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Background: Team‐based learning (TBL) is a widely recognised pedagogical strategy used in diverse fields and courses. Despite the success of TBL, certain concerns have arisen regarding social loafing within group collaboration contexts; this loafing can reduce the overall effectiveness of learning. Objectives: This study addressed the aforementioned concerns by integrating group awareness (GA) information into each stage of TBL, resulting in a TBL + GA system designed to enhance TBL instruction. During online collaborative learning, GA information provides insights into the activities completed by peers and thus the peers' preparedness and achievement; this knowledge fosters motivation, participation, and reflection. Methods: A quasiexperiment was performed with students from two freshman classes (40 and 41 students, respectively) in a Taiwanese university; the control and experimental classes used the TBL only and TBL + GA systems, respectively. Student learning effort was evaluated in terms of preclass preparation, including the use of learning materials and online test scores. Learning achievement was evaluated by assessing the quality of students' assignments. Student feedback, including peer evaluations and students' perceptions of their TBL experience, was collected and compared for the two classes. Results and Conclusions: The TBL + GA system significantly enhanced the preclass preparation efforts of the participants, mitigating social loafing. This improvement manifested as higher practice engagement and better online assessment scores. The TBL + GA system also improved assignment quality and elicited more constructive and positive peer feedback. Implications: Integrating GA information into each stage of TBL may positively affect the effectiveness of instruction. The proposed TBL + GA system can serve as a practical model for instructors seeking to enhance TBL implementation and foster a more engaging and constructive learning environment. Lay Description: What is already known about this topic: Team‐Based Learning (TBL) has recently drawn much attention and has been successfully applied in many fields (different courses)While TBL requires students to learn autonomously and work together as a team, it also results in social loafing during collaborative learning, thus reducing its learning effectiveness.Group awareness (GA) information, which provides visual information about peers' learning contexts (activities) in online collaborative learning, can increase the interaction and participation What this paper adds: This study adds GA information to each learning stage in the TBL process.This study further proposes the TBL + GA system for facilitating TBL teaching.This study investigates whether student engagement on each TBL stages significantly differs between the traditional TBL and the proposed TBL + GA systems. Implications for practice and/or policy: The TBL + GA system significantly enhanced the preclass preparation efforts of the participants, mitigating social loafing. This improvement manifested as an increase in practice engagement and online assessment scores.The TBL + GA system also improved assignment quality and elicited more constructive and positive peer feedback, compared with the traditional TBL.Integrating GA information into each stage of TBL may positively affect the effectiveness of instruction. The proposed TBL + GA system can serve as a practical model for instructors seeking to enhance TBL implementation, thereby fostering a more engaging and constructive learning environment. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to compare the safety and efficacy of drug-eluting bead (DEB) transarterial chemoembolization combined with lenvatinib and camrelizumab (DEB-TACE-Len-C) and DEB-TACE-Len for the treatment of unresectable hepatocellular carcinoma (uHCC). Methods: This retrospective study consecutively included uHCC patients who underwent DEB-TACE-Len-C or DEB-TACE-Len treatment at our hospital and Qujing Second People's Hospital from April 2020 to April 2022. In total, 85 patients were enrolled. There were 42 patients in the DEB-TACE-Len-C group and 43 patients in the DEB-TACE-Len group. The disease control rate (DCR), objective response rate (ORR), overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were compared between the two groups, and the factors influencing OS and PFS were analysed. Results: The ORR, DCR, PFS and OS were significantly greater in the DEB-TACE-Len-C group than in the DEB-TACE-Len group (ORR: 76.2% vs. 46.5%, P = 0.005; DCR: 88.1% vs. 67.8%, P = 0.039; PFS: 10 months vs. 6 months, P < 0.0001; OS: 24 months vs. 16 months, P = 0.0038). Multivariate Cox proportional hazard regression analysis revealed that portal tumour thrombus (PVTT) and therapeutic approach were independent factors affecting PFS and OS. There were no statistically significant differences in the incidence of AEs between the two groups (P > 0.05). Conclusion: Compared with DEB-TACE-Len, DEB-TACE-Len-C is an effective treatment option that can improve the tumour therapeutic response and prolong the OS and PFS in uHCC patients. [ABSTRACT FROM AUTHOR]

Development is a continuous process, but few studies have assessed the simultaneous impact of prenatal and postnatal phthalate exposure on children's behavioral and emotional development. A total of 491 mother–child pairs from the general population in southern Taiwan were studied from 2021 to 2022. Urinary concentrations of bisphenol A (BPA) and phthalate metabolites—mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-benzyl phthalate (MBzP), and mono-2-ethylhexyl phthalate (MEHP)—were measured in pregnant mothers during the second trimester and in their corresponding children aged 1.5 to 3 years. Behavioral symptoms in children were evaluated using the Child Behavior Checklist (CBCL). Odds ratios (ORs) represent a 1-unit increase in log10-transformed creatinine-corrected maternal urine concentrations. Prenatal maternal urinary MnBP levels were associated with total problems (OR = 19.32, 95% CI: 1.80–43.13, p = 0.04), anxiety (OR = 33.58, 95% CI: 2.16–521.18, p = 0.01), and sleep problems (OR = 41.34, 95% CI: 1.04–1632.84, p = 0.04) in children. Additionally, urinary MnBP levels in children correlated with total problems (OR = 7.06, 95% CI: 1.01–49.05, p = 0.04) and internalizing problems (OR = 11.04, 95% CI: 1.27–95.72, p = 0.01). These findings suggest that prenatal and postnatal exposure to dibutyl phthalate (DBP), metabolized as MnBP, distinctly affects children's behavioral development. [ABSTRACT FROM AUTHOR]

