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Abstract Background Definitive concurrent chemoradiotherapy (dCCRT) is the gold standard for the treatment of locally advanced esophageal squamous cell carcinoma (ESCC). However, the potential benefits of consolidation chemotherapy after dCCRT in patients with esophageal cancer remain debatable. Prospective randomized controlled trials comparing the outcomes of dCCRT with or without consolidation chemotherapy in patients with ESCC are lacking. In this study, we aim to generate evidence regarding consolidation chemotherapy efficacy in patients with locally advanced, inoperable ESCC. Methods This is a multicenter, prospective, open-label, phase-III randomized controlled trial comparing non-inferiority of dCCRT alone to consolidation chemotherapy following dCCRT. In total, 600 patients will be enrolled and randomly assigned in a 1:1 ratio to receive either consolidation chemotherapy after dCCRT (Arm A) or dCCRT alone (Arm B). Overall survival will be the primary endpoint, whereas progression-free survival, locoregional progression-free survival, distant metastasis-free survival, and treatment-related toxicity will be the secondary endpoints. Discussion This study aid in further understanding the effects of consolidation chemotherapy after dCCRT in patients with locally advanced, inoperable ESCC. Trial registration ChiCTR1800017646.

Chemoimmunotherapy has emerged as a promising strategy for improving the efficacy of cancer treatment. Herein, we present PD-1 receptor-presenting membrane-coated paclitaxel dimers nanoparticles (PD-1@PTX2 NPs) for enhanced treatment efficacy. PD-1 cell membrane-cloaked PTX dimer exhibited effective cellular uptake and increased cytotoxicity against cancer cells. PD-1@PTX2 NPs could selectively bind with PD-L1 ligands expressed on breast cancer cells. Our nanoparticles exhibit a remarkable tumor growth inhibition rate of 71.3% in mice bearing 4T1 xenografts and significantly prolong survival in mouse models of breast cancer. Additionally, our nanoparticles promoted a significant 3.2-fold increase in CD8+ T cell infiltration and 73.7% regulatory T cell (Treg) depletion within tumors, boosting a robust antitumor immune response. These findings underscore the potential of utilizing immune checkpoint receptor-presented PTX nanoparticles to enhance the efficacy of chemoimmunotherapy, providing an alternative approach for improving cancer treatment.

Hyperspectral remote sensing technology plays a vital role in advancing modern precision agriculture due to its non-destructive and efficient nature. To achieve accurate monitoring of winter wheat chlorophyll content, this study utilized 68 sets of chlorophyll content data and hyperspectral measurements collected during the jointing stage of winter wheat over two consecutive years (2019–2020), under various fertilization types and nitrogen application levels. Continuous wavelet transform was applied to transform the original reflectance, ranging from 21 to 210, and the correlation matrix method was utilized to identify the spectral index at each scale, with the highest correlation to winter wheat chlorophyll content as the optimal spectral index combination input. Subsequently, winter wheat chlorophyll content prediction models were developed using three machine learning methods: random forest (RF), support vector machine (SVM), and a genetic algorithm-optimized backpropagation neural network (GA-BP). The results indicate that the spectral data processed through continuous wavelet transform at seven scales, from 21 to 27, show the highest correlation with winter wheat chlorophyll content at a scale of 26, with a correlation coefficient of 0.738, compared with the correlation of 0.611 of the original reflectance, and the accuracy is improved by 20.7%. The average highest correlation value between the spectral index at scale 26 and winter wheat chlorophyll content is 0.752. As the scale of wavelet transform increases, the correlation between the spectral index and winter wheat chlorophyll content and the accuracy of the predictive model show a trend of first increasing and then decreasing. The optimal input variables for predicting winter wheat chlorophyll content and the best machine learning method are the spectral data at a scale of 26 processing combined with the GA-BP model. The optimal predictive model has a validation set coefficient of determination (R2) of 0.859, root mean square error (RMSE) of 1.366, and mean relative error (MRE) of 2.920%. The results show that the prediction model can provide a technical basis for improving the hyperspectral inversion accuracy of winter wheat chlorophyll and modern precision agriculture.

