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Abstract Coral reconstruction often serves as a major proxy of high-resolution sea surface temperature (SST) variability beyond the instrumental era. However, coral reconstructions are sparse and are usually studied for interannual variability, with few studies on the monthly features. In this study, we reconstruct the monthly SST spatial field by applying the paleoclimate data assimilation method to the coral records of the latest CoralHydro2k data set for the instrument period of 1880–2000. A comparison with observed SST variability shows that our assimilated tropical SST variability performs reasonably well for the seasonal cycle and monthly ENSO characteristics, notably the phase-locking and onset timing, and more realistic spatial fields relative to the model simulations. This study suggests the feasibility of applying paleoclimate data assimilation to reconstruct the monthly SST in the historical period.

To explored the protective effect and mechanism of Chinese yam total protein in human umbilical vein endothelial cells (HUVECs) with high-concentration D-glucose (HG)-induced oxidative stress injury. The HUVECs injury model was established by 50 mmol/L HG. HUVECs were randomly divided into control, model, low-dose Chinese yam total protein (0.5 mg/mL), and high-dose Chinese yam total protein (1 mg/mL) groups. The effects of Chinese yam total protein on the viability, morphology, and angiogenetic ability of HUVECs treated with HG were evaluated. The reactive oxygen species (ROS) level, superoxide dismutase (SOD) and catalase (CAT) activities in cells were determined. The nitric oxide (NO), 8-hydroxy deoxyguanosine (8-OHdG), malondialdehyde (MDA), interleukin-1β (IL-1β), and interleukin-6 (IL-6) levels in culture medium supernatant were measured. Protein expression levels of B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X (Bax), thioredoxin-interacting protein (Txnip), NOD-like receptor protein 3 (NLRP3), cleaved Caspase-1, and IL-1β were determined. The results showed that Chinese yam total protein could significantly increased the cell viability of HUVECs treated with HG (P

Considering the concerning increase in overweight and obesity rates among Filipino youth, this study seeks to evaluate the effectiveness of a housework-based exercise program. This program capitalizes on the inherent familiarity of traditional household chores, transforming them into structured exercise routines designed to improve the physical fitness levels of overweight and obese Filipino adolescents. A one-group pretest-posttest design was employed. The intervention transformed traditional household chores into structured exercise routines. Fitness parameters, including Body Mass Index (BMI), cardiovascular endurance, flexibility, and muscular strength & endurance, were assessed before and after the intervention. Statistical analysis was conducted using SPSS software version 29, with Q-Q plots used to confirm the normality of the data. Paired sample t-tests evaluated pre- and post-intervention changes, while independent sample –t-tests determined gender differences. Findings showed that males experienced a greater reduction in BMI (+13.37%, p < .001, effect size = 1.393), while females showed more improvement in cardiovascular endurance (+8.82%, p < .001, effect size = 2.354) and flexibility (left: −46.12%, p < .001, right: −8.31%, p < .001). Both sexes achieved similar gains in muscular strength and endurance (push-up: −35.33%, p < .001, plank: −30.77%, p < .001). This research supports the value of everyday activities beyond structured exercise programs, highlighting the potential of a culturally sensitive approach that utilizes familiar household chores. The program promotes physical activity in a way that resonates with Filipino adolescents and their families, offering a promising, cost-effective intervention to address childhood obesity within the Filipino community.

Abstract Background Oesophageal squamous cell carcinoma is one of the most commonly diagnosed carcinomas in China, and postoperative radiotherapy plays an important role in improving the prognosis of patients. Carcinomas in different locations of the oesophagus could have different patterns of lymph node metastasis after surgery. Methods In this multicentric retrospective study, we enrolled patients with middle thoracic oesophageal squamous cell carcinomas from 3 cancer centres, and none of the patients underwent radiotherapy before or after surgery. We analysed the lymph node recurrence rates in different stations to explore the postoperative lymphatic recurrence pattern. Results From January 1st, 2014, to December 31st, 2019, 132 patients met the criteria, and were included in this study. The lymphatic recurrence rate was 62.1%. Pathological stage (P = 0.032) and lymphadenectomy method (P = 0.006) were significant predictive factors of lymph node recurrence. The recurrence rates in the supraclavicular, upper and lower paratracheal stations of lymph nodes were 32.6%, 28.8% and 16.7%, respectively, showing a high incidence. The recurrence rate of the subcarinal node station was 9.8%, while 8.3% (upper, middle and lower) thoracic para-oesophageal nodes had recurrences. Conclusions We recommend including the supraclavicular, upper and lower paratracheal stations of lymph nodes in the postoperative radiation field in middle thoracic oesophageal carcinomas. Subcarinal station is also potentially high-risk, while whether to include thoracic para-oesophageal or abdominal nodes needs careful consideration.

