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Background: Recently, there has been a concerted effort within medical schools to depart from conventional lecture-based learning approaches to alternative teaching methods such as team-based learning (TBL) and problem-based learning (PBL), with the aim of enhancing both student engagement and instructional efficacy. Despite this shift, a comprehensive review that directly compares the impacts of PBL and TBL methods in medical education is lacking. This study seeks to address this gap by conducting a meta-analysis that compares the effects of TBL and PBL in the context of medical education. Methods: Studies from Embase, PubMed, Web of Science, China National Knowledge Infrastructure, and Chinese Wanfang Database were searched, from inception to July 11, 2023. A meta-analysis was performed using Stata 14.0, and a total of 10 studies (including 752 participants) were included. The standardized mean difference (SMD) was used to estimate pooled effects. Heterogeneity was detected using the I2 statistic and further explored using meta-regression analysis. Results: Compared with PBL, TBL significantly increased the number of theoretical tests (SMD = 0.37, 95% CI: 0.02–0.73). Additionally, TBL greatly improved teamwork skills compared with PBL. However, there were no significant differences between the TBL and PBL groups concerning practical skill scores, learning interest, or understanding skills. Conclusion: TBL in the theoretical aspects of medical education appears to be more effective than PBL in improving theoretical test scores and teamwork skills, providing evidence for the implementation of TBL in medical education. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the clinicopathological features and prognostic indicators of primary pulmonary adenoid cystic carcinoma (PACC). Methods: Clinical data were collected from 64 primary PACC patients and analyzed retrospectively at the Tianjin Medical University General Hospital, the West China Hospital of Sichuan University, the First Affiliated Hospital of Guangxi Medical University, and the Bishan Hospital of Chongqing Medical University from January 2003 to August 2023. The 64 patients (28 males and 36 females) were aged from 20 to 73 years, with a median age of 49 years and an average age of 49.3 years. Results: Immunohistochemical staining showed that the tumors expressed CK7, S‐100 protein, CK5/6, CD117, and p63. Seven patients underwent fluorescence in situ hybridization (FISH) testing and three were found to have myeloblastosis (MYB) gene translocation. In total, 53 patients underwent surgery, among whom 31 received only surgery and 22 received both surgery and postoperative chemoradiotherapy. In addition, 10 patients received chemoradiotherapy only, while one patient underwent treatment with traditional Chinese medicine. The overall survival rates in the first, third, and fifth years were 98.4%, 95.3%, and 87.5%, respectively. Conclusion: Prognostic analysis revealed that age, tumor size, lymph node metastasis status, margin status, and choice of treatment modality significantly influenced the patients' prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Patients undergoing hemodialysis (HD) are at a higher risk of falls than healthy individuals. Further knowledge regarding the risk of falls could lead to better risk prevention strategies. We designed a multicenter, prospective cohort study according to the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines to investigate the incidence and risk factors of falls in patients undergoing hemodialysis in Northern China. Methods: Patients undergoing hemodialysis in six hemodialysis units were recruited from January 2019 to January 2020. Data on demographics and disease conditions were collected at baseline. Data on other variables, the incidence of falls, and related conditions were collected every 3 months during a 1‐year follow‐up. The Generalized Estimating Equation model was used to evaluate factors associated with falls. Findings: This study included 472 patients. The incidence of falls was 0.31 per patient year. In patients aged 45–64 years (p = 0.01; odds ratio [OR]: 14.801; 95% confidence interval [CI]: 1.897–115.453) and ≥ 65 years (p = 0.007; OR: 16.562; 95% CI: 2.118–129.521), anemia (p = 0.015; OR: 2.122; 95% CI: 1.154–3.902) and moderately (p = 0.003; OR: 5.439; 95% CI: 1.791–16.516) and severely abnormal timed up and go test (TUGT) levels (p = 0.001; OR: 7.032; 95% CI: 2.226–22.216) were identified as independent risk factors of falls. Discussion: Falls are prevalent among patients undergoing in‐center hemodialysis. Advanced age, anemia, and moderately and severely abnormal TUGT levels may be risk factors of falls. [ABSTRACT FROM AUTHOR]

