[Current situation and development trend of digital traditional Chinese medicine pharmacy].

The 21st century is a highly information-driven era, and traditional Chinese medicine(TCM) pharmacy is also moving towards digitization and informatization. New technologies such as artificial intelligence and big data with information technology as the core are being integrated into various aspects of drug research, manufacturing, evaluation, and application, promoting interaction between these stages and improving the quality and efficiency of TCM preparations. This, in turn, provides better healthcare services to the general population. The deep integration of emerging technologies such as artificial intelligence, big data, and cloud computing with the TCM pharmaceutical industry will innovate TCM pharmaceutical technology, accelerate the research and industrialization process of TCM pharmacy, provide cutting-edge technological support to the global scientific community, boost the efficiency of the TCM industry, and promote economic and social development. Drawing from recent developments in TCM pharmacy in China, this paper discussed the current research status and future trends in digital TCM pharmacy, aiming to provide a reference for future research in this field.

Long-term trends in incidence, mortality and burden of liver cancer due to specific etiologies in Hubei Province.

Liver cancer, a chronic non-communicable disease, represents a serious public health problem. Long-term trends in the burden of liver cancer disease are heterogeneous across regions. Incidence and mortality of liver cancer, based on the Global Burden of Disease, were collected from the Chinese Centre for Disease Control and Prevention. Age-period-cohort model was utilized to reveal the secular trends and estimate the age, period and cohort effects on primary liver cancer due to specific etiologies. Both the age-standardized incidence and mortality rate of liver cancer in Hubei province were on the rise, although there were discrepancies between gender groups. From age-period-cohort analysis, both incidence and mortality of liver cancer due to Hepatitis B virus were the highest in all age groups. The incidence of all liver cancer groups increased with time period in males, while this upward trend was observed in females only in liver cancer due to alcohol use group. Cohort effects indicated the disease burden of liver cancer decreased with birth cohorts. Local drifts showed that the incidence of liver cancer due to specific etiologies was increasing in the age group of males between 40 and 75 years old. The impact of an aging population will continue in Hubei Province. the disease burden of liver cancer will continue to increase, and personalized prevention policies must be adopted to address these changes.

Cardiovascular diseases burden attributable to ambient PM2.5 pollution from 1990 to 2019: A systematic analysis for the global burden of disease study 2019.

BACKGROUND: Ambient PM2.5 pollution (APMP2.5) was the leading environmental risk factor for cardiovascular diseases (CVDs) worldwide. An up-to-date comprehensive study is needed to provide global epidemiological patterns. METHODS: Detailed data on CVDs burden attributable to APMP2.5 were obtained from the Global Burden of Disease Study (GBD) 2019. We calculated the estimated annual percentage change (EAPC) to assess temporal trends in age-standardized rates of deaths and disability-adjusted life years (DALYs) over 30 years. RESULTS: Globally, CVDs attributable to APMP2.5 resulted in 2.48 million deaths and 60.91 million DALYs, with an increase of 122%, respectively from 1990 to 2019. In general, men suffered markedly higher burden than women, but the gap will likely turn narrow. As for age distribution, CVDs deaths and DALYs attributable to APMP2.5 mainly occurred in the elder group (>70 years). Low- and middle-income regions endured the higher CVDs burden due to the higher exposure to APMP2.5, and the gap may potentially expand further compared with high-income regions. For regions, the highest age-standardized rates of APMP2.5-related CVDs deaths and DALYs were observed mainly in Central Asia, while the lowest was observed in Australasia. At the national level, countries with the largest ASDR decline were clustered in western Europe, while Equatorial Guinea, Timor-Leste and Bhutan exhibited relatively rapid increases over this period. CONCLUSIONS: The global CVDs burden attributable to APMP2.5 has contributed to the heterogeneity of spatial and temporal distribution. APMP2.5-related CVDs deaths have largely shifted from higher SDI regions to those with a lower SDI. Globally, APMP2.5-attributable CVDs pose a significant threat to public health and diseases burden has increased over time, particularly in male, old-aged populations. The governments and health systems should take measures to reduce air pollution to impede this rising trend.

