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Background With the precipice decline of the birth population and the successive adjustment of the fertility policy in China, it is inevitable to re-examine the breadth and depth of maternal and infant health care services. Also, it has posed great challenges to the community health service institutions, which are the important suppliers of maternal and infant health care services. Objective To investigate the current status of maternal and infant health services in Shanghai communities, in order to provide suggestions and evidence for upgrading the level of primary care services for mothers and infants. Methods From August 2022 to April 2023, using purposive sampling method, the study selected 5 community health centers in the central district of Shanghai, in which in-depth personal interviews were conducted with 10 maternal and infant health service providers during participatory observation; organized a focus group interview with 12 primary health workers in the urban-rural fringe areas. In addition, 8 obstetrics staff from tertiary hospitals participating the construction of obstetrics and gynecology medical consortium, were invited to conduct 2 focus group interviews to obtain information from different perspectives. The data were analyzed using the content analysis method. Results A total of 4 themes and 11 sub-themes were extracted: (1) some health care projects are poorly implemented (inadequate mental health care, ineffective contraceptive guidance, and difficulties in implementation of traditional Chinese medicine health care) ; (2) health talent team construction needs to be strengthened (inadequate human resources, limited professional knowledge and skills, poor motivation to work, and little role of the family physician teams) ; (3) the implementation process is challenging (difficulty in cross-district management and low participation of residents) ; (4) the services integration need to be improved (deviation in the positioning of higher-level medical institutions and insufficient coordination among agencies) . Conclusion At present, maternal and infant health care in Shanghai communities is still facing various challenges. It is necessary to make full use of the opportunity of medical union construction to strengthen talent training and establish an innovative human resource management model. At the same time, when strengthening the top-level design and clarifying the division of tasks between the various tiers of medical institutions, the performance assessment and incentive mechanism should be improved to truly stimulate the morale and service enthusiasm of community maternal and infant health service providers. Multiple measures should be taken to effectively enhance the quality of service and meet the needs of current health care tasks.

Objective To investigate the application and effects of apatinib mesylate combined with programmed death receptor-1 (PD-1) monoclonal antibody (mAb)—toripalimab in immunotherapy for triple negative breast cancer (TNBC). Methods Among 40 female BALB/C mice, 8 mice were randomly selected as the blank group without tumor inoculation, and the remaining 32 mice were inoculated with 4T1 cells to establish TNBC models. They were randomly divided into toripalimab group (n=8, administered 10 mg/kg of toripalimab through the tail vein on the 3rd, 6th, and 9th day)， apatinib group (n=8, received 60 mg/kg of apatinib mesylate by gavage daily for 21 consecutive days), combination group (n=8, administration route and dose of apatinib mesylate and toripalimab were the same as those of each single drug group), and model group (n=8, administered normal saline with same volume as administration groups by gavage and tail vein injection at the same time points). The changes of tumor weight and tumor volume in mice were monitored, the pathological changes of tumor in situ and liver/lung metastases in each group were analyzed by HE method, and the markers expressions of CD8+T lymphocytes, myeloid-derived suppressor cells (MDSCs), M2 tumor-associated macrophages (M2-TAMs) and regulatory T cells (Tregs) in the tumor tissues of mice in each group were analyzed by flow cytometry. Results (1) in situ tumors: the volume of in situ tumors in all three administration groups of mice was smaller than that in model group (P＜0.01), while that was smaller in combined group compared with apatinib group and toripalimab group (P＜0.01). Based on model group, the tumor inhibition rates of apatinib group, toripalimab group and combination group increased by (20.3±0.9)%, (24.5±1.2)% and (52.9±0.8)%, respectively, with the highest in combination group (F=997.528, P＜0.01). Pathology showed that the apoptosis phenomenon of in situ tumor cells in combination group was the most significant. (2) Lung/liver metastases: the pathology showed that combination group had the smallest area of lung metastases and the fewest number of liver metastases. (3) Immune cells: compared with the other three groups, the proportion of immune promoting cells (CD8+T cells) in the tumor tissue of combination group significantly increased (P＜0.05), while the proportion of immunosuppressive cells (MDSCs, M2-TAMs, and Tregs cells) significantly reduced (P＜0.05). Conclusion The combination of apatinib mesylate and toripalimab in the treatment of TNBC mice may inhibit the growth of in situ tumor and the formation of lung/liver metastasis formation, and significantly improve the immune efficacy by increasing the proportion of intratumoral immune-promoting cells and reducing the proportion of immunosuppressive cells.