Retaining a devoted and skilled workforce has become of paramount importance in China’s dynamic and competitive education sector. The consequences of employee turnover bear weight, especially for institutions striving for global excellence, impacting both institutional continuity and the quality of education. This study explores the factors influencing employee turnover intention within Chinese academic institutions and prioritizes these factors based on their significance. A two-round Delphi method was employed to solicit and synthesize expert opinions through iterative rounds. Nineteen experts from private education institutions in Fuzhou, China, were selected using a combination of purposeful and snowball sampling. In the first round, experts listed the factors contributing to employee turnover intentions, which were then analyzed using thematic analysis. In the second round, the experts ranked these dimensions from most to least important. The study identifies five pivotal factors affecting turnover intentions, listed in order of importance: (1) compensation, benefits, and employee recognition; (2) career development and advancement opportunities; (3) professional growth, training, and job security; (4) leadership, management support, and organizational culture; and (5) work-life balance and work environment. This research proffers actionable recommendations to discern and counteract contributors to employee turnover. The insights furnish invaluable guidance for Chinese educational institutions, underscoring the necessity of employee contentment and laying the groundwork for a sustained and driven workforce.

This study investigates the key factors influencing employee performance in the banking sector, focusing on how traditional and emergent challenges affect workforce efficiency and satisfaction. Given the rapidly evolving digital landscape, the research seeks to identify the most significant determinants of employee performance that banking institutions must address to maintain stability and growth. The study employs the Delphi Method, engaging a panel of 29 experts through two rounds of surveys to identify and rank the determinants of employee performance. This iterative process allowed for the refinement of expert insights, ultimately leading to a consensus on the most impactful factors influencing performance in the banking sector. The results indicate that compensation and benefits are the most critical factors affecting employee performance, followed by organizational culture and working environment, leadership and management, job satisfaction and motivation, and work-life balance and flexibility. The study highlights that while compensation is paramount, work-life balance and flexibility, though important, have a lower immediate impact on performance. This research contributes to the theoretical framework of employee performance by integrating contemporary challenges specific to the banking sector with broader motivational theories, such as Maslow’s Hierarchy of Needs. The study provides practical insights for banking institutions, emphasizing the need for holistic strategies that address employee well-being and organizational objectives. These findings offer valuable guidance for stakeholders to enhance productivity and employee satisfaction in the competitive banking industry.

The purpose of this research is to examine the determinants that impact employee job satisfaction in the manufacturing industry of Malaysia in the midst of technological progress and economic changes that have been further complicated by the COVID-19 pandemic. The study utilizes the Delphi method to ascertain and rank workplace factors that influence job satisfaction. By employing a qualitative Delphi approach, the study amasses expert consensus in order to investigate the complex dimensions of job satisfaction within the manufacturing sector. The study solicits input from industry experts via two rounds of surveys in order to evaluate the significance of a variety of working environment factors. The analysis is guided by theoretical frameworks, including Maslow’s Hierarchy of Needs and Herzberg’s Two-Factor Theory. In descending order of importance, industry experts agreed that compensation and benefits are the most significant determinant of employee job satisfaction, followed by support for work-life balance, rewards and recognition, organizational support, and opportunities for career growth and development. This research contributes to the body of knowledge on job satisfaction by utilizing the Delphi method, which is an innovative approach in this particular domain, to obtain expert consensus regarding the factors that influence job satisfaction in the manufacturing industry. This approach overcomes the constraints of quantitative methodologies by offering comprehensive analyses of the qualitative dimensions of employee satisfaction. In addition, the study provides policymakers and industry stakeholders with actionable suggestions, underscoring the importance of implementing comprehensive approaches to improve job satisfaction.

Attrition is the biggest pain point in the contact-center industry across nations. Hence, it is important to study how to retain contact center employees. This study aimed to identify the key factors influencing long-term retention among contact center employees in Malaysia. The Delphi method was implemented using purposive sampling. A total of 24 experts were selected from the contact center industry, who had been working in the field for more than five years in managerial positions. A two-round Delphi method was conducted where, in the first round, experts were requested to list the factors contributing to long-term retention among contact center employees in Malaysia. Thematic analysis was employed in the first round to identify the dimensions by grouping themes. In the second round, experts were requested to rank the dimensions from the most important to the least important. Based on the findings, the most important factors identified were supportive management, followed by work-life balance, compensation and benefits, working environment, career development, reward and recognition, training and development, and health support. Recommendation was provided to the contact center operation in Malaysia based on this finding on the initiative that can be worked on to retain the contact center employee in Malaysia.