[Current status, trends, and challenges of continuous manufacturing technology for oral traditional Chinese medicine solid preparations].

In recent years, continuous manufacturing technology has attracted considerable attention in the pharmaceutical industry. This technology is highly sought after for its significant advantages in cost reduction, increased efficiency, and improved productivity, making it a growing trend in the future of the pharmaceutical industry. Compared to traditional batch production methods, continuous manufacturing technology features real-time control and environmentally friendly intelligence, enabling pharmaceutical companies to produce drugs more efficiently. However, the adoption of continuous manufacturing technology has been slow in the field of traditional Chinese medicine(TCM) pharmaceuticals. On the one hand, there is insufficient research on continuous manufacturing equipment and technology that align with the characteristics of TCM preparations. On the other hand, the scarcity of talent with diverse expertise hampers its development. Therefore, in order to promote the modernization and upgrading of the TCM pharmaceutical industry, this article combined the current development status of the TCM industry to outline the development status and regulatory requirements of continuous manufacturing technology. At the same time, it analyzed the problems with existing TCM manufacturing models and explored the prospects and challenges of applying continuous manufacturing technology in the field of TCM pharmaceuticals. The analysis focused on continuous manufacturing control strategies, technical tools, and pharmaceutical equipment, aiming to provide targeted recommendations to drive the development of the TCM pharmaceutical industry.

Analyzing the influencing factors of collaborative innovation and industrial structure upgrading on the economy: reflection on the economic dilemma of enterprises.

The present study has investigated the impact of enterprises, collaborative innovation, industrial structure, inflation, and entrepreneurship in 27 provinces of China. The study used annual time series data from 2003 to 2019. This study adopts the CC-EMG and AMG tests to estimate the long-term association between the variables. The study applied one-step system GMM, two-step system GMM, Cup-FM, and Cup-BC regression estimations to calculate robust and reliable outcomes. The findings show that collaborative innovation, industrial structure, and entrepreneurship positively impact economic growth, whereas enterprises and inflation negatively impact economic growth. The estimated results also provide important policy implications for the selected and the other emerging economies in designing an appropriate way forward to economic development.

Assessment of mitral valve geometry in nonvalvular atrial fibrillation patients with or without ventricular dysfunction: insights from high volume rate three-dimensional transesophageal echocardiography.

Meticulous understanding of the mechanisms underpinning mitral regurgitation in atrial fibrillation (AF) patients is crucial to optimize therapeutic strategies. The morphologic characteristics of mitral valves in atrial functional mitral regurgitation (FMR) patients with and without left ventricular (LV) dysfunction were evaluated by high volume rate (HVR) three-dimensional transesophageal echocardiography (3D-TEE). In our study, 68 of 265 AF patients who underwent 3D-TEE were selected, including 36 patients with AF, FMR, and preserved LV function (AFMR group) and 32 patients with AF, FMR, and LV dysfunction (VFMR group). In addition, 36 fever patients without heart disease were included in the control group. Group comparisons were performed by one-way analysis of variance for continuous variables. The left atrium (LA) was enlarged in the AFMR and VFMR groups compared with the control group. The mitral annulus (MA) in the AFMR group was enlarged and flattened compared with the control group and was smaller than in the VFMR group. The annulus area fraction was significantly diminished in the AFMR and VFMR groups, indicative of reduced MA contractility. The posterior mitral leaflet (PML) angle was smallest in the AFMR group and largest in the control group, whereas the distal anterior mitral leaflet angle did not significantly differ among the three groups. LA remodeling causes expansion of the MA and reduced MA contractility, disruption of the annular saddle shape, and atriogenic PML tethering. Comparison of atrial FMR patients with and without LV dysfunction indicates that atriogenic PML tethering is an important factor that aggravates FMR. HVR 3D-TEE improves the 3D temporal resolution greatly.