Team-Based Learning (TBL) has been widely applied in different fields (courses) and has been indicated to be efficient. Meanwhile, many studies have asserted that Group awareness (GA) information, which visually displays peers' learning context and activities, can increase peer participation within an online collaborative learning environment. As the level of preparation by students before class affects their subsequent learning performance in the TBL process, this study incorporates GA information into the preparation stage of TBL process and further develops the online TBL + GA system in order to raise peer preparation level. Furthermore, self-regulated learning (SRL) levels of a student and online learning environment interactively influence learning effectiveness. Accordingly, this study further investigates how the TBL + GA environment influences students with different SRL levels. Two freshman classes were randomly chosen, with one as the control class (using the traditional TBL) and the other as the experimental class using the TBL + GA. Analytical results indicate that although the two classes do not reach significance overall on preparation level, TBL + GA can significantly enhance preparation levels for high-SRL students, but not low-SRL students. [ABSTRACT FROM AUTHOR]

The cloud phase is one of the most important parameters of clouds. In this paper, we propose a method for cloud phase classification that synergistically utilizes the far- and thermal-infrared bands based on the Atmospheric Emitted Radiance Interferometer (AERI) at the Atmospheric Radiation Measurement West Antarctic Radiation Experiment (AWARE) observatory in 2016. The possible features in the far- and thermal-infrared bands are analyzed based on the differences in the simulated cloud brightness temperature (BT) spectra with different cloud phases. Using the support vector machine (SVM) algorithm, four features are determined to identify the cloud phase, which include the BT at 900 cm−1, the slope of the fitted function of BT in the 900–1000 cm−1 interval, the BT difference (BTD) between 512 cm−1 and 726 cm−1, and the BTD between 550 cm−1 and 726 cm−1. Here, the performance of the proposed method is evaluated with Shupe’s and Turner’s method. The monthly average accuracy of the proposed method, the method without the two far-infrared features, and Turner’s method are about 76%, 36%, and 49%, respectively, which infer the good performance of the proposed method and also indicate that the far-infrared band features can effectively enhance cloud phase classification. It is notable that, compared to Shupe’s method, the accuracy for the proposed method is only 61% during the Antarctic summer, which results from the definitions of cloud phase and radiative effect. In addition, the accuracy is only 44% for Turner’s method in seasons with a low frequency of mixed clouds due to the significant effect of water vapor.

Introduction: It is still controversial whether automated peritoneal dialysis (APD) or hemodialysis (HD) is a more favorable choice for the rapid initiation of peritoneal dialysis (PD). Methods: A pilot randomized prospective controlled trial was carried out in Shanghai Ruijin Hospital. Sixty-seven patients who chose long-term PD treatment and needed unplanned dialysis were enrolled and randomized into HD-CAPD group (33 cases) or APD-CAPD group (34 cases) based on the dialysis modality during the transition period (within 14 days from the day PD catheter was implanted). Continuous ambulatory PD started after the transition period. The primary outcome was the decline rates of residual glomerular filtration rate (GFR). Secondary outcomes included the rates of mechanical complications, the rates of infectious complications, and complications of end-stage renal disease. Results: We found residual GFR decline was faster in HD-CAPD group than in APD-CAPD group (0.06 mL/min/w vs. 0.03 mL/min/w, p < 0.01). The incidences of mechanical complications were similar in APD-CAPD group comparing with HD-CAPD group, including hernia (2.9% vs. 3.0%, p = 1.00), catheter malposition (0.02 episodes/patient-months vs. 0.02 episodes/patient-months, p = 0.70), leakage (5.9% vs. 6.1%, p = 1.00), and omental wrap (0 episode vs. 3 episodes, p = 0.368). Though the 1-year overall infection rates were similar (0.03 episodes/patient-months vs. 0.05 episodes/patient-months, p = 0.10), APD-CAPD group had lower rate of bacteremia compared to HD-CAPD group (0 episodes/patient-months vs. 0.02 episodes/patient-months, p < 0.01). Conclusions: Both APD and HD could be used for patients who need to start dialysis in an unplanned manner. APD may have the advantage in protecting residual renal functions among these patients.

In this study, we designed geometry learning activities so that students could apply newly learned knowledge to solve real-life problems, such as estimating the distance to real objects they find in their local community, measuring objects' length, width, and height, and calculating objects' surface area. Our participating students were divided into three groups, and each group used different tools in different contexts for the measurements and calculations: the students in control group A used traditional tools, such as rulers, paper, and pencil, and their learning activities took place in the local community; the students in control group B used traditional tools as well, but their learning activities took place in classroom; the students in the experimental group learned geometry in a local community setting using a tablet PC-based ubiquitous geometry (UG) system that we developed for this study. We tested the difference in geometry learning performance, such as geometry reasoning and spatial estimation abilities, among the three groups. We also investigated the perceptions of students in the experimental group toward the UG system. Furthermore, student behaviors toward measuring objects using the UG system and their relationship with geometry reasoning and spatial estimation abilities were explored. Our results showed that the geometry learning performance of the students in the experimental group was significantly better than that of the students in the other two groups. Our results also showed that the students in the experimental group had high learning motivation and intention to use the UG system. Further analysis revealed that the students who measured more objects in the real world using our system had better geometry reasoning and spatial estimation abilities. However, only the students who measured objects correctly had high learning gains. The results suggest that the learning activities supported by the UG system were beneficial for enhancing geometry reasoning and spatial estimation abilities because the students were able to apply newly learned knowledge to the real world. Based on the results, we give some advice on the design of learning activities.

