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Objective To explore the feasibility and rationality of advanced integrated two-stage laparoscopic simulation training course in standardized training of surgical residents. Methods From December 2019 to December 2021, the advanced integrated two-stage laparoscopic simulation training course was carried out among 2019—2020 surgical residents who received standardized training in our hospital. The course was divided into two stages. In the first stage, BEST (best essential surgical technology training) course, adopted Darwin® endoscopic training system, Tianyan® endoscopic training system, Microport® 3D laparoscopic training system and simple simulative models were used. The second stage, BEST PLUS course, same platform as that in BEST course and in vitro animal models were used. The questionnaire survey method (before and after class questionnaire) was adopted to evaluate the curriculum setting, such as curriculum form, simulators, teaching method, time arrangement, curriculum difficulty, training effect, curriculum satisfaction and so on. Results A total of 37 surgical residents completed the two-stage course training and the questionnaire survey. The overall satisfaction rate with the curriculum setting was 100%. There were 32 residents (86.5%) thought that first stage training course could significantly improve their clinical skills, 35 residents (94.6%) thought that second stage training course could significantly improve their clinical skills, and 36 resident (97.3%) thought that the first stage curriculum could significantly help them improve performance in the second stage curriculum. Conclusions The trainees had a high degree of recognition and satisfaction for the advanced integrated two-stage laparoscopic simulation training course. The overall design of course was reasonable and feasible, and was attractive to trainees.

Significant corrosion problems in materials related to marine engineering projects are bound to be a threat to overall operational safety and reliability. This paper investigates the influence of corrosion time on the material product film performance and its corrosion resistance, combined with the function integral algorithm. The gray matrix transform, image binarization, and wavelet transform of the function integral algorithm are used to establish the corrosion damage image recognition model and quantify the microscopic characteristics of corrosion damage based on the corrosion morphological features. Through the corrosion damage image recognition model, evaluation and analysis of common marine engineering materials 2205 duplex stainless steel and Q420 steel in chloride ion (Cl−). Test results show that: chloride ion on 2205 duplex stainless steel corrosion resistance 17.89μA cm−2 was the critical point, the higher the concentration played a suppressive effect. Chloride ions on Q420 steel corrosion resistance in lower solutions below 2.23μA cm−2 concentration, Q420 surface product film has a certain protective effect on the substrate. The corrosion characteristic value evaluation results based on the function integration algorithm are consistent with the electrochemical test results, so the evaluation model established in this paper can effectively evaluate the corrosion resistance of the material.

The satellite navigation industry is an emerging industry of strategic significance, and formulating long-term, macroscopic, and systematic industrial policies is crucial for the high-quality development of the satellite navigation industry and the formation of a new industrial pattern. The innovation ecosystem theory focuses on the dynamic transition between (1) system composition and elements of the system and (2) system and environment; it can assist the transformation of current policies for China’s satellite navigation industry. Considering relevant requirements of the 14th Five-Year Plan, this study reviews policy documents regarding China’ssatellite navigation industry and analyzes the direct, radial, and systemic coupling relationships between industrial policies and other innovation subjects and subsystems using the innovation ecosystem theory model and focusing on the elements of industrial policies. This study indicates that the current policies require improvement in terms of policy systems and subsystems and are not conducive to the systematic and coupled development of the industry. Therefore, we propose the following suggestions: (1) accelerating the top-level design of legislation and systems; (2) clarifying the role of government; and (3) improving the promotion and application of policies.

Cetuximab is one of the most valuable targeted therapy monoclonal antibodies in the treatment of metastatic colorectal cancer (CRC). However, the mechanisms affecting cetuximab resistance in CRC treatment remain unclear. Metabolism, especially fatty acid metabolism, has been reported to play an important role in tumor treatment. The correlation between cetuximab resistance and metabolism and whether it can be a new biomarker to evaluate the sensitivity of cetuximab in CRC treatment still need to be further explored. In this study, we perform a comprehensive analysis to confirm the relationship between fatty acid metabolism and cetuximab resistance, and the differentially expressed genes (DEGs) related to cetuximab drug resistance in CRC are screened by bioinformatics technology. We find that acetyl-CoA carboxylase beta (ACACB), ADH1C, CES1, MGLL, FMO5, and GPT are the hub DEGs, and ACACB is the most important biomarker among them. In addition, we systematically analyze the role of ACACB in the tumorigenesis of CRC, including tissue expression, CRC cell growth, cetuximab sensitivity, and potential downstream pathways, by using bioinformatics techniques, in vitro experiments and clinical cohort validation. Our results confirm that cetuximab resistance is correlated with metabolism. ACACB can lead to decreased sensitivity to cetuximab in CRC, and its mechanism may be related to EGFR phosphorylation, which could affect the activation of the mTOR/Akt signaling pathway and regulation of CDT1-, cyclin D1-, and p21-related cell cycle modulation.

