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Aim To optimize gastric cancer screening score and reduce screening costs using machine learning models. Methods This study included 228,634 patients from the Taizhou Gastric Cancer Screening Program. We used three machine learning models to optimize Li's gastric cancer screening score: Gradient Boosting Machine (GBM), Distributed Random Forest (DRF), and Deep Learning (DL). The performance of the binary classification models was evaluated using the area under the curve (AUC) and area under the precision–recall curve (AUCPR). Results In the binary classification model used to distinguish low-risk and moderate- to high-risk patients, the AUC in the GBM, DRF, and DL full models were 0.9994, 0.9982, and 0.9974, respectively, and the AUCPR was 0.9982, 0.9949, and 0.9918, respectively. Excluding Helicobacter pylori IgG antibody, pepsinogen I, and pepsinogen II, the AUC in the GBM, DRF, and DL models were 0.9932, 0.9879, and 0.9900, respectively, and the AUCPR was 0.9835, 0.9716, and 0.9752, respectively. Remodel after removing variables IgG, PGI, PGII, and G-17, the AUC in GBM, DRF, and DL was 0.8524, 0.8482, 0.8477, and AUCPR was 0.6068, 0.6008, and 0.5890, respectively. When constructing a tri-classification model, we discovered that none of the three machine learning models could effectively distinguish between patients at intermediate and high risk for gastric cancer (F1 scores in the GBM model for the low, medium and high risk: 0.9750, 0.9193, 0.5334, respectively; F1 scores in the DRF model for low, medium, and high risks: 0.9888, 0.9479, 0.6694, respectively; F1 scores in the DL model for low, medium, and high risks: 0.9812, 0.9216, 0.6394, respectively). Conclusion We concluded that gastric cancer screening indicators could be optimized when distinguishing low-risk and moderate to high-risk populations, and detecting gastrin-17 alone can achieve a good discriminative effect, thus saving huge expenditures.

Background: This study focused on the integrated post-acute care (PAC) stage of stroke patients, and employed a retrospective study to examine the satisfaction with life quality in two groups, one that received home-based rehabilitation and one that received hospital-based rehabilitation. A secondary purpose was to analyze the correlations among the index and components concerning their quality of life (QOL) and compare the advantages and disadvantages of these two approaches to PAC. Methods: This research was a retrospective study of 112 post-acute stroke patients. The home-based group received rehabilitation for one to two weeks, and two to four sessions per week. The hospital-based group received the rehabilitation for three to six weeks, and 15 sessions per week. The home-based group mainly received the training and guidance of daily activities at the patients’ residence. The hospital-based group mainly received physical facilitation and functional training in the hospital setting. Results: The mean scores of QOL assessment for both groups were found to be significantly improved after intervention. Between-group comparisons showed that the hospital-based group had better improvement than the home-based group in mobility, self-care, pain/discomfort and depression/anxiety. In the home-based group, the MRS score and the participant's age can explain 39.4% of the variance of QOL scores. Conclusion: The home-based rehabilitation was of lower intensity and duration than the hospital-based one, but it still achieved a significant improvement in QOL for the PAC stroke patients. The hospital-based rehabilitation offered more time and treatment sessions. Therefore hospital-based patients responded with better QOL outcomes than the home-based patients.

Abstract Background We performed Mendelian randomization (MR) to assess the causal effect of tea intake on rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods Genetic instruments for tea intake were obtained from a large genome-wide association study (GWAS) dataset of the UK Biobank. Genetic association estimates for RA (6236 cases and 147,221 controls) and SLE (538 cases and 213,145 controls) were obtained from the FinnGen study through the IEU GWAS database. Results MR analyses using the inverse-variance weighted method showed that tea intake was not associated with risk of RA [odds ratio (OR) per standard deviation increment in genetically predicted tea intake = 0.997, 95% confidence interval (CI) 0.658–1.511] and SLE (OR per standard deviation increment in genetically predicted tea intake = 0.961, 95% CI 0.299–3.092). Weighted median, weighted mode, MR-Egger, leave-one-out and multivariable MR controlling for several confounding factors including current tobacco smoking, coffee intake, and alcoholic drinks per week yielded completely consistent results. No evidence of heterogeneity and pleiotropy was found. Conclusion Our MR study did not suggest a causal effect of genetically predicted tea intake on RA and SLE.

