Effect of the STK11 mutation on therapeutic efficacy and prognosis in patients with non-small cell lung cancer: a comprehensive study based on meta-analyses and bioinformatics analyses.

BACKGROUND: This study aimed to systematically analyze the effect of a serine/threonine kinase (STK11) mutation (STK11mut) on therapeutic efficacy and prognosis in patients with non-small cell lung cancer (NSCLC). METHODS: Candidate articles were identified through a search of relevant literature published on or before April 1, 2023, in PubMed, Embase, Cochrane Library, CNKI and Wanfang databases. The extracted and analyzed data included the hazard ratios (HRs) of PFS and OS, the objective response rate (ORR) of immune checkpoint inhibitors (ICIs), and the positive rates of PD-L1 expression. The HR of PFS and OS and the merged ratios were calculated using a meta-analysis. The correlation between STK11mut and clinical characteristics was further analyzed in NSCLC datasets from public databases. RESULTS: Fourteen retrospective studies including 4317 patients with NSCLC of whom 605 had STK11mut were included. The meta-analysis revealed that the ORR of ICIs in patients with STK11mut was 10.1% (95%CI 0.9-25.2), and the positive rate of PD-L1 expression was 41.1% (95%CI 25.3-57.0). STK11mut was associated with poor PFS (HR = 1.49, 95%CI 1.28-1.74) and poor OS (HR = 1.44, 95%CI 1.24-1.67). In the bioinformatics analysis, PFS and OS in patients with STK11 alterations were worse than those in patients without alterations (p < 0.001, p = 0.002). Nutlin-3a, 5-fluorouracil, and vinorelbine may have better sensitivity in patients with STK11mut than in those with STK11wt. CONCLUSIONS: Patients with STK11-mutant NSCLC had low PD-L1 expression and ORR to ICIs, and their PFS and OS were worse than patients with STK11wt after comprehensive treatment. In the future, more reasonable systematic treatments should be explored for this subgroup of patients with STK11-mutant NSCLC.

Association between elevated endocan levels and obstructive sleep apnea hypopnea syndrome in Turkey and China: A meta-analysis.

BACKGROUND: Endothelial dysfunction has been implicated in the pathogenesis of obstructive sleep apnea-hypopnea syndrome (OSAHS). Previous research has linked endothelial dysfunction to the vascular pathology marker endothelial cell-specific molecule-1 (endocan). This meta-analysis compared endocan concentrations among adult patients with OSAS and controls, and ascertained whether any differences exist. This study aimed to highlight the association between high endocan levels and OSAHS. METHODS: A comprehensive, systematic literature search of the PubMed, Cochrane Library, China National Knowledge Infrastructure, Web of Science, Embase, and Wan Fang databases for relevant studies, published between January 2000 and June 10, 2013, was performed. Additionally, standardized mean differences, correlation coefficients, and adjusted odds ratios were used to assess the effect size. Statistical analyses were performed using R version 4.13 (Copenhagen: The Cochrane Collaboration) and Stata version 10.0 (StataCorp LLC, College Station, TX). RESULTS: Twelve studies fulfilled the inclusion criteria. Nine studies reported endocan levels in patients with OSAHS and controls, and 6 reported serum endocan levels in relation to polysomnography (PSG) indexes (apnea-hypopnea index, body mass index, minimum oxygen (O2) saturation, and flow-mediated dilatation [FMD]). Five studies reported that serum endocan levels functioned independently as risk factors for OSAHS. These levels were determined to be elevated in adults with OSAHS compared with controls (standardized mean difference 1.30 [95% confidence interval (CI) 1.06-1.54]) and increased more significantly with increasing disease severity in individuals with OSAHS. Subjects were divided into different subgroups based on race, geographical region, sample type, and study design. Results indicated increased endocan levels across all OSAHS subgroups compared with the control group. The data highlighted a positive association between serum endocan levels and apnea-hypopnea index, and a negative association with FMD and minimum O2 saturation. The overall adjusted odds ratio between serum endocan levels and OSAHS was 1.04 (95% CI 1.02-1.06). CONCLUSION: Results of this meta-analysis provide further evidence supporting elevated endocan levels in adults with OSAHS. Serum endocan levels were correlated with various PSG indices and may be associated with OSAHS.

