Status quo and influencing factors of job burnout among residents in standardized training.

Background: With the continuous progress and in-depth implementation of the reform of the medical and health care system, alongside the gradual enhancement of the standardized training framework for residents, such training has become a crucial avenue for cultivating high-level clinicians and improving medical quality. However, due to various constraints and limitations in their own capabilities, residents undergoing standardized training are often susceptible to job burnout during this process. Numerous factors contribute to job burnout, which is closely associated with depression and anxiety.

Patterns of failure and the subsequent treatment after progression on first-line immunotherapy monotherapy in advanced non-small cell lung cancer: a retrospective study.

Background: Immune checkpoint inhibitors (ICIs) have become the recommended first-line treatment for advanced non-small cell lung cancer (NSCLC) without driver gene mutations. However, data on the failure patterns of first-line ICIs monotherapy is limited, and the optimal strategy for subsequent treatment remains controversial.

Methods: Advanced NSCLC patients receiving first-line ICIs monotherapy at Guangdong Lung Cancer Institute between December 2017 and October 2021 were identified.

3D Covalent Organic Frameworks with 16-Connectivity for Photocatalytic C(sp)-C(sp) Cross-Coupling.

The connectivity (valency) of building blocks for constructing 3D covalent organic frameworks (COFs) has long been limited to 4, 6, 8, and 12. Developing a higher connectivity remains a great challenge in the field of COF structural design. Herein, this work reports a hierarchical expansion strategy for making 16-connected building blocks to construct 3D COFs with sqc topology.

Correlation of distribution characteristics and dynamic changes of gut microbiota with the efficacy of immunotherapy in EGFR-mutated non-small cell lung cancer.

Background: The effects of gut microbiota and metabolites on the responses to immune checkpoint inhibitors (ICIs) in advanced epidermal growth factor receptor (EGFR) wild-type non-small cell lung cancer (NSCLC) have been studied. However, their effects on EGFR-mutated (EGFR +) NSCLC remain unknown.

Methods: We prospectively recorded the clinicopathological characteristics of patients with advanced EGFR + NSCLC and assessed potential associations between the use of antibiotics or probiotics and immunotherapy efficacy.

Three-Motif Molecular Junction Type Covalent Organic Frameworks for Efficient Photocatalytic Aerobic Oxidation.

Covalent organic frameworks (COFs), with the features of flexible structure regulation and easy introduction of functional groups, have aroused broad interest in the field of photocatalysis. However, due to the low light absorption intensity, low photoelectron conversion efficiency, and lack of suitable active sites, it remains a great challenge to achieve efficient photocatalytic aerobic oxidation reactions. Herein, based on reticular chemistry, we rationally designed a series of three-motif molecular junction type COFs, which formed dual photosensitizer coupled redox molecular junctions containing multifunctional COF photocatalysts.

PD-L1 expression guidance on sintilimab versus pembrolizumab with or without platinum-doublet chemotherapy in untreated patients with advanced non-small cell lung cancer (CTONG1901): A phase 2, randomized, controlled trial.

No direct comparison has been performed between different programmed cell death-1 (PD-1) inhibitors for first-line treatment in patients with advanced non-small cell lung cancer (NSCLC). The feasibility of using PD-L1-expression-guided immunotherapy remains unknown. In this open-label, phase 2 study (NCT04252365), patients with advanced NSCLC without EGFR or ALK alterations were randomized (1:1) to receive sintilimab or pembrolizumab monotherapy (PD-L1 expression ≥ 50%), or sintilimab or pembrolizumab plus platinum-based chemotherapy (PD-L1 expression < 50%).

Efficacy, safety and dose selection of AZD3759 in patients with untreated -mutated non-small-cell lung cancer and central nervous system metastases in China (CTONG1702-Arm 8): a multi-center, single-arm, phase 2 trial.

Background: Central nervous system (CNS) metastases is inevitable for epidermal growth factor receptor ()-mutant non-small cell lung cancer (NSCLC). AZD3759 is a novel EGFR-TKI with impressive CNS penetration.

Methods: We initiated a phase 2, multi-center, umbrella trial (CTONG1702, NCT03574402).

Relative Local Electron Density Tuning in Metal-Covalent Organic Frameworks for Boosting CO Photoreduction.

The high local electron density and efficient charge carrier separation are two important factors to affect photocatalytic activity, especially for the CO photoreduction reaction. However, the systematic studies on the structure-functional relationship regarding the above two factors based on precisely structure model are rarely reported. Herein, as a proof-of-concept, we developed a new strategy on the evaluation of local electron density by controlling the relative electron-deficient (ED) and electron-rich (ER) intensity of monomer at a molecular level based on three rational-designed vinylene-linked sp carbon-covalent organic frameworks (COFs).

Immune suppressive microenvironment in liver metastases contributes to organ-specific response of immunotherapy in advanced non-small cell lung cancer.

Background: The liver is a frequent site of metastases and liver metastases (LM) correlate with diminished immunotherapy efficacy in non-small cell lung cancer (NSCLC). This study aimed to analyze whether tumor response to immunotherapy differs between pulmonary lesions (PL) and LM in NSCLC and to explore potential mechanisms through multiomics analysis.

Methods: This observational longitudinal clinical cohort study included patients with NSCLC with LM receiving immunotherapy was conducted to evaluate organ-specific tumor response of PL and LM.

Dual Photosensitizer Coupled Three-Dimensional Metal-Covalent Organic Frameworks for Efficient Photocatalytic Reactions.