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Abstract: The Qaidam Basin is the largest intermontane basin of the northeastern Tibetan Plateau and contains a continuous Cenozoic sequence of lacustrine sediments. A ~1000-m-deep drilling (SG-1) with an average core recovery of ~95% was carried out in the depocenter of the Chahansilatu playa (sub-depression) in the western Qaidam Basin, aimed to obtain a high-resolution record of the paleoenvironmental evolution and the erosion history. Stepwise alternating field and thermal demagnetization, together with rock magnetic results, revealed a stable remanent magnetization for most samples, carried by magnetite. The polarity sequence consisted of 16 normal and 15 reverse zones which can be correlated with chrons 1n to 2An of the global geomagnetic polarity time scale. Magnetostratigraphic results date the entire core SG-1 at ~2.77Ma to ~0.1Ma and yielded sediment accumulation rate (SAR) ranging from 26.1cm/ka to 51.5cm/ka. Maximum SARs occurred within the intervals of ~2.6–2.2Ma and after ~0.8Ma, indicating two episodes of erosion, which we relate to pulse tectonic uplift of the NE Tibetan Plateau with subsequent global cooling. [Copyright &y& Elsevier]

Abstract: Geologists agree that the collision of the Indian and Asian plates caused uplift of the Tibet Plateau. However, controversy still exists regarding the modes and mechanisms of the Tibetan Plateau uplift. Geology has recorded this uplift well in the Qaidam Basin. This paper analyzes the tectonic and sedimentary evolution of the western Qaidam Basin using sub-surface seismic and drill data. The Cenozoic intensity and history of deformation in the Qaidam Basin have been reconstructed based on the tectonic developments, faults growth index, sedimentary facies variations, and the migration of the depositional depressions. The changes in the sedimentary facies show that lakes in the western Qaidam Basin had gone from inflow to still water deposition to withdrawal. Tectonic movements controlled deposition in various depressions, and the depressions gradually shifted southeastward. In addition, the morphology of the surface structures in the western Qaidam Basin shows that the Cenozoic tectonic movements controlled the evolution of the Basin and divided it into (a) the southern fault terrace zone, (b) a central Yingxiongling orogenic belt, and (c) the northern fold-thrust belt; divided by the XI fault (Youshi fault) and Youbei fault, respectively. The field data indicate that the western Qaidam Basin formed in a Cenozoic compressive tectonic environment caused by the India–Asia plate collision. Further, the Basin experienced two phases of intensive tectonic deformation. The first phase occurred during the Middle Eocene–Early Miocene (Xia Ganchaigou Fm. and Shang Ganchaigou Fm., 43.8–22Ma), and peaked in the Early Oligocene (Upper Xia Ganchaigou Fm., 31.5Ma). The second phase occurred between the Middle Miocene and the Present (Shang Youshashan Fm. and Qigequan Fm., 14.9–0Ma), and was stronger than the first phase. The tectonic–sedimentary evolution and the orientation of surface structures in the western Qaidam Basin resulted from the Tibetan Plateau uplift, and recorded the periodic northward growth of the Plateau. Recognizing this early tectonic–sedimentary evolution supports the previous conclusion that northern Tibet responded to the collision between India and Asia shortly after its initiation. However, the current results reveal that northern Tibet also experienced another phase of uplift during the late Neogene. The effects of these two stages of tectonic activity combined to produce the current Tibetan Plateau. [Copyright &y& Elsevier]

The Pliocene-Quaternary aridification of the Asian interior is key to understanding the impacts of global cooling and Tibetan Plateau uplift and the potential linkage to North Pacific Ocean biochemical processes and global changes. However, there is a lack of detailed continuous Pliocene-Quaternary paleoclimatic records from the Asian interior because most climatic records have been obtained from discontinuous coarse sediment outcrops around the rims of inland basins. Here, we provide a continuous, high-resolution 3.1 Myr record of grain size from the well-dated SG-3 borehole in the western Qaidam Basin on the northeastern Tibetan Plateau, NW China. The results reveal a long-term upward coarsening trend in grain-size that can be divided into three phases: (i) 3.1–1.1 Ma, laminated fine sediments (fine to medium silts) containing scattered gypsum crystals and interbedded by thin beds of marl; (ii) 1.1–0.15 Ma, massive medium to coarse silts interbedded by beds of mirabilite; (iii) 0.15–0 Ma, coarse silts containing thin layers of mirabilite, halite, bloedite, and polyhalite. This pattern reflects the upward shallowing and shrinking of the lake from a brackish lake to a salt lake, and then to a playa, suggesting a long-term stepwise drying of the Asian interior since the Late Pliocene, probably forced by global cooling and uplift of the Tibetan Plateau. • The lacustrine grain size of the Qaidam Basin can reflect the climate evolution. • The records reveal a closed lake experiencing a long-term stepwise drying trend. • The Asian interior drying was mainly forced by global cooling and tectonic uplift. [ABSTRACT FROM AUTHOR]

