Clinical Science Research Research Articles

A point-of-care testing strip based on a rationally designed antigen and antibody for fast and reliable Diquat poisoning detection: Ready for clinical application

AbstractDiquat (DQ) is a nonselective quick-acting herbicide, which can directly contaminate humans and the environment during improper use and production. The early diagnosis of DQ poisoning allows for patients to receive timely treatment. Here, a novel monoclonal antibody was screened based on the rational design and synthesis of a DQ hapten and complete antigen. With the custom-designed anti-DQ antibody, we developed a stable and specific immunochromatographic strip to recognize DQ within 10 ∼ 15 min in various biological samples. The test strips could recognize DQ at concentrations as low as 20 ng/mL and be read by the naked eye, reaching the detection level of liquid chromatography-mass spectrometry. Moreover, quantitative methods involving the use of immunochromatographic strips and ELISA were developed to continuously monitor DQ concentrations. DQ and paraquat (PQ) joint test strips were developed to simultaneously measure DQ and PQ. Notably, the clinical performance of the proposed test strips was evaluated in multiple hospitals and public health agencies. Taken together, our study provides the first clinical DQ-targeted colloidal gold immunochromatographic test strips with excellent performance, which are expected to be useful for clinical practice, environmental monitoring, food safety and scientific research.

A weakly supervised model for incomplete multimodal MRI synthesis with tumor-aware approach.

Magnetic resonance images (MRIs) are a valuable tool in the study of brain tumors, and multimodal sequences provide unique insights into different aspects of brain tumors. However, in clinical practice, missing modalities are often encountered due to various factors. This makes it difficult to obtain comprehensive and reliable information related to brain tumors. The purpose of this work is to develop an algorithm for the synthesis of missing MRI modality with high precision, and to center on generating accurate tumor-related information to offer more data for clinical diagnosis. A novel weakly supervised MRI synthesis model named TAM-DAM-GAN has been proposed, which integrates tumor-aware and detail adjustment mechanisms to enhance the quality of tumor generation. The tumor-aware mechanism leverages weak label information to guide the network to classify images based on crucial information in local structures, thereby compelling the generative network to identify and highlight the learning of local tumor regions. The detail adjustment mechanism utilizes a discriminator to create attention maps at the pixel level in real-time. These maps are then used to modify the loss weight, which in turn adjusts the details that are generated. Generation quality of four tasks (T1-to-T2, T2-to-T1, T1-to-FLAIR, and FLAIR-to-T1) was evaluated. Experiments on the BRATS2015 dataset show that the proposed approach is superior in both qualitative and quantitative measures. Taking FLAIR-to-T1 as an example, TAM-DAM-GAN improves PSNR of tumor region from 18.556 to 20.576 compared to baseline. Also, using real FLAIR data with generated T1 data boosts tumor segmentation accuracy by 10% compared to using only real FLAIR data. This finding will be conducive to enhancing the accuracy of cross-modality synthesis in incomplete multimodal MRI, especially for tumor regions, thereby providing more dependable and comprehensive data for clinical diagnosis and scientific research.

Improving the Science of Adolescent Social Media and Mental Health: Challenges and Opportunities of Smartphone-Based Mobile Sensing and Digital Phenotyping

AbstractThe impact of social media (SM) use (‘screentime’) on adolescent mental health has been the focus of increasing concern, despite mixed findings from empirical research. Current methodological approaches rely on self-reported SM use, which has limited accuracy and obscure the dynamic interplay of SM use and mental health. Smartphone-based mobile sensing offers new opportunities to gain insights into adolescents’ SM use patterns and behaviors, particularly at an idiographic level. Considerations and challenges of smartphone sensing methods for capturing adolescents’ SM use patterns and behaviors in clinical psychological science are discussed in the context of a pilot study using smartphone-based sensing with adolescents. The pilot study included 19 adolescents (Mean age = 15.84; 68% boys; 79% White) who installed a passive monitoring application (AWARE) on their phones for 31 (SD = 5.6) days. Descriptive data of sensing acceptability and feasibility are presented based on participant ratings and data yield ratio of usable data (74.18%). Sensing yielded 10,038 hourly observations collected from the ‘application foreground’ sensor across all participants from social media apps, and a total of 645 applications used. Categorization of SM apps were coded (kappa >.90) into ‘social networking’ (N = 20 apps) and ‘broader SM’ (N = 41) and compared to both Play Store-defined SM apps (N = 26) and popular SM apps based on Common Sense Media Survey (N = 9). Descriptive data on extracted behavioral features (duration, checking) from SM use categories (binned hourly and daily) are presented. Challenges, opportunities, and future directions of sensing methods for SM use are discussed to inform our understanding of its impacts on mental health and to improve the rigor of SM research in clinical psychological science.

