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Polycystic ovarian syndrome (PCOS) is a prevalent endocrinological disorder affected by ghrelin. This study aimed to investigate the molecular mechanisms underlying the effects of ghrelin on PCOS manifestations in mice and to assess the therapeutic potential of ghrelin. Female C57BL/6 mice were subcutaneously injected with 6 mg/100 g dehydroepiandrosterone (DHEA) for 20 days to induce PCOS. Alterations in reproductive cycles, ovarian morphology, serum sex hormone levels, and related signaling markers were examined. Furthermore, ghrelin-induced effects on granulosa cells and the role of ghrelin/Gq/11/ Yes-associated protein (YAP) signaling were studied by silencing Gαq/11 or YAP using si-RNAs. Finally, we evaluated the therapeutic potential of anti-ghrelin antibodies in DHEA-induced PCOS mice. DHEA administration led to significant PCOS-associated changes including weight gain, disrupted estrous cycles, ovarian morphological alterations, and hormonal imbalances in mice, with elevated Gαq/11 and acylated ghrelin expression, which was also noted in PCOS patients. However, treatment with anti-ghrelin antibodies effectively managed DHEA-induced damage in PCOS mice. In vitro, ghrelin exposure resulted in granulosa cell injury and modulated estrogen receptors alpha (ERα) and YAP protein levels, whereas silencing YAP and Gαq/11 reversed ghrelin-induced detrimental effects and up-regulated ERα expression. This study revealed that DHEA-induced PCOS traits in mice could be improved by anti-ghrelin antibodies, with the ghrelin/Gq/11/YAP signaling pathway identified as a crucial mediator in granulosa cells, affecting ERα transcription to regulate PCOS. These findings suggest a potential therapeutic strategy for the treatment of PCOS. [ABSTRACT FROM AUTHOR]

Background: Vancomycin-induced bleeding has been reported, attributed to the mechanism of immune thrombocytopenia. A rare case of vancomycin-induced gastrointestinal hemorrhage in a young patient with no underlying disease, receiving intravenous vancomycin for methicillin-resistant Staphylococcus aureus (MRSA) infection, is presented. This occurrence occurred without thrombocytopenia. Relevant cases reported in the literature were also reviewed. Case presentation: A 34-year-old male patient presented with maxillofacial multiple spaces infection accompanying left temporal abscess, bilateral lung abscesses. Culture results from both blood and secretion indicated that the infection was caused by MRSA. The patient received standard-dose vancomycin (1 g q12h intravenously guttae) for treatment. On the 5th day of therapy, he presented with bright red blood in his stool; however, vancomycin treatment was continued. By the 9th day, a decrease in hemoglobin level to 76 g/L and a platelet (PLT) count of 424 × 109/L raised concerns about gastrointestinal hemorrhage. The hemoglobin level decreased to 62 g/L on day 12. Due to the high tissue concentration of linezolid, administration of linezolid at a dose of 600 mg q12h intravenously guttae commenced on the 13th day as an alternative to vancomycin(D13-D17). Subsequently, on the 17th day, there was an improvement in hemoglobin level to 78 g/L. However, despite treatment with linezolid, the patient's fever showed no significant improvement, prompting a switch back to vancomycin at a dosage of 1 g q12h intravenously guttae(D18-D22). On the 21st day, there was a recurrence of gastrointestinal hemorrhage, accompanied by a hemoglobin level of 42 g/L and a PLT count of 224 × 109/L. Gastroscopy revealed the presence of a gastroduodenal ulcer. The patient had no prior history of hemorrhoids, gastrointestinal ulcers, liver cirrhosis, or purpura. Prior to admission, he had not been administered non-steroidal anti-inflammatory drugs (NSAIDs) or steroids. During hospitalization, the only medications given were vancomycin, ambroxol and lidocaine. Additional tests ruled out immunological disorders as the cause of gastrointestinal ulcers, and a positive vancomycin rechallenge test indicated an association between vancomycin and bleeding. After discontinuation of vancomycin, no further bleeding occurred. This case highlights a rare occurrence of vancomycin-induced bleeding without thrombocytopenia, classified as "Certain" according to the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) scale for standardized case causality assessment. Conclusion: This case represents the first documented instance of vancomycin-induced bleeding without thrombocytopenia, as confirmed by a positive rechallenge test. This discovery will aid in the early detection of this rare adverse reaction in future cases. [ABSTRACT FROM AUTHOR]

In recent years, with the dramatic surge in the demand for health and elderly care services, the emergence of the health dividend has presented good development opportunities for health and wellness tourism. However, as a sector of the economy, health and wellness tourism still faces numerous challenges in achieving high-quality development. Therefore, this paper focuses on 31 provinces in China and constructs a multidimensional evaluation index system for the high-quality development of health and wellness tourism. The global entropy-weighted TOPSIS method and cluster analysis are used to conduct in-depth measurements, regional comparisons, and classification evaluations of the high-quality development of health and wellness tourism in each province. The research results indicate that: (1) From a quality perspective, the level of health and wellness tourism development in 11 provinces in China has exceeded the national average, while the remaining 20 provinces are below the national average. (2) From a regional perspective, the current level of high-quality development in health and wellness tourism decreases sequentially from the eastern to the central to the western regions, with significant regional differences. (3) Overall, the development in the 31 provinces can be categorized into five types: the High-Quality Benchmark Type, the High-Quality Stable Type, the High-Quality Progressive Type, the General-Quality Potential Type, and the General-Quality Lagging Type. (4) From a single-dimension analysis perspective, there are significant differences in the rankings of each province across different dimensions. Finally, this paper enriches and expands the theoretical foundation on the high-quality development of health and wellness tourism; on the other hand, it puts forward targeted countermeasures and suggestions to help promote the comprehensive enhancement of health and wellness tourism. [ABSTRACT FROM AUTHOR]

