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Aim To optimize gastric cancer screening score and reduce screening costs using machine learning models. Methods This study included 228,634 patients from the Taizhou Gastric Cancer Screening Program. We used three machine learning models to optimize Li's gastric cancer screening score: Gradient Boosting Machine (GBM), Distributed Random Forest (DRF), and Deep Learning (DL). The performance of the binary classification models was evaluated using the area under the curve (AUC) and area under the precision–recall curve (AUCPR). Results In the binary classification model used to distinguish low-risk and moderate- to high-risk patients, the AUC in the GBM, DRF, and DL full models were 0.9994, 0.9982, and 0.9974, respectively, and the AUCPR was 0.9982, 0.9949, and 0.9918, respectively. Excluding Helicobacter pylori IgG antibody, pepsinogen I, and pepsinogen II, the AUC in the GBM, DRF, and DL models were 0.9932, 0.9879, and 0.9900, respectively, and the AUCPR was 0.9835, 0.9716, and 0.9752, respectively. Remodel after removing variables IgG, PGI, PGII, and G-17, the AUC in GBM, DRF, and DL was 0.8524, 0.8482, 0.8477, and AUCPR was 0.6068, 0.6008, and 0.5890, respectively. When constructing a tri-classification model, we discovered that none of the three machine learning models could effectively distinguish between patients at intermediate and high risk for gastric cancer (F1 scores in the GBM model for the low, medium and high risk: 0.9750, 0.9193, 0.5334, respectively; F1 scores in the DRF model for low, medium, and high risks: 0.9888, 0.9479, 0.6694, respectively; F1 scores in the DL model for low, medium, and high risks: 0.9812, 0.9216, 0.6394, respectively). Conclusion We concluded that gastric cancer screening indicators could be optimized when distinguishing low-risk and moderate to high-risk populations, and detecting gastrin-17 alone can achieve a good discriminative effect, thus saving huge expenditures.

Background: This study focused on the integrated post-acute care (PAC) stage of stroke patients, and employed a retrospective study to examine the satisfaction with life quality in two groups, one that received home-based rehabilitation and one that received hospital-based rehabilitation. A secondary purpose was to analyze the correlations among the index and components concerning their quality of life (QOL) and compare the advantages and disadvantages of these two approaches to PAC. Methods: This research was a retrospective study of 112 post-acute stroke patients. The home-based group received rehabilitation for one to two weeks, and two to four sessions per week. The hospital-based group received the rehabilitation for three to six weeks, and 15 sessions per week. The home-based group mainly received the training and guidance of daily activities at the patients’ residence. The hospital-based group mainly received physical facilitation and functional training in the hospital setting. Results: The mean scores of QOL assessment for both groups were found to be significantly improved after intervention. Between-group comparisons showed that the hospital-based group had better improvement than the home-based group in mobility, self-care, pain/discomfort and depression/anxiety. In the home-based group, the MRS score and the participant's age can explain 39.4% of the variance of QOL scores. Conclusion: The home-based rehabilitation was of lower intensity and duration than the hospital-based one, but it still achieved a significant improvement in QOL for the PAC stroke patients. The hospital-based rehabilitation offered more time and treatment sessions. Therefore hospital-based patients responded with better QOL outcomes than the home-based patients.

Abstract Background We performed Mendelian randomization (MR) to assess the causal effect of tea intake on rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods Genetic instruments for tea intake were obtained from a large genome-wide association study (GWAS) dataset of the UK Biobank. Genetic association estimates for RA (6236 cases and 147,221 controls) and SLE (538 cases and 213,145 controls) were obtained from the FinnGen study through the IEU GWAS database. Results MR analyses using the inverse-variance weighted method showed that tea intake was not associated with risk of RA [odds ratio (OR) per standard deviation increment in genetically predicted tea intake = 0.997, 95% confidence interval (CI) 0.658–1.511] and SLE (OR per standard deviation increment in genetically predicted tea intake = 0.961, 95% CI 0.299–3.092). Weighted median, weighted mode, MR-Egger, leave-one-out and multivariable MR controlling for several confounding factors including current tobacco smoking, coffee intake, and alcoholic drinks per week yielded completely consistent results. No evidence of heterogeneity and pleiotropy was found. Conclusion Our MR study did not suggest a causal effect of genetically predicted tea intake on RA and SLE.

