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Embedding clinically relevant learning experience in basic science subjects is desired for the preclinical phase of undergraduate medical education. The present study aimed to modify case-based learning (CBL) with a role-playing situational teaching method and assess the student feedback and learning effect. One hundred seventy-six sophomore students majoring in clinical medicine from Harbin Medical University were randomly divided into two groups: the control group (n = 90), who received traditional hybrid teaching, and the experimental group (n = 86), who received the role-playing situational teaching. Students in the experimental group were given a 1-wk preclass preparation to dramatize a hyperthyroidism scenario through online autonomous learning of thyroid physiology and performed the patient's consultation process in class, followed by a student presentation about key points of lecture content and a question-driven discussion. A posttest and questionnaire survey were conducted after class. The test scores of the two groups had no statistical differences, whereas the rate of excellence (high scores) of the experimental group was significantly higher than that of the control group. Furthermore, the record of online self-directed learning engagements was significantly improved in the experimental group. In the questionnaire, >70% of the students showed positive attitudes toward the role-playing situational teaching method and were willing to participate in other chapters of the physiology course. Such results show that CBL supported by a role-playing situational teaching method encourages active learning and improves the application of basic knowledge of physiology, which can be incorporated in the preclinical curricula to bridge the gap between theory and practice.

As an attempt to solve the mixed results between leader feedback quality and employee job performance, this study proposes that employees' expected feedback quality plays a key role in how employees react to leader feedback. Specifically, drawing on needs-supplies fit and social exchange theory, we posit that congruence between expected feedback quality and delivered feedback quality positively relates to employee task performance and organizational citizenship behavior (OCB) through leader-member exchange (LMX). Further, we posit that learning goal orientation may strengthen the positive effect of congruence between expected feedback quality and delivered feedback quality on LMX. Multi-wave data collected from 226 employees from China showed that congruence between expected feedback quality and delivered feedback quality improves LMX and in turn benefits task performance and OCB. Moreover, learning goal orientation intensifies the indirect effect of congruence between expected feedback quality and delivered feedback quality on task performance and OCB through LMX. The theoretical and practical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Background: Neonatal diabetes mellitus (NDM) is a rare form of diabetes. We analyzed a novel insulin gene (INS) mutation of a Chinese permanent neonatal diabetes mellitus (PNDM) patient to explore the clinical and genetic characteristics and put forward some opinions on treatment and its longterm management. Case description: A proband was recruited who was diagnosed with permanent neonatal diabetes on his first day after birth. His clinical and follow-up data were collected for 10 years. All of the family members were given an oral glucose tolerance test. Whole exome sequencing was performed on the proband, and the genomic DNA of family members was used for verification by first-generation Sanger sequencing technology. The pathogenic variant was screened according to the American College of Medical Genetics and Genomics classification guidelines and the clinical phenotype of the patient. Diagnostic assessment: The proband was diagnosed on the first day after birth, presenting with low birth weight, progressive hyperglycemia, and insulin deficiency. His parents and grandfathers were confirmed to have normal blood sugar levels. A novel homozygous mutation of c.1T>C in the INS gene was detected in the proband, located in the initiation codon. The heterozygous mutations were found in four family members, including his mother, father, and grandfathers. With regular insulin injections, long-term regular follow-up, close monitoring of blood glucose, balanced exercise and diet, and psychological and mutual family support, the blood glucose level was well controlled; there were no acute or chronic complications during this decade. The patient's growth and nervous system development are now no different to those of the same age. Conclusion: A favorable prognosis is presented for a permanent neonatal diabetes mellitus (PNDM) patient with a novel mutation in the INS gene in China. The present findings indicate that the genetic diagnosis, early use of insulin, close monitoring of blood glucose, and psychological and mutual family support for patients with INS mutation are necessary for their favorable long-term prognosis. [ABSTRACT FROM AUTHOR]

Background The high costs of novel anticancer drugs have caused concern among healthcare stakeholders. To address the knowledge gap on the proportion of survival benefit with the related economic expenditure, we aimed to assess the correlation between the costs and value of innovative drugs targeted to specific tumours, before and after price negotiation policy implementation. Methods We identified new drugs for lung and breast cancer that entered the National Reimbursement Drug List (NRDL) through price negotiation from 2016 to 2023. Therapeutic value consisted of traditional clinical endpoints, like the percentage improvement of overall survival (≥OS%) and progression-free survival (≥PFS%), and the quantified gains of the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). We calculated monthly drug costs and used Spearman's correlation coefficient and Cohen's kappa statistics for statistical analysis. Results Twenty-nine innovative price-negotiated drugs were collected between 2016 and 2023. The median monthly costs were US$3381.31 out of NRDL and US$1095.88 within NRDL, with an ≥OS% of 22.24% (IQR = 6.45-29.48) and a ≥PFS% of 83.82% (IQR = 50.41-104.05). The median ASCO-VF score was 40.98, and 17 drugs scored the meaningful benefit of ESMO-MCBS. We found no association between clinical benefits and their costs before and after NRDL, either overall or for specific cancers. The agreement between the two frameworks was stable. Conclusions The negotiation policy decreased medication costs, but did not generate the expected correlation between the value and costs of anticancer drugs. Comprehensive value assessments need to be performed in the future to explore more in-depth findings and promote the affordability and availability of effective anticancer drugs. [ABSTRACT FROM AUTHOR]

