Synergetic interface engineering and space-confined effect in CoSe2@Ti3C2Tx heterostructure for high power and long life sodium ion capacitors.

The intriguing characteristics of two-dimensional (2D) heterostructures stem from their unique interfaces, which can improve ion storage capability and rate performance. However, there are still challenges in increasing the proportion of heterogeneous interfaces in materials and understanding the complex interaction mechanisms at these interfaces. Here, we have successfully synthesized confined CoSe2 within the interlayer space of Ti3C2Tx through a simple solvothermal method, resulting in the formation of a superlattice-like heterostructures of CoSe2@Ti3C2Tx. Both density functional theory (DFT) calculations and experimental results show that compared with CoSe2 and Ti3C2Tx, CoSe2@Ti3C2Tx can significantly improve adsorption of Na+ ions, while maintaining low volume expansion and high Na+ ions migration rate. The heterostructure formed by MXene and CoSe2 is a Schottky heterostructure, and its interfacial charge transfer induces a built-in electric field that promotes rapid ion transport. When CoSe2@Ti3C2Tx was used as an anode material, it exhibits a high specific capacity of up to 600.1 mAh/g and an excellent rate performance of 206.3 mAh/g at 20 A/g. By utilizing CoSe2@Ti3C2Tx as the anode and activated carbon (AC) as the cathode, the sodium-ion capacitor of CoSe2@Ti3C2Tx//AC exhibits excellent energy and power density (125.0 Wh kg-1 and 22.5 kW kg-1 at 300.0 W kg-1 and 37.5 Wh kg-1, respectively), as well as a long service life (86.3 % capacity retention over 15,300 cycles at 5 A/g), demonstrating its potential for practical applications.

The Impact of Perceived Community Services for the Elderly on Self-Rated Health: An Analysis Utilizing a Mediated Latent Growth Model.

Background: This study aims to investigate the relationship between older adults' perceived community services for the elderly (PCSE), life satisfaction (LS), and self-rated health (SRH). Methods: Data from four rounds of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018 were used. A total of 2454 older adults were obtained. Unconditional Least Squares (ULS) was used to measure PCSE, LS, and SRH growth trajectories without covariates. Finally, a mediating latent growth model was constructed using Mplus 8.3 to examine the mediating role of LS in the relationship between PCSE and SRH after adjusting for some demographic characteristics. Results: The results from the ULS method indicate that the intercepts and slopes for PCSE and LS are significantly negatively correlated (ß 1 = -0.629, ß 2 = -0.579, p < 0.001). Additionally, there is a significant positive correlation between the intercept and slope of health levels (ß = 0.774, p < 0.001). Using a parallel growth model, significant regression coefficients were found between the intercept of PCSE and the intercepts of SRH and LS (ß 1 = -0.335, ß 2 = 0.378, p < 0.01). Similarly, the regression coefficients between the slope of PCSE and the slopes of SRH and LS were also significant (ß 1 = -0.532, ß 2 = 0.344, p < 0.01). Furthermore, the regression coefficient between the intercept of LS and the intercept of SRH was significant (ß = 0.415, p < 0.001). The regression coefficient between the slope of LS and the slope of SRH was also found to be significant (ß = 0.729, p < 0.001). Conclusion: It is essential to ensure adequate supply and accessibility of community services for older adults. LS especially is, and should be a promising target for assessing the quality of life and utilization of PCSE supply.

Fluspirilene exerts an anti-glioblastoma effect through suppression of the FOXM1-KIF20A axis.

