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AIM: To evaluate the effect of bone morphogenetic protein-6 (BMP-6) on transforming growth factor (TGF)-β2-induced epithelial-mesenchymal transition (EMT) in retinal pigment epithelium (RPE). METHODS: Adult retinal pigment epithelial cell line (ARPE-19) were randomly divided into control, TGF-β2 (5 µg/L), and BMP-6 small interfering RNA (siRNA) group. The cell morphology was observed by microscopy, and the cell migration ability were detected by Transwell chamber. The EMT-related indexes and BMP-6 protein levels were detected by Western blotting. Furthermore, a BMP-6 overexpression plasmid was constructed and RPE cells were divided into the control group, TGF-β2+empty plasmid group, BMP-6 overexpression group, and TGF-β2+BMP-6 overexpression group. The EMT-related indexes and extracellular regulated protein kinases (ERK) protein levels were detected. RESULTS: Compared with the control group, the migration of RPE cells in the TGF-β2 group was significantly enhanced. TGF-β2 increased the protein expression levels of α-smooth muscle actin (α-SMA), fibronectin and vimentin but significantly decreased the protein levels of E-cadherin and BMP-6 (P

As an important greenhouse gas (GHG) in the atmosphere, carbon dioxide (CO2) has a great impact on global climate change. Accurate knowledge of the spatiotemporal variations of CO2 is of great significance for understanding the carbon cycle and evaluating the effectiveness of carbon emission reduction. In recent years, several satellites with CO2 sensors have been launched and a series of atmospheric CO2 concentration products have been developed using different retrieval algorithms. This study validated nine satellite XCO2 products derived from Greenhouse gases Observing SATellite (GOSAT), GOSAT-2, Orbiting Carbon Observatory-2 (OCO-2), and OCO-3: including ACOS-GOSAT, NIES-GOSAT, BESD-GOSAT, OCFP-GOSAT, SRFP-GOSAT, EMMA, GOSAT-2, OCO-2, and OCO-3 XCO2. The remotely sensed XCO2 products were compared with the XCO2 observations from six Total Carbon Column Observing Network (TCCON) stations in East Asia for validation. The results showed that the OCO-2 XCO2 product outperformed other products, with the highest R2 of 0.94 and the lowest MAE of 1.24 ppm. The ACOS-GOSAT and EMMA-GOSAT XCO2 products also showed favorable accuracies, both achieving R2 of 0.93 and corresponding MAE values of 1.29 and 1.31 ppm, respectively. The GOSAT-2 XCO2 product showed the poorest accuracy, with an R2 of 0.77 and a mean absolute error of 3.28 ppm. There was a significant overestimation of the bias-uncorrected GOSAT-2 XCO2 product in East Asia, and it indicated that bias correction must be performed for this XCO2 product. The accuracy of TCCON XCO2 was not consistent with remotely sensed XCO2 at different stations. The RJ, JS, AN, and TK TCCON stations generally showed better agreements between satellite estimates and TCCON observations, except for the GOSAT-2 XCO2 product.

Abstract A hallmark of tumor cells, including bladder cancer (BLCA) cells, is metabolic reprogramming toward aerobic glycolysis (Warburg effect). The classical oncogene MYC, which is crucial in regulating glycolysis, is amplified and activated in BLCA. However, direct targeting of the c-Myc oncoprotein, which regulates glycolytic metabolism, presents great challenges and necessitates the discovery of a more clarified regulatory mechanism to develop selective targeted therapy. In this study, a siRNA library targeting deubiquitinases identified a candidate enzyme named USP43, which may regulate glycolytic metabolism and c-Myc transcriptional activity. Further investigation using functional assays and molecular studies revealed a USP43/c-Myc positive feedback loop that contributes to the progression of BLCA. Moreover, USP43 stabilizes c-Myc by deubiquitinating c-Myc at K148 and K289 primarily through deubiquitinase activity. Additionally, upregulation of USP43 protein in BLCA increased the chance of interaction with c-Myc and interfered with FBXW7 access and degradation of c-Myc. These findings suggest that USP43 is a potential therapeutic target for indirectly targeting glycolytic metabolism and the c-Myc oncoprotein consequently enhancing the efficacy of bladder cancer treatment.

ABSTRACTNature reserves play a key role in the conservation of habitats, species and ecosystems in China. However, the issue of light pollution within these reserves has not received well recognition. Whereas previous studies have investigated light pollution in protected areas by remote sensing, the influence of the atmospheric scattered light from neighborhoods was ignored by using only direct light emissions. This study mapped the nighttime all-sky brightness from NPP/VIIRS data to quantify light pollution over the national nature reserves in China from 2013 to 2022. Based on the remotely sensed sky brightness, the spatio-temporal variations of sky brightness were analyzed. The mean sky brightness across all nature reserves was 0.63 mcd/m2 and the mean trend was 0.0189 mcd/m2/a, indicating obvious and accelerating light pollution. Furthermore, the sky brightness around the nature reserves was estimated and compared with the reserves. In general, the surrounding regions showed higher sky brightness and brightening trends, suggesting a certain but insufficient protective effect on the sky quality of nature reserves. This study provides a comprehensive understanding of the light pollution conditions in the national nature reserves in China and serves as a valuable reference for future assessments of light pollution using remote sensing data.

The geometry of an orifice is a major determinant of nozzle internal flow and cavitation, which directly govern spray atomization and consequently affect combustion and fuel economy in internal combustion engines. In this study, simulation models of the nozzle at different angles between the normal and the injection hole inlet cross-section and the injection hole axis, as well as with different injection hole cone angles (a positive angle between the injection hole axis and its walls implies a divergent hole), were investigated by means of a previously developed numerical model that was validated based on experimental data from X-ray image technology. The results indicate that as the angle between the normal and the injection hole inlet cross-section and the injection hole axis increases, the cavitation asymmetry within the injection hole intensifies, accompanied by a decrease in the gas volume fraction. On one side of the injection hole, the hydraulic flip width expands, while, on the other side of the injection hole, the flow state gradually changes from hydraulic flip to super-cavitation flow, transitional cavitation and fully reattached flow. The divergent orifice layout intensifies cavitation, and the higher the positive injection hole cone angle, the bigger the hydraulic flip width. The convergent layout of the injection hole suppresses cavitation, and cavitation inside the nozzle disappears completely when the injection hole cone angle is less than −10°.

IntroductionEstradiol is a sex steroid hormone, which has been implicated in the pathogenesis of Alzheimer’s disease and cognitive impairment. This cross-sectional study aimed to examine the relationship between serum estradiol levels and cognitive performance in older American women.MethodsData were obtained from the National Health and Nutrition Examination Survey 2013–2014. A total of 731 women aged ≥60 years who met the inclusion criteria were included in this study. Serum estradiol levels were measured using the isotope dilution liquid chromatography tandem mass spectrometry (ID-LC–MS/MS) method developed by the Centers for Disease Control and Prevention for routine analysis. All measured serum levels were further divided into three parts: T1, 7.49 pg./mL, and analyzed. Participants’ cognitive abilities were tested using the Vocabulary Learning Subtest (CERAD), Animal Fluency Test (AFS), and digital symbol substitution test (DSST). Scores for each test were calculated based on the sample mean and standard deviation (SD). To examine the relationship between serum estradiol level tertiles and cognitive scores, multiple linear regression models were developed, controlling for race/ethnicity, education level, hypertension, diabetes, and insomnia.ResultsThe mean age of the participants was 69.57 ± 6.68 years. The non-Hispanic whites were 78.95%, and those who had completed at least some college-level education were 60.62%. The mean BMI of the participants was 29.30 ± 6.79, and 10.85% had a history of smoking. Further, 73.41% did not have a history of alcohol consumption, and 63.03% had hypertension (63.03%). In addition, 81.81 and 88.3% did not have a history of diabetes mellitus and did not have sleep disorders, respectively. The mean serum estradiol level was 8.48 ± 0.77 pg./mL. Multivariate linear regression of the reference group consisting of participants in tertiles of serum estradiol levels revealed that one unit increase in serum estradiol levels increased DSST scores by 0.61 (0.87, 6.34) in the T3 group. However, no significant correlation was found in the CERAD and AFS tests.ConclusionParticipants with higher estradiol levels had higher DSST scores and better processing speed, sustained attention, and working memory, suggesting that serum estradiol may serve as a biomarker for cognitive decline in older women.

Dilution affects the distribution and weathering of oil following a spill into coastal seawater, but including dilution in experiments is rare. In open water, dilution is expected to rapidly reduce the concentrations of hydrocarbons, and estimates of impacts and microbial responses from batch experiments may overestimate what happens during a spill event. Three experiments carried out in the southern Gulf of St. Lawrence incorporated periods of incubation of natural microbial communities with either Heidrun medium crude or Bunker C fuel oil followed by dilutions using unexposed seawater. Higher concentrations of n-alkanes (C10 – C35) in Heidrun, resulted in higher initial total hydrocarbon concentrations in incubations with Heidrun compared to Bunker C. Similar polycyclic aromatic hydrocarbon concentrations and potential toxicity were measured in the water column for both oils. Dilution effectively decreased the hydrocarbon concentrations, reducing them to background levels after two dilutions (13.8-fold). Neither the abundance nor the diversity of the prokaryote community was strongly affected by the addition of oil. The natural coastal microbiome was dominated by bacteria that may be facultative hydrocarbon degraders. The abundance of phytoplankton and the diversity of the microeukaryote community decreased during the second incubation in response to both Heidrun and Bunker C, potentially due to photooxidative byproducts produced under full sunlight. Dilution appears to limit the bacterial response to oil, but low hydrocarbon concentrations may still be linked to impacts on the microeukaryote community.