Efficient acquisition of crop leaf moisture information holds significant importance for agricultural production. This information provides farmers with accurate data foundations, enabling them to implement timely and effective irrigation management strategies, thereby maximizing crop growth efficiency and yield. In this study, unmanned aerial vehicle (UAV) multispectral technology was employed. Through two consecutive years of field experiments (2021–2022), soybean (Glycine max L.) leaf moisture data and corresponding UAV multispectral images were collected. Vegetation indices, canopy texture features, and randomly extracted texture indices in combination, which exhibited strong correlations with previous studies and crop parameters, were established. By analyzing the correlation between these parameters and soybean leaf moisture, parameters with significantly correlated coefficients (p < 0.05) were selected as input variables for the model (combination 1: vegetation indices; combination 2: texture features; combination 3: randomly extracted texture indices in combination; combination 4: combination of vegetation indices, texture features, and randomly extracted texture indices). Subsequently, extreme learning machine (ELM), extreme gradient boosting (XGBoost), and back propagation neural network (BPNN) were utilized to model the leaf moisture content. The results indicated that most vegetation indices exhibited higher correlation coefficients with soybean leaf moisture compared with texture features, while randomly extracted texture indices could enhance the correlation with soybean leaf moisture to some extent. RDTI, the random combination texture index, showed the highest correlation coefficient with leaf moisture at 0.683, with the texture combination being Variance1 and Correlation5. When combination 4 (combination of vegetation indices, texture features, and randomly extracted texture indices) was utilized as the input and the XGBoost model was employed for soybean leaf moisture monitoring, the highest level was achieved in this study. The coefficient of determination (R2) of the estimation model validation set reached 0.816, with a root-mean-square error (RMSE) of 1.404 and a mean relative error (MRE) of 1.934%. This study provides a foundation for UAV multispectral monitoring of soybean leaf moisture, offering valuable insights for rapid assessment of crop growth.

ABSTRACT Bleaching is one of the most relevant factors implicated in the integrity of coral reef ecosystems, with the increasing frequency and intensity of damaging events representing a serious threat to reef biodiversity. Here, we analyzed changes in coral-associated bacteria from three types of non-bleached and bleached scleractinian corals (Acropora digitifera, Galaxea fascicularis, and Porites pukoensis) in Hainan Luhuitou peninsula coastal areas. The community structure of symbiotic bacteria differed significantly among the three apparently healthy corals. The bleached corals had higher bacterial alpha diversity and some specific bacteria genera, including Ruegeria, Methyloceanibacter, Filomicrobium, Halioglobus, Rubripirellula, Rhodopirellula, Silicimonas, Blastopirellula, Sva0996 marine group, Woeseia, and unclassified_c_Gammaproteobacteria, were consistently increased in bleached groups. Network analysis revealed significantly different degrees of modularity between bleached and non-bleached groups at the bacterial genus level, and a higher proportion of links was dominated by positive co-occurrences. Functional prediction analysis illustrated that coral-associated bacteria remained relatively consistent in the bleached and non-bleached groups. Structure equation modeling revealed that the bacterial community diversity and function were directly influenced by host and environment factors. These findings suggested that coral-associated bacterial responses to bleaching occur in a host-dependent manner, informing novel strategies for restoring coral and aiding adaption to bleaching stress. IMPORTANCE Accumulating evidence indicates that coral-associated bacteria play an important role in the health of holobionts. However, the variability of the symbiotic bacterial community structure among coral species with different coral health statuses remains largely unknown. Here, we investigated three apparent non-bleached (healthy) and bleached coral species (sampled in situ), involving related symbiotic bacterial profiles, including composition, alpha diversity, network relationship, and potential function. Structural equation modeling analysis was used to analyze the relationship between coral status and abiotic and biotic factors. The bacterial community structure of different groups was shown to exhibit host-specific traits. Both host and environmental impacts had primary effects on coral-associated microbial communities. Future studies are needed to identify the mechanisms that mediate divergent microbial consortia.