Given the infiltrative nature of human glioblastoma (GBM), cocktail drug therapy will remain a vital tool for the treatment of the disease. We investigated fluspirilene, perphenazine, and sulpiride, three classic anti-schizophrenic drugs, as possible anti-GBM agents. The CCK-8 assay demonstrated that fluspirilene possesses the most outstanding anti-GBM effect. We performed molecular mechanisms studies in vitro and an orthotopic xenograft model in mice. Fluspirilene inhibited proliferation and migration in vitro in U87MG and U251 GBM cell lines. Flow cytometry demonstrated that treatment increased apoptosis and cells accumulated in the G2/M phase. Our analysis of publicly available expression data for several cell lines treated with the drug led to the identification of several genes, including KIF20A, that are downregulated by fluspirilene and lead to growth inhibition/apoptosis. We also demonstrated that siRNA knockdown of KIF20A, a member of the kinesin family, attenuated cell proliferation in GBM cells and an orthotopic xenograft model in mice. A regulator of KIF20A, the oncogenic transcription factor FOXM1, was identified using the String database, which harbors protein interaction networks. In fluspirilene-treated cells, FOXM1 protein was decreased, indicating that KIF20A was downregulated in the presence of the drug due to decreased FOXM1 protein. These results demonstrate that fluspirilene is an effective anti-GBM agent that works by suppressing the FOXM1-KIF20A oncogenic axis.

Development of Chinese college students' perception teacher differential behavior scale and its reliability and validity test.

OBJECTIVE: To compile a scale of Chinese college students' perception of teachers' differential behavior and to provide a reference for college students to establish correct life values, promote college students' physical and mental health, and reduce teachers' differential treatment. METHODS: Open-ended questionnaires and expert interviews were used to conduct interviews and correspondence with 58 college students, ten psychologists, and six psychologists to form an initial questionnaire. Then, the scale's exploratory factor analysis, confirmatory factor analysis, and reliability and validity test were conducted on 7053 college students from 18 universities in 6 provinces (municipalities directly under the Central Government). RESULTS: The Chinese college students' perception of teachers' differential behavior scale has two dimensions: teacher prejudice and preference. Each dimension includes three aspects: emotional feedback, behavior orientation, and opportunity privilege, and each aspect have a total of 4 items. The consistency test coefficients of each dimension and each factor of the prepared scale are all above 0.7, and the split-half reliability is above 0.6. Confirmatory factor analysis shows that the six-factor structural model fits well (χ2/df = 4.287, RMSEA = 0.066, CFI = 0.950, TLI = 0.919). Using the generalized anxiety disorder scale and the patient health questionaire-9items as empirical criteria, each factor in the scale demonstrated significant correlations with both the GAD scale and the patient health questionaire-9items. CONCLUSIONS: The Chinese college students' perception of teachers' differential behavior scale has a two-dimensional six-factor structure and has good reliability and validity. It can be used as an effective tool to measure Chinese college students' perceived teacher differential behavior.

Prognostic Nomograms for Patients With NF-Pan-NET After Pancreatectomy: A Retrospective Analysis Based on SEER Database.

AIMS: Surgical resection is the primary treatment option for patients diagnosed with nonfunctional pancreatic neuroendocrine tumors (NF-Pan-NETs). However, the postoperative prognostic evaluation for NF-Pan-NET patients remains obscure. This study aimed to construct an efficient model to predict the prognosis of NF-Pan-NET patients who have received surgical resection. METHODS: NF-Pan-NET patients after pancreatectomy were retrieved from the SEER database for the period of 2010 to 2019. A total of 2844 patients with NF-Pan-NET from SEER database were included in our study. After careful screening, six clinicopathological variables including age, grade, AJCC T stage, AJCC N stage, AJCC M stage, and chemotherapy were selected to develop nomograms to predict overall survival (OS) and cancer-specific survival (CSS) respectively of the patients. RESULTS: The novel models demonstrated high accuracy and discrimination in prognosticating resected NF-Pan-NET through various validation methods. Furthermore, the risk subgroups classified by the newly developed risk stratification systems based on the nomograms exhibited significant differences in both OS and CSS, surpassing the efficacy of the AJCC 8th TNM staging system. Novel nomograms and corresponding risk classification systems were developed to predict OS and CSS in patients with NF-Pan-NET after pancreatectomy. CONCLUSION: The models demonstrated superior performance compared to traditional staging systems, providing clinicians with more accurate and personalized guidance for postoperative surveillance and treatment.