As an indispensable part of Chinese science and technology, astronomical technology in the Mongol Yuan Dynasty serves as a link between the development of the preceding periods and the following ones. It is a typical representative of splendid Mongolian culture and national history as well. The translation of Chinese science and technology can not only promote the cultural transmission but it is also of academic value. This article discusses the translation problems and strategies in translating astronomical technology in the Yuan Dynasty. Based on the text type of the technological monographs, and combining the two strategies of domestication and foreignization, this article attempts to render a proper way for the translation in the related field, contributing a share to the construction of China's foreign discourse system and dissemination of excellent Chinese culture. [ABSTRACT FROM AUTHOR]

In the Chinese electric vehicle industrial innovation, the focal firms, which are the key technological, manufacturing and business wise key players, are increasingly involved in the crossindustrial interactions. However, no studies have analysed how they interact across industrial boundaries as well as their consequences. The aim of this article is to explore the focal firms' cross-industrial interactions in the Chinese EV industrial innovation. Relying on the concept of gatekeeping and using the firms' public information during 2009 and 2014, this study identified that the focal firms' interaction activities include information-gatekeeping, platform-providing, and benefit-gatekeeping. A framework of 'industrial gatekeeping' was developed. It highlights that the focal firms' gatekeeping in the Chinese EV industry settings are transforming: they do not only concern technological information but also firms' benefits. Furthermore, the framework extends the scope of gatekeeping to the cross-industrial settings. Practical recommendations for industrial players and insights for policy-makers are provided. [ABSTRACT FROM AUTHOR]

Background: The emergence of fosfomycin resistance and extended-spectrum β-lactamase (ESBL) genes is a serious threat to public health and a new challenge in shigellosis treatment. The purpose of this study was to identify fosfomycin resistance and characterize β-lactamase genes in fos-carrying isolates of Shigella flexneri from patients in China. Methods: A total of 263 S. flexneri isolates were collected from 34 hospitals in the Anhui Province of China during September 2012-September 2015 and screened for fosA3, fosA, and fosC2 by PCR amplification and sequencing. The fos-carrying isolates were then screened for β-lactamase genes. The clonal relationships between fosA3-carrying isolates, the transmissibility of fosfomycin resistance, replicon types of plasmids carrying fosfomycin resistance genes and other associated resistance genes were investigated. Results: Twenty-five of the 263 isolates (9.5%) showed resistance to fosfomycin, and 18 (6.8%) were positive for fosA3. None of the isolates was positive for fosA or fosC2. Seventeen of the isolates carrying fosA3 (94%) were CTX-M producers (seven CTX-M-55, five CTX-M-14, and five CTX-M-123), while three (16.7%) were TEM producers (TEM-1).Sixteen (88.9%) fosA3-carrying isolates exhibited multi-drug resistance. The replicon types of the 13 fosA3-carrying plasmids were IncF (n=13), IncHI2 (n=3), IncIl-Ir (n=2), and IncN (n=1). Conclusions: Our results indicated that fosA3 could spread through plasmids in S. flexneri isolates, along with the blaCTX-M and blaTEM, which facilitate its quick dispersal. To the best of our knowledge, this is the first report of CTX-M-123-type ESBLs in S. flexneri isolates from patients in China. [ABSTRACT FROM AUTHOR]

GPS has become a very effective tool to remotely sense precipitable water vapor (PWV) information, which is important for weather forecasting and nowcasting. The number of geodetic GNSS stations set up in China has substantially increased over the last few decades. However, GPS PWV derivation requires surface pressure to calculate the precise zenith hydrostatic delay and weighted mean temperature to map the zenith wet delay to precipitable water vapor. GPS stations without collocated meteorological sensors can retrieve water vapor using standard atmosphere parameters, which lead to a decrease in accuracy. In this paper, a method of interpolating NWP reanalysis data to site locations for generating corresponding meteorological elements is explored over China. The NCEP FNL dataset provided by the NCEP (National Centers for Environmental Prediction) and over 600 observed stations from different sources was selected to assess the quality of the results. A one-year experiment was performed in our study. The types of stations selected include meteorological sites, GPS stations, radio sounding stations, and a sun photometer station. Compared with real surface measurements, the accuracy of the interpolated surface pressure and air temperature both meet the requirements of GPS PWV derivation in most areas; however, the interpolated surface air temperature exhibits lower precision than the interpolated surface pressure. At more than 96% of selected stations, PWV differences caused by the differences between the interpolation results and real measurements were less than 1.0 mm. Our study also indicates that relief amplitude exerts great influence on the accuracy of the interpolation approach. Unsatisfactory interpolation results always occurred in areas of strong relief. GPS PWV data generated from interpolated meteorological parameters are consistent with other PWV products (radio soundings, the NWP reanalysis dataset, and sun photometer PWV data). The differences between them were approximately 1~3 mm at most at our selected stations, and GPS data processing is the main factor influencing the agreement of the GPS PWV results with those of other methods. [ABSTRACT FROM AUTHOR]

