Effects over the Pan-Arctic during 2001–19

The pan-Arctic is confronted with air pollution transported from lower latitudes.Observations have shown that aerosols help increase plant photosynthesis through the diffuse radiation fertilization effects(DRFEs).While such DRFEs have been explored at low to middle latitudes,the aerosol impacts on pan-Arctic ecosystems and the contributions by anthropogenic and natural emission sources remain less quantified.Here,we perform regional simulations at 0.2o×0.2ousing a well-validated vegetation model(Yale Interactive terrestrial Biosphere,YIBs)in combination with multi-source of observations to quantify the impacts of aerosol DRFEs on the net primary productivity(NPP)in the pan-Arctic during 2001-19.Results show that aerosol DRFEs increase pan-Arctic NPP by 2.19 Pg C(12.8%)yr^(-1)under clear-sky conditions,in which natural and anthropogenic sources contribute to 8.9% and 3.9%,respectively.Under all-sky conditions,such DRFEs are largely dampened by cloud to only 0.26 Pg C(1.24%)yr^(-1),with contributions of 0.65% by natural and 0.59% by anthropogenic species.Natural aerosols cause a positive NPP trend of 0.022% yr^(-1)following the increased fire activities in the pan-Arctic.In contrast,anthropogenic aerosols induce a negative trend of-0.01% yr^(-1)due to reduced emissions from the middle latitudes.Such trends in aerosol DRFEs show a turning point in the year of 2007 with more positive NPP trends by natural aerosols but negative NPP trends by anthropogenic aerosols thereafter.Though affected by modeling uncertainties,this study suggests a likely increasing impact of aerosols on terrestrial ecosystems in the pan-Arctic under global warming.

Effects of Maillard reaction and its product AGEs on aging and age-related diseases

Maillard reaction(MR)is a non-enzymatic browning reaction commonly seen in food processing,which occurs between reducing sugars and compounds with amino groups.Despite certain advantages based on Maillard reaction products(MRPs)found in some food for health and storage application have appeared,however,the MR occurring in human physiological environment can produce advanced glycation end products(AGEs)by non-enzymatic modification of macromolecules such as proteins,lipids and nucleic acid,which could change the structure and functional activity of the molecules themselves.In this review,we take AGEs as our main object,on the one hand,discuss physiologic aging,that is,age-dependent covalent cross-linking and modification of proteins such as collagen that occur in eyes and skin containing connective tissue.On the other hand,pathological aging associated with autoimmune and inflammatory diseases,neurodegenerative diseases,diabetes and diabetic nephropathy,cardiovascular diseases and bone degenerative diseases have been mainly proposed.Based on the series of adverse effects of accelerated aging and disease pathologies caused by MRPs,the possible harm caused by some MR can be slowed down or inhibited by artificial drug intervention,dietary pattern and lifestyle control.It also stimulates people's curiosity to continue to explore the potential link between the MR and human aging and health,which should be paid more attention to for the development of life sciences.

Product quality prediction based on RBF optimized by firefly algorithm

With the development of information technology,a large number of product quality data in the entire manufacturing process is accumulated,but it is not explored and used effectively.The traditional product quality prediction models have many disadvantages,such as high complexity and low accuracy.To overcome the above problems,we propose an optimized data equalization method to pre-process dataset and design a simple but effective product quality prediction model:radial basis function model optimized by the firefly algorithm with Levy flight mechanism(RBFFALM).First,the new data equalization method is introduced to pre-process the dataset,which reduces the dimension of the data,removes redundant features,and improves the data distribution.Then the RBFFALFM is used to predict product quality.Comprehensive expe riments conducted on real-world product quality datasets validate that the new model RBFFALFM combining with the new data pre-processing method outperforms other previous me thods on predicting product quality.