Metal-N Coordination in Lithium-Sulfur Batteries: Inhibiting Catalyst Passivation.

Lithium-sulfur (Li-S) batteries exhibit great potential as the next-generation energy storage techniques. Application of catalyst is widely adopted to accelerate the redox kinetics of polysulfide conversion reactions and improve battery performance. Although significant attention has been devoted to seeking new catalysts, the problem of catalyst passivation remains underexplored. Herein, we find that metal-N coordination has a previously overlooked role in preventing the catalyst passivation. In the case of nickel, the Ni catalyst reacts with S8 to produce NiSx compounds on the surface, leading to catalyst passivation and slow the kinetics of LiPSs conversion. In contrast, when Ni is coordinated with N (typically Ni-N4), S8 remains stable on the surface. The Ni-N4 exhibits excellent resistance to passivation and rapid kinetics of LiPSs conversion. Consequently, the sulfur cathode with Ni-N4 exhibits a high rate capability of 604.11 mAh g-1 at 3 C and maintains a low capacity decay rate of 0.046 % per cycle over 1000 cycles at 2 C. Furthermore, preventing S passivation in M-N coordination applies not only to Ni-N4 but also to various coordination numbers and transition metals. This study reveals a new aspect of metal-N coordination in inhibiting catalyst passivation, improving our understanding of catalysts in Li-S batteries.

Immunotherapy and liver cancer research trends and the 100 most cited articles: A bibliometric analysis.

BACKGROUND: Bibliometric analysis of liver cancer research, particularly in immunotherapy, reveals crucial insights. The US leads in liver cancer mortality but ranks fifth globally. OBJECTIVE: Scopus database analysis identified 2,349 papers, with the top 100 ranging from 127 to 4,959 citations. Notably, "Microenvironmental Regulation of Tumours Progression and Metastasis" in the Journal of Nature Medicine garnered the highest citations. METHODS: Journals like the Journal of Hepatology, Hepatology, and Nature Reports Clinical Oncology contributed significantly. Understanding molecular mechanisms and prognostic indicators is paramount for advancing combination therapies. RESULTS: For better patient outcomes, research trends in liver cancer immunotherapy point to improved treatment protocols, knowledge of the tumor microenvironment, combining therapies, predicting disease course, international cooperation, sophisticated surgical techniques, early detection, oncolytic virotherapy, and patient-centered care. CONCLUSIONS: This research underscores immunotherapy's pivotal role and encourages further exploration, offering valuable insights into liver cancer treatment trends.

Evaluating precision medicine approaches for gene therapy in patient-specific cellular models of Bietti crystalline dystrophy.

Patient-specific induced pluripotent stem cell-derived (iPSC-derived) cell lines allow for therapies to be tailored to individual patients, increasing therapeutic precision and efficiency. Bietti crystalline dystrophy (BCD) is a rare blinding disease estimated to affect about 67,000 individuals worldwide. Here, we used iPSC-derived retinal pigment epithelium (iRPE) cells from patients with BCD to evaluate adeno-associated virus-mediated (AAV-mediated) gene augmentation therapy strategies. We found that BCD iRPE cells were vulnerable to blue light-induced oxidative stress and that cellular phenotype can be quantified using 3 robust biomarkers: reactive oxygen species (ROS), 4-hydroxy 2-nonenal (4-HNE) levels, and cell death rate. Additionally, we demonstrated that AAV-mediated gene therapy can significantly reduce light-induced cell death in BCD iRPE cells. This is the first proof-of-concept study to our knowledge to show that AAV-CYP4V2 gene therapy can be used to treat light-induced RPE damage in BCD. Furthermore, we observed significant variability in cellular phenotypes among iRPE from patients with BCD of divergent mutations, which outlined genotype-phenotype correlations in BCD patient-specific cell disease models. Our results reveal that patient-specific iRPE cells retained personalized responses to AAV-mediated gene therapy. Therefore, this approach can advance BCD therapy and set a precedent for precision medicine in other diseases, emphasizing the necessity for personalization in healthcare to accommodate individual diversity.

