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Beer is a fermented beverage prepared from water, malted barley, hops, and yeast that has been around for centuries. Alcoholic beverages alter the composition of the gut microbiota, which in turn causes oxidative stress brought on by alcohol, increases intestinal permeability to luminal bacterial products. However, beer has been shown to contain several intriguing non-alcoholic chemicals. Recent research demonstrates that moderate beer drinking could have positive impacts on human health. Beer’s non-alcoholic ingredients have a significant impact on gut microbiota, and this type of diet is known to modulate gut microbiota, which has a variety of effects on the body, including effects on intestinal permeability, mucosal immune function, intestinal motility, antioxidant activity, and anti-inflammatory activity. Although the negative consequences of excessive alcohol intake are widely known, it is still debatable whether or not some non-alcoholic components, such as polyphenols and carbohydrates, have any positive benefits. In this review, we explain the primary benefits of moderate beer consumption on the gut microbiota, which are mostly attributable to non-alcoholic components such polyphenols. Despite any potential advantages of moderating consumption of alcoholic beverages, the lowest alcohol intake is the most secure.

BackgroundChina has changed its COVID-19 prevention and control status since 2023. However, what role telemedicine will play post–COVID-19 is still uncertain. ObjectiveWe aimed to determine the frequency change in health care providers offering telemedicine services before, during, and after COVID-19, as well as the correlation between the frequency change and telemedicine visit time. MethodsThe Telemedicine Informationization Professional Committee of China (TIPC) carried out a nationwide questionnaire survey. We adopted data from part of the questionnaires that answered questions regarding the frequency of offering telemedicine services before, during, and after the COVID-19 explosion. Chi-square tests were applied to compare general differences in the between-group telemedicine frequency. Regression models were performed to analyze correlations between the frequency change and the time spent in online versus in-person visits. ResultsQuestionnaires from 428 providers were included. As reported, 39 (9.11%) providers often and 159 (37.15%) always offered telemedicine services before COVID-19 exploded. The component ratio increased to 12.38% (n=53) of providers often and 45.79% (n=196) always offering telemedicine during COVID-19 explosion and 12.62% (n=54) often and 50% (n=214) always offering telemedicine after pandemic control was relaxed. The increase in frequency shown as a difference between the before and during groups (χ2=17.21, P.002) and between the before and after groups (χ2=30.17, P

Abstract In this paper, the solid solution and precipitation behavior of inclusions on the surface and 1/2 thickness of the tested steel plate under the condition of welding heat input of 400 kJ/cm is investigated by using laser confocal experiments with hot-rolled state DH36 ship plate steel as the research object, and the mechanism of the effect of inclusions on the phase transformation of an acicular ferrite is revealed. The results show that the inclusions of the tested steel are mainly composed of Oxide-MnS, MnS, Oxide, TiN, Spinel, etc. The amount of inclusions on the surface of the tested steel plate is significantly higher than that at the 1/2 thickness position. During the heating stage, the small inclusions on the surface immediately disappeared, and the large inclusions gradually solidified in the matrix; atomic diffusion occurred at the bond between the inclusions and the matrix; while the small inclusions at the 1/2 thickness position gradually disappeared at the beginning of the heating stage, and the inclusions began to precipitate and grow when the temperature was increased to 990 °C. The acicular ferrite preferentially nucleates and grows near the boundary of the inclusions during the post-weld cooling stage, and its growth ends when two acicular ferrites cross.

Abstract Background Telemedicine is beneficial for improving treatment efficiency and reducing medical expenses of cancer patients. This study focuses on cancer patients participating in teleconsultations through a regional telemedicine platform in China, analyzes the consultation process, and provides references for the clinical application of telemedicine. Methods We collected information on teleconsultations of cancer patients conducted from 2015 to 2022 through the regional telemedicine platform. Utilizing SPSS 23.0 software, we conducted descriptive analysis to summarize the distribution of patient gender, age, region, and disease types. The ordinal logistic regression analysis was adopted to analyze the factors influencing the waiting time and consultation duration for teleconsultations. Results From 2015 to 2022, a total of 23,060 teleconsultations were conducted for cancer patients via regional telemedicine platform, with an average growth rate of 11.09%. The main types of consultations were for lung cancer, liver cancer, and breast cancer, accounting for 18.14%, 10.49%, and 9.46% respectively. 57.05% of teleconsultations had a waiting time of less than 24 h, while patient age, consultation expert level, and disease type were the main factors influencing the waiting time. 50.06% of teleconsultations had a duration of more than 20 min, and the inviting hospital level and the title of invited consultant were the main factors influencing the consultation duration. Conclusions In China, telemedicine has been widely employed in the clinical diagnosis and treatment of cancers, covering various types of oncological diseases. However, the waiting time for teleconsultations was generally more than 12 h, indicating the need to enhance consultation scheduling and allocate more expert resources to further optimize the efficiency of teleconsultations. Additionally, further exploration is required for remote health management of outpatients with cancers outside the hospital.

