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.

Background Enhancing the sense of honor and belonging among medical staff is a key component of establishing a modern hospital management system. Compared to medical staff at general hospitals, medical staff at oncology hospitals are more prone to job burnout, yet few studies in China have focused on job burnout among employees in oncology hospitals. Objective To propose a hypothetical model in which job well-being moderates the relationship between stressors and occupational burnout, to explore how stressors influence burnout and potential moderating role of job well-being, and to provide better understanding of job burnout and motivate employees based on the double-edge sword effect of stressors. Methods A cross-sectional survey was conducted in May 2022 at a tertiary oncology specialty hospital in Chongqing, China. A total of 1 898 medical staff were recruited. Data were collectedthrough four scales including a general information questionnaire, Maslach Burnout Inventory-Human Service Survey, Work Stressor Scale, and Occupational Well-being Scale for Medical Staff. Independent sample t-tests and one-way ANOVA were used for univariate comparisons of job burnout. Pearson correlation analysis was employed to examine the relationships between job burnout, stressors, and job well-being. Hierarchical linear regression was conducted to identify factors influencing job burnout and to examine potential moderating role of job well-being in the relationship between stressors and job burnout. Results A total of 2 123 questionnaires were distributed, with 1 898 valid responses, yielding an effective response rate of 89.4%. The prevalence of job burnout was 60.1%. The correlation coefficient was 0.717 (P<0.001) between stressors and burnout, −0.784 (P<0.05) between job well-being and burnout, and −0.744 (P<0.001) between stressors and job well-being. The quadratic stressors showed a statistically significant effect on burnout (β=0.404, P<0.01). Job well-being positively moderated the relationship between the linear stressors and burnout (β=1.289, P<0.001) and negatively moderated the relationship between the quadratic stressors and job burnout (β=−0.571, P<0.01), explaining 7.1% of the variance. Conclusion Job burnout prevalence is relatively high among employees in oncology hospitals. There is a curvilinear relationship between stressors and job burnout, with job well-being moderating this relationship. From a practical perspective, it is recommended to establish a tiered stress alert system to monitor employees’ stress levels and prevent prolonged exposure to high-pressure conditions. Additionally, improving employees’ job well-being through institutional incentives and developmental support can enhance its moderating role in mitigating the adverse effects of stressors on job burnout. Meanwhile, fostering coordinated responses between organizations and individuals is crucial for strengthening mental health management systems, thereby supporting a healthy, stable, and sustainable development of the healthcare workforce.

Modulating Tankyrases (TNKS), interactions with USP25 to promote TNKS degradation, rather than inhibiting their enzymatic activities, is emerging as an alternative/specific approach to inhibit the Wnt/β-catenin pathway. Here, we identified UAT-B, a novel neoantimycin analog isolated from Streptomyces conglobatus, as a small-molecule inhibitor of TNKS-USP25 protein-protein interaction (PPI) to overcome multi-drug resistance in colorectal cancer (CRC). The disruption of TNKS-USP25 complex formation by UAT-B led to a significant decrease in TNKS levels, triggering cell apoptosis through modulation of the Wnt/β-catenin pathway. Importantly, UAT-B successfully inhibited the CRC cells growth that harbored high TNKS levels, as demonstrated in various in vitro and in vivo studies utilizing cell line-based and patient-derived xenografts, as well as APC^min/+ spontaneous CRC models. Collectively, these findings suggest that targeting the TNKS-USP25 PPI using a small-molecule inhibitor represents a compelling therapeutic strategy for CRC treatment, and UAT-B emerges as a promising candidate for further preclinical and clinical investigations.

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.

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.

Within traditional teaching models,students frequently assume a passive role in acquiring knowledge,potentially resulting in diminished motivation and limited engagement,particularly within the realm of Medical Immunology education.The inte-gration of role-playing,informed by constructivist learning theory,situated learning theory,and multiple intelligences theory,has demonstrated encouraging outcomes within clinical medical education settings.However,the extent to which this approach has been explored within the context of Immunology instruction remains insufficiently examined.This study investigates the utilization of role-playing as a pedagogical approach in Medical Immunology education,wherein students are assigned specific scenarios to simulate the functions of various immune components.The primary objective is to augment interactivity and the overall appeal of the learning pro-cess.Efficacy of this instructional method was evaluated through in-class quizzes,surveys,and performance analysis.The findings demonstrate that role-playing substantially enhances student engagement,comprehension,knowledge retention,and examination per-formance.In practical application,the integration of role-playing with ideological and political elements has the potential to enhance learning outcomes and foster students'enthusiasm for engaging in cutting-edge literature and immunological research.This approach also necessitates greater proficiency in teachers'professional competencies and organizational skills,as well as increased allocation of class time and spatial resources.Future research should investigate the applicability of role-playing across various educational levels and examine its potential integration with classroom ideological and political education.