Understanding the shock initiation mechanisms of explosives is pivotal for advancing physicochemical theories and enhancing experimental methodologies. This study delves into the size-dependent shock responses of nanogranular hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) through nonequilibrium reactive molecular dynamics simulations. Utilizing the ReaxFF-lg force field, we examine the influence of the particle size on the decomposition dynamics of RDX under varying shock velocities. Our findings reveal that larger particles promote more significant RDX decomposition at lower velocities due to fluid jet formation and gas compression during void collapse. Conversely, smaller particles exhibit a higher average temperature and a faster decomposition rate under high-velocity shocks, attributed to their increased specific surface area. Detailed chemical reaction pathways are analyzed to elucidate the growth and initiation of reactions during shock waves. The results contribute to resolving the discrepancies observed in experimental studies of shocked granular explosives and provide a deeper understanding of the underlying mechanisms governing their behavior. This research offers valuable insights into the design and control of nano- and submicron-sized explosives with tailored sensitivity to external stimuli. [ABSTRACT FROM AUTHOR]

Metal-organic framework (MOF) nanomaterials are emerging porous coordinative polymers with large surface area and high porosity. Their application scenarios highly depend on adsorption/desorption dynamics of guest molecules in the framework. For representative ZIF-8 with framework flexibility, the study of molecule transportation in the pore channels of ZIF-8 will address the ambiguity of unclear application scenarios. In this study, the integration of lab-on-fiber technology and nanotechnology are demonstrated for real-time monitoring of adsorption/desorption dynamics of heterocyclic volatile compounds (VOCs) with kinetic diameters larger than the window aperture of ZIF-8. The in-line fiber interferometer with cascaded long-period gratings is used to monitor the real-time refractive index change of VOC adsorption/desorption. The structure-effect relationship between guest VOCs and framework flexibility is analyzed. It shows that the adsorption dynamics is highly related to the molecular geometry and kinetic diameter. The framework flexibility results in the trapping of guest VOCs toluene, pyridine, and tetrahydrofuran in the frameworks. The methanol adsorption/desorption is an effective strategy for the fast desorption of trapped residual VOCs in the framework. Finally, we conceptually demonstrated the real-time monitoring of trace toluene enrichment using ZIF-8 for indoor air purification. This study paves the way for the in-depth understanding of framework flexibility for MOF’s application.

Synaptic refinement is a critical step in nervous system maturation, requiring a carefully timed reorganization and refinement of neuronal connections. We have identified myrf-1 and myrf-2, two C. elegans homologs of Myrf family transcription factors, as key regulators of synaptic rewiring. MYRF-1 and its paralog MYRF-2 are functionally redundant specifically in synaptic rewiring. They co-exist in the same protein complex and act cooperatively to regulate synaptic rewiring. We find that the MYRF proteins localize to the ER membrane and that they are cleaved into active N-terminal fragments, which then translocate into the nucleus to drive synaptic rewiring. Overexpression of active forms of MYRF is sufficient to accelerate synaptic rewiring. MYRF-1 and MYRF-2 are the first genes identified to be indispensable for promoting synaptic rewiring in C. elegans. These findings reveal a molecular mechanism underlying synaptic rewiring and developmental circuit plasticity.

Identifying crucial nodes in complex networks is paid more attention in recent years. Some classical methods, such as degree centrality, betweenness centrality and closeness centrality, have their advantages and disadvantages. Recently, the gravity model is applied to describe the relationship of nodes in a complex network. However, the interaction force in gravity model follows the square law of distance, which is inconsistent with the actual situation. Most people are generally affected by those who are surrounding them, which means that local influence should be emphasized. To address this issue, we propose an indexing method called localized decreasing gravity centrality by maximizing the local influence of a node. In the proposed measure, the mass and radius of gravity model are redefined, which can represent the spreading ability of the node. In addition, a decreasing weight is added to strengthen the local influence of a node. To evaluate the performance of the proposed method, we utilize four different types of networks, including interaction networks, economic networks, collaboration networks and animal social networks. Also, two different infectious disease models, susceptible-infectious-recovered (SIR) and susceptible-exposed-low risk-high risk-recovered (SELHR), are utilized to examine the spreading ability of influential nodes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pressure injury (PI) is a local injury of the skin and/or soft tissue located at the bone caused by medical or other equipment and is common in long-term bedridden patients. OBJECTIVE: To investigate the clinical effect of Urgotul foam dressing in the treatment of stage 3 ∼ 4 PI and deep tissue PI. METHODS: A total of 38 patients with stage 3 ∼ 4 PI and deep tissue PI admitted to Jinan Central Hospital from January 2016 to December 2018 were selected and randomly divided into a control group (dressing change plus silver ion cream dressing) and an observation group (dressing change plus Urgotul Absorb non-border foam dressing), with 19 cases in each group. After 4 weeks of treatment, the pain intensity during dressing change and the treatment efficacy for PI wounds were compared between the two groups. RESULTS: There were no differences in gender (P = 0.740), age (P = 0.130), single wound area (P = 0.673), consultation department (P = 0.972), stage (P = 0.740), presence of undermining (P = 0.721), deep tissue PI (P = 0.721), and systemic antibiotic therapy (P = 1.000) between the two groups, which were comparable. The treatment effect of the observation group was better than that of the control group (P = 0.003), and the pain score of the observation group was lower than that of the control group (P < 0.001). CONCLUSION: Urgotul Absorb non-border foam dressing has a good effect in the treatment of stage 3 ∼ 4 PI and deep tissue PI and can relieve patients' pain, and is thus worth promoting. [ABSTRACT FROM AUTHOR]