“Center edge” is a classical theory used to explain education and national development in comparative higher education research. The study analyzes the objective trend and the role of public health and preventive medicine education from the theory through multidimensional interpretation of policy requirements, epidemic demand, education supply and foreign experience, points out that public health education should become the communication center from university to society and disseminate public health education among the public actively. But there are practical bottlenecks in the development of public health and preventive medicine education in China, such as insufficient professional identity from the vague target positioning, existing gap between education and new medicine standard, and the weakness of public health knowledge and skills in the training of clinical medical talents. It is necessary to reform the mode of public health and general medicine talent training comprehensively and gradually, especially to promote the enrollment of large categories, separate track training and layered training. At the same time, we should pool the joint efforts of schools, governments, relevant institutions and society to establish a full chain development mechanism for public health talents under the system integrating the concept of “starting-process-result”.

C30H36F2N6O9S, orthorhombic, P212121 (no. 19), a = 5.2364(8) Å, b = 10.0250(14) Å, c = 59.689(9) Å, V = 3133.4(8) Å3, Z = 4, Rgt(F) = 0.0384, wRref(F2) = 0.0969, T = 170 K.

For GaN-based vertical-cavity surface-emitting lasers (VCSELs), a suitable current confinement layer is essential for high-performance devices. The effect of different current confinement layers, including SiO2, AlN, and diamond, on the performance of GaN-based VCSELs was compared through simulation. The devices’ heat dissipation and current confinement characteristics were analyzed based on the electro-opto-thermal model. Considering thermal management, the diamond was a better candidate under high injected current. Benefiting from the excellent heat dissipation, the device with diamond shows a significant improvement in output power and the thermal roll-over current. This work gives a superior option for the current confinement layer and can be helpful for future design and fabrication of high-power GaN-based VCSELs.

Background: Sjögren’s syndrome (SjS) is a rare autoimmune disease, and despite our knowledge of SjS, we still lack effective treatments. Chloroquine drugs used to treat autoimmune diseases are still the primary medicine for SjS but increase the risk of chloroquine retinopathy. Objectives: The objective of this study is to use Optical Coherence Tomography Angiography (OCTA) images to monitor the microvascular changes in the fundus of SjS patients after hydroxychloroquine (HCQ) treatment and the feasibility of using them as diagnostic indicators. Design: This is a retrospective observational cohort study. Methods: Twelve healthy controls (HCs group; 24 eyes), 12 SjS patients (SjS group; 24 eyes), and 12 SjS patients treated with HCQ (HCQ group; 24 eyes) were recruited. Three-dimensional OCTA images of the retina were collected, and microvascular density was calculated for each eye. OCTA image segmentation for analysis was conducted using the central wheel division method (C1–C6), hemisphere segmentation method (SR, SL, IL, and IR), and the early treatment of diabetic retinopathy study method (ETDRS) (R, S, L, and I). Results: Retinal microvascular density was significantly lower in the SjS patients compared to the HCs group ( p

Aluminum is the second largest metallic material after steel. It is also an indispensable and basic raw material in the economic development of a country. Besides, aluminum is known as a green strategic material due to its efficient recycling performance. China’s aluminum industry has made remarkable achievements in technological innovation and scientific progress through decades of development. However, in recent years, the huge production scale of the aluminum industry has increasingly prominent problems of limited resources, rising energy costs, and environmental pollution. It should be realized that the development and survival of China’s aluminum industry have reached a very critical period. This paper comprehensively studied the current situation of the production and technology of China’s aluminum metallurgical industry. Major contradictions and challenges faced by the development of China’s aluminum industry in the fields of resources, energy, and the environment were revealed. In addition, the competitiveness of the production cost for Chinese alumina refining and aluminum smelting in the world was compared and analyzed. It is shown that the major factors restricting China’s aluminum industry development include the lack of high-quality bauxite resources, high energy costs, the requirement for further improvement of the production technology, and no effective treatment of solid and hazardous wastes. Hence, a development strategy for China’s aluminum industry was proposed, which includes the strict control of the production capacity without out-of-order expansion and establishment of a reasonable industry arrangement, optimization of the resource and energy supply structure, improvement of the production core competitiveness by implementing high-quality, energy-saving, and low consumption strategy, and realizing standardized discharge and resource utilization of waste gas emissions, wastewater, and solid disposals from China’s aluminum industry. The research results of this work are of great significance to the industrial structure adjustment and high-quality, sustainable development for China’s aluminum industry.