Morphological characteristics of talocalcaneal coalitions: Anatomical observation, finite element analysis and clinical application

BackgroundThe intricate anatomical structure of talocalcaneal coalitions (TCCs) presents significant challenges for clinicians in both diagnosis and treatment. This study aimed to investigate the anatomy, imaging characteristics, and biomechanical properties of TCCs, providing essential references for contemporary clinical diagnosis, treatment, scientific research, and education regarding TCCs. MethodsThe morphologies of TCCs were examined and classified in intact dry osseous specimens from 131 Asian adults. The imaging characteristics of TCCs were summarized by carefully observing the X-rays and CT scans. Additionally, finite element models of TCCs were established and validated, allowing for the simulation and analysis of stress and strain. ResultsThe TCCs were primarily located in the region between the posterior end of sustentaculum tali (ST), the medial port of the tarsal canal, and the medial edge of the posterior talar articular surface (PTF). In comparison to specimens with cartilage and ligament connections, the medial tubercle of osseous connections exhibited significant inward and downward protrusion, while the ST was longer and thicker. Statistically significant differences were noted in the widths of the calcaneus and talus, as well as in the thickness and length of the ST (P < 0.05). CT imaging provided an accurate determination of TCCs’ locations, while X-rays revealed the presence of the “C sign” and “duck beak sign” in all osseous connection specimens. Finite element model analysis indicated that stress was primarily concentrated at the osseous connection, which also reduced displacement of the subtalar joint. ConclusionsThe comprehension of the precise location, anatomical morphological characteristics, imaging features and finite element mechanical properties of TCCs is instrumental in enhancing the diagnosis and treatment of TCCs.

Synthesis of Starfish-Shaped ZnS Nanostructures by Hydrothermal Method and Their Electrochemical Sensing of Dopamine.

Introduction Dopamine serves an essential function as a neurotransmitter, influencing the regulation of movement, cognitive processes, and emotional states. The identification of abnormal dopamine levels is critical for clinical diagnoses and scientific research, given its links to various disorders, including depression, schizophrenia, and Parkinson's disease. The distinctive electrochemical characteristics, stability, and broad bandgap of zinc sulfide (ZnS) nanostructures render them particularly fascinating. The hydrothermal method is recognized as an effective and economical approach for the fabrication of ZnS nanostructures, exhibiting a range of morphologies. Utilizing this method to create ZnS nanostructures leads to the formation of structures characterized by extensive surface areas, hierarchical designs, and improved electrochemical properties. Aim The objective is to examine the electrochemical characteristics of ZnS starfish-shaped nanostructures produced through the hydrothermal technique and to assess their viability as a sensing platform for dopamine detection. Materials and methods To synthesize ZnS nanoflowers, stoichiometric amounts of transition metal salts were prepared: 10 mM of Zn(NO3)2•3H2O and 30 mM of sodium thiosulfate (Na2S2O3•5H2O) were dissolved in 30 mL of deionized water and stirred for 20 minutes. The solutions were then combined and transferred into a 100 mL Teflon autoclave reactor, which was heated at 200 °C for 12 hours in a furnace. This process utilized the hydrothermal technique to produce the desired ZnS nanoflowers. Result The crystalline arrangement of ZnS was validated by X-ray diffraction (XRD) analysis, aligning with the Joint Committee on Powder Diffraction Standards (JCPDS). Moreover, field emission scanning electron microscopy (FE-SEM) illustrated the particle morphology of ZnS, showing a range between 200 and 500 nm size. Additionally, the cyclic voltammetry results indicated that the modified electrode produced a greater current response than the bare electrode, highlighting its improved sensitivity to dopamine molecules. Conclusion ZnSnanoparticles were synthesized via a hydrothermal method and characterized using XRDand FE-SEM. These nanoparticles were used for electrochemical dopamine detection, showing potential for advanced sensing platforms. Integrating ZnS into microfluidic devices enables real-time dopamine monitoring, opening new possibilities for healthcare and neurochemical research. Exploring surface engineering techniques could further enhance the electrochemical performance of ZnS-based sensors.

