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BackgroundLong COVID has widened the health gap across society and highlighted the vulnerabilities and risks faced by health care systems. For instance, the global trend of medical workers resigning has become a prominent topic on social media. In response to this severe social problem in global public health within the digital society, it is urgent to investigate how the professional identity of medical students, who are digital natives and the future workforce of medical practitioners, is affected by the media environment. ObjectiveThis study aims to examine how media exposure relates to medical students’ perceptions of informational and emotional support, and how these perceptions further influence the development of their professional identity. MethodsBuilding on the Stimulus-Organism-Response (SOR) framework, this study develops a theoretical model to illustrate how media exposure affects medical students’ professional identity through the mediation of social support. Specifically, media exposure was assessed through online news media and social media exposure; social support was evaluated in terms of informational and emotional support; and professional identity was measured through medical students’ sense of belonging and professional commitment. A survey was conducted at a medical school in China, yielding 1087 valid responses that were analyzed using SmartPLS 4.0. ResultsConsistent with our expectations, online news media exposure was positively associated with both informational support (β=.163; P

Abstract Background Intraductal papillary mucinous neoplasm (IPMN) is a cystic tumor of the pancreas arising from abnormal papillary proliferation of ductal epithelial cells, and is a precancerous lesion of pancreatic malignancy. This study aimed to evaluate associations between acute pancreatitis (AP) and histologic subtypes of IPMN. Methods In the clinical study, patients with IPMN confirmed by surgical resection specimens at our institute between 2009 and 2021 were eligible for inclusion. Associations and predictive accuracy of AP on the presence of HGD were determined by logistic regressions. In addition, a systematic review and meta-analysis was conducted through literatures upon search in PubMed, Embase, CENTRAL, China National Knowledge Infrastructure (CKNI), and Wanfang database, up to June, 2023. Pooled effects of the associations between AP and HGD and intestinal epithelial subtype subtype, shown as odds ratios (ORs) with 95% confidence intervals (CIs), were calculated using random effects model. Results The retrospective cohort study included 47 patients (32 males, 15 females) diagnosed with IPMN at our center between 2009 and 2021, including 11 cases with AP (median 62 years) and 36 cases (median 64.5 years) without. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of AP in predicting HGD were 78.7%, 57.1%, 82.5%, 36.4%, and 91.7%, respectively. Univariate logistic regression analysis showed that AP group had greater odds of presence of HGD (OR: 6.29,95% CI: 1.14–34.57) than non-AP group. Meta-analysis of five case-control studies in the literature included 930 patients and showed that AP-IPMN patients had higher odds for HGD (OR: 2.13, 95% CI 1.38–3.29) and intestinal epithelial subtype (OR: 5.38, 95% CI: 3.50–8.27) compared to non-AP IPMN. Conclusions AP is predictive of malignancy in patients with IPMN.

Abstract Background During the early stages of Trichinella spiralis infection, macrophages predominantly undergo polarization to the M1-like phenotype, causing the host’s inflammatory response and resistance against T. spiralis infection. As the disease progresses, the number of M2-type macrophages gradually increases, contributing to tissue repair processes within the host. While cysteine protease overexpression is typically associated with inflammation, the specific role of T. spiralis cathepsin L (TsCatL) in mediating macrophage polarization remains unknown. The aim of this study was to assess the killing effect of macrophage polarization mediated by recombinant T. spiralis cathepsin L domains (rTsCatL2) on newborn larvae (NBL). Methods rTsCatL2 was expressed in Escherichia coli strain BL21. Polarization of the rTsCatL2-induced RAW264.7 cells was analyzed by enzyme-linked immunosorbent assay (ELISA), quantitative PCR (qPCR), western blot, immunofluorescence and flow cytometry. The effect of JSH-23, an inhibitor of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), on rTsCatL2-induced M1 polarization investigated. Cytotoxic effects of polarized macrophages on NBL were observed using in vitro killing assays. Results Following the co-incubation of rTsCatL2 with RAW264.7 murine macrophage cells, qPCR and ELISA revealed increased transcription and secretion levels of inducible nitric oxide synthase (iNOS), interleukin (IL)-6, IL-1β and tumor necrosis factor alpha (TNF-α) in macrophages. Western blot analysis showed a significant increase in iNOS protein expression, while the expression level of arginase-1 protein remained unchanged. Flow cytometry revealed a substantial increase in the number of CD86-labeled macrophages. The western blot results also indicated that rTsCatL2 increased the expression levels of phospho-NF-κB and phospho-nuclear factor-κB inhibitor alpha (IκB-α) proteins in a dose-dependent manner, while immunofluorescence revealed that rTsCatL2 induced nuclear translocation of the p65 subunit of NF-κB (NF-κB p65) protein in macrophages. The inhibitory effect of JSH-23 suppressed and abrogated the effect of rTsCatL2 in promoting M1 macrophage polarization. rTsCatL2 mediated polarization of macrophages to the M1-like phenotype and enhanced macrophage adhesion and antibody-dependent cell-mediated cytotoxicity (ADCC) killing of NBL. Conclusions The results indicated that rTsCatL2 induces macrophage M1 polarization via the NF-κB pathway and enhances the ADCC killing of NBL. This study provides a further understanding of the interaction mechanism between T. spiralis and the host. Graphical Abstract