The wind power generation capacity is increasing rapidly every year. There needs to be a corresponding development in the management of wind power. Accurate wind speed forecasting is essential for a wind power management system. However, it is not easy to forecast wind speed precisely since wind speed time series data are usually nonlinear and fluctuant. This paper proposes a novel combined wind speed forecasting model that based on PSR (phase space reconstruction), NNCT (no negative constraint theory) and a novel GPSOGA (a hybrid optimization algorithm that combines global elite opposition-based learning strategy, particle swarm optimization and the genetic algorithm) optimization algorithm. SSA (singular spectrum analysis) is firstly applied to decompose the original wind speed time series into IMFs (intrinsic mode functions). Then, PSR is employed to reconstruct the intrinsic mode functions into input and output vectors of the forecasting model. A combined forecasting model is proposed that contains a CBP (cascade back propagation network), RNN (recurrent neural network), GRU (gated recurrent unit), and CNNRNN (convolutional neural network combined with recurrent neural network). The NNCT strategy is used to combine the output of the four predictors, and a new optimization algorithm is proposed to find the optimal combination parameters. In order to validate the performance of the proposed algorithm, we compare the forecasting results of the proposed algorithm with different models on four datasets. The experimental results demonstrate that the forecasting performance of the proposed algorithm is better than other comparison models in terms of different indicators. The DM (Diebold–Mariano) test, Akaike's information criterion and the Nash–Sutcliffe efficiency coefficient confirm that the proposed algorithm outperforms the comparison models. [ABSTRACT FROM AUTHOR]

Background: After acute treatment, patients with schizophrenia return to their original living environment for further rehabilitation, which not only determines the quality of life of the patients and their families but also has an important impact on society. However, patients often find it difficult to adapt to changes in the environment when they are discharged from the hospital. This may be related to the incompleteness of China's mental health service system, as many services for schizophrenia patients are only in the treatment stage. In China, schizophrenia is traditionally associated with poor moral quality, and patients find it difficult to obtain support. Many patients have trouble reintegrating into the community after treatment. Schizophrenic multifamily teams gather families affected by the same illness and pain together to promote healing together in an environment that allows mutual sharing, understanding and transparency, maximizes the use of family resources for support, improves discharge readiness, and better deals with post-discharge recovery. Methods: The multifamily group intervention method was used to improve the motivation of the patients' family motivation as well as the discharge readiness and self-efficacy of the patient. Results: After the intervention, the motivation of the family and discharge readiness of the patient were improved compared with that of the baseline period; however, the improvement was not significant. The self-efficacy of the patients was significantly improved (P=0.042). Conclusions: In the discharge preparation of schizophrenia patients, multifamily teams can be used to help patients and their families share resources, enhance support and prepare for discharge. Patients will have better support following discharge for recovery in the community. Additional consideration should be given to the impact of the environment on patient services, and the evaluation of the service process is key to continuously improving the service effect. [ABSTRACT FROM AUTHOR]

Background: In 2010, China launched a rural-oriented tuition-waived medical education (RTME) programme to train more general practitioners (GPs) to meet the needs of the rural health workforce. Motivating and maintaining GPs is an important consideration for the shortage in the rural health workforce. This study aimed to investigate job satisfaction and turnover among the first group of rural-oriented tuition-waived medical students (RTMSs) who had completed a three-year compulsory service in Guangxi, as well as the factors affecting RTMSs turnover. Methods: This study adopted a mixed-method approach. A quantitative survey of 129 RTMSs was analysed (81.6% response rate), and qualitative interviews were conducted with 30 stakeholders, including 18 RTMSs, six administrators of the County Health Bureau, and six administrators of township health centers (THCs). A t-test, chi-square test, Fisher's exact test, and logistic regression analysis were used to examine the quantitative data, and thematic analysis was used to analyse the qualitative data. Results: Among the 129 participants, the turnover rate was high, with 103 RTMSs reporting turnover (79.84%). Interpersonal relationships scored the highest in job satisfaction (3.63 ± 0.64) among RTMSs, while working conditions were rated the lowest (2.61 ± 0.85). Marital status (odds ratio [OR] = 0.236, 95% confidence interval [95%CI] = 0.059–0.953, P = 0.043), only child status (OR = 8.660, 95%CI = 1.714–43.762, P = 0.009), and job return satisfaction (OR = 0.290, 95%CI = 0.090–0.942, P = 0.039) were significantly associated with turnover. Univariate analyses showed that income had a significant influence on turnover, but the relationship gone by multivariable; however it was deemed important in the qualitative study. Qualitative analysis revealed that turnover was influenced by the working atmosphere, effort-reward imbalance, professional competence, and opportunities for training and promotion. Conclusions: This study provides insights for the policymakers about the priority areas for retaining GPs in rural locations and provides reference values for the retention of GPs in other regions with a shortage of rural health workers. For RTMSs to continue providing services to rural areas, the government should improve their salaries, balance their income and workload, provide more opportunities for training and career promotion, and managers should recognise their efforts and create an optimistic working atmosphere. [ABSTRACT FROM AUTHOR]

Objectives: Lung cancer (LC) is the malignant tumor with the highest mortality rate worldwide, and precise early diagnosis can improve patient prognosis. The purpose of this study was to investigate whether alterations in the glycopatterns recognized by the Hippeastrum hybrid lectin (HHL) in salivary proteins are associated with the development of LC. Materials and methods: First, we collected saliva samples from LC (15 lung adenocarcinoma (ADC); 15 squamous cell carcinoma (SCC); 15 small cell lung cancer (SCLC)) and 15 benign pulmonary disease (BPD) for high-throughput detection of abundance levels of HHL-recognized glycopatterns using protein microarrays, and then validated the pooled samples from each group with lectin blotting analysis. Finally, the N-glycan profiles of salivary glycoproteins isolated from the pooled samples using HHL-magnetic particle conjugates were characterized separately using MALDI-TOF/TOF-MS. Results: The results showed that the abundance level of glycopatterns recognized by HHL in salivary proteins was elevated in LC compared to BPD. The proportion of mannosylated N-glycans was notably higher in ADC (31.7%), SCC (39.0%), and SCLC (46.6%) compared to BPD (23.3%). Conclusions: The altered salivary glycopatterns such as oligomannose, Manα1-3Man, or Manα1-6Man N-glycans recognized by HHL might serve as potential biomarkers for the diagnosis of LC patients. Clinical relevance: This study provides crucial information for studying changes in salivary to differentiate between BPD and LC and facilitate the discovery of biomarkers for LC diagnosis based on precise alterations of mannosylated N-glycans in saliva. [ABSTRACT FROM AUTHOR]

