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BackgroundGestational diabetes mellitus (GDM) can cause adverse consequences to both mothers and their newborns. However, pregnant women living in low- and middle-income areas or countries often fail to receive early clinical interventions at local medical facilities due to restricted availability of GDM diagnosis. The outstanding performance of artificial intelligence (AI) in disease diagnosis in previous studies demonstrates its promising applications in GDM diagnosis. ObjectiveThis study aims to investigate the implementation of a well-performing AI algorithm in GDM diagnosis in a setting, which requires fewer medical equipment and staff and to establish an app based on the AI algorithm. This study also explores possible progress if our app is widely used. MethodsAn AI model that included 9 algorithms was trained on 12,304 pregnant outpatients with their consent who received a test for GDM in the obstetrics and gynecology department of the First Affiliated Hospital of Jinan University, a local hospital in South China, between November 2010 and October 2017. GDM was diagnosed according to American Diabetes Association (ADA) 2011 diagnostic criteria. Age and fasting blood glucose were chosen as critical parameters. For validation, we performed k-fold cross-validation (k=5) for the internal dataset and an external validation dataset that included 1655 cases from the Prince of Wales Hospital, the affiliated teaching hospital of the Chinese University of Hong Kong, a non-local hospital. Accuracy, sensitivity, and other criteria were calculated for each algorithm. ResultsThe areas under the receiver operating characteristic curve (AUROC) of external validation dataset for support vector machine (SVM), random forest, AdaBoost, k-nearest neighbors (kNN), naive Bayes (NB), decision tree, logistic regression (LR), eXtreme gradient boosting (XGBoost), and gradient boosting decision tree (GBDT) were 0.780, 0.657, 0.736, 0.669, 0.774, 0.614, 0.769, 0.742, and 0.757, respectively. SVM also retained high performance in other criteria. The specificity for SVM retained 100% in the external validation set with an accuracy of 88.7%. ConclusionsOur prospective and multicenter study is the first clinical study that supports the GDM diagnosis for pregnant women in resource-limited areas, using only fasting blood glucose value, patients’ age, and a smartphone connected to the internet. Our study proved that SVM can achieve accurate diagnosis with less operation cost and higher efficacy. Our study (referred to as GDM-AI study, ie, the study of AI-based diagnosis of GDM) also shows our app has a promising future in improving the quality of maternal health for pregnant women, precision medicine, and long-distance medical care. We recommend future work should expand the dataset scope and replicate the process to validate the performance of the AI algorithms.

Objective By studying the carbon footprint of two kinds of side wallboard made of different materials for rail vehicles, the accounting method for the carbon footprint of interior products is explored to guide designers in achieving low-carbon design. Method Side wallboards made of PC (polycarbonate) and FRP (fiberglass-reinforced plastic) for rail vehicle interiors are selected as research objects. Following the lifecycle assessment method outlined in PAS 2050:2011 'Specification for the Assessment of the Life Cycle Greenhouse Gas Emissions of Goods and Services', published by the British Standards Institution, the carbon footprints and contributions of the two different materials' side wallboards at each lifecycle stage are calculated. Result & Conclusion Within the defined system boundaries, the carbon footprint of FRP side wallboard is greater than that of PC one, with the highest contribution to the carbon footprint observed during the raw material acquisition stage for both types of wallboards. Under the premise of meeting vehicle performance requirements, selecting PC side wallboards with a lower carbon footprint is more conducive to overall vehicle decarbonization.

Coexisting or mixed type of colorectal tumors has been rarely reported. This study was designed to investigate clinicopathological characteristics of co-existing or mixed colorectal adenocarcinoma and highly differentiated neuroendocrine tumor (NET-G1). To do that, clinicopathological characteristics of five cases of co-existing or mixed colorectal adenocarcinoma and NET-G1 admitted to our institution between 2017 and 2021 were retrospectively analyzed and literature review was conducted. Four patients were male and one female, aged 62–75 years old. Among them, four cases were diagnosed with rectal cancer and one case of colon cancer. Gross examination found that one patient was diagnosed with multiple colon polyps including three malignant polyps, and the remaining four cases of ulcerous masses. The tumors infiltrated into the muscle layer in two cases, and three cases with tumors infiltrating into surrounding adipose tissues. Microscopic examination revealed one patient developed poorly differentiated adenocarcinoma and four cases of moderately differentiated adenocarcinoma. Four patients had adenocarcinoma and NET-G1 in colon, and one case of adenocarcinoma in colon and NET-G1 in appendix. To conclude, co-existing or mixed colorectal tumors are extremely rare in clinical settings. Clinicopathological characteristics of five cases of co-existing or mixed adenocarcinoma and NET-G1 are diverse and adenocarcinoma is more aggressive in most affected patients.