Sulfonic Acid-Functionalized Graphdiyne for Effective Li-S Battery Separators.

Lithium-sulfur (Li-S) batteries enable a promising high-energy-storage system while facing practical challenges regarding lithium dendrites and lithium polysulfides (LiPSs) shuttling. Herein, a fascinating SO3H-functionalized graphdiyne (SOGDY) was developed by grafting SO3H onto GDY to modify the separator in Li-S batteries. It realizes structure-retained material transformation, that is, SOGDY retains the crystalline all-carbon network and uniform subnanopores from the initial GDY. The abundant SO3H and uniform pores create a rapid Li+ transport relay station, benefit rapid Li+ transport and even lithium deposition, and prevent lithium dendrite growth. The spatial obstruction and strong polar adsorption sites from SO3H effectively inhibit LiPS shuttling. Additionally, SOGDY establishes a fast electron-transfer pathway to facilitate the LiPS conversion. The SOGDY/PP separator exhibited steady cycling at 1 mA cm-2 over 3500 h in the Li∥Li symmetric battery and achieved outstanding low-temperature and high-rate performance in the Li-S battery with a high initial specific capacity of 804.5 mA h g-1 and a final capacity of 504.9 mA h g-1 after 500 cycles at 3 C and -10 °C. This work demonstrates that introducing a stable all-carbon network and uniform functionalized nanopores is an effective strategy to modify the Li-S battery separator.

Development and Validation of an ICU-Venous Thromboembolism Prediction Model Using Machine Learning Approaches: A Multicenter Study.

Purpose: The purpose of this study was to establish and validate machine learning-based models for predicting the risk of venous thromboembolism (VTE) in intensive care unit (ICU) patients. Patients and Methods: The clinical data of 1494 ICU patients who underwent Doppler ultrasonography or venography between December 2020 and March 2023 were extracted from three tertiary hospitals. The Boruta algorithm was used to screen the essential variables associated with VTE. Five machine learning algorithms were employed: Random Forest (RF), eXtreme Gradient Boosting (XGBoost), Support Vector Machine (SVM), Gradient Boosting Decision Tree (GBDT), and Logistic Regression (LR). Hyperparameter optimization was conducted on the predictive model of the training dataset. The performance in the validation dataset was measured using indicators, including the area under curve (AUC) of the receiver operating characteristic (ROC) curve, specificity, and F1 score. Finally, the optimal model was interpreted using the SHapley Additive exPlanation (SHAP) package. Results: The incidence of VTE among the ICU patients in this study was 26.04%. We screened 19 crucial features for the risk prediction model development. Among the five models, the RF model performed best, with an AUC of 0.788 (95% CI: 0.738-0.838), an accuracy of 0.759 (95% CI: 0.709-0.809), a sensitivity of 0.633, and a Brier score of 0.166. Conclusion: A machine learning-based model for prediction of VTE in ICU patients were successfully developed, which could assist clinical medical staff in identifying high-risk populations for VTE in the early stages so that prevention measures can be implemented to reduce the burden on the ICU patients.

Role of cyclone activity in summer precipitation over the northern margin of Eurasia.