Nitrogen is a fundamental component for building amino acids and proteins, playing a crucial role in the growth and development of plants. Leaf nitrogen concentration (LNC) serves as a key indicator for assessing plant growth and development. Monitoring LNC provides insights into the absorption and utilization of nitrogen from the soil, offering valuable information for rational nutrient management. This, in turn, contributes to optimizing nutrient supply, enhancing crop yields, and minimizing adverse environmental impacts. Efficient and non-destructive estimation of crop LNC is of paramount importance for on-field crop management. Spectral technology, with its advantages of repeatability and high-throughput observations, provides a feasible method for obtaining LNC data. This study explores the responsiveness of spectral parameters to soybean LNC at different vertical scales, aiming to refine nitrogen management in soybeans. This research collected hyperspectral reflectance data and LNC data from different leaf layers of soybeans. Three types of spectral parameters, nitrogen-sensitive empirical spectral indices, randomly combined dual-band spectral indices, and “three-edge” parameters, were calculated. Four optimal spectral index selection strategies were constructed based on the correlation coefficients between the spectral parameters and LNC for each leaf layer. These strategies included empirical spectral index combinations (Combination 1), randomly combined dual-band spectral index combinations (Combination 2), “three-edge” parameter combinations (Combination 3), and a mixed combination (Combination 4). Subsequently, these four combinations were used as input variables to build LNC estimation models for soybeans at different vertical scales using partial least squares regression (PLSR), random forest (RF), and a backpropagation neural network (BPNN). The results demonstrated that the correlation coefficients between the LNC and spectral parameters reached the highest values in the upper soybean leaves, with most parameters showing significant correlations with the LNC (p < 0.05). Notably, the reciprocal difference index (VI6) exhibited the highest correlation with the upper-layer LNC at 0.732, with a wavelength combination of 841 nm and 842 nm. In constructing the LNC estimation models for soybeans at different leaf layers, the accuracy of the models gradually improved with the increasing height of the soybean plants. The upper layer exhibited the best estimation performance, with a validation set coefficient of determination (R2) that was higher by 9.9% to 16.0% compared to other layers. RF demonstrated the highest accuracy in estimating the upper-layer LNC, with a validation set R2 higher by 6.2% to 8.8% compared to other models. The RMSE was lower by 2.1% to 7.0%, and the MRE was lower by 4.7% to 5.6% compared to other models. Among different input combinations, Combination 4 achieved the highest accuracy, with a validation set R2 higher by 2.3% to 13.7%. In conclusion, by employing Combination 4 as the input, the RF model achieved the optimal estimation results for the upper-layer LNC, with a validation set R2 of 0.856, RMSE of 0.551, and MRE of 10.405%. The findings of this study provide technical support for remote sensing monitoring of soybean LNCs at different spatial scales.

Elucidating the interactions between algal and microbial communities is essential for understanding the dynamic mechanisms regulating algal blooms in the marine environment. Shifts in bacterial communities when a single species dominates algal blooms have been extensively investigated. However, bacterioplankton community dynamics during bloom succession when one algal species shift to another is still poorly understood. In this study, we used metagenomic analysis to investigate the bacterial community composition and function during algal bloom succession from Skeletonema sp. to Phaeocystis sp. The results revealed that bacterial community structure and function shifted with bloom succession. The dominant group in the Skeletonema bloom was Alphaproteobacteria, while Bacteroidia and Gammaproteobacteria dominated the Phaeocystis bloom. The most noticeable feature during the successions was the change from Rhodobacteraceae to Flavobacteriaceae in the bacterial communities. The Shannon diversity indices were significantly higher in the transitional phase of the two blooms. Metabolic reconstruction of the metagenome-assembled genomes (MAGs) showed that dominant bacteria exhibited some environmental adaptability in both blooms, capable of metabolizing the main organic compounds, and possibly providing inorganic sulfur to the host algae. Moreover, we identified specific metabolic capabilities of cofactor biosynthesis (e.g., B vitamins) in MAGs in the two algal blooms. In the Skeletonema bloom, Rhodobacteraceae family members might participate in synthesizing vitamin B1 and B12 to the host, whereas in the Phaeocystis bloom, Flavobacteriaceae was the potential contributor for synthesizing vitamin B7 to the host. In addition, signal communication (quorum sensing and indole-3-acetic acid molecules) might have also participated in the bacterial response to bloom succession. Bloom-associated microorganisms showed a noticeable response in composition and function to algal succession. The changes in bacterial community structure and function might be an internal driving factor for the bloom succession.

