Assessing public health service capability of primary healthcare personnel: a large-scale survey in Henan Province, China.

BACKGROUND: The public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement. METHODS: We used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences. RESULTS: The total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones. CONCLUSIONS: The public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

Genetic variants in primary cilia-related genes associated with the prognosis of first-line chemotherapy in colorectal cancer.

BACKGROUND: Primary cilia are antenna-like organelles that conduct physical and chemical signals, which affect cell proliferation, migration, and differentiation. Some researchers have reported the correlation between primary cilia-related genes and prognosis of colorectal cancer (CRC). METHODS: The association between single nucleotide polymorphisms (SNPs) of primary cilia-related genes and outcome after the first-line chemotherapy was explored by the Cox regression model. Expression qualitative trait locus (eQTL) analysis was performed to explore the impact of SNPs on gene expression. Tumor Immune Estimation Resource and TISIDB databases were used for investigating the relevance between ODF2L and tumor infiltration immune cells and immunomodulators. RESULTS: We identified that rs4288473 C allele of ODF2L had poor progression-free survival (PFS) and overall survival (OS) of CRC patients in the additive model (adjusted HRPFS = 1.39, 95% CI = 1.14-1.70, p = 1.36 × 10-3 , and adjusted HROS = 1.31, 95% CI = 1.03-1.65, p = 2.62 × 10-2 ). The stratified analysis indicated that rs4288573 CC/CT genotype was involved with poor prognosis in the irinotecan-treated subgroup (PPFS = 1.03 × 10-2 , POS = 3.29 × 10-3 ). Besides, ODF2L mRNA expression level was notably up-regrated in CRC tissues. The C allele of rs4288573 was notably related to higher ODF2L mRNA expression levels based on eQTL analysis. Functionally, knockdown of ODF2L inhibited cell proliferation and decrease the chemoresistance of HCT-116 and DLD-1 cells to irinotecan. CONCLUSION: Our study indicates that rs4288573 in ODF2L is a potential predictor of the chemotherapy prognosis of CRC.

Designing a microbial fermentation-functionalized alginate microsphere for targeted release of 5-ASA using nano dietary fiber carrier for inflammatory bowel disease treatment.

Patients with inflammatory bowel disease (IBD) always suffer from severe abdominal pain and appear to be at high risk for colorectal cancer. Recently, the co-delivery of targeted drugs and gut microbiota has developed into an attractive strategy. A new strategy using gut microbiota fermentation to overcome the interspace diffuse resistance from the mucus layer to control drug release in inflammatory bowel sites (IBS sites) has not yet been available. Here, we designed an alginate hydrogel microsphere encapsulating bifidobacterium (Bac) and drug-modified nanoscale dietary fibers (NDFs). The hydrogel microsphere is responsible for protecting drugs from acidic and multi-enzymatic environments and delivering drugs to the colorectum. Subsequently, the fermentation of Bac by digesting NDFs and proteins as carbon and nitrogen sources can promote drug release and play a probiotic role in the gut microbiota. In vitro evidence indicated that small-sized NDF (NDF-1) could significantly promote short-chain fatty acid (SCFA) expression. Notably, NDF-1 hydrogel microspheres showed a boost release of 5-ASA in the IBS sites, resulting in the amelioration of gut inflammation and remodeling of gut microbiota in chronic colitis mice. This study developed a controlled release system based on microbial fermentation for the treatment of IBD.

Deciphering salt tolerance in tetraploid honeysuckle (Lonicera japonica Thunb.) from ion homeostasis, water balance and antioxidant defense.