High-rate electrochemical H_(2)O_(2) production over multimetallic atom catalysts under acidic–neutral conditions

Hydrogen peroxide(H_(2)O_(2))production by the electrochemical 2-electron oxygen reduction reaction(2e−ORR)is a promising alternative to the energy-intensive anthraquinone process,and single-atom electrocatalysts show the unique capability of high selectivity toward 2e−ORR against the 4e−one.The extremely low surface density of the single-atom sites and the inflexibility in manipulating their geometric/electronic configurations,however,compromise the H_(2)O_(2) yield and impede further performance enhancement.Herein,we construct a family of multiatom catalysts(MACs),on which two or three single atoms are closely coordinated to form high-density active sites that are versatile in their atomic configurations for optimal adsorption of essential*OOH species.Among them,the Cox–Ni MAC presents excellent electrocatalytic performance for 2e−ORR,in terms of its exceptionally high H_(2)O_(2) yield in acidic electrolytes(28.96 mol L^(−1) gcat.^(−1) h^(−1))and high selectivity under acidic to neutral conditions in a wide potential region(>80%,0–0.7 V).Operando X-ray absorption and density functional theory analyses jointly unveil its unique trimetallic Co2NiN8 configuration,which efficiently induces an appropriate Ni–d orbital filling and modulates the*OOH adsorption,together boosting the electrocatalytic 2e−ORR capability.This work thus provides a new MAC strategy for tuning the geometric/electronic structure of active sites for 2e−ORR and other potential electrochemical processes.

Research Progress and Prospects of Total Factor Productivity in the Construction Industry

The high-quality development of the construction industry fundamentally stems from the significant improvement of total factor productivity.Therefore,it is of crucial significance for promoting the development of the construction industry to a higher level by scientifically and accurately measuring the total factor productivity of the construction industry and deeply analyzing the influencing factors behind it.Based on a comprehensive consideration of research methods and influencing factors,this paper systematically reviews the existing relevant literature on total factor productivity in the construction industry,aiming to reveal the current research development trend in this field and point out potential problems.This effort aims to provide a solid theoretical foundation and valuable reference for further in-depth research,and jointly promote the continuous progress and development of total factor productivity research in the construction industry.

Spatiotemporal changes of gross primary productivity and its response to drought in the Mongolian Plateau under climate change

Gross primary productivity(GPP)of vegetation is an important constituent of the terrestrial carbon sinks and is significantly influenced by drought.Understanding the impact of droughts on different types of vegetation GPP provides insight into the spatiotemporal variation of terrestrial carbon sinks,aiding efforts to mitigate the detrimental effects of climate change.In this study,we utilized the precipitation and temperature data from the Climatic Research Unit,the standardized precipitation evapotranspiration index(SPEI),the standardized precipitation index(SPI),and the simulated vegetation GPP using the eddy covariance-light use efficiency(EC-LUE)model to analyze the spatiotemporal change of GPP and its response to different drought indices in the Mongolian Plateau during 1982-2018.The main findings indicated that vegetation GPP decreased in 50.53% of the plateau,mainly in its northern and northeastern parts,while it increased in the remaining 49.47%area.Specifically,meadow steppe(78.92%)and deciduous forest(79.46%)witnessed a significant decrease in vegetation GPP,while alpine steppe(75.08%),cropland(76.27%),and sandy vegetation(87.88%)recovered well.Warming aridification areas accounted for 71.39% of the affected areas,while 28.53% of the areas underwent severe aridification,mainly located in the south and central regions.Notably,the warming aridification areas of desert steppe(92.68%)and sandy vegetation(90.24%)were significant.Climate warming was found to amplify the sensitivity of coniferous forest,deciduous forest,meadow steppe,and alpine steppe GPP to drought.Additionally,the drought sensitivity of vegetation GPP in the Mongolian Plateau gradually decreased as altitude increased.The cumulative effect of drought on vegetation GPP persisted for 3.00-8.00 months.The findings of this study will improve the understanding of how drought influences vegetation in arid and semi-arid areas.

