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Abstract Background Building on the job demands–resources (JD–R) model and regulatory focus theory, this study examined how regulatory foci shaped the effects of different job demands and resources on both negative and positive workplace outcomes among medical staff. Methods Two independent studies (N Study 1 = 267; N Study 2 = 350) were designed for cross-validation. Participants completed a battery of measures evaluating job demands (workload, emotional demands, interpersonal stress), job resources (psychological safety, perceived organizational support, servant leadership), and well-being (job burnout, affective commitment, job satisfaction). Results Multiple linear regression analyses showed employees’ well-being was affected by job demands and resources through energetic and motivational processes, respectively. The deleterious effect of emotional demands on job burnout was pronounced in individuals with weak prevention focus (B = 0.392, standard error [SE] = 0.069, p

A thulium-doped fiber laser (TDFL) with a dual-active cavity and a directly linked three-coupler triple-ring filter is designed and demonstrated. Its operational principle is analyzed, and a corresponding experimental setup is built. Eleven single-wavelength laser outputs with a single-longitudinal-mode (SLM) output near 2 μm are obtained. The laser output covers a wavelength range from 1933.95 nm to 1971.76 nm, with a continuous switchable output range of 37.81 nm and a minimum center wavelength interval of 0.22 nm. The optical signal-to-noise ratio (OSNR) of the output laser within the tuning range is >48.53 dB, and its maximum OSNR is 70.24 dB. The minimum wavelength fluctuation is 0.03 nm, and the power fluctuation is between 0.15 and 2.61 dB. A single wavelength with a center wavelength of 1933.95 nm is monitored for 75 min, and the radio-frequency spectrum is scanned 27 times within the frequency range of 0 to 400 MHz. The results demonstrate that the TDFL can operate continuously and stably in an SLM state. The linewidth and linewidth fluctuation of the TDFL are measured, and the minimum linewidth, corresponding to a measurement time of 0.001 s, is 65.14 kHz. The experimental results show that the proposed TDFL has a high OSNR and excellent wavelength-switching ability, and its SLM operation is very stable.

The expansion applications of semiconducting polymer dots (Pdots) among optical nanomaterial field have long posed a challenge for researchers, promoting their intelligent application in multifunctional nano-imaging systems and integrated nanomedicine carriers for diagnosis and treatment. Despite notable progress, several inadequacies still persist in the field of Pdots, including the development of simplified near-infrared (NIR) optical nanoprobes, elucidation of their inherent biological behavior, and integration of information processing and nanotechnology into biomedical applications. This review aims to comprehensively elucidate the current status of Pdots as a classical nanophotonic material by discussing its advantages and limitations in terms of biocompatibility, adaptability to microenvironments in vivo, etc. Multifunctional integration and surface chemistry play crucial roles in realizing the intelligent application of Pdots. Information visualization based on their optical and physicochemical properties is pivotal for achieving detection, sensing, and labeling probes. Therefore, we have refined the underlying mechanisms and constructed multiple comprehensive original mechanism summaries to establish a benchmark. Additionally, we have explored the cross-linking interactions between Pdots and nanomedicine, potential yet complete biological metabolic pathways, future research directions, and innovative solutions for integrating diagnosis and treatment strategies. This review presents the possible expectations and valuable insights for advancing Pdots, specifically from chemical, medical, and photophysical practitioners’ standpoints.

Our research focuses on winter jujube trees and is conducted in a greenhouse environment in a structured orchard to effectively control various growth conditions. The development of a robotic system for winter jujube harvesting is crucial for achieving mechanized harvesting. Harvesting winter jujubes efficiently requires accurate detection and location. To address this issue, we proposed a winter jujube detection and localization method based on the MobileVit-Large selective kernel-GSConv-YOLO (MLG-YOLO) model. First, a winter jujube dataset is constructed to comprise various scenarios of lighting conditions and leaf obstructions to train the model. Subsequently, the MLG-YOLO model based on YOLOv8n is proposed, with improvements including the incorporation of MobileViT to reconstruct the backbone and keep the model more lightweight. The neck is enhanced with LSKblock to capture broader contextual information, and the lightweight convolutional technology GSConv is introduced to further improve the detection accuracy. Finally, a 3-dimensional localization method combining MLG-YOLO with RGB-D cameras is proposed. Through ablation studies, comparative experiments, 3-dimensional localization error tests, and full-scale tree detection tests in laboratory environments and structured orchard environments, the effectiveness of the MLG-YOLO model in detecting and locating winter jujubes is confirmed. With MLG-YOLO, the mAP increases by 3.50%, while the number of parameters is reduced by 61.03% in comparison with the baseline YOLOv8n model. Compared with mainstream object detection models, MLG-YOLO excels in both detection accuracy and model size, with a mAP of 92.70%, a precision of 86.80%, a recall of 84.50%, and a model size of only 2.52 MB. The average detection accuracy in the laboratory environmental testing of winter jujube reached 100%, and the structured orchard environmental accuracy reached 92.82%. The absolute positioning errors in the X, Y, and Z directions are 4.20, 4.70, and 3.90 mm, respectively. This method enables accurate detection and localization of winter jujubes, providing technical support for winter jujube harvesting robots.