Polyethylene terephthalate (PET) drinking bottles, rubber tires, and concrete are the very common municipal solid wastes, which are usually disposed of at landfills and stockpiles and cause continuous damage to the environment. Some studies have indicated that waste PET can be chemically converted into an additive for improving the overall properties of asphalt pavement incorporating natural aggregates, especially the moisture-induced damage resistance. However, it is not clear whether this PET additive still works for asphalt rubber containing recycled concrete aggregates (RCA). To well reveal this issue, this study first adopted a similar way to chemically recycle waste PET into the additive for modifying crumb rubber modified asphalt (CRMA) binder and then mixed the binder with the 13 mm maximum aggregate stone matrix asphalt containing 100% coarse RCA for preparing the mixtures. After a series of physicochemical characterizations of the PET additive, the moisture resistance, rutting resistance, low-temperature cracking resistance, and fatigue resistance of the mixture were systematically evaluated. The results showed that the PET additive is capable of improving the resistance to moisture and high-temperature deformation of asphalt rubber and helps greatly reduce the moisture-induced damage to the interfacial bonding layer. To be more detailed, the residual Marshall stability (RMS) value of RCA-CRMAM/1PET after 72 h of immersion is higher than 85% by contrast to that of RCA-CRMAM (77.1%), while the tensile strength ratio (TSR) value of RCA-CRMAM/1PET shows more than 80% compared to that of 65.2%. In addition, only 1% PET additive can enhance the high-temperature resistance of asphalt rubber containing RCA to rut and allow it to maintain higher resistance to rut after moisture-induced damage. 1% PET additive can help improve the bearing capacity of RCA-CRMAM under a low-temperature environment and delay its fatigue life at small stresses. Generally, with the successful introduction of PET additives to asphalt rubber containing RCA, more durable and sustainable highway pavement can be produced and applied in practice to alleviate the negative impacts caused by waste PET, waste tire rubber, and waste concrete.

ABSTRACT Treatment of osteomyelitis is still challenging, as conventional antibiotic therapy is limited by the emergence of resistant strains and the formation of biofilms. Sonoantimicrobial chemotherapy (SACT) is a novel therapy of low-frequency and low-intensity ultrasound (LFLIU) combined with a sonosensitizer. Therefore, in our study, a sonosensitizer named emodin (EM) was proposed to be combined with LFLIU to relieve acute osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA) through antibacterial and antibiofilm effects. The efficiencies of different intensities of ultrasound, including single (S-LFLIU, 15 min) and multiple ultrasound (M-LFLIU, 3 times for 5 min at 4-h intervals), against bacteria and biofilms were compared, contributing to developing the best treatment regimen. Our results demonstrated that EM plus S-LFLIU or M-LFLIU (EM+S-LFLIU or EM+M-LFLIU) had significant combined bactericidal and antibiofilm effects, with EM+M-LFLIU in particular exhibiting superior antibiofilm performance. Furthermore, it was suggested that EM+M-LFLIU could produce a large amount of reactive oxygen species (ROS), destroy the integrity of the bacterial membrane and cell wall, and downregulate the expression of genes involved in oxidative stress, membrane wall synthesis, and bacterial virulence, as well as that of other related genes (agrB, pbp3, sgtB, gmk, zwf, and msrA). In vivo studies, micro-computed tomography (micro-CT), hematoxylin and eosin (H&E) staining, enzyme-linked immunosorbent assay (ELISA), and bacterial quantification of bone tissue indicated that EM+M-LFLIU could also relieve osteomyelitis due to MRSA infection. Our work proffers an original approach to bacterial osteomyelitis treatment that weakens drug-resistant bacteria and suppresses and degrades biofilm formation through SACT, which may provide new prospects for clinical treatment. IMPORTANCE Antibiotic therapy is the first choice for clinical treatment of osteomyelitis, but the formation of bacterial biofilms and the emergence of many drug-resistant strains also create an urgent need to find an alternative treatment to effectively eliminate the infection. Recently, LFLIU has come to be considered a safe and promising method of debridement and antibacterial therapy. In this study, we found that ultrasound and EM have a significant combined antibacterial effect in vivo and in vitro, which may play an antibacterial role by stimulating the production of ROS, destroying the bacterial cell wall, and inhibiting the expression of related genes. Our study expands the body of knowledge on the antibacterial effect of drugs—specifically emodin (EM)—through combined physiotherapy. If successfully integrated into clinical practice, these methods may reduce the burden of high concentrations of drugs needed to treat bacterial biofilms and avoid the growing resistance of bacteria to antibiotics.

