A COBRA family protein, PtrCOB3, contributes to gelatinous layer formation of tension wood fibers in poplar.

Angiosperm trees usually develop tension wood (TW) in response to gravitational stimulation. TW comprises abundant gelatinous (G-) fibers with thick G-layers primarily composed of crystalline cellulose. Understanding of the pivotal factors governing G-layer formation in TW fiber remains elusive. This study elucidates the role of a Populus trichocarpa COBRA family protein, PtrCOB3, in the G-layer formation of TW fibers. PtrCOB3 expression was upregulated, and its promoter activity was enhanced during TW formation. Comparative analysis with wild-type trees revealed that ptrcob3 mutants, mediated by Cas9/gRNA gene editing, were incapable of producing G-layers within TW fibers and showed severely impaired stem lift. Fluorescence immunolabelling data revealed a dearth of crystalline cellulose in the tertiary cell wall (TCW) of ptrcob3 TW fibers. The role of PtrCOB3 in G-layer formation is contingent upon its native promoter, as evidenced by the comparative phenotypic assessments of pCOB11::PtrCOB3, pCOB3::PtrCOB3, and pCOB3::PtrCOB11 transgenic lines in the ptrcob3 background. Overexpression of PtrCOB3 under the control of its native promoter expedited G-layer formation within TW fibers. We further identified three transcription factors that bind to the PtrCOB3 promoter and positively regulate its transcriptional levels. Alongside the primary TCW synthesis genes, these findings enable the construction of a two-layer transcriptional regulatory network for the G-layer formation of TW fibers. Overall, this study uncovers mechanistic insight into TW formation, whereby a specific COB protein executes the deposition of cellulose, and consequently, G-layer formation within TW fibers.

"Trojan Horse" Salmonella Enabling Tumor Homing of Silver Nanoparticles via Neutrophil Infiltration for Synergistic Tumor Therapy and Enhanced Biosafety.

Salmonella selectively colonizes into the hypoxic tumor region and exerts antitumor effects via multiple mechanisms, while the tumor colonized Salmonella recruits host neutrophils into the tumor, presenting a key immunological restraint to compromise the Salmonella efficacy. Here, we develop a combinatorial strategy by employing silver nanoparticles (AgNPs) to improve the efficacy and biosafety of Salmonella. The AgNPs were decorated with sialic acid (SA) to allow selective recognition of L-selectin on neutrophil surfaces, based on which the tumor-homing of AgNPs was achieved by neutrophil infiltration in the Salmonella colonized tumor. The tumor-targeting AgNPs exert the functions of (1) local depletion of neutrophils in tumors to boost the efficacy of Salmonella, (2) direct killing tumor cells via L-selectin-mediated intracellular delivery, and (3) clearing the residual Salmonella after complete tumor eradication to minimize the side effects. With a single tail vein injection of such combination treatment, the tumor was eliminated with high biosafety, resulting in a superior therapeutic outcome.

Factors influencing mortality in abdominal solid organ transplant recipients with multidrug-resistant gram-negative bacteremia.

BACKGROUND: Although multidrug-resistant (MDR) gram-negative bacteremia (GNB) has been recognized as an important cause of morbidity and mortality among abdominal solid organ transplant (ASOT) recipients, there are no data on its prognostic factors after an interim standard definition of MDR was proposed in 2012. The objective of this study was to describe the epidemiology, microbiology, and predictors of infection-related 30-day mortality in ASOT recipients with MDR GNB. METHODS: We performed a retrospective, double-center analysis of ASOT patients with MDR GNB over a 13-year study period. Univariate and multivariate analyses were performed to identify the risk factors for mortality. RESULTS: During the observational period, 2169 subjects underwent ASOT. Ninety-nine episodes of MDR GNB were diagnosed in 91 (4.6%) ASOT recipients, with a predominance of E.coli (29 isolates, 29.3%) and A.baumanii (24 isolates, 24.2%). The median age of these 91 recipients was 45 years (interquartile range 35-54). Mortality after the first episode of MDR GNB was 39.6% (36 deaths). The univariate analysis identified the following variables as predictors of MDR GNB-related mortality: lung focus (P = 0.001),nosocomial origin (P = 0.002), graft from donation after cardiac death or deceased donors (P = 0.023), presence of other concomitant bloodstream infection (P < 0.001), temperature of 40 °C or greater at the onset of MDR GNB (P = 0.039), creatinine > 1.5 mg/dl (P = 0.006), albumin < 30 g/L (P = 0.009), platelet count < 50,000/mm3 (P < 0.001), and septic shock (P < 0.001). In the multivariate logistic regression analysis, septic shock (odds ratio (OR) = 160.463, 95% confidence interval (CI) = 19.377-1328.832, P < .001), as well as creatinine > 1.5 mg/dl (OR = 24.498, 95% CI = 3.449-173.998, P = 0.001), nosocomial origin (OR = 23.963, 95% CI = 1.285-46.991, P = 0.033), and presence of other concomitant bloodstream infections (OR = 27.074, 95% CI = 3.937-186.210, P = 0.001) were the variables associated with MDR GNB-related 30-day mortality. CONCLUSIONS: MDR GNB was associated with high morbidity and mortality in ASOT recipients, with a predominant causative organisms being E.coli and A.baumanii. Nosocomial origin, as well as presence of other concomitant bloodstream infections, increased creatinine level and septic shock were the main predictors of MDR GNB-related 30-day mortality.