Abstract Background The occurrence of postoperative complications was associated with poor outcomes for patients undergoing robotic-assisted radical prostatectomy. A prediction model with easily accessible indices could provide valuable information for surgeons. This study aims to identify novel predictive circulating biomarkers significantly associated with surgical complications. Methods We consecutively assessed all multiport robotic-assisted radical prostatectomies performed between 2021 and 2022. The clinicopathological factors and perioperative levels of multiple circulating markers were retrospectively obtained from the included patients. The associations of these indices with Clavien-Dindo grade II or greater complications, and surgical site infection were assessed using univariable and multivariable logistic regression models. Further, the models were validated for the overall performance, discrimination, and calibration. Results In total, 229 patients with prostate cancer were enrolled in this study. Prolonged operative time could independently predict surgical site infection (OR, 3.39; 95% CI, 1.09–10.54). Higher RBC (day 1-pre) implied lower risks of grade II or greater complications (OR, 0.24; 95% CI, 0.07–0.76) and surgical site infection (OR, 0.23; 95% CI, 0.07–0.78). Additionally, RBC (day 1-pre) independently predicted grade II or greater complications of obese patients (P value = 0.005) as well as those in higher NCCN risk groups (P value = 0.012). Regarding the inflammatory markers, NLR (day 1-pre) (OR, 3.56; 95% CI, 1.37–9.21) and CRP (day 1-pre) (OR, 4.16; 95% CI, 1.69–10.23) were significantly associated with the risk of grade II or greater complications, and both the indices were independent predictors in those with higher Gleason score, or in higher NCCN risk groups (P value

Abstract Background The purpose of this study was to evaluate the accuracy of automatic cephalometric landmark localization and measurements using cephalometric analysis via artificial intelligence (AI) compared with computer-assisted manual analysis. Methods Reconstructed lateral cephalograms (RLCs) from cone-beam computed tomography (CBCT) in 85 patients were selected. Computer-assisted manual analysis (Dolphin Imaging 11.9) and AI automatic analysis (Planmeca Romexis 6.2) were used to locate 19 landmarks and obtain 23 measurements. Mean radial error (MRE) and successful detection rate (SDR) values were calculated to assess the accuracy of automatic landmark digitization. Paired t tests and Bland‒Altman plots were used to compare the differences and consistencies in cephalometric measurements between manual and automatic analysis programs. Results The MRE for 19 cephalometric landmarks was 2.07 ± 1.35 mm with the automatic program. The average SDR within 1 mm, 2 mm, 2.5 mm, 3 and 4 mm were 18.82%, 58.58%, 71.70%, 82.04% and 91.39%, respectively. Soft tissue landmarks (1.54 ± 0.85 mm) had the most consistency, while dental landmarks (2.37 ± 1.55 mm) had the most variation. In total, 15 out of 23 measurements were within the clinically acceptable level of accuracy, 2 mm or 2°. The rates of consistency within the 95% limits of agreement were all above 90% for all measurement parameters. Conclusion Automatic analysis software collects cephalometric measurements almost effectively enough to be acceptable in clinical work. Nevertheless, automatic cephalometry is not capable of completely replacing manual tracing. Additional manual supervision and adjustment for automatic programs can increase accuracy and efficiency.

In the tunnel construction practice, multiple buildings’ tilt rate data are collected. In this study, data causality is defined to reflect the causal relation between the input and output of the building tilt rate detection data. Upon defining and calculating the data causality, a new high resilient causality detection (HiReCau) method is proposed for abnormal building tilt rate detection. A numerical case and another practical case are studied for validation purposes. The case study results show that the proposed HiReCau method can accurately detect high-causality data and low-causality data among the building tilt rate detection data and produces superior results compared with the direct adoption of a machine learning approach. Furthermore, the resilience of HiReCau is validated by investigations testing varied levels of additional low-causality data in the training dataset. Presently, HiReCau is limited to handling problems with a single output. Furthermore, only the back-propagation neural network (BPNN) is tested as the baseline model and there is also room to further expand the data size. The proposed approach is versatile and able to be adjusted to handle fault diagnosis and safety assessment problems in varied theoretical and engineering backgrounds.