Objective:To explore the latent profile types of capability-opportunity-motivation-behavior in stroke patients and analyze the influencing factors of different latent profiles.Methods:From January to October 2023, totally 596 stroke patients from the Neurology Department of five ClassⅢ Grade A hospitals in Henan Province were selected by stratified random sampling. The patients were surveyed using a general information questionnaire, the Stroke Prevention Knowledge Questionnaire (SPKQ), the Social Support Rating Scale (SSRS), the WHO's Quality of Life Questionnaire- Brief Version (WHOQOL-BREF), the Short Form Health Belief Model Scale (SF-HBMS), and the Health Promoting Lifestyle ProfileⅡ (HPLPⅡ). Latent profile analysis was used to classify the capability-opportunity-motivation-behavior characteristics of stroke patients, and multiple logistic regression was conducted to explore the influencing factors of different latent profiles.Results:Three latent profiles of capability-opportunity-motivation-behavior in stroke patients were identified, including low capability-opportunity-motivation-behavior with high health beliefs (32.4%, 193/596), moderate capability-opportunity-motivation-behavior with insufficient health beliefs (47.5%, 283/596), and high capability-opportunity-motivation-behavior with lack of social support (20.1%, 120/596). Multiple logistic regression analysis showed that educational level, smoking history, family history, body mass index, and Charlson Comorbidity Index score were influencing factors of different latent profiles ( P<0.05) . Conclusions:Stroke patients exhibit distinct classifications of capability-opportunity-motivation-behavior. Targeted interventions should be conducted based on the characteristics of each category to improve health behavior management outcomes in patients.

Objective:To explore the mediating effect of rumination between self-perceived burden (SPB) and stigma in stroke patients, so as to provide theoretical basis for the development of targeted nursing interventions in clinical practice.Methods:In September 2022, cluster sampling was used to select 1 126 stroke patients admitted to Department of Neurology of five ClassⅢ Grade A hospitals in Henan Province as subjects. General Information Questionnaire, Self-Perceived Burden Scale (SPBS), Stroke Stigma Scale (SSS), and Chinese Version of Event Related Rumination Inventory (C-ERRI) were used to investigate stroke patients. Pearson correlation analysis was used to explore the correlation between SPB, rumination, and stigma. AMOS 28.0 software was used to establish the structural equation model, and Bootstrap method was used to test the mediating effect.Results:A total of 1 126 questionnaires were distributed, and 1 026 valid questionnaires were collected, with a valid response rate of 91.12% (1 026/1 126). SPBS score of 1 026 stroke patients was (28.68±8.32), the SSS score was (40.53±9.48) and the C-ERRI score was (25.43±12.62). Pearson correlation analysis showed that SPB in stroke patients was positively correlated with stigma and rumination ( P<0.01), and rumination was positively correlated with stigma ( P<0.01). Bootstrap mediating effect test showed that rumination partially mediated the relationship between SPB and stigma in stroke patients, accounting for 55.15% of the total effect. Conclusions:SPB of stroke patients both directly affect stigma and indirectly affect stigma through rumination. Clinical nursing workers should promptly evaluate patients' SPB, pay attention to the mediating role of rumination, develop effective psychological intervention programs, implement personalized and targeted nursing measures, relieve patients' stigma, and improve treatment and rehabilitation compliance.