BackgroundWith the number of people with dementia dramatically increasing over time and dementia becoming a major health concern worldwide, scales have been developed to assess the stigma socially attached to this neurodegenerative disorder. There are, however, almost no available methods and assessment constructs for person-centered translation of dementia public stigma scales.ObjectiveTo develop such a method and such an assessment construct by translating the Dementia Public Stigma Scale (DPSS) into standard written Chinese.MethodsWe translated the DPSS following three major steps: (1) literal translation and mistranslation identification; (2) panel discussions of items with problematic translations; and (3) the final checking of the translated scale. Informed by the translation and adaptation process, we then developed a method for person-centered translation of dementia public stigma scales. Based on this method and our panel discussions, we finally proposed a tripartite assessment construct for quality evaluation of the translation of dementia public stigma scales.ResultsForward and backward translation did not work sufficiently in dementia public stigma scale translation. Mistranslations were induced by three major causes, including confusion caused by multiple Chinese meanings of the immediate Chinese direct translation, the lack of immediate Chinese direct translation because of varying positive/negative emotions attached to multiple translations, and the lack of culture-specific idioms in Chinese. Based on these factors, we proposed a tripartite dementia translation assessment construct. Following this assessment tool, we determined the best Chinese version that could further be tested for its psychometric properties among the public.ConclusionA method and an assessment construct for person-centered translation of dementia public stigma scales were developed. Such a method and such an assessment construct could be followed in the translation of dementia public stigma scales and the translation evaluation of such scales.

Objective: Optimizing the extraction conditions of polysaccharides from Dendrobium officinale under ultra-high pressure, improving the yield of polysaccharides, and studying its basic properties and antioxidant activity in vitro. Methods: Using D. officinale dry powder as raw material, orthogonal experiment was used to optimize the extraction conditions of polysaccharide from D. officinale by ultra-high pressure technology. The relative molecular weight and monosaccharide composition of polysaccharides extracted from D. officinale by traditional hot water extraction method and ultra-high pressure extraction method were determined, and their antioxidant activities in vitro were compared. Results: Under the optimal conditions of 200 MPa, solid-liquid ratio of 1∶25 （g/mL） and treatment time of 5 min, the polysaccharide yield of D. officinale was 33.3%, which was 128% higher than that of the traditional hot water extraction method. The protein content and relative molecular weight of the extraction method were decreased, while the mannose content was increased. The scavenging ability of DPPH and other free radicals was improved. Conclusion: The polysaccharide extracted from Dendrobium officinale under ultra-high pressure has high yield and good antioxidant activity in vitro.

BackgroundThe deluge of COVID-19 misinformation makes people confused, and acting on such misinformation can kill, leading to the tragic outcome of death. This makes it necessary to identify significant factors associated with college students’ susceptibility.ObjectiveThis descriptive study sought to ascertain factors significantly associated with college students’ susceptibility to online COVID-19 misinformation.MethodsTo assess college students’ susceptibility to COVID-19 misinformation, we first chose as independent variables some demographic information, some well-developed, validated literacy tools, and the Patient Health Questionnaire-9 Items. Second, we selected as the dependent variable COVID-19 myths from some authoritative, official websites. Third, we integrated the independent and dependent variables into an online questionnaire. Fourth, we recruited students from Nantong University in China to participate in an online questionnaire survey. Finally, based on the data collected, we conducted quantitative and qualitative analyses to relate the independent variables to the dependent variable.ResultsFive hundred forty-six students participated in the survey voluntarily, and all questionnaires they answered were valid. The participants had an average of 2.32 (SD = 0.99) years of higher education. They have a mean age of 20.44 (SD = 1.52) years. 434 (79.5%) of the 546 participants were females. The frequency of their Internet use averaged 3.91 (SD = 0.41), indicating that they logged onto the Internet almost every day. Their self-reported Internet skill was rated 3.79 (SD = 1.07), indicating that the participants rated their Internet skills as basically “good.” The mean scores of the sub-constructs in the AAHLS were 6.14 (SD = 1.37) for functional health literacy, 5.10 (SD = 1.65) for communicative health literacy, and 11.13 (SD = 2.65) for critical health literacy. These mean scores indicated that the participants needed help to read health-related materials “sometimes,” the frequency that they knew how to communicate effectively with professional health providers was between “often” and “sometimes,” and the frequency that they were critical about health information was between “often” and “sometimes,” respectively. The sum of their scores for eHealth literacy averaged 28.29 (SD = 5.31), showing that they had a relatively high eHealth literacy level. The mean score for each question in the GHNT was determined at 1.31 (SD = 0.46), 1.36 (SD = 0.48), 1.41 (SD = 0.49), 1.77 (SD = 0.42), 1.51 (SD = 0.50), and 1.54 (SD = 0.50), respectively. These mean scores showed that a high percentage of the participants answered the 6 questions wrongly, especially Questions 4–6. Similarly, participants performed unsatisfactorily in answering the 3 questions in the CRT, with a mean score of 1.75 (SD = 0.43), 1.55 (SD = 0.50), and 1.59 (SD = 0.49) for each question, respectively. In the PHQ-9, the participants reported that they never felt depressed or felt depressed only for 1–3 days in the past week. The mean score for myths 1–6 and 9–10 ranged from 1.15 (SD = 0.36) to 1.29 (SD = 0.46). This meant that the participants rated these myths false. However, most of the participants rated myths 7–8 true (1.54, SD = 0.50; 1.49, SD = 0.50), showing that they were highly susceptible to these 2 pieces of misinformation. Through data analysis via Logistic Regression (forward stepwise), we found that (1) at an average threshold of 0.5, Internet use frequency, functional health literacy, general health numeracy, reflective thinking tendency, and depression severity were significant predictors of susceptibility to misinformation for both male and female students, (2) at a higher threshold of 0.8, aggregated general health numeracy scores and functional health literacy scores, as well as depression severity were predictors of susceptibility to misinformation for both male and female students, (3) functional health literacy, general health literacy, and depression predicted resistance to misinformation for female students, and (4) internet use frequency and self-reported digital health literacy predicted resistance to misinformation for male students.ConclusionWe revealed the complexity, dynamics, and differences in age, gender, education, Internet exposure, communicative health literacy, and cognitive skills concerning college students’ susceptibility to online COVID-19 misinformation. Hopefully, this study can provide valuable implications for counteracting COVID-19 misinformation among Chinese college students.

BackgroundBladder cancer is a leading cause of death among Chinese male populations in recent years. The health locus of control construct can mediate health status and outcomes, and it has proven helpful in predicting and explaining specific health-related behaviors. However, it has never been used to investigate health beliefs about bladder cancer prevention and treatment. ObjectiveThis study aimed to classify male patients into different latent groups according to their beliefs about bladder cancer prevention and treatment and to identify associated factors to provide implications for the delivery of tailored education and interventions and the administration of targeted prevention and treatment. MethodsFirst, we designed a four-section questionnaire to solicit data: section 1—age, gender, and education; section 2—the communicative subscale of the All Aspects of Health Literacy Scale; section 3—the eHealth Literacy Scale; and section 4—health beliefs about bladder cancer prevention and treatment measured by the Multidimensional Health Locus of Control Scale Form C. We hypothesized that the participants’ health beliefs about bladder cancer prevention and treatment measured in section 4 could be closely associated with information collected through sections 1 to 3. We recruited 718 Chinese male patients from Qilu Hospital of Shandong University, China, and invited them to participate in a web-based questionnaire survey. Finally, we used latent class analysis to identify subgroups of men based on their categorical responses to the items on the Multidimensional Health Locus of Control Scale Form C and ascertained factors contributing to the low self-efficacy group identified. ResultsWe identified 2 subgroups defined as low and moderate self-efficacy groups representing 75.8% (544/718) and 24.2% (174/718) of the total sample, respectively. Men in the low self-efficacy cluster (cluster 1: 544/718, 75.8%) were less likely to believe in their own capability or doctors’ advice to achieve optimal outcomes in bladder cancer prevention and treatment. Men in the moderate self-efficacy cluster (cluster 2: 174/718, 24.2%) had distinct psychological traits. They had stronger beliefs in their own capability to manage their health with regard to bladder cancer prevention and treatment and moderate to high levels of trust in health and medical professionals and their advice to achieve better prevention and treatment outcomes. Four factors contributing to low self-efficacy were identified, including limited education (Year 6 to Year 12), aged ≥44 years, limited communicative health literacy, and limited digital health literacy. ConclusionsThis was the first study investigating beliefs about bladder cancer prevention and treatment among Chinese male patients. Given that bladder cancer represents a leading cause of death among Chinese male populations in recent years, the low self-efficacy cluster and associated contributing factors identified in this study can provide implications for clinical practice, health education, medical research, and health policy-making.