Late Cenozoic sediments in the Linxia Basin of China, on the northeastern Tibetan Plateau, bear abundant fossils of the Hipparion fauna. From late Miocene times, these sections record a history of aridification in the Asian Interior, the evolution of the east Asian monsoon, and multiple uplifts of the Tibetan Plateau. In this paper, a new detailed magnetostratigraphic study of a sedimentary sequence from the Duikang (DK) section containing the Hipparion fauna is presented, to better understand interconnected ecologic and environmental changes. The 90-m-thick section reveals nine normal and nine reversed zones that span from chron. C5n.2n to chron. C3Ar or from chron. C4n.2n to chron. C2Ar, yielding magnetostratigraphic ages of ~8.1 Ma - 3.7 Ma for the studied section and 5.3 Ma for the Hipparion fauna-bearing bed. Combined with all the previous magnetostratigraphic ages of the fauna-bearing sediments in the Linxia Basin, Hipparion can be distinguished as mainly having lived during five periods: Phase I (11.5 Ma), Phase II (8.2 Ma), Phase III (6.3 Ma), Phase IV (~5.3 Ma) and Phase V (2.5 Ma). Based on comparison of climate records in the Linxia Basin with aridification records from surrounding regions and global cooling during the late Cenozoic, we suggest that the evolution of Hipparion from the Linxia Basin was mainly driven by continuous global cooling and tectonic uplift of the northeastern Tibetan Plateau since the late Miocene. • Depositional age of the DK section in the Linxia Basin is between 8.1 Ma and 3.7 Ma. • Hipparion lived during five different periods (11.5, 8.2, 6.3, 5.3 and 2.5 Ma). • Linxia Basin experienced the stepwise aridification since the late Miocene. [ABSTRACT FROM AUTHOR]

The Longdan mammal fauna from the central part of Linxia Basin, NE Tibetan Plateau, is the first Early Pleistocene fauna in China in which the fossils are derived loess deposits, and it provides an excellent opportunity to document mammalian and environmental evolution in Asia. However, the precise age and palaeoenvironmental setting of the fauna are controversial due to the poor exposure of the outcrop section. In the present study, a 105-m-long drill core was obtained from Longdan village and used for detailed magnetostratigraphic dating. The results demonstrate that the late Pliocene- Pleistocene loess deposits in the Longdan section deposited since ca. 3 Ma and that the Longdan fauna has an age range of 2.5–2.2 Ma. In addition, the results of lithological and rock magnetic analyses demonstrate that paleosols are weakly developed throughout the whole core and that in the lower and middle parts the core the magnetic susceptibility and its frequency dependence are relatively low and uniform. These observations, combined with the ecological characteristics of the Longdan fauna, indicate that during the Early Pleistocene the climate in the Longdan area, and even in the Linxia Basin, was sub-humid and that the aeolian dust was frequently subjected to post-depositional reworking by water. [ABSTRACT FROM AUTHOR]

Abstract The Xining Basin is well known for its thick and continuous sequence of fine-grained Cenozoic sediments. In addition, it contains important Xiejia fauna which define the Xiejian Stage of the early Miocene in the standard Chinese land mammal zonation, and it also provides detailed histories of eolian dust deposition which document the aridification of Asia, monsoon evolution and the initiation of the Yellow River in relation to the uplift of the Tibetan Plateau. However, the results of magnetostratigraphic dating of the fossil-bearing sequence has yielded conflicting ages for the fauna and stratigraphy, hindering the use of the sequence for addressing major paleoenvironmental and paleoclimatic issues. Here, we review the paleontological, lithological and magnetostratigraphic record of the Xining Basin and provide a new, long and continuous high-resolution magnetostratigraphy from the basin center. The results show that the observed magnetic polarity zones from the various sections at different sites in the basin exhibit similar magnetic polarity patterns which can be readily correlated, in terms of both magnetic polarity zonation and lithofacies; in addition, they show that the sedimentary sequence of the basin was sub-continuously deposited from ~54 Ma to 4.8 Ma. The magnetostratigraphic correlations confirm previous constraint of the Xiejia fauna in the late Oligocene at ~25 Ma, challenging the current Chinese mammal land zonation for the early Miocene, and we suggest that it provides a superior record of eolian dust deposition and river incision in the late Pliocene than previous studies. There is a close match of the climatic proxy records of the Xiejia section, dated by magnetostratigraphy, with the global climatic record which corroborates the paleomagnetic correlations. The evolution of the sedimentary environment provided by the lithofacies demonstrates a complete cycle of basin formation and termination, which records the eastern Qilian Shan experienced three main phases of uplifts: slow episodic uplifts at ~54 Ma and 22.5 Ma and a late rapid episodic uplifts at 8–7 Ma and since 4.8–3.6 Ma. This tectonic uplift in the NE Tibetan Plateau was mostly nearly synchronous responses to the initial and continuing collision of India and Asia since ~50 ± 5 Ma. [ABSTRACT FROM AUTHOR]