Objective To investigate the application effect of aerosol inhalation of acetylcysteine in the diagnosis of pulmonary tuberculosis in children. Methods A total of 180 children suspected of pulmonary tuberculosis who were admitted to Qingdao Chest Hospital were enrolled and randomly divided into control group, bronchoscopy group, and acetylcysteine group. For the control group, routine sputum examination (including concentrated smear method, culture method, and GeneXpert test) was performed to identify Mycobacterium tuberculosis; for the bronchoscopy group, routine sputum examination combined with collection of alveolar lavage fluid by bronchoscopy was performed to identify Mycobacterium tuberculosis; for the acetylcysteine group, routine sputum examination combined with collection of sputum after aerosol inhalation of acetylcysteine was performed to identify Mycobacterium tuberculosis. The three groups were compared in terms of the detection rate of Mycobacterium tuberculosis in sputum or alveolar lavage fluid and the incidence rate of adverse reactions. Results There was a significant difference in the detection rate of Mycobacterium tuberculosis between the control group, the bronchoscopy group, and the acetylcysteine group (χ2=9.850,P

Abstract As a promising candidate for high-density data storage and neuromorphic computing, cross-point memory arrays provide a platform to overcome the von Neumann bottleneck and accelerate neural network computation. In order to suppress the sneak-path current problem that limits their scalability and read accuracy, a two-terminal selector can be integrated at each cross-point to form the one-selector-one-memristor (1S1R) stack. In this work, we demonstrate a CuAg alloy-based, thermally stable and electroforming-free selector device with tunable threshold voltage and over 7 orders of magnitude ON/OFF ratio. A vertically stacked 64 × 64 1S1R cross-point array is further implemented by integrating the selector with SiO2-based memristors. The 1S1R devices exhibit extremely low leakage currents and proper switching characteristics, which are suitable for both storage class memory and synaptic weight storage. Finally, a selector-based leaky integrate-and-fire neuron is designed and experimentally implemented, which expands the application prospect of CuAg alloy selectors from synapses to neurons.

Primary pulmonary hyalinizing clear cell carcinoma (HCCC) is a rare salivary gland-type tumor newly recognized in recent years, with approximately 21 cases reported to date in the English literature, which constitutes a challenge in pathology diagnosis, particularly in small biopsy specimens. Here, we present a case of pulmonary HCCC diagnosed by computed tomography-guided percutaneous lung biopsy in a 70-year-old man’s right lower lung. Although the morphology and immunophenotype of the tumor suggested the diagnosis of mucoepidermoid carcinoma, fluorescence in situ hybridization failed to reveal the rearrangement of MAML2 gene, which is characteristic of mucoepidermoid carcinoma. Instead, further molecular genetic testing showed that the tumor harbored a rare EWSR1::CREM fusion combined with a previously unreported IRF2::NTRK3 fusion. Pulmonary HCCC is commonly regarded as a low-grade malignant tumor with an indolent course, but this case has a different biological behavior, presenting extensive dissemination and metastases at the time of diagnosis, which expands our understanding of the prognosis of this tumor. The patient has had five cycles of combination chemotherapy and has been alive with the tumor for eight months.

Non-aqueous biocatalysis has attracted broad interest recently due to its differences from traditional aqueous catalysis and increased substrate solubility, which reduces feedback inhibition, improving enantiomer selectivity and completing synthesis reactions that cannot be performed in an aqueous solution. This approach shows remarkable application value in producing natural products, chemical products, pharmaceutical intermediates, and foods. This study aims to provide a concise overview of the current state of non-aqueous biocatalysis and its sustainability, summarizing the mechanism of non-aqueous biocatalysis and recent progress using immobilization technology. It includes different non-aqueous systems, such as organic phase systems, two-phase systems, ionic liquid systems, deep eutectic solvent systems, and non-solvent systems. Finally, this manuscript illustrates the challenges of non-aqueous catalysis and the prospects of the future areas of non-aqueous catalysis research. [ABSTRACT FROM AUTHOR]