To investigate the effects of different pasteurization processes (85 ℃ for 20 min and 75 ℃ for 30 min) on the edible quality and shelf life of white cut chicken, the samples were stored at 0~4 ℃ for 0-30-40 d, and the pH, color, texture, volatile flavor substances, volatile salt base nitrogen (TVB-N), total number of colonies, and sensory quality were determined. Results indicated that the pH value of white cut chicken treated by pasteurization process was stable, the total colony count was lower, and the generation of TVB-N was lower. After comparing with the control group, neither of the two groups of different treatments of the pasteurization process would have a significant trending effect on the eating characteristics of white cut chicken such as color, hardness and chewiness, and the sensory scores were not significantly different from those of the control group (P>0.05). Meanwhile, this study compared the relative superiority of two different pasteurization processes and demonstrated that the process condition of 85 ℃ pasteurization treatment for 20 min had a significant effect on inhibiting microbial growth in the product, prolonging the shelf-life of the white cut chicken, and reducing the deterioration of the edible quality of the chicken meat during storage.

Sinter is the main raw material of blast furnaces, and its strength influences its running condition. Nevertheless, there is no comprehensive definition of the influencing mechanisms of the strength of the sinter. In this paper, the influences of the quantity and quality of the bonding phase on the strength of the sinter were investigated by changing the sintering parameters, such as the maximum sintering temperature, the binary basicity of adhering fines, holding time at high temperature, and types of core ores. As the maximum temperature increased from 1240 °C to 1320 °C and the binary basicity of the adhering fines increased from 5.0 to 9.0, and the strength of the sinter increased first and then decreased. The strength of the sinter was improved by increasing the holding time at high temperatures and reducing the melt absorbability of core ores. The strength of the sinter was comprehensively influenced by the strength of the bonding phase, the fluidity of the original melt, and the melt absorbability of core ores. There is a multivariate linear relationship between them. Moreover, the strength of the bonding phase had the greatest effect on the strength of the sinter, followed by the fluidity of the original melt, and the melt absorbability of core ores was the smallest.

To analyze the changes of spoilage bacteria on the carcasses of broiler during the slaughtering of yellow feather broiler, the diversity of spoilage bacteria in the processing environment and on the carcass surface during the efficient slaughter of yellow feather broiler was determined by the plate pouring method and Illumina MiSeq high-throughput sequencing. The results showed that the main contamination procedure for the growth of bacteria of yellow feather broilers was eviscerating, pre-cooling and grading procedure, and the grading scale, in which the grading scale, workers' gloves from grading workshop, pre-cooling tank and workers' gloves from eviscerating manual gloves were contamination sources in the three processes aforementioned. Moreover, grading scale and workers' gloves in the decomposition workshop were the main source of contaminated flora of yellow feather broilers carcasses. The growth rate of total viable counts (TVC) and Pseudomonas on the surface of yellow feather broilers carcasses was as high as 24.13% and 41.27%, respectively. The TVC of yellow feather broilers increased to 4.63 lg(CFU/g) after grading scale and grading workshop worker's hands (P

Abstract G-quadruplexes (G4s) can recruit transcription factors to activate gene expression, but detailed mechanisms remain enigmatic. Here, we demonstrate that G4s in the CCND1 promoter propel the motility in MAZ phase-separated condensates and subsequently activate CCND1 transcription. Zinc finger (ZF) 2 of MAZ is a responsible for G4 binding, while ZF3-5, but not a highly disordered region, is critical for MAZ condensation. MAZ nuclear puncta overlaps with signals of G4s and various coactivators including BRD4, MED1, CDK9 and active RNA polymerase II, as well as gene activation histone markers. MAZ mutants lacking either G4 binding or phase separation ability did not form nuclear puncta, and showed deficiencies in promoting hepatocellular carcinoma cell proliferation and xenograft tumor formation. Overall, we unveiled that G4s recruit MAZ to the CCND1 promoter and facilitate the motility in MAZ condensates that compartmentalize coactivators to activate CCND1 expression and subsequently exacerbate hepatocarcinogenesis.

Abstract Background The widespread adoption of telehealth services necessitates accurate online department selection based on patient medical records, a task requiring significant medical knowledge. Incorrect triage results in considerable time wastage for both patients and medical professionals. To address this, we propose an intelligent triage model based on a Bidirectional Long Short-Term Memory (Bi-LSTM) neural network with character embedding to enhance the efficiency and capacity of telehealth services. Methods We gathered a 1.3 GB medical dataset comprising 200,000 records, each including medical history, physical examination data, and other pertinent information found on the electronic medical record homepage. Following data preprocessing, a clinical corpus was established to train character embeddings with a medical context. These character embeddings were then utilized to extract features from patient chief complaints, and a 2-layer Bi-LSTM neural network was trained to categorize these complaints, enabling intelligent triage for telehealth services. Results 60,000 chief complaint-department data pairs were extracted from clinical corpus and divided into the training, validation, and test sets of 42,000, 9,000, and 9,000, respectively. The character embedding based Bi-LSTM neural network achieved a macro-precision of 85.50% and an F1 score of 85.45%. Conclusion The telehealth triage model developed in this study demonstrates strong implementation outcomes and significantly improves the efficiency and capacity of telehealth services. Character embedding outperforms word embedding, and future work will incorporate additional features such as patient age and gender into the chief complaint feature to future enhance model performance.

