Objective: To conduct a scoping review on the types, construction methods and predictive performance of health literacy prediction models based on machine learning methods, so as to provide the reference for the improvement and application of such models. Methods: Publications on health literacy prediction models conducted using machine learning methods were retrieved from CNKI, Wanfang Data, VIP, PubMed and Web of Science from inception to May 1, 2024. The quality of literature was assessed using the Prediction Model Risk of Bias ASsessment Tool. Basic characteristics, modeling methods, data sources, missing value handling, predictors and predictive performance were reviewed. Results: A total of 524 publications were retrieved, and 22 publications between 2007 and 2024 were finally enrolled. Totally 48 health literacy prediction models were involved, and 25 had a high risk of bias (52.08%), with major issues focusing on missing value handling, predictor selection and model evaluation methods. Modeling methods included regression models, tree-based machine learning methods, support vector machines and neural network models. Predictors primarily encompassed factors at four aspects: individual, interpersonal, organizational and society/policy aspects, with age, educational level, economic status, health status and internet use appearing frequently. Internal validation was conducted in 14 publications, and external validation was conducted in 4 publications. Forty-two models reported the areas under the receiver operating characteristic curve, which ranged from 0.52 to 0.983, indicating good discrimination. Conclusion Health literacy prediction models based on machine learning methods perform well, but have deficiencies in risk of bias, data processing and validation.

Pyroptosis, a form of inflammatory cell death mediated by the Gasdermins family, promotes the release of inflammatory mediators and activates immune cell populations such as NK cells, T cells and macrophages in the tumor microenvironment(TME) to exert immune-regulating and anti-tumor effects. Glioblastoma(GBM) is the most serious and malignant glioma, and the median survival of patients diagnosed with GBM is less than 2 years, and the presence of the blood-brain barrier makes it difficult to deliver drugs to the brain, thus affecting the effect of drugs against GBM. Therefore, it is important to explore new measures and mechanisms to treat GBM, which has a complex TME with a large number of immune cell populations that are often immunosuppressed by GBM. Cellular pyroptosis as a mode of cell death capable of activating immunity, has the effect of activating the body’s immunity to help reverse TME immunosuppression. This review will focus on the relationship between cell pyroptosis and the immune system, how cell pyroptosis affects the immune cell population of TME in GBM, and the new progress in drug research on cell pyroptosis pathways in GBM treatment, providing new directions and strategies for future clinical treatment of GBM.

Abstract Health literate schools (HeLit-Schools) play a significant role in fostering students health literacy. The paper elucidates the background and conceptual connotations of HeLit-Schools, and analyzes how HeLit-Schools effectively integrate and enhance the health literacy of schools in three aspects: philosophy and core drivers, strategy and method implementation, as well as evaluation mechanisms and standard setting. Furthermore, the paper explores the implications of foreign HeLit-Schools research and practice for China under the context of "Healthy China" construction, as well as the key strategies for Chinese schools in the implementation of HeLit-Schools, aiming to provide a new perspective and theoretical support for Chinese schools to practice the "Healthy China initiative" and strengthen school construction from the perspective of health literacy.