This paper presents experimental evidence regarding a novel switchable dual-wavelength thulium-doped fiber laser (TDFL). Wavelength switching is achieved by combining a polarization-maintaining fiber Bragg grating (PM-FBG) with a polarization controller (PC). The three-coupler double-ring compound cavity (TC-DRC) structure, acting as a mode-selection filter, is designed to select a single longitudinal mode (SLM) from the dense longitudinal modes. This paper introduces the design and fabrication method of the TC-DRC filter and analyzes, in detail, the mechanism for SLM selection. The experimental results demonstrate that the designed filter exhibits excellent performance. By adjusting the PC, the TDFL achieves stable SLM operation at the wavelengths of 1940.54 nm and 1941.06 nm, respectively. The optical signal-to-noise ratio (OSNR) is superior to 65 dB. When the TDFL is tested at room temperature, there is no significant wavelength drift, and power fluctuations are less than 1.5 dB. The operation of the SLM is verified through the self-heterodyne method, and the laser maintains stable SLM states for both wavelengths after continuous operation for an hour. Furthermore, based on the phase noise demodulation method, the linewidths of both wavelengths are measured to be less than 10 kHz at the integration time of 0.001 s.

ObjectiveThe objective of this study is to explore the association between patient-centered care (PCC) and inpatient healthcare outcomes, including self-reported physical and mental health status, subjective necessity of hospitalization, and physician-induced demand behaviors.MethodsA cross-sectional survey was conducted to assess patient-centered care among inpatients in comprehensive hospitals through QR codes after discharge from September 2021 to December 2021 and had 5,222 respondents in Jiayuguan, Gansu. The questionnaire included a translated 6-item version of the PCC questionnaire, physician-induced behaviors, and patients' sociodemographic characteristics including gender, household registration, age, and income. Logistic regression analyses were conducted to assess whether PCC promoted self-reported health, the subjective necessity of hospitalization, and decreased physician-induced demand. The interactions between PCC and household registration were implemented to assess the effect of the difference between adequate and inadequate healthcare resources.ResultsPCC promoted the patient's self-reported physical (OR = 4.154, p < 0.001) and mental health (OR = 5.642, p < 0.001) and subjective necessity of hospitalization (OR = 6.160, p < 0.001). Meanwhile, PCC reduced physician-induced demand in advising to buy medicines outside (OR = 0.415, p < 0.001), paying at the outpatient clinic (OR =0.349, p < 0.001), issuing unnecessary or repeated prescriptions and medical tests (OR = 0.320, p < 0.001), and requiring discharge and readmitting (OR = 0.389, p < 0.001).ConclusionBy improving health outcomes for inpatients and reducing the risk of physician-induced demand, PCC can benefit both patients and health insurance systems. Therefore, PCC should be implemented in healthcare settings.

Abstract Background To evaluate the early functional and oncological outcomes of single-port robot-assisted perineal radical prostatectomy (sp-pRARP) using the da Vinci XI system and analyze its learning curve using the cumulative sum (CUSUM) method. Methods The clinical data of 50 patients who underwent sp-pRARP for localized prostate cancer between May 2020 and May 2022 in our center by a single surgeon were analyzed retrospectively. Demographic information, preoperative and postoperative variables, complications, early functional and oncological outcomes of patients were recorded. The CUSUM method was used to illustrate the learning curve based on operation time. Results All surgeries were completed without conversion. The median (interquartile range, IQR) operation time was 205.0 (82.5) min, whereas the median (IQR) docking time was 30.0 (15.0) min and the console time was 120.0 (80.5) min. The median (IQR) estimated blood loss (EBL) was 50.0 (137.5) mL. Positive surgical margins were detected in five patients (10.0%). The continence rate was 40.9%, 63.6%, 88.4%, and 97.7% at the 1, 3, 6, and 12 months after surgery. According to the CUSUM plot, the inflection points of the learning curve were 20 cases, splitting the case series into “early phase” and “late phase.” In “late phase” cases, there was less time spent on each step of the operation and less EBL. Conclusions Sp-pRARP using the da Vinci XI system was verified to be a feasible and reliable surgical approach. According to the CUSUM plot, 20 cases was considered the turning point for surgeons to master the novel technique.