This novel report presents the first known case, to our knowledge, of a 16-year-old male patient who experienced intraventricular thrombosis and pulmonary embolism after a Nuss procedure for pectus excavatum, attributed to chronic bar displacement. Two years after the operation, the patient experienced post-exercise cough and hemoptysis, which led to his admission. Imaging revealed pulmonary embolism, thrombosis in the right ventricular outflow tract, and lung infiltrative lesions. We hypothesize that the chronic bar displacement led to its embedment in the right ventricle, resulting in thrombus formation, which subsequently contributed to partial pulmonary embolism. Surgery revealed the bars' intrusion into the right ventricle and lung. This case highlights the risk of severe complications from bar displacement in the Nuss procedure, which necessitates long-term follow-up evaluation, caution against strenuous activities after surgery, and use of thoracoscopic guidance during bar implantation and removal. It underscores the importance of vigilant evaluation for late-stage complications in patients with respiratory distress or thrombosis after a Nuss procedure. [ABSTRACT FROM AUTHOR]

Understanding soil phosphorus (P) distribution and its key drivers is fundamental for sustainable P management. In this study, a 21-year fertilization experiment on black soil was carried out, setting up five fertilization treatments: unfertilized control (CK), nitrogen and potassium (NK), nitrogen, P and potassium (NPK), NPK plus straw (NPKS), and NPK plus manure (NPKM). The distribution and effecting factors of P pools within soil aggregates were investigated. Compared to CK, the NK and NPK treatments decreased calcium-associated P concentration in all aggregate fractions. Meanwhile, the NPK treatment significantly increased the organic P extracted from NaOH in unaggregated particles (<0.053 mm). This was mainly due to the reduction in soil pH. The NPKS and NPKM treatments increased almost all P forms in aggregates, especially Ca-P. For the NPKM treatment, inorganic P extracted from resin, NaHCO3, and NaOH increased as aggregate size increased. This was mainly because straw or manure addition promoted soil organic carbon (SOC) storage in aggregates, creating more sorption sites via association with amorphous metallic minerals, and, thus, facilitating P accumulation. In conclusion, decreasing soil pH by chemical fertilizers is an effective strategy for mobilizing soil P, whereas increasing SOC by straw or manure facilitates P accumulation. [ABSTRACT FROM AUTHOR]

Purpose: The practice of renovation and construction of university libraries is flourishing, but how to attract readers to use the library is an issue that urgently needs to be explored. Spatial cognition is a subjective judgment of a person's tendency to take action in the future and implies behavioral intention. Based on the sensory–image–cognition relationship, a theoretical model of university library readers' spatial cognition is conducted, and the influencing factors and mechanisms of spatial cognition are explored based on empirical data to provide theoretical references for spatial practices in university libraries. Design/methodology/approach: A visual and art-based mental map approach is introduced based on a questionnaire survey. The questionnaire is mainly used for the specific evaluation of spatial use and the breakdown of the detailed elements, while the mental map method is mainly used for the evaluation of readers' spatial cognition. Relevant empirical data are collected from the library of the Zhejiang University of Technology. Findings: The results indicate that readers' spatial sensory experience and mental imagery have positive effects on readers' behavior via the mediator spatial cognition, readers' spatial sensory experience and mental imagery have a positive effect on readers' spatial cognition and spatial cognition has a significant effect on readers' behavior. Originality/value: The main contribution of this study is to construct a theoretical model of readers' spatial cognition and to explore the factors that have an impact on spatial cognition and the influence of cognition on behavior. This provides a more rational and in-depth thinking paradigm for the study of university library space and provides theoretical references for library practice. [ABSTRACT FROM AUTHOR]

Controlled-release urea (CRU) fertilizers are widely used in agricultural production to reduce conventional nitrogen (N) fertilization-induced agricultural greenhouse gas emissions (GHGs) and improve N use efficiency (NUE). However, the long-term effects of different CRU fertilizers on GHGs and crop yields in vegetable fields remain relatively unexplored. This study investigated the variations in GHG emissions at four growth stages of lettuce in the spring and autumn seasons based on a five-year field experiment in the North China Plain. Four treatments were setup: CK (without N application), U (conventional urea—N application), ON (20% reduction in urea—N application), CRU (20% reduction in polyurethane-coated urea without topdressing), and DCRU (20% reduction in polyurethane-coated urea containing dicyandiamide [DCD] without topdressing). The results show that N application treatments significantly increased the GHG emissions and the lettuce yield and net yield, and DCRU exhibited the lowest N2O and CO2 emissions, the highest lettuce yield and net yield, and the highest lettuce N content of the N application treatments. When compared to U, the N2O emission peak under CRU and DCRU treatments was notably decreased and delayed, and their average N2O emission fluxes were significantly reduced by 10.20–20.72% and 17.51–29.35%, respectively, leading to a significant reduction in mean cumulative N2O emissions during the 2017–2021 period. When compared to U, the CO2 fluxes of DCRU significantly decreased by 8.0–16.54% in the seedling period, and mean cumulative CO2 emission decreased by 9.28%. Moreover, compared to U, the global warming potential (GWP) and greenhouse gas intensity (GHGI) of the DCRU treatment was significantly alleviated by 9.02–17.13% and 16.68–20.36%, respectively. Compared to U, the N content of lettuce under DCRU was significantly increased by 6.48–17.25%, and the lettuce net yield was also significantly increased by 5.41–7.71%. These observations indicated that the simple and efficient N management strategy to strike a balance between enhancing lettuce yields and reduce GHG emissions in open-field lettuce fields could be obtained by applying controlled-release urea containing DCD without topdressing. [ABSTRACT FROM AUTHOR]

Background: Frequent repairs of pediatric flexible bronchoscopes can lead to a huge financial burden for the hospital. This study aimed to investigate the common causes of the failures in pediatric flexible bronchoscopes and propose the measures to prevent the failures. Methods: This was a retrospective study. We collected repair information of the pediatric flexible bronchoscopes reprocessed in the Department of Sterile Processing at a hospital between September 1, 2018 and September 1, 2022 in order to investigate the causes and possible factors associated with the failures in pediatric flexible bronchoscopes. Results: The Department of Sterile Processing staff reprocessed the pediatric flexible bronchoscopes 4280 times. A total of 29 failures were identified. The failure rate was 0.678%. The average repair cost was USD7246.60. The common failures in the pediatric flexible bronchoscopes included dim video image, black dots, improper video image display or no image during angulation adjustment, and pressure marks in the insertion tube. The failure rates in flexible electronic bronchoscopes and small-diameter flexible bronchoscopes were 65.5% and 93.1%, respectively. The failure rate in the pediatric flexible bronchoscopes reprocessed by the staff members with less work experience was 75.9%. Conclusion: The failure rate in the pediatric flexible bronchoscopes was not high but the repair costs were extremely high. The types and size of the flexible bronchoscopes and work experience of the staff members responsible for bronchoscope reprocessing were the possible factors associated with the failure rate in the pediatric flexible bronchoscopes. It is advisable to further optimize the central workflow and management mode for reprocessing the pediatric flexible bronchoscopes, thereby extending their useful life and reducing costs. [ABSTRACT FROM AUTHOR]