Polyploid plants are usually salt tolerant, but the underlying mechanisms remain fragmental. This study aimed to dissect salt resistance of tetraploid honeysuckle (Lonicera japonica Thunb.) from ion balance, osmotic adjustment and antioxidant defense by contrasting with its autodiploid through pot experiments. Less salt-induced reduction in leaf and root biomass confirmed higher tolerance in tetraploid honeysuckle, and moreover, its greater stability of photosynthetic apparatus was verified by mild influence on delayed chlorophyll fluorescence transients. Compared with the diploid, greater root Na+ exclusion helped alleviate salt-induced decrease in leaf K+/Na+ for maintaining ion balance in tetraploid honeysuckle, and relied on Na+/H+ antiporter activity, because their difference of root Na+ exclusion disappeared after applying a specific inhibitor of Na+/H+ antiporter. Lower reduction in leaf relative water content suggested higher tolerance to osmotic pressure in tetraploid honeysuckle under salt stress, which hardly resulted from osmotic adjustment given the similar decrease extent of leaf osmotic potential with that in the diploid. In contrast to significant elevated leaf lipid peroxidation and superoxide dismutase and ascorbate peroxidase activities in the diploid, no obvious changes in them suggested that tetraploid honeysuckle never suffered salt-induced oxidative stress. According to more accumulated leaf chlorogenic acid and phenolics and greater elevated leaf phenylalanine ammonia-lyase activity and transcription, leaf phenolic synthesis was enhanced greater in tetraploid honeysuckle upon salt stress, which might serve to prevent oxidative threat by consuming reducing power. In conclusion, polyploidy enhanced salt tolerance in honeysuckle by maintaining ion homeostasis and water balance and preventing oxidative stress.

Time-frequency co-movement and risk connectedness among cryptocurrencies: new evidence from the higher-order moments before and during the COVID-19 pandemic.

Analyzing comovements and connectedness is critical for providing significant implications for crypto-portfolio risk management. However, most existing research focuses on the lower-order moment nexus (i.e. the return and volatility interactions). For the first time, this study investigates the higher-order moment comovements and risk connectedness among cryptocurrencies before and during the COVID-19 pandemic in both the time and frequency domains. We combine the realized moment measures and wavelet coherence, and the newly proposed time-varying parameter vector autoregression-based frequency connectedness approach (Chatziantoniou et al. in Integration and risk transmission in the market for crude oil a time-varying parameter frequency connectedness approach. Technical report, University of Pretoria, Department of Economics, 2021) using intraday high-frequency data. The empirical results demonstrate that the comovement of realized volatility between BTC and other cryptocurrencies is stronger than that of the realized skewness, realized kurtosis, and signed jump variation. The comovements among cryptocurrencies are both time-dependent and frequency-dependent. Besides the volatility spillovers, the risk spillovers of high-order moments and jumps are also significant, although their magnitudes vary with moments, making them moment-dependent as well and are lower than volatility connectedness. Frequency connectedness demonstrates that the risk connectedness is mainly transmitted in the short term (1-7 days). Furthermore, the total dynamic connectedness of all realized moments is time-varying and has been significantly affected by the outbreak of the COVID-19 pandemic. Several practical implications are drawn for crypto investors, portfolio managers, regulators, and policymakers in optimizing their investment and risk management tactics.

[Effects of Trichoderma on nitrogen absorption and use efficiency in Lycium chinense roots under saline stress]. / æœ¨éœ‰å¯¹ç›æ¸é€†å¢ƒä¸‹æž¸æžæ ¹ç³»æ°®ç´ å¸æ”¶å’Œæ°®ç´ åˆ©ç”¨æ•ˆçŽ‡çš„å½±å“.