IntroductionServant leadership has long been associated with maintaining employee’s affective commitment, yet the underlying mechanism remains unclear. Research from non-western cultures remains scarce.MethodsThis study sought to fill in such research gap by introducing insights from social exchange theory perspective, and examined two potential mediators (viz., psychological safety and job burnout) with a largescale, representative Chinese sample.ResultsA total of 931 staffs in a Chinese hospital were surveyed, and structural equation models revealed that psychological safety (indirect effect = 0.052, 95% Bootstrap CI = [0.002, 0.101]) and job burnout (indirect effect = 0.277, 95% Bootstrap CI = [0.226, 0.331]) parallelly (and partially) mediated the effect of servant leadership on affective commitment. Moreover, these effects held the same between permanent and temporary staffs, as well as between male and female staffs.DiscussionResults suggested that a leader’s orientation to care, validate, and respond to their followers’ needs was effective in creating a psychological safe environment and downplaying job burnout in workplace, in exchange to which, followers remained affectively committed to their organization in a long term. Not only did this study contribute to existing literature by providing non-western data for service leadership research, it also provided a deeper understanding of associated mechanisms of how servant leadership might cast on talent retain and organizational development in a long term. These mechanisms shed light on how serving helps leading and advocate servant leadership for hospitals, as well as other serving organizations.

A single-longitudinal-mode (SLM) thulium-doped fiber laser, based on an eye-shaped passive dual-ring filter, is designed and constructed. The eye-shaped passive compound cavity consisting of four couplers is used to increase the longitudinal mode spacing, and its performance is numerically analyzed in detail. A homemade uniform fiber Bragg grating serves as a wavelength selection device and a saturable absorber is used to further suppress the intense longitudinal mode competition in the laser cavity, ensuring the single-longitudinal-mode output. The experimental results demonstrate a laser output with a center wavelength of 2,049.85 nm and an optical signal-to-noise ratio of 63 dB. Moreover, the power fluctuation is less than 0.6 dB, and the center wavelength fluctuation is less than 0.03 nm over a continuous measurement period of 60 min, demonstrating an excellent stability. The laser linewidth is measured using an unbalanced Michelson interferometer and β-separation line method, resulting in a linewidth of 11.22 kHz.

Background: Immune checkpoint inhibitors (ICIs) have been proved having a better safety profile compared to platinum-based chemotherapy and have demonstrated encouraging anti-tumor therapeutic effects for patients with metastatic urothelial carcinoma (mUC). However, few studies have evaluated the efficacy of ICIs in patients with metastatic upper tract urothelial carcinoma (mUTUC). Case reports: Case 1 was a 71-year-old male patient diagnosed with left renal pelvic carcinoma, accompanied by a metastasis to the second lumbar spine. As the patient became refractory to chemotherapy, four cycles of camrelizumab, one of the ICIs, were administered, which helped to control the metastases and extend the patient's progression-free survival to five months. Case 2 was an 88-year-old female with middle and lower right ureter carcinoma with right iliac arteriovenous invasion. The patient received five cycles of camrelizumab plus vascular endothelial growth factor receptor 2 (VEGFR2) inhibitors and achieved stable disease. Conclusion: For patients who are ineligible for chemotherapy, immunotherapy might be a feasible treatment, regardless of whether or not they are given VEGFR2 inhibitors

Abstract Background Circular RNA (circRNA) is a novel class noncoding RNA (ncRNA) that plays a critical role in various cancers, including prostate cancer (PCa). However, the clinical significance, biological function, and molecular mechanisms of circRNAs in prostate cancer remain to be elucidated. Methods A circRNA array was performed to identified the differentially expressed circRNAs. circPDE5A was identified as a novel circRNA which downregulated in clinical samples. Functionally, the in vitro and in vivo assays were applied to explore the role of circPDE5A in PCa metastasis. Mechanistically, the interaction between circPDE5A and WTAP was verified using RNA pulldown followed by mass spectrometry, RNA Immunoprecipitation (RIP) assays. m6A methylated RNA immunoprecipitation sequencing (MeRIP-seq) was then used to identified the downstream target of circPDE5A. Chromatin immunoprecipitation assay (ChIP) and dual-luciferase reporter assay were used to identified transcriptional factor which regulated circPDE5A expression. Results circPDE5A was identified downregulated in PCa tissues compared to adjacent normal tissue and was negatively correlated with gleason score of PCa patients. circPDE5A inhibits PCa cells migration and invasion both in vitro and in vivo. circPDE5A blocks the WTAP-dependent N6-methyladenisine (m6A) methylation of eukaryotic translation initiation factor 3c (EIF3C) mRNA by forming the circPDE5A-WTAP complex, and finally disrupts the translation of EIF3C. Moreover, the circPDE5A-dependent decrease in EIF3C expression inactivates the MAPK pathway and then restrains PCa progression. Conclusions Our findings demonstrate that FOXO4-mediated upregulation of circPDE5A controls PCa metastasis via the circPDE5A-WTAP-EIF3C-MAPK signaling pathway and could serve as a potential therapeutic targer for PCa.

