Objective To explore an artificial intelligence (AI)-based method for automated hand hygiene monitoring and to compare the effectiveness of three algorithms (UniFormerV2, TDN, C3D) in recognizing hand hygiene steps in surgical settings, thereby aiding hospital infection control. Methods From April to October 2024, we non-invasively collected 641 video recordings of healthcare staff performing hand hygiene at four-bay scrub sinks in two tertiary hospitals using overhead HD cameras. The dataset was annotated by five trained experts for model training and validation. Results Following training on 385 samples, internal validation (n=119) showed the C3D model achieved 81% accuracy, 87% recall, and an 83% F1-score. The TDN model achieved 93%, 91%, and 92% for the same metrics. The UniFormerV2 model outperformed both, with an accuracy, recall, and F1-score of 93%—an improvement of over 10 percentage points compared to traditional CNNs (TDN, C3D). It also achieved an 84% accuracy in external validation, demonstrating strong generalization. Conclusion The UniFormerV2 model is more accurate than CNN-based models for hand hygiene step recognition and shows robust performance in external validation. It presents a viable tool for healthcare facilities to enhance hand hygiene management, ultimately improving medical quality and patient safety.

Background and Aims:Long noncoding RNA(lncRNA)nuclear-enriched abundant transcript 1(NEAT1)is an oncogenic lncRNA that promotes the progression of various cancers through the competing endogenous RNA(ceRNA)mechanism.Using the TargetScan database,we previously identified binding sites between NEAT1 and microRNA-124-3p(miR-124-3p),as well as between miR-124-3p and catenin beta-1(CTNNB1).Therefore,this study was conducted to investigate the expression of NEAT1,miR-124-3p,and CTNNB1 in pancreatic cancer and their interactions affecting pancreatic cancer cell functions.Methods:A dual-luciferase reporter assay was used to validate the relationships among NEAT1,miR-124-3p,and CTNNB1.The expression levels of NEAT1 and miR-124-3p,as well as CTNNB1 protein expression,were detected in pancreatic cancer tissues and adjacent normal tissues,as well as in pancreatic cancer PANC-1 cells and normal pancreatic epithelial H6C7 cells.PANC-1 cells were transfected with NEAT1 siRNA alone or co-transfected with a miR-124-3p inhibitor.After transfection,changes in PANC-1 cell biological functions,epithelial-mesenchymal transition related protein expression,and tumor growth ability in mice were assessed.Results:The dual-luciferase reporter assay confirmed the targeting relationships between NEAT1 and miR-124-3p,as well as between miR-124-3p and CTNNB1.NEAT1 and CTNNB1 expression levels were significantly upregulated,while miR-124-3p expression was downregulated in pancreatic cancer tissues(vs.adjacent tissues)and in PANC-1 cells(vs.H6C7 cells)(all P<0.05).NEAT1 siRNA transfection led to decreased NEAT1 and CTNNB1 expression and increased miR-124-3p expression in PANC-1 cells.However,co-transfection with a miR-124-3p inhibitor suppressed the expression changes in miR-124-3p and CTNNB1(all P<0.05).NEAT1 siRNA transfection significantly reduced PANC-1 cell proliferation,migration,and invasion,while promoting apoptosis.Additionally,E-cadherin protein expression was upregulated,whereas N-cadherin and vimentin protein expression were downregulated.Tumor growth in mice was also significantly inhibited(all P<0.05).These changes were attenuated upon co-transfection with the miR-124-3p inhibitor(all P<0.05).Conclusion:NEAT1 may act as a ceRNA by competitively binding to miR-124-3p,thereby attenuating miR-124-3p-mediated inhibition of CTNNB1.This leads to CTNNB1 upregulation,ultimately promoting the malignant biological behavior of pancreatic cancer cells.

Objective:To systematically review the research progress in the evaluation of the integration of medical care and prevention in China.Methods:The keywords "medical care","prevention","public health", and "evaluate" were used to search in Chinese databases (CNKI, Wangfang and VIP Chinese Science and Technology Journal) and English databases (PubMed, Embase, Cochrane, and Web of Science) from March 17, 2009, to August 7, 2024. The language of studies was restricted to Chinese and English. The inclusion criteria were the integration of medical care and prevention occurring at one of the three dimensions, i.e., macro-system level, meso-institution and professional level and micro-service level. The study area should be located in China. The studies about theoretical exploration, policy analysis, and review of theory and practice in foreign countries regarding the integration of medical care and prevention and the article types of conference abstract, editorial, letter, and news were excluded. A total of 30 studies (in Chinese) were finally included. The definition of the integration of medical care and prevention, study design, evaluation objects, and specific evaluation indicators were compared and analyzed.Results:The evaluation objects of the included studies were mainly primary health staff and patients with chronic diseases in primary care. The study designs were mainly cross-sectional studies ( n=18) and controlled trials ( n=8). The included studies involved a total of 39 specific evaluation indicators at the macro-system level (5), meso-institutional level (8), professional level (11), micro-service level (12), and outcome level (3). Conclusion:Research on the integration of medical care and prevention is still in the development stage. The existing studies lack commonly recognized evaluation indicators regarding the integration of medical care and prevention.