[Effect of motivational interviewing combined with peer participation on obesity management in adolescents].

OBJECTIVE: To investigate the effect of motivational interviewing combined with peer participation on obesity management in adolescents. METHODS: A total of 100 adolescents with simple obesity were randomly divided into traditional management and peer participation groups (n=50 each). The traditional management group received traditional health management. The peer participation group received motivational interviewing performed by psychological consultants combined with peer participation through the entire process in addition to traditional health management. The physical exercise, dietary behavior, differences in body composition parameters, and effect of comprehensive intervention were compared between the two groups after intervention for half a year. RESULTS: After the health management for six months, the peer participation group showed better improvements in the control of energy intake, adjustment of dietary structure, adherence to moderate/high intensity exercise, and increase in lean body mass compared with the traditional management group (P<0.05). The peer participation group had a significantly higher attendance rate for guidance and counseling performed by a multidisciplinary team once a week than the traditional management group (89% vs 57%; P<0.05), as well as a significantly higher response rate to health management than the traditional management group (83% vs 43%; P<0.05). CONCLUSIONS: Motivational interviewing combined with peer participation for obesity management can improve the compliance and the effect of comprehensive intervention in losing weight in adolescents.

The correlation between parents' education attainment and humanistic literacy of eight-year medical students.

Objectives: To explore the content, ways, and methods of family education in cultivating students' humanistic literacy. Methods: We used a cross-sectional study and collected questionnaire data from 616 eight-year clinical medical students of Central South University by a convenience sampling survey. To determine the influence of parents' educational attainment on children's humanistic literacy, the students were mainly divided into two groups including parents' education attainment was college or above (Group B) and parents' education attainment below college (Group A). Non-parametric tests are used to test the differences between the two groups in humanistic spirit, interpersonal communication, humanistic knowledge and ability, and development planning. Results: Group B had better social morality and a sense of social responsibility than group A (P=0.024, P=0.001). Compared to group A, students in group B could better integrate into the new environment, communicate with students from different institutes, and take an active part in activities (P=0.001). In a nutshell, students in group B had more excellent humanistic knowledge and ability and could consult medical literature and write in Chinese or English more proficiently than group A (P=0.0001, P=0.0001). Conclusions: We found that the eight-year medical students whose parents' highest education attainment is college or above almost mastered a higher level of humanistic literacy. It demonstrated family humanistic literacy education is irreplaceable. We recommend systematic efforts to build a reasonable and effective family humanistic literacy education platform and form an educational synergy with school education to make the cultivation of humanistic literacy among students more efficient.

Multiply cross-linked poly(vinyl alcohol)/cellulose nanofiber composite ionic conductive hydrogels for strain sensors.

Building multiple chemical crosslinks is an effective strategy to improve mechanical properties and to diversify final application of polysaccharide nanoparticles reinforced poly(vinyl alcohol) (PVA) physical hydrogels. In this work, PVA/cellulose nanofibers (CNFs) were used as composite substrate to fabricate ionic conductive hydrogels for strain sensor. Three types of characteristic crosslinks, including chemical crosslinking via boronic ester covalent bonds only, and with additional metal coordination bonding, as well as coexistence of physical crosslinks via PVA crystallites and aforementioned two kinds of chemical crosslinks, were constructed. The sample with triple crosslinks has superior mechanical strength and resistance to fatigue, and the polydopamine/Fe3+ ratio act as key to tune final performance because double-network structure prefers to form as Fe3+ is superfluous, while dual-crosslink one forms in the case of insufficient Fe3+. As-optimized ionic conductive hydrogel is suitable as strain sensor for probing human motions. This work provides an interesting insight into the network structure and property regulation for PVA/CNF composite hydrogels with multiple crosslinks.