Spirituality and Attitudes Toward Death Among Older Adults in Rural and Urban China: A Cross-Sectional Study.

The purpose of this study was to investigate spirituality and attitudes toward death among rural and urban elderly. We asked 134 older adults from rural areas and 128 from urban areas to complete a self-administrated questionnaire including the Spiritual Self-assessment Scale and Death Attitude Scale. The fear and anxiety of death, escape acceptance, natural acceptance, approach acceptance, and death avoidance scores of older adults living in rural areas were higher than those living in urban areas. The construction of social infrastructure and medical care should be strengthened in rural areas so as to improve older adults' attitudes toward death.

Identification of RNU44 as an Endogenous Reference Gene for Normalizing Cell-Free RNA in Tuberculosis.

Background: Normalization of cell-free RNA (cf-RNA) concentration can be affected by variable experimental conditions and thus impact the performance of their diagnostic potential. Our study aimed to identify appropriate endogenous reference genes for cf-RNA biomarker evaluation in the diagnosis of tuberculosis (TB). Methods: Subjects consisting of patients with TB with and without malignancy, patients with pneumonia, and healthy controls were recruited. Candidate reference genes were screened and identified by literature reviewing and RNA-Seq analysis. Expression levels of the candidate genes were determined by reverse-transcription real-time quantitative polymerase chain reaction in plasma from patients with TB and healthy controls. The stability of gene expression was assessed by geNorm, NormFinder, BestKeeper, the Comparative Delta Ct method, and RefFinder. Differential expression of 2 small RNAs (sRNAs) encoding by genome of Mycobacterium tuberculosis in plasma of patients with TB were determined by both absolute quantification and relative quantification with candidate reference genes. Results: According to the stability ranking analyzed with the 5 computational programs, the top 4 candidates-miR-93, RNU44, miR-16, and glyceraldehyde 3-phosphate dehydrogenase-were used to normalize the transcript levels of 2 mycobacterial sRNAs, MTS2823 and MTS1338, which were observed to have higher copy numbers in the plasma of patients with TB. Normalization with RNU44 displayed significantly higher levels of the 2 M tuberculosis sRNAs in the patients' plasma than those of healthy controls. Conclusions: RNU44 was demonstrated as a proper endogenous gene for cf-RNA normalization in TB diagnosis.

Association between spiritual care competency and perceived professional benefit among nurses: A cross-sectional study.

AIMS: This study aimed to investigate the status quo of nurses' spiritual care competency and their relationship with perceived professional benefit. BACKGROUND: Spiritual care has always been considered a vitally important part of holistic nursing. Understanding the spiritual care competency of nurses during the COVID-19 pandemic can help nursing managers understand the weak links in spiritual care practice and improve the quality of nursing service. As a positive emotional experience and cognitive evaluation of the profession, perceived professional benefit can serve to adjust work pressure, relieve job burnout and promote an individual's overall growth. However, the relationship between perceived professional benefit among nurses and spiritual care competency remains unclear. METHODS: A total of 372 nurses were recruited from 15 separate Chinese hospitals. An online questionnaire was used to assess nurses' sociodemographic, spiritual care competency and perceived professional benefit. Statistical analyses were performed using Pearson's correlation analysis, t test, analysis of variance (ANOVA) and multiple stepwise linear regression analysis. RESULTS: The total mean score of spiritual care competency (99.43 ± 21.10) among nurses was found to be moderate. Nurses' spiritual care competency was positively correlated with perceived professional benefit (P < .01). The multiple stepwise linear regression model (n = 372) had an explained variance (R2 = 0.218) and showed that perceived professional benefit and the manner of receiving spiritual training were the main influencing factors of nurses' spiritual care competency (P < .001). CONCLUSION: The study findings indicated that nurses need to improve their spiritual care competency by improving their perceived professional benefit. IMPLICATION FOR NURSING MANAGERS: Our study evaluated the spiritual care competency of nurses and explored the correlation between perceived professional benefit and spiritual care competency among nurses. The results of this study can help nursing managers to carry out relevant interventions, thus improving nurses' spiritual care competency and optimizing the quality of nursing.