BackgroundCerebral radiation necrosis (RN), a severe complication of stereotactic radiotherapy (SRT), has been shown to significantly decrease patient survival time and quality of life. The purpose of this study was to analyze whether bevacizumab can prevent or reduce the occurrence of SRT-induced cerebral RN in non-small cell lung cancer (NSCLC) patients with brain metastases.Materials and methodsWe retrospectively reviewed the clinical records of NSCLC patients with brain metastases from March 2013 to June 2023 who were treated with SRT. Patients were divided into two groups: those in the bevacizumab group received SRT with four cycles of bevacizumab, and patients in the control group received SRT only. Inverse probability of treatment weighting (IPTW) was performed based on a multinomial propensity score model to balance the baseline characteristics. The chi-square test was used. A Cox model was used to evaluate overall survival (OS).ResultsA total of 80 patients were enrolled, namely, 28 patients in the bevacizumab group and 52 patients in the control group. The possibility of developing cerebral RN and/or symptomatic edema (RN/SE) was significantly decreased in patients treated with bevacizumab compared to those who did not receive bevacizumab before IPTW (p=0.036) and after IPTW (p=0.015) according to chi-square analysis. The IPTW-adjusted median OS was 47.7 months (95% CI 27.4-80.8) for patients in the bevacizumab group and 44.1 months (95% CI 36.7-68.0) (p=0.364) for patients in the control group.ConclusionThe application of bevacizumab concurrent with SRT may prevent or reduce the occurrence of cerebral RN in NSCLC patients with brain metastases.

This study aims to analyze the mediating role of employee engagement and the green work environment in the relationship between motivation and the performance of logistics company employees in Jakarta, Indonesia. Employing a causal quantitative research approach, we distributed 222 questionnaires among logistics employees from four surrounding cities in Jakarta, namely Bogor, Depok, Tangerang, and Bekasi. These questionnaires were adapted from past studies. The data were processed using Structural Equation Modeling (SEM) with Partial Least Squares. The results showed that employee performance in logistics companies was positively and significantly influenced by motivation. Furthermore, a green work environment and employee engagement were found to significantly mediate the relationship between motivation and performance. These findings underscore the importance of a green work environment and employee engagement in enhancing motivation and performance in logistics companies. The study implies that employee performance in logistics companies can be elevated through the provision of a green work environment, alongside fostering employee motivation and engagement.

IntroductionThis study conducts a bibliometric analysis on neurofeedback research to assess its current state and potential future developments.MethodsIt examined 3,626 journal articles from the Web of Science (WoS) using co-citation and co-word methods.ResultsThe co-citation analysis identified three major clusters: “Real-Time fMRI Neurofeedback and Self-Regulation of Brain Activity,” “EEG Neurofeedback and Cognitive Performance Enhancement,” and “Treatment of ADHD Using Neurofeedback.” The co-word analysis highlighted four key clusters: “Neurofeedback in Mental Health Research,” “Brain-Computer Interfaces for Stroke Rehabilitation,” “Neurofeedback for ADHD in Youth,” and “Neural Mechanisms of Emotion and Self-Regulation with Advanced Neuroimaging.DiscussionThis in-depth bibliometric study significantly enhances our understanding of the dynamic field of neurofeedback, indicating its potential in treating ADHD and improving performance. It offers non-invasive, ethical alternatives to conventional psychopharmacology and aligns with the trend toward personalized medicine, suggesting specialized solutions for mental health and rehabilitation as a growing focus in medical practice.

This study presents a comprehensive bibliometric analysis of the literature on psychological capital (PsyCap) within higher education institutions (HEIs). Its main objective is to offer an encompassing perspective on this field's current state and potential developments. To achieve this, the study examines present research trends and predicts future directions using a bibliometric approach. A total of 412 journal articles were gathered from the Web of Science database. The analysis identifies influential publications, outlines the knowledge structure, and forecasts future trends through bibliographic coupling and co-word analyses. The bibliographic coupling revealed five distinct clusters, while the co-word analysis identified four clusters. Despite the growing significance of PsyCap research in HEIs, there remains a need for greater academic efforts to comprehend the research landscape fully. This paper provides valuable insights into the expanding area of PsyCap research within HEIs. In conclusion, the study sheds light on the extensive research conducted on PsyCap in the context of HEIs and offers insights into its potential for further growth.