The high-quality reutilization of waste styrene–butadiene–styrene copolymer (SBS) modified asphalt mixtures is a difficult issue in the field of highways today, and the main reason is that conventional rejuvenation technology fails to achieve the effective rejuvenation of aged SBS in binder, causing significant deterioration in the high-temperature performance of the rejuvenated mixture. In view of this, this study proposed a physicochemical rejuvenation process using a reactive single-component polyurethane (PU) prepolymer as the repairing substance for structural reconstruction and aromatic oil (AO) as a common rejuvenator used to supplement the lost light fractions of asphalt molecules in aged SBSmB, according to the characteristics of oxidative degradation products of SBS. The joint rejuvenation of aged SBS modified bitumen (aSBSmB) by PU and AO was investigated based on Fourier transform infrared Spectroscopy, Brookfield rotational viscosity, linear amplitude sweep, and dynamic shear rheometer tests. The results show that 3 wt% PU can completely react with the oxidation degradation products of SBS and rebuild its structure, while AO mainly acted as an inert component to increase the content of aromatic components, thereby reasonably adjusting the compatibility of chemical components of aSBSmB. Compared with the PU reaction-rejuvenated binder, the 3 wt% PU/10 wt% AO rejuvenated binder had a lower high-temperature viscosity for better workability. The chemical reaction between PU and SBS degradation products dominated in the high-temperature stability of rejuvenated SBSmB and had a negative impact on its fatigue resistance, while the joint rejuvenation of 3 wt% PU and 10 wt% AO not only gave a better high-temperature property to aged SBSmB but could also have the capacity to improve its fatigue resistance. Compared to virgin SBSmB, PU/AO rejuvenated SBSmB has comparative low-temperature viscoelastic behavior characteristics and a much better resistance to medium-high-temperature elastic deformation.

ABSTRACT Background To investigate the short‐ and medium‐term outcomes of using a reduced‐port laparoscopic surgery (RPLS), compared to multi‐port laparoscopic surgery (MPLS), for the treatment of upper rectal cancer (URC) among elderly patients. Methods We conducted a retrospective analysis of the clinical and follow‐up data of 181 elderly patients with URC, who underwent radical laparoscopic surgery at our hospital, between January 2015 and January 2019. Among these 181 cases, 62 underwent RPLS and 119 MPLS. Results Compared to MPLS, RPLS decreased the length of surgical incision, lower pain on postoperative days 1 and 2, decreased the time to first flatus after surgery, as well as the time to mobilization after surgery. There was no difference between the short‐term outcomes between the two laparoscopic approaches, and no difference in the 3‐year disease‐free and overall survival rate. Conclusion Compared to MPLS, RPLS provides several advantages for the treatment of URC among elderly individuals, including a shorter length of surgical incision, reduced postoperative pain, shorter time to first flatus after surgery, earlier mobilization, and better cosmetic outcomes. These advantages are achieved with no difference in the length of surgery, nor in the 3‐year disease‐free and overall survival rate, compared to MPLS.

Abstract Background Exercise is widely known to lower intraocular pressure and increase ocular blood flow, which may be beneficial for glaucoma management. However, there are few studies that have reported on the relationship between exercise and glaucoma progression. The aim of our study was to investigate the exercise habits of those with primary open angle glaucoma (POAG) and its association with the progression of visual field (VF) loss. Methods Daily physical activity (PA) was monitored by an accelerometer (ActiGraph wGT3x-BT) which patients wore for more than 10 h of being awake on their right wrists for 1 week. Results Seventy-one non-progressive and 27 progressive patients were enrolled in the study. 24-h moderate to vigorous physical activity (MVPA) exercise showed that POAG patients had similar variation trends consisting of 3 wave peaks and 2 wave hollows. Minutes spent in MVPA was 19.89 ± 15.81 and 21.62 ± 15.10 during 07:00–09:00 h (p = 0.204), 15.40 ± 14.49 and 15.67 ± 12.43 during 15:00–17:00 h (p = 0.822) and 17.26 ± 21.11 and 11.42 ± 11.58 during 18:00–20:00 h (p = 0.001) in the non-progressive and progressive group, respectively. Univariate analysis indicated that 10 min of MVPA (18:00–20:00 h) [odds ratio, OR (95% CI) = 0.82 (0.73, 0.92)], average mean arterial pressure [OR (95% CI) = 0.96 (0.94, 0.98)], age [OR (95% CI) = 1.06 (1.03, 1.08)], male [OR (95% CI) = 0.67 (0.48, 0.96)], spherical equivalent [OR (95% CI) = 1.14 (1.07, 1.22)] and IOP-lowering medications [OR (95% CI) = 1.54 (1.16, 2.05)] were significantly correlated with having progressive VF damage. Multivariable analysis showed that 10 min of MVPA (18:00–20:00 h) [OR (95% CI) = 0.85 (0.75, 0.97)] was associated with progressive VF loss even after adjusting for other risk factors. Conclusions Evening exercise may lower the odds of VF progression, suggesting that exercise habits possibly play an important role in glaucoma progression.