IntroductionExport quality improvement is a crucial path for a country or region to climb up the advanced division of labor in the global value chain. For developing countries that have long been at the lower end of the global value chain division of labor, the dominance of agricultural trade is often controlled by international retailers, leading to higher costs of agricultural trade and hindering the upgrading of the quality of agricultural exports. As a traditional agricultural exporting country, China still needs a competitive advantage despite the large scale of its agricultural exports. Currently, e-commerce can provide buyers and sellers with comprehensive transaction information and technical support, allowing them to realize rational allocation of resources and export upgrading. Therefore, studying how e-commerce can promote the quality upgrade of agricultural exports is crucial for China to build a trade power.MethodsThis paper clarifies the mechanism of e-commerce’s theoretical impact on the quality of agricultural exports and then empirically tests it using a high-dimensional fixed-effects model with Chinese customs data from 2000 to 2020 as a sample.ResultsThe results show that e-commerce significantly promotes the quality of agricultural exports in all regions of China, and this conclusion still holds after various robustness tests; the heterogeneity test shows that e-commerce fosters the quality of agricultural exports in eastern China, densely populated regions, and economically underdeveloped regions, especially in the case of heterogeneous products; the mechanism analysis confirms that e-commerce promotes the quality of agricultural exports mainly through the optimization of the agricultural industry chain and supply chain, and the enhancement of the level of servicing. Mechanism analysis confirms that e-commerce improves agricultural export quality mainly through optimizing the agricultural industry chain and supply chain, improving the level of servitization, and docking the demand information of the consumer market, etc. Expanded analysis shows that constructing cross-border e-commerce platforms also significantly improves the quality of micro enterprises’ agricultural exports. This paper enriches the research on e-commerce and agricultural trade.DiscussionThis paper provides an essential reference for constructing a robust agricultural trade country and developing high-quality agriculture. Despite encompassing data up to 2020, in the context of today’s global economic volatility directly affecting agricultural trade, future investigations will broaden the scope to delve deeper into how e-commerce can help countries cope with global economic uncertainty.

BackgroundTelemedicine has demonstrated its potential in alleviating the unbalanced distribution of medical resources across different regions. Henan, a province in China with a population of approximately 100 million, is especially affected by a health care divide. The province has taken a proactive step by establishing a regional collaborative platform for telemedicine services provided by top-tier provincial hospitals. ObjectiveWe aim to identify the key factors that influence the current operationalization and effectiveness of telemedicine services in Henan province. The insights gained from this study will serve as valuable references for enhancing the efficient operation of telemedicine platforms in low- and middle-income regions. MethodsWe analyzed service reports from the performance management system of telemedicine services in Henan province throughout 2020. Using descriptive statistics and graphical methods, we examined key influencing factors, such as management competency; device configuration; and hospital capability, capacity, and service efficacy, across hospitals at 2 different tiers. In addition, we used generalized linear models and multiple linear regression models to identify key operational factors that significantly affect the service volume and efficacy of 2 major telemedicine services, namely teleconsultation and tele-education. ResultsAmong the 89 tier 3 hospitals and 97 tier 2 hospitals connected to the collaborative telemedicine platform, 65 (73%) and 55 (57%), respectively, have established standardized management procedures for telemedicine services. As the primary delivery method for telemedicine services, 90% (80/89) of the tier 3 hospitals and 94% (91/97) of the tier 2 hospitals host videoconferencing consultations through professional hardware terminals rather than generic computers. Teleconsultation is the dominant service type, with an average annual service volume per institution of 173 (IQR 37-372) and 60 (IQR 14-271) teleconsultations for tier 3 and tier 2 hospitals, respectively. Key factors influencing the service volume at each hospital include available funding, management competency, the number of connected upper tiers, and the number of professional staff. After receiving teleconsultations from tier 3 (65/89, 73%) and tier 2 (61/97, 63%) hospitals, patients reported significant improvements in their medical conditions. In addition, we observed that service efficacy is positively influenced by management competency, financial incentives, the number of connected upper or lower tiers, and the involvement of participating medical professionals. ConclusionsTelemedicine has become increasingly popular in Henan province, with a notable focus on teleconsultation and tele-education services. Despite its popularity, many medical institutions, especially tier 2 hospitals, face challenges related to management competency. In addition to enhancing the effectiveness of existing telemedicine services, health care decision-makers in Henan province and other low- and middle-income regions should consider expanding the service categories, such as including remote emergency care and telesurgery, which have promise in addressing crucial health care needs in these regions.

Abstract G-quadruplexes (G4s) regulate DNA replication and gene transcription, and are enriched in promoters without fully appreciated functional relevance. Here we show high selection pressure on putative G4 (pG4) forming sequences in promoters through investigating genetic and genomic data. Analyses of 76,156 whole-genome sequences reveal that G-tracts and connecting loops in promoter pG4s display lower or higher allele frequencies, respectively, than pG4-flanking regions, and central guanines (Gs) in G-tracts show higher selection pressure than other Gs. Additionally, pG4-promoters produce over 72.4% of transcripts, and promoter G4-containing genes are expressed at relatively high levels. Most genes repressed by TMPyP4, a G4-ligand, regulate epigenetic processes, and promoter G4s are enriched with gene activation histone marks, chromatin remodeler and transcription factor binding sites. Consistently, cis-expression quantitative trait loci (cis-eQTLs) are enriched in promoter pG4s and their G-tracts. Overall, our study demonstrates selective constraint of promoter G4s and reinforces their stimulative role in gene expression.