【Objective】 To investigate the expression of optineurin (OPTN) in multiple myeloma (MM) and explore the mechanism and clinical value of OPTN gene in the occurrence and development of MM. 【Methods】 In this study, three gene expression omnibus (GEO) data sets were used to analyze the expression level of OPTN in MM. Clinical bone marrow samples of MM patients were collected. qRT-PCR was used to further verify the expression of OPTN in MM patients. The Kaplan-Meier survival curve and receiver operating characteristic (ROC) curve were used to analyze the value of OPTN in the prognosis and diagnosis of MM. At the same time, MM transcriptome data were downloaded from the Cancer Genome Atlas (TCGA) database. According to the median boundary of OPTN mRNA expression level, the MM patients were divided into OPTN high- and low-expression groups. In order to investigate the possible molecular mechanisms of OPTN in MM, gene set enrichment analysis (GSEA) was made after the differentially expressed genes were filtered using the limma package of the R language. 【Results】 The expression level of OPTN was significantly lower in MM tissues than in normal tissues (P<0.05). OPTN expression level was significantly correlated with International Staging System (ISS) in MM patients (P<0.05). ROC results showed that the expression level of OPTN could distinguish between normal and MM patients. Survival analysis showed that the overall survival (OS) of patients with low OPTN expression was significantly lower than that of patients with high OPTN expression (P<0.05). GO, KEGG and GSEA enrichment analyses indicated that OPTN might affect apoptosis and autophagy, and regulate cellular immune response by regulating Nod-like receptors, NF-κB, TNF and RAS/MAPK pathways. 【Conclusion】 Low expression of OPTN in MM is associated with poor prognosis of patients, and thus may be an important potential biomarker for the diagnosis and treatment of MM.

Abstract As dietary issues of children and adolescents become increasingly complex, the assessment of food literacy (FL) is increasingly importance. FL involves a comprehensive cognition and practical ability concerning food among children, playing a key role in fostering healthy eating habits and improving health levels. The article explores the definition and connotations of FL, and introduces eight FL assessment tools in terms of theoretical foundations, dimensions, assessment methods, and their reliability and validity. Moreover, it provides a comparative analysis of these tools by examining their dimensional design, evaluation indicators, strengths, and weaknesses, as well as their applicable subjects and scenarios, aiming to offer references for implementing relevant policies and developing more comprehensive and effective FL assessment tools.

Objective To investigate the clinical features and genetic characteristics of patients with late-onset Pompe disease(LOPD).Methods A total of 13 patients diagnosed with LOPD in the First Affilia-ted Hospital of Zhejiang University School of Medicine from September 2020 to December 2023 were selected,and all patients were subjected to clinical investigation,GAA activity detection and GAA gene testing.Results Among the 13 patients,7 were males and 6 were females;5 were family patients and 8 were sporadic patients;and the median age of onset was 17 years(8-52 years),the median age of presentation was 24 years(10-52 years),and the median age of diagnosis was 31 years(14-58 years).In terms of the first symptoms,10 pa-tients presented with limb weakness and 3 patients presented with dyspnea.The average serum creatine kinase level was 552 U/L(55-1084 U/L),and the serum creatine kinase level was normal in one patient.All pa-tients had scoliosis and different degrees of restrictive ventilatory dysfunction.Neuroelectrophysiological exami-nations of 9 patients showed myogenic damage,and 8 of them had muscle tonic discharge.The mean value of GAA activity was 0.3 μmol/(L·h)[0.17-0.5 μmol/(L·h)].A total of 13 mutations were detected in GAA gene,and the most common mutation was c.2238G＞C(p.W746C).There were five new variant sites:c.543del(p.F181Lfs*40),c.839_840insCC(p.R281Pfs*34),c.1800_1823del(p.S601_R608del),c.2296T＞C(p.Y766H)and c.995C＞A(p.S332*).Conclusions LOPD is a rare disease that tends to delay diagnosis.Proximal limb weakness,decreased respiratory function,mild-to-moderate elevation of creatine kinase,scoliosis,and clinical inferior tonic discharge on electromyography are high-risk images of LOPD.c.2238G＞C(p.W746C)is a hotspot mutation,and the discovery of five new mutations enriches the GAA gene mutations lineage.