In recent decades, the atmospheric moisture capacity has increased globally in concert with global warming, with a particularly notable warming trend in Arctic regions. However, due to limited observational data, the variation and causes of polar precipitation, especially large-scale precipitation events associated with Arctic cyclones, remain unclear. In this paper, GPM satellite data are compared with ERA5 reanalysis data to explore the characteristics of summer precipitation at the northern margin of the Eurasian region (NMER) and the influence of cyclone activity on precipitation. It is revealed that high precipitation values in the Arctic region, as indicated by the GPM and ERA5 data, are mainly concentrated at the NMER. However, the GPM data show an overall larger precipitation amount, while the station observations more closely agree with the ERA5 precipitation changes at the NMER. The cyclone identification results indicate that summer cyclones at the NMER are mainly distributed in the Barents, Kara and Laptev Seas, and the precipitation contribution rate of ERA5-derived cyclones is 37.35%, which is significantly higher than that of GPM-derived cyclones (29.47%). Furthermore, high cyclone activity results in more intense precipitation, with the top 5% of the strongest cyclones contributing 60% (GPM) and 40% (ERA5) to the total cyclonic precipitation.

Resolving conflict and promoting coordination for an integrated old-age healthcare service system in China: GMCR-AHP based decision analysis approach.

China faces a healthcare challenge due to its aging population, necessitating an integrated old-age healthcare system considering multiple stakeholders' interests. Conflict and inequality may arise from varying stakeholder interests. This study develops a conflict resolution strategy for the coordination of stakeholders involved in the old-age healthcare service system, promoting harmonization and minimizing conflict to establish an equitable system meeting elderly needs. It contributes to a robust healthcare system for comprehensive, quality care. The focus of the study is to identify relevant stakeholders and decision-makers involved in developing an integrated old-age healthcare service system and explore a feasible solution through stakeholder analysis using the Mitchell score-based technique and stakeholder theory. Decision-makers' preferences are estimated using the Analytic Hierarchy Process (AHP). Solution strategies are developed through multiple stability concepts within the graph model for conflict resolution (GMCR). The conflict resolution analysis based on the integrated AHP-GMCR approach reveals that the development of an integrated old-age healthcare system is feasible by addressing potential conflicts among the stakeholders. Considering the current predicament of comprehensive medical services in China, governments should distribute authority, simplify procedures, and improve the insurance system. Furthermore, medical institutions should explore funding options, expand services, and enhance accessibility. Elderly individuals should prioritize healthy aging and seek suitable healthcare providers. Stakeholder participation is crucial for effective implementation. These recommendations enable China to advance integrated elderly care successfully, addressing challenges posed by the aging population.

Distinct time trends in colorectal cancer incidence in countries with SDI levels from 1990 to 2019: an age-period-cohort analysis for the Global Burden of Disease 2019 study.

Introduction: The burden of colorectal cancer (CRC) plays a pivotal role in the global cancer epidemic. Our study reported the incidence trends in CRC and the associated effects of age, period, and birth cohort in 204 countries and territories over the past 30 years. Methods: The incidence data of CRC were extracted from the Global Burden of Disease Study (GBD) 2019. We performed the age-period-cohort (APC) model to estimate the overall annual percentage change (net drift) in the incidence rate, the annual percentage change by age group (local drift), and the relative risk (period and cohort effects) of the period and cohort in CRC during 1990-2019. This approach allows examining and distinguishing age, period, and cohort effects in incidence and potentially distinguishing colorectal cancer gaps in prevention and screening. Results: In 2019, the incidence of CRC was 2.17 (95% UI 2.00-2.34) million, of which China, the United States of America, and Japan had the highest incidence population, accounting for 45.9% of the global population. The age-standardized incidence rate (ASIR) was 26.7 (95% UI 28.9-24.6) per 100,000 people, of which 30 countries had an incidence rate greater than 40.0 per 100,000 people. From 1990 to 2019, the middle SDI region had the largest increase in incidence rate, with a net drift of 2.33% (95% CI 2.2-2.46%, p < 0.001). Globally, the incidence population was concentrated in the age group of 50-69 years, and the age group of 30-34 years had the largest increase in incidence rate (local drift 1.19% (95% CI 1.01-1.37%)). At the same time, the sex and age distributions of CRC incidence had significant heterogeneity across regions and countries. In the past 30 years, the incidence rate in 31 countries has been well controlled (net drift <0), and most of them were concentrated in high-and high-middle-SDI regions, such as Australia, Czechia, and Belgium, and the relative risk of incidence generally improved over time and consecutive young birth cohorts. CRC incidence showed an unfavorable trend (net drift ≥1%) in 89 countries, of which 27 countries were more significant (net drift >2%), mostly concentrated in the middle SDI region, such as China, Mexico, and Brazil, and the risk of period and birth cohort was unfavorable. Conclusion: Globally, the incidence of CRC has shown an overall upward trend over the past 30 years, with the exception of some countries with higher SDI values. Significant age-period-cohort differences were observed in the risk of incidence in CRC worldwide. Effective prevention and control policies need to take into account the age-period-cohort effect characteristics of different regions.