To clarify the mechanisms underlying the improvement of Trichoderma on Chinese wolfberry (Lycium chinense) growth under saline stress, we analyzed the effects of application of organic fertilizer, Trichoderma agent and fertilizer on nitrogen uptake, assimilation, accumulation and use efficiency in Chinese wolfberry, based on a pot experiment with coastal saline soil. The organic fertilizer was the sterilization substance of Trichoderma fertilizer without viable Trichoderma, without any difference in the content of nutrients (such as nitrogen, phosphorus and potassium) between them. The results showed that the application of organic fertilizer, Trichoderma agent and ferti-lizer significantly increased NO3- and NH4+ influx rate in meristematic zone and NO3- influx rate in maturation zone of roots. The magnitude of such enhancement was greater in the application with Trichoderma fertilizer than organic fertilizer. Compared with the control, the application of Trichoderma agent and fertilizer significantly increased root, stem and leaf biomass and nitrogen content as well as plant nitrogen accumulation, strengthened root and leaf nitrate reductase, nitrite reductase and glutamine synthetase activities, and elevated nitrogen uptake efficiency, photosynthetic rate, stable carbon isotope abundance and photosynthetic nitrogen use efficiency. For all those variables, the beneficial effect was obviously stronger in the application with Trichoderma fertilizer than organic fertilizer. Therefore, Trichoderma facilitated nitrogen uptake, assimilation and accumulation in Chinese wolfberry under saline stress, improved photosynthetic carbon fixation ability and nitrogen use efficiency, and ultimately promoted plant growth.

Dissecting photosynthetic electron transport and photosystems performance in Jerusalem artichoke (Helianthus tuberosus L.) under salt stress.

Jerusalem artichoke (Helianthus tuberosus L.), a vegetable with medical applications, has a strong adaptability to marginal barren land, but the suitability as planting material in saline land remains to be evaluated. This study was envisaged to examine salt tolerance in Jerusalem artichoke from the angle of photosynthetic apparatus stability by dissecting the photosynthetic electron transport process. Potted plants were exposed to salt stress by watering with a nutrient solution supplemented with NaCl. Photosystem I (PSI) and photosystem II (PSII) photoinhibition appeared under salt stress, according to the significant decrease in the maximal photochemical efficiency of PSI (△MR/MR0) and PSII. Consistently, leaf hydrogen peroxide (H2O2) concentration and lipid peroxidation were remarkably elevated after 8 days of salt stress, confirming salt-induced oxidative stress. Besides photoinhibition of the PSII reaction center, the PSII donor side was also impaired under salt stress, as a K step emerged in the prompt chlorophyll transient, but the PSII acceptor side was more vulnerable, considering the decreased probability of an electron movement beyond the primary quinone (ETo/TRo) upon depressed upstream electron donation. The declined performance of entire PSII components inhibited electron inflow to PSI, but severe PSI photoinhibition was not averted. Notably, PSI photoinhibition elevated the excitation pressure of PSII (1-qP) by inhibiting the PSII acceptor side due to the negative and positive correlation of △MR/MR0 with 1-qP and ETo/TRo, respectively. Furthermore, excessive reduction of PSII acceptors side due to PSI photoinhibition was simulated by applying a specific inhibitor blocking electron transport beyond primary quinone, demonstrating that PSII photoinhibition was actually accelerated by PSI photoinhibition under salt stress. In conclusion, PSII and PSI vulnerabilities were proven in Jerusalem artichoke under salt stress, and PSII inactivation, which was a passive consequence of PSI photoinhibition, hardly helped protect PSI. As a salt-sensitive species, Jerusalem artichoke was recommended to be planted in non-saline marginal land or mild saline land with soil desalination measures.

Revealing Genetic Differences in Fiber Elongation between the Offspring of Sea Island Cotton and Upland Cotton Backcross Populations Based on Transcriptome and Weighted Gene Coexpression Networks.