Cold rolling oily sludge contains a series of mixtures such as high content of iron and organic residues. The evolution law of volatile components of cold rolling oily sludge during thermal treatment was studied through pyrolytic and kinetic analysis. The effect of heating rate on cold rolling oily sludge was studied by TG. According to the results of mass loss, it divided to two stages: 100 °C–600 °C and 600 °C–1000 °C. The pyrolysis kinetics were investigated by three kinetic models: KAS, FWO, and DEAM. By analyzing the models, it was found that the increasing value of Eawas accompanied by a progressive increase in conversion rate between 100 °C and 600 °C and the average of Ea, ΔH, ΔGand ΔSvalue were also calculated as 163.26 kJ⋅ mol−1, 157.45 kJ⋅ mol−1, 194.67 kJ⋅ mol−1, -67.41J⋅ (mol⋅ T)−1 respectively. When the temperature was above 600 °C, it was hard to acquire the active energy owing to synergistic effect of redox reaction and pyrolysis reaction. Combining TG-MS and Py-EGA/MS, it seemed that the gas escaping trace had the similar trend. There were H2, CH4, CO, CO2 found in gaseous products. Carbon dioxide and carbon oxide were the main gas products above 600 °C.

Abstract Background Gastric cancer ranks high in terms of morbidity and mortality worldwide. Multimodal therapy is therefore essential for locally advanced gastric cancer. Recent studies have demonstrated that both perioperative chemotherapy and neoadjuvant chemoradiotherapy can improve the prognosis of patients. However, the completion rate of chemotherapy after surgery remains low, which may affect survival. Thus, identifying the best way to combine radiotherapy, chemotherapy and surgery is important. The aim of this study was to explore the toxicity and efficacy of the total neoadjuvant therapy modality for locally advanced gastric cancer. Methods This study will be a prospective, multicenter, single-arm, phase II clinical trial. Patients diagnosed with locally advanced (stage cT3-4 and cN positive, AJCC 8th) gastric cancer and gastroesophageal junction adenocarcinoma will be enrolled. Patients will initially receive radiotherapy (95% planned target volume: 45 Gy/25 f) and concurrent chemotherapy (S-1: 40–60 mg twice a day) followed by six cycles of consolidated chemotherapy (SOX, consisting of S-1 and oxaliplatin) and surgery. The primary objective will assess pathological complete response; the secondary objectives will include toxicities assessing surgical complications, the tumor downstaging rate and the R0 resection rate. Discussion Investigation of total neoadjuvant therapy in gastric cancer is limited. The goal of this trial is to explore the efficacy and toxicity of total neoadjuvant therapy for locally advanced gastric cancer and gastroesophageal junction adenocarcinoma. Trial registration: Clinicaltrials.gov (NCT04062058, August 20, 2019).

Abstract Background Peri-operative chemo-radiotherapyplayed important rolein locally advanced gastric cancer. Whether preoperative strategy can improve the long-term prognosis compared with postoperative treatment is unclear. The study purpose to compare oncologic outcomes in locally advanced gastric cancer patients treated with preoperative chemo-radiotherapy (pre-CRT) and postoperative chemo-radiotherapy (post-CRT). Methods From January 2009 to April 2019, 222 patients from 2 centers with stage T3/4 and/or N positive gastric cancer who received pre-CRT and post-CRT were included. After propensity score matching (PSM), comparisons of local regional control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) were performed using Kaplan-Meier analysis and log-rank test between pre- and post-CRT groups. Results The median follow-up period was 30 months. 120 matched cases were generated for analysis. Three-year LC, DMFS, DFS and OS for pre- vs. post-CRT groups were 93.8% vs. 97.2% (p = 0.244), 78.7% vs. 65.7% (p = 0.017), 74.9% vs. 65.3% (p = 0.042) and 74.4% vs. 61.2% (p = 0.055), respectively. Pre-CRT were significantly associated with DFS in uni- and multi-variate analysis. Conclusion Preoperative CRT showed advantages of oncologic outcome compared with postoperative CRT. Trial registration ClinicalTrial.gov NCT01291407 , NCT03427684 and NCT04062058 , date of registration: Feb 8, 2011.

Abstract Background Respiratory motion may introduce errors during radiotherapy. This study aims to assess and validate internal gross tumour volume (IGTV) margins in proximal and distal borders of gastroesophageal junction (GEJ) tumours during simultaneous integrated boost radiotherapy. Methods We enrolled 10 patients in group A and 9 patients in group B. For all patients, two markers were placed at the upper and lower borders of the tumour before treatment. In group A, within the simulation and every 5 fractions of radiotherapy, we used 4-dimensional computed tomography (4DCT) to record the intrafractional displacement of the proximal and distal markers. By fusing the average image of each repeated 4DCT with the simulation image based on the lumbar vertebra, the interfractional displacement could be obtained. We calculated the IGTV margin in the proximal and distal borders of the GEJ tumour. In group B, by referring to the simulation images and cone-beam computed tomography (CBCT) images, the range of tumour displacement in proximal and distal borders of GEJ tumour was estimated. We calculated the proportion of marker displacement range in group B lay within the IGTV margin calculated based on the data obtained in group A to estimate the accuracy of the IGTV margin. Results The intrafractional displacement in the cranial–caudal (CC) direction was significantly larger than that in the anterior–posterior (AP) and left–right (LR) directions for both the proximal and distal markers of the tumour. The interfractional displacement in the AP and LR directions was larger than that in the CC direction (p = 0.001, p = 0.017) based on the distal marker. The IGTV margins in the LR, AP and CC directions were 9 mm, 8.5 mm and 12.1 mm for the proximal marker and 15.8 mm, 12.7 mm and 11.5 mm for the distal marker, respectively. In group B, the proportions of markers that located within the IGTV margin in the LR, AP and CC directions were 96.5%, 91.3% and 96.5% for the proximal marker and 100%, 96.5%, 93.1% for the distal marker, respectively. Conclusions Our study proposed individualized IGTV margins for proximal and distal borders of GEJ tumours during neoadjuvant radiotherapy. The IGTV margin determined in this study was acceptable. This margin could be a reference in clinical practice.