Response characteristics of MAPbBr3 direct conversion X-ray detectors based on measurements and Monte Carlo simulation.

In recent years, higher requirements have been placed on the response characteristics of X-ray detectors in the field of medical diagnostic imaging. Due to this, high sensitivity, high attenuation coefficient and low cost detection materials need to be developed. In this paper, the geometric model of a detector was established by Geant4 code. The absorption efficiency and mass attenuation coefficient of MAPbBr3 crystals were calculated in the energy range of 30 keV to 100 keV. Compared with the mass attenuation coefficient of the NIST database, the deviation was within 1.39%. The signal charge number and detection sensitivity of the X-ray interaction with the MAPbBr3 crystal ware calculated. Compared with the CdTe crystal and α-Se, the MAPbBr3 crystal still had a larger detection sensitivity under a smaller applied electric field, which was approximately 9 times higher than that of α-Se. This result indicated that the detection sensitivity could be greatly improved by using a high atomic number and high charge mobility-lifetime product. Based on the simulation results, the 2 mm thick MAPbBr3 crystal exhibited the highest detection sensitivity at 60 keV X-rays, which was in agreement with the experimental results.

[Direct determination of five xanthic acids in water by ultra performance liquid chromatography-tandem mass spectrometry].

Xanthates with different alkyl groups, such as ethyl, propyl, butyl, and amyl groups, are widely used in large quantities in the mining flotation of metallic minerals. Xanthates enter environmental waters through mineral processing wastewater discharge and are ionized or hydrolyzed into ions or molecules of xanthic acids (XAs) in water. XAs endanger aquatic plants and animals, as well as human health. To the best of our knowledge, XA analysis is mainly limited to butyl xanthate. Moreover, the isomers and congeners of XAs cannot be determined separately using the existing methods. Herein, a novel method based on ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was established to separate and analyze five XAs, namely, ethyl-, isopropyl-, n-butyl-, isobutyl-, and amyl-XAs, in water. Water samples were filtered through a 0.22 µm hydrophilic polytetrafluoroethylene (PTFE) membrane and directly injected into the UPLC-MS/MS instrument. Separation was performed using a Waters Acquity UPLC BEH C18 column (100 mm×2.1 mm, 1.7 µm) with ammonia solution (pH 11)-acetonitrile (9∶1, v/v) as the mobile phase for isocratic elution. The five XAs were detected in the negative electrospray ionization (ESI-) and multiple reaction monitoring (MRM) modes. An internal standard method was used for quantification. The pretreatment and UPLC-MS/MS conditions were comprehensively optimized to achieve the separation and analysis of the five XAs via direct injection. The XAs showed negligible adsorption on hydrophobic PTFE, hydrophilic PTFE, hydrophilic polypropylene, and polypropylene membranes during filtration. However, the amyl-XA showed obvious adsorption on nylon and polyether sulfone membranes. The five XAs mainly formed [M-H]- parent ions in the ESI- mode and the main daughter ions obtained following collisional fragmentation depended on the alkyl groups of the XAs. Increasing the pH of the ammonia solution in the mobile phase to 11 led to the isomeric separation of n-butyl- and isobutyl-XAs. The optimized mobile phase inhibited the tailing of the chromatographic peak of amyl-XA and effectively improved all the chromatographic peak shapes of XAs. The BEH C18 column was selected as the chromatographic column owing to its better compatibility with high-pH solutions compared with the T3 C18 column. Preservation experiments conducted over 8 d showed that the concentration of all five XAs decreased over time at room temperature; among the XAs analyzed, the concentration of ethyl-XA revealed the most significant decrease. However, the recoveries of the five XAs at 4 and -20 ℃ remained high, ranging from 101% to 105% and from 100% to 106%, respectively, on the 8th day. The preservation observed with a high concentration of XAs was similar to that found with a low concentration. The preservation time was extended to 8 days at pH 11 and 4 ℃ away from the light. No significant matrix effects were observed for the five XA samples in surface water and groundwater, but industrial sewage exerted obvious matrix inhibitory effects on ethyl- and isopropyl-XAs. Owing to the short retention times of ethyl- and isopropyl-XAs, the co-fluxed interferents in the industrial sewage depressed the MS signals. The five XAs showed good linearity in the range of 0.25-100 µg/L, with correlation coefficients greater than 0.9996. The method detection limits were as low as 0.03-0.04 µg/L, and the intra- and inter-day precisions were 1.3%-2.1% and 3.3%-4.1%, respectively. The recoveries obtained under low, medium, and high spiked levels (1.00, 20.0, 80.0 µg/L) were 96.9%-133%, 100%-107%, and 104%-112%, respectively. The corresponding RSDs were 2.1%-3.0%, 0.4%-1.9%, and 0.4%-1.6%, respectively. The optimized method was successfully applied to the analysis of XAs in surface water, groundwater, and industrial sewage. The method could separate and detect various congeners and isomers of XAs without the need for cumbersome pretreatment processes, and its advantages include smaller sample requirements, simpler operation, higher sensitivity, and longer preservation time. The proposed technique presents excellent application potential in XA environmental monitoring and water evaluation, and mineral flotation studies.