This study provides a bibliometric analysis of smart hotel research, drawing from 613 publications in the Web of Science (WoS) database to examine scholarly trends and developments in this dynamic field. Smart hotels, characterized by integrating advanced technologies such as AI, IoT, cloud computing, and big data, aim to redefine customer experiences and operational efficiency. Utilizing co-citation and co-word analysis techniques, the research delves into the depth of literature from past to future trends. In co-citation analysis, clusters including ''Sustainable Hotel and Green Hotel'', ''Theories Integration in Smart Hotel Research'', and ''Consumers' Decisions about Green Hotels'' underscore the pivotal areas of past and current research. Co-word analysis further reveals emergent trend clusters: ''The New Era of Sustainable Tourism'', ''Elevating Standards and Guest Loyalty'', and ''Hotels' New Sustainable Blueprint in Modern Travel''. These clusters reflect the industry's evolving focus on sustainability and technology-enhanced guest experiences. Theoretically, this research bridges gaps in smart hotel literature, proposing new frameworks for understanding customer decisions amid technological advancements and environmental responsibilities. Practically, it offers valuable insights for hotel managers, guiding technology integration strategies for enhanced efficiency and customer loyalty while underscoring the critical role of green strategies and sustainability.

This study utilizes bibliometric analysis to examine historical and present research patterns in the area of energy transition and green finance and to forecast potential future domains. Using the bibliometric method, 328 scholarly articles from the Web of Science database were evaluated. This paper identifies influential publications, maps the research landscape, and forecasts emerging tendencies through co-citation and co-word analyses. Co-citation analysis found three main clusters, while co-word analysis revealed four main clusters. Despite the growing significance of research on energy transition and green finance research, further in-depth investigation is necessary to offer a thorough depiction of the research domain. This research represents a pioneering endeavour in the utilization of bibliometric analysis to investigate the interrelationship between two items. It offers valuable insights into the rapidly expanding field of energy transition and green finance, effectively highlighting its contours and indicating potential future developments.

This comprehensive bibliometric study analyzes 1820 journal articles from the Web of Science database to explore Equity, Diversity, and Inclusion (EDI) leadership in higher education institutions (HEIs). Utilizing co-citation and co-word analysis, the study identifies distinct thematic clusters. The co-citation analysis reveals five key themes: Race, Diversity, and Inclusion (RDI), Diversity, Leadership, and Self-Efficacy (DLSE), Gender Dynamics and Leadership Challenges, Women's Representation in Academic Medicine Leadership, and Transformational Leadership in HEIs. Meanwhile, the co-word analysis highlights three critical areas: Transformative Collaborative Resilience in HEIs, Advancing Gender Equality in Academic Medicine and STEM, and Inclusive Educational Leadership in HEIs. These themes collectively provide a deep understanding of the EDI leadership field's intellectual structure, suggesting significant areas for future research and practical application. The study emphasizes the necessity for HEIs to engage comprehensively in EDI leadership research, shedding light on the importance of transformative collaborative resilience, gender equality in STEM, and inclusive leadership. This research offers valuable insights for developing effective EDI leadership policies and practices, highlighting the interconnectedness of these themes in fostering a more equitable, diverse, and inclusive environment in higher education and beyond.

Abstract Background Immunotherapy has made significant advances in the treatment of extensive-stage small-cell lung cancer (ES-SCLC), but data in combination with radiotherapy are scarce. This study aims to assess the safety and efficacy of chemoimmunotherapy combined with thoracic radiotherapy in patients with ES-SCLC. Methods This single-center retrospective study analyzed patients with ES-SCLC who received standard platinum–etoposide chemotherapy combined with atezolizumab or durvalumab immunotherapy as induction treatment, followed by consolidative thoracic radiotherapy (CTRT) before disease progression in the first-line setting. Adverse events during radiotherapy with or without maintenance immunotherapy and survival outcomes were assessed. Results Between December 2019 and November 2021, 36 patients with ES-SCLC were identified to have received such treatment modality at one hospital. The number of metastatic sites at diagnosis was 1–4. The biological effective dose of CTRT ranged from 52 to 113 Gy. Only two patients (6%) developed grade 3 toxic effect of thrombocytopenia, but none experienced grade 4 or 5 toxicity. Four patients developed immune-related pneumonitis during the induction treatment period but successfully completed later CTRT. The rate of radiation-related pneumonitis was 8% with grades 1–2 and well tolerated. The median progression-free survival (PFS) was 12.8 months, but the median overall survival (OS) was not determined. The estimated 1-year OS was 80.2% and 1-year PFS was 53.4%. Conclusions Immunotherapy combined with CTRT for ES-SCLC is safe and has ample survival benefit.