Objective:To explore the impact of the hospital health literacy environment on patients′ postoperative pain self-management behaviors, aiming to provide insights for hospitals to implement the Comprehensive Pain Management Pilot Work Program in hospitals and to promote self-health management among patients with other diseases or symptoms. Methods:From November to December 2023, a convenience sampling method was used to select postoperative patients from three grade A tertiary general hospitals in Zhejiang Province for an on-site questionnaire survey. The Chinese version of brief health literacy screen (BHLS), short-form health literacy environment scale (SF-HLES) and postoperative pain self-management behavior questionnaire (PPSMB) were used as survey tools to investigate the health literacy level of patients, the health literacy environment of the hospital, and the postoperative pain management behaviors of patients. Two-way ANOVA was used to compare the impact of different dimensions of the hospital health literacy environment on postoperative pain management behaviors among patients with different levels of health literacy. Multiple linear regression analysis was used to explore the relationship between the hospital health literacy environment, individual health literacy, and patients′ postoperative pain self-management behaviors, and to discuss the impact of individual health literacy on patients′ postoperative pain self-management behaviors under different hospital health literacy environments.Results:341 valid questionnaires were collected. The average score of the hospitals′ SF-HLES was (73.62±19.54) points. The average score of the patients′ BHLS was (9.65±2.88) points. The average score of the patients′ PPSMB was (25.99±6.35) points. Two-way ANOVA results showed that the interaction between individual health literacy and the clinical dimension ( F=5.463, P=0.020) and structural dimension ( F=6.470, P=0.011) of the hospital health literacy environment had a statistically significant impact on patients′ postoperative pain self-management behaviors, while the interaction with the interpersonal dimension ( F=0, P=0.984) had no statistically significant impact on pain self-management behaviors. Simple effect analysis indicated that only in the high health literacy environment of the clinical and structural dimensions did the difference in pain self-management behaviors between patients with good health literacy and those with limited health literacy had statistical significance ( P<0.001). Multiple linear regression analysis results showed that for each 1-point increase in the patients′ BHLS score, their PPSMB score increased by 3.74 points ( β1=0.832, P<0.001); for each 1-point increase in the hospital′s SF-HLES score, the patients′ PPSMB score could increase by 0.198 points ( β2=0.610, P<0.001). In a low health literacy environment, individual health literacy did not affect pain self-management behaviors ( P>0.05); however, in a high health literacy environment, for each 1-point increase in the patients′ BHLS score, their PPSMB score correspondingly increased by 4.037 points ( β4=0.317, P<0.001). Conclusions:The positive impact of individual health literacy on pain self-management is contingent upon a high-quality hospital health literacy environment. This suggests that optimizing the hospital health literacy environment is a necessary precondition for implementing the relevant content of the Comprehensive Pain Management Pilot Work Program and can provide a reference for promote self-health management among patients with pain and other diseases or symptoms.