Monoclonal antibodies (mAbs) could be a Future in Biomedicine.

The discovery of mAbs has fundamentally changed the field of biomedicine by offering precise treatment options for a variety of illnesses, including autoimmune disorders and cancer. Future developments in the state of affairs and breakthroughs in mAbs in the multidisciplinary fields of biomedicine were explored. We begin by reviewing the developments in mAb technology, the production of fully human antibodies, bispecific antibodies, and antibody-drug conjugates, all of which have greatly increased the potency and specificity of their therapeutic effects. Next are the latest developments in mAb engineering, such as the use of AI in antibody discovery and optimization and the development of novel delivery systems that maximize bioavailability while minimizing side effects. The most recent developments in clinical practice and scientific research that will boost the therapeutic potential of mAbs for many applications, including rare diseases and personalized medicine, are also reviewed. In summary, the present research highlights the difficulties that the discipline faces due to large run-costs and the need for new methods. While not providing a comprehensive overview of this ever-evolving topic, the study does offer enough information to understand how mAbs in biomedicine could impact the development of novel treatment techniques in the future.

Pharmacologic Therapy for Spinal Cord Injury.

Neuroprotective strategies aimed at preventing secondary neurologic injury following acute spinal cord injury remain an important area of clinical, translational, and basic science research. Despite recent advancement in the understanding of basic mechanisms of primary and secondary neurologic injury, few pharmacologic agents have shown consistent promise in improving neurologic outcomes following SCI in large randomized clinical trials. The authors review the existing literature and clinical guidelines for pharmacologic therapy investigated for managing acute SCI, including corticosteroids, GM-1 ganglioside (Sygen), Riluzole, opioid antagonists, Cethrin, minocycline, and vasopressors for mean arterial pressure augmentation. Therapies for managing secondary effects of SCI, such as bradycardia, are discussed. Current clinical trials for pharmacotherapy and cellular transplantation following acute SCI are also reviewed. Despite the paucity of current evidence for clinically beneficial post-SCI pharmacotherapy, future research efforts will hopefully elucidate promising therapeutic agents to improve neurologic function.

Establishment of Nano-ITO induced rat model of indium lung disease and exploration of its pathological characteristics

Objective: To study the dynamic pathological characteristics of lung tissue in a Nano-ITO induced rat model of indium lung disease and to guide clinical and basic scientific research to further explore the mechanisms of pulmonary interstitial injury and pulmonary alveolar proteinosis (PAP). Methods: Dose-response (three divided doses) and time-course studies (six exposure periods) were performed to investigate the pulmonary toxicity induced by Nano-ITO. At the end of the experiment, cytokine levels and oxidative stress were analyzed in the bronchoalveolar lavage fluid. Rat lung tissues were also collected for staining with H&E, PAS, Masson's, Oil Red O, and Sirius Red. Ultrastructure of lung tissue cells was observed by transmission electron microscopy. Expression of IL-1β, HO-1, SP-A was observed by immunohistochemistry, and the expression of α-SMA was observed by immunofluorescence. Results: Nano-ITO intratracheal instillation caused pulmonary toxicity by inducing acute inflammation at 3 days, granuloma (nodule) formation and collagen hyperplasia at 14 days, and alveolar proteinosis at 56 days post-exposure. Pathological features of lung tissue included typical alveolar exudates, cellular fibrous nodules, enlarged alveolar fat droplet fusion, cholesterol crystal granuloma and pulmonary alveolar proteinosis. The intra-alveolar eosinophilic material (multilamellated, lattice-shaped, and myelin-like structure) showed abnormal lamellar bodies (features of alveolar type Ⅱ epithelial cells) and abundant rough endoplasmic reticulum and mitochondria (features of fibroblasts) on transmission electron microscopy of the lung tissue from rats exposed to Nano-ITO on the 84th day. Cellular pathology revealed that a large amount of amorphous PAS stain-positive substances appear in BALF at 28 days post-exposure, and pink granular protein-like substances can be seen in alveolar macrophages. Conclusions: There are three characteristic developmental stages in Nano-ITO induced pulmonary injury in rats, acute inflammation, granuloma (nodule) formation and collagen proliferation, and pulmonary alveolar proteinosis, which provide a reference feature model for the pathogenesis of indium lung disease.