Adoptive transfer of T cell receptor-engineered T cells (TCR-T) is a promising strategy for immunotherapy against solid tumors. However, the potential of [CD4.sup.+] T cells in mediating tumor regression has been neglected. Nasopharyngeal cancer is consistently associated with EBV. Here, to evaluate the therapeutic potential of CD4 TCR-T in nasopharyngeal cancer, we screened for CD4 TCRs recognizing EBV nuclear antigen 1 (EBNA1) presented by HLA-DP5. Using mass spectrometry, we identified [EBNA1.sub.567-581], a peptide naturally processed and presented by HLA-DP5. We isolated TCR135, a CD4 TCR with high functional avidity, that can function in both [CD4.sup.+] and [CD8.sup.+] T cells and recognizes HLA-DP5-restricted [EBNA1.sub.567-581]. TCR135-transduced T cells functioned in two ways: directly killing [HLA-DP5.sup.+][EBNA1.sup.+] tumor cells after recognizing EBNA1 presented by tumor cells and indirectly killing HLA-DP5-negative tumor cells after recognizing EBNA1 presented by antigen- presenting cells. TCR135-transduced T cells preferentially infiltrated into the tumor microenvironment and significantly inhibited tumor growth in xenograft nasopharyngeal tumor models. Additionally, we found that 62% of nasopharyngeal cancer patients showed 50%-100% expression of HLA-DP on tumor cells, indicating that nasopharyngeal cancer is well suited for CD4 TCR-T therapy. These findings suggest that TCR135 may provide a new strategy for EBV-related nasopharyngeal cancer immunotherapy in [HLA-DP5.sup.+] patients., Introduction Recent advances in immunotherapy have shown promising results in the treatment of solid tumors. Adoptive transfer of T cell receptor- engineered (TCR-engineered) T cells (TCR-T) is a promising approach [...]

Objective·To study the effect of phosphatase and tensin homolog on chromosome 10 (PTEN) on alternative splicing of forkhead box M1 (FoxM1), and its impact on tumor cell migration.Methods·PTEN was knocked down by short hairpin RNA (shRNA) in human embryonic kidney 293T cells, human prostate cancer DU145 cells, human colorectal adenocarcinoma RKO cells, and human colon cancer SW480 and SW620 cells. Specific primers were designed for FoxM1 and its subtypes FoxM1B and FoxM1C, and the mRNA expression levels of FoxM1B and FoxM1C were detected by quantitative real-time PCR (qRT-PCR). FoxM1B and FoxM1C were overexpressed in DU145 cells, and their effects on tumor cell migration were tested by Transwell assay and wound healing assay. Immunofluorescence and dual luciferase reporter gene assay were used to explore the potential mechanism of differential regulation of tumor cell migration by FoxM1B and FoxM1C.Results·① PTEN was knocked down in 293T, DU145, RKO, SW480, and SW620 cell lines. qRT-PCR results showed that compared with the control cells, the mRNA expression level of FoxM1B significantly increased in PTEN knockdown cells, while the mRNA expression level of FoxM1C decreased or remained unchanged. Knockdown of PTEN did not affect the transcription level of FoxM1, but caused the variable splicing of FoxM1 and promoted the generation of FoxM1B. ② Compared with the control cells, the number of DU145 cells migrating to the below chamber increased in the FoxM1B overexpression group (P=0.024), while the number of migrating DU145 cells in the FoxM1C overexpression group was lower (P=0.000). The healing ability of DU145 cells was significantly enhanced in the FoxM1B overexpression group (P=0.001), while the healing ability of DU145 cells was weakened in the FoxM1C overexpression group (P=0.021). Overall, FoxM1B and FoxM1C had opposite effects on tumor cell migration. FoxM1B promoted tumor cell migration, while FoxM1C inhibited tumor cell migration. ③ Neither FoxM1B nor FoxM1C overexpression could induce β-catenin to enter the nucleus. Dual luciferase reporter gene assay showed no difference in the transcriptional activity of FoxM1B and FoxM1C. The difference between FoxM1B and FoxM1C in the regulation of tumor metastasis was also not mediated by β-catenin translocation.Conclusion·Knockdown of PTEN regulates the alternative splicing of FoxM1, leading to increasing expression of transcript FoxM1B, which plays a positive role in tumor cell migration.