BackgroundSuitable health education materials can educate people about the potential harms of high-risk factors, leading to expected behavior changes and improved health outcomes. However, most patient education materials were not suitable in terms of content, structure, design, composition, and language, as stated in the literature. There is a pressing need to use well-designed scales to assess the suitability of health education materials. Although such assessment is a common practice in English-speaking communities, few assessment tools are available in mainland China. ObjectiveThis study aimed to translate the Suitability Assessment of Materials (SAM) for the evaluation of health-related information for adults into a simplified Chinese version (S-C-SAM) and validate its reliability for evaluating the suitability of health education materials written in simplified Chinese in mainland China. MethodsThe SAM was translated into an S-C-SAM in three steps: (1) translating the SAM into an S-C-SAM, (2) translating the S-C-SAM back into an English version, and (3) testing the translation equivalence between the 2 English versions (original and back-translated) of the SAM linguistically and culturally. Any differences between these 2 English versions were resolved through a panel discussion. The validity of the S-C-SAM was determined by measuring its content validity index. The final version of the S-C-SAM was used by 3 native Chinese-speaking health educators to assess 15 air pollution–related health education materials. The Cohen κ coefficient and Cronbach α were calculated to determine the interrater agreement and internal consistency of the S-C-SAM. ResultsWe agreed on the final version of the S-C-SAM after settling the discrepancies between the 2 English versions (original and back-translated) and revising 2 items (sentences) rated negatively in content validation. The S-C-SAM was proven valid and reliable: the content validity index was 0.95 both in clarity and in relevance, the Cohen κ coefficient for the interrater agreement was 0.61 (P

BackgroundProviding people with understandable and actionable health information can considerably promote healthy behaviors and outcomes. To this end, some valid and reliable scales assessing the patient-friendliness of health education materials, like the PEMAT-P (Patient Education Materials Assessment Tool for printable materials), have been well developed in English-speaking countries. However, the English version of the PEMAT-P has not been translated and adapted into simplified Chinese and validated in mainland China. ObjectiveThis study sought to translate the PEMAT-P tool into a simplified Chinese (Mandarin) version (C-PEMAT-P, a Chinese version of the Patient Education Materials Assessment Tool for printable materials) and verify its validity and reliability for assessing the comprehensibility and actionability of health education resources written in simplified Chinese. As a result, the validated C-PEMAT-P could be used to guide health researchers and educators to design more comprehensible and actionable materials for more tailored and targeted health education and interventions. MethodsWe translated the PEMAT-P into simplified Chinese in the following three steps: (1) forward-translating the PEMAT-P into simplified Chinese, (2) back-translating the simplified Chinese version into English, and (3) testing translation equivalence linguistically and culturally by examining the original English version of the PEMAT-P and the back-translated English version of the tool. Any discrepancies between the original English tool and the back-translated English tool were resolved through a panel discussion among the research team of all authors to produce a revised forward-translated Chinese version (C-PEMAT-P). We then evaluated the clarity of construction and wording as well as the content relevance of the C-PEMAT-P using a 4-point ordinal scale to determine its content validity. After that, 2 native Chinese speakers (health educators) used the C-PEMAT-P to rate 15 health education handouts concerning air pollution and health to validate their reliability. We calculated the Cohen coefficient and Cronbach α to determine the interrater agreement and internal consistency of the C-PEMAT-P, respectively. ResultsWe finalized the translated Chinese tool after discussing the differences between the 2 English versions (original and back-translated) of the PEMAT-P, producing the final Chinese version of the PEMAT-P (C-PEMAT-P). The content validity index of the C-PEMAT-P version was 0.969, the Cohen coefficient for the interrater scoring agreement was 0.928, and the Cronbach α for internal consistency was .897. These values indicated the high validity and reliability of the C-PEMAT-P. ConclusionsThe C-PEMAT-P has been proven valid and reliable. It is the first Chinese scale for assessing the comprehensibility and actionability of Chinese health education materials. It can be used as an assessment tool to evaluate health education materials currently available and a guide to help health researchers and educators design more comprehensible and actionable materials for more tailored and targeted health education and interventions.

BackgroundLimited cancer health literacy may be attributed to various factors. Although these factors play decisive roles in identifying individuals with limited cancer health literacy, they have not been sufficiently investigated, especially in China. There is a pressing need to ascertain the factors that effectively identify Chinese people with poor cancer health literacy. ObjectiveThis study aimed to identify the factor associated with limited cancer health literacy among Chinese people based on the 6-Item Cancer Health Literacy Test (CHLT-6). MethodsWe first categorized Chinese study participants according to the answers provided for cancer health literacy as follows: people who provided ≤3 correct answers were labeled as having limited cancer health literacy, whereas those who provided between 4 and 6 correct answers were labeled as having adequate cancer health literacy. We then adopted logistic regression to analyze the factors that were closely related to limited cancer health literacy among at-risk study participants. ResultsThe logistic regression analysis identified the following factors that effectively predicted limited cancer health literacy: (1) male gender, (2) low education attainment, (3) age, (4) high levels of self-assessed general disease knowledge, (5) low levels of digital health literacy, (6) limited communicative health literacy, (7) low general health numeracy, and (8) high levels of mistrust in health authorities. ConclusionsUsing regression analysis, we successfully identified 8 factors that could be used as predictors of limited cancer health literacy among Chinese populations. These findings have important clinical implications for supporting Chinese people with limited cancer health literacy through the development of more targeted health educational programs and resources that better align with their actual skill levels.

BackgroundCurrently, breast cancer is the most commonly diagnosed cancer and the sixth-leading cause of cancer-related deaths among Chinese women. Worse still, misinformation contributes to the aggravation of the breast cancer burden in China. There is a pressing need to investigate the susceptibility to breast cancer misinformation among Chinese patients. However, no study has been performed in this respect. ObjectiveThis study aims to ascertain whether some demographics (age, gender, and education), some health literacy skills, and the internal locus of control are significantly associated with the susceptibility to misinformation about all types of breast cancers among randomly sampled Chinese patients of both genders in order to provide insightful implications for clinical practice, health education, medical research, and health policy making. MethodsWe first designed a questionnaire comprising 4 sections of information: age, gender, and education (section 1); self-assessed disease knowledge (section 2); the All Aspects of Health Literacy Scale (AAHLS), the eHealth Literacy Scale (eHEALS), the 6-item General Health Numeracy Test (GHNT-6), and the “Internal” subscale of the Multidimensional Health Locus of Control (MHLC) scales (section 3); and 10 breast cancer myths collected from some officially registered and authenticated websites (section 4). Subsequently, we recruited patients from Qilu Hospital of Shandong University, China, using randomized sampling. The questionnaire was administered via wenjuanxing, the most popular online survey platform in China. The collected data were manipulated in a Microsoft Excel file. We manually checked the validity of each questionnaire using the predefined validity criterion. After that, we coded all valid questionnaires according to the predefined coding scheme, based on Likert scales of different point (score) ranges for different sections of the questionnaire. In the subsequent step, we calculated the sums of the subsections of the AAHLS and the sums of the 2 health literacy scales (the eHEALS and GHNT-6) and the 10 breast cancer myths. Finally, we applied logistic regression modeling to relate the scores in section 4 to the scores in sections 1-3 of the questionnaire to identify what significantly contributes to the susceptibility to breast cancer misinformation among Chinese patients. ResultsAll 447 questionnaires collected were valid according to the validity criterion. The participants were aged 38.29 (SD 11.52) years on average. The mean score for their education was 3.68 (SD 1.46), implying that their average educational attainment was between year 12 and a diploma (junior college). Of the 447 participants, 348 (77.85%) were women. The mean score for their self-assessed disease knowledge was 2.50 (SD 0.92), indicating that their self-assessed disease knowledge status was between “knowing a lot” and “knowing some.” The mean scores of the subconstructs in the AAHLS were 6.22 (SD 1.34) for functional health literacy, 5.22 (SD 1.54) for communicative health literacy, and 11.19 (SD 1.99) for critical health literacy. The mean score for eHealth literacy was 24.21 (SD 5.49). The mean score for the 6 questions in the GHNT-6 was 1.57 (SD 0.49), 1.21 (SD 0.41), 1.24 (SD 0.43), 1.90 (SD 0.30), 1.82 (SD 0.39), and 1.73 (SD 0.44), respectively. The mean score for the patients’ health beliefs and self-confidence was 21.19 (SD 5.63). The mean score for their response to each myth ranged from 1.24 (SD 0.43) to 1.67 (SD 0.47), and the mean score for responses to the 10 myths was 14.03 (SD 1.78). Through interpreting these descriptive statistics, we found that Chinese female patients’ limited ability to rebut breast cancer misinformation is mainly attributed to 5 factors: (1) lower communicative health literacy, (2) certainty about self-assessed eHealth literacy skills, (3) lower general health numeracy, (4) positive self-assessment of general disease knowledge, and (5) more negative health beliefs and lower levels of self-confidence. ConclusionsDrawing on logistic regression modeling, we studied the susceptibility to breast cancer misinformation among Chinese patients. The predicting factors of the susceptibility to breast cancer misinformation identified in this study can provide insightful implications for clinical practice, health education, medical research, and health policy making.

BackgroundeHealth resources and interventions promise to promote favorable behavior change, self-efficacy, and knowledge acquisition, thereby improving health literacy. However, individuals with limited eHealth literacy may find it difficult to identify, understand, and benefit from eHealth use. It is necessary to identify the self-assessed eHealth literacy of those who use eHealth resources to classify their eHealth literacy levels and to determine the demographic characteristics associated with higher and lower eHealth literacy skills. ObjectiveThis study aimed to identify notable factors closely associated with limited eHealth literacy among Chinese male populations to provide some implications for clinical practice, health education, medical research, and public health policy making. MethodsWe hypothesized that participants’ eHealth literacy status was associated with various demographic characteristics. Therefore, we elicited the following information in the questionnaire: age and education, self-assessed disease knowledge, 3 well-developed health literacy assessment tools (ie, the All Aspects of Health Literacy Scale, eHealth Literacy Scale, and General Health Numeracy Test), and the 6 Internal items on health beliefs and self-confidence in the Multidimensional Health Locus of Control Scales. Using randomized sampling, we recruited survey participants from Qilu Hospital of Shandong University, China. After validating the data collected through a web-based questionnaire survey via wenjuanxing, we coded all valid data according to predefined coding schemes of Likert scales with different point (score) ranges. We then calculated the total scores of the subsections of the scales or the entire scale. Finally, we used logistic regression modeling to associate the scores of the eHealth Literacy Scale with the scores of the All Aspects of Health Literacy Scale, the General Health Numeracy Test-6, and age and education to ascertain factors considerably associated with limited eHealth literacy among Chinese male populations. ResultsAll data from the 543 returned questionnaires were valid according to the validation criteria. By interpreting these descriptive statistics, we found that 4 factors were significantly correlated with participants’ limited eHealth literacy: older age, lower education attainment, lower levels of all aspects of health literacy (functional, communicative, and critical), and weaker beliefs and self-confidence in internal drivers and strengths to stay healthy. ConclusionsBy applying logistic regression modeling, we ascertained 4 factors that were significantly correlated with limited eHealth literacy among Chinese male populations. These relevant factors identified can inform stakeholders engaging in clinical practice, health education, medical research, and health policy making.