In this paper, we study the portfolio selection problem considering the uncertain investment time horizon. We employ the Period Value at Risk (PVaR) to characterise the risk in the special cases and establish a fundamental mixed integer linear programming (MILP) model to obtain the optimal portfolio solutions. Identifying that the symmetric property of PVaR can significantly reduce the computation burden of the CPLEX solver, an enhanced MILP model is proposed. To verify the quality of obtained solutions, we also develop fast lower and upper bound estimation schemes respectively. Using the real-world data sets from NYSE and NASDAQ stock markets, numerical results are provided to show the efficiency of the enhanced model. [ABSTRACT FROM AUTHOR]

Sudan I is a cancer-causing chemical synthetic dye that is often illegally added to foods as a colorant. In this manuscript, based on molecularly imprinted polymers coated carbon dots (CDs@SiO2@MIPs), a novel fluorescence sensor is reported for the selective and sensitive determination of Sudan I. The sensor was prepared upon the surface of silica-coated carbon dots (CD@SiO2) by a one-pot sol-gel method using Sudan I as the template, 3-aminopropyl triethoxysilane (APTES) as the monomer, and tetraethyl orthosilicate (TEOS) as the crosslinker. Due to fluorescence resonance energy transfer, quenching occurred when CDs@SiO2@MIPs combined with Sudan I. The established sensor showed excellent recognition and performance for Sudan I with a wide linear range (1 to 120 μM) and low detection limit (0.61 μM). Furthermore, the sensor was successfully applied to determine Sudan I in chili powder and ketchup with recoveries from 89.7 to 101.7%. This work provides broad applications of fluorescence sensors based on CDs@SiO2@MIPs for the rapid analysis of food. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of the application of the FOCUS-PDCA quality improvement model in terms of reducing the distribution defect rate of the sterile packages processed by the CSSD. The FOCUS-PDCA quality improvement model was applied to analyze the causes of the distribution defects of sterile packages, develop improvement measures, and compare the distribution defect rates before and after the application of the FOCUS-PDCA model. Following implementation of the FOCUS-PDCA quality improvement model, the distribution defect rate of sterile packages decreased from 1.74 to 0.37% (P < 0.05). The FOCUS-PDCA quality improvement model can produce a substantial reduction in the distribution defect rate of sterile packages, ensuring the quality of sterile supplies. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) frameworks are essential for development since they offer pre-built tools and libraries that speed up and simplify the production of AI models, leveraging symmetry to save time and effort. They guarantee effective computing by modifying code for particular hardware, facilitating quicker testing and deployment. The identification of a suitable and optimal AI framework for development is a multi-criteria decision-making (MCDM) dilemma, where the considered AI frameworks for development are evaluated by considering various criteria and these criteria may have dual aspects (positive and negative). Thus, in this manuscript, we diagnosed a technique of MCDM within the bipolar fuzzy set (BFS) for identification and selection of optimal AI framework for development. In this regard, we diagnosed probability aggregation operators (AOs) within BFS, such as probability bipolar fuzzy weighted averaging (P-BFWA), probability bipolar fuzzy ordered weighted averaging (P-BFOWA), immediate probability bipolar fuzzy ordered weighted averaging (IP-BFOWA), probability bipolar fuzzy weighted geometric (P-BFWG), probability bipolar fuzzy ordered weighted geometric (P-BFOWH), and immediate probability bipolar fuzzy ordered weighted geometric (IP-BFOWG) operators. The diagnosed technique would be based on these invented probably AOs. Afterward, in this manuscript, we took a case study and obtained the optimal AI framework for development by employing the diagnosed technique of MCDM. We also investigated the comparison of the devised theory with certain prevailing theories to reveal the dominance and significance of the devised theory. [ABSTRACT FROM AUTHOR]

Background: The number of people living with HIV (PWH) aged 50 and above is increasing. The question of care among older PWH (aged ≥ 50 years) is an increasing concern. Understanding the care preference of older people can better provide care services for them. The purpose of this study was to investigate the care preference (home-based care, self-care, institutional care, community-based care, and mutual-aid care) among older PWH and identify the factors affecting their care preference. Methods: A cross-sectional survey was conducted among older PWH (aged ≥ 50 years) about care preference from May to November 2021. We enrolled 319 participants using convenience sampling. We designed a questionnaire to assess the care preference of older PWH. The Chi-square test and Fisher's exact test were used to conduct univariate analysis of care preference. Multinomial logistic regression was used to identify factors influencing care preference. Results: Most older PWH (72.7%) preferred home-based care, and few (15.7%) preferred self-care. Fewer older PWH preferred community-based care (5.3%), institutional care (5.0%) and mutual-aid care (1.3%). Multivariate analysis showed that older PWH with a house, spouse and more children were more inclined to choose home-based care (p <.05). Older PWH living alone, having higher monthly income and higher HIV stigma preferred to choose self-care (p <.05). Conclusion: Home-based care was the most preferred model of older PWH, and self-care ranked second. The number of those who preferred institutional care, community-based care and mutual-aid care were few. Nation and government should take measures to allocate care resources for older adults reasonably to better meet the care needs of older PWH. It is important to strengthen social security, reduce internalized HIV stigma, improve social support, and explore diversified care models for improving the quality of life of older PWH. [ABSTRACT FROM AUTHOR]

The "hotness" or "coldness" of the tumors are determined by the information of the cancer cells themselves, tumor immune characteristics, tumor microenvironment, and signaling mechanisms, which are key factors affecting cancer patients' clinical efficacy. The switch mechanism of "hotness" and "coldness" and its corresponding pathological characteristics and treatment strategies are the frontier and hot spot of tumor treatment. How to distinguish the "hotness" or "coldness" effectively and clarify the causes, microenvironment state, and characteristics are very important for the tumor response and efficacy treatments. Starting from the concept of hot and cold tumor, this review systematically summarized the molecular characteristics, influencing factors, and therapeutic strategies of "hot and cold tumors," and analyzed the immunophenotypes, the tumor microenvironment, the signaling pathways, and the molecular markers that contribute to "hot and cold tumors" in details. Different therapeutic strategies for "cold and hot tumors" based on clinical efficacy were analyzed with drug targets and proteins for "cold and hot tumors." Furthermore, this review combines the therapeutic strategies of different "hot and cold tumors" with traditional medicine and modern medicine, to provide a basis and guidance for clinical decision‐making of cancer treatment. [ABSTRACT FROM AUTHOR]