Abstract To evaluate the impact of the Qinshan Nuclear Power Plant (Qinshan NPP) in normal operation on the surrounding environment and population, the radioactivity levels of drinking water and the ambient environment, as well as the residents’ cancer incidence, were continuously monitored for a period of 9 years (2012–2020). All of the gross α and β radioactivity concentrations in drinking water were less than the WHO recommended values (0.5 Bq/L for gross α and 1 Bq/L for gross β). The results of ambient environment accumulated dose monitored by thermoluminescent dosimeters (TLDs) indicated that the ambient environment radioactive level around the Qinshan NPP is consistently at natural background radiation levels. The age-dependent annual effective doses due to the ingestion of tap water or exposure to the outdoor ambient environment are lower than the reference dose of 0.1 mSv/year. The corresponding excess risks are at relatively low levels. Thus, the consumption of drinking water and outdoor activities are not expected to give rise to any detectable adverse effects on the health of the public around the Qinshan NPP. For all cancers combined, the age-standardized incidence rate by the Chinese 2000 standard population of the inhabitants living around Qinshan NPP is consistent with that of Zhejiang Province as a whole. Based on current radiation risk estimates, radiation exposure is not a plausible explanation for any excess cancers observed in the vicinity of the Qinshan NPP.

Abstract Background Ganxianfang (GXF) formula as a traditional Chinese medicine (TCM) is used for liver fibrosis in clinical practice while its mechanism is unclear. The aim of this study is to explore the molecular mechanism of GXF against CCl4-induced liver fibrosis rats. Methods Detected the main compounds of GXF by UPLC-MS/MS. Evaluated the efficacy of GXF (1.58, 3.15, 4.73 g/kg/day) and Fuzheng Huayu (FZHY, positive control, 0.47 g/kg/day) through serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels and histopathological changes. Explored the underlying mechanisms by integrating our total liver RNA sequencing (RNA-seq) data with recent liver single-cell sequencing (scRNA-seq) studies. Verified potential pharmacodynamic substances of GXF by hepatic stellate cell (HSC)-T6 line. Results Main compounds were identified in GXF by UPLC-MS/MS, including baicalin, wogonoside and matrine etc. With GXF-high dose treatment, the elevation of ALT and AST induced by CCl4 were significantly reduced, and the protective effect of GXF-high dose treatment was better than FZHY. Liver histopathological changes were alleviated by GXF-high dose treatment, the ISHAK scoring showed the incidence of liver cirrhosis (F5/F6) decreased from 76.5 to 55.6%. The results of liver hydroxyproline content were consistent with the histopathological changes. RNA-seq analysis revealed the differential genes (DEGs) were mainly enriched in ECM-receptor interaction and chemokine signaling pathway. GXF effectively inhibited collagen deposition and significantly downregulated CCL2 to inhibit the recruitment of macrophages in liver tissue. Integrating scRNA-seq data revealed that GXF effectively inhibited the expansion of scar-associated Trem2+CD9+ macrophages subpopulation and PDGFRα+PDGFRβ+ scar-producing myofibroblasts in the damaged liver, and remodeled the fibrotic niche via regulation of ligand-receptor interactions including TGFβ/EGFR, PDGFB/PDGFRα, and TNFSF12/TNFRSF12a signaling. In vitro experiments demonstrated that baicalin, matrine and hesperidin in GXF inhibited the activation of hepatic stellate cells. Conclusions This study clarified the potential anti-fibrotic effects and molecular mechanism of GXF in CCl4-induced liver fibrosis rats, which deserves further promotion and application.

Abstract Objectives We aimed to verify the role of signal peptide-CUB-EGF-like domain-containing protein3 (SCUBE3) in the hepatocellular carcinoma (HCC) progression. Methods The role of SCUBE3 in HCC cell proliferation, apoptosis, and cell cycle in vitro were detected using MTT assay, colony formation assay, 5-ethynyl-2´-deoxyuridine assay (EDU), Celigo cell counting assay, Caspase3/7 activity assay, and flow cytometry. The effect of SCUBE3 on HCC cell proliferation in vivo was inspected by a xenograft tumour model in nude mice. The related mechanisms were further studied. Results The level of SCUBE3 was upregulated in HCC tissues and cell lines. Knockdown of SCUBE3 inhibited proliferation, promoted apoptosis, and induced cell cycle arrest in HCC cell lines in vitro and in vivo. Screening of cell cycle-related proteins revealed that CCNL2, CDK6, CCNE1, and CCND1 exhibited a significantly different expression profile. We found that SCUBE3 may promote the proliferation of HCC cells by regulating CCNE1 expression. The pathway enrichment analysis showed that the TGFβ signalling pathway and the PI3K/AKT signalling pathway were significantly altered. Co-immunoprecipitation results showed that SCUBE3 binds to the TGFβRII receptor. SCUBE3 knockdown inhibited the PI3K/AKT signalling pathway and the phosphorylation of GSK3β to inhibit its kinase activity. Conclusions SCUBE3 promotes HCC development by regulating CCNE1 via TGFβ/PI3K/AKT/GSK3β pathway. In addition, SCUBE3 may be a new molecular target for the clinical diagnosis and treatment of HCC.