Evaluation of the Ecological Effects of Ecological Restoration Programs: A Case Study of the Sloping Land Conversion Program on the Loess Plateau, China.

The Sloping Land Conversion Program (SLCP) is the largest ecological restoration program in the world. Evaluating the ecological effects of the SLCP not only provides a scientific basis for China to improve the SLCP but also provides a reference for other countries in the world to evaluate the ecological effects of ecological restoration programs being implemented or to be implemented. To this end, we took the Loess Plateau, the core area for the implementation of the SLCP, as an example and, based on multi-source remote sensing data and GIS technology, we conducted a comprehensive evaluation of the ecological effects of the implementation of the SLCP on the Loess Plateau. The results showed that, first, from 2000 to 2018, a total of 12,372.05 km2 of cultivated land was converted into forest land and grassland on the Loess Plateau, and this contributed to an increase in vegetation cover from 45.09% in 2000 to 64.15% in 2018, and a decrease in the soil erosion modulus from 26.41 t·hm-2·yr-1 in 2000 to 17.92 t·hm-2·yr-1 in 2018. Second, the 6-25° slope range is the core area of the Loess Plateau for implementation of the SLCP. In this range, the area of cultivated land converted into forest land and grassland accounts for 60.16% of the total area of transferred cultivated land. As a result, the 6-25° slope range has become the most significant area for improving vegetation cover and reducing the soil erosion intensity, and it is mainly concentrated in the southwestern, central and central-eastern hilly and gully areas of the Loess Plateau. Third, from 2000 to 2018, the climate of the Loess Plateau tended to be warm and humid and was conducive to the implementation of the SLCP. Among these factors, precipitation is the dominant factor in determining the spatial distribution of vegetation on the Loess Plateau, and the increase in precipitation is also the main reason for the promotion of vegetation growth. Fourthly, from 2000 to 2018, the ecological environment of the Loess Plateau was significantly improved as a result of the combined effects of the implementation of the SLCP and climate warming and humidification, but the primary reason is still the implementation of the SLCP.

Screening of 20 Mycobacterium tuberculosis sRNAs in plasma for detection of active pulmonary tuberculosis.

BACKGROUND: Mycobacterium tuberculosis (MTB) sRNAs are abundant. However, the level of MTB sRNA in peripheral blood remains elusive. METHODS: Twenty MTB sRNAs annotated in the reference genome of H37Rv were detected in the plasma of 170 active pulmonary tuberculosis patients and 124 healthy people by qRT-PCR detection system. The differential expression of sRNAs were analyzed in two groups. The value of sRNAs for diagnosis of active tuberculosis were evaluated by ROC curve analysis. RESULTS: Eight of the 20 sRNAs (MTS2823, MTS0997, MTS1338, ASdes, G2, C8, mcr15 and MTS1082) were found in at least 50% of the samples detected. The relative expression levels of MTS2823, MTS0997, MTS1338 and ASdes in plasma of tuberculosis patients were statistically higher than those in healthy controls. ROC curve analysis showed that the AUC of MTS0997, MTS1338, MTS2823 and ASdes were 0.8935 (95% CI 0.8109-0.9760), 0.8722 (95% CI 0.7862-0.9581), 0.8208 (95% CI 0.7246-0.9170) and 0.5792 (95% CI 0.4240-0.7344), respectively. The AUC value of combination of MTS0997, MTS1338 and MTS2823 was 0.914 (95% CI 0.8281-0.9926). CONCLUSIONS: MTB sRNAs MTS2823, MTS0997 and MTS1338 have the potential to be plasma biomarkers for active pulmonary tuberculosis.

Dynamic Relationships, Regional Differences, and Driving Mechanisms between Economic Development and Carbon Emissions from the Farming Industry: Empirical Evidence from Rural China.

