Identifying influence factors and thresholds of the next day's pollen concentration in different seasons using interpretable machine learning.

The prevalence of pollen allergies is a pressing global issue, with projections suggesting that half of the world's population will be affected by 2050 according to the estimation of the World Health Organization (WHO). Accurately forecasting pollen allergy risks requires identifying key factors and their thresholds for aerosol pollen. To address this, we developed a technical framework combining advanced machine learning and SHapley Additive exPlanations (SHAP) technology, focusing on Beijing. By analyzing meteorological data and vegetation phenology, we identified the factors influencing next-day's pollen concentration (NDP) in Beijing and their thresholds. Our results highlight vegetation phenology data from Synthetic Aperture Radar (SAR), temperature, wind speed, and atmospheric pressure as crucial factors in spring. In contrast, the Normalized Difference Vegetation Index (NDVI), air temperature, and wind speed are significant in autumn. Leveraging SHAP technology, we established season-specific thresholds for these factors. Our study not only confirms previous research but also unveils seasonal variations in the relationship between radar-derived vegetation phenology data and NDP. Additionally, we observe seasonal fluctuations in the influence patterns and threshold values of daily air temperatures on NDP. These insights are pivotal for improving pollen concentration prediction accuracy and managing allergic risks effectively.

Identifying interactive effects of spatial drivers in soil heavy metal pollutants using interpretable machine learning models.

The accurate identification of spatial drivers is crucial for effectively managing soil heavy metals (SHM). However, understanding the complex and diverse spatial drivers of SHM and their interactive effects remains a significant challenge. In this study, we present a comprehensive analysis framework that integrates Geodetector, CatBoost, and SHapley Additive exPlanations (SHAP) techniques to identify and elucidate the interactive effects of spatial drivers in SHM within the Pearl River Delta (PRD) region of China. Our investigation incorporated fourteen environmental factors and focused on the pollution levels of three prominent heavy metals: Hg, Cd, and Zn. These findings provide several key insights: (1) The distribution of SHM is influenced by the combined effects of various individual factors and interactions within the source-flow-sink process. (2) Compared with the spatial interpretation of individual factors, the interaction between Hg and Cd exhibited enhanced spatial explanatory power. Similarly, interactions involving Zn mainly demonstrated increased spatial explanatory power, but there was one exception in which a weakening was observed. (3) Spatial heterogeneity plays a crucial role in determining the contributions of environmental factors to soil heavy metal concentrations. Although individual factors generally promote metal accumulation, their effects fluctuate when interactions are considered. (4) The SHAP interpretable method effectively addresses the limitations associated with machine-learning models by providing understandable insights into heavy metal pollution. This enables a comparison of the importance of environmental factors and elucidates their directional impacts, thereby aiding in the understanding of interaction mechanisms. The methods and findings presented in this study offer valuable insights into the spatial heterogeneity of heavy metal pollution in soil. By focusing on the effects of interactive factors, we aimed to develop more accurate strategies for managing SHM pollution.

The finite element analysis study of the impact of single and double lag screw fixation on ankle fractures of different sizes.

In clinical practice, the choice of single vs. double screw fixation for posterior malleolus fractures (PMF) is theoretically unclear, particularly concerning the size-stability relationship. This study, employing Finite Element Analysis (FEA), assesses biomechanical stability in PMF of varying sizes under both fixation methods. Utilizing a 3D model based on CT scans, we simulated fractures with 10-50% fragment sizes and applied a 600 N force to mimic the single-leg stance. Our evaluation focused on screw Von Mises stress (VMS) and fracture relative displacement (RD). Results show that stability increases with fragment size for both fixation types. Single screw fixation is comparable to double screw in fragments up to 25%, but in larger fragments, double screw significantly enhances stability. This suggests that for fragments over 25%, double screw fixation is preferable, marking a critical threshold for PMF stability.

A spatial feature analysis of primary health care utilization in a large city in China and its implications for family doctor contract service policy.