Abstract Background Cancer cells have an imbalance in oxidation-reduction (redox) homeostasis. Understanding the precise mechanisms and the impact of the altered redox microenvironment on the immunologic reaction to tumors is limited. Methods We isolated exosomes from ovarian cancer cells through ultracentrifuge and characterized by Western-blots and Nanoparticle Tracking Analysis. 2D, 3D-coculture tumor model, and 3D live cell imaging were used to study the interactions between tumor cells, macrophages and CD3 T cells in vitro. The role of exosomal miR-155-5p in tumor growth was evaluated in xenograft nude mice models and immune-competent mice models. Flow cytometry and flow sorting were used to determine the expression levels of miR-155-5p and PD-L1 in ascites and splenic macrophages, and the percentages of CD3 T cells subpopulations. Results The elevation of reactive oxygen species (ROS) greatly downregulated exosomal miR-155-5p expression in tumor cells. Neutralization of ROS with N-acetyl-L-cysteine (NAC) increased the levels of miR-155-5p in tumor exosomes that were taken up by macrophages, leading to reduction of macrophage migration and tumor spheroid infiltration. We further found that programmed death ligand 1 (PD-L1) is a functional target of miR-155-5p. Co-culture of macrophages pre-treated with NAC-derived tumor exosomes or exosomal miR-155-5p with T-lymphocytes leading to an increased percentage of CD8+ T-lymphocyte and a decreased CD3+ T cell apoptosis through PD-L1 downregulation. Tumor growth in nude mice was delayed by treatment with NAC-derived tumor exosomes. Delivery of tumor exo-miR-155-5p in immune-intact mice suppressed ovarian cancer progression and macrophage infiltration, and activated CD8+ T cell function. It is of note that exo-miR-155-5p inhibited tumor growth more potently than the PD-L1 antibody, suggesting that in addition to PD-L1, other pathways may also be targeted by this approach. Conclusions Our findings demonstrate a novel mechanism, ROS-induced down-regulation of miR-155-5p, by which tumors modulate the microenvironment that favors tumor growth. Understanding of the negative impact of ROS on the tumor immune response will improve current therapeutic strategies. Targeting miR-155-5p can be an alternative approach to prevent formation of an immunosuppressive TME through downregulation of PD-L1 and other immunosuppressive factors. Graphical Abstract

Background and objectiveLifestyle modifications aimed at weight loss have been introduced as a cornerstone of nonalcoholic fatty liver disease (NAFLD) management. However, very few patients follow the doctor's prescription to change their lifestyle to achieve weight loss in the real world. The purpose of this study was to use the Health Action Process Approach (HAPA) model to examine the factors that affect adherence to lifestyle prescriptions among patients with NAFLD.MethodsSemi-structured interviews were conducted with patients with NAFLD. Reflexive thematic analysis and framework analysis were used to determine naturally identified themes and allocate them to theoretically driven domains.ResultsThirty adult patients with NAFLD were interviewed, and the identified themes were mapped directly onto the constructs of the HAPA model. This study revealed that key barriers to adhering to lifestyle prescriptions are related to the coping strategy and outcome expectation constructs of the HAPA model. For physical activity, conditional limits, lack of time, symptoms such as fatigue and poor physical fitness, and fear of sports injury are the primary barriers. Barriers to diet are mainly diet environment, mental stress, and food cravings. Key facilitators for adherence to lifestyle prescriptions include developing simple and specific action plans, coping strategies to flexibly deal with obstacles and difficulties, receiving regular feedback from doctors to improve self-efficacy, and using regular tests and behavior recording to enhance action control.ConclusionsFuture lifestyle intervention programs should pay particular attention to the planning, self-efficacy, and action control-related constructors of the HAPA model to promote the adherence of patients with NAFLD to lifestyle prescriptions.

ObjectivesRadioactivity monitoring around nuclear facilities is crucial to provide important baseline data for effective detection of radioactive leakage to the environment. We aim to establish a baseline study for monitoring radioactive levels of 90Sr and 137Cs around Sammen Nuclear Power Plant (SNPP) and to assess their associated health impact on surrounding residents.MethodsIn this study, we collected water and food samples around the SNPP from 2011 to 2020 and determined for 90Sr and 137Cs activity concentrations. We statistically analyzed the temporal trends of 90Sr and 137Cs and evaluated their radiation exposure to the local residents.ResultsDuring this period, the activity concentrations of 90Sr and 137Cs varied within 1.2–9.9 mBq/L and 0.10–7.6 mBq/L in water, and 0.037–1.3 Bq/kg and 0.011–0.45 Bq/kg in food, respectively, with no significant seasonal variation trend.ConclusionsAll reported activity concentrations of 90Sr and 137Cs were significantly lower than the recommended value of WHO and Chinese national standards. There is no indication of notable radioactive release into the study area due to the operation of SNPP during 2018–2020. The annual effective doses (AEDs) from the ingestion of 90Sr and 137Cs in water and food were well below the international permissible limits, indicating the radiation exposure around SNPP during 2011–2020 was kept at a safe level.

IntroductionSanmen nuclear power plant (SNPP) operates the first advanced passive (AP1000) nuclear power unit in China.MethodsTo assess the radiological impacts of SNPP operation on the surrounding environment and the public health, annual effective dose (AED) and excess risk (ER) were estimated based on continuous radioactivity monitoring in drinking water and ambient dose before and after its operation during 2014–2021. In addition, the residents' cancer incidence was further analyzed through authorized health data collection.ResultsThe results showed that the gross α and gross β radioactivity in all types of drinking water were ranged from 0.008 to 0.017 Bq/L and 0.032 to 0.112 Bq/L, respectively. The cumulative ambient dose in Sanmen county ranged from 0.254 to 0.460 mSv/y, with an average of 0.354 ± 0.075 mSv/y. There is no statistical difference in drinking water radioactivity and ambient dose before and after the operation of SNPP according to Mann–Whitney U test. The Mann-Kendall test also indicates there is neither increasing nor decreasing trend during the period from 2014 to 2021. The age-dependent annual effective doses due to the ingestion of drinking water or exposure to the outdoor ambient environment are lower than the recommended threshold of 0.1 mSv/y. The incidence of cancer (include leukemia and thyroid cancer) in the population around SNPP is slightly higher than that in other areas, while it is still in a stable state characterized by annual percentage changes.DiscussionThe current comprehensive results show that the operation of SNPP has so far no evident radiological impact on the surrounding environment and public health, but continued monitoring is still needed in the future.