Dynamic Cross-Linking Network Construction of Carboxymethyl Starch Enabling Temperature and Strain Bimodal Film Sensors.

Building stimulus-responsive units in the hydrogel coatings remains challenging for film sensors consisting of alternated layers of inert substrates and hydrogel coatings. An interesting film sensor with a carboxymethyl starch-based hydrogel coating was developed here. The cross-linking networks of carboxymethyl starch play the roles of structure-constructing units and stimulus-controlling units simultaneously, endowing the coatings with thermal sensing and strain sensing capabilities. The dynamic cross-links formed via the boronic ester bonds are temperature-sensitive, releasing or consuming additional acid ions with temperature alteration, and also as primary networks give the hydrogel strength and stretchability with the assistance of semi-penetrated polyacrylamide chains. Therefore, as-prepared flexible film sensors can be used to detect the periodic changes of human temperature and small-scale motion with multiple working modes, discriminating the physical states related to human health. Moreover, this kind of starch-based coating is degradable in a strongly alkaline solution and the inert substrate layer can protect the skin from erosion caused by direct hydrogel-skin contact, and thereby the film sensor is human- and environmentally friendly. This work also proposes a strategy of building temperature-sensitive units in the film sensor via regulating the chemical networks, instead of tuning physical structures.

From the West to the East: an evidence-based educational reform for modern medical students in traditional Chinese medicine learning.

Introduction: Generally, Traditional Chinese Medicine (TCM) courses are now given to modern medicine students without proper course scheduling, resulting in poor teaching results. Methods: To analyze the main factors affecting TCM learning, we surveyed the medical students and TCM teachers from Xiangya School of Medicine of Central South University via online questionnaires. The questionnaire comprised two parts, the students' part included the basic information, the subjective cognition in TCM, the attitude toward TCM course arrangements, and the attitude toward curriculum content and the design of TCM. The teachers' part included the basic information, the attitudes and opinions on TCM course arrangements, and suggestions and views on TCM teaching reform. The related data were collected from 187 medical students divided into two groups, namely, clinical medical students and non-clinical medical students. Results: We found a more positive attitude toward TCM [including "Scientific nature of TCM" (P = 0.03) and "Necessity for modern medicine students to learn TCM" (P = 0.037)] in clinical medical students compared with non-clinical medical students, clinical and non-clinical medical students tended to find TCM courses difficult, and the students prefer clinical training to be better than theoretical teaching, while the teachers believe that lecture-based education should have a more significant proportion. Discussion: Hence, to optimize the current TCM teaching, we conducted education reform, including differentiated teaching, hybrid teaching, and selective teaching.

The Impact of Undergraduate Tutor System in Chinese 8-Year Medical Students in Scientific Research.

Purpose: This study aimed to evaluate the effect and influence of the undergraduate tutor system on the undergraduate stage of Chinese 8-year medical program students in scientific research. Methods: We collected related data from 194 medical students in the Xiangya Medical School of Central South University. The questionnaire was composed of three parts, namely, eight questions for basic information about individual and undergraduate tutor system, five questions for the subjective feeling impact of the undergraduate tutor system, and 22 questions for accessing the scientific research ability and academic results. The students were mainly divided into three groups to compare different kinds of undergraduate tutor systems, namely, single tutor for multiple students' system (group A), multiple tutors for multiple students' system (group B), and no tutor system for comparison (group C). Results: The type of tutorial system, the frequency of guidance, and the way of guidance were independent influence factors of the view of 8-year medical students on scientific research. Group B behaved better than group C in literature processing (P = 0.012), experimental operation (P < 0.001), statistical analysis (P < 0.001), and manuscript producing (P = 0.019). Group A and B joined in more National college students' innovation and entrepreneurship training programs (P = 0.003, P < 0.001). The most popular types of articles published by students were bioinformatics, meta-analysis, and reviews. Conclusion: Undergraduate tutor system has made tremendous achievements in cultivating students' scientific research capacity; however, implement improvement should be considered to better educate students.

A cross-sectional study on the response abilities of clinical and preventive medical students in public health emergency.