Fiber length is an important indicator of cotton fiber quality, and the time and rate of cotton fiber cell elongation are key factors in determining the fiber length of mature cotton. To gain insight into the differences in fiber elongation mechanisms in the offspring of backcross populations of Sea Island cotton Xinhai 16 and land cotton Line 9, we selected two groups with significant differences in fiber length (long-fiber group L and short-fiber group S) at different fiber development stages 0, 5, 10 and 15 days post-anthesis (DPA) for transcriptome comparison. A total of 171.74 Gb of clean data was obtained by RNA-seq, and eight genes were randomly selected for qPCR validation. Data analysis identified 6055 differentially expressed genes (DEGs) between two groups of fibers, L and S, in four developmental periods, and gene ontology (GO) term analysis revealed that these DEGs were associated mainly with microtubule driving, reactive oxygen species, plant cell wall biosynthesis, and glycosyl compound hydrolase activity. Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis indicated that plant hormone signaling, mitogen-activated protein kinase (MAPK) signaling, and starch and sucrose metabolism pathways were associated with fiber elongation. Subsequently, a sustained upregulation expression pattern, profile 19, was identified and analyzed using short time-series expression miner (STEM). An analysis of the weighted gene coexpression network module uncovered 21 genes closely related to fiber development, mainly involved in functions such as cell wall relaxation, microtubule formation, and cytoskeletal structure of the cell wall. This study helps to enhance the understanding of the Sea Island-Upland backcross population and identifies key genes for cotton fiber development, and these findings will provide a basis for future research on the molecular mechanisms of fiber length formation in cotton populations.

Adjuvant-free cellulose nanofiber vaccine induces permanent humoral immune response in mouse.

Vaccines have become one of the most effective strategies to deal with various infectious diseases and chronic noninfectious diseases, such as SARS virus, Novel Coronavirus, cancer, etc. However, recent studies have found that the neutralizing antibody titers induced by vaccines would drop to half level or even lower after vaccination. In this study, we designed a novel small-sized positively charged nanofiber-1 (PEI-CNF-1) as a vaccine carrier, which can induce a high long-term humoral immune response by controlled release of antigen. Further studies showed that PEI-CNF-1 could significantly induce the release of immune response factor IL-1ßand bone marrow-derived cell (BMDC) maturation. Moreover, compare to other cellulose nanofibers (CNFs), PEI-CNF-1 combined antigen (ovalbumin, OVA) induced and maintained the highest and longest antibody titers after vaccination. Interestingly, the antibody titers have no significant difference between at 21 and 90 d. Mechanically, we found that PEI-NCF-1 not only could control the slow-release of antigen, but also could be more easily swallowed by macrophages and metabolized by the bodies, thus presenting antigen more effectively. In conclusion, we believe that PEI-CNF-1 have a very high application prospect in inducing long-term humoral immune response, so as to achieve efficient prevention effect to epidemic viruses.

Machine learning-based operation skills assessment with vascular difficulty index for vascular intervention surgery.

An accurate assessment of surgical operation skills is essential for improving the vascular intervention surgical outcome and the performance of endovascular surgery robots. In existing studies, subjective and objective assessments of surgical operation skills use a variety of indicators, such as the operation speed and operation smoothness. However, the vascular conditions of particular patients have not been considered in the assessment, leading to deviations in the evaluation. Therefore, in this paper, an operation skills assessment method including the vascular difficulty level index for catheter insertion at the aortic arch in endovascular surgery is proposed. First, the model describing the difficulty of the vascular anatomical structure is established with characteristics of different aortic arch branches based on machine learning. Afterwards, the vascular difficulty level is set as an objective index combined with operating characteristics extracted from the operations performed by surgeons to evaluate the surgical operation skills at the aortic arch using machine learning. The accuracy of the assessment improves from 86.67 to 96.67% after inclusion of the vascular difficulty as an evaluation indicator to more objectively and accurately evaluate skills. The method described in this paper can be adopted to train novice surgeons in endovascular surgery, and for studies of vascular interventional surgery robots. Graphical abstract Operation skill assessment with vascular difficulty for vascular interventional surgery.

A novel noncontact detection method of surgeon's operation for a master-slave endovascular surgery robot.