Antibacterial Activity and Mechanism of Action of Osthole against Listeria monocytogenes.

The purpose of this study was to investigate the antibacterial activity and mechanism of action of osthole against Listeria monocytogenes. The antibacterial activity of osthole was evaluated by determining the minimum inhibitory concentration (MIC) and growth curve. Cell morphology, membrane permeability, membrane integrity, bacterial physiology, and metabolism were explored using different methods to elucidate the mechanism of action of osthole. It was shown that the MIC of osthole against L. monocytogenes was 62.5 µg/mL and it inhibited the growth of L. monocytogenes effectively in a concentration-dependent manner. Scanning electron microscopy (SEM) images demonstrated morphology changes of L. monocytogenes, including rough surface, cell shrinkage, and rupture. It was found that extracellular conductivity and macromolecule content were increased significantly in the presence of osthole, indicating the disruption of cell membrane integrity and permeability. Laser confocal microscopy results supported the conclusion that osthole caused severe damage to the cell membrane. It was also noticed that osthole depleted intracellular adenosine triphosphate (ATP), inhibited Na+-K+-ATPase and Ca2+-Mg2+-ATPase activity, and promoted the accumulation of intracellular reactive oxygen species (ROS), leading to cell death. This study suggests that osthole is a promising antibacterial agent candidate against L. monocytogenes, and it shows potential in the prevention and control of foodborne pathogens.

Identification of fibronectin type III domain containing 3B as a potential prognostic and therapeutic target for pancreatic cancer: a preliminary analysis.

BACKGROUND: Fibronectin type III domain containing 3B (FNDC3B), a member of the fibronectin type III domain-containing protein family, has been indicated in various malignancies. However, the precise role of FNDC3B in the progression of pancreatic cancer (PC) still remains to be elucidated. METHODS: In this study, we integrated data from the National Center for Biotechnology Information, the Cancer Genome Atlas, Genotype-Tissue Expression database, and Gene Expression Omnibus datasets to analyze FNDC3B expression and its association with various clinicopathological parameters. Subsequently, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes, along with Gene Set Enrichment Analysis (GSEA), single sample Gene Set Enrichment Analysis (ssGSEA) and estimate analysis were recruited to delve into the biological function and immune infiltration based on FNDC3B expression. Additionally, the prognostic estimation was conducted using Cox analysis and Kaplan-Meier analysis. Subsequently, a nomogram was constructed according to the result of Cox analysis to enhance the prognostic ability of FNDC3B. Finally, the preliminary biological function of FNDC3B in PC cells was explored. RESULTS: The study demonstrated a significantly higher expression of FNDC3B in tumor tissues compared to normal pancreatic tissues, and this expression was significantly associated with various clinicopathological parameters. GSEA revealed the involvement of FNDC3B in biological processes and signaling pathways related to integrin signaling pathway and cell adhesion. Additionally, ssGSEA analysis indicated a positive correlation between FNDC3B expression and infiltration of Th2 cells and neutrophils, while showing a negative correlation with plasmacytoid dendritic cells and Th17 cells infiltration. Kaplan-Meier analysis further supported that high FNDC3B expression in PC patients was linked to shorter overall survival, disease-specific survival, and progression-free interval. However, although univariate analysis demonstrated a significant correlation between FNDC3B expression and prognosis in PC patients, this association did not hold true in multivariate analysis. Finally, our findings highlight the crucial role of FNDC3B expression in regulating proliferation, migration, and invasion abilities of PC cells. CONCLUSION: Despite limitations, the findings of this study underscored the potential of FNDC3B as a prognostic biomarker and its pivotal role in driving the progression of PC, particularly in orchestrating immune responses.