Background: Mesenchymal stem cells (MSCs) have been identified to have a unique migratory pattern toward tumor sites across diverse cancer types, playing a crucial role in cancer progression, treatment resistance, and immunosuppression. This study aims to formulate a prognostic model focused on MSC‐associated markers to efficiently predict the clinical outcomes and responses to therapy in individuals with bladder cancer (BC). Methods: Clinical and transcriptome profiling data were extracted from The Cancer Genome Atlas Urothelial Bladder Carcinoma (TCGA‐BLCA) and GSE31684 databases. Systematic quantification of MSC prevalences and stromal indices was undertaken, culminating in the discernment of genes correlated with stromal MSCs following a thorough application of weighted gene coexpression network analysis techniques. Subsequently, an exhaustive risk signature pertinent to MSC was formulated by amalgamating methods from univariate and Least Absolute Shrinkage and Selection Operator (LASSO) Cox regression models. Drugs targeting genes associated with MSCs were screened using molecular docking. Results: The prognostic model for MSC incorporated five critical genes: ZNF165, matrix remodeling‐associated 7 (MXRA7), CEMIP, ADP‐ribosylation factor‐like 4C (ARL4C), and cerebral endothelial cell adhesion molecule (CERCAM). In the case of BC patients, stratification was performed into discrete risk categories, utilizing the median MSC risk score as a criterion. It was striking that those classified within the high‐MSC‐risk bracket demonstrated correlations with unfavorable prognostic implications. Enhanced responsiveness to immunotherapy in low‐MSC‐risk patients was delineated compared to their high‐MSC‐risk counterparts. A heightened receptivity was noted toward particular chemotherapy drugs, encompassing gemcitabine, vincristine, paclitaxel, gefitinib, and sorafenib, within this high‐risk group. Conversely, a superior reaction to cisplatin was distinctly evident among those marked by low MSC scores. The results of molecular docking demonstrated that kaempferol exhibited favorable docking with ZNF165, quercetin exhibited favorable docking with MXRA7, mairin exhibited favorable docking with CEMIP, and limonin diosphenol exhibited favorable docking with ARL4C. Conclusions: The five‐gene MSC prognostic model demonstrates substantial efficacy in prognosticating clinical outcomes and gauging responsiveness to chemotherapy and immunotherapy regimens. The genes ZNF165, MXRA7, CEMIP, ARL4C, and CERCAM are underscored as promising candidates warranting further exploration for anti‐MSC therapeutic strategies, thereby offering novel insights for personalized treatment approaches in BC. [ABSTRACT FROM AUTHOR]

Background The 'Learn, See, Practice, Prove, Do, Maintain' (LSPPDM) pedagogical framework is an evidence-based framework developed through a careful review and synthesis of the literature. The purpose of the study was to explore the effectiveness and applicability of the LSPPDM pedagogical framework in the laparoscopic training course for surgical residents. Methods Prospective study of surgical residents who underwent standardized surgical residency training in a single institution from December 2020 to December 2022. Trainees were randomized to either the pedagogical group (6-step LSPPDM pedagogical framework) or traditional group (2-step traditional approach with twice-weekly lectures and a weekly laparoscopic operating skills session). The Global Operative Assessment of Laparoscopic Skills scale was used for technical skills, and the Non-Technical Skills for Surgeons assessment form was used for non-technical skills. Results Sixty trainees were randomized. The pedagogical group scored higher on subjective perception (P < 0.050) and the theoretical assessment (mean(s.d.) 41.83(6.66)) than those in the traditional group (37.83(5.77)) (P = 0.016). Trainees in the pedagogical group took less time to complete the assessment of models, had fewer failures and higher scores, took less time to complete laparoscopic sutures and knots, showed better proficiency with laparoscopic instruments, and completed at higher quality (P < 0.050). Trainees performing laparoscopic cholecystectomy in animal models demonstrated higher technical and non-technical skill scores in the pedagogical group (P < 0.050). 'Tissue handling' and 'Decision making' were common areas for improvement for both groups of trainees. Conclusions The LSPPDM pedagogical framework is feasible and demonstrated improvements in technical and non-technical skills in surgical trainees compared to a traditional training programme. [ABSTRACT FROM AUTHOR]

Environmental barrier coatings (EBCs) are widely used to protect ceramic matrix composites (CMCs, SiCf/SiC, and Al2O3f/Al2O3), and they should have low thermal expansion coefficients (TECs) matching the CMCs and excellent mechanical properties to prolong their lifetime. Current EBC materials have disadvantages of phase transitions and insufficient mechanical properties, which affect their working temperatures and lifetime. It is necessary to develop new oxide EBCs. Ytterbium tantalate (YbTaO4) is a stable and novel EBC material, and we have improved the mechanical properties and TECs of Yb1−xAlxTaO4 (x = 0.05, 0.1, 0.2, 0.3, 0.4, 0.5) ceramics by replacing Yb with Al. XRD, SEM, and EDS are used to verify the crystal and microstructures, and nano-indentation is used to measure the modulus and hardness when changes in TECs are measured within a thermal expansion device. The results show that the phase structure of Yb1−xAlxTaO4 (x = 0.05, 0.1, 0.2, 0.3, 0.4, 0.5) is stable at 25–1400 °C within air atmosphere, and their high-temperature TECs (6.4–8.9 × 10−6 K−1, 1400 °C) are effectively regulated by introductions of different contents of Al, which enlarge their engineering applications for SiCf/SiC and Al2O3f/Al2O3 CMCs. The evolutions of TECs are analyzed from structural characteristics and phase compositions, and the increased TECs make Yb1−xAlxTaO4 potential EBCs for Al2O3 matrixes. Due to the high bonding strength of Al–O bonds, hardness, as well as Young's modulus, are enhanced with the increasing Al content, with Yb1−xAlxTaO4 (x = 0.05, 0.1, 0.2, 0.3, 0.4, 0.5) having a nano-hardness of 3.7–12.8 GPa and a Young's modulus of 100.9–236.6 GPa. The TECs of YbTaO4 are successfully regulated to expand their applications, and they match those of Al2O3 and SiC matrixes, as well as displaying improved mechanical properties. This work promotes applications of YbTaO4 as potential EBCs and provides a new way to regulate the TECs of tantalates. [ABSTRACT FROM AUTHOR]