The Altyn Tagh range (ATR) is the northern geological boundary of the Tibetan Plateau and plays a key role in accommodating its Cenozoic lithospheric deformation. However, knowledge of the structural style and age of uplift of the ATR is limited and controversial. The Qaidam Basin, in the southeast side of the ATR, provides an outstanding field laboratory for understanding the history and mechanisms of ATR growth. This study presents a detailed sedimentological analysis of a 1040-m-thick late Cenozoic (~17–5.0 Ma) sedimentary sequence from the western Qaidam Basin, together with the analysis of sedimentological data from nearby boreholes and sections. Our aims were to determine the spatiotemporal evolution of the sedimentary sequences in the study area and to explore their response to late Cenozoic tectonic activity in the ATR. The results show three major intervals of the sedimentary characteristics in the study area: ~>17–16 Ma, 10 Ma and <5 Ma, which are closely related to the development of unconformities and growth strata recorded by high-resolution seismic reflection profiles. Combining the results with a comprehensive provenance analysis and with published records of regional climate change and tectonic activity, we discuss the possible factors responsible for the variations in the sedimentary characteristics of the studied sections. We conclude that significant tectonic responses in the western Qaidam Basin during the late Cenozoic were caused by three stages of tectonic activity of the ATR, at ~>17–16 Ma, ~16–10 Ma and ~10 Ma, during which the ATR respectively experienced tectonic uplift, fast strike-slip motion and intense uplift. [ABSTRACT FROM AUTHOR]

Abstract: Qaidam Basin is a tectonically controlled depression on the northern margin of the Tibetan Plateau. In 2008, a long core was drilled in the Qahansilatu sub-basin in the western Qaidam basin. The sediment layers in the upper 400m alternate between evaporite mineral layers and carbonaceous clay layers. The detailed mineralogical investigation focused on evaporite minerals including halite, gypsum, mirabilite, thenardite, glauberite, eugsterite, and bloedite. Gypsum and halite make up the majority of the evaporate minerals. Environmentally induced variations in the mineralogy and crystal habit of the sulfates have been extensively investigated. Gypsum has prismatic and pyramid habits, such as disc pyramid, stubby prismatic, slender prismatic. Visible isolated gypsum and aggregates (rosette/radial and twins) are mostly scattered in carbonaceous clay layers, suggesting that secondary gypsum is well developed. Gypsum may be a precursor mineral of glauberite, and thenardite is the precursor of bloedite. As a metastable and rare mineral, eugsterite does not appear in other Tibetan areas. It forms at the expense of pre-existing gypsum or thenardite in the core at an experimental temperature of higher than room temperature. The presence of eugsterite indicates a warm and/or hot climate at its deposition time. Mineralogical variations have been explained by the brine evolution of Na–Cl, Na–Ca–SO4, Na–SO4, Na–SO4–Cl, Na–Ca–SO4–Cl, Ca–SO4, and Na–Mg–SO4. For instance, Na–Mg–SO4 corresponds to bloedite, while Na–Ca–SO4–Cl to the assemblage of halite, gypsum and glauberite. The evaporite minerals and carbonaceous clay layers'' alternation indicates the shift between dry and wet climate. According to the thickness, 18 evaporite stages and/or dry climate stages were identified from 0.97Ma to about 0.03Ma. The two early dry climate stages are identified at 0.96–0.97Ma and 0.87Ma. The other 16 evaporite stages occurred from 0.78Ma to about 0.03Ma. The evaporate-rich stages suggested that evaporation was high and groundwater inflow was sufficient at the sub-basin. [Copyright &y& Elsevier]

Abstract: The NE Tibetan Plateau has become an important region for deciphering the Cenozoic uplift of the Plateau. Previous studies have verified that the Quaternary uplift in this region had a multi-stage character; however geologists have not established which event constituted the main tectonic phase. Fortunately, stratigraphic and paleomagnetic evidence from the Jiuquan Basin, Gansu Province, China, now confirm that the Laojunmiao Movement (represented as an angular unconformity) occurred between ∼0.9 and 0.8Ma; and an almost synchronous tectonic event has been well recorded within and around the Plateau. Moreover, many proxies indicate that the global climate changed more rapidly after ∼0.9Ma. These proxies include eolian loess and vermiculated red soils caused by the Asian monsoon, the eolian sedimentation rate, the Stilostomella extinction, changes in the global thermohaline circulation, and the increased δ 13C values recorded in the marine sediments. Based on the uplift-driven climate change, the mid-Pleistocene Transition (MPT) could be the result of the Laojunmiao Movement. Certainly, the Laojunmiao Movement and MPT had the significant impact on the Quaternary earth. We conclude that the Laojunmiao Movement was likely the main tectonic phase of the Quaternary Plateau uplift. [Copyright &y& Elsevier]