BACKGROUND: Family doctor contract policy is now run by the State Council as an important move to promote the hierarchical medical system. Whether the family doctor contract policy achieves the initial government's goal should be measured further from the perspective of patient visits between hospitals and community health centers, which are regarded as grass medical agencies. METHODS: The spatial feature measurement method is applied with ArcGIS 10.2 software to analyze the spatial aggregation effect of patient visits to hospitals or community health centers among 20 districts of one large city in China and analyze the family doctor contract policy published in those areas to compare the influence of visit tendencies. RESULTS: From year 2016-2020, visits to hospitals were in the high-high cluster, and the density was spatially overflow, while there was no such tendency in visits to community health centers. The analysis of different family doctor contract policy implementation times in 20 districts reflects that the family doctor contract policy has a very limited effect on the promotion of the hierarchical medical system, and the innovation of the family doctor contract policy needs to be considered. CONCLUSIONS: A brief summary and potential implications. A multi-integrated medical system along with family doctor contract policy needs to be established, especially integrated in leadership and governance, financing, workforce, and service delivery between hospitals and community health centers, to promote the hierarchical medical system.

A novel risk model of three gefitinib-related genes FBP1, SBK1 and AURKA is related to the immune microenvironment and is predicting prognosis of lung adenocarcinoma patients.

PURPOSE: Gefitinib, an anticancer drug, has been reported to potentially improve the prognosis of patients with lung adenocarcinoma (LUAD). This study aims to investigate the roles and mechanisms of Gefitinib. METHODS: The effects of Gefitinib on the growth and migration of LUAD cells were assessed using various methods, including CCK-8, flow cytometry, wound healing, and Transwell assays. To analyze the function and mechanisms of the differentially expressed Gefitinib target genes (GTGs), data from the TCGA database were utilized. Kaplan-Meier survival and ROC analysis identified prognostic-related GTGs and constructed a prognostic nomogram in LUAD. Consensus clustering, COX analysis and survival analysis evaluated the relationship between GTGs and the prognosis of LUAD patients. The mechanisms of the risk model involved LUAD progression, and the relationship between the risk model and immune microenvironment were investigated. RESULTS: Gefitinib could inhibit proliferation, migration and invasion and promote cell apoptosis. 84 DEGTGs were involved in RAS, MAPK, ERBB pathways. The DEGTGs (FBP1, SBK1, and AURKA) were the independent risk factors for dismal prognosis of LUAD patients and were used to establish risk model and nomogram. Gefitinib could promote the expression of FBP1 and inhibit the expression of SBK1 and AURKA. High-risk LUAD patients had the dismal prognosis, and the high-risk score group was significantly associated with the immune microenvironment. CONCLUSION: FBP1, SBK1, and AURKA are prognostic risk factors, and the risk model and nomogram of FBP1, SBK1 and AURKA are associated with dismal prognosis and immune cell infiltration, and have huge prospects for application in evaluating the prognosis in LUAD.

A Study on Autophagy Related Biomarkers in Alzheimer's Disease Based on Bioinformatics.

Alzheimer's disease (AD) is a neurodegenerative disease with an annual incidence increase that poses significant health risks to people. However, the pathogenesis of AD is still unclear. Autophagy, as an intracellular mechanism can degrade damaged cellular components and abnormal proteins, which is closely related to AD pathology. The goal of this work is to uncover the intimate association between autophagy and AD, and to mine potential autophagy-related AD biomarkers by identifying key differentially expressed autophagy genes (DEAGs) and exploring the potential functions of these genes. GSE63061 and GSE140831 gene expression profiles of AD were downloaded from the Gene Expression Omnibus (GEO) database. R language was used to standardize and differentially expressed genes (DEGs) of AD expression profiles. A total of 259 autophagy-related genes were discovered through the autophagy gene databases ATD and HADb. The differential genes of AD and autophagy genes were integrated and analyzed to screen out DEAGs. Then the potential biological functions of DEAGs were predicted, and Cytoscape software was used to detect the key DEAGs. There were ten DEAGs associated with the AD development, including nine up-regulated genes (CAPNS1, GAPDH, IKBKB, LAMP1, LAMP2, MAPK1, PRKCD, RAB24, RAF1) and one down-regulated gene (CASP1). The correlation analysis reveals the potential correlation among 10 core DEAGs. Finally, the significance of the detected DEAGs expression was verified, and the value of DEAGs in AD pathology was detected by the receiver operating characteristic curve. The area under the curve values indicated that ten DEAGs are potentially valuable for the study of the pathological mechanism and may become biomarkers of AD. This pathway analysis and DEAG screening in this study found a strong association between autophagy-related genes and AD, providing new insights into the pathological progression of AD. Exploring the relationship between autophagy and AD: analysis of genes associated with autophagy in pathological mechanisms of AD using bioinformatics. 10 autophagy-related genes play an important role in the pathological mechanisms of AD.