BackgroundPrevious studies have revealed that functional health literacy plays a less important role than communicative and critical health literacy (CRHL) and that communicative literacy and CRHL contribute more to better patient self-management. Although improving health literacy has been identified as an approach to fostering community involvement and empowerment, CRHL may be regarded as the neglected domain of health literacy, rarely achieving any focus or interventions that claim to be working toward this outcome. Considering this research background, close scholarly attention needs to be paid to CRHL and its associated factors. ObjectiveThis study aimed to assess CRHL and identify essential factors closely associated with the status of CRHL among Chinese patients and to provide some implications for clinical practice, health education, medical research, and public health policy making. MethodsWe conducted this cross-sectional study, which lasted from April 8, 2022, to September 23, 2022, following the steps below. We first designed a 4-section survey questionnaire and then recruited Mandarin Chinese–speaking patients from Qilu Hospital of Shandong University, China, using randomized sampling. Subsequently, we administered the questionnaire via wenjuanxing, the most popular web-based survey platform in China, between July 20, 2022, and August 19, 2022. Finally, we used latent class modeling to analyze the valid data collected to classify the patient participants and identify the factors potentially associated with different CRHL levels. ResultsAll data in the 588 returned questionnaires were valid. On the basis of the collected data, we classified the patient participants into 3 latent classes of limited, moderate, and adequate CRHL and identified 4 factors associated with limited CRHL, including middle and old age, male sex, lower educational attainment, and low internal drive to maintain one’s health. ConclusionsUsing latent class modeling, we identified 3 classes of CRHL and 4 factors associated with limited CRHL among the Chinese study participants. These literacy classes and the predicting factors ascertained in this study can provide some implications for clinical practice, health education, medical research, and health policy making.

BackgroundBreast cancer is the most common cancer among Chinese women, with an age-standardized prevalence of 21.6 cases per 100,000 women. Limited cancer health literacy reduces females’ ability to engage in cancer prevention and detection. It is necessary to assess Chinese women’s breast cancer literacy to deliver targeted interventions and effective education. However, there is no Breast Cancer Literacy Assessment Tool (B-CLAT) available in China currently. ObjectiveThis study aimed to translate and linguistically and culturally adapt the B-CLAT into a simplified-Chinese version (C-B-CLAT), and then validate its psychometric properties by administering it to Chinese college students. MethodsFirst, we translated the B-CLAT into a simplified-Chinese version and verified its validity and reliability using rigorous translation and validation guidelines proposed in previous studies. We then evaluated the psychometric properties among 50 female participants with a mean age of 19.62 (SD 1.31) years recruited from Nantong University, China. ResultsItems 1, 6, 8, 9, 10, 16, 17, 20, 21, 22, 23, 24, 25, 26, 29, and 30 were deleted to increase the relevant subscale internal consistency. Items 3, 12, 13, 14, 18, 20, 27, and 31 were deleted due to their Cronbach α being lower than .5 in the test-retest analysis. After deletion, the internal consistency of the entire scale was fair with α=.607. The prevention and control subscale had the highest internal consistency with α=.730, followed by the screening and knowledge subscale with α=.509, while the awareness subscale had the lowest internal consistency with α=.224. The intraclass correlation coefficient for the C-B-CLAT (items 2, 4, 5, 7, 11, 15, 28, 32, 33, and 34) was fair to excellent (odds ratio [OR] 0.88, 95% CI 0.503-0.808). The values of Cronbach α for items 2, 4, 5, 7, 11, 15, 28, 32, 33, and 34 ranged from .499 to .806, and the α value for the C-B-CLAT was .607. This indicates fair test-retest reliability. The mean difference in the C-B-CLAT scores between stage 1 and stage 2 was 0.47 (OR 0.67, 95% CI −0.53 to 1.47), which was not significantly different from zero (t48=0.945; P=.35). This result implies that the C-B-CLAT produced the same scores at stage 1 and stage 2 on average, thus showing good agreement in the C-B-CLAT scores between stage 1 and stage 2. The SD of the difference was 3.48. The 95% limits of agreement were −6.34 to 7.28. ConclusionsWe developed a simplified-Chinese version of the B-CLAT through translation and adaptation. Psychometric properties testing has proven this version valid and reliable for assessing breast cancer literacy among Chinese college students.

BackgroundPoor functional health literacy has been found to be independently associated with poor self-assessed health, poor understanding of one’s health condition and its management, and higher use of health services. Given the importance of functional health literacy, it is necessary to assess the overall status of functional health literacy in the general public. However, the literature review shows that no studies of functional health literacy have been conducted among the Chinese population in China. ObjectiveThis study aimed to classify Chinese populations into different functional health literacy clusters and ascertain significant factors closely associated with low functional health literacy to provide some implications for health education, medical research, and public health policy making. MethodsWe hypothesized that the participants’ functional health literacy levels were associated with various demographic characteristics. Therefore, we designed a four-section questionnaire including the following information: (1) age, gender, and education; (2) self-assessed disease knowledge; (3) 3 validated health literacy assessment tools (ie, the All Aspects of Health Literacy Scale, the eHealth Literacy Scale, and the 6-item General Health Numeracy Test); and (4) health beliefs and self-confidence measured by the Multidimensional Health Locus of Control Scales Form B. Using randomized sampling, we recruited survey participants from Qilu Hospital affiliated to Shandong University, China. The questionnaire was administered via wenjuanxing. A returned questionnaire was valid only when all question items included were answered, according to our predefined validation criterion. All valid data were coded according to the predefined coding schemes of Likert scales with different point (score) ranges. Finally, we used latent class analysis to classify Chinese populations into clusters of different functional health literacy and identify significant factors closely associated with low functional health literacy. ResultsAll data in the 800 returned questionnaires proved valid according to the predefined validation criterion. Applying latent class analysis, we classified Chinese populations into low (n=292, 36.5%), moderate-to-adequate (n=286, 35.7%), and low-to-moderate (n=222, 27.8%) functional health literacy groups and identified five factors associated with low communicative health literacy: (1) male gender (aged 40-49 years), (2) lower educational attainment (below diploma), (3) age between 38 and 68 years, (4) lower self-efficacy, and (5) belief that staying healthy was a matter of luck. ConclusionsWe classified Chinese populations into 3 functional health literacy groups and identified 5 factors associated with low functional health literacy. These associated factors can provide some implications for health education, medical research, and health policy making.

BackgroundThere is a wide variation in the quality of information available to patients on the treatment of the diseases afflicting them. To help patients find clear and accessible information, many scales have been designed to evaluate the quality of health information, including the Patient Education Materials Assessment Tool; the Suitability Assessment of Materials for evaluation of health-related information for adults; and DISCERN, an instrument for judging the quality of written consumer health information on treatment choices. These instruments are primarily in English. Few of them have been translated and adapted into simplified Chinese tools for health information assessment in China. ObjectiveThis study aimed to translate and adapt DISCERN into the first simplified Chinese version and validate the psychometric properties of this newly developed scale for judging the quality of patient-oriented health information on treatment choices. MethodsFirst, we translated DISCERN into simplified Chinese using rigorous guidelines for translation and validation studies. We tested the translation equivalence and measured the content validity index. We then presented the simplified Chinese instrument to 3 health educators and asked them to use it to assess the quality of 15 lung cancer–related materials. We calculated the Cohen κ coefficient and Cronbach α for all items and for the entire scale to determine the reliability of the new tool. ResultsWe decided on the simplified Chinese version of the DISCERN instrument (C-DISCERN) after resolving all problems in translation, adaptation, and content validation. The C-DISCERN was valid and reliable: the content validity index was 0.98 (47/48, 98% of the items) for clarity and 0.94 (45/48, 94% of the items) for relevance, the Cronbach α for internal consistency was .93 (95% CI 0.699-1.428) for the whole translated scale, and the Cohen κ coefficient for internal consistency was 0.53 (95% CI 0.417-0.698). ConclusionsC-DISCERN is the first simplified Chinese version of the DISCERN instrument. Its validity and reliability have been attested to assess the quality of patient-targeted information for treatment choices.

Gasoline–water mixed injections are of great interest because of their advantages for reduced manufacturing costs and improved atomization, with the potential to alleviate engine detonation and reduce emissions. In this work, based on the principle of impinging flow, a real-time gasoline–water mixture preparation system for internal combustion engines was designed and the preparation system performance was compared with the standard swirl mixing technique. An image processing method was established to quantify the uniformity of the prepared mixture. Based on the flash-boiling spray flash-boiling spray experiment, the spray characteristics of different gasoline–water mixtures were analyzed under different injection temperatures (30–160 °C) and pressures (5–15 MPa). The experiments showed that the impinging pressure was the main factor affecting the emulsification performance of the real-time gasoline–water mixture, and that the proposed real-time mixing system could produce a stable gasoline–water emulsion. For temperatures in the 30–160 °C range, the flash-boiling spray flash-boiling spray experiments showed that the spray penetration distance first decreases and then increases with the injection temperature, while the spray angle shows an opposite trend. The turning point corresponded to the flash-boiling point of each gasoline–water mixture.