Abstract Background Sunitinib resistance can be classified into primary and secondary resistance. While accumulating research has indicated several underlying factors contributing to sunitinib resistance, the precise mechanisms in renal cell carcinoma are still unclear. Methods RNA sequencing and m6A sequencing were used to screen for functional genes involved in sunitinib resistance. In vitro and in vivo experiments were carried out and patient samples and clinical information were obtained for clinical analysis. Results We identified a tumor necrosis factor receptor-associated factor, TRAF1, that was significantly increased in sunitinib-resistant cells, resistant cell-derived xenograft (CDX-R) models and clinical patients with sunitinib resistance. Silencing TRAF1 increased sunitinib-induced apoptotic and antiangiogenic effects. Mechanistically, the upregulated level of TRAF1 in sunitinib-resistant cells was derived from increased TRAF1 RNA stability, which was caused by an increased level of N6-methyladenosine (m6A) in a METTL14-dependent manner. Moreover, in vivo adeno-associated virus 9 (AAV9) -mediated transduction of TRAF1 suppressed the sunitinib-induced apoptotic and antiangiogenic effects in the CDX models, whereas knockdown of TRAF1 effectively resensitized the sunitinib-resistant CDXs to sunitinib treatment. Conclusions Overexpression of TRAF1 promotes sunitinib resistance by modulating apoptotic and angiogenic pathways in a METTL14-dependent manner. Targeting TRAF1 and its pathways may be a novel pharmaceutical intervention for sunitinib-treated patients.

For medical staff, job satisfaction is essential for advancement on an individual and organizational level. This study looked into the relationships between challenging job demands, job resources, personal resources, and well-being. Additionally, it examined the potential mediating effects of emotional exhaustion and work motivation within the framework of the job demands–resources (JD–R) model. Results from a cross-sectional study of 267 medical employees at a second-grade comprehensive hospital in Jiangsu, China’s mainland, indicated that challenging job demands and job satisfaction were positively correlated and mediated via (decreasing) emotional exhaustion. The relationship between job resources and job satisfaction was found to be mediated via (decreasing) emotional exhaustion and (increasing) work motivation. The investigation also demonstrated that the two regulatory focuses serve different purposes. It was discovered that promotion focus had a favorable effect on work motivation but a negative effect on emotional exhaustion. Conversely, preventive focus only positively predicted emotional exhaustion. Thus, the JD–R model offers a valuable structure for clarifying the job satisfaction of health personnel. The implications for enhancing individual and job outcomes are discussed.

Clear cell renal cell carcinoma (ccRCC) is the most lethal urological cancer and is characterized by a high rate of metastasis and relapse. N6-Methyladenosine (m6A) is implicated in various stages of cancer development. However, a thorough understanding of m6A-modified lncRNAs in ccRCC is lacking. The results showed that METTL14 had decreased expression in ccRCC tissues. In addition, the expression of METTL14 was negatively correlated to the prognosis, stage, and ccRCC tumor grade. The silencing of METTL14 was shown to significantly increase metastasis in vitro and in vivo. High-throughput methylated RNA immunoprecipitation sequencing (MeRIP-seq) showed that the m6A levels of Lnc-LSG1 could be regulated by METTL14. Lnc-LSG1 can directly bind to ESRP2 protein and promote ESRP2 degradation via facilitating ESRP2 ubiquitination. However, m6A modification on Lnc-LSG1 can block the interaction between Lnc-LSG1 and ESRP2 via the m6A reader, YTHDC1. Taken together, our findings unraveled the novel mechanism of METTL14 inhibiting ccRCC progression, and explored the correlation between m6A and lncRNA in ccRCC for the first time.

We propose and demonstrate a stable single-longitudinal mode (SLM) thulium-doped fiber laser (TDFL) with a Fabry- Pérot (F-P) fiber Bragg grating (FBG) filter and a triple-coupler based double-ring cavity (TC-DRC) filter. For the first time, this structure of TC-DRC filter is used to select a single mode from dense longitudinal-modes in a ring cavity TDFL. The design and fabricate methods of TC-DRC filter are revealed and the principle of SLM selection is also analyzed in detail. The experimental results demonstrated the good performance of the proposed filter. The central wavelength of proposed TDFL is 2049.49 nm and its OSNR is higher than 35 dB. There is no obvious wavelength drift during the test, and the power fluctuation is less 0.5 dB. The SLM operation is verified through the self-homodyne method, this laser can be stably maintained in a SLM state after operating for one hour under laboratory condition. In addition, the linewidth is measured less than 10 kHz based on the phase noise demodulation method.