Loss to Specialized Cardiology Follow-Up in Adults Living with Congenital Heart Disease

Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

The Performance of Downward Shortwave Radiation Products from Satellite and Reanalysis over the Transect of Zhongshan Station to Dome A, East Antarctica

The downward shortwave radiation(DSR) is an important part of the Earth's energy balance, driving Earth's system's energy, water, and carbon cycles. Due to the harsh Antarctic environment, the accuracy of DSR derived from satellite and reanalysis has not been systematically evaluated over the transect of Zhongshan station to Dome A, East Antarctica.Therefore, this study aims to evaluate DSR reanalysis products(ERA5-Land, ERA5, MERRA-2) and satellite products(CERES and ICDR) in this area. The results indicate that DSR exhibits obvious monthly and seasonal variations, with higher values in summer than in winter. The ERA5-Land(ICDR) DSR product demonstrated the highest(lowest) accuracy,as evidenced by a correlation coefficient of 0.988(0.918), a root-mean-square error of 23.919(69.383) W m^(–2), a mean bias of –1.667(–28.223) W m^(–2) and a mean absolute error of 13.37(58.99) W m^(–2). The RMSE values for the ERA5-Land reanalysis product at seven stations, namely Zhongshan, Panda 100, Panda 300, Panda 400, Taishan, Panda 1100, and Kunlun, were 30.938, 29.447, 34.507, 29.110, 20.339, 17.267, and 14.700 W m^(-2), respectively;with corresponding bias values of 9.887, –12.159, –19.181, –15.519, –8.118, 6.297, and 3.482 W m^(–2). Regarding seasonality, ERA5-Land, ERA5,and MERRA-2 reanalysis products demonstrate higher accuracies during spring and summer, while ICDR products are least accurate in autumn. Cloud cover, water vapor, total ozone, and severe weather are the main factors affecting DSR. The error of DSR products is greatest in coastal areas(particularly at the Zhongshan station) and decreases towards the inland areas of Antarctica.

Essential role of postoperative follow-up in the management of clear cell sarcoma

Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatment for localizedCCS,while radiotherapy and chemotherapy are preferred for metastatic cases.The roles of adjuvant chemotherapy,radiotherapy,and lymph node dissection arecontroversial.Although immunotherapy has emerged as a promising avenue inCCS treatment research,there are no established clinical standards for postoperativefollow-up.This editorial discusses a recent article by Liu et al,with afocus on current diagnostic modalities,treatment approaches,and the challengingprognosis associated with CCS.Our aim is to underscore the importance of longtermpatient follow-up in CCS management.

Evolving patterns of agricultural production space in China:A network-based approach

The agricultural production space,as where and how much each agricultural product grows,plays a vital role in meeting the increasing and diverse food demands.Previous studies on agricultural production patterns have predominantly centered on individual or specific crop types,using methods such as remote sensing or statistical metrological analysis.In this study,we characterize the agricultural production space(APS)by bipartite network connecting agricultural products and provinces,to reveal the relatedness between diverse agricultural products and the spatiotemporal characteristic of provincial production capabilities in China.The results show that core products are cereal,pork,melon,and pome fruit;meanwhile the milk,grape,and fiber crop show an upward trend in centrality,which is in line with diet structure changes in China over the past decades.The little changes in community components and structures of agricultural products and provinces reveal that agricultural production patterns in China are relatively stable.Additionally,identified provincial communities closely resemble China's agricultural natural zones.Furthermore,the observed growth in production capabilities in North and Northeast China implies their potential focus areas for future agricultural production.Despite the superior production capa-bilities of southern provinces,recent years have witnessed a notable decline,warranting special attentions.The findings provide a comprehensive perspective for understanding the complex relationship of agricultural prod-ucts'relatedness,production capabilities and production patterns,which serve as a reference for the agricultural spatial optimization and agricultural sustainable development.

Optimization of Gas Production from Hydrate-Bearing Sediments with Fluctuation Characteristics

As an important source of low-carbon,clean fossil energy,natural gas hydrate plays an important role in improving the global energy consumption structure.Developing the hydrate industry in the South China Sea is important to achieving‘carbon peak and carbon neutrality’goals as soon as possible.Deep-water areas subjected to the action of long-term stress and tectonic movement have developed complex and volatile terrains,and as such,the morphologies of hydrate-bearing sediments(HBSs)fluctuate correspondingly.The key to numerically simulating HBS morphologies is the establishment of the conceptual model,which represents the objective and real description of the actual geological body.However,current numerical simulation models have characterized HBSs into horizontal strata without considering the fluctuation characteristics.Simply representing the HBS as a horizontal element reduces simulation accuracy.Therefore,the commonly used horizontal HBS model and a model considering the HBS’s fluctuation characteristics with the data of the SH2 site in the Shenhu Sea area were first constructed in this paper.Then,their production behaviors were compared,and the huge impact of the fluctuation characteristics on HBS production was determined.On this basis,the key parameters affecting the depressurization production of the fluctuating HBSs were studied and optimized.The research results show that the fluctuation characteristics have an obvious influence on the hydrate production of HBSs by affecting their temperatures and pressure distributions,as well as the transmission of the pressure drop and methane gas discharge.Furthermore,the results show that the gas productivity of fluctuating HBSs was about 5%less than that of horizontal HBSs.By optimizing the depressurization amplitude,well length,and layout location of vertical wells,the productivity of fluctuating HBSs increased by about 56.6%.