Gastrodia elata Blume is a well-known traditional Chinese medicine that is mainly used to treat diseases related to the nervous system, such as stroke, epilepsy, and headache. Gastrodin is the main bioactive component of Gastrodia elata Blume, and studies have shown that it has extensive pharmacological activity. This narrative review aims to systematically review relevant studies on the pharmacological effects of gastrodin to provide researchers with the latest and most useful information. Studies have shown that gastrodin has prominent neuroprotective effects and can treat or improve epilepsy, Tourette syndrome, Alzheimer's disease, Parkinson's disease, emotional disorders, cerebral ischemia-reperfusion injury, cognitive impairment, and neuropathic pain. Gastrodin can also improve myocardial hypertrophy, hypertension, and myocardial ischemia-reperfusion injury. In addition, gastrodin can mitigate liver, kidney, and bone tissue damage caused by oxidative stress and inflammation. In short, gastrodin is expected to treat many diseases, and it is worth investing more effort in research on this compound. [ABSTRACT FROM AUTHOR]

Background: It is imperative to develop novel therapeutics to overcome chemoresistance, a significant obstacle in the clinical management of prostate cancer (PCa) and other cancers. Methods: A phenotypic screen was performed to identify novel inhibitors of chemoresistant PCa cells. The mechanism of action of potential candidate(s) was investigated using in silico docking, and molecular and cellular assays in chemoresistant PCa cells. The in vivo efficacy was evaluated in mouse xenograft models of chemoresistant PCa. Results: Nicardipine exhibited high selectivity and potency against chemoresistant PCa cells via inducing apoptosis and cell cycle arrest. Computational, molecular, and cellular studies identified nicardipine as a putative inhibitor of embryonic ectoderm development (EED) protein, and the results are consistent with a proposed mechanism of action that nicardipine destabilised enhancer of zeste homologue 2 (EZH2) and inhibited key components of noncanonical EZH2 signalling, including transducer and activator of transcription 3, S-phase kinase-associated protein 2, ATP binding cassette B1, and survivin. As a monotherapy, nicardipine effectively inhibited the skeletal growth of chemoresistant C4-2B-TaxR tumours. As a combination regimen, nicardipine synergistically enhanced the in vivo efficacy of docetaxel against C4-2 xenografts. Conclusion: Our findings provided the first preclinical evidence supporting nicardipine as a novel EED inhibitor that has the potential to be promptly tested in PCa patients to overcome chemoresistance and improve clinical outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of the application of the FOCUS-PDCA quality improvement model in terms of reducing the distribution defect rate of the sterile packages processed by the CSSD. The FOCUS-PDCA quality improvement model was applied to analyze the causes of the distribution defects of sterile packages, develop improvement measures, and compare the distribution defect rates before and after the application of the FOCUS-PDCA model. Following implementation of the FOCUS-PDCA quality improvement model, the distribution defect rate of sterile packages decreased from 1.74 to 0.37% (P < 0.05). The FOCUS-PDCA quality improvement model can produce a substantial reduction in the distribution defect rate of sterile packages, ensuring the quality of sterile supplies. [ABSTRACT FROM AUTHOR]

Phosphorus (P) leaching from excessive P application is the primary pathway of P losses in agricultural soils. Different P fertilizer practices have mixed effects on P leaching. We conducted a meta-analysis of the relevant literature regarding the response of crop yields, soil-available P (AP), and total P (TP) leaching to reduced P input (RP) and an inorganic-organic combination fertilizer (NPKM) for different agricultural land-use types. Compared to conventional P application (CP), RP (10~90% reduction) did not reduce crop yields in vegetable fields (experiments were 1~4 years) but significantly reduced cereal yields by 4.57%. Compared to chemical fertilizer (NPK), NPKM significantly increased cereal yields by 12.73%. Compared to CP, RP significantly reduced AP at 0~60 cm in vegetable and cereal fields. The greatest reduction occurred at 20~40 cm in vegetable fields (40.29%) and 0~20 cm in cereal fields (34.45%). Compared to NPK, NPKM significantly increased the AP at 0~60 cm in vegetable fields, with the greatest increase (52.44%) at 20~40 cm. The AP at 0~40 cm in cereal fields significantly increased under the NPKM treatment, with the greatest increase at 0~20 cm (76.72%). Compared to CP, RP significantly decreased TP leaching by 16.02% and 31.50% in vegetable and cereal fields, respectively. Compared to NPK, NPKM significantly increased TP leaching in vegetable fields (30.43%); no significant difference in leaching occurred in cereal fields. P leaching, in response to RP, was influenced by the P amounts applied (34.49%); soil organic matter (14.49%); and TP (12.12%). P leaching in response to NPKM was influenced by multiple factors: rainfall (16.05%); soil organic matter (12.37%); soil bulk density (12.07%); TP (11.65%); pH (11.41%). NPKM was more beneficial for improving yields in cereal fields with low soil fertility and lower P-leaching risks. [ABSTRACT FROM AUTHOR]

Anise fruit (Aniseed) has been used for many years as a traditional medicine in various countries throughout the world; however, the chemical material basis of Aniseed water extract (AWE) has not been examined in detail, limiting our understanding of its pharmacological mechanism and methods for practical quality control. A high‐efficiency and high‐sensitivity LC‐triple time‐of‐flight tandem mass spectrometry (MS/MS) analysis method using data processing method combined with product ion and neutral loss filtering for systematic screening and identification of the constituents of AWE was established. A quantitative method was established by using LC–MS/MS with multiple reaction monitoring for 10 min to determine the concentration of 17 representative constituents. A total of 89 compounds were discovered in AWE, of which 31 were confirmed by the reference standards, while 24 were found in Aniseed for the first time. The qualification analysis results showed that chlorogenic acids and luteolin derivatives were the major compounds. The linearity, sensitivity, precision, stability, repeatability, and accuracy of the method were verified, which demonstrated that the method could meet the requirements for quantification. This work contributes to a better understanding of the chemical material basis of Aniseed and assists in the development of effective analytical methods for natural medicines. [ABSTRACT FROM AUTHOR]