BackgroundOur study aimed to evaluate the safety and immunogenicity of the third (booster) dose of the COVID-19 vaccine for patients with endocrine-related cancers.MethodsThis observational study involved 94 breast cancer patients, 92 thyroid cancer patients, and 123 healthy individuals who had received the third (booster) dose of the COVID-19 vaccine. Data on the adverse effects, serum anti-receptor binding domain (RBD)-immunoglobulin (Ig) G, and neutralizing antibodies (NAbs) were collected prospectively.ResultsThe serum anti-RBD-IgG and NAb titers were significantly lower for the patients with endocrine-related malignancies than for the healthy controls (3.01 [IQR: 1.11–6.70] vs. 4.19 [1.95–9.11], p = 0.001; 0.23 [0.11–0.52] vs. 0.41 [0.22–0.78], p = 0.001), and the seroconversion rates of anti-RBD-IgG and NAbs showed similar results. The serum antibody titers and seroconversion rates were significantly lower for patients aged ≥65 years with endocrine-related cancers, but there were no significant differences related to gender, vaccine type, or cancer type. Subgroup analysis showed that the antibody titers and seroconversion rates were significantly lower for patients with intermediate to advanced breast cancer, HR–/Her2+ breast cancer, and breast cancer undergoing treatment than for healthy controls. In contrast, breast cancer patients who completed their treatment and those who received endocrine therapy after completing their treatment were not significantly different from healthy controls. The NAbs titers and seroconversion rates were significantly lower for patients with primary thyroid cancer (0.19 [IQR: 0.10–0.46] vs. 0.41 [0.22–0.78], p = 0.003; 55.9 vs. 84.9%, p < 0.001); the seroconversion rates were significantly higher for the patients with combined Hashimoto's thyroiditis than for those without it. Multiple linear regression showed that patients aged ≥65 years who were receiving treatment were at risk of having lower antibody levels.ConclusionThe third (booster) dose of the COVID-19 vaccine is safe and well-tolerated. Our data support a third (booster) dose of the SARS-CoV-2 vaccine for breast and thyroid cancer patients. Breast cancer patients aged ≥65 years who are receiving treatment should be more protected, while thyroid cancer and breast cancer patients who have completed their treatment can be vaccinated like the general population.

Abstract Introduction Influenza or SARS‐CoV‐2 vaccination is especially recommended for people with underlying diseases. For the large number of patients with chronic hepatitis B virus infection (CHB), studies on their immune responses to these vaccines are still lacking. Methods A total of 57 CHB patients and 19 healthy controls (HCs) receiving inactivated influenza vaccination were prospectively followed up. Influenza‐specific immunoglobulin G (IgG) antibodies (anti‐H1N1, anti‐H3N2, and anti‐B IgG), antibody‐secreting cells (ASCs), and circulating T follicular helper cells were assessed simultaneously. Eight CHB patients subsequently got inactivated SARS‐CoV‐2 vaccination during 1‐year follow‐up, and levels of serum antibodies against SARS‐CoV‐2 were further analyzed. Results On day 28 after influenza vaccination, three influenza antibodies levels appeared to be lower in CHB patients than in HCs. And anti‐H1N1 IgG level was significantly decreased in cirrhotic patients (p

BackgroundThe COVID-19 pandemic has seriously increased depression prevalence among the public, including Chinese college students. However, many exercise cannot be performed as usual under the stay-at-home order. This study was a 12-week three-arm randomized controlled trial using the intention-to-treat principle, aiming to explore and compare the feasibility and effect of individual-based personalized aerobic-exercise and resistance-training prescriptions on depressive symptoms in college students, and conclude with some recommendations for individual-based exercise prescriptions.MethodsEighty-six college students with depressive symptoms were randomized into aerobic-exercise (AE), resistance-training (RT), and wait-list control (WLC) groups. Participants in two experimental groups received 12-week personalized AE and RT prescriptions on their individual situations, respectively. No intervention was implemented on participants in the WLC group. Depressive symptoms and physical activity (PA) were measured by Zung Self-Rating Depression Scale (SDS) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All data were collected at the baseline, 4, 8, and 12 weeks, and 4-week post-intervention.ResultsAt 12 weeks, 72.09% of depressive participants improved to “normal.” Participants exhibited a statistical reduction in SDS in all 3 groups (p < 0.05) at 12 weeks compared to baseline. Follow-up assessments showed no significant increase in SDS at 4-week post-intervention compared to 12 weeks (p > 0.05). The independent t-test revealed significantly lower SDS in AE and RT group than in WLC group (pAE < 0.001 and pRT < 0.05) at 4, 8, and 12 weeks, and 4-week post-intervention. Furthermore, the PA of participants (including total PA and intensities) in both experimental groups represented a significant improvement at 4-week post-intervention compared to baseline (p < 0.05), while no differences were observed in the PA of participants in the WLC group (p > 0.05).ConclusionPersonalized exercise prescriptions have good feasibility as they can increase adherence to intervention and reduce serious adverse events. Besides, individual-based personalized aerobic-exercise and resistance-training prescriptions result in a similar effect in relieving depressive symptoms and improving physical activity in college students. The individual-based exercise programs performed in 45- to 60- min with progressive moderate-to-vigorous intensity, 3 times/week for at least 12 weeks, may reduce depressive symptoms in college students during the COVID-19.