BackgroundMental disorders (MDs) impose heavy burdens on health care (HC) systems and affect a growing number of people worldwide. The use of mobile health (mHealth) apps empowered by artificial intelligence (AI) is increasingly being resorted to as a possible solution. ObjectiveThis study adopted a topic modeling (TM) approach to investigate the public trust in AI apps in mental health care (MHC) by identifying the dominant topics and themes in user reviews of the 8 most relevant mental health (MH) apps with the largest numbers of reviewers. MethodsWe searched Google Play for the top MH apps with the largest numbers of reviewers, from which we selected the most relevant apps. Subsequently, we extracted data from user reviews posted from January 1, 2020, to April 2, 2022. After cleaning the extracted data using the Python text processing tool spaCy, we ascertained the optimal number of topics, drawing on the coherence scores and used latent Dirichlet allocation (LDA) TM to generate the most salient topics and related terms. We then classified the ascertained topics into different theme categories by plotting them onto a 2D plane via multidimensional scaling using the pyLDAvis visualization tool. Finally, we analyzed these topics and themes qualitatively to better understand the status of public trust in AI apps in MHC. ResultsFrom the top 20 MH apps with the largest numbers of reviewers retrieved, we chose the 8 (40%) most relevant apps: (1) Wysa: Anxiety Therapy Chatbot; (2) Youper Therapy; (3) MindDoc: Your Companion; (4) TalkLife for Anxiety, Depression & Stress; (5) 7 Cups: Online Therapy for Mental Health & Anxiety; (6) BetterHelp-Therapy; (7) Sanvello; and (8) InnerHour. These apps provided 14.2% (n=559), 11.0% (n=431), 13.7% (n=538), 8.8% (n=356), 14.1% (n=554), 11.9% (n=468), 9.2% (n=362), and 16.9% (n=663) of the collected 3931 reviews, respectively. The 4 dominant topics were topic 4 (cheering people up; n=1069, 27%), topic 3 (calming people down; n=1029, 26%), topic 2 (helping figure out the inner world; n=963, 25%), and topic 1 (being an alternative or complement to a therapist; n=870, 22%). Based on topic coherence and intertopic distance, topics 3 and 4 were combined into theme 3 (dispelling negative emotions), while topics 2 and 1 remained 2 separate themes: theme 2 (helping figure out the inner world) and theme 1 (being an alternative or complement to a therapist), respectively. These themes and topics, though involving some dissenting voices, reflected an overall high status of trust in AI apps. ConclusionsThis is the first study to investigate the public trust in AI apps in MHC from the perspective of user reviews using the TM technique. The automatic text analysis and complementary manual interpretation of the collected data allowed us to discover the dominant topics hidden in a data set and categorize these topics into different themes to reveal an overall high degree of public trust. The dissenting voices from users, though only a few, can serve as indicators for health providers and app developers to jointly improve these apps, which will ultimately facilitate the treatment of prevalent MDs and alleviate the overburdened HC systems worldwide.

BackgroundCOVID-19–related health inequalities were reported in some studies, showing the failure in public health and communication. Studies investigating the contexts and causes of these inequalities pointed to the contribution of communication inequality or poor health literacy and information access to engagement with health care services. However, no study exclusively dealt with health inequalities induced by the use of social media during COVID-19. ObjectiveThis review aimed to identify and summarize COVID-19–related health inequalities induced by the use of social media and the associated contributing factors and to characterize the relationship between the use of social media and health disparities during the COVID-19 pandemic. MethodsA systematic review was conducted on this topic in light of the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. Keyword searches were performed to collect papers relevant to this topic in multiple databases: PubMed (which includes MEDLINE [Ovid] and other subdatabases), ProQuest (which includes APA PsycINFO, Biological Science Collection, and others), ACM Digital Library, and Web of Science, without any year restriction. Of the 670 retrieved publications, 10 were initially selected based on the predefined selection criteria. These 10 articles were then subjected to quality analysis before being analyzed in the final synthesis and discussion. ResultsOf the 10 articles, 1 was further removed for not meeting the quality assessment criteria. Finally, 9 articles were found to be eligible and selected for this review. We derived the characteristics of these studies in terms of publication years, journals, study locations, locations of study participants, study design, sample size, participant characteristics, and potential risk of bias, and the main results of these studies in terms of the types of social media, social media use–induced health inequalities, associated factors, and proposed resolutions. On the basis of the thematic synthesis of these extracted data, we derived 4 analytic themes, namely health information inaccessibility–induced health inequalities and proposed resolutions, misinformation-induced health inequalities and proposed resolutions, disproportionate attention to COVID-19 information and proposed resolutions, and higher odds of social media–induced psychological distress and proposed resolutions. ConclusionsThis paper was the first systematic review on this topic. Our findings highlighted the great value of studying the COVID-19–related health knowledge gap, the digital technology–induced unequal distribution of health information, and the resulting health inequalities, thereby providing empirical evidence for understanding the relationship between social media use and health inequalities in the context of COVID-19 and suggesting practical solutions to such disparities. Researchers, social media, health practitioners, and policy makers can draw on these findings to promote health equality while minimizing social media use–induced health inequalities.

BackgroundThe usability of mobile health (mHealth) apps needs to be effectively evaluated before they are officially approved to be used to deliver health interventions. To this end, the mHealth App Usability Questionnaire (MAUQ) has been designed and proved valid and reliable in assessing the usability of mHealth apps. However, this English questionnaire needs to be translated into other languages, adapted, and validated before being utilized to evaluate the usability of mHealth apps. ObjectiveThis study aims to improve, further adapt, and validate the Chinese version of the MAUQ (C-MAUQ; interactive for patients) on Left-handed Doctor, one of the most popular “reaching out to patients” interactive mHealth apps with chatbot function in China, to test the reliability and cross-cultural adaptability of the questionnaire. MethodsThe MAUQ (interactive for patients) has been translated into Chinese and validated for its reliability on Good Doctor, one of the most influential “reaching out to patients” mHealth apps without chatbot function in China. After asking for the researchers’ approval to use this Chinese version, we adjusted and further adapted the C-MAUQ by checking it against the original English version and improving its comprehensibility, readability, idiomaticity, and cross-cultural adaptability. Following a trial survey completed by 50 respondents on wenjuanxing, the most popular online questionnaire platform in China, the improved version of the C-MAUQ (I-C-MAUQ) was finally used to evaluate the usability of Left-handed Doctor through an online questionnaire survey (answered by 322 participants) on wenjuanxing, to test its internal consistency, reliability, and validity. ResultsThe I-C-MAUQ still retained the 21 items and 3 dimensions of the original MAUQ: 8 items for usability and satisfaction, 6 items for system information arrangement, and 7 items for efficiency. The translation problems in the C-MAUQ, including (1) redundancy, (2) incompleteness, (3) misuse of parts of speech, (4) choice of inappropriate words, (5) incomprehensibility, and (6) cultural difference–induced improper translation, were improved. As shown in the analysis of data obtained through the online survey, the I-C-MAUQ had a better internal consistency (ie, the correlation coefficient between the score of each item and the total score of the questionnaire determined within the range of 0.861-0.938; P

BackgroundGiven the growing significance of conversational agents (CAs), researchers have conducted a plethora of relevant studies on various technology- and usability-oriented issues. However, few investigations focus on language use in CA-based health communication to examine its influence on the user perception of CAs and their role in delivering health care services. ObjectiveThis review aims to present the language use of CAs in health care to identify the achievements made and breakthroughs to be realized to inform researchers and more specifically CA designers. MethodsThis review was conducted by following the protocols of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. We first designed the search strategy according to the research aim and then performed the keyword searches in PubMed and ProQuest databases for retrieving relevant publications (n=179). Subsequently, 3 researchers screened and reviewed the publications independently to select studies meeting the predefined selection criteria. Finally, we synthesized and analyzed the eligible articles (N=11) through thematic synthesis. ResultsAmong the 11 included publications, 6 deal exclusively with the language use of the CAs studied, and the remaining 5 are only partly related to this topic. The language use of the CAs in these studies can be roughly classified into six themes: (1) personal pronouns, (2) responses to health and lifestyle prompts, (3) strategic wording and rich linguistic resources, (4) a 3-staged conversation framework, (5) human-like well-manipulated conversations, and (6) symbols and images coupled with phrases. These derived themes effectively engaged users in health communication. Meanwhile, we identified substantial room for improvement based on the inconsistent responses of some CAs and their inability to present large volumes of information on safety-critical health and lifestyle prompts. ConclusionsThis is the first systematic review of language use in CA-based health communication. The results and limitations identified in the 11 included papers can give fresh insights into the design and development, popularization, and research of CA applications. This review can provide practical implications for incorporating positive language use into the design of health CAs and improving their effective language output in health communication. In this way, upgraded CAs will be more capable of handling various health problems particularly in the context of nationwide and even worldwide public health crises.

In this paper, glutathione (GSH)-coated Zn-doped CdTe quantum dots (QDs) with different particle sizes were synthesized using the “reflow method”, and the interaction mechanism between the two QDs and lactoferrin (LF) was investigated systemically with different spectroscopic methods. The steady-state fluorescence spectra showed that the LF formed a tight complex with the two QDs through static bursting and that the electrostatic force was the main driving force between the two LF–QDs systems. The complex generation process was found to be spontaneous (ΔG < 0) and accompanied by exothermic and increasing degrees of freedom (ΔH < 0, ΔS > 0) by using the temperature-dependent fluorescence spectroscopy. The critical transfer distance (R0) and donor–acceptor distance (r) of the two LF–QDs systems were obtained based on the fluorescence resonance energy transfer theory. In addition, it was observed that the QDs changed the secondary and tertiary structures of LF, leading to an increase in the hydrophobicity of LF. Further, the nano-effect of orange QDs on LF is much larger than that of green QDs. The above results provide a basis for metal-doped QDs with LF in safe nano-bio applications.