The coordinated development of the economy, resources, and environment is a key aspect of sustainable development. China's rapid agricultural modernization has been accompanied by the continuous growth of rural economic aggregate and carbon emissions from the planting industry. However, the quantitative relationship between these two factors and its internal mechanism are not yet fully understood. In this paper, the Intergovernmental Panel on Climate Change (IPCC) method is used to calculate the carbon emissions of the planting industry in China from 1998-2019. Based on this, the Tapio decoupling analysis model was constructed to study the decoupling relationship between economic development and carbon emissions of the planting industry in China from 1998-2019 and the associated spatial and temporal evolution patterns. The effect of the complete decomposition model (without residuals), in terms of carbon emissions from the planting industry, on the process of economic development and its transmission mechanism are introduced. The results show that: (1) The carbon emissions of the planting industry in China increased with the economic development occurring from 1998-2005, where agricultural economic development was highly dependent on resource factors and the environment. The growth trend of carbon emissions of the planting industry slowed from 2006 to 2019, while economic development has gradually realized the decoupling of carbon emissions from the planting industry. (2) From 1998-2019, in Heilongjiang, Sichuan, and Hunan, the economic development was given priority, showing strong and negative decoupling with carbon emissions from farming. The economic development in most regions were given priority, showing strong decoupling with carbon emissions from farming. Up to 2019, decoupling was observed with a significant trend of spatial agglomeration. (3) Economic scale effects had a positive influence on the carbon emissions of the planting industry, while the technology effect and population effect had an inhibiting influence on the carbon emissions of the planting industry. The key policy implication of this paper is that improvement of the quality of economic development serves as the premise for the transformation of the economic development mode. It is necessary to reasonably regulate the economic growth rate and expansion scale, reduce resource consumption and pollutant emission technology, and to make full use of resources, in order to provide a basis for the formulation of reasonable emission reduction policies. An effective way to realize the sustainable development of the agricultural economy would be to improve the technical efficiency, control the population scale appropriately, and optimize the agricultural industrial structure.

Synergetic Relationship between Urban and Rural Water Poverty: Evidence from Northwest China.

Combining the measurement of urban and rural areas to link water and poverty provides a new insight into the fields of water resources management and poverty alleviation. Owing to rapid urban development, water resource conflicts between urban and rural areas are gettingbecoming more intensified and more complex. This study details the application of a water poverty index (WPI) using 26 indicators to evaluate urban and rural water poverty in northwest China during the period 2000-2017. This study also analyzes temporal variations of urban and rural water poverty by the kernel density estimation (KDE). We found that the level of water poverty is gradually declining over time and the improvements in urban and rural areas are not harmonious. Additionally, it applies the synergic theory to analyze the relationships between urban and rural water poverty. The correspondence analysis between urban and rural water poverty is significant because of the synergic level results. The results show that there are four primary types in northwest China: synchronous areas, urban-priority areas, rural-priority areas, and conflict areas, and their evolution stages. The results suggest the need for location-specific policy interventions. Furthermore, we put forward corresponding countermeasures. The research findings also provide a theoretical foundation for the evaluation of urban and rural water poverty, and a regional strategy to relieve conflict between urban and rural water poverty.

Application of OECD LSE Framework to Assess Spatial Differences in Rural Green Development in the Arid Shaanxi Province, China.

The green development theory proposed by the Organization for Economic Cooperation and Development (OECD) has promoted the harmonious development of the economy, society, and environment in many countries, in particular, it has provided a good option for the coordinative development of economic growth, resource utilization, and ecological protection in rural areas of developing countries. For this reason, we used the OECD model to measure green development in arid, rural areas of China, and also subjective and objective weighting methods to measure the rural green development level of 78 county-level regions in Shaanxi province in 2018. At the same time, the least square error (LSE) method was used to determine the contribution rate of government support, environmental pressure, resource endowment, and quality of life, so as to determine the influencing factors of rural green development in Shaanxi. The results show that the levels of rural green development in Shaanxi province differed internally: the level of green development in the north was strong, moderate in the southwest and northwest, and weak in the center and south. The driving types of rural green development in Shaanxi province are divided into five types: Three Factors I, Three Factors II, Four Factors I, Four Factors II, and Five Factors; the influencing factors of rural green development are varied from county to county. In terms of different regions, different development approaches and countermeasures are proposed respectively. This research provides scientific guidance for local government to formulate green agricultural development policies and to overcome the development difficulties in rural areas.