In this work, we innovatively assembled two types of traditional photosensitizers, that is pyridine ruthenium/ferrum (Ru(bpy) /Fe(bpy) ) and porphyrin/metalloporphyrin complex (2HPor/ZnPor) by covalent linkage to get a series of dual photosensitizer-based three-dimensional metal-covalent organic frameworks (3D MCOFs), which behaved strong visible light-absorbing ability, efficient electron transfer and suitable band gap for highly efficient photocatalytic hydrogen (H ) evolution. Rubpy-ZnPor COF achieved the highest H yield (30 338 μmol g  h ) with apparent quantum efficiency (AQE) of 9.68 %@420 nm, which showed one of the best performances among all reported COF based photocatalysts.

Heterogeneity in the immune microenvironment of bone metastasis in driver-positive non-small cell lung cancer.

Mutations in epidermal growth factor receptor and anaplastic lymphoma kinase are common driver events in non-small cell lung cancer (NSCLC), which are associated with a high frequency of bone metastases (BMs). While the bone marrow represents a specialized immune microenvironment, the immune repertoire of BMs remains unknown. Considering the higher incidence of BMs in driver gene-positive NSCLCs, and the unique biology of the bone, herein, we assessed the infiltrating immune cells and T cell receptor (TCR) profile of BMs in driver-positive NSCLCs.

[Characteristics and factors influencing organic carbon decomposition in sediment in check dams].

More than 56000 check dams have been built in the Loess Plateau, which capture around 0.95 Pg of organic carbon and act as an important carbon sink. However, the decomposition mechanism of organic carbon in the sediment in these dams is still poorly understood, and thus it is difficult to quantify their role in terrestrial carbon cycling.

Covalent Organic Framework Based Functional Materials: Important Catalysts for Efficient CO Utilization.

As hot topics in the chemical conversion of CO , the photo-/electrocatalytic reduction of CO and use of CO as a supporter for energy storage have shown great potential for the utilization of CO . However, many obstacles still exist on the road to realizing highly efficient chemical CO conversion, such as inefficient uptake/activation of CO and mass transport in catalysts. Covalent organic frameworks (COFs), as a kind of porous material, have been widely explored as catalysts for the chemical conversion of CO owing to their unique features.

Clinical outcomes of non-small cell lung cancer patients with leptomeningeal metastases after immune checkpoint inhibitor treatments.

Objective: Leptomeningeal metastases (LM) occur in up to 5% of non-small cell lung cancer (NSCLC) patients and often develop after previous systemic treatments. In this article, we explored whether immune checkpoint inhibitors (ICIs) enhanced the dismal survival of patients with LM.

Materials And Methods: Data on NSCLC patients with LM prescribed ICIs were collected at the Guangdong Lung Cancer Institute.

[Spatial variation and source identification of heavy metals in sediments in Shaanxi section of Weihe River, Northwest China.].

In order to understand the spatial variation of heavy metals in Shaanxi section of Weihe River, the contents and sources of Cd, Co, Cu, Pb, Sb, As, Ni, Cr, Zn, Mn in sediments at 17 sampling sites in Shaanxi section of Weihe River and its tributaries were analyzed. The results showed that the average contents of Cd, Co, Cu, Pb, Sb, As, Ni, Cr, Zn, Mn were 0.10, 1.

[Effects of "Grain for Green" program and coal mining on sediment production in a typical small watershed of Yushenfu Mining Region, Northwest China].

Soil erosion in the ecologically fragile zone is severely affected by the intensified coal mining activities in the Yushenfu Mining Region of the Loess Plateau. Soil erosion controlling projects such as the "Grain for Green" program are continuously implemented by the government, which has effectively mitigated or even controlled soil erosion. Coal mining results in new environmental problems, which has changed the erosion characteristics and sediment transport in watersheds.

Effect of vegetation utilization on runoff and sediment production on grain-for-green slopes in the wind-water erosion crisscross region.

To effectively utilize the vegetation on grain-for-green slopes in the wind-water erosion crisscross region, it is necessary to determine the reasonable vegetation utilization intensity. We set up runoff plots on slopes which were not cultivated and were closed for many years in the Liudaogou catchment, a typical catchment in wind-water erosion crisscross region of the Loess Plateau. With artificial simulated rainfall experiments, the characteristics of runoff and sediment yield on slopes (10°, 20° and 30°) under different utilization intensity of vegetation were studied to select the reasonable utilization intensity.

Validating and improving interrill erosion equations.

Existing interrill erosion equations based on mini-plot experiments have largely ignored the effects of slope length and plot size on interrill erosion rate. This paper describes a series of simulated rainfall experiments which were conducted according to a randomized factorial design for five slope lengths (0.4, 0.

Syndromic recognition of influenza A infection in a low prevalence community setting.

Background: With epidemics of influenza A virus infection, people and medical professionals are all concerned about symptoms or syndromes that may indicate the infection with influenza A virus.

Methodology/principal Findings: A prospective study was performed at a community clinic of a metropolitan area. Throat swab was sampled for 3-6 consecutive adult patients with new episode (<3 days) of respiratory tract infection every weekday from Dec.

Ultrastructural observation of spermatozoa and fertilization in Schistosoma japonicum.

The ultrastructure of the sperm and the process of fertilization are described in Schistosoma japonicum. The sperm of S. japonicum has an elongated head and a single tail.

Reactive thrombocytosis alone does not affect the patency of microvascular anastomosis in the splenectomy rat.

Vascular thrombosis is a harbinger of failure in microsurgery. However, there is still controversy regarding the correlation of the complications of thrombocytosis and thrombosis. Some evidence indicates that patients with elevated platelet counts tend to have a higher flap failure rate, and surgeons usually hesitate to operate on patients with thrombocytosis.