Influence of Production Factors on the Physico-Chemical Characteristics of Fermented Cassava Dough and Sensory Evaluation of Attieke

Attieke is an Ivorian semolina which obtained by fermenting, pressing and steaming cassava dough. Attieke production remains a traditional activity carried out by less literate women. However, perceived differences in measurable factors and attieke qualities require an investigation of their influence on the characteristics of the pressed dough and attieke. The aim of this study is to improve the quality of the dough in relation to that of the attieke produced. The experiment was carried out on 4 production factors, namely the type of boiled or braised ferment, the incorporation rate of the ferment between 8 and 10%, the addition of oil from 0.1 to 1% and the fermentation time from 12 to 15 hours applied to the Improved African Cassava (IAC) variety. A complete experiment design of 16 samples of fermented dough and attieke was employed. These samples underwent physic-chemical analyses for the fermented dough and sensory evaluation for the attieke. It was found that, except for titratable acidity, reducing sugar content and ash content, the physico-chemical characteristics of the dough of IAC variety were significantly influenced by all production factors and their interaction. Fermentation time significantly influences 60% of the physico-chemical characteristics of the fermented dough. The type of ferment, the oil addition and the ferment rate have a significant influence at 40% of these characteristics. At the sensory level, color, acidity and grain binding with an explained variance of 34.60% were essential for the appreciation of the attieke samples. Thus, these production factors could be considered for the improvement of the fermented dough and attieke production process.

Short Communication: Enhancing the Drying Process of Microbial-Based Products with a Dehumidifier

The development of microbial-based products requires certain criteria for them to be successfully commercialized. The product must meet the following desirable criteria: effectiveness, contamination free, stability, cost-effectiveness, and a prolonged shelf life. Controlling the drying process is crucial for ensuring the stability and durability of the product. The traditional approach, which involved mechanical and natural drying, led to decreased productivity and quality. The objective of this research endeavour was to achieve a dry process enhancement while preserving the microbial quality of Trichoderma asperellum (M103). The temperature and relative humidity during the drying period were monitored under two conditions: with and without a dehumidifier. The results demonstrate that the dehumidifier increases drying period efficiency by up to 63%.

DNA G-Quadruplexes as Targets for Natural Product Drug Discovery

DNA guanine(G)-quadruplexes(G4s)are unique secondary structures formed by two or more stacked Gtetrads in G-rich DNA sequences.These structures have been found to play a crucial role in highly transcribed genes,especially in cancer-related oncogenes,making them attractive targets for cancer therapeutics.Significantly,targeting oncogene promoter G4 structures has emerged as a promising strategy to address the challenge of undruggable and drug-resistant proteins,such as MYC,BCL2,KRAS,and EGFR.Natural products have long been an important source of drug discovery,particularly in the fields of cancer and infectious diseases.Noteworthy progress has recently been made in the discovery of naturally occurring DNA G4-targeting drugs.Numerous DNA G4s,such as MYC-G4,BCL2-G4,KRAS-G4,PDGFR-b-G4,VEGF-G4,and telomeric-G4,have been identified as potential targets of natural products,including berberine,telomestatin,quindoline,sanguinarine,isaindigotone,and many others.Herein,we summarize and evaluate recent advancements in natural and nature-derived DNA G4 binders,focusing on understanding the structural recognition of DNA G4s by small molecules derived from nature.We also discuss the challenges and opportunities associated with developing drugs that target DNA G4s.