Inconsistent training programs for public health emergency (PHE) have been criticized as a contributing factor in PHE's managerial weak points. In response, to analyze the relevant discrepancies among the medical students in the class of 2021 from Xiangya School of Medicine of Central South University, the present study conducted an online questionnaire survey using convenience sampling. The questionnaire comprised four sections, including the basic information, the subjective cognition in PHE, the rescue knowledge and capabilities of PHE, and the mastery of PHE regulations and psychological intervention abilities. To compare the abovementioned aspects, related data were collected from 235 medical students divided into two groups, namely, clinical medical students (Group A) and preventive medical students (Group B). We found a more positive attitude in PHE (P = 0.014) and a better grasp of the PHE classification (P = 0.027) and the reporting system in group B compared with group A. In addition, even if group B showed the same response capability in communicable diseases as group A, the former had less access to clinical practice, resulting in poorer performance in the noncommunicable diseases during a fire, flood, and traffic accidents (P = 0.002, P = 0.018, P = 0.002). The different emphasis of each training program contributed to the uneven distribution of abilities and cognition. Meanwhile, the lack of an integrated PHE curriculum led to unsystematic expertise. Hence, to optimize the PHE management system, equal attention should be paid to medical students with diverse majors along with a complete integrated PHE curriculum.

Tertiary Lymphoid Structures in Cancer: The Double-Edged Sword Role in Antitumor Immunity and Potential Therapeutic Induction Strategies.

The complex tumor microenvironment (TME) plays a vital role in cancer development and dramatically determines the efficacy of immunotherapy. Tertiary lymphoid structures (TLSs) within the TME are well recognized and consist of T cell-rich areas containing dendritic cells (DCs) and B cell-rich areas containing germinal centers (GCs). Accumulating research has indicated that there is a close association between tumor-associated TLSs and favorable clinical outcomes in most types of cancers, though a minority of studies have reported an association between TLSs and a poor prognosis. Overall, the double-edged sword role of TLSs in the TME and potential mechanisms need to be further investigated, which will provide novel therapeutic perspectives for antitumor immunoregulation. In this review, we focus on discussing the main functions of TLSs in the TME and recent advances in the therapeutic manipulation of TLSs through multiple strategies to enhance local antitumor immunity.

Association of Paraspinal Muscle Measurements on Chest Computed Tomography With Clinical Outcomes in Patients With Severe Coronavirus Disease 2019.

BACKGROUND: Skeletal muscle depletion is common in old adults and individuals with chronic comorbidities, who have an increased risk of developing severe coronavirus disease 2019 (COVID-19), which is defined by hypoxia requiring supplemental oxygen. This study aimed to determine the association between skeletal muscle depletion and clinical outcomes in patients with severe COVID-19. METHODS: One hundred and sixteen patients with severe COVID-19 who underwent chest computed tomography scan on admission were included in this multicenter, retrospective study. Paraspinal muscle index (PMI) and radiodensity (PMD) were measured using computed tomography images. The primary composite outcome was the occurrence of critical illness (respiratory failure requiring mechanical ventilation, shock, or intensive care unit admission) or death, and the secondary outcomes were the duration of viral shedding and pulmonary fibrosis in the early rehabilitation phase. Logistic regression and Cox proportional hazards models were employed to evaluate the associations. RESULTS: The primary composite outcome occurred in 48 (41.4%) patients, who were older and had lower PMD (both p < .05). Higher PMD was associated with reduced risk of critical illness or death in a fully adjusted model overall (odds ratio [OR] per standard deviation [SD] increment: 0.87, 95% confidence interval [CI]: 0.80-0.95; p = .002) and in female patients (OR per SD increment: 0.71, 95% CI: 0.56-0.91; p = .006), although the effect was not statistically significant in male patients (p = .202). Higher PMD (hazard ratio [HR] per SD increment: 1.08, 95% CI: 1.02-1.14; p = .008) was associated with shorter duration of viral shedding among female survivors. However, no significant association was found between PMD and pulmonary fibrosis in the early rehabilitation phase, or between PMI and any outcome in both men and women. CONCLUSIONS: Higher PMD, a proxy measure of lower muscle fat deposition, was associated with a reduced risk of disease deterioration and decreased likelihood of prolonged viral shedding among female patients with severe COVID-19.

Knowledge, Attitudes, and Social Responsiveness Toward Corona Virus Disease 2019 (COVID-19) Among Chinese Medical Students-Thoughts on Medical Education.