Synergic effects of PM1 and thermal inversion on the incidence of small for gestational age infants: a weekly-based assessment.

BACKGROUND: The synergic effects of thermal inversion (TI) and particulate matter with an aerodynamic diameter ≤1 µm (PM1) exposure and incidence of small for gestational age (SGA) was not clear. OBJECTIVE: We aimed to explore the independent effects of prenatal TI and PM1 exposure on incidence of SGA and their potential interactive effects. METHODS: A total of 27,990 pregnant women who delivered in Wuhan Children's Hospital from 2017 to 2020 were included. The daily mean concentration of PM1 was obtained from ChinaHighAirPollutants (CHAP) and matched with the residential address of each woman. Data on TI was derived from National Aeronautics and Space Administration (NASA). The independent effects of PM1 and TI exposures on SGA in each gestational week were estimated by the distributed lag model (DLM) nested in Cox regression model, and the potential interactive effects of PM1 and TI on SGA were investigated by adapting the relative excess risk due to interaction (RERI) index. RESULTS: Per 10 µg/m3 increase in PM1 was associated with an increase in the risk of SGA at 1-3 and 17-23 gestational weeks, with the strongest effect at the first gestational week (HR = 1.043, 95%CI: 1.008, 1.078). Significant links between one day increase of TI and SGA were found at the 1-4 and 13-23 gestational weeks and the largest effects were observed at the 17th gestational week (HR = 1.018, 95%CI: 1.009, 1.027). Synergistic effects of PM1 and TI on SGA were detected in the 20th gestational week, with RERI of 0.208 (95%CI: 0.033,0.383). IMPACT STATEMENT: Both prebirth PM1 and TI exposure were significantly associated with SGA. Simultaneous exposure to PM1 and TI might have synergistic effect on SGA. The second trimester seems to be a sensitive window of environmental and air pollution exposure.

The Effect of Family Fertility Support Policies on Fertility, Their Contribution, and Policy Pathways to Fertility Improvement in OECD Countries.