Individualized active surveillance for carbapenem-resistant microorganisms using Xpert Carba-R in intensive care units.

Carbapenem antibiotics are widely used in ICU, and the prevalence of carbapenem-resistant microorganisms (CRO) has increased. This study aimed to assess the role of individualized active surveillance using Xpert Carba-R of carbapenem resistance genes on CRO risk. A total of 3,765 patients were admitted to the ICU of Zhongnan Hospital of Wuhan University between 2020 and 2022. The presence of carbapenem resistance genes were monitored using Xpert Carba-R, and CRO incidence was assigned as the investigated outcome. Of 3,765 patients, 390 manifested the presence of CRO, representing a prevalence of 10.36%. Active surveillance using Xpert Carba-R was associated with a lower CRO risk (odds ratio [OR]: 0.77; 95% confidence interval [CI] 0.62-0.95; P = 0.013), especially for carbapenem-resistant Acinetobacter + carbapenem-resistant Pseudomonas aeruginosa (OR: 0.79; 95% CI 0.62-0.99; P = 0.043), carbapenem-resistant Klebsiella pneumoniae (OR: 0.56; 95% CI 0.40-0.79; P = 0.001), and carbapenem-resistant Enterobacteriaceae (OR: 0.65; 95% CI 0.47-0.90; P = 0.008). Individualized active surveillance using Xpert Carba-R may be associated with a reduction in the overall CRO incidence in ICU. Further prospective studies should be performed to verify these conclusions and guide further management of patients in ICU.

Multiple-Beam Steering Using Graphene-Based Coding Metasurfaces.

Recently, the coding metasurface has gained significant attention due to its exceptional potential in controlling electromagnetic (EM) waves with the rapid development of wireless communication systems. Meanwhile, graphene shows tremendous promise for the implementation of reconfigurable antennas due to its high tunable conductivity and its unique property that makes it a very suitable material for realizing steerable coded states. In this paper, we first propose a simple structured beam reconfigurable millimeter wave (MMW) antenna using a novel graphene-based coding metasurface (GBCM). Different from the previous method, its coding state can be manipulated by altering the sheet impedance of graphene instead of bias voltage. Then, we design and simulate several most popular coding sequences, including dual-, quad-and single-beam-generated implement, 30° beam deflection, as well as a random coding sequence for radar cross-section (RCS) reduction. The theoretical and simulation results show that graphene has great potential for MMW manipulation applications, which lay a foundation for the subsequent development and fabrication of GBCM.

Clinical-pathological features and perioperative outcomes of mediastinoscopy vs. thoracoscopy esophagectomy in esophageal cancer: A meta-analysis.

Objective: To compare the clinicopathological features and perioperative outcomes of video-assisted mediastinoscopy esophagectomy (VAME) compared to video-assisted thoracoscopy esophagectomy (VATE) in esophageal cancer. Methods: We comprehensively searched online databases (PubMed, Embase, Web of Science and Wiley online library) to find available studies exploring the clinicopathological features and perioperative outcomes between VAME and VATE in esophageal cancer. Relative risk (RR) with 95% confidence interval (CI) and standardized mean difference (SMD) with 95% CI were used to evaluate the perioperative outcomes and clinicopathological features. Results: A total of seven observational studies and one randomized controlled trial involving 733 patients were considered eligible for this meta-analysis, of which 350 patients underwent VAME in contrast to 383 patients underwent VATE. Patients in the VAME group had more pulmonary comorbidities (RR = 2.18, 95% CI 1.37-3.46, P = 0.001). The pooled results showed that VAME shortened the operation time (SMD = -1.53, 95% CI -2.308--0.76, P = 0.000), and retrieved less total lymph nodes (SMD = -0.70, 95% CI -0.90--0.50, P = 0.000). No differences were observed in other clinicopathological features, postoperative complications or mortality. Conclusions: This meta-analysis revealed that patients in the VAME group had more pulmonary disease before surgery. The VAME approach significantly shortened the operation time and retrieved less total lymph nodes and did not increase intra- or postoperative complications.

Effect of Stereotactic Body Radiation Therapy on Diverse Organ Lesions in Advanced Non-Small Cell Lung Cancer Patients Receiving Immune Checkpoint Inhibitors.