Abstract Purpose To explore functional connectivity density (FCD) values of brain areas in children with strabismus and amblyopia (SA) based on blood oxygen level-dependent (BOLD) signals. Methods This study recruited 26 children (14 male, 12 females) with SA and 26 healthy children (14 male, 12 female) as healthy controls (HCs). Both groups matched in age, gender, educational level and socioeconomic background. While resting, all participants underwent fMRI scanning and global FCD (gFCD) and local FCD (lFCD) values were calculated. Receiver operating characteristic (ROC) curves were created to investigate whether there was a significant difference between children with SA and healthy controls. Results When compared with healthy controls, children with SA had significantly lower gFCD values in the right cerebellum, left putamen, and right superior frontal gyrus; however, the same metrics showed opposite changes in the right angular gyrus, left middle cingulate gyrus, left angular gyrus, right superior parietal gyrus, and right middle frontal gyrus. In children with SA, lFCD values were found to be remarkably decreased in regions of the middle right temporal pole, right cerebellum, left putamen, left hippocampus, right hippocampus, left thalamus, left cerebellum; values were increased in the right superior parietal gyrus as compared with healthy controls. Conclusion We noted abnormal neural connectivity in some brain areas of children with SA; detailing such connectivity aberrations is useful in exploring the pathophysiology of SA and providing useful information for future clinical management.

ObjectiveTo explore influencing factors of doctor-patient information communication (DPIC) and to provide evidences for improving the situation of DPIC in China.MethodsTo screen influencing factors of DPIC based on grounded theory, we conducted an expert fractal analysis and semi-structured interviews among 8 schoolors engaged in medical humanities education and research, 20 senior doctors and 20 patients in three tertiary hospitals in Nanjing city using purposive sampling. With the coded influencing factors prelimilarily determined, we compiled a questionnaire. Then we conducted an on-site self-administered questionnaire survey among 2 727 medical professionals and 1 781 patients and their relatives recruited using cluster random sampling at tertiary hospitals in 23 municipalities/provinces across China during March – May 2016. We analyzed the data collected for weighting and ranking all influencing factor of DPIC by comprehensive and average impact scores calculated for each of the factors.ResultsOf the surveyed medical professionals and patients and their relatives, 45.9% and 44.1% reported a strong willingness to conduct DPIC; 75.9% and 71.4% affirmed the necessity of governmental agencies' role in DPIC; 49.0% and 53.9% evaluated the role of media and network in DPIC as very necessary; 21.6% and 18.0% approved representative role of medical associations in the process of DPIC but only 14.5% and 26.7% approved the representative role of consumers associations. There were significant disparities between medical professionals and patients and their relatives in attitudes towards DPIC and its relevant dimensions mentioned above (all P < 0.01). The rank order from high to low for impact scores of DPIC influencing factors was governmental administration (score = 3.69), demand for the communication (3.34), media and network (3.18), medical association (2.56), and consumer association (2.21) among the medical professionals; while among the patients and their relatives, the rank order was government administration (3.61), media and network (3.32), demand for the communication (3.25), consumer association (2.71), and medical association (2.47).ConclusionA good doctor-patient information communication comes from the joint efforts among medical staff, patients, government agencies, media and network, and relevant social organizations. The study result suggests that a comprehensive platform needs to be established to promote the communication.

Hyperglycemia, which can be caused by either an insulin deficit and/or insulin resistance, is the main symptom of Type 2 diabetes, a significant endocrine metabolic illness. Conventional medications, including insulin and oral antidiabetic medicines, can alleviate the signs of diabetes but cannot restore insulin release in a physiologically normal amount. The liver detects and reacts to shifts in the nutritional condition that occur under a wide variety of metabolic situations, making it an essential organ for maintaining energy homeostasis. It also performs a crucial function in glucolipid metabolism through the secretion of hepatokines. Emerging research shows that feeding induces hepatokines release, which regulates glucose and lipid metabolism. Notably, these feeding-induced hepatokines act on multiple organs to regulate glucolipotoxicity and thus influence the development of T2DM. In this review, we focus on describing how feeding-induced cross-talk between hepatokines, including Adropin, Manf, Leap2 and Pcsk9, and metabolic organs (e.g.brain, heart, pancreas, and adipose tissue) affects metabolic disorders, thus revealing a novel approach for both controlling and managing of Type 2 diabetes as a promising medication.

Hepatitis C remains a major public health problem in the world. The host immune system plays a key role in viral clearance. This study aimed to investigate the connection between retinoic acid-inducible gene I-like (RIG-I-like) receptor gene polymorphism and hepatitis C chronicity in the Chinese Han population. The current study genotyped three SNPs (IFIH1 rs10930046 and DHX58 rs2074158, rs2074160) to assess their association with the chronicity of hepatitis C virus (HCV) infection among 1,590 participants (590 spontaneous HCV clearance cases and 1,000 persistent infection patients). Our research shows that DHX58 rs2074158-G allele (dominant model: adjusted OR = 1.53, 95% CI [1.20–1.95], P = 0.001; additive model: adjusted OR = 1.50, 95% CI [1.27–1.78], P