A thulium-doped fiber laser (TDFL) with switchable single-wavelength output was proposed and experimentally constructed, and its output characteristics were investigated. The central wavelengths were 1940.52 nm and 2048.04 nm, defined by a superimposed uniform fiber Bragg grating (SI-UFBG) with reflectivity larger than 92%. Switchable output was successfully achieved by using polarization-dependent loss, with the help of a drop-in polarization controller and an in-line polarizer. For both output wavelengths, optical signal-to-noise ratios larger than 80 dB were achieved. Maximum fluctuations of the central wavelengths of 1940.52 nm and 2048.02 nm under 60 min were, respectively, 0.04 nm and 0.01 nm. Maximum fluctuations of output power for the same wavelengths over the same time period were, respectively, 1.09 dB and 0.12 dB. Maximum output powers of 215.12 mW and 155.53 mW were achieved for the respective output wavelengths of 1940.52 nm and 2048.02 nm. Moreover, a tuning range of ∼2 nm was realized by enforcing a strain on the SI-UFBG. The proposed TDFL may be applied in laser medicine and free-space-related applications.

Abstract Background Circular RNAs (circRNAs) have been reported to play a significant role in tumorigenesis. However, the detailed function of circRNA in prostate cancer (PCa) is still largely unknown. Methods We quantified circTFDP2 expression in PCa tissues and adjacent normal tissues using quantitative reverse transcription‐polymerase chain reaction (qRT‐PCR). Colony formation, Cell Counting Kit‐8 (CCK‐8), flow cytometry, transwell, and in vivo progression and metastasis assays were applied to reveal the proliferation and metastatic abilities of circTFDP2 in PCa cells. Mass spectrometry, RNA pulldown, RNA‐immunoprecipitation (RIP), western blotting and immunofluorescence were used for the mechanistic studies. qRT‐PCR and RIP assays were used to explore the regulatory role of eIF4A3 in the biogenesis of circTFDP2. Finally, functional assays showed the effect of circTFDP2‐containing exosomes on PCa cell progression. Results circTFDP2 was upregulated in PCa tissues compared with adjacent normal tissues. Furthermore, high circTFDP2 expression was positively correlated with the Gleason score. Functionally, circTFDP2 promoted PCa cell proliferation and metastasis both in vivo and in vitro. Mechanistically, circTFDP2 interacted with poly(ADP‐ribose) polymerase 1 (PARP1) protein in its DNA‐binding domain to prevent it from active caspase‐3‐dependent cleavage, and finally relieved PCa cells from DNA damage. In addition, RNA‐binding protein eIF4A3 can interact with the flanking region of circTFDP2 and promote the biogenesis of circTFDP2. Moreover, exosome‐derived circTFDP2 promoted PCa cell progression. Conclusions In general, our study demonstrated that circTFDP2 promoted PCa cell progression through the PARP1/DNA damage axis, which may be a promising therapeutic target for PCa.

ObjectiveTo introduce patient-centered approach in China and to relate it with Chinese patient satisfaction via validating the Chinese version of Patient-Professional Interaction Questionnaire (PPIQ-C).DesignThis cross-sectional survey was conducted through face-to-face interviews from June to September in 2019. Participants rated their patient-centered care experience via the 16-item translated PPIQ, their experience of the received medical service, and their overall satisfaction.SettingKunshan Huaqiao People's Hospital in Jiangsu, China.ParticipantsA total of 230 participants (87 males and 143 females; 108 outpatients and 122 inpatients).ResultsPPIQ-C exhibited acceptable psychometric properties. Data revealed a single factor model of the 16 PPIQ-C items [χ(4)2 = 12.394, p = 0.823, CFI = 1.000, TLI = 1.019, RMSEA = 0.000, SRMR = 0.032] had a superior model fit over the original first-order with four correlated factors and the second-order structures. The overall reliability was excellent (McDonald's ω = 0.975). In terms of patient satisfaction, process, treatment quality, and communication significantly predicted patient satisfaction, while environment, staff attitude, and medical ethics did not [R2 = 0.427, F(6) = 24.887, p < 0.001]. Most importantly, the total score of PPIQ-C predicted patient satisfaction above and beyond the above-mentioned medical service perspectives (B = 0.595, SE = 0.207, p = 0.004). Finally, the constructive effect of PCC on patient satisfaction was stronger for departments of Pediatrics than Surgery.ConclusionsThe Chinese version of the PPIQ scale (PPIQ-C) exhibited acceptable psychometric properties. Yet the distinction among the four factors was not supported, suggesting potential difference(s) across cultures. Patient-centered care (PCC), reflected by the overall PPIQ-C score, predicted overall patient satisfaction above and beyond other medical service perspectives. Adopting PCC approach in appropriate situations will probably advance the development of performance evaluation systems in China, thus improving the overall health care and patient satisfaction.