OBJECTIVE: The combination of stereotactic body radiation therapy (SBRT) and immune checkpoint inhibitors (ICIs) is actively being explored in advanced non-small-cell lung cancer (NSCLC) patients. However, little is known about the optimal fractionation and radiotherapy target lesions in this scenario. This study investigated the effect of SBRT on diverse organ lesions and radiotherapy dose fractionation regimens on the prognosis of advanced NSCLC patients receiving ICIs. METHODS: The medical records of advanced NSCLC patients consecutively treated with ICIs and SBRT were retrospectively reviewed at our institution from Dec. 2015 to Sep. 2021. Patients were grouped according to radiation sites. Progression-free survival (PFS) and overall survival (OS) were recorded using the Kaplan-Meier method and compared between different treatment groups using the log-rank (Mantel-Cox) test. RESULTS: A total of 124 advanced NSCLC patients receiving ICIs combined with SBRT were identified in this study. Radiation sites included lung lesions (lung group, n=43), bone metastases (bone group, n=24), and brain metastases (brain group, n=57). Compared with the brain group, the mean PFS (mPFS) in the lung group was significantly prolonged by 13.3 months (8.5 months vs. 21.8 months, HR=0.51, 95%CI: 0.28-0.92, P=0.0195), and that in the bone group prolonged by 9.5 months with a 43% reduction in the risk of disease progression (8.5 months vs. 18.0 months, HR=0.57, 95%CI: 0.29-1.13, P=0.1095). The mPFS in the lung group was prolonged by 3.8 months as compared with that in the bone group. The mean OS (mOS) in the lung and bone groups was longer than that of the brain group, and the risk of death decreased by up to 60% in the lung and bone groups as compared with that of the brain group. When SBRT was concurrently given with ICIs, the mPFS in the lung and brain groups were significantly longer than that of the bone group (29.6 months vs. 16.5 months vs. 12.1 months). When SBRT with 8-12 Gy per fraction was combined with ICIs, the mPFS in the lung group was significantly prolonged as compared with that of the bone and brain groups (25.4 months vs. 15.2 months vs. 12.0 months). Among patients receiving SBRT on lung lesions and brain metastases, the mPFS in the concurrent group was longer than that of the SBRT→ICIs group (29.6 months vs. 11.4 months, P=0.0003 and 12.1 months vs. 8.9 months, P=0.2559). Among patients receiving SBRT with <8 Gy and 8-12 Gy per fraction, the mPFS in the concurrent group was also longer than that of the SBRT→ICIs group (20.1 months vs. 5.3 months, P=0.0033 and 24.0 months vs. 13.4 months, P=0.1311). The disease control rates of the lung, bone, and brain groups were 90.7%, 83.3%, and 70.1%, respectively. CONCLUSION: The study demonstrated that the addition of SBRT on lung lesions versus bone and brain metastases to ICIs improved the prognosis in advanced NSCLC patients. This improvement was related to the sequence of radiotherapy combined with ICIs and the radiotherapy fractionation regimens. Dose fractionation regimens of 8-12 Gy per fraction and lung lesions as radiotherapy targets might be the appropriate choice for advanced NSCLC patients receiving ICIs combined with SBRT.

Adjuvant zoledronic acid therapy for postmenopausal women with early breast cancer in China: a cost-effectiveness analysis.

Combination therapy of zoledronic acid (ZOL) plus aromatase inhibitor (AI) was found to reduce bone metastasis risk and improve overall survival for treatment-naïve postmenopausal women (PMW) with hormone receptor-positive (HR+) early breast cancer (EBC), when compared with AI alone. The objective of this study was to evaluate the cost-effectiveness of adding ZOL to AI in treating PMW with HR+ EBC in China. A 5-state Markov model was constructed to evaluate the cost-effectiveness of adding ZOL to AI for PMW-EBC (HR+) over a lifetime horizon from the perspective of Chinese healthcare provider. Data used were obtained from previous reports and public data. The primary outcomes of this study were direct medical cost, life years (LYs), quality-adjusted LYs (QALYs), and incremental cost-effectiveness ratios (ICERs). One-way and probabilistic sensitivity analyses were performed to examine the robustness of the presented model. Over a lifetime horizon, adding ZOL to AI was projected to yield a gain of 1.286 LYs and 1.099 QALYs compared with AI monotherapy, which yielded ICER $11 140.75 per QALY with an incremental cost of $12 247.36. The one-way sensitivity analysis indicated that the cost of ZOL was the most influential factor in our study. The probability that adding ZOL to AI was cost-effective at a threshold of $30 425 per QALY in China was 91.1%. ZOL is likely to be cost-effective in reducing bone metastasis risk and improving overall survival for PMW-EBC (HR+) in China.