The cost of childbirth has been confirmed as a vital factor in families' fertility decision-making, and family welfare policies are capable of compensating for the increase in household living expenses regarding childbirth, such that the country's fertility situation can be optimized. In this study, the fertility promotion effects of family welfare policies in OECD(Organization for Economic Co-operation and Development) countries are investigated through regression analysis, grey correlation (GRA), and the fuzzy set qualitative comparative analysis fsQCA method. As indicated by the results: (1) Family welfare policies notably boost fertility, and the boosting effect is long-lasting. However, this boost will be weakened in countries where fertility rates remain below 1.5. (2) The contribution of welfare policy measures to the fertility-promotion effect varies by country. The contribution of cash benefits is highest in over half of the countries worldwide, the contribution of relevant services and in-kind expenditure is highest in 29% of the countries, and that of tax incentive expenditure is highest in 14% of the countries. (3) The policy mix to boost fertility also varies according to the social context, with three policy groups derived using the fsQCA method. To be specific, the core antecedent conditions comprise cash benefits, relevant services, and in-kind expenditure. On that basis, China should pay attention to the following three points when formulating family welfare policies to tackle their demographic challenges. First, a system of family welfare policies should be developed as early as possible in the context of increasingly severe demographic issues since the incentive effect of family welfare policies will be weakened in countries with chronically low fertility rates. Second, the effects of improvements vary by country, and China should comprehensively consider its national circumstances when formulating and dynamically adjusting the mix of government fertility support policies in accordance with its social development. Third, employment is the main means of securing family income and takes on critical significance to sustaining families. Unemployment exerts a significant disincentive effect, such that it is imperative to reduce youth unemployment and enhance the quality of youth employment. On that basis, the disincentive effect of unemployment on fertility can be reduced.

Rehemorrhage of brainstem cavernous malformations: a benchmark approach to individualized risk and severity assessment.

OBJECTIVE: Brainstem cavernous malformations (BSCMs) represent a unique subgroup of cavernous malformations with more hemorrhagic presentation and technical challenges. This study aimed to provide individualized assessment of the rehemorrhage clustering risk of BSCMs after the first symptomatic hemorrhage and to identify patients at higher risk of neurological deterioration after new hemorrhage, which would help in clinical decision-making. METHODS: A total of 123 consecutive BSCM patients with symptomatic hemorrhage were identified between 2015 and 2022, with untreated follow-up > 12 months or subsequent hemorrhage during the untreated follow-up. Nomograms were proposed to individualize the assessment of subsequent hemorrhage risk and neurological status (determined by the modified Rankin Scale [mRS] score) after future hemorrhage. The least absolute shrinkage and selector operation (LASSO) regression was used for feature screening. The calibration curve and concordance index (C-index) were used to assess the internal calibration and discrimination performance of the nomograms. Cross-validation was further performed to validate the accuracy of the nomograms. RESULTS: Prior hemorrhage times (adjusted OR [aOR] 6.78 per ictus increase) and Zabramski type I or V (OR 11.04) were associated with rehemorrhage within 1 year. A lower mRS score after previous hemorrhage (aOR 0.38 for a shift to a higher mRS score), Zabramski type I or V (OR 3.41), medulla or midbrain location (aOR 2.77), and multiple cerebral cavernous malformations (aOR 11.76) were associated with worsened neurological status at subsequent hemorrhage. The nomograms showed good accuracy and discrimination, with a C-index of 0.80 for predicting subsequent hemorrhage within 1 year and 0.71 for predicting neurological status after subsequent hemorrhage, which were maintained in cross-validation. CONCLUSIONS: An individualized approach to risk and severity assessment of BSCM rehemorrhage was feasible with clinical and imaging features.

Global Burden of osteoarthritis associated with high body mass index in 204 countries and territories, 1990-2019: findings from the Global Burden of Disease Study 2019.