High-dose vitamin C as a metabolic treatment of cancer: a new dimension in the era of adjuvant and intensive therapy.

The anti-cancer mechanism of High-dose Vitamin C (HDVC) is mainly to participate in the Fenton reaction, hydroxylation reaction, and epigenetic modification, which leads to the energy crisis, metabolic collapse, and severe peroxidation stress that results in the proliferation inhibition or death of cancer cells. However, the mainstream view is that HDVC does not significantly improve cancer treatment outcomes. In clinical work and scientific research, we found that some drugs or therapies can significantly improve the anti-cancer effects of HDVC, such as PD-1 inhibitors that can increase the anti-cancer effects of cancerous HDVC by nearly three times. Here, the adjuvant and intensive therapy and synergistic mechanisms including HDVC combined applicationof chemoradiotherapies multi-vitamins, targeted drugs, immunotherapies, and oncolytic virus are discussed in detail. Adjuvant and intensive therapy of HDVC can significantly improve the therapeutic effect of HDVC in the metabolic treatment of cancer, but more clinical evidence is needed to support its clinical application.

Utilization of recurrent laryngeal nerve monitoring during thyroid surgery in china: a point prevalence survey (2015-2023).

The survey aimed to elucidate the complete range of national practices, including all technical and non-technical aspects, as well as surgical stratification and maturation, of the use of intraoperative neuromonitoring (IONM) during thyroid surgery in China. Six national questionnaires, developed by the Chinese Neural Monitoring Study Group (CNMSG) between 2015 and 2023, were used to collect and analyze data regarding the clinical application, education, and scientific research related to IONM in Chinese medical institutions. Among the surveyed hospitals, 45% reported an average annual surgical volume exceeding 3,000 cases, with 82.5% performing more than 80% of the surgeries for malignant thyroid tumors. Additionally, 97.5% of the hospitals reported a<3% incidence of postoperative hoarseness with IONM. Statistical analysis from 2011 to 2015 found that the incidence of postoperative hoarseness decreased by 30% in 2013 compared with 2011, when the technology was introduced. Preoperative and postoperative laryngoscopies were routinely performed by 82.5% and 15% of the hospitals, respectively. For 65% of the hospitals, the publication of the Chinese edition of neuromonitoring guidelines in 2013 prompted the utilization of IONM technology. An average annual number of IONM applications exceeding 500 cases (18.5% the average volume) was reported by 80% of the hospitals, while 62.5% reported a cumulative number of applications greater than 5,000 cases (47.1% the average cumulative volume). Regarding technical parameters, 75% of the hospitals reported an intraoperative V1 amplitude of >500µV, and 70% reported an intraoperative loss of signal (LOS) rate of<3%. 92.5% of the surveyed hospitals believed that IONM could help identify dissociated nerves, and 95% of the surveyed hospitals believed that IONM could reduce nerve damage. However, 72.5% of the respondents thought that cost was the main limitation. Furthermore, 67.5% of the hospitals reported that half of their thyroid surgical team members were trained in IONM, with 17.5% reporting that all team members were trained. Areas for reinforced training included IONM research methods and directions (72.5%), and analysis and treatment of abnormal EMG signals (72.5%). Research projects related to IONM were conducted by 42.5% of the hospitals, while 52.5% had published papers on neuromonitoring. IONM was independently and incrementally associated with the annual surgical volume. This survey emphasized the importance of national collaboration and/or a registry for the uptake, consolidation, and development of CNMSG consensus.