Delta-shaped gastroduodenostomy (DSGD) and overlap gastroduodenostomy (OGD) are the two most widely used intracorporeal Billroth I anastomosis methods after distal gastrectomy. In this study, we compared the short-term outcomes of DSGD and OGD in total laparoscopic distal gastrectomy (TLDG). In a retrospective cohort study, we examined 92 gastric cancer patients who underwent TLDG performed by the same surgeon between January 2014 and June 2018. All patients underwent Billroth I reconstruction (OGD, n = 45; DSGD, n = 47) and D2 lymph node dissection. We retrospectively reviewed the surgical outcomes, clinical pathological results, and endoscopy results. Laparoscopic surgery was successfully performed in both groups without conversion to open surgery. The demographic and clinical characteristics were similar between the two groups (P>0.05). There were no significant differences between the two groups in operation time (158.9 ± 13.6 min vs. 158.8 ± 14.8 min, P=0.955), anastomotic time (19.4 ± 3.0 min vs. 18.8 ± 2.9 min, P=0.354), intraoperative blood loss (88.9 ± 25.4 mL vs. 83.7 ± 24.3 mL, P=0.321), number of lymph node dissections (31.0 ± 7.1 vs. 29.2 ± 7.5, P=0.229), length of hospital stay (8.8 ± 2.7 days vs. 9.1 ± 3.0 days, P=0.636), fluid intake time (3.1 ± 0.7 days vs. 3.2 ± 0.7 days, P=0.914), and morbidity of postoperative complications (6.7% [3/45] vs. 10.6% [5/47], P=0.499). Endoscopy performed 6 months postoperatively showed that the residual food (P=0.033), gastritis (P=0.029), and bile (P=0.022) classification score significantly decreased in the OGD group, and there were no significant differences 12 months postoperatively. OGD is a safe and effective reconstruction technique with comparable postoperative surgical outcomes and endoscopy results when compared with those of DSGD.

CFD modelling and experiments are carried out to study the influences of flow field on the measurement accuracy of ultrasonic water meters. The swirl generator and flow disturber are selected to change the flow field distributions inside the pipe. The calculation results show that the installation of left-handed swirl generator induces a specific flow pattern of the fluid inside the pipe, while the installation of flow disturber leads to the distortion of the axial velocity distributions. The critical distance of the fluid reaching the steady flow is 10D for left-handed swirl generator and flow disturber. In the experiment part, six different ultrasonic water meters are selected for the intrinsic errors tests. The results show that the installations of swirl generator and flow disturber induce the intrinsic errors shift to negative values. Compared with the flow disturber, the swirl generator has greater impact on the measurement accuracy.

Given that customer voice behaviors are confused with customer complaint behaviors in usage, this study thoroughly explains the essential differences between the two constructs. On that basis, this study investigates how employee–customer interaction (ECI) quality affects customers’ prohibitive voice behaviors, which is an crucial type of customer voice behaviors, by examining customer trust and identification as mediators. Data from 395 restaurant customers are collected and analyzed using structural equation modeling. Results show that ECI quality positively affects customers’ prohibitive voice behaviors. In this effect, customer trust and identification play direct and sequential mediating roles. This study contributes theoretically to the current knowledge by clearly distinguishing customer voice behaviors from customer complaint behaviors and by providing new insights into the mechanism of customers’ prohibitive voice behaviors from the perspectives of service interaction and relational benefit enhancement. The practical implications of this study can help pointedly foster customers’ prohibitive voice behaviors.

Employee turnover caused by over-qualification has become a new problem in organizational management. The mechanism underpinning the boundaries between perceived over-qualification and employee turnover, however, remains unclear. To address this gap, the current study employed multi-factor ANOVA, hierarchical regression analysis and the bootstrap method to analyze the relationship between perceived over-qualification and employee turnover intention based on the survey data of 396 respondents in China. Overall, the results revealed that perceived over-qualification was positively correlated with turnover intention. It was also found that self-efficacy had a mediating effect on the relationship between perceived over-qualification and turnover intention. Further, professional identity had a moderating effect on the relationship between perceived over-qualification and turnover intention. Our findings expand the boundary of influence around perceived over-qualification and provide theoretical support for employee management.