Antioxidant and ultraviolet shielding performance of lignin-polysaccharide complex isolated from spent coffee ground.

Spent coffee ground (SCG) is a representative type of biomass waste with huge annual output. To better develop high value applications of SCG, in this study, the lignin-polysaccharide complex (LPC) was isolated from SCG by applying effective ball milling and the subsequent solvent extraction of 96 % 1, 4-dioxane aqueous solution. In addition to the comprehensive analyses of the obtained LPC regarding its chemical composition, surface morphology, molecular weight distribution, characteristic functional groups, surface chemical linkages, and thermal stability, its potentials in radical scavenging and UV shielding had been emphatically investigated. As revealed from the results, a proper duration (e.g., 4 h) of UV irradiation could evidently enhance the radical-scavenging capacity of LPC, ascribed to the increasing number of antioxidant groups. Moreover, the LPC-containing composite sunscreens also exhibited strengthened UV resistance after UV irradiation, which may benefit from the UV-induced conjugated structures and the π-π stacking of aromatic rings from both LPC and the active ingredients in commercial sunscreen. Therefore, LPC is highly promising to be exploited for the development of novel antioxidants and UV-shielding products, by virtue of its characteristic chemical structure and potential synergistic effect with other active ingredients from the composite.

The Inflammatory Gene PYCARD of the Entorhinal Cortex as an Early Diagnostic Target for Alzheimer's Disease.

The incidence of Alzheimer's disease (AD) is increasing year by year, which brings great challenges to human health. However, the pathogenesis of AD is still unclear, and it lacks early diagnostic targets. The entorhinal cortex (EC) is a key brain region for the occurrence of AD neurodegeneration, and neuroinflammation plays a significant role in EC degeneration in AD. This study aimed to reveal the close relationship between inflammation-related genes in the EC and AD by detecting key differentially expressed genes (DEGs) via gene function enrichment pathway analysis. GSE4757 and GSE21779 gene expression profiles of AD were downloaded from the Gene Expression Omnibus (GEO) database. R language was used for the standardization and differential analysis of DEGs. Then, significantly enriched Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were analyzed to predict the potential biological functions of the DEGs. Finally, the significant expressions of identified DEGs were verified, and the therapeutic values were detected by a receiver operating characteristic (ROC) curve. The results showed that eight up-regulated genes (SLC22A2, ITGB2-AS1, NIT1, FGF14-AS2, SEMA3E, PYCARD, PRORY, ADIRF) and two down-regulated genes (AKAIN1, TRMT2B) may have a potential diagnostic value for AD, and participate in inflammatory pathways. The area under curve (AUC) results of the ten genes showed that they had potential diagnostic value for AD. The AUC of PYCARD was 0.95, which had the most significant diagnostic value, and it is involved in inflammatory processes such as the inflammasome complex adaptor protein. The DEGs screened, and subsequent pathway analysis revealed a close relationship between inflammation-related PYCARD and AD, thus providing a new basis for an early diagnostic target for AD.

Did the general practice residents well adapt to real public health prevention --a study from the COVID-19 prevention training in China.

OBJECT: GP residents's has the obligation to take task with the public health prevetion. GP residents receive the public health training during their college study period and the residents training. The sudden outbreak of the COVID-19 epidemic, highlight the importance and competence of the community prevention as the front line of epidemic prevention and control, pushing the general practitioner (GP) residents into the front team of epidemic prevention and control. Residents' participation in epidemic prevention and control is not only a field workload participation in public health disease prevention and control, but also a rare and value-oriented training experience. This study aims to explores the research on the training content, ability improvement and cognitive load of the resident, and to demonstrate past and future training effects of epidemic prevention and control. METHODS: Object cognitive load scale (NASA-TLX scale) and self-developed questionnaires were adopted to conduct a questionnaire survey on resident doctors who were in GP training program from West China Hospital of Sichuan University, and finally 190 questionnaires were collected. SPSS 23.0 statistical software for statistical analysis of data. RESULT: Most indicators of cognitive load NASA scale are at a "moderate" level by the GP residents, generally indicating that the intensity of on-site epidemic prevention and control (training) can be tolerated. The chi-square test is used to study the status of "How responsible you are for epidemic prevention and control in a community in the future", the residents grade shows no significant difference while " how many months after the outbreak when you participated in the epidemic prevention" shows significant difference, the result show that GP residents already have konwledge and skills for the public health prevetion, they need more attitude and mental preparation. Continuing education will have a significant positive relationship with the GP residents's confidence of the prevetion ofpublic health prevetion. CONCLUSION: Former medical school education and training at the regulatory training stage have a good effect for residents to master the ability of epidemic prevention and control, and to prepare for the needs of epidemic prevention and control physically and mentally. After this stage, the epidemic prevention and control training under the real situation will make a great contribution to the self-assessment and performance improvement of the final general practitioners.