Abstract Background The coronavirus disease 2019 (COVID-19) has become a pandemic. Few studies have been conducted to investigate the spatio-temporal distribution of COVID-19 on nationwide city-level in China. Objective To analyze and visualize the spatiotemporal distribution characteristics and clustering pattern of COVID-19 cases from 362 cities of 31 provinces, municipalities and autonomous regions in mainland China. Methods A spatiotemporal statistical analysis of COVID-19 cases was carried out by collecting the confirmed COVID-19 cases in mainland China from January 10, 2020 to October 5, 2020. Methods including statistical charts, hotspot analysis, spatial autocorrelation, and Poisson space–time scan statistic were conducted. Results The high incidence stage of China’s COVID-19 epidemic was from January 17 to February 9, 2020 with daily increase rate greater than 7.5%. The hot spot analysis suggested that the cities including Wuhan, Huangshi, Ezhou, Xiaogan, Jingzhou, Huanggang, Xianning, and Xiantao, were the hot spots with statistical significance. Spatial autocorrelation analysis indicated a moderately correlated pattern of spatial clustering of COVID-19 cases across China in the early phase, with Moran’s I statistic reaching maximum value on January 31, at 0.235 (Z = 12.344, P = 0.001), but the spatial correlation gradually decreased later and showed a discrete trend to a random distribution. Considering both space and time, 19 statistically significant clusters were identified. 63.16% of the clusters occurred from January to February. Larger clusters were located in central and southern China. The most likely cluster (RR = 845.01, P

Abstract Background Screening carotid B-mode ultrasonography is a frequently used method to detect subjects with carotid atherosclerosis (CAS). Due to the asymptomatic progression of most CAS patients, early identification is challenging for clinicians, and it may trigger ischemic stroke. Recently, machine learning has shown a strong ability to classify data and a potential for prediction in the medical field. The combined use of machine learning and the electronic health records of patients could provide clinicians with a more convenient and precise method to identify asymptomatic CAS. Methods Retrospective cohort study using routine clinical data of medical check-up subjects from April 19, 2010 to November 15, 2019. Six machine learning models (logistic regression [LR], random forest [RF], decision tree [DT], eXtreme Gradient Boosting [XGB], Gaussian Naïve Bayes [GNB], and K-Nearest Neighbour [KNN]) were used to predict asymptomatic CAS and compared their predictability in terms of the area under the receiver operating characteristic curve (AUCROC), accuracy (ACC), and F1 score (F1). Results Of the 18,441 subjects, 6553 were diagnosed with asymptomatic CAS. Compared to DT (AUCROC 0.628, ACC 65.4%, and F1 52.5%), the other five models improved prediction: KNN + 7.6% (0.704, 68.8%, and 50.9%, respectively), GNB + 12.5% (0.753, 67.0%, and 46.8%, respectively), XGB + 16.0% (0.788, 73.4%, and 55.7%, respectively), RF + 16.6% (0.794, 74.5%, and 56.8%, respectively) and LR + 18.1% (0.809, 74.7%, and 59.9%, respectively). The highest achieving model, LR predicted 1045/1966 cases (sensitivity 53.2%) and 3088/3566 non-cases (specificity 86.6%). A tenfold cross-validation scheme further verified the predictive ability of the LR. Conclusions Among machine learning models, LR showed optimal performance in predicting asymptomatic CAS. Our findings set the stage for an early automatic alarming system, allowing a more precise allocation of CAS prevention measures to individuals probably to benefit most.

Summary: Passive cooling of buildings has become increasingly important for green and low-carbon development, especially in the near decade where daytime radiative cooling technology (DRCT) has drawn attention with big breakthroughs. However, irresistibly importing heat from sunlight and surroundings results in notable temperature rise, thus limiting the cooling effect. Here, we report a radiative paint with latent heat storage capacity to store imported heat by coupling randomly-distributed phase-change materials (PCMs) based microcapsules with acrylic resin to enhance cooling performance. The bifunctional paint shows good performance in selected-suitable phase transition temperature, high enthalpy, high reflectivity in the sunlight region and strong emissivity in the atmospheric window region. The temperature measurements demonstrate that the paint possesses enhanced cooling performance of temperature drop and time buffering effect compared with the pure radiative cooling paint. This work offers the potential to broaden the applications of PCMs and DRCT for energy saving and environment protection.

PurposeTo compare the survival benefit in the adjuvant chemoradiotherapy (CRT) group and chemotherapy (CT) group for stage III gastric or gastroesophageal junction (GEJ) cancer after D2/R0 resection.Methods and MaterialsFrom January 2011 to May 2018, 819 patients (CRT group: 215 patients, CT group: 604 patients) diagnosed as pathological stage III after D2/R0 resection were retrospectively collected and the survival and recurrence patterns were analyzed. The baseline characteristics were balanced based on propensity score matching (PSM). The survival benefit was compared between two groups using Kaplan–Meier analysis and Cox regression model.ResultsThe 5-year overall survival (OS) rate in the CRT group was significantly higher than that in the CT group whether before or after the PSM. The multivariate Cox regression analysis identified the significant poor OS in patients with advanced TNM stage (P < 0.001) and patients who did not receive the adjuvant CRT (P = 0.008). For the recurrence patterns, 85 (39.5%) patients in the CRT group and 300 (49.7%) patients in the CT group were diagnosed as recurrence (P = 0.011). The regional recurrence in the CRT group was less than that in the CT group (20.5% vs. 35.1%, P = 0.028).ConclusionFor patients diagnosed as stage III gastric cancer or gastroesophageal junction cancer, the addition of adjuvant chemoradiotherapy will significantly improve the overall survival and regional control.