Background and Aims:Long noncoding RNA(lncRNA)nuclear-enriched abundant transcript 1(NEAT1)is an oncogenic lncRNA that promotes the progression of various cancers through the competing endogenous RNA(ceRNA)mechanism.Using the TargetScan database,we previously identified binding sites between NEAT1 and microRNA-124-3p(miR-124-3p),as well as between miR-124-3p and catenin beta-1(CTNNB1).Therefore,this study was conducted to investigate the expression of NEAT1,miR-124-3p,and CTNNB1 in pancreatic cancer and their interactions affecting pancreatic cancer cell functions.Methods:A dual-luciferase reporter assay was used to validate the relationships among NEAT1,miR-124-3p,and CTNNB1.The expression levels of NEAT1 and miR-124-3p,as well as CTNNB1 protein expression,were detected in pancreatic cancer tissues and adjacent normal tissues,as well as in pancreatic cancer PANC-1 cells and normal pancreatic epithelial H6C7 cells.PANC-1 cells were transfected with NEAT1 siRNA alone or co-transfected with a miR-124-3p inhibitor.After transfection,changes in PANC-1 cell biological functions,epithelial-mesenchymal transition related protein expression,and tumor growth ability in mice were assessed.Results:The dual-luciferase reporter assay confirmed the targeting relationships between NEAT1 and miR-124-3p,as well as between miR-124-3p and CTNNB1.NEAT1 and CTNNB1 expression levels were significantly upregulated,while miR-124-3p expression was downregulated in pancreatic cancer tissues(vs.adjacent tissues)and in PANC-1 cells(vs.H6C7 cells)(all P<0.05).NEAT1 siRNA transfection led to decreased NEAT1 and CTNNB1 expression and increased miR-124-3p expression in PANC-1 cells.However,co-transfection with a miR-124-3p inhibitor suppressed the expression changes in miR-124-3p and CTNNB1(all P<0.05).NEAT1 siRNA transfection significantly reduced PANC-1 cell proliferation,migration,and invasion,while promoting apoptosis.Additionally,E-cadherin protein expression was upregulated,whereas N-cadherin and vimentin protein expression were downregulated.Tumor growth in mice was also significantly inhibited(all P<0.05).These changes were attenuated upon co-transfection with the miR-124-3p inhibitor(all P<0.05).Conclusion:NEAT1 may act as a ceRNA by competitively binding to miR-124-3p,thereby attenuating miR-124-3p-mediated inhibition of CTNNB1.This leads to CTNNB1 upregulation,ultimately promoting the malignant biological behavior of pancreatic cancer cells.

The efficient production of L-glutamate is dependent on the product's rapid efflux, hence researchers have recently concentrated on artificially modifying its transport system and cell membrane wall structure. Considering the unique composition and structure of the cell wall of Corynebacterium glutamicum, we investigated the effects of CmpLs on L-glutamate synthesis and transport in SCgGC7, a constitutive L-glutamate efflux strain. First, the knockout strains of CmpLs were constructed, and it was confirmed that the deletion of CmpL1 and CmpL4 significantly improved the performance of L-glutamate producers. Next, temperature-sensitive L-glutamate fermentation with the CmpL1 and CmpL4 knockout strains were carried out in 5 L bioreactors, where the knockout strains showcased temperature-sensitive characteristics and enhanced capacities for L-glutamate production under high temperatures. Notably, the CmpL1 knockout strain outperformed the control strain in terms of L-glutamate production, showing production and yield increases of 69.2% and 55.3%, respectively. Finally, the intracellular and extracellular metabolites collected at the end of the fermentation process were analyzed. The modification of CmpLs greatly improved the L-glutamate excretion and metabolic flux for both L-glutamate production and transport. Additionally, the CmpL1 knockout strain showed decreased accumulation of downstream metabolites of L-glutamate and intermediate metabolites of tricarboxylic acid (TCA) cycle, which were consistent with its high L-glutamate biosynthesis capacity. In addition to offering an ideal target for improving the stability and performance of the industrial strains for L-glutamate production, the functional complementarity and redundancy of CmpLs provide a novel target and method for improving the transport of other metabolites by modification of the cell membrane and cell wall structures in C. glutamicum.
Corynebacterium glutamicum/genetics* ; Glutamic Acid/biosynthesis* ; Fermentation ; Metabolic Engineering ; Bacterial Proteins/metabolism* ; Bioreactors/microbiology* ; Gene Knockout Techniques