The joint green R&D of suppliers and manufacturers and the green marketing of manufacturers directly affect the degree of green products. Based on this, this paper establishes a coordination decision-making model of green innovation on the basis of cost-sharing contracts to stimulate supply chain partnerships, and studies the green R&D efforts and green marketing investment decisions of the secondary supply chain composed of a single supplier and a single manufacturer under different leadership scenarios, as well as the relationship between the green R&D decisions of the supply chain and the green marketing decisions of the manufacturer. The influence of green innovation capability on enterprise profit, product greenness and marketing investment is analyzed by numerical simulation. The results show that if an enterprise increases the unit cost coefficient of green innovation, it will reduce the green input of all members of the supply chain; When consumers’ green preference is low, manufacturers will tend to increase investment in green marketing; Cost-sharing contracts can promote the overall green degree of products. The research conclusion can provide reference value for green supply chain management decision-making.

Recent studies have demonstrated that stem cells have attracted much attention due to their special abilities of proliferation, differentiation and self-renewal, and are of great significance in regenerative medicine and anti-aging research. Hence, finding natural medicines that intervene the fate specification of stem cells has become a priority. Ginsenosides, the key components of natural botanical ginseng, have been extensively studied for versatile effects, such as regulating stem cells function and resisting aging. This review aims to summarize recent progression regarding the impact of ginsenosides on the behavior of adult stem cells, particularly from the perspective of proliferation, differentiation and self-renewal.

Objective: To compare the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) for preventive or delayed treatment in neutropenia, completion rate of concurrent chemoradiotherapy and hospitalization rate in patients with esophageal squamous carcinoma during definitive concurrent chemoradiotherapy. Methods: A total of 70 patients with esophageal squamous carcinoma in Peking University Cancer Hospital from January 2019 to December 2020, who received PEG-rhG-CSF during concurrent chemoradiotherapy, were enrolled in this retrospective analysis. There were 32 patients in the preventive group, and 38 patients in the delayed group. The incidence of neutropenia, completion rate of concurrent chemoradiotherapy and neutropenia-related hospitalization rate were compared between PEG-rhG-CSF preventive group and delayed group. Results: The incidence of severe neutropenia (Grades 3–4) in all patients was 31.4%. Comparison between preventive group and delayed group showed that the incidence of severe neutropenia was 6.3% and 39.4% (χ2 ​= ​10.428, P ​= ​0.001), respectively. In preventive group, the incidence of severe neutropenia was 3.7% and 20.0%, respectively, for primary prevention and secondary prevention of PEG-rhG-CSF (χ2 ​= ​12.321, P ​= ​0.001). The completion rate of concurrent chemoradiotherapy was 93.8% in the preventive group and 63.2% in the delayed group (χ2 ​= ​9.220, P ​= ​0.002). The incidence of treatment interruption was 25.7% in the whole group, 12.5% in the preventive group and 36.8% in the delayed group (χ2 ​= ​5.389, P ​= ​0.020). Seven patients (7/70, 10.0%) were hospitalized and treated with intravenous antibiotics for neutropenia, including 1 in the preventive group and 6 in the delayed group (P ​= ​0.078). Conclusions: Prophylactic use of PEG-rhG-CSF during concurrent chemoradiotherapy for patients with esophageal squamous carcinoma can effectively reduce the incidence of neutropenia, ensure the safety of treatment, and improve the completion rate of concurrent chemoradiotherapy.

Abstract Background To study lymphatic recurrence distribution after radical surgery in the real world and guide clinical tumor volume delineation for regional lymph nodes during postoperative radiotherapy for lower thoracic squamous cell esophageal carcinomas. Methods We enrolled patients who underwent radical esophagectomy, without radiation before or after surgery, at 3 cancer hospitals. Patients were classified into groups according to tumor locations. We included patients with tumors in the lower thoracic segment and analyzed the postoperative lymph node recurrence mode. A cutoff value of 10% was used to differentiate high-risk lymph node drainage areas from others. Results We enrolled 1905 patients in the whole study series, including 652 thoracic esophageal carcinomas that met our inclusion criteria; there were 241 cases of lower thoracic esophageal carcinomas. 1st, 2nd, 4th, 7th, 8th groups of lymph nodes, according to the 8th edition of the AJCC classification, displayed as high-risk recurrence areas, representing 17.8%, 23.9%, 11.7%, 10.9% and 12.2% of lymph node recurrence. Stage III-IV tumors located in the lower segment of the thoracic esophagus showed a tendency to recur in the left gastric nodes (7.9%) and celiac nodes (10.6%). Conclusions According to our results, we recommended including the 4th, 7th and 8th groups of lymph nodes in the radiation field, and for patients with stage III-IV disease, the 17th and 20th groups of nodes should be irradiated during postoperative treatment. Whether including 1st/2nd groups in preventive irradiation needed more proofs.