Abstract Background Prone position ventilation is a widely used lung protection ventilation strategy. The strategy is more convenient to implement in children compared to adults. Due to the precise mechanism of improving oxygenation function, development of pediatric prone ventilation technology has been largely focused on children with acute respiratory distress syndrome. There is a paucity of high-quality studies investigating the effects of prone position ventilation after pediatric cardiac surgery. The purpose of this study is to evaluate the feasibility and effectiveness of prone position ventilation in infants who develop postoperative acute lung injury after surgery for congenital heart disease. Methods A single-center, randomized controlled trial of pediatric patients with acute lung injury after surgery for congenital heart disease who will receive prone position ventilation or usual care (control group). A total of 68 children will be enrolled according to the inclusion criteria. The main outcome measures will be lung compliance and oxygenation index. The secondary outcomes will be duration of mechanical ventilation, length of stay in cardiac intensive care unit, reintubation rate, and complication rate. Discussion This study will investigate the feasibility and effectiveness of prone position ventilation techniques in children who develop postoperative acute lung injury after surgery for congenital heart disease. The results may help inform strategies to improve airway management after surgery for congenital heart disease. Trial registration ClinicalTrials.gov NCT04607993 . Initially registered on 29 October 2020.

Abstract. Low-level viremia (LLV) was defined as persistent or intermittent episodes of detectable hepatitis B virus (HBV) DNA (

Currently, increasing attention has been paid to the association of the serofast status with natural killer (NK) cells. Remarkable diversity among the results of different studies has been observed. We conducted this meta-analysis to evaluate the variation of the proportion of NK cells in serofast patients compared with that of healthy controls and cured patients. Through the designed retrieval methods, 631 serofast patients, 562 healthy controls and 160 patients whose serology turned negative following treatment were derived from 16 publications for further analysis. The established items were used for the standard selection and quality assessment. The Stata software was used for meta-analysis. The final results indicated that serofast patients exhibited a dramatic decrease in the number of NK cells in the peripheral blood compared with that noted in healthy control subjects [standardized mean difference (SMD) = –0.63, 95% CI (–1.08, –0.17), p = 0.007]. The proportion of NK cells was significantly lower in serofast patients than that noted in cured patients [SMD = –0.25, 95% CI (–0.48, –0.02), p = 0.033] and no significant difference was noted in the proportion of NK cells between cured patients and healthy controls [SMD = –0.39, 95% CI (–0.93, 0.14), p = 0.148]. The present meta-analysis indicated that the proportion of NK cells in the peripheral blood was significantly lower in serofast patients compared with that of the healthy controls and cured patients, indicating that the reduction in the number of NK cells may be closely associated with the syphilis serofast status.

Objectives: Norovirus is associated with one-fifth of all gastroenteritis cases, but basic epidemiological data is lacking, especially in developing countries. As long-term surveillance on norovirus gastroenteritis is scarce in western China, this study aims to update the epidemiological knowledge of norovirus gastroenteritis and to characterize the genotypes of norovirus strains. Methods: Stool samples were collected from hospitalized children under 5 years old with gastroenteritis in Chengdu, China. All samples were tested for norovirus as well as rotavirus, sapovirus, enteric adenovirus, and astrovirus by real-time RT-PCR. RdRp and VP1 genes were sequenced in norovirus-positive samples to investigate viral phylogenies. Results: Of the 1181 samples collected from 2015 to 2019, 242 (20.5%) were positive for norovirus.Among norovirus-positive cases, 65 cases had co-infection with another virus; norovirus/enteric adenovirus was most frequently detected (50.8%, 33/65). The highest positive rate was observed in children aged 13–18 months (23.7%, 68/287). Norovirus infection peaked in autumn (36.6%, 91/249), followed by summer (20.3%, 70/345). Pearson correlation analysis showed significant correlation between the norovirus-positive rate and humidity (r = 0.773, P

Abstract Background SETD1A, a member of SET1/MLL family H3K4 methyltransferases, is involved in the tumorigenesis of numerous cancers. However, the biological role and mechanism of SETD1A in non-small cell lung cancer (NSCLC) remain to be elucidated. Methods The expression of SETD1A, NEAT1, EZH2, and β-catenin in NSCLC tissues and cell lines was detected by qRT-PCR, immunohistochemistry and western blotting. The regulatory mechanisms were validated by chromatin immunoprecipitation, co-immunoprepitation and luciferase reporter assay. The self-renewal, cisplatin sensitivity and tumorigenesis of NSCLC cells were analyzed using sphere formation, CCK-8, colony formation assays and xenograft tumor models. Results SETD1A expression was significantly increased in NSCLC and its overexpression predicted a poor prognosis of patients with NSCLC. Functional experiments showed that SETD1A positively regulated cancer stem cell property and negatively regulated cisplatin sensitivity in NSCLC cells via the Wnt/β-catenin pathway. Next, we found that SETD1A positively regulated the Wnt/β-catenin pathway via interacting with and stabilizing β-catenin. The SET domain is dispensable for the interaction between SETD1A and β-catenin. Furthermore, we identified that SETD1A bound to the promoters of NEAT1 and EZH2 to activate gene transcription by inducing H3K4me3 enrichment. Rescue experiments showed that SETD1A promoted the Wnt/β-catenin pathway and exerted its oncogenic functions in NSCLC, at least, partly through NEAT1 and EZH2 upregulation. In addition, SETD1A was proven to be a direct target of the Wnt/β-catenin pathway, thus forming a positive feedback loop in NSCLC cells. Conclusion SETD1A and Wnt/β-catenin pathway form a positive feedback loop and coordinately contribute to NSCLC progression.