Summary: Background: Multiple approaches based on cell-free DNA (cfDNA) have been applied to detect minimal residual disease (MRD) and to predict prognosis or recurrence. However, a comparison of the approaches used in different cohorts and studies is difficult. We aimed to compare multiple approaches for MRD analysis after neoadjuvant therapy (NAT) in patients with locally advanced rectal cancer (LARC). Methods: Sixty patients with LARC from a multicentre, phase II/III randomized trial were included, with tissue and blood samples collected. For each cfDNA sample, we profiled MRD using 3 approaches: personalized assay targeting tumour-informed mutations, universal panel of genes frequently mutated in colorectal cancer (CRC), and low depth sequencing for copy number alterations (CNAs). Findings: Positive MRD based on post-NAT personalized assay was significantly associated with an increased risk of recurrence (HR = 27.38; log-rank P < 0.0001). MRD analysis based on universal panel (HR = 5.18; log-rank P = 0.00086) and CNAs analysis (HR = 9.24; log-rank P = 0.00017) showed a compromised performance in predicting recurrence. Both the personalized assay and universal panel showed complementary pattern to CNAs analysis in detecting cases with recurrence and the combination of the two types of biomarkers may lead to better performance. Interpretation: The combination of mutation profiling and CNA profiling can improve the detection of MRD, which may help optimize the treatment strategies for patients with LARC.

Ensuring sustainable levels of rice yield has become a significant concern in recent years. To improve yields in rice production, it is essential to increase factor inputs and productivity. However, current research primarily focuses on general grain productivity, rather than rice. In this study, utilize the DEA-Malmquist index to present a comprehensive temporal and spatial analysis of rice productivity and its determinants in China. Our findings reveal that the overall efficiency of rice production in China exhibits a fluctuating upward trend, with technological progress being the primary driver of improvement in production efficiency. Moreover, rice production efficiency demonstrates a distribution pattern that decreases from east to west, with resource endowment, production conditions, socioeconomic development levels, and the political system being crucial factors influencing efficiency. This study proposes novel ideas for structural adjustments and regional divisions within China’s rice industry and provides a theoretical foundation for governments to develop evidence-based policies.

Forty-one ostrich eggshell (OES) artifacts excavated at five localities of the late Paleolithic Shizitan site, on the North China Loess Plateau, allow the observation of diachronic changes in the utilization of ostrich eggs in the production and use of ornaments considered to be technologies of social signaling, beginning during the Last Glacial Maximum (LGM) and continuing through the Younger Dryas. Based on changes in dimensions, production techniques such as drilling, coloration through heat treatment or the application of ochre, and stringing techniques, the OES pendant and bead use at Shizitan is divided into four phases. Phases 1–3 feature only completed ornaments, usually with heavy usewear. Only in Phase 4, during the Younger Dryas, blanks and drilled preforms are found that indicate local production. While Phase 1 features the use of larger pendants colored grey/black by burning, subsequent phases see beads replacing pendants, no heat coloration, and the use of the ochre pigment. The switch to beads corresponds with the change to microblade technology at Shizitan 29. Phase 3 shows a trend toward a larger relative surface display area and maturation of techniques to produce visual effects of roundedness and weightiness. Phase 4 local production shows technological developments that allowed drilling smaller apertures while also decreasing the bead diameter and increased standardization, implying changing display objectives (stringing beads together with a uniform appearance). The changes observed in the Shizitan diachronic dataset may relate to changing requirements in social signaling—part of the adaptations the hunter–gatherer groups made to survive the challenges of climatic change from the LGM through the Terminal Pleistocene in North China.

Polydatin (PD) is a natural compound with anticancer activities, but the underlying mechanisms remain largely unclear. To understand how PD inhibited hepatocellular carcinoma (HCC), we studied PD treatments in HCC HepG2 and SK-HEP1 cells, and normal liver HL-7702 cells. PD selectively blocked the proliferation of HCC cells but showed low toxicity in normal cells, while the effects of doxorubicin (DOX) and cisplatin (DDP) on HCC and normal liver cells were opposite. In the cotreatment studies, PD synergistically improved the inhibitory activities of DOX and DDP in HCC cells but alleviated their toxicity in HL-7702 cells. Furthermore, RNA-seq studies of PD-treated HepG2 cells revealed multiple altered signaling pathways. We identified 1679 Differentially Expressed Genes (DEGs) with over a 2.0-fold change in response to PD treatment. Integrative analyses using the DEGs in PD-treated HepG2 cells and DEGs in a TCGA dataset of HCC patients revealed five PD-repressed DEGs regulating mitotic spindle midzone formation. The expression of these genes showed significantly positive correlation with poor clinical outcomes of HCC patients, suggesting that mitotic machinery was likely a primary target of PD. Our findings improve the understanding of PD’s anticancer mechanisms and provide insights into developing effective clinical approaches in HCC therapies.