OBJECTIVE: To quantify the burden of osteoarthritis (OA) associated with high body mass index (BMI) across 204 countries and territories from 1990 to 2019. METHODS: This study extracted global, regional, and national data on years lived with disability (YLD) of OA associated with high BMI from GBD 2019. The YLD burden of OA associated with high BMI was systematically analyzed by age, SDI, sex, and EAPC. RESULTS: At the global level, ~2.67 million (95% UI: 1.04, 5.75) YLD were attributable to OA associated with high BMI, with an age-standardized rate of 31.9 (95% UI: 12.4, 68.75) YLD per 100,000 population in 2019. There was a 0.5 increase (95% UI: 0.35, 0.79) over the 30 years with an EAPC of 1.45. In 2019, Australasia {57.49 (95% UI: 23.62, 125.38)}, high-income North America {56.2 (95% UI: 23.32, 121.97)}, and Andean Latin America {49.77 (95% UI: 19.73, 111.73)} had the highest age-standardized YLD rates. The population aged at 60-74 group had a higher YLD rate for both males and females. Females tended to be more sensitive to the OA associated with high BMI than male in any region. CONCLUSIONS: In summary, the YLD rate of OA associated with high BMI presented a continuous upward trend in most countries. Women and older people are more sensitive to OA due to physiological and psychological factors. Controlling modifiable risk factors such as maintaining an appropriate BMI is needed for disease prevention.

Social Determinants of Health, Prenatal Maternal Stress, and Earlier Birth During the COVID-19 Pandemic.

During the COVID-19 pandemic, pregnant women, especially those from socioeconomically disadvantaged and marginalized groups, experienced unprecedented stress. Prenatal stress and social determinants of health (SDoH) such as lower education and lack of a relationship partner are known to contribute to earlier birth. However, whether SDoH and stress independently contribute or whether the harmful impact of SDoH is mediated by stress is unknown. Moreover, the contributions of these factors has not been investigated in the context of a communal health crisis such as the COVID-19 pandemic. To examine these processes, we used a longitudinal cohort of 2,473 women pregnant during the COVID-19 pandemic who reported a live birth. We compared structural equation models predicting gestational age at birth from SDoH (race/ethnicity, education, financial security, health insurance, relationship status, and lifetime abuse) and from prenatal maternal stress related and unrelated to the COVID-19 pandemic. Results indicate that the association of SDoH with earlier birth was partially mediated by prenatal stress. These findings help uncover mechanisms explaining health disparities in the U.S. and highlight the need to address both SDoH and the stress that these factors produce in under-resourced and marginalized communities.

Cost-effectiveness analysis of sintilimab plus chemotherapy for advanced or metastatic esophageal squamous cell carcinoma.

Background: Sintilimab plus chemotherapy (SIDCHM) is more effective than placebo plus chemotherapy (PLCHM) for advanced or metastatic esophageal squamous cell carcinoma (ESCC). However, considering the high cost of sintilimab, this study evaluated the cost-effectiveness of SIDCHM in comparison with PLCHM for advanced or metastatic ESCC from the Chinese healthcare system perspective. Methods: Polymorphic Markov models were constructed to simulate the course and cost of SIDCHM. Treatment drug costs were calculated at national list prices and clinical data, other costs, and utility values were extracted from the reference literature. Primary outcomes included quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). The robustness of the model was verified by one-way sensitivity analysis and probabilistic sensitivity analysis (PSA). Results: SIDCHM obtained 1.03 QALYs at $24,044.49, whereas the effectiveness and cost of PLCHM were 0.67 QALYs and $14,166.24, respectively. The ICER for SIDCHM versus PLCHM was $23,458.08/QALY. The utility of the PFS state was the parameter that had the greatest effect on the ICER. The PSA showed that SIDCHM had an 86% probability of being cost-effective at the willingness-to-pay threshold of 3* Chinese gross domestic product per capita ($37,653/QALY). Conclusion: From the Chinese healthcare system perspective, SIDCHM is considered a cost-effective treatment option compared with PLCHM as first-line therapy for advanced or metastatic ESCC.

Assessment of the correlation between clinical and radiological outcomes in patients suffering from mild to moderate cervical spine dysfunction symptoms: a prospective study.