Background: High‐intensity focused ultrasound (HIFU) is currently used for the treatment of various diseases, but it still lacks a reliable technique in the preoperative stage to accurately place its "energy blade" onto diseased targets. Acoustic radiation force imaging (ARFI) was recently introduced to tackle this issue, but its applicability and limitations were not clear. Purpose: The aim of this study was to evaluate the performance of ARFI method in prediction of HIFU focal location at the preoperative stage. Methods: A point spread function (PSF) localization method, which was borrowed from the ultrasound super resolution field, was used to validate the core autocorrelation‐based motion estimation algorithm in the ARFI procedure. Accuracy of the ARFI method for estimating the HIFU focus were tested with in vitro and ex vivo experiments with a clinically equivalent HIFU system. Comparisons were made between the estimated focal locations and those of the damaged area after the testing objects were cut open. Results: Results showed that the PSF localization was able to serve as a validating method for motion detection only when the tissue displacement was large. With the ARFI method, location of the HIFU focus could be accurately predicted by a 2D motion map preoperatively, and the axial spatial errors were less than 0.5 mm. However, the derived 2D motion maps can only be valuable when the acoustic stimulation in ARFI were strong enough, which was probably due to the fact that the HIFU focal locations were at large depths and the ultrasound imaging signal had low signal to noise ratio. Conclusion: The ARFI method was indeed an accurate technique for preoperatively predicting HIFU focus in vitro and ex vivo. If clinical applications were to be considered, particularly in deep tissues, efforts might need to be made to improve ability of the ultrasound motion estimation technique. [ABSTRACT FROM AUTHOR]

Background: Post-stroke depression (PSD) was one of the most prevalent and serious neuropsychiatric effects after stroke. Nevertheless, the association between liver function test indices and PSD remains elusive, and there is a lack of effective prediction tools. The purpose of this study was to explore the relationship between the liver function test indices and PSD, and construct a prediction model for PSD. Methods: All patients were selected from seven medical institutions of Chongqing Medical University from 2015 to 2021. Variables including demographic characteristics and liver function test indices were collected from the hospital electronic medical record system. Univariate analysis, least absolute shrinkage and selection operator (LASSO) and logistic regression analysis were used to screen the predictors. Subsequently, logistic regression, random forest (RF), extreme gradient boosting (XGBoost), gradient boosting decision tree (GBDT), categorical boosting (CatBoost) and support vector machine (SVM) were adopted to build the prediction model. Furthermore, a series of evaluation indicators such as area under curve (AUC), sensitivity, specificity, F1 were used to assess the performance of the prediction model. Results: A total of 464 PSD and 1621 stroke patients met the inclusion criteria. Six liver function test items, namely AST, ALT, TBA, TBil, TP, ALB/GLB, were closely associated with PSD, and included for the construction of the prediction model. In the test set, logistic regression model owns the AUC of 0.697. Compared with the other four machine learning models, the GBDT model has the best predictive performance (F1 = 0.498, AUC = 0.761) and was chosen to establish the prediction tool. Conclusions: The prediction model constructed using these six predictors with GBDT algorithm displayed a promising prediction ability, which could be used for the participating hospital units or individuals by mobile phone or computer. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery with cardiopulmonary bypass (CPB). Methods: A total of 180 patients undergoing elective heart valve surgery with CPB were randomly divided into four groups: 45 in group P (intravenous penehyclidine hydrochloride 0.02 mg/kg 10 min before anesthesia induction and at the beginning of CPB, total 0.04 mg/kg); 43 in group D (dexmedetomidine 0.5 μg/kg/h after induction of anesthesia until the end of anesthesia); 44 in group PD (penehyclidine hydrochloride 0.04 mg/kg combined with dexmedetomidine 0.5 μg/kg/h intravenously during anesthesia); and 43 in group C (same amount of normal saline 10 min before and after anesthesia induction, to the end of anesthesia, and at the beginning of CPB). The main outcomes were the incidence and severity of postoperative pulmonary complications (PPCs). The secondary outcomes were: (1) extubation time, length of stay in intensive care, and postoperative hospital stay, and adverse events; and (2) pulmonary function evaluation indices (oxygenation index and respiratory index) and plasma inflammatory factor concentrations (tumor necrosis factor-α, interleukin-6, C-reactive protein and procalcitonin) during the perioperative period. Results: The incidence of PPCs in groups P, D and PD after CPB was lower than that in group C (P < 0.05), and the incidence in group PD was significantly lower than that in groups P and D (P < 0.05). The scores for PPCs in groups P, D and PD were lower than those in group C (P < 0.05). Conclusion: Combined use of penehyclidine hydrochloride and dexmedetomidine during anesthesia reduced the occurrence of postoperative pulmonary dysfunction, and improved the prognosis of patients undergoing heart valve surgery with CPB. Trial registration: The trial was registered in the Chinese Clinical Trial Registry on 3/11/2020 (Registration No.: ChiCTR2000039610). [ABSTRACT FROM AUTHOR]

Voriconazole is widely used in the treatment and prevention of invasive fungal diseases. Common drug-induced liver injuries increase the economic burdens and the risks of premature drug withdrawal and disease recurrence. This study estimated the disposal cost of voriconazole-related liver injury, explored the risk factors of voriconazole-related liver injury in hospitalized patients, and established a predictive model of liver injury to assist clinicians and pharmacists in estimating the probability or risk of liver injury after voriconazole administration to allow for early identification and intervention in patients at high risk of liver injury. A retrospective study was conducted on the selected inpatients whose blood concentration of voriconazole was measured in the West China Hospital of Sichuan University from September 2016 to June 2020. The incidence and disposal cost of voriconazole-related liver injuries were calculated. The incidence of voriconazole-related liver injury was 15.82% (217/1372). The disposal cost has been converted to 2023 at a discount rate of 5%. The median (P25, P75) disposal cost of severe liver injury (n = 42), general liver injury (n = 175), and non-liver injury (n = 1155) was 993.59 (361.70, 1451.76) Chinese yuan, 0.00 (0.00, 410.48) yuan, and 0.00 (0.00, 0.00) yuan, respectively, with a statistically significant difference (p < 0.001). Single factor analysis and multiple factor logistic regression were used to analyze the risk factors of voriconazole-related liver injury. The voriconazole-related liver injury was related to the trough concentration (Cmin, OR 1.099, 95% CI 1.058–1.140), hypoproteinemia (OR 1.723, 95% CI 1.126–2.636), and transplantation status (OR 0.555, 95% CI 0.325–0.948). The prediction model of liver injury was Logit (P)= −2.219 + 0.094 × Cmin + 0.544 × Hydroproteinemia − 0.589 × Transplantation, and the prediction model nomogram was established. The model validation results showed that the C-index of the derivation set and validation set was 0.706 and 0.733, respectively. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.705 and 0.733, respectively, indicating that the model had good prediction ability. The prediction model will be helpful to develop clinical individualized medication of voriconazole and to identify and intervene in the cases of patients at high risk of voriconazole-related liver injury early on, in order to reduce the incidence of voriconazole-related liver injuries and the cost of treatment. [ABSTRACT FROM AUTHOR]