Vehicle Ad-hoc network (VANET) can provide technical support and solutions for the construction of intelligent and efficient transportation systems, and the routing protocol directly affects the efficiency of VANET. The rapid movement of nodes and uneven density distribution affect the routing stability and data transmission efficiency in VANET. To improve the local optimality and routing loops of the path-aware greedy perimeter stateless routing protocol (PA-GPSR) in urban sparse networks, a weight-based path-aware greedy perimeter stateless routing protocol (W-PAGPSR) is proposed. The protocol is divided into two stages. Firstly, in the routing establishment stage, the node distance, reliable node density, cumulative communication duration, and node movement direction are integrated to indicate the communication reliability of the node, and the next hop node is selected using the weight greedy forwarding strategy to achieve reliable transmission of data packets. Secondly, in the routing maintenance stage, based on the data packet delivery angle and reliable node density, the next hop node is selected for forwarding using the weight perimeter forwarding strategy to achieve routing repair. The simulation results show that compared to the greedy peripheral stateless routing protocol (GPSR), for the maximum distance–minimum angle greedy peripheral stateless routing (MM-GPSR) and PA-GPSR protocols, the packet loss rate of the protocol is reduced by an average of 24.47%, 25.02%, and 14.12%, respectively; the average end-to-end delay is reduced by an average of 48.34%, 79.96%, and 21.45%, respectively; and the network throughput is increased by an average of 47.68%, 58.39%, and 20.33%, respectively. This protocol improves network throughput while reducing the average end-to-end delay and packet loss rate.

Aging is a complex process of impaired physiological integrity and function, and is associated with increased risk of cardiovascular disease, diabetes, neurodegeneration, and cancer. The cellular environment of the aging brain exhibits perturbed bioenergetics, impaired adaptive neuroplasticity and flexibility, abnormal neuronal network activity, dysregulated neuronal Ca2+ homeostasis, accumulation of oxidatively modified molecules and organelles, and clear signs of inflammation. These changes make the aging brain susceptible to age-related diseases, such as Alzheimer’s and Parkinson’s diseases. In recent years, unprecedented advances have been made in the study of aging, especially the effects of herbal/natural compounds on evolutionarily conserved genetic pathways and biological processes. Here, we provide a comprehensive review of the aging process and age-related diseases, and we discuss the molecular mechanisms underlying the therapeutic properties of herbal/natural compounds against the hallmarks of brain aging.

This study aimed to construct a transdermal iontophoresis delivery system for terazosin hydrochloride (IDDS-TEH), which included a positive and negative electrode hydrogel prescription. Intact guinea pig skin was used as a model for the skin barrier function, and the current intensity, terazosin hydrochloride (TEH) concentration, pH, competitive salt, and transdermal enhancer properties were studied. The blood drug concentration was determined in Sprague–Dawley (SD) rats using HPLC, and the antihypertensive effects of IDDS-TEH were evaluated in spontaneously hypertensive rats (SHRs). The results showed that the steady-state penetration rate of TEH increased (from 80.36 µg·cm−2·h−1 to 304.93 µg·cm−2·h−1), followed by an increase in the current intensity (from 0.10 mA·cm−2 to 0.49 mA·cm−2). The pH values also had a significant influence on percutaneous penetration. The blood concentration of IDDS-TEH was significantly higher (p

Abstract Background There is no consensus on the definition or recommended radiotherapy treatment of ultracentral non‐small cell lung cancer (NSCLC). Here, we report our institution's experience in treating ultracentral lung cancer patients with stereotactic ablative radiotherapy (SABR) of 60 Gy in eight fractions. Methods We retrospectively reviewed the outcomes of 21 ultracentral NSCLC patients treated with 60 Gy SABR in eight fractions. We defined ultracentral lung cancer as the planning target volume (PTV) directly abutting or overlapping central structures, including the proximal bronchial tree, heart, and great vessels but not the esophagus. The Kaplan‐Meier method was used to estimate overall survival (OS), progression‐free survival (PFS) and local control (LC). Toxicity was scored per the CTCAE v4.03. Results The median follow‐up time was 15 months, and the median OS was 15 months. The one‐ and two‐year OS rates were 87.5% and 76.6%, respectively. The one‐ and two‐year PFS rates were 71.1% and 64.0%, respectively. The one‐ and two‐year LC rates were 92.9% and 92.9%, respectively. The rate of grade 2 treatment‐related toxicities was 19.1%. There was no grade ≥ 3 treatment‐related toxicity. Conclusion SABR of 60 Gy in eight fractions is feasible for ultracentral NSCLC.