Master-slave endovascular interventional surgery (EIS) robots have brought revolutionary advantages to traditional EIS, such as avoiding X-ray radiation to the surgeon and improving surgical precision and safety. However, the master controllers of most of the current EIS robots always lead to bad human-machine interaction, because of the difference in nature between the rigid operating handle and the flexible medical catheter used in EIS. In this paper, a noncontact detection method is proposed, and a novel master controller is developed to realize real-time detection of surgeon's operation without interference to the surgeon. A medical catheter is used as the operating handle. It is enabled by using FAST corner detection algorithm and optical flow algorithm to track the corner points of the continuous markers on a designed sensing pipe. A mathematical model is established to calculate the axial and rotational motion of the sensing pipe according to the moving distance of the corner points in image coordinates. A master-slave EIS robot system is constructed by integrating the proposed master controller and a developed slave robot. Surgical task performance evaluation in an endovascular evaluator (EVE) is conducted, and the results indicate that the proposed detection method breaks through the axial measuring range limitation of the previous marker-based detection method. In addition, the rotational detection error is reduced by 92.5% compared with the previous laser-based detection method. The results also demonstrate the capability and efficiency of the proposed master controller to control the slave robot for surgical task implementation. Graphical abstract A novel master controller is developed to realize real-time noncontact detection of surgeon's operation without interference to the surgeon. The master controller is used to remotely control the slave robot to implement certain surgical tasks.

A CNN-based prototype method of unstructured surgical state perception and navigation for an endovascular surgery robot.

Performance of robot-assisted endovascular surgery (ES) remains highly dependent on an individual surgeon's skills, due to common adoption of master-slave robotic structure. Surgeons' skill modeling and unstructured surgical state perception pose prohibitive challenges for an autonomous ES robot. In this paper, a novel convolutional neural network (CNN)-based framework is proposed to address these challenges for navigation of an ES robot based on surgeons' skill learning. An operating action probability estimator is proposed by integrating a two-dimensional CNN, with which the features of a surgical state image are extracted and then directly mapped to the action probability. A one-dimensional CNN with multi-input is developed to recognize the guide wire operating force condition. An eye-hand collaborative servoing algorithm is proposed to combine the outputs of these two networks and to control the robot under a closed-loop architecture. A real-world ES robot is employed for data collection and task performance evaluation in laboratory condition. Compared with the state of the art, the CNN-based method shows its capability of adapting to different situations and achieves similar success rate and average operating time. Robotic operation performs similar operating trajectory and maintains similar level of operating force with manual operation. The CNN-based method can be easily extended to many other surgical robots. Graphical abstract A surgeon's guide wire operating skills in endovascular surgery (ES) is learned by the proposed CNN-based method. Then, the learned model is used for autonomous control of a ES robot with surgical state input (images and operating force).

Operation evaluation in-human of a novel remote-controlled vascular interventional robot.

Remote-controlled vascular interventional robots (RVIRs) are being developed to increase the accuracy of surgical operations and reduce the number of occupational risks sustained by intervening physicians, such as radiation exposure and chronic neck/back pain. However, complex control of the RVIRs improves the doctor's operation difficulty and reduces the operation efficiency. Furthermore, incomplete sterilization of the RVIRs will increase the risk of infection, or even cause medical accidents. In this study, we introduced a novel method that provides higher operation efficiency than a previous prototype and allows for complete robot sterilization. A prototype was fabricated and validated through laboratory setting experiments and an in-human experiment. The results illustrated that the proposed RVIR has better performance compared with the previous prototype, and preliminarily demonstrated that the proposed RVIR has good safety and reliability and can be used in clinical surgeries.

[Application of microbial fuel cell (MFC) in solid waste composting].

Microbial fuel cell (MFC) is a new technology that can recover energy from biomass with simultaneous waste treatment. This technique has been developed fast in recent years in combining with environmental techniques such as wastewater treatment, degradation of toxic pollutants and desalination. With the increase of solid waste, applying MFC in composting is promising due to its property of waste disposal with simultaneous energy generation. In this paper, the microbial community of MFCs during composting was summarized. Four major influencing factors including electrodes, separators, oxygen supplement and configurations on the performance of composting MFCs were discussed. The characteristics of composting MFC as a new technique for reducing solid waste were as follows: high microbial biomass resulted in the high current density; adaptable to different environmental conditions; self-adjustable temperature with high energy efficiency; the transportation of proton from anode to cathode were limited by different solid substrates.