Background: The major emerging infectious diseases (MEIDs) have occurred frequently and become increasingly serious in the world. Sufficient personal emergency preparedness is critical for the general people in efficiently responding to and recovering from MEIDs. Nevertheless, few specific indicators are available for assessing the individual emergency preparedness of the general public during these periods. Therefore, the aim of this study was to construct an index system for comprehensively evaluating the personal emergency preparedness of the public regarding MEIDs. Methods: Based on the global national-level emergency preparedness index framework and a literature review, a preliminary index system was constructed. From June 2022 to September 2022, a panel of 20 experts from nine provinces and municipalities across multiple research areas participated in this Delphi study. They rated the importance of pre-defined indicators using a five-point Likert scale and provided their qualitative comments. According to the feedback of each round of experts, the indicators of the evaluation index system were revised. Results: After two rounds of expert consultation the evaluation index system reached a consensus, containing five first-level indicators, cooperating with prevention and control work, improving emergency response capacity, securing supplies and equipment, preparing economic resources, maintaining physical and mental health with affiliated 20 s-level indicators and 53 third-level indicators. The expert authority coefficient of consultation was 0.88 and 0.90. The Kendall's coefficient of concordance of expert consultations was 0.294 and 0.322, respectively. The differences were statistically significant (P < 0.05). Conclusion: A valid, reliable and scientific evaluation index system was established. This personal emergency preparedness index system, as a precursor form, will further lay the foundation for the formation of an assessment instrument. At the same time, it could provide a reference for future education and training of emergency preparedness for the general public. [ABSTRACT FROM AUTHOR]

Introduction: It has been acknowledged in China that actions should be taken immediately to ease the critical shortage of psychiatric nurses. However, with national data lacking, little is known about nurses' mental health status. Aim: To evaluate psychiatric nurses' mental health status by measuring their burnout, depression, anxiety and stress. Methods: All psychiatric nurses in the 41 selected hospitals in China were invited to participate in the survey. The Maslach Burnout Inventory‐Human Service Survey and Depression Anxiety Stress Scale were used to assess variables of interest. Results: 38.6% of psychiatric nurses met the criteria for burnout. The rates of depression, anxiety and stress were 26.3%, 36.4% and 12.5%, respectively. It was found that workplace region, educational level, working years, longer working hours and night shifts were associated with risk of burnout and DASS. Conclusions: More than a quarter of psychiatric nurses are suffering from burnout, depression or anxiety in China. Policymakers and hospital administrators should design a flexible schedule and restrict working hours for psychiatric nurses to achieve work‐life balance. Implications for Practice: The study informs policymakers and administrators on addressing the nursing shortage by identifying nurses immersed in negative emotions and preventing mental health problems. [ABSTRACT FROM AUTHOR]

Background: The frequent occurrence and increasing severity of major emerging infectious diseases (MEIDs) have posed considerable public health, economic and social issues worldwide. The emergency preparedness of public is inadequate to respond to and recover from MEIDs. Due to the limitation of time, space and resources, it is also difficult to carry out large-scale emergency preparedness training related to MEIDs. Then we developed a virtual interactive training system to improve emergency preparedness of public, including preparation of legal compliance, emergency knowledge, emergency capacity, economic estimation, material reserve and physical and mental health. Methods: A protocol for conducting a randomized controlled trail to evaluate the People's War against Pandemic, a virtual interactive training system aimed to improve emergency preparedness of public for MEIDs. During the intervention, participants need to complete the storyline task at least once a day, watch at least one article and one video in the knowledge corner, and complete a retest of wrong choices in the intelligent evaluation module. The primary outcome is emergency preparedness of public for MEIDs. The secondary outcome is prevention and control knowledge of MEIDs. Discussion: The People's War Against Pandemic may be an effective approach to provide public with a panoramic understanding of the response to MEIDs, so as to promote their comprehensive preparation and finally achieve effective response. Trial registration: This study was funded in 2021 and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2200060919) in June 2022. Recruitment and enrollment of participants began in July 2022. [ABSTRACT FROM AUTHOR]

A fabric air dispersion system (FADS) is a type of flexible air supply system that integrates air transmission and distribution. This innovative system has the potential to address common issues such as uneven air supply and surface condensation, which are often associated with traditional ventilation systems. Existing numerical simulation studies on fiber ducts have encountered problems with mesh generation and simulation accuracy. This work develops a simulation method based on the equivalent discounting method to overcome these challenges. The proposed method is utilized to investigate the flow and heat transfer characteristics inside fiber ducts while also examining the effects of various shapes and opening configurations. The findings indicate that the temperature rise inside the duct is positively correlated with flow rate, with higher temperatures resulting from faster flow speeds. The temperature rise of FADS with four rows of openings increased by 0.4 k compared to other opening methods. Additionally, the study shows that increasing the number of rows of openings in the fiber duct leads to a faster decay of flow velocity and a higher temperature rise. At the same time, increasing the number of openings in the duct slightly reduces flow velocity while slightly increasing the temperature rise. The presence of more fiber duct elbows leads to greater local resistance, which accelerates the decay of the flow velocity and increases the temperature rise. Compared to the "1"-shaped FADS, the temperature rises of the "L"-shaped and "U"-shaped systems have increased by 0.9 k and 2.9 k, respectively. [ABSTRACT FROM AUTHOR]