Multi-Beam Conformal Array Antenna Based on Highly Conductive Graphene Films for 5G Micro Base Station Applications.

Recently, micro base station antennas have begun to play a more important role in 5G wireless communication, with the rapid development of modern smart medical care, the Internet of things, and portable electronic devices. Meanwhile, in response to the global commitment to long-term carbon neutrality, graphene film has received significant attention in the field of antennas due to its low carbon environmental impact and high electrical conductivity properties. In this work, a conformal array antenna based on highly conductive graphene films (CGF) is proposed for 5G millimeter-wave (MMW) applications. The proposed antenna consists of three antenna arrays, with eight patch elements in each array, operating at 24 GHz, with linear polarization. Each antenna array's current amplitude distribution coefficient is constructed by synthesizing a series-feeding linear array using the Chebyshev method. The measurement results demonstrated that the proposed CGF antenna exhibits a peak realized gain higher than 8 dBi in the bandwidth of 23.0-24.7 GHz. The proposed antenna achieves three independent beams from bore-sight to ±37° in conformal installations, with a cylinder radius of 30 mm, showing excellent beam-pointing performance. These characteristics indicate that the CGF can be used for the design of MMW micro base station antennas, fulfilling the requirements of the conformal carrier platform for a lightweight and compact antenna.

Therapeutic targeting of glutamate dehydrogenase 1 that links metabolic reprogramming and Snail-mediated epithelial-mesenchymal transition in drug-resistant lung cancer.

Acquired drug resistance and epithelial-mesenchymal transition (EMT) mediated metastasis are two highly interacting determinants for non-small-cell lung cancer (NSCLC) prognosis. This study investigated the common mechanisms of drug resistance and EMT from the perspective of metabolic reprogramming, which may offer new ideas to improve anticancer therapy. Acquired resistant cells were found to grow faster and have a greater migratory and invasive capacity than their parent cells. Metabolomics analysis revealed that acquired resistant cells highly relied on glutamine utilization and mainly fluxed into oxidative phosphorylation energy production. Further mechanistic studies screened out glutamate dehydrogenase 1 (GLUD1) as the determinant of glutamine addiction in acquired resistant NSCLC cells, and provided evidence that GLUD1-mediated α-KG production and the accompanying reactive oxygen species (ROS) accumulation primarily triggered migration and invasion by inducing Snail. Pharmacological and genetic interference with GLUD1 in vitro significantly reversed drug resistance and decreased cell migration and invasion capability. Lastly, the successful application of R162, a selective GLUD1 inhibitor, to overcome both acquired resistance and EMT-induced metastasis in vivo, identified GLUD1 as a promising and druggable therapeutic target for malignant progression of NSCLC. Collectively, our study offers a potential strategy for NSCLC therapy, especially for drug-resistant patients with highly expressed GLUD1.

Pulse width and intensity effects of pulsed electric fields on cancerous and normal skin cells.

Microsecond pulsed electric fields (PEF) have previously been used for various tumour therapies, such as gene therapy, electrochemotherapy and irreversible electroporation (IRE), due to its demonstrated ability. However, recently nanosecond pulsed electric fields (nsPEF) have also been used as a potential tumor therapy via inducing cell apoptosis or immunogenic cell death to prevent recurrence and metastasis by interacting with intracellular organelles. A large proportion of the existing in-vitro studies of nsPEF on cells also suggests cell necrosis and swelling/blebbing can be induced, but the replicability and potential for other effects on cells suggesting a complicated process which requires further investigation. Therefore, this study investigated the effects of pulse width and intensity of nsPEF on the murine melanoma cells (B16) and normal murine fibroblast cells (L929) through electromagnetic simulation and in-vitro experiments. Through examining the evolution patterns of potential difference and electric fields on the intracellular compartments, the simulation has shown a differential effect of nsPEF on normal and cancerous skin cells, which explains well the results observed in the reported experiments. In addition, the modelling has provided a clear evidence that a few hundreds of ns PEF may have caused a mixed mode of effects, i.e. a 'cocktail effect', including cell electroporation and IRE due to an over their threshold voltage induced on the plasma membrane, as well as cell apoptosis and other biological effects caused by its interaction with the intracellular compartments. The in-vitro experiments in the pulse range of the hundreds of nanoseconds showed a possible differential cytotoxicity threshold of electric field intensity between B16 cells and L929 cells.