Society of Family Planning Research Practice Support: Approaching the concepts of gender and sex in family planning research

Gender and sex are distinct constructs that shape family planning related experiences, outcomes, and opportunities. This commentary provides guidance to clinical and social science researchers on: 1) current definitions of gender and sex; 2) when and why capturing information about gender, sex, or both is relevant to family planning studies; 3) recommended language for each stage of the research process to accurately and affirmingly recruit participants, collect and analyze data, and disseminate findings; and 4) approaches for engaging with already collected data or published research. Failing to address gender and sex with clarity and intention in family planning research can lead to biased samples, biased instruments, and biased data, consequently limiting scholarly knowledge of family planning desires, abilities, experiences, outcomes, and preferences.

Publication trends of Leber congenital amaurosis researches: a bibliometric study during 2002-2022.

To analyze the changes in scientific output relating to Leber congenital amaurosis (LCA) and forecast the study trends in this field. All of the publications in the field of LCA from 2002 to 2022 were collected from Web of Science (WOS) database. We analyzed the quantity (number of publications), quality (citation and H-index) and development trends (relative research interest, RRI) of published LCA research over the last two decades. Moreover, VOSviewer software was applied to define the co-occurrence network of keywords in this field. A total of 2158 publications were ultimately examined. We found that the focus on LCA kept rising and peaked in 2015 and 2018, which is consistent with the development trend of gene therapy. The USA has contributed most to this field with 1162 publications, 56 674 citations and the highest H-index value (116). The keywords analysis was divided into five clusters to show the hotspots in the field of LCA, namely mechanism-related, genotype-related, local phenotype-related, system phenotype-related, and therapy-related. We also identified gene therapy and anti-retinal degeneration therapy as a major focus in recent years. Our study illustrates historical research process and future development trends in LCA field. This may help to guide the orientation for further clinical diagnosis, treatment and scientific research.

Mechanisms of mitophagy and oxidative stress in cerebral ischemia-reperfusion, vascular dementia, and Alzheimer's disease.

Neurological diseases have consistently represented a significant challenge in both clinical treatment and scientific research. As research has progressed, the significance of mitochondria in the pathogenesis and progression of neurological diseases has become increasingly prominent. Mitochondria serve not only as a source of energy, but also as regulators of cellular growth and death. Both oxidative stress and mitophagy are intimately associated with mitochondria, and there is mounting evidence that mitophagy and oxidative stress exert a pivotal regulatory influence on the pathogenesis of neurological diseases. In recent years, there has been a notable rise in the prevalence of cerebral ischemia/reperfusion injury (CI/RI), vascular dementia (VaD), and Alzheimer's disease (AD), which collectively represent a significant public health concern. Reduced levels of mitophagy have been observed in CI/RI, VaD and AD. The improvement of associated pathology has been demonstrated through the increase of mitophagy levels. CI/RI results in cerebral tissue ischemia and hypoxia, which causes oxidative stress, disruption of the blood-brain barrier (BBB) and damage to the cerebral vasculature. The BBB disruption and cerebral vascular injury may induce or exacerbate VaD to some extent. In addition, inadequate cerebral perfusion due to vascular injury or altered function may exacerbate the accumulation of amyloid β (Aβ) thereby contributing to or exacerbating AD pathology. Intravenous tissue plasminogen activator (tPA; alteplase) and endovascular thrombectomy are effective treatments for stroke. However, there is a narrow window of opportunity for the administration of tPA and thrombectomy, which results in a markedly elevated incidence of disability among patients with CI/RI. It is regrettable that there are currently no there are still no specific drugs for VaD and AD. Despite the availability of the U.S. Food and Drug Administration (FDA)-approved clinical first-line drugs for AD, including memantine, donepezil hydrochloride, and galantamine, these agents do not fundamentally block the pathological process of AD. In this paper, we undertake a review of the mechanisms of mitophagy and oxidative stress in neurological disorders, a summary of the clinical trials conducted in recent years, and a proposal for a new strategy for targeted treatment of neurological disorders based on both mitophagy and oxidative stress.