BackgroundRenal pelvic urothelial carcinoma with sarcomatoid carcinoma differentiation is a very dangerous malignant tumor and extremely rare in clinical practice. In general, these tumors with a dismal prognosis, and there is no standard treatment.Case presentationIn this case, an 81-year-old male patient was diagnosed with right renal pelvic carcinoma. After an open right radical nephroureterectomy, postoperative pathological examination showed infiltrating urothelial carcinoma with sarcomatoid differentiation. Overexpression of programmed death ligand-1 by immunohistochemistry. The carcinoma recurred 4.5 months after surgery. After informed, tislelizumab combined with anlotinib were used as first-line treatment. The patients showed a clinical partial response that lasted for 20 months.ConclusionThis case demonstrates the efficacy of tislelizumab combined with anlotinib in patients diagnosed with metastatic renal pelvic urothelial carcinoma with sarcomatoid carcinoma differentiation. Moreover, to our knowledge, this is the first application of this treatment.

The mechanization of red jujube industry is a high-potential agricultural research field in China. In this study, a vibration harvesting device has been developed for jujube trees that features adjustable vibration frequency and amplitude. The device is designed to make jujube trees vibrate with varying diameters by utilizing different vibration frequencies and amplitudes according to the tree’s size such that jujubes can be harvested efficiently. The study completed the structural design of excitation and fruit collection mechanisms based on the working principle of vibration harvesting. The red jujube excitation mechanism was dynamically simulated using ADAMS, and it was found that the acceleration at the end of the vibration rod of the mechanism had a tendency to sharply increase and decrease, which was conducive to the vibration shedding of red jujube. A collision model between the red jujubes and the fruit collection umbrella was constructed, and the fruit collection mechanism was structurally simulated using ANSYS. The tests showed that the device effectively harvested red jujubes from nine types of jujube trees with diameter ranges of 29.15–31.26 mm, 49.56–52.34 mm, and 65.23–73.25 mm. The average net harvesting rates were 93.98%, 94.71%, and 94.33%, and the average fruit collection efficiencies were 95.78%, 89.43%, and 85.04%, respectively. These results demonstrate the effectiveness of the excitation and collection mechanisms and provide a theoretical basis for the development of vibratory harvesting devices for red jujubes.

Late blight, caused by phytophthora infestans, is a devastating disease in potato production. In severe cases, this can lead to potato crop failure. To rapidly detect potato late blight, in this study, a deep learning model was developed to discriminate the degree of potato leaf diseases with high recognition accuracy and a fast inference speed. It constructed a total of seven categories of potato leaf disease datasets in single and complex backgrounds, which were augmented using data enhancement method increase to increase the number of images to 7039. In this study, the performance of the pre-trained model for fine-grained classification of potato leaf diseases was evaluated comprehensively in terms of accuracy, inference speed, and the number of parameters. The ShuffleNetV2 2× model with better generalization ability and faster inference speed was selected and improved. Three improvement strategies were proposed: introducing an attention module, reducing the depth of the network, and reducing the number of 1 × 1 convolutions. Their effects on the performance of the underlying model were explored through experiments, and the best form of improvement was determined. The loss function of the improved model converged to 0.36. This was compared to the base model, which was reduced by 34.5%. In the meantime, the improved model reduced the number of parameters, FLOPs, and model size by approximately 23%, increased classification accuracy by 0.85%, and improved CPU inference speed by 25%. Deploying the improved model to the embedded device, the overall classification precision was 94%, and the average time taken to detect a single image was 3.27 s. The method provided critical technical support for the automatic identification of potato late blight.

In this article, a precisely controlled, switchable thulium-doped fiber laser (TDFL) with high optical signal-to-noise ratio (OSNR) is proposed and demonstrated. A home-made multimode fiber Bragg grating (MMFBG) with multireflection peaks was used as an optical filter to select the desired lasing channel. Using a manually controlled fusion splicer, the axial misalignment was applied between the single mode fiber and the MMFBG to switch the output wavelength. In the experiment, the number of switchable lasing lines was up to 12, and the fluctuation of the center wavelength and output power was less than 0.03 nm and 0.67 dB, respectively. A maximum slope efficiency of 1.3% was obtained when the axial misalignment was 0 μm, and the OSNR was higher than 65 dB. In addition, the proposed fiber laser was used as an optical fiber laser sensor to quantify the strain applied on the MMFBG, and a sensitivity of 1.16 pm/μϵ was obtained.

