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Objective To evaluate the improvement effect of the modified three-step method(theoretical knowledge, basic skills, practical operation) applied in the training of laparoscopic skills of Eight-year Program of Clinical Medical students. Methods A total of 6 medical students in Peking Union Medical College who were in practice or just after practice and had no experience in laparoscopic operation were randomly selected as the experimental group for a period of 10 weeks, one time a week, 3 hours each time of modified three-step laparoscopic basic operation skills training and 6 medical students during the same period were trained by tradional method used as the control. The level of basic skill operation of medical students was evaluated at the beginning and at the end of the training in 10 items: basic clamping, advanced clamping, pile clamping, imitation meat suture, blunt separation, ultrasonic knife separation, ultrasonic knife cutting, simple intermittent suture, continuous suture, and lymphatic dissection. Results At the end of the training, students of experimental group performed better in 7 items of basic clamping, advanced clamping, pile clamping, imitation meat suture, ultrasonic knife separation, ultrasonic knife cutting and continuous suture. The operation time was significantly reduced or the score was significantly improved (P＜0.05). Conclusions The training of the improved three-step method can significantly improve the basic skills of laparoscopic operation of eight-year medical students, lay a solid foundation for the formal clinical operation and is an effective training method for medical students.

An tea is highly valued for its unique post-fermentation process, which enriches its flavor and aroma. In this study, the digestion and fermentation characteristics of An tea polysaccharides (ATPSs) were investigated in vitro. The results indicated that the molecular weight and sugar content of ATPSs remained unchanged during simulated saliva, gastric, and small intestinal digestion but were reduced during fermentation, suggesting that ATPSs could pass the digestive system and be metabolized by the gut microbiota. Notably, ATPSs modulated the gut microbiota, reducing pathogenic bacteria such as Desulfovibrio and Escherichia, while enhancing beneficial genera like Lactobacillus, Bifidobacterium, and Prevotella, alongside an increase in short-chain fatty acids (SCFAs). In vivo experiments on C57BL/6J mice demonstrated that ATPSs promoted the levels of Lactobacillus and Bifidobacterium. These findings suggest that ATPSs could serve as a potential prebiotic to improve human health by modulating the gut microbiota. [ABSTRACT FROM AUTHOR]

Context Genetic testing for 21-hydroxylase deficiency (21-OHD) is always challenging. The current approaches of short-read sequencing and multiplex ligation-dependent probe amplification (MLPA) are insufficient for the detection of chimeric genes or complicated variants from multiple copies. Recently developed long-read sequencing (LRS) can solve this problem. Objective To investigate the clinical utility of LRS in precision diagnosis of 21-OHD. Methods In the cohort of 832 patients with 21-OHD, the current approaches provided the precise molecular diagnosis for 81.7% (680/832) of cases. LRS was performed to solve the remaining 144 cases with complex chimeric variants and 8 cases with variants from multiple copies. Clinical manifestations in patients with continuous deletions of CYP21A 2 extending to TNXB (namely CAH-X) were further evaluated. Results Using LRS in combination with previous genetic test results, a total of 16.9% (281/1664) CYP21A1P/CYP21A2 or TNXA/TNXB chimeric alleles were identified in 832 patients, with CYP21A1P / CYP21A2 accounting for 10.4% and TNXA / TNXB for 6.5%. The top 3 common chimeras were CYP21 CH-1, TNX CH-1, and TNX CH-2, accounting for 77.2% (217/281) of all chimeric alleles. The 8 patients with variants on multiple copies of CYP21A2 were accurately identified with LRS. The prevalence of CAH-X in our cohort was 12.1%, and a high frequency of connective tissue-related symptoms was observed in CAH-X patients. Conclusion LRS can detect all types of CYP21A2 variants, including complex chimeras and pathogenic variants on multiple copies in patients with 21-OHD, which could be utilized as a first-tier routine test for the precision diagnosis and categorization of congenital adrenal hyperplasia. [ABSTRACT FROM AUTHOR]