Understanding the transformation of accumulated phosphorus (P) is vital for P management. However, previous studies are limited to a few sites in Chinese agroecosystems. In this study, to investigate the temporal-spatial differences of transformation from accumulated P to available P (determined by the Olsen method), a dataset was assembled based on 91 national long-term experimental sites across China in the recent 31 years (1988–2018). A boosted regression tree (BRT) and a structural equation model (SEM) were used to analyze the factors influencing the transformation. The results showed that the transformation from accumulated P to available P in South China (1.97 mg kg−1) was significantly higher than that in other regions (0.69–1.22 mg kg−1). Soil properties were the main driving factors with a relative contribution of 81.8%, while climate and management practices explained 7.8% and 10.4% of the variations, respectively. Furthermore, SEM analysis revealed that the soil organic matter (SOM) could positively and directly affect the transformation, whereas the soil pH, soil silt content, and P fertilizer had negative and direct effects on it. For the first time, this study analyzed the transformation from soil accumulated P to available P at a national scale and at multiple sites and quantified the contribution of the main influencing factors. These results help to predict the soil available P content across different agroecosystems based on the input amount of P fertilizer, contributing to the regional precise management of P fertilizer application. [ABSTRACT FROM AUTHOR]

Direct use of chemotherapy drugs in the treatment of gastric cancer often leads to systemic side effects and unsatisfied therapeutic efficacy due to the lack of tumour-targeting ability. The excellent properties of nanoparticles make them good tools to provide more options for the targeted delivery of chemotherapeutic drugs. Herein, we developed a novel nanomedicine (GOQD-ICG-CS-6@HM nanoparticles, GIC@HM NPs), which employed graphene oxide quantum dots (GOQDs) to co-load photosensitizer indocyanine green (ICG) and chemotherapeutic drug gamabufotalin (CS-6) as the core and wrapped with the hybrid membrane (erythrocyte membrane and gastric cancer cell membrane, HM) on its surface. This nanomedicine possesses the functions of photothermal therapy and chemotherapy, making it a good choice for the treatment of gastric cancer. The results showed that the bionic-coated hybrid membrane not only improves the biocompatibility of the nanomedicine, and prolong its circulating half-life, but also delivers the drug to the tumour site precisely and improves the efficiency of drug utilisation. In vitro and in vivo studies further showed that GIC@HM NPs exhibited combinational effects on tumour therapy while displaying no obvious side effects on normal tissue. To sum up, the newly developed GIC@HM NPs provide a safer, more efficient, and more precise method for gastric cancer treatment. [ABSTRACT FROM AUTHOR]

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Understanding the renal region-specific metabolic alteration in different animal models of diabetic nephropathy (DN) is critical for uncovering the underlying mechanisms and for developing effective treatments. In the present study, spatially resolved metabolomics based on air flow-assisted desorption electrospray ionization mass spectrometry imaging (AFADESI-MSI) was used to compare the local metabolic changes in the kidneys of HFD/STZ-induced diabetic rats and db/db mice. As a result, a total of 67 and 59 discriminating metabolites were identified and visualized in the kidneys of the HFD/STZ-induced diabetic rats and db/db mice, respectively. The result showed that there were significant region-specific changes in the glycolysis, TCA cycle, lipid metabolism, carnitine metabolism, choline metabolism, and purine metabolism in both DN models. However, the regional levels of the ten metabolites, including glucose, AMP, eicosenoic acid, eicosapentaenoic acid, Phosphatidylserine (36:1), Phosphatidylserine (36:4), Phosphatidylethanolamine (34:1), Phosphatidylethanolamine (36:4), Phosphatidylcholine (34:2), Phosphatidylinositol (38:5) were changed in reversed directions, indicating significant differences in the local metabolic phenotypes of these two commonly used DN animal models. This study provides comprehensive and in-depth analysis of the differences in the tissue and molecular pathological features in diabetic kidney injury in HFD/STZ-induced diabetic rats and db/db mice. [ABSTRACT FROM AUTHOR]

To achieve transformation, libraries must undertake a profound and rapid reconfiguration of space. The spatial literacy competencies of librarians are directly related to the construction and service level of library spaces. This paper clarifies the concept of spatial literacy and its constituent elements. Using the method of systematic literature review, the current status of research on librarians' spatial literacy is analyzed from three aspects: spatial theory, spatial method, and spatial practice by focusing on the trajectory of library space-related literature. [ABSTRACT FROM AUTHOR]

Objectives. Indoleamine 2,3-dioxygenase 1 (IDO1) acts as the key rate-limiting enzyme that converts tryptophan (Trp) to kynurenine (Kyn). Its activity was primarily induced by interferon-γ (IFN-γ), which was reported to play a role in the development of acute radiation-induced pneumonitis. In this study, we aimed to investigate the correlation between IDO1 activity and radiation-induced lung toxicity (RILT) in stage III nonsmall cell lung cancer (NSCLC) patients who were treated with chemoradiotherapy (CRT). Materials and Methods. Systemic IDO1 activity was reflected by Kyn : Trp ratio. Plasma levels of Kyn and Trp in 113 stage III NSCLC patients were measured by high-performance liquid chromatography (HPLC) before the initiation of radiotherapy. Dynamic change of IDO1 activity was followed in 23 patients before, during, and after radiotherapy. We also used RNA sequencing (RNA-seq) data from the Cancer Genome Atlas Program (TCGA) database and performed gene set enrichment analysis (GSEA) to explore how IDO1 was involved in the development of RILT. Results. 9.7% (11/113) of the whole group developed G 3 + (greater than or equal to Grade 3) RILT. Preradiation IDO1 activity was significantly higher in patients who developed G 3 + RILT than in non G 3 + RILT patients. (P = 0.029 , AUC = 0.70). Univariate and multivariate analyses showed that high IDO1 activity was independently associated with the risk of G 3 + RILT (P = 0.034). A predictive model combining both IDO1 activity and FEV1 was established for severe RILT and displayed a moderate predictive value (AUC = 0.83, P < 0.001). The incidence of G 3 + RILT was 2.6% (1/38) in patients with an IDO activity ≤0.069 and FEV1 > 59.4%, and 50.0% (6/12) in those with an IDO activity >0.069 and FEV1 ≤ 59.4%. Of 23 patients with dynamic tracking, the IDO1 activity of postradiation was significantly lower than midradiation (P = 0.021), though no significant differences among the three time points were observed (P = 0.070). Bioinformatic analysis using RNA-seq data from 1014 NSCLC patients revealed that IDO mainly functioned in the inflammatory response instead of the late fibrosis process in NSCLC patients. Conclusion. High baseline IDO1 activity combined with unfavorable baseline FEV1 was predictive of severe RILT in unresectable stage III NSCLC patients. IDO1 might play a role in the acute inflammatory response. Finding effective interventions to alleviate RILT using IDO inhibitors is warranted in the future. [ABSTRACT FROM AUTHOR]