Purpose: To assess knowledge, attitudes, and social responsiveness toward COVID-19 among Chinese medical students. Methods: Self-administered questionnaires were used to collect data from 889 medical students in three well-known Chinese medical universities. The questionnaire was comprised of three domains which consisted of demographic characteristic collection, seven items for knowledge, and eight items for attitudes and social responsiveness toward COVID-19. Data from different universities were lumped together and were divided into different groups to compare the differences, including (1) students at the clinical learning stage (Group A) or those at the basic-medicine stage (Group B) and (2) students who have graduated and worked (Group C) or those newly enrolled (Group D). Results: Medical students at group B had a weaker knowledge toward COVID-19 than did students at group A, especially in the question of clinical manifestations (p < 0.001). The percentage of totally correct answers of COVID-19 knowledge in group C was higher than that in Group D (p < 0.001). There were significant differences between groups C and D in the attitudes and social responsiveness toward COVID-19. Surprisingly, we found that the idea of newly enrolled medical students could be easily affected by interventions. Conclusions: In light of this information, medical education should pay attention not only to the cultivation of professional knowledge and clinical skills but also to the positive interventions to better the comprehensive qualities including communicative abilities and empathy.

Alkyne- and Nitrile-Anchored Gold Nanoparticles for Multiplex SERS Imaging of Biomarkers in Cancer Cells and Tissues.

Surface-enhanced Raman spectroscopy (SERS) has proven a powerful tool for multiplex detection and imaging due to its narrow peak width and high sensitivity. However, conventional SERS reporters are limited to thiolated compounds, which have limitations such as chemical stability and spectral overlap. Here, we used alkyne- and nitrile-bearing molecules to directly fabricate a set of SERS tags for multiplex imaging. The alkyne and nitrile groups act as both the anchoring points to interact with gold nanoparticle (AuNP) surfaces and the reporters exhibiting strong and nonoverlapping signals in the cellular Raman-silent region. The SERS tags were subsequently modified with different antibodies for multicolor imaging of cancer cells and human breast cancer tissues. The reporters have a simple and readily accessible structure, hence providing new opportunities to prepare SERS nanoprobes.

Exploring Chinese Women's Perception of Cervical Cancer Risk as It Impacts Screening Behavior: A Qualitative Study.

BACKGROUND: Chinese women rarely undergo regular cervical screening. Women's decisions about cervical screening may be influenced by their perception of the risk of cervical cancer. Therefore, understanding how women perceive the risk of cervical cancer, how personal risk factors are interpreted, and the influence of cultural issues on cervical screening behavior is important. OBJECTIVE: The aim of this study is to understand cervical cancer risk perception and the role of personal risk factors as they influence screening behavior among Chinese women. METHOD: An exploratory qualitative research design was used. We conducted semistructured, in-depth interviews of 27 women in Changsha, a medium-size city in Hunan province, China. RESULTS: Participants identified that cervical cancer had serious consequences, but they distanced themselves psychologically from the disease because they felt that "cervical cancer is a shameful and deadly disease." Although women identified some of the risk factors for the disease, they had little specific knowledge of human papillomavirus infection, its association with cervical cancer, and the importance of cervical screening. CONCLUSION: This study contributes new knowledge to the understanding of cervical screening behavior within a specific social and cultural context. Better efforts should be made to educate Chinese women on the risk of cervical cancer and emphasize that effective cancer treatments are available and that there is a good chance of survival. IMPLICATIONS FOR PRACTICE: Nurses working with Chinese women should ensure that the information they provide is culturally sensitive, particularly by acknowledging the normative beliefs of this population group.

Fluorescence Dye Loaded Nano-graphene for Multimodal Imaging Guided Photothermal Therapy.

Photoacoustic imaging (PA) has emerged as a novel and noninvasive imaging modality owing to its high spatial resolution and high soft tissue contrast. Herein, we loaded a near-infrared (NIR) fluorescence dye (CySCOOH) onto the surface of PEGylated graphene oxide (GO) via π-π stacking to increase the NIR absorbance of GO. The PA imaging proved that PEGylated GO-CysCOOH (GO-PEG-CysCOOH) significantly enhances the PA signal in the tumor site compared with free GO-PEG. We then utilized the strong optical absorbance of GO-PEG-CySCOOH in the NIR region for in vivo photothermal therapy, achieving efficient tumor ablation after intravenous injection of GO-PEG-CySCOOH and low-power laser irradiation on the tumor. Our results indicate that this graphene-based nanocomposite can be developed as a promising contrast agent for PA imaging and a thermal agent for imaging guided photothermal therapy.