Abstract Background The small tyrosine kinase inhibitors (TKIs) subversively altered the lung cancer treatments, but patients will inevitably face the therapy resistance and disease recurrence. We aim to explore the potential roles of non-coding RNAs in sensitizing the TKIs effects. Methods: Multiple cellular and molecular detections were applied to confirm the mechanistic regulations and intracellular connections. Results We explored the specific gene features of candidates in association with resistance, and found that m6A controlled the stemness of EMT features through METTL3 and YTHDF2. The miR-146a/Notch signaling was sustained highly activated in a m6A dependent manner, and the m6A regulator of YTHDF2 suppressed TUSC7, both of which contributed to the resistant features. Functionally, the sponge type of TUSC7 regulation of miR-146a inhibited Notch signaling functions, and affected the cancer progression and stem cells’ renewal in Erlotinib resistant PC9 cells (PC9ER) and Erlotinib resistant HCC827 cells (HCC827ER) cells. The Notch signaling functions manipulated the cMYC and DICER inner cytoplasm, and the absence of either cMYC or DICER1 lead to TUSC7 and miR-146a decreasing respectively, formed the closed circle to maintain the balance. Conclusion PC9ER and HCC827ER cells harbored much more stem-like cells, and the resistance could be reversed by Notch signaling inactivation. The intrinsic miR-146 and TUSC7 levels are monitored by m6A effectors, the alternation of either miR-146 or TUSC7 expression could lead to the circling loop to sustain the new homeostasis. Further in clinics, the combined delivery of TKIs and Notch specific inhibitory non-coding RNAs will pave the way for yielding the susceptibility to targeted therapy in lung cancer.

Abstract Sepsis is a potentially fatal condition caused by infection. It is frequently difficult to distinguish sepsis from systemic inflammatory response syndrome (SIRS), often resulting in poor prognoses and the misuse of antibiotics. Hence, highly sensitive and specific biomarkers are needed to differentiate sepsis from SIRS. Urine samples were collected and segregated by group (a sepsis group, a SIRS group, and a healthy control group). iTRAQ was used to identify the differentially expressed proteins among the three groups. The identified proteins were measured by ELISA in urine samples. Finally, all the acquired data were analyzed in SPSS. C-reactive protein, leucine-rich alpha glycoprotein-1 and serum amyloid A (SAA) protein were differentially expressed among the three groups. The adjusted median concentrations of urinary C-reactive protein were 1337.6, 358.7, and 2.4 in the sepsis, SIRS, and healthy control groups, respectively. The urinary leucine-rich alpha glycoprotein-1 levels in these three groups were 1614.4, 644.5, and 13.6, respectively, and the levels of SAA were 6.3, 2.9, and 0.07, respectively. For all three of these measures, the sepsis group had higher levels than the SIRS group (P

Abstract Environmental radioactivity monitoring in the surroundings of nuclear facilities is important to provide baseline data for effective detection in case of any radioactive release in the region. In this work, we report for the first time the long-term monitoring data of 137Cs and 90Sr in environmental and food samples around Qinshan nuclear power plant in 2012–2019. The distribution levels, temporal variations and source terms of 137Cs and 90Sr in the investigated samples were discussed. The annual effective dose (AED) for the local population from the ingestion of foods was also evaluated. Peak values of 90Sr and 137Cs concentrations and 137Cs/90Sr activity ratio were observed in total atmospheric deposition in 2016 and some water and food samples in the following years. This seems to be associated to an additional radioactive input, mostly likely from the operational release of a local facility. This demonstrates that 90Sr and 137Cs, especially the 137Cs/90Sr activity ratio, are sensitive indicators for detecting potential radioactive releases. Nevertheless, overall 90Sr and 137Cs activity concentrations measured during 2012–2019 in this work were at the background levels with average AED far below the internationally permissible limit and recommendation.

Background and aimsThe prevalence of metabolic syndrome (MS), wich mainly including hypertension, hyperglycemia, hyperlipidemia, remains high, and the safety and antibody response of inactivated coronavirus disease 2019 (COVID-19) vaccination in patients with metabolic syndrome (MS) is still inconsistency, therefore it is necessary to explore the safety and antibody responses of inactivated COVID-19 vaccination in MS patients in clinical practice.Methods157 adults patients who were suffering from MS and 117 health controls (HC) at an interval of at least 21 days after full-course (2nd dose) vaccination were enrolled. The safety of inactivated COVID-19 vaccination was evaluated through collected adverse events (AEs) by questionnaire. The immunogenicity of included participant to inactivated COVID-19 vaccination was represented by serum seropositivity rate of anti-receptor binding domain (RBD) IgG, SARS-CoV-2 neutralizing antibodies (CoV-2 Nab) and titers of anti-RBD IgG, CoV-2 Nab. The B cells, mainly including RBD-specific B cells, RBD-specific memory B cell (MBC), RBD+ resting MBC cells, RBD+ activated MBC cells, RBD+ atypical MBC cells (atyMBCs), and RBD+ intermediate MBC cells, were also analyzed.ResultsIn terms of safety, all AEs in MS patients were mild and self-limiting, and the incidence was comparable to that of HC participants, with overall AEs within seven days reported in 9.6% (15/157) of 3H and 11.1% (13/117) of HC. Both groups experienced no serious adverse events. As for immunogenicity of MS patients to inactivated COVID-19 vaccination, compared with health controls, the seroprevalence of anti-RBD IgG and CoV-2 Nab was significantly decreased in MS patients (p = 0.000, p = 0.003, respectively), while the titers of anti-RBD IgG (AU/ml) and CoV-2 Nab (μg/ml) were also significant lower in MS patients (p = 0.014, p = 0.002, respectively). As for frequencies of B cells, MS patients had lower frequencies of RBD-specific B cells, RBD+ resting MBCs, and RBD+ intermediate MBCs (p = 0.003, p = 0.000, p = 0.000, respectively), but had a higher frequencies of RBD+ atypical MBCs (p = 0.000) than HC. In comorbidity number subgroups analysis of MS, except frequencies of RBD+ resting MBC cells, RBD+ activated MBC cells and RBD+ intermediate MBC cells had significant difference among three groups (p = 0.035, p = 0.042, p = 0.046, respectively), antibody response had no significant difference among 1H, 2H, and 3H groups (p > 0.05). And took 70 years old as a boundary, also no statistically significant differences (p > 0.05) were found in age subgroups. Lastly, comprehensive analysis in MS patients indicated that interval time after 2nd dose vaccine was the statistical significant factor which impacting antibody response in MS individuals.ConclusionsInactivated COVID-19 vaccines were well-tolerated, but induced a poorer antibody response against SARS-CoV-2 in MS patients comparing to HC participants. Patients with MS should therefore be more proactive in receiving inactivated COVID-19 vaccine, and a booster vaccination may be considered necessary.Clinical trial registrationhttps://clinicaltrials.gov/, identifier: NCT05043246.