Optimizing the intermediates adsorbability and revealing the dynamic reconstruction of Co6Fe3S8 solid solution for bifunctional water splitting.

Co9S8 has been extensively studied as a promising catalyst for water electrolysis. Doping Co9S8 with Fe improves its oxygen evolution reaction (OER) performance by regulating the catalyst self-reconfigurability and enhancing the absorption capacity of OER intermediates. However, the poor alkaline hydrogen evolution reaction (HER) properties of Co9S8 limit its application in bifunctional water splitting. Herein, we combined Fe doping and sulfur vacancy engineering to synergistically enhance the bifunctional water-splitting performance of Co9S8. The as-synthesized Co6Fe3S8 catalyst exhibited excellent OER and HER characteristics with low overpotentials of 250 and 84 mV, respectively. It also resulted in the low Tafel slopes of 135 mV dec-1 for the OER and 114 mV dec-1 for the HER. A two-electrode electrolytic cell with Co6Fe3S8 used as both the cathode and anode produced a current density of 10 mA cm-2 at a low voltage of only 1.48 V, maintaining high stability for 100 h. The results of in/ex-situ experiments indicated that the OER process induced electrochemical reconfiguration, forming CoOOH/FeOOH active species on the catalyst surface to enhance its OER performance. Density functional theory (DFT) simulations revealed that Fe doping and the presence of unsaturated coordination metal sites in Co6Fe3S8 promoted H2O and H* adsorption for the HER. The findings of this study can help develop a strategy for designing highly efficient bifunctional water splitting electrocatalysts.

Research on collaborative development mechanism of multiple stakeholders in medical institutions based on rough set.

Reducing doctor-patient conflict is an important part of coordinating doctor-patient disputes and easing doctor-patient relationship, which is conducive to building a harmonious medical environment and promoting the healthy development of medical undertakings. This paper constructs a multi-decision-maker mixed conflict model based on rough set theory, puts forward the matrix operation expression of the conflict degree theory in the Pawlak model, and gives a more objective and scientific evaluation function. Combined with hot issues of doctor-patient conflict, the proposed multi-decision-maker mixed conflict model is applied to doctor-patient conflict, examines the doctor-patient relationship in the medical institution system from multiple internal perspectives, and calculates feasible solutions in the conflict system. The results show that high medical quality, high standardize medication, high institutional efficiency, high staff efficiency, high hospital benefits, high hospital revenue, medium employee development, medium equipment development, or high medical quality, high standardize medication, high institutional efficiency, medium staff efficiency, medium hospital benefits, high hospital revenue, high employee development, and high equipment development are important conditions for building a harmonious medical environment and reducing doctor-patient conflicts.

Causal association between adiponectin and risk of trigeminal neuralgia: A Mendelian randomization study.