The India–Asia collision and subsequent uplift of the Tibetan Plateau during the Cenozoic were the main drivers of Asian monsoon development and evolution. However, the climate and possible existence of a desert landscape in southern China prior to the significant uplift of the Tibetan Plateau remain uncertain, because of a lack of reliable proxies or direct geological evidence. The well–preserved early Eocene palynomorphs recovered from the Hengyang Basin, southern China, provide an ideal opportunity to address this problem. The palynological record suggests that the Hengyang Basin was dominated by xerophytic shrubs and an open forest vegetation landscape, confirming that a typical arid desert environment prevailed in the Hengyang Basin during the early Eocene. The high proportion of thermophilic and xerophytic taxa implies a hot and arid climate. The estimated mean annual precipitation (<230 mm) of the early Eocene in the Hengyang Basin was significantly lower than that of present (1354 mm). We propose that, prior to the significant uplift of the Tibetan Plateau, the combined effects of a strong subtropical anticyclone associated with the extremely warm climate and a rain–shadow effect caused by coastal mountains, were the primary factors responsible for the extreme arid climate and desert–like landscape of inland southern China during the early Eocene. • Early Eocene palynoflora was systematically studied in the Hengyang Basin. • Our result confirmed desert environment prevailed in southern China before the TP uplift. • The estimated MAP of the early Eocene in the Hengyang Basin was significantly lower than that of present. [ABSTRACT FROM AUTHOR]

Lung cancer has emerged as a major global public health concern. With growing public interest in lung cancer, online searches for related information have surged. However, a comprehensive evaluation of the credibility, quality, and value of lung cancer-related videos on digital media platforms remains unexamined. This study aimed to assess the informational quality and content of lung cancer-related videos on Douyin and Bilibili. A total of 200 lung cancer-related videos that met the criteria were selected from Douyin and Bilibili for evaluation and analysis. The first step involved recording and analyzing the basic information provided in the videos. Subsequently, the source and type of content for each video were identified. All videos' educational content and quality were then evaluated using JAMA, GQS, and Modified DISCERN. Douyin videos were found to be more popular in terms of likes, comments, favorites, and shares, whereas Bilibili videos were longer in duration (P < .001). The majority of video content on both platforms comprised lung cancer introductions (31/100, 31%), with medical professionals being the primary source of uploaded videos (Douyin, n = 55, 55%; Bilibili, n = 43, 43%). General users on Douyin scored the lowest on the JAMA scale, whereas for-profit businesses scored the highest (2.50 points). The results indicated that the videos' informational quality was insufficient. Videos from science communications and health professionals were deemed more reliable regarding completeness and content quality compared to videos from other sources. The public should exercise caution and consider the scientific validity when seeking healthcare information on short video platforms., (© 2024. The Author(s).)

As a crucial part of the Asian monsoon stretching from tropical India to temperate East Asia, the Indian monsoon (IM) contributes predominant precipitation over Asian continent. However, our understanding of IM's onset, development and the underlying driving mechanisms is limited. Increasing evidence indicates that the IM began in the Eocene or even the Paleocene and was unexceptionally linked to the early rise of the Tibetan Plateau (TP). These were challenged by the heterogeneous and diachronous uplift of the TP and all the reported records were confined to tropical zone under tropical monsoon driven by the Intertropical Convergence Zone (ITCZ) that is irrelevant to the TP. Therefore, reliable paleoclimatic records from the extra-tropical IM region is crucial to reveal how the tropical IM expanded to subtropical and temperate zones and what driving factors might be related to it. Here we present robust Eocene paleoenvironmental records from central Yunnan (~26°N) in subtropical East Asia. The multiproxy results of two sites demonstrate a consistent sudden switch from a dry environment in the early Eocene to a seasonally wet one at 41 Ma, suggesting a jump of the tropical IM to the southern subtropical zone at 41 Ma. The full collision of India with Asia, and the resulting changes in paleogeography at 41 Ma (closure of the Neotethys sea, retreat of the Paratethys seas, fast northward movement of the southern margin of the TP and rise of the central TP), aided by synchronous Antarctic cooling, might have worked together to drive the IM enhancement and northward expansion., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2021 Science China Press. Published by Elsevier B.V. All rights reserved.)