Background: The outbreak of novel coronavirus disease 2019 (COVID-19) has led to tremendous individuals visit medical institutions for healthcare services. Public gatherings and close contact in clinics and emergency departments may increase the exposure and cross-infection of COVID-19.Objectives: The purpose of this study was to develop and deploy an intelligent response system for COVID-19 voice consultation, to provide suggestions of response measures based on actual information of users, and screen COVID-19 suspected cases.Methods: Based on the requirements analysis of business, user, and function, the physical architecture, system architecture, and core algorithms are designed and implemented. The system operation process is designed according to guidance documents of the National Health Commission and the actual experience of prevention, diagnosis and treatment of COVID-19. Both qualitative (system construction) and quantitative (system application) data from the real-world healthcare service of the system were retrospectively collected and analyzed.Results: The system realizes the functions, such as remote deployment and operations, fast operation procedure adjustment, and multi-dimensional statistical report capability. The performance of the machine-learning model used to develop the system is better than others, with the lowest Character Error Rate (CER) 8.13%. As of September 24, 2020, the system has received 12,264 times incoming calls and provided a total of 11,788 COVID-19-related consultation services for the public. Approximately 85.2% of the users are from Henan Province and followed by Beijing (2.5%). Of all the incoming calls, China Mobile contributes the largest proportion (66%), while China Unicom and China Telecom are accounted for 23% and 11%. For the time that users access the system, there is a peak period in the morning (08:00–10:00) and afternoon (14:00–16:00), respectively.Conclusions: The intelligent response system has achieved appreciable practical implementation effects. Our findings reveal that the provision of inquiry services through an intelligent voice consultation system may play a role in optimizing the allocation of healthcare resources, improving the efficiency of medical services, saving medical expenses, and protecting vulnerable groups.

Abstract Background Clinical named entity recognition (CNER) is important for medical information mining and establishment of high-quality knowledge map. Due to the different text features from natural language and a large number of professional and uncommon clinical terms in Chinese electronic medical records (EMRs), there are still many difficulties in clinical named entity recognition of Chinese EMRs. It is of great importance to eliminate semantic interference and improve the ability of autonomous learning of internal features of the model under the small training corpus. Methods From the perspective of deep learning, we integrated the attention mechanism into neural network, and proposed an improved clinical named entity recognition method for Chinese electronic medical records called BiLSTM-Att-CRF, which could capture more useful information of the context and avoid the problem of missing information caused by long-distance factors. In addition, medical dictionaries and part-of-speech (POS) features were also introduced to improve the performance of the model. Results Based on China Conference on Knowledge Graph and Semantic Computing (CCKS) 2017 and 2018 Chinese EMRs corpus, our BiLSTM-Att-CRF model finally achieved better performance than other widely-used models without additional features(F1-measure of 85.4% in CCKS 2018, F1-measure of 90.29% in CCKS 2017), and achieved the best performance with POS and dictionary features (F1-measure of 86.11% in CCKS 2018, F1-measure of 90.48% in CCKS 2017). In particular, the BiLSTM-Att-CRF model had significant effect on the improvement of Recall. Conclusions Our work preliminarily confirmed the validity of attention mechanism in discovering key information and mining text features, which might provide useful ideas for future research in clinical named entity recognition of Chinese electronic medical records. In the future, we will explore the deeper application of attention mechanism in neural network.

BackgroundTelemedicine that combines information technology and health care augments the operational model of traditional medical services and brings new opportunities to the medical field. China promotes telemedicine with great efforts, and its practices in the deployment of telemedicine platforms and delivery of services have become important references for the research and development in this field. ObjectiveOur work described in this paper focuses on a regional telemedicine platform that was built in 2014. We analyzed the system design scheme and remote consultations that were conducted via the system to understand the deployment and service delivery processes of a representative telemedicine platform in China. MethodsWe collected information on remote consultations conducted from 2015 to 2020 via the regional telemedicine platform that employs a centralized architectural system model. We used graphs and statistical methods to describe the changing trends of service volume of remote consultation, geographical and demographic distribution of patients, and waiting time and duration of consultations. The factors that affect consultation duration and patient referral were analyzed by multivariable linear regression models and binary logistic regression models, respectively. The attitudes toward telemedicine of 225 medical practitioners and 225 patients were collected using the snowball sampling method. ResultsThe regional telemedicine platform covers all levels of medical institutions and hospitals in all 18 cities of Henan Province as well as some interprovince hospitals. From 2015 to 2020, 103,957 remote medical consultations were conducted via the platform with an annual increasing rate of 0.64%. A total of 86.64% (90,069/103,957) of medical institutions (as clients) that applied for remote consultations were tier 1 or 2 and from less-developed regions; 65.65% (68,243/103,945) of patients who applied for remote consultations were aged over 50 years. The numbers of consultations were high for departments focusing in the treatment of chronic diseases such as neurology, respiratory medicine, and oncology. The invited experts were mainly experienced doctors with senior professional titles. Year of consultation, tier of hospital, consultation department, and necessity of patient referral were the main factors affecting the duration of consultations. In surveys, we found that 60.4% (136/225) of medical practitioners and 53.8% (121/225) of patients had high satisfaction and believed that telemedicine is of vital importance for the treatment of illness. ConclusionsThe development of telemedicine in China shows a growing trend and provides great benefits especially to medical institutions located in less developed regions and senior citizens who have less mobility. Cases of remote consultations are mainly for chronic diseases. At present, the importance and necessity of telemedicine are well recognized by both patients and medical practitioners. However, the waiting time needs to be further reduced to improve the efficiency of remote medical services.