BACKGROUND: Neck pain and cervical disc degeneration (CDD) are common findings. Valid data on correlation between clinical scores and radiological grade of CDD in patients with mild to moderate clinical disability are not available. The study has been designed to investigate the correlation between clinical and radiological outcomes in these patients. METHODS: A cohort of 150 patients who suffered from mild to moderate cervical spine dysfunction symptoms from September 2020 to May 2021 was enrolled. We evaluated functional status using Japanese Orthopaedic Association scores (JOA), the visual analog scale, and the Neck Disability Index. We assessed the CDD with magnetic resonance imaging-based grading systems. We analyzed relationships between radiological grades of CDD and clinical symptoms along with demographic data. RESULTS: One hundred thirteen patients [mean age 44.78, 78 (69%) females] were finally included. CDD occurred most at the C5-C6 level, with 56.93% of higher grade III from Miyazaki. The grades of Miyazaki (P < 0.05) and the scores of Nakashima (P < 0.05) were positively correlated with the duration of symptoms, and the severity of the CDD increased with aging (P < 0.01). Moreover, we correlated patients' JOA scores with the current scoring and grading systems, especially the grades of Miyazaki (P < 0.01) and the scores of Nakashima (P < 0.01). CONCLUSION: Increasing grades of CDD paralleled decreasing JOA scores in the population studied.

Cost-effectiveness analysis of adebrelimab combined with chemotherapy for extensive-stage small cell lung cancer.

Background: The findings of the CAPSTONE-1 trial showed that adebrelimab in combination with chemotherapy (etoposide-carboplatin) (ADCHM) is clinically beneficial as a first-line treatment for patients with extensive-stage small cell lung cancer (ES-SCLC), compared with placebo plus chemotherapy (PLCHM, etoposide-carboplatin). However, owing to the higher cost of adebrelimab, it is unclear whether ADCHM is cost-effective compared with PLCHM. This study aimed to evaluate the cost-effectiveness of ADCHM as a first-line treatment for patients with ES-SCLC from the perspective of the Chinese healthcare system. Methods: A Markov model with three health states was developed to assess the cost-effectiveness of ADCHM as a first-line treatment option with ES-SCLC. Clinical data were obtained from the CAPSTONE-1 trial. Costs of the drug were calculated at national tender prices, and other costs and utility values were obtained from published literature. The outcomes included life years (LYs), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis and probabilistic sensitivity analysis were used to validate the robustness of the model. Results: The ADCHM group achieved 1.21 QALYs (2.47 LYs) for $25,312, whereas the PLCHM group achieved 0.81 QALYs (1.59 LYs) for $14,846. The ICER for ADCHM versus PLCHM was $25914 per QALY gained. The variables with the greatest impact on the model results were the utility value of progressive disease, the utility value of progression-free survival, and the price of adebrelimab (100 mg). At a willingness-to-pay threshold of $37,653/QALY, ADCHM had an 89.1% probability of being cost-effective compared with PLCHM. Conclusion: ADCHM may be a cost-effective first-line treatment strategy for ES-SCLC from the perspective of the Chinese healthcare system.

A Comprehensive Assessment of Cultivation Environment of Top Innovative High-Level Talents Based on Deep Learning Algorithm.

The quality of talent has increased across all fields due to the constant growth of different industries and the growing job saturation. Real-time job information on recruitment platforms can, therefore, accurately reflect the demand for talent from businesses, serving as a basis for the creation of training policies in schools. In international competition, the development of talents, especially top-level talents, will become more and more crucial. Growing in importance is China's economy and social development. The evaluation of higher vocational and technical talents, however, should also be assessed from a variety of angles, given the diversification of talent training objectives and teaching methods, as well as the expansion of teaching functions. An emerging machine learning technology called deep learning (DL) has been developed to bring machine learning closer to the goals of artificial intelligence. This essay offers a thorough evaluation of the depth of deep learning as it relates to the development of innovative talent in schools. The entire school must be strengthened. It is demonstrated that the average execution time is slashed by 0.0024 s, and the learning sample size error of the DL model is reduced by 0.05276 when compared to the Apriori method. As a result, implementing and researching the DL model can significantly improve both the overall teaching quality of schools and their capacity for innovation.

