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Background With the development of society and the improvement of people's living standards, health issues are receiving increasing attention. The aging population and the high incidence of chronic diseases have made health management an urgent problem that needs to be addressed. Primary healthcare institutions, as the "main battlefield" for residents' health, play a crucial role in health management. However, in the current implementation of health management, primary healthcare institutions still face numerous challenges, and their proactivity remains unclear. Objective To understand the current implementation status of health management in primary healthcare institutions in Shanghai and to discuss strategies for enhancing the implementation of proactive health-oriented health management. Methods From February 2023 to May 2023, a survey was conducted on 33 primary healthcare institutions in Shanghai. The survey aimed to understand the implementation of health management, assessment of high-risk factors and disease screening, execution of health education and information dissemination, coordination of health management resources and functional services, as well as the status of online health management services and health monitoring. Additionally, interviews were conducted with institution heads to gather information on implementation difficulties and suggestions. Results The research results showed that all participating institutions carried out health management for chronic disease patients, with 93.9% (31/33) covering key populations, 72.7% (24/33) involving rehabilitation populations, and 54.6% (18/33) including healthy populations. A total of 81.8% (27/33) of institutions utilized health data platforms, with the main functions including contract management, health record management, data querying, and health indicator management. Furthermore, 97.0% (32/33) of institutions conducted high-risk factor assessments and disease screenings, as well as follow-up, diagnosis, and management. The majority of institutions carried out health education and information dissemination activities through various platforms. Additionally, 87.9% (29/33) of institutions collaborated with other units to implement health management projects, providing diverse functional services. About 63.6% (21/33) of institutions offered online services, and 42.4% (14/33) were equipped with health monitoring devices. Managers believed that primary healthcare institutions and their staff have significant advantages in implementing proactive health-oriented management, but they also face challenges due to a lack of policy and financial support. Conclusion Primary healthcare institutions in Shanghai have made positive progress in implementing proactive health-oriented management. However, comprehensive measures are still needed to address existing challenges, in order to further improve the quality and efficiency of health management services and better meet the health needs of residents.

To improve people's health via meeting their growing health needs, the "Healthy China 2030" Planning Outline highlights the concept of protective care, and actively promotes the transformation from disease-centered care to human-centered care. There is still no a standard proactive care system. We summarized the essence, development status and significance of proactive care, then based on this, explored implementation strategies and assessment system regarding proactive care management conducted by community health institutions and community medical workers. We believe that community health institutions and community medical workers play an important role in the implementation of proactive care, and improving people's awareness of proactive care and self-health management ability via integrating proactive care into health management is of great significance to improve the national health level.

Background: Coronavirus disease (COVID)-19 can lead to chronic lung damage and respiratory issues, potentially increasing surgical difficulty and risk for patients with non-small-cell lung cancer (NSCLC). However, the impacts of a COVID-19 history on early outcomes in NSCLC patients remain controversial. Objectives: To evaluate the effect of COVID-19 history on early outcomes in NSCLC patients and identify high-risk groups undergoing radical resection based on the largest Chinese multi-center real-world data to date. Design: Multi-center retrospective cohort study. Methods: NSCLC patients with (POCVD group) or without (NCVD group) a history of COVID-19 who underwent radical surgery at six institutions from January 2022 to January 2024 were retrospectively reviewed from a prospectively maintained database. Propensity-score matching (PSM) was utilized to minimize patient selection bias. Results: Out of 7932 cases included, PSM resulted in 3021 cases per group. The two groups were comparable regarding the proportion of male patients (52.0% vs 51.6%) and those aged ⩾70 years (13.3% vs 13.8%). Although the two groups had comparable incidences of complications with Clavien-Dindo grades ⩾II (13.0% vs 14.4%, p = 0.117), the POCVD group had longer surgical durations (120.87 ± 40.23 min vs 110.74 ± 38.76 min, mean difference (95% confidence interval (CI) = 10.13 (8.138–12.122)) and higher rates of respiratory complications than the NCVD group. Subgroup logistic regression analysis indicated that patients aged ⩾70 years (odds ratio (OR) (95% CI) = 1.322 (1.022–1.876)) and those with a smoking history (OR (95% CI) = 1.235 (1.008–1.543)) had an increased risk of developing complications with Clavien-Dindo grades ⩾II. Further analysis confirmed that these high-risk patients experienced extended surgical durations, longer chest tube drainage, and prolonged postoperative hospital stay, along with increased postoperative respiratory complications following COVID-19. Conclusion: Generally, radical resection is safe for NSCLC patients with a COVID-19 history. However, these patients experienced prolonged surgical durations and a higher incidence of postoperative respiratory complications compared to those without a COVID-19 history. In addition, individuals aged ⩾70 years or with a smoking history faced elevated surgical risks following COVID-19. Plain language summary: Analyzing the impact of COVID-19 history on early outcomes and identifying high-risk groups among non-small cell lung cancer patients undergoing radical resection Aim and Purpose Research Question: Does a COVID-19 history affect the early outcomes of radical surgery (lobectomy/bi-lobectomy/pneumectomy) in patients with non-small cell lung cancer (NSCLC)? Hypothesis: Patients with a COVID-19 history face elevated surgical risks compared to those without. Objective: To understand how past COVID-19 infection impacts early outcomes in NSCLC patients undergoing surgery and to identify high-risk groups. Background Why This Study: COVID-19 can cause long-term lung damage, making surgery riskier for NSCLC. However, it's unclear how past COVID-19 infection affects NSCLC patients receiving surgery. Importance: The research helps to understand the additional risks for NSCLC patients with a COVID-19 history based on the largest cohort to date, aiming to improve their surgical outcomes. Method and Design Research Design: Multi-center retrospective cohort study. Methods and Participants: 7932 NSCLC patients undergoing radical surgery between January 2022 and January 2024 were included and divided into two groups: those with a COVID-19 history (POCVD group) and those without (NCVD group). Result and Importance Findings: 1. The POCVD group had longer surgical durations and higher rates of respiratory complications compared to the NCVD group. 2. The POCVD and NCVD groups were associated with a comparable incidence of postoperative complications with Clavien-Dindo grades ⩾II. 3. The elderly (aged ⩾70 years) and smokers were at higher risk for complications post-COVID-19. Implications: While surgery is generally safe for NSCLC patients with a COVID-19 history, they do face increased risks and complications. This highlights the need for special care and monitoring for older patients and those with smoking histories. Key Message: NSCLC patients with a COVID-19 history can safely undergo radical surgery, but they may experience longer surgical durations and more postoperative respiratory complications, especially the elderly and smokers. [ABSTRACT FROM AUTHOR]