IntroductionFemale college students are a group with high incidence of anxiety, and anxiety will lead to the disorder of autonomic nervous system (ANS), which will adversely affect their study and life. Resistance training plays a positive role in improving anxiety, but there is little evidence on whether resistance training can improve ANS of anxious female college students. Heart rate variability (HRV) has gained widespread acceptance in assessing ANS modulation. Therefore, the objective of this study aimed to investigate the effects of resistance training on heart rate variability (HRV) in anxious female college student.MethodsA randomized controlled study of resistance training intervention was conducted in 27 anxious female college students that assigned randomly into an intervention group (n = 14) and a control group (n = 13). The intervention group was intervened by cluster training for 8 weeks. Self-rating anxiety scale (SAS) was used. ANS is evaluated by short-term HRV. Muscle strength was assessed by 1 RM indirect method. Independent-sample t-test was used to test post-test–pre-test scores between the intervention and control groups.ResultsAfter the intervention, SAS score of the intervention group was significantly decreased (P < 0.05), SDNN of the intervention group was significantly increased (P < 0.05) and LF/HF was significantly decreased (P < 0.05).ConclusionThe resistance training intervention adopted in this study significantly increased the HRV of anxious female college students and improved their autonomic nervous disorder.

The transmission of SARS-CoV-2 leads to devastating COVID-19 infections around the world, which has affected both human health and the development of industries dependent on social gatherings. Sports events are one of the subgroups facing great challenges. The uncertainty of COVID-19 transmission in large-scale sports events is a great barrier to decision-making with regard to reopening auditoriums. Policymakers and health experts are trying to figure out better policies to balance audience experiences and COVID-19 infection control. In this study, we employed the generalized SEIR model in conjunction with the Wells–Riley model to estimate the effects of vaccination, nucleic acid testing, and face mask wearing on audience infection control during the 2021 Chinese Football Association Super League from 20 April to 5 August. The generalized SEIR modeling showed that if the general population were vaccinated by inactive vaccines at an efficiency of 0.78, the total number of infectious people during this time period would decrease from 43,455 to 6,417. We assumed that the general population had the same odds ratio of entering the sports stadiums and becoming the audience. Their infection probabilities in the stadium were further estimated by the Wells–Riley model. The results showed that if all of the 30,000 seats in the stadium were filled by the audience, 371 audience members would have become infected during the 116 football games in the 2021 season. The independent use of vaccination and nucleic acid testing would have decreased this number to 79 and 118, respectively. The combined use of nucleic acid testing and vaccination or face mask wearing would have decreased this number to 14 and 34, respectively. The combined use of all three strategies could have further decreased this number to 0. According to the modeling results, policymakers can consider the combined use of vaccination, nucleic acid testing, and face mask wearing to protect audiences from infection when holding sports events, which could create a balance between audience experiences and COVID-19 infection control.

ObjectivesThe commonly used methods for the occupational health risk assessment (OHRA) of chemical toxicants cannot fully meet the needs of practical work. This study evaluated OHRA strategies for chemical toxicants in the workplace by establishing a quantitative analysis model.MethodsFive typical industries in China that implement OHRA using the six common models (the Environmental Protection Agency, Australian, Romanian, Singaporean, International Council on Mining and Metals, and the Control of Substances Hazardous to Health models) were selected as the research objects. We established a quantitative analysis model to compare the six models and applied it to compare the results obtained using each model and preliminarily analyze the advantages, limitations, and application scope of each method.ResultsThe risk ratio (RR) values of the six methods decreased in the following order: RREPA > RRCOSHH > RRICMM > RRAustralia > RRSingaporean > RRRomanian (P < 0.05). Among the six models, the Singaporean model had the strongest RR correlation with the other models (P < 0.01). The sequence of RRs obtained from the Singaporean, ICMM, Australian, and Romanian models in the five industries was consistent with the sequence of the three inherent risk levels in those industries. Only the Romanian model could distinguish between the RRs of all five industries. The EPA and Singaporean models could effectively distinguish the differences in inherent risk for four hazard factors (manganese and inorganic compounds, benzene, xylene, and ethyl acetate), with the assessment accuracy being relatively higher for the EPA model.ConclusionsAmong the six models, the EPA model had the relatively highest accuracy in assessing chemical toxicants, followed by the Singaporean model. The EPA and Romanian models were strongest in differentiating the differences in toxicity risk. More studies on OHRA methodology are needed.