Objective:To explore the methylation degree of miRNA-4729 (miR-4729) in renal cancer tissues and its impact on the proliferation and migration abilities of renal cancer cell lines.Methods:Data from the SurvivalMeth database (updated in October 2022) was used to analyze the methylation degree of miR-4729 in 178 renal cancer tissues. Target gene with complementary binding sites to miR-4729 was predicted by miRNApath software. The normal renal tubular epithelial cell line HK-2 and the renal cancer cell lines Caki-1, A-498, ACHN, and 786-O were selected. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression of miR-4729 in each cell line and the effect of methylation inhibitor 5-aza-2'-deoxycytidine (5-Aza-CdR) on the expression of miR-4729 in renal cancer cells. A-498 cells with the lowest relative expression of miR-4729 were transfected with miR-4729 mimic (miR-4729 group) and miRNA-NC (NC group), and colony formation assay and scratch assay were used to detect the effect of overexpression of miR-4729 on the proliferation and migration abilities of A-498 cells. Dual-luciferase reporter gene assay was used to verify the targeting relationship between miR-4729 and DEAD box peptide 5 (DDX5). Western blotting was used to detect the effect of miR-4729 overexpression on the expression of DDX5 protein and AKT signaling pathway-related proteins (p-AKT, p-IKKα, p-Tpl2 and AS160) in A-498 cells.Results:The analysis results of data from the SurvivalMeth database showed that the methylation degree of miR-4729 in renal cancer tissues was higher than that in paracancerous tissues ( P < 0.01). The relative expressions of miR-4729 in renal cancer Caki-1, A-498, ACHN, 786-O cells and normal renal tubular epithelial HK-2 cells were 0.62±0.05, 0.16±0.04, 0.53±0.02, 0.69±0.03, and 0.99±0.07, respectively, and the difference was statistically significant ( F = 47.39, P < 0.01). Compared with various cell groups cultured with dimethyl sulfoxide (DMSO), the relative expressions of miR-4729 in renal cancer Caki-1, A-498, ACHN and 786-O cells cultured with 5-Aza-CdR were higher (all P < 0.01). The results of colony formation assay showed that the number of colonies formed in A-498 cells of the miR-4729 group and NC group were 53±6 and 102±10, respectively, and the difference was statistically significant ( t = 4.25, P < 0.01). The results of scratch assay showed that the scratch healing rates of A-498 cells in the miR-4729 group and NC group were (42.3±2.7)% and (67.6±4.8)%, respectively, and the difference was statistically significant ( t = 4.58, P < 0.01). The results of dual-luciferase reporter gene assay showed that miR-4729 directly targeted and bound to DDX5. The relative expressions of DDX5 mRNA in A-498 cells of the miR-4729 group and NC group were 0.93±0.25 and 5.29±0.74, respectively, and the difference was statistically significant ( t = 5.60, P < 0.01). The results of Western blotting showed that compared with the NC group, the expression of DDX5 protein in A-498 cells of the miR-4729 group was lower, and the expressions of AKT signaling pathway-related proteins p-AKT, p-IKKα, p-Tpl2 and AS160 were also lower. Conclusions:Overexpression of miR-4729 decreases the activation level of AKT signaling pathway by targeting and inhibiting the expression of DDX5 gene, thereby inhibiting the proliferation and migration of renal cancer cells.

Objective:To design a visual allocation system of emergency medical equipment based on the Internet of Things technology,and to realize the coordinated allocation of emergency medical equipment in hospitals.Methods:The client and server(C/S)architecture was adopted,and the design of emergency medical equipment visual allocation system was mainly based on Bluetooth 5.1 technology,with automatic acquisition and automatic analysis of Bluetooth positioning tag,low power consumption sensor and signal communication of Bluetooth Internet of Things base station.The sample data of 150 pieces of equipment managed by the traditional allocation center mode of The 900th Hospital of People's Liberation Army Joint Logistics Support Force from January to December 2021 were selected,and the sample data of 150 pieces of equipment allocation during the application of the visual allocation system from June 2022 to June 2023 were randomly selected,and the allocation response time and the allocation warehousing in and out time were compared.A total of 40 ventilator devices were randomly selected during the traditional allocation center mode and the visual allocation period,with 20 ventilators in each mode,the start-up rate,utilization rate and profitability of medical equipment during the service period were compared.Results:The visual allocation system can realize the functions of automatic equipment positioning,emergency deployment,ledger management,remote repair report and benefit analysis.The allocation response time,allocation outbound time and allocation inbound time of the visual allocation system were(19.61±3.119)min,(11.73±2.104)min,(10.21±2.165)min,respectively,which were shorter than(54.98±3.999)min,(21.54±2.811)min,(16.80±2.000)min of the traditional allocation center mode,the difference was statistically significant(t=85.407,34.229,27.395,P<0.05).The start-up rate,utilization rate and profitability of ventilator equipment using visual allocation mode were 78.24%,51.23%and 82.76%,respectively,which were higher than 43.52%,36.26%and 47.83%of the traditional allocation center mode,the difference was statistically significant(x2=8.792,7.813,12.216,P<0.05).Conclusion:The visual allocation system of emergency medical equipment based on the Internet of Things technology can realize the functions of emergency medical equipment allocation and storage,equipment positioning and use status analysis,provide a theoretical basis for the allocation of hospital emergency medical equipment,and maximize the role of emergency medical equipment.