OBJECTIVE: To determine whether adiponectin levels and the risk of trigeminal neuralgia (TN) were causally related, a two-sample Mendelian Randomization (MR) study design was used. METHODS: We obtained data regarding adiponectin from the UK Biobank genome wide association studies (GWAS) (n = 39,883) as the exposure and TN, using GWAS summary statistics generated from FinnGen, (total n = 195 847 159; case = 800, control = 195 047) as the outcome. We conducted a two-sample Mendelian randomization analysis employing inverse variance-weighted (IVW), MR-Egger regression, weighted median, and weighted mode analyses. RESULTS: We selected 14 single nucleotide polymorphisms (SNPs) with genome-wide significance from the GWAS on adiponectin as instrumental variables. Based on the IVW method, a causal association between adiponectin levels and TN was evidenced (OR= 0.577, 95 %CI: 0.393-0.847). MR-Egger regression revealed that directional pleiotropy was unlikely to be biasing the result (intercept = -0.01; P = 0.663), but it showed no causal association between adiponectin and TN (OR=0.627, 95 %CI: 0.369-1.067). However, the weighted median (OR=0.569, 95 %CI: 0.353-0.917) and Weighted mode (OR= 0.586, 95 %CI: 0.376-0.916) approach yielded evidence of a causal association between adiponectin and TN. Cochran's Q-statistics and funnel plots indicated no evidence of heterogeneity or asymmetry, indicating no directional pleiotropy. CONCLUSION: The results of the MR analysis suggested that adiponectin may be causally associated with an increased TN risk.

Survival benefit of adjuvant chemotherapy in patients with resected gallbladder adenocarcinoma: An updated retrospective cohort analysis.

BACKGROUND: The rarity yet high malignancy of gallbladder adenocarcinoma (GBA) endows it with a distinctive nature. Radical resection remains the foremost therapeutic approach for GBA, while the impact of early recurrence and metastasis on patient prognosis necessitates the utilization of adjuvant chemotherapy (AC). Despite numerous previous studies on this topic, a consensus regarding the authentic efficacy of AC has yet to be reached. METHODS: We conducted an updated retrospective cohort analysis utilizing data from the Surveillance, Epidemiology, and End Results (SEER) database spanning from 2010 to 2020 to explore the association between AC and survival outcomes in patients with resected GBA. RESULTS: Our study included 2782 patients from the SEER database, with further evaluation of 843 patients in each cohort following meticulous execution of a 1:1 propensity score matching. Remarkably, the AC cohort exhibited a significant survival advantage when juxtaposed against the non-AC cohort. Multivariable Cox regression analysis identified age at diagnosis, year at diagnosis, grade, AJCC T stage, AJCC N stage as well as AC as independent prognostic factors. Furthermore, our findings unveiled that poor/undifferentiated tumor histology, pathological T2 or higher category and pathological N1 category were significantly associated with improved survival when treated with AC while simultaneously observing improved survival across all age categories. CONCLUSION: These results provide additional evidence supporting the survival benefits of AC and offer guidance for personalized therapy in patients with resected GBA.

Dynamic Changes and Effects of H2S, IGF-1, and GH in the Traumatic Brain Injury.

The aim of this study was to examine the expression changes of H2S, IGF-1, and GH in traumatic brain injury (TBI) patients and to detect their neuroprotective functions after TBI. In this study, we first collected cerebrospinal fluid (CSF) and plasma from TBI patients at different times after injury and evaluated the concentrations of H2S, IGF-1, and GH. In vitro studies were using the scratch-induced injury model and cell-cell interaction model (HT22 hippocampal neurons co-cultured with LPS-induced BV2 microglia cells). In vivo studies were using the controlled cortical impact (CCI) model in mice. Cell viability was assessed by CCK-8 assay. Pro-inflammatory cytokines expression was determined by qRT-PCR, ELISA, and nitric oxide production. Western blot was performed to assess the expression of CBS, CSE, IGF-1, and GHRH. Moreover, the recovery of TBI mice was evaluated for behavioral function by applying the modified Neurological Severity Score (mNSS), the Rotarod test, and the Morris water maze. We discovered that serum H2S, CSF H2S, and serum IGF-1 concentrations were all adversely associated with the severity of the TBI, while the concentrations of IGF-1 and GH in CSF and GH in the serum were all positively related to TBI severity. Experiments in vitro and in vivo indicated that treatment with NaHS (H2S donor), IGF-1, and MR-409 (GHRH agonist) showed protective effects after TBI. This study gives novel information on the functions of H2S, IGF-1, and GH in TBI.