In this paper, the torsional moment of the right-angle fastener bolt is taken as the main research parameter, and the torsional stiffness performance of the right-angle fastener under different working conditions is studied experimentally. By establishing the moment–rotation relationship model of the node, the mechanical performance and rotation characteristics of the semirigid connection of the node are studied. According to the joint stiffness value determined by the experimental study and the theory of semirigid connection frame with lateral displacement, the calculation formulas of the stiffness correction coefficient αu of the transverse bar and the constraint coefficient K at the end of the vertical bar are derived, and the effective length coefficient μ of the vertical bar and the theoretical value of the stable bearing capacity of the vertical bar under different working conditions are given. Compared with the current standard values, it is found that the theoretical calculation results of the percentage increase of the stable bearing capacity of the vertical bar are 3 to 4 times larger than the standard calculation results when the step distance is reduced. The theoretical calculation method can better consider the semirigid characteristics of the joint and the influence of adjacent members on the stable bearing capacity of the vertical bar.

The calculation method of steel pipe support in current specifications is not uniform, and it is unsafe to directly apply the stability coefficient of the vertical bar in the current code, which leads to frequent safety accidents of fastener steel pipe supports. Through the field statistics of the initial defects of the steel pipe, it is found that the initial bending values of the 3 m and 6 m steel pipes with the largest size are larger in L/400. The stability coefficient table is obtained by taking the initial bending of L/400 as the initial defect, which is 43.15% smaller than the stability coefficient given by the specification. Through the comparative analysis of the actual engineering monitoring results, the calculation results of the original specification and the calculation results after the correction of the stability coefficient, it is concluded that the stress calculated by the stability coefficient proposed in this paper is similar to the actual monitoring results of the project and is greater than the stress of the vertical rod calculated by the stability coefficient of the original specification. It is suggested that the corrected stability coefficient should be applied to the actual project.

BackgroundLong before the outbreak of COVID-19, chatbots had been playing an increasingly crucial role and gaining growing popularity in health care. In the current omicron waves of this pandemic when the most resilient health care systems at the time are increasingly being overburdened, these conversational agents (CA) are being resorted to as preferred alternatives for health care information. For many people, especially adolescents and the middle-aged, mobile phones are the most favored source of information. As a result of this, it is more important than ever to investigate the user experience of and satisfaction with chatbots on mobile phones. ObjectiveThe objective of this study was twofold: (1) Informed by Deneche and Warren’s evaluation framework, Zhu et al’s measures of variables, and the theory of consumption values (TCV), we designed a new assessment model for evaluating the user experience of and satisfaction with chatbots on mobile phones, and (2) we aimed to validate the newly developed model and use it to gain an understanding of the user experience of and satisfaction with popular health care chatbots that are available for use by young people aged 17-35 years in southeast China in self-diagnosis and for acquiring information about COVID-19 and virus variants that are currently spreading. MethodsFirst, to assess user experience and satisfaction, we established an assessment model based on relevant literature and TCV. Second, the chatbots were prescreened and selected for investigation. Subsequently, 413 informants were recruited from Nantong University, China. This was followed by a questionnaire survey soliciting the participants’ experience of and satisfaction with the selected health care chatbots via wenjuanxing, an online questionnaire survey platform. Finally, quantitative and qualitative analyses were conducted to find the informants’ perception. ResultsThe data collected were highly reliable (Cronbach α=.986) and valid: communalities=0.632-0.823, Kaiser-Meyer-Olkin (KMO)=0.980, and percentage of cumulative variance (rotated)=75.257% (P

BackgroundOver 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students’ mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being. ObjectiveThe aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students’ affairs counselors, and mental health providers. MethodsWe performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis. ResultsWe retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students’ affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers. ConclusionsThis was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students’ mental health is a research topic worth further investigation.

AIM: To observe the efficacy and safety of pars plana vitrectomy(PPV)combined with air tamponade in the treatment of rhegmatogenous retinal detachment(RRD), which caused by superior break(s)following previous vitreoretinal surgery.METHODS: Retrospective analysis of the inpatients in our hospital from November 2017 to October 2019. Patients with RRD caused by superior break(s)who had underwent previous vitreoretinal surgeries and the proliferative vitreoretinopathy less than PVR-C1 were enrolled. For treatment, patients underwent PPV combined with air tamponade. During the operation, the residual vitreous cortex was fully removed, and the subretinal fluid was aspirated from retinal break(s)as much as possible. Make sure the subretinal fluid around the hole was fully drained. Then firmly laser spots were accomplished to seal the retinal break(s). Finally, filtered air was left in the vitreous cavity as tamponade agent. The patients were informed to keep a prone position for 24h postoperation. The primary outcomes were primary and final success rates, best corrected visual acuity(BCVA), and the secondary outcomes were rate of postoperative cataract surgery and high intraocular pressure.RESULTS: Totally 31 patients(31 eyes)with follow-up time more than 6mo were included. The range of retinal detachment was 6.7±3.8h, and the number of retinal breaks was 1.2±0.7. There are 23 eyes(74%)with macular detachment and 18 eyes(58%)with intraocular lens. 6 eyes(19%)were treated with phacoemulsification and intraocular lens implantation together. The rate of primary retinal reattachment in enrolled patients was 87%(27/31), and the final reattachment rate was 100%(31/31). At the 6mo of postoperatively, the BCVA(LogMAR)increased from 2.17±1.27 to 0.53±0.25(P

Websites are rich resources for the public to access health information, and readability ensures whether the information can be comprehended. Apart from the linguistic features originated in traditional readability formulas, the reading ability of an individual is also influenced by other factors such as age, morbidities, cultural and linguistic background. This paper presents a reader-oriented readability assessment by combining readability formula scores with machine learning techniques, while considering reader background. Machine learning algorithms are trained by a dataset of 7 readability formula scores for 160 health articles in official health websites. Results show that the proposed assessment tool can provide a reader-oriented assessment to be more effective in proxy the health information readability. The key significance of the study includes its reader centeredness, which incorporates the diverse backgrounds of readers, and its clarification of the relative effectiveness and compatibility of different medical readability tools via machine learning.

AIM: To assess the efficacy and safety of parafoveal retinal massage combined with autologous whole blood cover in the treatment of refractory macular holes (MHs) and present the surgical procedure. METHODS: Patients with giant (minimum diameter ≥800 μm), recurrent or persistent MHs who underwent PPV combined with parafoveal retinal massage and autologous whole blood cover using C3F8 as tamponade agent from February 2018 to May 2019 were enrolled in this retrospective study. After surgery, all patients were informed to maintain a prone position for at least 7d. Preoperative and postoperative best-corrected visual acuities (BCVAs) were compared and MH closure rate was measured as the main outcome. RESULTS: A total of 13 MH patients consisted of 6 giant MHs, 4 persistent holes and 3 recurrent holes (5 men and 8 women; average age was 56.40±11.72y) were enrolled in this study. MH closure was achieved in 11 eyes by this modified surgical technique while 2 eyes failed. Revitrectomy with autologous neurosensory retinal patch transplantations was applied for those 2 patients and then both holes were closed. No intraoperative complications were observed. BCVA improved from 1.73 logMAR to 0.74 logMAR at 6mo postoperation. There was significant difference in BCVA before versus after the surgery (P

BackgroundTricuspid annuloplasty (TAP) is accepted as the standard technique for correcting tricuspid regurgitation (TR). We conducted the present study to provide an overview of the contemporary results of 3D rigid ring annuloplasty for TR.MethodsA systematic literature search was carried out in eight databases to collect all relevant studies on the three-dimensional (3D) rigid ring annuloplasty treatment of TR published before October 1, 2020. The main outcomes of interest were postoperative TR grade, perioperative mortality, and recurrent TR.ResultsA total of eight studies were included, all of which were retrospective observational studies. Rigid 3D rings were compared with flexible bands, and there was no difference in perioperative mortality [odds ratio (OR) = 1.02; 95% CI (0.52, 2.02); p = 0.95], late mortality [OR = 0.99; 95% CI (0.28, 3.50); p = 0.98], or recurrent TR [OR = 0.59; 95% CI (0.29, 1.21); p = 0.15]. The postoperative TR grade associated with 3D rigid rings was 0.12 lower [mean difference (MD) = −0.12; 95% CI (−0.22, −0.01); p = 0.03], which indicated that 3D rigid rings result in better postoperative outcomes than flexible bands. Compared with suture annuloplasty, the postoperative TR grade of the 3D rigid ring group was 0.51 lower [MD = −0.51; 95% CI (−0.59, −0.43); p < 0.05]. Within the 5 years of follow-up, patients who underwent 3D rigid ring annuloplasty had lower TR recurrence [OR = 0.26; 95% CI (0.13, 0.50); p < 0.05].ConclusionsCompared with suture annuloplasty, 3D rigid rings present early advantages. The 3D rigid rings provide an acceptable short-term effect similar to that of the flexible bands, and a significant difference between these approaches was not discovered. However, the conclusion was based on the limited, short-term data available at the time of the study. Further research on the long-term effects of 3D rigid ring annuloplasty for TR is clearly needed.Systematic Review Registrationhttps://inplasy.com/inplasy-2021-3-0105/, identifier: 202130105.