A high-power, narrow-linewidth, continuous-wave, thulium-doped fiber laser (TDFL) based on a master-oscillator power-amplifier (MOPA) was experimentally demonstrated. The main oscillator (seed source) yielded 0.64 W of narrow-linewidth laser output at a central wavelength of 1940.32 nm and a 3 dB spectral bandwidth of 0.05 nm. The output narrow-linewidth laser from the main oscillator was amplified by two-stage, cladding-pumped, thulium-doped, all-fiber amplifiers. The main amplifier yielded 26 W of narrow-linewidth laser at a central wavelength of 1940.33 nm. The slope efficiency of the main amplifier was approximately 55.6%. Significant residual pumping light component in the output laser was not observed. During the amplification process, no stimulated Brillouin scattering (SBS) effect, strong amplified spontaneous emission (ASE) effect, and parasitic lasers were observed at the reverse monitoring end. Moreover, the output power was only limited by the incident pump power and the output power had a good stability in a 50 min monitoring period.

Winter jujube is a popular fresh fruit in China for its high vitamin C nutritional value and delicious taste. In terms of winter jujube object detection, in machine learning research, small size jujube fruits could not be detected with a high accuracy. Moreover, in deep learning research, due to the large model size of the network and slow detection speed, deployment in embedded devices is limited. In this study, an improved Yolov5s (You Only Look Once version 5 small model) algorithm was proposed in order to achieve quick and precise detection. In the improved Yolov5s algorithm, we decreased the model size and network parameters by reducing the backbone network size of Yolov5s to improve the detection speed. Yolov5s’s neck was replaced with slim-neck, which uses Ghost-Shuffle Convolution (GSConv) and one-time aggregation cross stage partial network module (VoV-GSCSP) to lessen computational and network complexity while maintaining adequate accuracy. Finally, knowledge distillation was used to optimize the improved Yolov5s model to increase generalization and boost overall performance. Experimental results showed that the accuracy of the optimized Yolov5s model outperformed Yolov5s in terms of occlusion and small target fruit discrimination, as well as overall performance. Compared to Yolov5s, the Precision, Recall, mAP (mean average Precision), and F1 values of the optimized Yolov5s model were increased by 4.70%, 1.30%, 1.90%, and 2.90%, respectively. The Model size and Parameters were both reduced significantly by 86.09% and 88.77%, respectively. The experiment results prove that the model that was optimized from Yolov5s can provide a real time and high accuracy small winter jujube fruit detection method for robot harvesting.

This paper proposes and demonstrates a single-longitudinal-mode thulium-doped fiber laser using a passive triple-coupler ring-based compound-cavity filter (TCR-CC) and a uniform fiber Bragg grating. For the first time, the TCR-CC filter is used to select a single mode from dense longitudinal modes. Experimental results show that laser in the wavelength of 1941.28 nm can maintain exceptional stability with an optical signal-to-noise ratio of 74.1 dB. The measured maximum wavelength drift and power fluctuation are 0.01 nm and 0.45 dB, respectively. Meanwhile, the measured linewidth of the laser is 910 Hz, and the relative intensity noise is below −125.82 dB/Hz above 2 MHz frequencies.

Music has become a common adjunctive treatment for Alzheimer’s disease (AD) in recent years. Because Alzheimer’s disease can be classified into different degrees of dementia according to its severity (mild, moderate, severe), this study is to investigate whether there are differences in brain response to music stimulation in AD patients with different degrees of dementia. Seventeen patients with mild-to-moderate dementia, sixteen patients with severe dementia, and sixteen healthy elderly participants were selected as experimental subjects. The nonlinear characteristics of electroencephalogram (EEG) signals were extracted from 64-channel EEG signals acquired before, during, and after music stimulation. The results showed the following. (1) At the temporal level, both at the whole brain area and sub-brain area levels, the EEG responses of the mild-to-moderate patients showed statistical differences from those of the severe patients (p < 0.05). The nonlinear characteristics during music stimulus, including permutation entropy (PmEn), sample entropy (SampEn), and Lempel–Ziv complexity (LZC), were significantly higher in both mild-to-moderate patients and healthy controls compared to pre-stimulation, while it was significantly lower in severe patients. (2) At the spatial level, the EEG responses of the mild-to-moderate patients and the severe patients showed statistical differences (p < 0.05), showing that as the degree of dementia progressed, fewer pairs of EEG characteristic showed significant differences among brain regions under music stimulation. In this paper, we found that AD patients with different degrees of dementia had different EEG responses to music stimulation. Our study provides a possible explanation for this discrepancy in terms of the pathological progression of AD and music cognitive hierarchy theory. Our study has adjunctive implications for clinical music therapy in AD., potentially allowing for more targeted treatment. Meanwhile, the variations in the brains of Alzheimer’s patients in response to music stimulation might be a model for investigating the neural mechanism of music perception.