ObjectiveTo analyze the changing trend of the disease burden of acute viral hepatitis （AVH） globally and in China from 1990 to 2021， and to provide a basis for optimizing prevention and control strategies. MethodsRelated data were extracted from the Global Burden of Disease 2021 database， including incidence rate， mortality rate， and disability-adjusted life years （DALY） for AVH globally and in China from 1990 to 2021， and the patients were divided into groups according to region， age， sex， and type of hepatitis. The Joinpoint regression model was used to calculate average annual percentage change （AAPC） and its 95% confidence interval （CI）. ResultsFrom 1990 to 2021， there was a tendency of reduction in the age-standardized incidence rate， mortality rate， and DALY rate of AVH globally， with an average annual reduction of 1.02% （95%CI： -1.10% to -0.94%， P<0.001）， 3.97% （95%CI： -4.12% to -3.82%， P<0.001）， and 3.64% （95%CI： -3.84% to -3.44%， P<0.001）， respectively； in China， there was also a tendency of reduction in these indicators， with an average annual reduction of 1.63% （95%CI： -1.70% to -1.57%， P<0.001）， 9.24% （95%CI： -9.51% to -8.97%， P<0.001）， and 7.93% （95%CI： -8.15% to -7.71%， P<0.001）， respectively. In addition， China’s share of the global disease burden of AVH continued to decrease； the proportion of new cases decreased from 24% in 1990 to 15% in 2021， the proportion of deaths decreased from 19% to 4%， and the proportion of DALY decreased from 16% to 4%. From 1990 to 2021 globally， the peaks in the incidence rate， mortality， and DALY of AVH were observed in children under 5 years of age； in China， although the peak incidence rate of the disease was still observed in children under 5 years of age， there was a tendency of increase in the incidence rate of AVH among young adults aged 25 — 29 years in recent years， with the most significant increase in the cases of acute hepatitis B （accounting for 59% of the cases in this age group）， while the disease burden of mortality and DALY mainly affected the middle-aged and elderly populations. The disease burden of AVH in the male population was higher than that in the female population. As for the distribution of disease types， acute hepatitis A was the predominant type of AVH， accounting for 64% globally and 48% in China， whereas acute hepatitis B was the leading cause of mortality and DALY， accounting for 50% of deaths globally， 80% of deaths in China， 47% of DALY globally， and 69% of DALY in China. ConclusionThere is a tendency of reduction in the disease burden of AVH globally and in China from 1990 to 2021， but there is a tendency of increase in the incidence rate of AVH among young adults in China， especially acute hepatitis B. It is necessary to implement targeted prevention and control strategies.

Objective:To systematically review the research progress in the evaluation of the integration of medical care and prevention in China.Methods:The keywords "medical care","prevention","public health", and "evaluate" were used to search in Chinese databases (CNKI, Wangfang and VIP Chinese Science and Technology Journal) and English databases (PubMed, Embase, Cochrane, and Web of Science) from March 17, 2009, to August 7, 2024. The language of studies was restricted to Chinese and English. The inclusion criteria were the integration of medical care and prevention occurring at one of the three dimensions, i.e., macro-system level, meso-institution and professional level and micro-service level. The study area should be located in China. The studies about theoretical exploration, policy analysis, and review of theory and practice in foreign countries regarding the integration of medical care and prevention and the article types of conference abstract, editorial, letter, and news were excluded. A total of 30 studies (in Chinese) were finally included. The definition of the integration of medical care and prevention, study design, evaluation objects, and specific evaluation indicators were compared and analyzed.Results:The evaluation objects of the included studies were mainly primary health staff and patients with chronic diseases in primary care. The study designs were mainly cross-sectional studies ( n=18) and controlled trials ( n=8). The included studies involved a total of 39 specific evaluation indicators at the macro-system level (5), meso-institutional level (8), professional level (11), micro-service level (12), and outcome level (3). Conclusion:Research on the integration of medical care and prevention is still in the development stage. The existing studies lack commonly recognized evaluation indicators regarding the integration of medical care and prevention.