AIM: To observe the efficacy and safety of pars plana vitrectomy (PPV) with eye position guided fluid-air exchange (FAX) and air tamponade in the treatment of rhegmatogenous retinal detachment (RRD). METHODS: RRD patients without severe proliferative vitreoretinopathy (PVR) C1 or more were enrolled. All patients underwent PPV combining with air tamponade. During operation, the primary retinal break(s) were placed at lower site and subretinal fluid was aspirated through the break(s) at the same time when eye position guided FAX was proceeding. Sufficient laser spots were made to seal the retinal break(s) after FAX, and filtered air was left in vitreous cavity as tamponade agent finally. The main outcomes were primary and final success rates, best corrected visual acuity (BCVA), and the secondary outcomes were rate of postoperative cataract surgery and high intraocular pressure. RESULTS: A total of 37 eyes (20 males and 17 females) with a follow-up time of ≥6mo were included. The range of RRD was 5.6±1.8h, and the number of retinal breaks was 1.9±1.2. The breaks located at inferior quadrants (between 3:00 and 9:00) in 5 cases (13.5%), and both superior and inferior breaks were found in 3 cases (8.1%). A total of 25 cases (67.6%) with macular detached involvement, 9 cases (24.3%) with intraocular lens, and 8 patients (21.6%) were treated with phacoemulsification and intraocular lens implantation together. The success rate of primary retinal reattachment was 100% (37/37). At 6mo postoperatively, BCVA (logMAR) was increased from 1.13±1.07 to 0.23±0.15 (P

Abstract Background Bruton tyrosine kinase (BTK) inhibitors have demonstrated a high degree of efficacy in the treatment of B cell malignancies characterized by constitutive B cell receptor activation, including chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Methods The efficacy and safety of zanubrutinib, an investigational highly selective BTK inhibitor, was evaluated in this single-arm, phase 2 study of Chinese patients with relapsed/refractory CLL/SLL. The primary endpoint was overall response rate as assessed by an independent review committee. Results Of the 91 evaluable patients, 77 (84.6%) achieved a response, with three (3.3%), 54 (59.3%), and 20 (22%) patients achieving a complete response, partial response, and partial response with lymphocytosis, respectively, after a median follow-up of 15.1 months. The estimated 12-month event-free rate for duration of response was 92.9%. The most commonly reported grade ≥ 3 adverse events (AEs) were neutropenia (44%), thrombocytopenia (15.4%), lung infection/pneumonia (13.2%), upper respiratory tract infection (9.9%), and anemia (8.8%). The 12-month overall survival rate was 96%. Eight (9.0%) patients discontinued zanubrutinib due to AEs, and seven (8.0%) patients required at least one dose reduction. Conclusion Treatment of patients with relapsed/refractory CLL/SLL with zanubrutinib was generally well tolerated and resulted in a high overall response rate, thereby conferring a favorable benefit-risk profile. Trial registration Prospectively registered in China public registry (CTR20160890) on December 7, 2016: http://www.chinadrugtrials.org.cn/ . Retrospectively registered in ClinicalTrials.gov ( NCT03206918 ) on July 2, 2017.

Abstract Background Clinical data show that due to the limited effects of lifestyle regulation and unsatisfactory drug adherence, only half of the hypertensive population have their blood pressure (BP) under control. In recent years, catheter-based renal denervation (RDN) has been used as a novel approach for treating uncontrolled hypertension. The safety and efficacy of catheter-based RDN have been confirmed by a number of studies and trials in which the participants were all non-Chinese and RDN was conducted via radiofrequency or ultrasound. Methods/design This study is a prospective multicenter randomized sham-controlled trial that aims to investigate the safety and efficacy of cryoablation RDN (cryo-RDN) using a novel dedicated cryoablation balloon catheter (Cryofocus, China). A total of 200 Chinese patients who have uncontrolled hypertension despite standard medical treatment will be enrolled. With drug standardization, eligible participants will be randomized in a 1:1 ratio to undergo cryo-RDN treatment or renal angiography alone as a sham treatment. The primary endpoint is defined as the change in 24-h ambulatory systolic blood pressure from baseline to 6 months. Office BP and other 24-h ambulatory BP are included as secondary endpoints. Safety endpoints primarily include any adverse effects. Discussion This study was designed to verify the safety and efficacy of cryo-RDN with Cryofocus balloon catheters in uncontrolled hypertensive patients on polypharmacy. The aim is to provide a new way to improve the control of hypertension in China as a complement to drug therapy. Trial registration ChiCTR, ChiCTR1800017707. Registered on 10 August 2018.

BackgroundLinguistic accessibility has an important impact on the reception and utilization of translated health resources among multicultural and multilingual populations. Linguistic understandability of health translation has been understudied. ObjectiveOur study aimed to develop novel machine learning models for the study of the linguistic accessibility of health translations comparing Chinese translations of the World Health Organization health materials with original Chinese health resources developed by the Chinese health authorities. MethodsUsing natural language processing tools for the assessment of the readability of Chinese materials, we explored and compared the readability of Chinese health translations from the World Health Organization with original Chinese materials from the China Center for Disease Control and Prevention. ResultsA pairwise adjusted t test showed that the following 3 new machine learning models achieved statistically significant improvement over the baseline logistic regression in terms of area under the curve: C5.0 decision tree (95% CI –0.249 to –0.152; P

Background: Due to its convenience, wide availability, low usage cost, neural machine translation (NMT) has increasing applications in diverse clinical settings and web-based self-diagnosis of diseases. Given the developing nature of NMT tools, this can pose safety risks to multicultural communities with limited bilingual skills, low education, and low health literacy. Research is needed to scrutinise the reliability, credibility, usability of automatically translated patient health information.Objective: We aimed to develop high-performing Bayesian machine learning classifiers to assist clinical professionals and healthcare workers in assessing the quality and usability of NMT on depressive disorders. The tool did not require any prior knowledge from frontline health and medical professionals of the target language used by patients.Methods: We used Relevance Vector Machine (RVM) to increase generalisability and clinical interpretability of classifiers. It is a typical sparse Bayesian classifier less prone to overfitting with small training datasets. We optimised RVM by leveraging automatic recursive feature elimination and expert feature refinement from the perspective of health linguistics. We evaluated the diagnostic utility of the Bayesian classifier under different probability cut-offs in terms of sensitivity, specificity, positive and negative likelihood ratios against clinical thresholds for diagnostic tests. Finally, we illustrated interpretation of RVM tool in clinic using Bayes' nomogram.Results: After automatic and expert-based feature optimisation, the best-performing RVM classifier (RVM_DUFS12) gained the highest AUC (0.8872) among 52 competing models with distinct optimised, normalised features sets. It also had statistically higher sensitivity and specificity compared to other models. We evaluated the diagnostic utility of the best-performing model using Bayes' nomogram: it had a positive likelihood ratio (LR+) of 4.62 (95% C.I.: 2.53, 8.43), and the associated posterior probability (odds) was 83% (5.0) (95% C.I.: 73%, 90%), meaning that approximately 10 in 12 English texts with positive test are likely to contain information that would cause clinically significant conceptual errors if translated by Google; it had a negative likelihood ratio (LR-) of 0.18 (95% C.I.: 0.10,0.35) and associated posterior probability (odds) was 16% (0.2) (95% C.I: 10%, 27%), meaning that about 10 in 12 English texts with negative test can be safely translated using Google.

BackgroundCurrent health information understandability research uses medical readability formulas to assess the cognitive difficulty of health education resources. This is based on an implicit assumption that medical domain knowledge represented by uncommon words or jargon form the sole barriers to health information access among the public. Our study challenged this by showing that, for readers from non-English speaking backgrounds with higher education attainment, semantic features of English health texts that underpin the knowledge structure of English health texts, rather than medical jargon, can explain the cognitive accessibility of health materials among readers with better understanding of English health terms yet limited exposure to English-based health education environments and traditions. ObjectiveOur study explores multidimensional semantic features for developing machine learning algorithms to predict the perceived level of cognitive accessibility of English health materials on health risks and diseases for young adults enrolled in Australian tertiary institutes. We compared algorithms to evaluate the cognitive accessibility of health information for nonnative English speakers with advanced education levels yet limited exposure to English health education environments. MethodsWe used 113 semantic features to measure the content complexity and accessibility of original English resources. Using 1000 English health texts collected from Australian and international health organization websites rated by overseas tertiary students, we compared machine learning (decision tree, support vector machine [SVM], ensemble tree, and logistic regression) after hyperparameter optimization (grid search for the best hyperparameter combination of minimal classification errors). We applied 5-fold cross-validation on the whole data set for the model training and testing, and calculated the area under the operating characteristic curve (AUC), sensitivity, specificity, and accuracy as the measurement of the model performance. ResultsWe developed and compared 4 machine learning algorithms using multidimensional semantic features as predictors. The results showed that ensemble classifier (LogitBoost) outperformed in terms of AUC (0.858), sensitivity (0.787), specificity (0.813), and accuracy (0.802). Support vector machine (AUC 0.848, sensitivity 0.783, specificity 0.791, and accuracy 0.786) and decision tree (AUC 0.754, sensitivity 0.7174, specificity 0.7424, and accuracy 0.732) followed. Ensemble classifier (LogitBoost), support vector machine, and decision tree achieved statistically significant improvement over logistic regression in AUC, sensitivity, specificity, and accuracy. Support vector machine reached statistically significant improvement over decision tree in AUC and accuracy. As the best performing algorithm, ensemble classifier (LogitBoost) reached statistically significant improvement over decision tree in AUC, sensitivity, specificity, and accuracy. ConclusionsOur study shows that cognitive accessibility of English health texts is not limited to word length and sentence length as had been conventionally measured by medical readability formulas. We compared machine learning algorithms based on semantic features to explore the cognitive accessibility of health information for nonnative English speakers. The results showed the new models reached statistically increased AUC, sensitivity, and accuracy to predict health resource accessibility for the target readership. Our study illustrated that semantic features such as cognitive ability–related semantic features, communicative actions and processes, power relationships in health care settings, and lexical familiarity and diversity of health texts are large contributors to the comprehension of health information; for readers such as international students, semantic features of health texts outweigh syntax and domain knowledge.