Based on the statistical data of land use change, friom the perspective of sustainable use, we use literiaturie inquiriy, statistical analysis, GIS spatial analysis and dynamic degriee model of land use, to analyze the land use change chariacteristics, land use amount ad spatial distribution chariacteriistics in Guangzhou City during 1996 - 2012, and furitheri elaboriate the driving forices of land use change to get the basic law of land use change in Guangzhou City. The riesults show that the constriction land was riapidly expanded, causing a significant rieduction in ariable land (friom 129286 ha in 1996 to 84567 ha in 2012); in construction land, the land fori riesidential, industrial and mining use and triasporiation land driamatically incrieased, and the single dynamic degriee of triansporitation land was close to 7.1%. In comparison with otheri developed cities, it is found that economic factoris a d policy factoris arie imporiant factoris afecting land use chage in Guangzhou City, and the griowth riate of economic density of land was high in Tianhe District and Yuexiu District. Friom the perispective of sustainable use, the futurie land use in Guagzhou City needs to betteri cooridinate the rielationship between various types of land, between socio-economic development and cooridinated land use development, between envirionmental priotection a d land development and utilization. Thriough a seriies of land consolidation activities, it is necessariy to strengthen the priotection of farmland, impriove the intensive and economical use of constriction land, impriove the ecological envirionment, and cooridinate development of uriban and riurial areas, to ultimately achieve sustainUe land use in Guangzhou City. [ABSTRACT FROM AUTHOR]

The compositions and annual variations of landfill gas (LFG) were studied at two large-scale sites of Chen-Jia-Chong Landfill. Seventy-six wells were built and used for the collection and measurement of LFG. The investigation revealed the similarities and differences of LFG components and variations at two sites with different phases. It was found that ambient temperature and rainfall exhibited strong correlations with LFG components at both sites. Methane (CH4) contents showed excellent correlations with CO2 at both sites. Notable correlations between hydrogen sulfide (H2S) and major components (CH4 and carbon dioxide [CO2]) were only observed in unstable methane phase. Especially, the CH4/CO2 volumetric ratio could act as an excellent indicator for anaerobic reaction stage by judging its phasic variations. The study is beneficial for the efficient operation of LFG collection system and could shed light on gas purification and utilization. [ABSTRACT FROM AUTHOR]

Background Suboptimal health status (SHS) is the intermediate health state between health and disease, refers to medically undiagnosed or functional somatic syndromes, and has been a major global public health challenge. However, both the etiology and mechanisms associated with SHS are still unclear. Breakfast eating behavior is a dietary pattern marker and previous studies have presented evidence of associations between failure to consume breakfast and increased diseases. Accordingly, in view of the significance of breakfast eating behaviors with respect to health status, the associations between breakfast eating habits and healthy lifestyle, SHS require further elucidation. Methods A cross-sectional survey was conducted within a clustered sample of 24,159 individuals aged 12-80 years in 2012-13 within the population of Southern China. Breakfast eating habits were categorically defined by consumption frequency ('scarcely, sometimes or always'). Health-promoting lifestyle was assessed via the health-promoting lifestyle profile (HPLP-II). SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Results Of the 24,159 participants, the prevalence rates for the 'health', 'SHS', and 'disease' were 18.8%, 46.0%, and 35.2%, respectively. Overall, 19.6% of participants reported 'scarce' breakfast eating habits, with frequent breakfast eaters scoring higher on both HPLP-II and SHMS V1.0. After demographic adjustment, regression analyses revealed a significant association between breakfast eating habits and healthy lifestyle (p <0.001). There were lower levels of breakfast consumption regularity amongst individuals with SHS than those with disease. Categorically 'scarce' breakfast eaters were approximately three times more likely to be assigned SHS (OR: 2.745, 95% CI: 2.468-3.053), while infrequent breakfast eaters ('sometimes') were just less than twice as likely to be assessed as being of SHS (OR: 1.731, 95% CI: 1.595-1.879). Conclusions Breakfast eating habits are significantly associated with a healthy lifestyle, and appear to be a useful predictor of a healthy lifestyle. Irregular breakfast eating habits are related to an increased risk of SHS; increased breakfast eating frequency may contribute to lowering the prevalence of SHS in Southern China. [ABSTRACT FROM AUTHOR]