Objective:To understand the research status and hotspots in the field of stroke health management at home and abroad, and to provide insights for stroke health management research in China.Methods:Relevant literature on stroke health management published between 2013 and 2023 was retrieved from the Web of Science Core Collection and China National Knowledge Infrastructure databases. CiteSpace 6.1.R6 was used for the visual analysis of the number of publications, authors, institutions, countries, and keywords.Results:A total of 382 relevant articles were included, with 169 in English and 213 in Chinese. The number of publications on stroke health management showed a fluctuating upward trend. Research hotspots and frontiers in stroke health management mainly focused on telemedicine, big data and "Internet+", primary and secondary prevention, risk prediction models, quality of life, and swallowing disorders. Future research trends may focus on management models for post-stroke swallowing disorders, risk identification, and the role of caregivers in remote rehabilitation interventions.Conclusions:Researchers can refer to the research hotspots and trends shown by the visual analysis, with particular attention to health management models for patients with post-stroke swallowing disorders and issues related to remote intervention rehabilitation.

Objective:To investigate the pregnancy outcomes of different treatment methods for triplet pregnancies with different chorionicities.Methods:A retrospective study was conducted on 97 triplet pregnancies who visited and delivered at the Department of Obstetrics, the Third Affiliated Hospital of Zhengzhou University, from January 1, 2017, to November 30, 2023. The pregnancies were categorized based on chorionicity into monochorionic triamniotic (MCTA) ( n=24), dichorionic triamniotic (DCTA) ( n=33), and trichorionic triamniotic (TCTA) ( n=40). They were further divided into expectant management group ( n=46), reduction to twins group ( n=40), and reduction to singleton group ( n=11) based on the treatment method. Pregnancy outcomes were compared among the groups. Statistical analysis were performed using t-test, corrected t-test, one-way analysis of variance and LSD test, Kruskal-Wallis test and Mann-Whitney U test, Chi-square test, continuity correction Chi-square test, Fisher's exact test, and Bonferroni correction. Results:(1) Comparison of pregnancy outcomes with different treatment methods for the same chorionicity: In MCTA, there were no statistically significant differences in gestational age at delivery, live birth rate before 37 weeks, live birth rate before 32 weeks, neonatal birth weight, and incidence of severe neonatal complications between the expectant management group and the reduction to monochorionic diamniotic (MCDA) group (all P>0.05). In DCTA, compared to the reduction to singleton group, the expectant management group had lower gestational age at delivery [(31.8±2.7) vs. (37.9±1.3) weeks, U=－3.66] and neonatal birth weight [(1 604.3±422.6) vs. (2 997.1±598.9) g, U=－3.84] (both P<0.05), but higher live birth rate before 37 weeks (9/10 vs.1/8, Bonferroni correction, P<0.017). The expectant management group showed a trend towards higher rates of pregnancy complications (5/10 vs. 2/15 and 0/8) and severe neonatal complications [37.0% (10/27) vs. 10.7% (3/28) and 0/7] compared to the groups reduced to dichorionic diamniotic (DCDA) twins and singletons. However, the differences between the groups were not statistically significant (all P>0.017). In TCTA, compared to the expectant management group, the reduction to DCDA group had a higher gestational age at delivery [(37.1±0.9) vs. (34.1±2.7) weeks, t'=－4.36], and increased neonatal birth weight [(2 647.5±377.8) vs. (1 902.5±459.9) g, t'=－6.98] (both P<0.05). The incidence of maternal pregnancy complications [3/15 vs. 54.2% (13/24)] and live birth rate before 37 weeks [3/15 vs. 66.7% (16/24)] were lower (Fisher's exact test, both P<0.05). (2) Comparison of pregnancy outcomes with different chorionicities for the same treatment method: In the expectant management group, the DCTA group had the lower neonatal birth weight compared to the MCTA and TCTA groups [(1 604.3±422.6) vs. (1 948.3±573.4) and (1 902.5±459.9) g, LSD test, both P<0.05]. In the fetal reduction group, the TCTA group had higher neonatal birth weight compared to the MCTA and DCTA groups [(2 657.6±373.3) vs. (2 000.8±443.3) and (2 078.8±799.9) g, U=－2.91 and U=－3.12] (both P<0.05). Conclusions:The appropriate treatment method for triplet pregnancies should be selected based on chorionicity. Expectant management is recommended for MCTA, fetal reduction is suggested for DCTA to improve pregnancy outcomes. For TCTA, the pregnant woman should be informed of the risks of preterm birth associated with expectant management, who should then decide whether to undergo fetal reduction.