BackgroundMedical writing styles can have an impact on the understandability of health educational resources. Amid current web-based health information research, there is a dearth of research-based evidence that demonstrates what constitutes the best practice of the development of web-based health resources on children’s health promotion and education. ObjectiveUsing authoritative and highly influential web-based children’s health educational resources from the Nemours Foundation, the largest not-for-profit organization promoting children’s health and well-being, we aimed to develop machine learning algorithms to discriminate and predict the writing styles of health educational resources on children versus adult health promotion using a variety of health educational resources aimed at the general public. MethodsThe selection of natural language features as predicator variables of algorithms went through initial automatic feature selection using ridge classifier, support vector machine, extreme gradient boost tree, and recursive feature elimination followed by revision by education experts. We compared algorithms using the automatically selected (n=19) and linguistically enhanced (n=20) feature sets, using the initial feature set (n=115) as the baseline. ResultsUsing five-fold cross-validation, compared with the baseline (115 features), the Gaussian Naive Bayes model (20 features) achieved statistically higher mean sensitivity (P=.02; 95% CI −0.016 to 0.1929), mean specificity (P=.02; 95% CI −0.016 to 0.199), mean area under the receiver operating characteristic curve (P=.02; 95% CI −0.007 to 0.140), and mean macro F1 (P=.006; 95% CI 0.016-0.167). The statistically improved performance of the final model (20 features) is in contrast to the statistically insignificant changes between the original feature set (n=115) and the automatically selected features (n=19): mean sensitivity (P=.13; 95% CI −0.1699 to 0.0681), mean specificity (P=.10; 95% CI −0.1389 to 0.4017), mean area under the receiver operating characteristic curve (P=.008; 95% CI 0.0059-0.1126), and mean macro F1 (P=.98; 95% CI −0.0555 to 0.0548). This demonstrates the importance and effectiveness of combining automatic feature selection and expert-based linguistic revision to develop the most effective machine learning algorithms from high-dimensional data sets. ConclusionsWe developed new evaluation tools for the discrimination and prediction of writing styles of web-based health resources for children’s health education and promotion among parents and caregivers of children. User-adaptive automatic assessment of web-based health content holds great promise for distant and remote health education among young readers. Our study leveraged the precision and adaptability of machine learning algorithms and insights from health linguistics to help advance this significant yet understudied area of research.

Modern industrialization has led to the creation of a wide range of organic chemicals, especially in the form of multicomponent mixtures, thus making the evaluation of environmental pollution more difficult by normal methods. In this paper, we attempt to use forward stepwise multiple linear regression (MLR) and nonlinear radial basis function neural networks (RBFNN) to establish quantitative structure–activity relationship models (QSARs) to predict the toxicity of 79 binary mixtures of aquatic organisms using different hypothetical descriptors. To search for the proper mixture descriptors, 11 mixture rules were performed and tested based on preliminary modeling results. The statistical parameters of the best derived MLR model were Ntrain = 62, R2 = 0.727, RMS = 0.494, F = 159.537, Q2LOO = 0.727, and Q2pred = 0.725 for the training set; and Ntest = 17, R2 = 0.721, RMS = 0.508, F = 38.773, and q2ext = 0.720 for the external test set. The RBFNN model gave the following statistical results: Ntrain = 62, R2 = 0.956, RMS = 0.199, F = 1279.919, Q2LOO = 0.955, and Q2pred = 0.855 for the training set; and Ntest = 17, R2 = 0.880, RMS = 0.367, F = 110.980, and q2ext = 0.853 for the external test set. The quality of the models was assessed by validating the relevant parameters, and the final results showed that the developed models are predictive and can be used for the toxicity prediction of binary mixtures within their applicability domain.

Gutman proposed the concept of Sombor index. It is defined via the term $ \sqrt{d_F(v_i)^2+d_F(v_j)^2} $, where $ d_F(v_i) $ is the degree of the vertex $ v_i $ in graph $ F $. Also, the reduced Sombor index and the Average Sombor index have been introduced recently, and these topological indices have good predictive potential in mathematical chemistry. In this paper, we determine the extreme molecular graphs with the maximum value of Sombor index and the extremal connected graphs with the maximum (reduced) Sombor index. Some inequalities relations among the chemistry indices are presented, these topology indices including the first Banhatti-Sombor index, the first Gourava index, the Second Gourava index, the Sum Connectivity Gourava index, Product Connectivity Gourava index, and Eccentric Connectivity index. In addition, we characterize the graph where equality occurs.

Pancreatic cancer (PCa) is one of the most aggressive lethal malignancies, and cancer metastasis is the major cause of PCa-associated death. F-box/LRR-repeat protein 7 (FBXL7) regulates cancer metastasis and the chemosensitivity of human pancreatic cancer. However, the clinical significance and biological role of FBXL7 in PCa have been rarely studied. In this study, we found that the expression of FBXL7 was down-regulated in PCa tissues compared with tumor-adjacent tissues, and the low expression of FBXL7 was positively associated with cancer metastasis. Functionally, overexpression of FBXL7 attenuated PANC1 cell invasion, whereas FBXL7 silencing promoted BxPC-3 cell invasion. Forced expression of FBXL7 upregulated the expression of epithelial markers (e.g., E-cadherin) and repressed the expression of mesenchymal markers (e.g., N-cadherin and Vimentin), indicating that FBXL7 negatively regulated the epithelial-mesenchymal transition (EMT) of PCa cells. Furthermore, we identified that FBXL7 repressed the expression of Snail1, a crucial transcription factor of EMT. Mechanistically, FBXL7 bound to Snail1 and promoted its ubiquitination and proteasomal degradation. In vivo studies demonstrated that FBXL7 inhibition promotes PCa metastasis. Taken together, our findings demonstrate that FBXL7 knockdown could efficiently enhance PCa metastasis by regulating Snail1-dependent EMT.

Dendritic cells (DCs) are efficient antigen-presenting cells (APCs) and potent activators of naïve T cells. Therefore, they act as a connective ring between innate and adaptive immunity. DC subsets are heterogeneous in their ontogeny and functions. They have proven to potentially take up and process tumor-associated antigens (TAAs). In this regard, researchers have developed strategies such as genetically engineered or TAA-pulsed DC vaccines; these manipulated DCs have shown significant outcomes in clinical and preclinical models. Here, we review DC classification and address how DCs are skewed into an immunosuppressive phenotype in cancer patients. Additionally, we present the advancements in DCs as a platform for cancer immunotherapy, emphasizing the technologies used for in vivo targeting of endogenous DCs, ex vivo generated vaccines from peripheral blood monocytes, and induced pluripotent stem cell-derived DCs (iPSC-DCs) to boost antitumoral immunity.

The aims are to improve the efficiency in analyzing the regional economic changes in China's high-tech industrial development zones (IDZs), ensure the industrial structural integrity, and comprehensively understand the roles of capital, technology, and talents in regional economic structural changes. According to previous works, the economic efficiency and impact mechanism of China's high-tech IDZ are analyzed profoundly. The machine learning (ML)-based Data Envelopment Analysis (DEA) and Malmquist index measurement algorithms are adopted to analyze the dynamic and static characteristics of high-tech IDZ's economic data from 2009 to 2019. Furthermore, a high-tech IDZ economic efficiency influencing factor model is built. Based on the detailed data of a high-tech IDZ, the regional economic changes are analyzed from the following dimensions: economic environment, economic structure, number of talents, capital investment, and high-tech IDZ's regional scale, which verifies the effectiveness of the proposed model further. Results demonstrate that the comprehensive economic efficiency of all national high-tech IDZs in China is relatively high. However, there are huge differences among different regions. The economic efficiency of the eastern region is significantly lower than the national average. The economic structure, number of talents, capital investment, and economic efficiency of the high-tech IDZs show a significant positive correlation. The economic changes in high-tech IDZs can be improved through the secondary industry, employee value, and funding input. The ML technology applied can make data processing more efficient, providing proper suggestions for developing China's high-tech industrial parks.

Aims: This study investigated the application of the domestic Argus Insight-100 optical coherence tomography (OCT) system in porcine arteries and to evaluate the efficiency and safety of Insight-100°CT immediately after implantation and at 4-week follow-up. Subjects and Methods: Eight porcine arteries were implanted with HELIOS drug-eluting stents. Scans were performed with Insight-100 and C7-XR OCT immediately after implantation and at 4-week follow-up, respectively, to obtain lumen images and measured data. Statistical Analysis Used: SPSS v22 software was used for statistical analysis. Results: Both the Insight-100 and C7-XR scans were successfully performed during the implantation and follow-up. Parameters at 4-week postoperatively showed no significant difference between these two groups. No differences were observed in the reference vessel minimal lumen diameters between Insight-100 and C7-XR in the same frame (2.59 ± 0.18 mm vs. 2.60 ± 0.23 mm, respectively, P = 0.91 and 2.83 ± 0.27 mm vs. 2.98 ± 0.27 mm, respectively, P = 0.19). Moreover, the values of mean lumen diameter in the stent segment are comparable between Insight-100 and C7-XR (2.91 ± 0.11 mm vs. 2.97 ± 0.16 mm, P = 0.50). At 4-week follow-up, the mean lumen diameter of Insight-100 was 2.54 ± 0.28 mm, while that of C7-XR was 2.55 ± 0.32 mm, without difference between two groups (P = 0.92). Conclusions: The Argus OCT system appears to be safe during implantation and follow-up. The efficacy and measurement accuracy of Argus OCT is equivalent to that of the C7-XR.