Trends in the global burden of oral cancer joint with attributable risk factors: Results from the global burden of disease study 2019.

OBJECTIVES: To investigate the characteristics of risk factors for oral cancer and the disease burden they caused. MATERIALS AND METHODS: Data from GBD2019, where the EAPC was calculated to understand mortality trends and the APC model was used for the analysis of age characteristics. RESULTS: Overall oral cancer mortality showed a promising downward trend [EAPC = -0.05 (-0.08 to -0.02)]. Oral cancer mortality attributable to tobacco chewing alone showed a significant upward trend [EAPC = 0.44 (0.36-0.52)]. Males are the majority of oral cancer deaths, while the disease burden of oral cancer in females could be largely attributable to chewing tobacco. The age of death attributable to each risk factor for oral cancer is concentrated between 45 and 74 years. Mortality for oral cancer caused by alcohol and smokeless tobacco was increasing in younger age groups (age < 45), and this trend was more pronounced in middle and middle-high SDI areas. The disease burden of oral cancer in high SDI regions was mainly attributed to alcohol consumption, while in middle and lower SDI regions it was mainly attributed to tobacco. CONCLUSION: Smokeless tobacco proved a critical factor in the significant regional distribution of oral cancer. Oral cancer is on the increase in younger age groups. According to the characteristics of the distribution of risk factors, in traditionally high-incidence regions, such as India and Pakistan, oral cancer kept the highest ASDR, but was not experiencing the fastest growth rate. Additionally, it was oral cancer in middle SDI regions that needs more attention.

Long-term whole blood DNA preservation by cost-efficient cryosilicification.

Deoxyribonucleic acid (DNA) is the blueprint of life, and cost-effective methods for its long-term storage could have many potential benefits to society. Here we present the method of in situ cryosilicification of whole blood cells, which allows long-term preservation of DNA. Importantly, our straightforward approach is inexpensive, reliable, and yields cryosilicified samples that fulfill the essential criteria for safe, long-term DNA preservation, namely robustness against external stressors, such as radical oxygen species or ultraviolet radiation, and long-term stability in humid conditions at elevated temperatures. Our approach could enable the room temperature storage of genomic information in book-size format for more than one thousand years (thermally equivalent), costing only 0.5 $/person. Additionally, our demonstration of 3D-printed DNA banking artefacts, could potentially allow 'artificial fossilization'.

Development and Application of Global Health Events-Mental Stress Scale for Assessment of Medical Staff's Acute Mental Stress Responses.

Background: Medical workers have been increasingly involved in emergent public health events, which can lead to severe stress. However, no standardized, officially recognized, unified tool exists for mental distress measurement in medical workers who experienced the public health events. Purpose: In the present study, we propose the Global Health Events-Mental Stress Scale (GHE-MSS), as a revised version of the Impact of Event Scale-Revision (IES-R), for assessment of medical workers' acute mental stress responses within one month and their chronic mental stress responses within six months after major health events. Patients and methods: The IES-R was slightly modified, developed, and its reliability and validity were tested using the Delphi survey, primary survey with 115 participants, formal survey with 300 participants, and clinical evaluation with 566 participants. Results: Exploratory factor analysis and confirmatory factor analysis confirmed a promising validity of the scale. The values of Cronbach's alpha coefficient, the Spearman-Brown coefficient, and the retested Cronbach's alpha coefficient of the scale applied for the clinical evaluation were 0.88, 0.87, and 0.98, respectively, which confirmed a good internal consistency and stability. The results of the goodness-of-fit test indicated a good adaptation of the model. A correlation analysis was conducted to assess the correlation between the GHE-MSS and the PCL-C, which had a correlation coefficient of 0.68 (P<0.01). Conclusion: GHE-MSS can be applied with a promising reliability and validity for the assessment of the acute mental stress response of medical workers experiencing public health events. This method can also be used for the screening of mental stress-associated disorders.