Cervical cancer is a common gynecological malignancy afflicting women all over the world. Ginsenoside Rh2 (GRh2), especially 20(S)-GRh2, is a biologically active component in the natural plant ginseng, which can exhibit anticancer effects. Here, we aimed to investigate the effect of 20(S)-GRh2 on cervical cancer and elucidate the underlying mechanism through RNA-seq. In this study, the CCK-8 assay showed that 20(S)-GRh2 inhibited HeLa cell viability in a time- and dose-dependent manner. Caspase 3 activity and Annexin V staining results showed that 20(S)-GRh2 induced apoptosis of HeLa cells. Gene function enrichment analysis revealed that the biological process gene ontology (GO) terms were associated with the apoptotic signaling pathway. Biological process GO terms’ similarity network indicated that apoptosis might be from endoplasmic reticulum stress (ERs). Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that 20(S)-GRh2 primarily modulates apoptosis pathway genes. Combined protein–protein interaction network, hub gene screening, and qPCR validation data showed that ERs-related genes (ATF4 and DDIT3) and the downstream apoptotic genes (JUN, FOS, BBC3, and PMAIP1) were potential novel targets of 20(S)-GRh2-inducing cervical cancer cell apoptosis. Differential transcript usage analysis indicated that DDIT3 is also a differential transcript and its usage of the isoform (ENST00000552740.5) was reduced by 20(S)-GRh2. Molecular docking suggested that 20(S)-GRh2 binds to the targets (ATF4, DDIT3, JUN, FOS, BBC3, and PMAIP1) with high affinity. In conclusion, our findings indicated that 20(S)-GRh2 might promote ERs-related apoptosis of cervical cancer cells by regulating the DDIT3-based targets’ signal pathway. The role of 20(S)-GRh2 at the transcriptome level provides novel targets and evidence for the treatment of cervical cancer.

BackgroundHypofractionated radiotherapy (HypoRT) has been used to pursue an alternative treatment regimen for patients with non-small-cell lung cancer (NSCLC) who are not eligible for stereotactic ablative radiotherapy (SABR), surgery or concurrent chemoradiotherapy (CCRT) and has shown good local control and safety. We analyzed the feasibility of using volumetric-modulated arc radiotherapy (VMAT) with the simultaneous integrated boost (SIB) technique to achieve high local control with few treatment-related toxicities.Patients and MethodsA total of 55 patients with stage I-IV NSCLC who were not candidates for SABR, surgery or CCRT were included in the present study. All patients received a prescribed dose of 60 to 66 Gy in 15 fractions. Local progression-free survival (LPFS), PFS, overall survival (OS), and toxicities were retrospectively analyzed.ResultsThirty-three patients (60.0%) had stage IV or recurrent disease in this study. The median follow-up time was 8 months (interquartile range: 5.0-16.3 months). The 1-year and 2-year OS rates were 84.3% and 69.9%, and the 1-year and 2-year LPFS rates were 91.0% and 63.0%. The median OS (mOS) and median LPFS (mLPFS) were not reached, and median PFS (mPFS) was 15 months. Twenty-eight (51.9%) patients had disease progression at the time of analysis. Of these, 7 (13.0%), 7 (13.0%) and 21 (38.9%) had local recurrence, locoregional failure and distant metastasis, respectively. All cases of local recurrence were found within the SIB region. Four patients had grade 2-3 pneumonitis, and 8 patients had grade 2-3 esophagitis. Patients with grade 2-3 esophagitis had significantly higher maximum dose and dose to 5 cm3 volume to esophagus than those with grade 0-1 esophagitis. No grade 4 or higher toxicity was observed.ConclusionThe 60 to 66 Gy in 15 fractions RT regimen provides favorable local control and survival with well-tolerated toxicities. Hypofractionated VMAT+SIB is an alternative treatment option for patients with NSCLC who cannot tolerate standard definitive therapy.