AIM: To assess changed spontaneous brain activity in hyperthyroid exophthalmos (HE) patients by the amplitude of the low-frequency fluctuation (ALFF) method, and to analyze the correlation between brain activity and ALFF values in these patients. METHODS: Totally 18 HE and 18 hyperthyroid non-exophthalmos (HNE) patients were enrolled. The participants were tested by resting-state functional magnetic resonance imaging, and receiver operating characteristic (ROC) curves were generated to classify the ALFF values of the study population. Pearson's correlation analysis was utilized to evaluate the relationship between the ALFF values obtained from different brain areas and clinical manifestations. RESULTS: Contrary to HNE patients, we observed lower ALFF values in the left calcarine fissure and surrounding cortex (LCFSC) in HE patients. In the ROC curve analysis of the LCFSC, the area under the curve reflected a high degree of accuracy. In addition, there was positive correlation between mean ALFF values of the LCFSC and the best-corrected visual acuity of the affected eyes. CONCLUSION: The study displays abnormal brain activity in LCFSC in patients with HE, which might suggest pathological mechanism of visual impairment of HE patients.

AIM: To investigate the retinal vascular network alterations in eyes of patients with pterygium. METHODS: Totally 18 left eyes from 18 female pterygium patients and 18 left eyes from 18 female healthy control subjects were enrolled. Optical coherence tomography angiography (OCTA) images were generated of the superficial retinal layer and deeper retinal layer of the macular retina for each eye. The microvascular (MIR) and macrovascular (MAR) densities were calculated and MIR, MAR, and total microvascular (TMI) density was compared in the healthy control and pterygium groups. RESULTS: In pterygium group, in the superficial retinal layer, the vascular density in superficial MIR, superior right (SR), inferior right (IR), right (R), superficial central annuli (SC)1, SC2, and SC3 decreased significantly in the macular area (P0.05). CONCLUSION: OCTA findings suggest that pterygium patients present with decreased retinal MIR density, and the major vascular alterations occurr mainly on the bitamporal side. The vascular density of the superficial SC1, SC2, SC3 adjacent to the foveal and deep layer of DC2, DC2 regions, significantly decreased.

We used correlation analysis to examine whether changes in grey matter volume in patients correlated with clinical presentation. gray matter volume was markedly reduced in neovascular glaucoma patients than healthy controls in the following brain regions: left cingulum anterior/medial frontal gyrus; left middle frontal gyrus, orbital part; left inferior frontal gyrus, orbital part; superior temporal gyrus/right frontal inferior orbital part. VBM directly suggests that neovascular glaucoma patients have changed in the volume of multiple brain regions. These changes exist in brain areas related to the visual pathway, as well as other brain areas which are not related to vision. The alteration of specific brain areas are closely related to clinical symptoms such as increased intraocular pressure and optic nerve atrophy in neovascular glaucoma patients. In conclusion, neovascular glaucoma may cause paralgesia, anxiety, and depression in patients.

The spontaneous changes in brain activity in patients with diabetic optic neuropathy using steady-state fMRI. The fractional amplitude of the low-frequency fluctuation method was applied to evaluate neural activity changes. The Hospital Anxiety and Depression Scale was used to assess the anxiety and depression status of participants. The independent sample t-test and chi-squared test were applied to analyze the demographics of diabetic optic neuropathy patients and healthy controls. Receiver operating characteristic curves were applied to analyze the variation in mean fractional amplitude of low-frequency fluctuation values between diabetic optic neuropathy patients and healthy controls. Pearson’s correlation analysis analyzed the relationships between the fractional amplitude of low-frequency fluctuation values of brain regions and clinical behaviors in the diabetic optic neuropathy group. The fractional amplitude of low-frequency fluctuation value of diabetic optic neuropathy patients was significantly higher than healthy controls in the right precentral gyrus. However, the fractional amplitude of low-frequency fluctuation values in the right anterior cingulate gyrus and left middle cingulate gyrus were markedly decreased in diabetic optic neuropathy patients. The area under the curve of receiver operating characteristics for each brain region showed high accuracy. Pearson’s correlation analysis showed that fractional amplitude of low-frequency fluctuation values of the right anterior cingulate gyrus and left middle cingulate gyrus was negatively correlated with Hospital Anxiety and Depression Scale scores. The fractional amplitude of low-frequency fluctuation values of the left middle cingulate gyrus was negatively correlated with diabetic optic neuropathy disease duration. In conclusion, we found abnormal spontaneous brain activities in regions related to cognitive and emotional dysfunction, eye movement disorder, and vision loss in patients with diabetic optic neuropathy. These results may indicate the underlying neuropathological mechanisms of diabetic optic neuropathy and show that fractional amplitude of low-frequency fluctuation may be an effective method to distinguish patients with diabetic optic neuropathy from healthy individuals.