Abstract Background An accurate, reproducible, and comfortable immobilization device is essential for stereotactic radiotherapy (SBRT) in patients with lung cancer. This study compared thermoplastic masks (TMP) and vacuum cushion (VCS) system to assess the differences in interfraction and intrafraction setup accuracy and the impact of body mass index (BMI) with respect to the immobilization choice. Methods This retrospective study was conducted on patients treated with lung SBRT between 2012 and 2015 at the Zhejiang cancer hospital. The treatment setup accuracy was analyzed in 121 patients. A total of 687 cone beam computed tomography (CBCT) scans before treatment and 126 scans after treatment were recorded to determine the uncertainties, and plan target volume margins. Data were further stratified and analyzed by immobilization methods and patients’ BMI. The t-test (Welch) was used to assess the differences between the two immobilization systems when stratified by the patients’ BMI. Results For patients with BMI ≥ 24, the mean displacements for the TMP and VCS systems were 1.4 ± 1.2 vs. 2.4 ± 2.0 mm at medial-lateral (ML) direction (p

Background: We previously established a 53-gene prognostic signature for overall survival (OS) of gastric cancer patients. This retrospective multi-center study aimed to develop a clinically applicable gene expression detection assay and to investigate the prognostic value of this signature. Methods: A TCGA gastric adenocarcinoma cohort (TCGA-STAD) was used for comparing 53-gene signature with other gene signatures. A high-throughput mRNA hybridization gene expression assay was developed to quantify the expression of 53-genes in formalin-fixed paraffin-embedded tissues of 540 patients enrolled from three hospitals. 180 patents were randomly selected from two hospitals to build a prognostic prediction model based on the 53-gene signature using leave-p-out (one-third out) cross-validation method together with Cox regression and Kaplan-Meier analysis, and the model was assessed on three validation cohorts. Findings: In the evaluation phase, studies based on TCGA-STAD showed that the 53-gene signature was significantly superior to other three prognostic signatures and was independent of TCGA molecular subtypes and clinical factors. For clinical validation and utility, the prognostic scores were generated using the newly developed assay, which was reliable and sensitive, in 100 sampling training sets and were significantly associated with OS in 100 sampling validation sets. The scores were significantly associated with OS in three independent and combined validation cohorts, and in patients with stages II and III/IV. The multivariate Cox regression demonstrated that the prognostic power of the score was independent of clinical factors, consistent with those findings in the TCGA dataset. Finally, patients with good prognostic scores exhibited significantly a better 5-year OS rate from adjuvant FOLFOX chemotherapy after surgery than from other chemotherapies. Interpretation: The 53-gene prognostic score system is clinically applicable for predicting the OS of patients independent of clinical factors in gastric cancers, which could also be a promising predictive biomarker for FOLFOX regimen. Funding: Chinese National Science and Technology, National Natural Science Foundation and Natural Science Foundation of Jiangsu Province.

Tibial plateau fractures are multiple fracture patterns associated with soft-tissue injuries. Among which, the combined existence of posterolateral tibial plateau depression fracture with anterior cruciate ligament (ACL) rupture has been reported rarely. Meanwhile, surgical method for the treatment of depression fracture is fairly complex. The aim of this article is to show a case series of this unusual injury pattern and the therapy of posterolateral tibial plateau depression fracture accompanying ACL rupture. In our treatment, arthroscopy assisted reduction of depression fracture and ACL reconstruction reduces surgical trauma and leads to good functional recovery. We also review the current literature.

Purpose. To characterize the needs for visual improvement of new-visit patients with low vision. Methods. This cross-sectional study collected detailed information of patients presented at low-vision center of the Eye Hospital of Wenzhou Medical University between January 2015 and January 2017. A questionnaire interview, including demographic information and needs for visual improvement, was conducted before ophthalmology examinations. Results. The main need for visual improvement was engagement in hobbies (68.9%), followed by reading (20.9%), engaging in occupation (20.1%), and watching TV or movies (17.1%). Less than 10% of patients mentioned the demand of using public transportation (5.8%), doing housework (3.7%), writing (1.9%), walking on irregular surfaces (1.5%), driving (1.1%), and others (2.4%). Women were significantly associated with a concern for performing hobbies (OR 1.45, 95% CI 1.0–2.0) but associated with lower odds of reading (OR 0.46, 95% CI 0.3–0.7). Older subjects were more willing to choose hobbies (OR 1.35 (per 10-year increase), 95% CI 1.3–1.4), reading (OR 1.11 (per 10-year increase), 95% CI 1.0–1.2), watching TV or movies (OR 1.4 (per 10-year increase), 95% CI 1.3–1.6), and housework (OR 1.21 (per 10-year increase), 95% CI 1.0–1.5) than younger individuals. In comparison with younger participants, older individuals were less likely to choose occupation (OR 0.53 (per 10-year increase), 95% CI 0.5–0.6). No significant association was found between visual acuity and needs for visual improvement. Conclusion. Hobbies, reading, engaging in occupation, and watching TV were the most common needs for visual rehabilitation in patients with visual impairment. Gender and age showed a modest influence on the choice of different needs.