Introduction: Growth hormone (GH) is crucial for immune system development and regulation, potentially benefiting COVID-19 outcomes. However, there are limited studies on the role of GH treatment in COVID-19 in children with short stature. Methods: We conducted a survey study to evaluate the association between GH treatment and COVID-19 risk in short stature children aged 7 to 18 years. Two groups were defined: GH Treated and GH Untreated. The primary endpoint was the proportion of children with COVID-19 histories. Secondary endpoints included the presence, severity, and duration of COVID-19 symptoms. Exploratory endpoints included the frequency of common colds after GH treatment. We further performed two-sample Mendelian randomization (MR) analyses to explore the causal relationship between GH levels and COVID-19 susceptibility, hospitalization, and severity using genome-wide association study summary-level data. Results: Of the 201 children, 113 (56.2%) reported COVID-19 history, and 149 (74.1%) used GH. The mean age was 11.02 ± 2.10 years. GH treatment was associated with a somewhat lower proportion of COVID-19 history (− 9.77%, 95% confidence interval [CI] − 26.41% to 6.87%; P = 0.289), and the odds ratio (OR) is 0.58 (95% CI 0.29 to 1.14, P = 0.120) after adjusting for confounders. Among the 113 children with COVID-19 histories, the highest body temperature was significantly lower in the GH Treated group (P = 0.040). In the MR analyses, for one unit increase in GH level, the OR was 0.95 (95% CI 0.92 to 0.99, P = 0.022) for COVID-19 susceptibility, 0.86 (95% CI 0.77 to 0.96, P = 0.007) for COVID-19 hospitalization, and 0.95 (95% CI 0.84 to 1.07, P = 0.392) for COVID-19 severity. Conclusion: GH treatment was associated with somewhat decreased COVID-19 susceptibility but was not statistically significant. Higher GH levels were causally associated with a significantly lower rate of COVID-19 susceptibility and hospitalization. [ABSTRACT FROM AUTHOR]

To analyse the vertical dynamic characteristics of the aircraft towing system under different constraints on the nose landing gear wheels of the aircraft during the towing slip-out mode, a dynamic model of the towing system considering the constraints between the clamping mechanism and the aircraft nose landing gear wheels was established based on the general towing system dynamic model. On this basis, an analysis was conducted to determine whether considering the aircraft wheel constraints affects the vertical vibration acceleration of the towing vehicle and the nose landing gear in low-speed (10 km/h) and high-speed (40 km/h) operating conditions. With the consideration of constraints at both ends of the aircraft wheels, the vertical acceleration of the towing vehicle's centre of mass increased by 153% and 172% at low speed and high speed, respectively, compared to not considering the aircraft wheel constraints. Additionally, with the consideration of constraints at both ends of the aircraft wheels, the vertical acceleration of the nose landing gear's centre of mass decreased to 20% and 57% at low speed and high speed, respectively, compared to not considering the aircraft wheel constraints. An analysis of the vertical vibration acceleration of the towing vehicle under different wheel constraint conditions found that the Root Mean Square (RMS) value of the vertical vibration acceleration of the towing vehicle's centre of mass was minimized when the clamping angles of the clamping mechanism to the nose landing gear wheels were 63° and 64°, respectively. Under this clamping angle, the influence of the clamping forces at both ends of the clamping mechanism on the vertical vibration acceleration of the towing vehicle was minimal. The research results provide valuable reference for the direct constraints between the clamping mechanism and the nose landing gear wheels in the aircraft towing slip-out system. [ABSTRACT FROM AUTHOR]

This article explores the use of breast cancer organoids (BCOs) in personalized medicine. The study reveals that BCOs effectively preserve molecular characteristics in hormone receptor-positive and HER2-positive breast cancers, but there are notable differences in triple-negative breast cancer (TNBC) due to culture conditions. BCOs exhibit a decrease in immune and stromal cells compared to primary breast cancer tissues, but an increase in epithelial cells. The study also investigates genomic concordance, gene expression profiling, and drug sensitivity in BCOs. The findings suggest that BCOs are valuable for studying epithelial components of tumors, but may have limitations in accurately predicting drug sensitivity in TNBC. The article provides supporting information for a research project and is authored by a group of individuals whose names are listed at the end of the article. [Extracted from the article]

Analyzing degradation heterogeneity of proton exchange membrane fuel cell (PEMFC) while maintaining high practicality is consistently challenging, primarily due to the destructive and costly nature of existing techniques relying on material characterization. In this work, a designed magnetic array integrating 16 sensors within 25 cm2 space is used for direct scanning and imaging of PEMFC performance heterogeneity during its degradation. Results are validated through degradation mechanism analysis and material characterization, confirming its potential in guiding the development of durable materials. [ABSTRACT FROM AUTHOR]

Building on earlier research that examined the characteristics people associate with heroes, our research examined similarities and differences of the hero stereotype across cultures. Specifically, in Study 1 (N = 209) and Study 2 (N = 298), we investigated lay perceptions of heroes among participants from a collectivistic culture. In Study 3 (N = 586), we examined whether group membership could be determined by participants' centrality ratings of the combined set of hero features. In Study 4 (N = 197), we tested whether the hero features that distinguish American and Chinese participants, when used to describe a target person, influence the impression that the target person is a hero. In Study 5 (N = 158) and Study 6 (N = 591), we investigated cultural differences in perceptions of different types of heroes (e.g., social, martial, civil) and the influence of individualism and collectivism on the perception of those heroes. [ABSTRACT FROM AUTHOR]