Data transformation of the reference soil organic matter (SOM) decomposition rates (kref), often derived as turnover times or in alternative formats, is commonly used to develop ecological models for projecting the persistence of SOM. However, the effects of reciprocal or logarithmic transformation of kref on model performance and edaphic‐climatic patterns remain uncertain. Here, we convert published kref values into reciprocal or logarithmic formats and establish machine learning models between the transformed kref and edaphic‐climatic predictors. We show that models trained with the transformed kref exhibit a 11.6%−68.4% reduction in performance upon re‐conversion to kref compared to those trained with the original kref. The variable importance analysis identifies distinct key predictors governing the original kref and its transformed counterparts. This suggests that data transformation alters the relative significance of predictors without necessarily improving kref prediction performance. Consequently, our study underscores the importance of directly focusing on the original values rather than alternative representations when dissecting a given variable's patterns and mechanisms in ecological modeling. Core Ideas: Data transformation caused reduced predictive performance upon re‐conversion to kref compared to the original kref.Models trained with data transformation exhibited divergent edaphic‐climatic controls for different formatted kref.This study underscores the importance of directly focusing on original values rather than alternative representations. Plain Language Summary: The first‐order model is commonly used to simulate the dynamics of soil organic matter decomposition. The reference decomposition rates (kref) in the first‐order model are usually transformed into reciprocal or logarithmic formats, which may affect model performance as well as the regulatory patterns of edaphic‐climatic factors. In this study, we investigated the effects of data transformation on predictive performance and variable importance. We found that models trained with transformed kref exhibited reduced performance upon re‐conversion to kref, compared to those trained with the original kref. In addition, data transformation altered the distribution and range of the dependent variable, leading to divergent controlling roles of explanatory variables pertaining to models trained with different formatted kref. Our study underscores the need to apply models directly to the original variables rather than their transformed representations. [ABSTRACT FROM AUTHOR]

This paper reports that the in situ growth magnetic field (Hg) during magnetic-phase CoFeB deposition impacts the electric-field control of magnetic anisotropy in Co40Fe40B20/(011)-Pb(Mg1/3Nb2/3)0.7Ti0.3O3 [CoFeB/(011)-PMN-PT] composite multiferroic heterostructures at room temperature. In the Hg1 mode (in situ Hg along the [ 01 1 ¯ ] direction of the ferroelectric PMN-PT substrate), the electric-field-controlled modulation ratios of the magnetic coercivity HC and saturation magnetic field HS are approximately −47% and +156%, respectively. However, in the Hg2 mode (in situ Hg along the [100] direction of the ferroelectric PMN-PT substrate) of the CoFeB/(011)-PMN-PT multiferroic heterostructure, the electric-field-controlled modulation ratios of the magnetic coercivity HC and saturation magnetic field HS can reach as high as +162% and +393%, respectively. Moreover, the electric-field-controlled magnetic coercive field HC exhibits a butterfly shape when plotted versus the applied electric fields in both modes, which matches the in-plane butterfly strain loop of the ferroelectric PMN-PT substrate. However, the electric-field-controlled saturation magnetic field HS presents a square loop, which is very consistent with the ferroelectric loop of the PMN-PT substrate. This result may be ascribed to the distinct pathway of the ferroelastic domain switching in the (011)-oriented PMN-PT substrate. This study provides a new idea for the design of spintronic devices based on multiferroic heterostructures. [ABSTRACT FROM AUTHOR]