Acute myeloid leukemia （AML） is a kind of myeloid clonal proliferative tumor with strong heterogeneity. Chemotherapy and hematopoietic stem cell transplantation are the main treatment methods for AML. Although patients can achieve better therapeutic effects, the elderly people cannot tolerate conventional chemotherapy due to many reasons such as advanced age, physiological and cognitive impairment, and increased complications, with limited treatment options and shorter survival period （only 2 months）. Venetoclax is the first approved B-cell lymphoma/leukemia-2 inhibitor （BCL-2） in the world. Many studies have shown that hypomethylating agents (HMA) such as azacytidine or dexcitabine and other low-intensity chemotherapy regimens combined with venetoclax has good efficacy in elderly patients, significantly improving combined overall response rate and overall survival （CR/Cri 66.4%, median OS 14.7 months）, enable more patients to transition to the allogeneic hematopoietic stem cell transplantation stage （allo-HSCT）. This article briefly reviews the mechanism of action of venetoclax, its clinical application in AML and some related issues including drug resistance.

This research aimed to examine the impact of different factors on high school chemistry teachers' use of curriculum materials in China. The examination was conducted on a theoretical framework in which three aspects of curriculum materials and three ways of curriculum use are involved and nine factors are suggested. Through a questionnaire survey of 212 chemistry teachers, the findings included the following aspects. Firstly, the nine factors more induced teachers to supplement the teaching elements, but less affected teachers to delete the original contents in the curriculum materials. Secondly, among the nine factors, 'knowledge about students' was recognized as the core factor in the three dimensions of teaching objectives, teaching strategies, and teaching activities, whereas 'class size' was regarded as the peripheral factor in all three dimensions. 'Teaching resources' was another peripheral factor for the dimensions of teaching strategies and teaching activities. Thirdly, two factors were found to be significantly different among teachers who are in different areas of economic development: 'knowledge about students' and 'class size'. Fourthly, 'knowledge about curriculum' and 'knowledge about instructional strategies' were two factors that made significant differences in the comparison among teachers who have different years of teaching experience.

In order to explore the possibility of using laser induced technology to produce coal-based graphene by using coal as carbon-containing precursor, this paper chooses high volatile bituminous coal in Wajinwan and low volatile bituminous coal in Tashan as carbon sources, and uses laser induced technology to produce coal-based graphene. Raman spectroscopy (Raman), X-ray diffraction spectroscopy (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM) and high resolution transmission electron microscopy (HRTEM) were used to characterize raw coal and the products after laser irradiation. The results show that after laser irradiation, the Raman spectra of the products have a typical 2D peaks and sharp G peaks, indicating an alignment structure for the products generated. XRD results show that the diffraction peaks (002) and (100) become narrow and sharp, and the layer spacing is 0.345 nm. XPS results show that the C=C bond and π—π interaction of sp2 are enhanced after laser irradiation of bituminous coal, forming sp2 network aromatic layer. The layered porous structure of the sample after laser irradiation was observed by SEM, HRTEM results show that the aromatic fringe has the characteristics of few graphene layers, the graphene layers are mostly concentrated in 2−10 layers, and the layer spacing is 0.346 nm, which is basically consistent with the XRD results. All these data indicate that bituminous coal has been formed into coal-base graphene after laser irradiation. However, limited by the number of samples used in this paper, this study is only a preliminary understanding, and further research needs to increase the number of samples.