Objective:Through comprehensive analysis of symptoms and signs, biochemistry, imaging, and dynamic tests, to explore the diagnosis and differential diagnosis of thyrotropin-secreting pituitary adenoma(TSH adenoma) and syndrome of resistance to thyroid hormone(RTH).Methods:A retrospective analysis was conducted on clinical data from 14 patients who visited the First Affiliated Hospital of Zhengzhou University from July 2016 to September 2022, exhibiting elevated levels of free thyroxine(FT4) and free triiodothyronine(FT3) in the presence of increased TSH.Results:There were 7 cases of TSH adenoma and 7 cases of RTH, with the average age of diagnosis at 40.0 years and 26.6 years, respectively. Thirteen patients showed thyrotoxicosis or occasional palpitation, some with pituitary occupancy manifestations or abnormal growth and development; One patient presented with neck thickening. Sex hormone binding globulin was elevated in 3 cases of TSH adenoma. Pituitary magnetic resonance imaging showed that all 7 cases of TSH adenoma were macroadenomas and 1 case of RTH was microadenoma. The octreotide suppression test in 13 patients was inhibited, but there was a significant difference in the inhibition rate of 24 h/2 h TSH inhibition rate of TSH adenoma and RTH, ranging from 46.6% to 83.9% and 4.6% to 28.8% respectively. Six cases of RTH had thyroid hormone receptor β mutation.Conclusion:Syndrome of inappropriate secretion of thyrotropin is a rare condition, mainly including TSH adenoma and RTH. The diagnosis and differentiation of the two conditions require comprehensive assessment incorporating family history, symptoms and signs, laboratory tests, dynamic test, and genetic test. Among these, the 24 h/2 h TSH inhibition rate of octreotide suppression test can effectively distinguish TSH adenoma from RTH.

【Objective】 To understand factors associated with children′s attendance at nursery care institutions (NCIs) and the basic characteristics of the NCIs children were enrolled in, so as to provide scientific evidence for policymakers. 【Methods】 During November 2020 and January 2021, parents who visited the Department of Child Health Care in six selected maternal and children′s hospitals, as well as nearby NCIs in Zhejiang were invited to finish an online questionnaire. Information such as children′s sociodemographic characteristics, parents′ knowledge, attitude and practice regarding nursery and feeding, etc. were collected. A total of 1 756 questionnaires were collected. 【Results】 Compared to children who were not in NCIs, children enrolled in NCIs were older (94.4% of children ≥24 months vs. 30.1%, χ²=835.27), more likely to be from the local area (87.2% vs. 81.4%,χ²=12.25), more likely to have parents with a college degree (mother: 83.6% vs. 74.2%, χ²=35.29; father: 79.9% vs. 70.0%, χ²=27.01), had a higher prevalence of family annual income >200 000 CNY (49.5% vs. 28.2%, χ²=110.49), and were less likely to have their grandparents available to take care of them (16.7% vs. 26.8%, χ²=31.4) The difference all have great significant.(P<0.05). In a multivariate Logistic regression model, the older the child, the more likely they were to attend an NCI (for children aged 6 - 23 months, OR=6.70; for children aged 24 - 35 months, OR=134.03; and for children aged 36 - 42 months, OR=699.33; P<0.05). Family annual income was positively associated with children′s attendance at NCIs (for those earning 100 000 - 200 000 CNY/year, OR=1.63; for those earning 200 000 - 500 000 CNY/year, OR=2.96; and for those earning >500 000 CNY/year, OR=4.62, P<0.05). Conversely, the higher the level of grandparent involvement in daily care, the lower the attendance at NCIs (for children cared for by both parents and grandparents, OR=0.57; for those primarily cared for by grandparents, OR=0.26, P<0.05). For children who used to stay at NCIs, 82.8% stayed at institutions that only recruited children aged 0 - 3 years, 97.4% spent their whole day in NCIs, and 71.4% spent less than 3 000 CNY per month for NCI services. Additionally, over 95% of parents were satisfied with the food and care services in NCIs, as well as their children′s physical development in NCIs. However, 32.1% of NCIs were reported by parents as having no room for breastfeeding. 【Conclusions】 Children′s age, grandparent involvement in routine care, and family annual income are the main factors associated with children′s attendance at NCIs. There is a greater need for more affordable and community-based NCIs, particularly for children under 2 years old. Additionally, more attention should be paid to the quality surveillance, assessment and management of NCIs.

Objective:To examine the impact of Developmental Human Resource Management Practices(D-HRMPs)on innova-tive performance of health professionals from the public hospitals.Methods:A questionnaire survey was conducted to collect data from health professionals in the public hospitals in Beijing,including D-HRMPs scale,innovation performance scale,inclusive lead-ership scale and team innovation atmosphere scale.Descriptive statistics and structural equation model were used for the analysis.Results:D-HRMPs had a direct effect on the innovation performance of public hospital health professionals.Inclusive leadership can positive-ly affect the implementation of D-HRMPs and the formation of team innovation atmosphere.Meanwhile,team innovation atmo-sphere plays a mediating effect,that is,D-HRMPs can actively promote the formation of team innovation climate,and further indi-rectly affect the innovation performance of employees.Conclusion:The directors of public hospitals can further explore the im-plementation of D-HRMPs,and pay attention to adopting inclusive leadership to deepen the reform of personnel management system,and promote high-quality development of public hospitals.