Background and objective The standard treatment for locally advanced non-small cell lung cancer (NSCLC) is radiotherapy concurrent with chemotherapy, but the survival was not satisfied. With the development of intensity modulated radiotherapy, simultaneous integrated boost technique (SIB) becomes the research direction of locally advanced NSCLC. The aim of this study is to investigate the efficacy and safety of SIB intensity modulated radiotherapy technique for locally advanced NSCLC. Methods We retrospectively reviewed the clinical data of locally advanced NSCLC who were treated with radiotherapy by SIB technique in Peking University Cancer Hospital from June 2015 to December 2018. Kaplan-Meier method was used for analysis. Results Ninty-three patients were included in the analysis. After a median follow-up of 34.23 months, 3-year overall survival (OS), progression-free survival (PFS), local-recurrence free survival (LRFS) and metastasis free survival (MFS) rates were 53.0%, 37.0%, 50.5% and 50.5%, respectively. The incidence of grade ≥3 esophagitis was 5.4%. There were 2 (2.2%) patients experiencing grade ≥3 radiation-related pneumonia. Conclusion Radiation with SIB intensity modulated radiotherapy technique is effective and safe for patients with locally advanced NSCLC.

PurposeTo identify cytokines in plasma that may predict objective response and progression-free survival (PFS) in patients with locally advanced non-small cell lung cancer (NSCLC) treated with chemoradiotherapy.Materials and MethodsFrom April 2016 to May 2017, thirty-one patients with locally advanced inoperable/unresectable NSCLC were included, and treated with concurrent chemoradiotherapy (CCRT). No immune checkpoint inhibitors were administered after CCRT. Plasma from each patient was collected before radiotherapy, and 25 cytokines in the plasma were measured by Luminex or U-PLEX assays. Logistic regression and COX regression were performed to identify the predictive factors for objective response and PFS, respectively. Kaplan-Meier survival analysis was used to compare the PFS between the groups.ResultsHigh levels of IL-13 and TNF-α, and low levels of ICAM-1, IFN-γ, and soluble PD-L1 (sPD-L1) were significantly associated with objective response (P

This research focuses on female managers and aims to explore the factors influencing work-life balance among female managers in Chinese higher education institutions (HEIs), while also ranking the importance of these factors within HEIs. The research is divided into five main sections and employs a two-round Delphi research method, utilizing expert discussions and opinions to thoroughly analyze the work-life balance challenges faced by female managers. The findings of the research reveal six primary dimensions that influence the work-life balance of female managers in Chinese HEIs. These factors, ranked in order of importance, are as follows: (1) family factors, (2) work-related factors, (3) cultural and social norms, (4) health factors, (5) self-management and personal skills, and (6) support and satisfaction. In conclusion, this research offers valuable recommendations for understanding and improving the work-life balance of female managers in Chinese HEIs, providing essential guidance for both these institutions and female managers in achieving a balanced development in their professional and personal lives.

This study aims to analyze the mediating role of employee engagement and the green work environment in the relationship between motivation and the performance of logistics company employees in Jakarta, Indonesia. Employing a causal quantitative research approach, we distributed 222 questionnaires among logistics employees from four surrounding cities in Jakarta, namely Bogor, Depok, Tangerang, and Bekasi. These questionnaires were adapted from past studies. The data were processed using Structural Equation Modeling (SEM) with Partial Least Squares. The results showed that employee performance in logistics companies was positively and significantly influenced by motivation. Furthermore, a green work environment and employee engagement were found to significantly mediate the relationship between motivation and performance. These findings underscore the importance of a green work environment and employee engagement in enhancing motivation and performance in logistics companies. The study implies that employee performance in logistics companies can be elevated through the provision of a green work environment, alongside fostering employee motivation and engagement. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the effect of various leadership styles on employee performance in the Fast-Moving Consumer Goods (FMCG) industry in China. The unexpected global spread of the coronavirus pandemic and its complicated issues have created a substantial amount of uncertainty in consumer demand worldwide which has motivated this research and highlighted the crucial role that the FMCG industry's marketing relationship plays in determining enterprise profit. There is a growing concern among enterprise managers, academics and policymakers about employee performance and its overarching impact on the organization. The study is underpinned by social exchange theory and employs a cross-sectional design. An online survey was conducted with 384 employees from the FMCG industry to measure the impact of three independent variables: authentic leadership style, servant leadership style and ethical leadership style. The findings reveal that authentic, servant and ethical leadership all significantly affect employee performance in the Chinese FMCG industry. Among these, ethical leadership is found to have the extreme effect. The implications of this study are of practical relevance to FMCG companies. FMCG companies can potentially navigate through the uncertainty in global consumer demand more effectively by reconfiguring their leadership styles to enhance employee performance. The study provides insights that can be used by FMCG companies to increase employee performance which is directly linked to enterprise profit. [ABSTRACT FROM AUTHOR]