Amine-functionalized metal-organic frameworks (MOFs) are a promising strategy for the high-efficiency capture and separation of CO2. In this work, by tuning the ratio of 1,3,5-benzenetricarboxylic acid (H3BTC) to 5-aminoisophthalic acid (5-NH2-H2IPA), we designed and synthesized a series of amine-functionalized highly stable Ti-based MOFs (named MIP-207-NH2-n, in which n represents 15%, 25%, 50%, 60%, and 100%). The structural analysis shows that the original framework of MIP-207 in the MIP-207-NH2-n (n = 15%, 25%, and 50%) MOFs remains intact when the mole ratio of ligand H3BTC to 5-NH2-H2IPA is less than 1 to 1 in the resulting MOFs. By the introduction of amino groups, MIP-207-NH2-25% demonstrates outstanding CO2 capture performance up to 3.96 and 2.91 mmol g−1, 20.7% and 43.3% higher than those of unmodified MIP-207 at 0 and 25 °C, respectively. Furthermore, the breakthrough experiment indicates that the dynamic CO2 adsorption capacity and CO2/N2 separation factors of MIP-207-NH2-25% are increased by about 25% and 15%, respectively. This work provides an additional strategy to construct amine-functionalized MOFs with the maintenance of the original MOF structure and high performance of CO2 capture and separation.

Aberrant metabolism is one of the hallmarks of cancers. The contributions of dysregulated metabolism to cancer development, such as tumor cell survival, metastasis and drug resistance, have been extensively characterized. “Reprogrammed” metabolic pathways in cancer cells are mainly represented by excessive glucose consumption and hyperactive de novo lipogenesis. Natural compounds with anticancer activities are constantly being demonstrated to target metabolic processes, such as glucose transport, aerobic glycolysis, fatty acid synthesis and desaturation. However, their molecular targets and underlying anticancer mechanisms remain largely unclear or controversial. Mounting evidence indicated that these natural compounds could modulate the expression of key regulatory enzymes in various metabolic pathways at transcriptional and translational levels. Meanwhile, natural compounds could also inhibit the activities of these enzymes by acting as substrate analogs or altering their protein conformations. The actions of natural compounds in the crosstalk between metabolism modulation and cancer cell destiny have become increasingly attractive. In this review, we summarize the activities of natural small molecules in inhibiting key enzymes of metabolic pathways. We illustrate the structural characteristics of these compounds at the molecular level as either inhibitor of various enzymes or regulators of metabolic pathways in cancer cells. Our ultimate goal is to both facilitate the clinical application of natural compounds in cancer therapies and promote the development of novel anticancer therapeutics.

The lithic assemblage from Shizitan 29, a late Upper Paleolithic open-air site in Shanxi, China, provides evidence for the earliest, well-dated microblade production in East Asia, ca. 26/24 Ka cal BP. To pursue a behavioral rather than traditional typological understanding of this key adaptive technology, we apply a techno-functional approach that enables us to reconstruct the entire operational sequence in behavioral terms through the derivation of technical objectives. This methodology can serve as a model to be applied to other assemblages for greater understanding of the origins and spread of the broadly distributed eastern Asian Late Pleistocene microblade industries. Within the eight cultural layers at Shizitan 29, microblade production abruptly appears at the top of Layer 7 following earlier core-and-flake production, supporting hypotheses of microblade technology arising within adaptive strategies to worsening Late Glacial Maximum environments. Significantly, reconstruction of the operational sequence supports microblade technology being introduced into the North China Loess Plateau from regions further north. It also allows us to re-think microblades' relationship in behavioral terms with earlier limited examples of East Asian blade production and the evolution and spread of microblade technology, providing new insights into the adaptive relationships between subsequent microblade productions.

The auroral arc is the typical track of the interaction between the solar wind and the Earth's magnetosphere. A sketch of skeletons for arc-like aurora is usually used to describe auroral structures, such as vortex, fold and curl structures, etc. With artificial intelligence technologies, sketching auroral skeleton structure (AuroSS) in all-sky images enables automatic detection and measurement of aurora arcs in very large amounts of ground-based auroral observation data. The skeleton is a highly characterizing topological structure that has been extensively studied in the field of computer vision. However, AuroSS is not the medial axis of auroral shapes and a large number of accurate AuroSS annotations are not available. It is difficult to detect AuroSS by using an unsupervised or fully-supervised method. In this paper, we formulate the automatic AuroSS extraction to learn a mapping from an all-sky auroral image to a ridge style AuroSS. Without accurate AuroSS annotations, emission ridge and coarse localization of aurora are incorporated to generate pseudo-labels of AuroSS. A series of functional weakly supervised models are trained and cascaded to achieve AuroSS detection. Experimental results on auroral images obtained from all-sky imagers at Yellow River Station (YRS) show that the detected AuroSS is consistent with that of human visual perception. Based on the obtained AuroSS, the orientations and lengths of auroral arcs can be estimated automatically. By browsing the temporal variation in arc orientation from dusk to dawn, we can acquire synoptic observations of auroral activities at YRS. [ABSTRACT FROM AUTHOR]