Purpose: Sternoclavicular joint is an amphiarthrodial joint formed by the clavicle and sternal manubrium. This joint becomes chronically unstable in case of a medial clavicle dislocation or fracture, and improper treatment could cause malformation and pain. We aimed to determine the efficacy of a novel sternoclavicular hook plate for treatment of unstable sternoclavicular joint dislocation or fracture. Methods: Between June 2011 and December 2013, the sternoclavicular hook plate was used to surgically treat 32 adult patients with unstable sternoclavicular joint dislocation or fracture. Of these, 12 and 5 patients suffered from anterior and posterior dislocation of the sternoclavicular joint, respectively, 10 had medial clavicle fracture, and 5 had fracture dislocation. For anterior fracture dislocation, the standard sternoclavicular hook plate was used, while for the posterior dislocation, screws were added at the distal end of the hook plate, anterior to the sternal manubrium, to prevent postoperative redislocation. Results: No intraoperative complications were observed during the procedure. Postoperative X-ray and computed tomography revealed normal anatomical positions of sternoclavicular joints and excellent positions of internal fixation. About 3–6 months after surgery, all patients achieved primary healing without redislocation of the sternoclavicular joint along with satisfactory restoration of anatomical structures of the medial clavicle; nine patients had swelling but no pain around the sternoclavicular joints. Internal fixation was removed in 29 patients 6–12 months postoperatively and no sequelae were observed. Conclusion: This novel sternoclavicular hook plate demonstrated excellent efficacy and could provide a reliable therapeutic approach for this kind of trauma.

Ras homologous C (RhoC) is expressed in various cancers, including hepatocellular carcinoma (HCC). In this study, we first analyzed RhoC expression in 46 HCC tissue specimens and found that RhoC expression was significantly increased in HCC tissues compared to the adjacent normal liver tissues. Next, we investigated the role of RhoC in malignant transformation of normal hepatocytes. The HL7702 cell line was stably transfected with a RhoC expression vector and then subjected to cell proliferation, differentiation, colony formation, migration and invasion assays, as well as nude mouse xenograft assays. Gene expressions in these cells were determined using RT-PCR and Western blot. Overexpression of RhoC significantly promoted proliferation and anchorage-independent growth of HL7702 cells, but suppressed cell differentiation, as compared with the parental cells and the empty vector-transfected control cells. Moreover, RhoC overexpression induced migration and invasion of HL7702 cells in vitro. Molecularly, RhoC increased the expression of cell cycle-related genes, matrix metalloprotease 2 (MMP2), MMP9 and vascular endothelial growth factor (VEGF). In addition, RhoC-transfected cells formed tumors in nude mice, whereas vector-transfected HL7702 cells did not form any tumors in nude mice. This study demonstrated the role of RhoC overexpression in malignant transformation of normal human hepatocytes, suggesting that RhoC may function as an oncogene in hepatocytes.

Prorocentrum donghaiense is a common but dominant harmful algal bloom (HAB) species, which is widely distributed along the China Sea coast. Development of methods for rapid and precise identification and quantification is prerequisite for early-stage warning and monitoring of blooms due to P. donghaiense. In this study, sequences representing the partial large subunit rDNA (D1-D2), small subunit rDNA and internal transcribed spacer region (ITS-1, 5.8S rDNA and ITS-2) of P. donghaiense were firstly obtained, and then seven candidate DNA probes were designed for performing fluorescence in situ hybridization (FISH) tests on P. donghaiense. Based on the fluorescent intensity of P. donghaiense cells labeled by the DNA probes, the probe DP0443A displayed the best hybridization performance. Therefore, a PNA probe (PP0443A) analogous to DP0443A was used in the further study. The cells labeled with the PNA probe displayed more intensive green fluorescence than that labeled with its DNA analog. The PNA probe was used to hybridize with thirteen microalgae belonging to five families, i.e., Dinophyceae, Prymnesiophyceae, Raphidophyceae, Chlorophyceae and Bacillariophyceae, and showed no visible cross-reaction. Finally, FISH with the probes PP0443A and DP0443A and light microscopy (LM) analysis aiming at enumerating P. donghaiense cells were performed on the field samples. Statistical comparisons of the cell densities (cells/L) of P. donghaiense in the natural samples determined by FISH and LM were performed using one-way ANOVA and Duncan's multiple comparisons of the means. The P. donghaiense cell densities determined by LM and the PNA probe are remarkably higher than (p