“Center edge” is a classical theory used to explain education and national development in comparative higher education research. The study analyzes the objective trend and the role of public health and preventive medicine education from the theory through multidimensional interpretation of policy requirements, epidemic demand, education supply and foreign experience, points out that public health education should become the communication center from university to society and disseminate public health education among the public actively. But there are practical bottlenecks in the development of public health and preventive medicine education in China, such as insufficient professional identity from the vague target positioning, existing gap between education and new medicine standard, and the weakness of public health knowledge and skills in the training of clinical medical talents. It is necessary to reform the mode of public health and general medicine talent training comprehensively and gradually, especially to promote the enrollment of large categories, separate track training and layered training. At the same time, we should pool the joint efforts of schools, governments, relevant institutions and society to establish a full chain development mechanism for public health talents under the system integrating the concept of “starting-process-result”.

C30H36F2N6O9S, orthorhombic, P212121 (no. 19), a = 5.2364(8) Å, b = 10.0250(14) Å, c = 59.689(9) Å, V = 3133.4(8) Å3, Z = 4, Rgt(F) = 0.0384, wRref(F2) = 0.0969, T = 170 K.

For GaN-based vertical-cavity surface-emitting lasers (VCSELs), a suitable current confinement layer is essential for high-performance devices. The effect of different current confinement layers, including SiO2, AlN, and diamond, on the performance of GaN-based VCSELs was compared through simulation. The devices’ heat dissipation and current confinement characteristics were analyzed based on the electro-opto-thermal model. Considering thermal management, the diamond was a better candidate under high injected current. Benefiting from the excellent heat dissipation, the device with diamond shows a significant improvement in output power and the thermal roll-over current. This work gives a superior option for the current confinement layer and can be helpful for future design and fabrication of high-power GaN-based VCSELs.

Background: Sjögren’s syndrome (SjS) is a rare autoimmune disease, and despite our knowledge of SjS, we still lack effective treatments. Chloroquine drugs used to treat autoimmune diseases are still the primary medicine for SjS but increase the risk of chloroquine retinopathy. Objectives: The objective of this study is to use Optical Coherence Tomography Angiography (OCTA) images to monitor the microvascular changes in the fundus of SjS patients after hydroxychloroquine (HCQ) treatment and the feasibility of using them as diagnostic indicators. Design: This is a retrospective observational cohort study. Methods: Twelve healthy controls (HCs group; 24 eyes), 12 SjS patients (SjS group; 24 eyes), and 12 SjS patients treated with HCQ (HCQ group; 24 eyes) were recruited. Three-dimensional OCTA images of the retina were collected, and microvascular density was calculated for each eye. OCTA image segmentation for analysis was conducted using the central wheel division method (C1–C6), hemisphere segmentation method (SR, SL, IL, and IR), and the early treatment of diabetic retinopathy study method (ETDRS) (R, S, L, and I). Results: Retinal microvascular density was significantly lower in the SjS patients compared to the HCs group ( p

Aluminum is the second largest metallic material after steel. It is also an indispensable and basic raw material in the economic development of a country. Besides, aluminum is known as a green strategic material due to its efficient recycling performance. China’s aluminum industry has made remarkable achievements in technological innovation and scientific progress through decades of development. However, in recent years, the huge production scale of the aluminum industry has increasingly prominent problems of limited resources, rising energy costs, and environmental pollution. It should be realized that the development and survival of China’s aluminum industry have reached a very critical period. This paper comprehensively studied the current situation of the production and technology of China’s aluminum metallurgical industry. Major contradictions and challenges faced by the development of China’s aluminum industry in the fields of resources, energy, and the environment were revealed. In addition, the competitiveness of the production cost for Chinese alumina refining and aluminum smelting in the world was compared and analyzed. It is shown that the major factors restricting China’s aluminum industry development include the lack of high-quality bauxite resources, high energy costs, the requirement for further improvement of the production technology, and no effective treatment of solid and hazardous wastes. Hence, a development strategy for China’s aluminum industry was proposed, which includes the strict control of the production capacity without out-of-order expansion and establishment of a reasonable industry arrangement, optimization of the resource and energy supply structure, improvement of the production core competitiveness by implementing high-quality, energy-saving, and low consumption strategy, and realizing standardized discharge and resource utilization of waste gas emissions, wastewater, and solid disposals from China’s aluminum industry. The research results of this work are of great significance to the industrial structure adjustment and high-quality, sustainable development for China’s aluminum industry.