Training needs and curriculum of continuing medical education among general practitioners in Tibet, China: A cross-sectional survey.

Background: Uneven distribution of health resources is higher in Tibet than in other regions. The development of core professional capability for general practitioners (GPs) is the main goal of continuing medical education (CME) training programs. Aim: This study aimed to explore the needs of CME for GPs and provide advice for the development of policy, practice, and CME curriculums. Methods: We conducted a cross-sectional online survey among GPs in Tibet Autonomous Region, China. We designed an online questionnaire including the demographic section, training contents, and training formats about CME. Results: A total of 108 questionnaires were included in this study. Notably, 79 (73.15%) were women and 56 participants (51.85%) were working in primary care settings. We developed a curriculum priority: first-choice, major alternatives, and secondary considerations. The topics identified as first-choice for CME were related to "cardiovascular disease" (85.19%), "respiratory disease" (81.48%), and "digestive disease" (80.56%). Major alternatives included two essential knowledge and eight clinical skill items. We rated 10 items as secondary considerations. Only 39.81% ranked mental health as an essential priority; bedside teaching (51.85%) was the first choice. Conclusion: We presented priority areas identified in this study to focus on CME for GPs in Tibet. The 23 topics may reflect the features of general practice, which increasingly require common disease management skills, while a demand-oriented curriculum and staged training plans should be adopted. CME programs should be adapted dynamically to respond to evolving needs.

MiR-942-3p as a Potential Prognostic Marker of Gastric Cancer Associated with AR and MAPK/ERK Signaling Pathway.

Gastric cancer is a common tumor with high morbidity and mortality. MicroRNA (miRNA) can regulate gene expression at the translation level and various tumorigenesis processes, playing an important role in tumor occurrence and prognosis. This study aims to screen miRNA associated with gastric cancer prognosis as biomarkers and explore the regulatory genes and related signaling pathways. In this work, R language was used for the standardization and differential analysis of miRNA and mRNA expression profiles. Samples were randomly divided into a testing group and a training group. Subsequently, we built the five miRNAs (has-miR-9-3p, has-miR-135b-3p, has-miR-143-5p, has-miR-942-3p, has-miR-196-3p) prognostic modules, verified and evaluated their prediction ability by the Cox regression analysis. They can be used as an independent factor in the prognosis of gastric cancer. By predicting and analyzing potential biological functions of the miRNA target genes, this study found that the AR gene was not only a hub gene in the PPI network, but also associated with excessive survival of patients. In conclusion, this study demonstrated that hsa-miR-942-3p could be a potential prognostic marker of gastric cancer associated with the AR and MAPK/ERK signaling pathways. The results of this study provide insights into the occurrence and development of gastric cancer.

High-Performance and Water Resistant PVA-Based Films Modified by Air Plasma Treatment.

Plasma treatment is considered a straightforward, cost-effective, and environmental-friendly technique for surface modification of film materials. In this study, air plasma treatment was applied for performance improvement of pure PVA, cellulose nanocrystal (CNC)/PVA, and CNC/oxalic acid (OA)/PVA films. Compared with the original performance of pure PVA, the mechanical properties and water resistance of air plasma treated films were greatly improved. Among them, the CNC/OA/PVA film treated by three minutes of air plasma irradiation exhibits the most remarkable performance in mechanical properties (tensile strength: 132.7 MPa; Young's modulus: 5379.9 MPa) and water resistance (degree of swelling: 47.5%; solubility: 6.0%). By means of various modern characterization methods, the wettability, surface chemical structure, surface roughness, and thermal stability of different films before and after air plasma treatment were further revealed. Based on the results obtained, the air plasma treatment only changed the surface chemical structure, surface roughness, and hydrophobicity, while keeping the inner structure of films intact.