Unravelling The Cause and Consequences of Post Traumatic Stress Disorder: A Comprehensive Review

Post-traumatic stress disorder (PTSD) is a psychiatric disorder caused by experiencing or witnessing traumatic or potentially life-threatening events, that has grown in prevalence due to global conflicts, natural disasters, and domestic violence. When a victim experiences trauma such as death or serious injury, three dimensions of PTSD develop: re-experience the event, Symptoms of trauma may include distressing memories, dreams, flashbacks, and physical distress, as well as avoidance of triggers and increased arousal. Traumatic events cause stress, which leads to a variety of psychosocial and physiological outcomes. PTSD has significant psychobiological correlates that can impair a person's daily life and be life-threatening. Given current events (for example, extended combat, terrorism, and exposure to certain environmental toxins), a significant increase in PTSD diagnoses is expected over the next decade. PTSD is a serious public health concern, necessitating the development of new paradigms and theoretical models to gain a better understanding of the condition and develop new and improved treatment interventions. therefore, understanding the specific causes of PTSD and how it affects patients is critical for both clinical practice and scientific research. To treat PTSD, nonpharmacologic interventions such as cognitive behavioural therapy, antidepressants (selective serotonin reuptake inhibitors), antianxiety medications, mood stabilizers, and antipsychotics are recommended. This review of PTSD will help readers gain a better understanding of the PTSD condition and probable causes that contribute to PTSD disease and explore the influence on the patient himself after suffering from PTSD. It discusses the ways to improve the ability to recognize and treat it, appreciate the internist's role in managing it, and help to enhance the quality of life of people suffering from PTSD.

Role of macrophage polarization in heart failure and traditional Chinese medicine treatment.

Heart failure (HF) has a severe impact on public health development due to high morbidity and mortality and is associated with imbalances in cardiac immunoregulation. Macrophages, a major cell population involved in cardiac immune response and inflammation, are highly heterogeneous and polarized into M1 and M2 types depending on the microenvironment. M1 macrophage releases inflammatory factors and chemokines to activate the immune response and remove harmful substances, while M2 macrophage releases anti-inflammatory factors to inhibit the overactive immune response and promote tissue repair. M1 and M2 restrict each other to maintain cardiac homeostasis. The dynamic balance of M1 and M2 is closely related to the Traditional Chinese Medicine (TCM) yin-yang theory, and the imbalance of yin and yang will result in a pathological state of the organism. Studies have confirmed that TCM produces positive effects on HF by regulating macrophage polarization. This review describes the critical role of macrophage polarization in inflammation, fibrosis, angiogenesis and electrophysiology in the course of HF, as well as the potential mechanism of TCM regulation of macrophage polarization in preventing and treating HF, thereby providing new ideas for clinical treatment and scientific research design of HF.

Characteristics and considerations of French medical education

Abstract French medical education, with a long history and guided by laws and decrees set by the French Ministry of Education and Ministry of Health, aims at elite training, focusing on the cultivation of students’ clinical practice and scientific research capabilities, and implementing a unified medical talent training model. The French medical education system continuously seeks innovation and change. In September 2020, a new round of reforms was initiated in aspects such as admission pathways, examination system, and assessment methods. These changes aim to enhance medical students’ disciplinary backgrounds, strengthen process-based assessment, and foster the development of versatile medical professionals. This article analyzes the characteristics of French medical education and the main measures of this round of reforms, providing insights and considerations for the training of cultivated medical talents in China.

Aortic Valve Calcium Score: Applications in Clinical Practice and Scientific Research-A Narrative Review.

In this narrative review, we investigate the essential role played by the computed tomography Aortic Valve Calcium Score (AVCS) in the cardiovascular diagnostic landscape, with a special focus on its implications for clinical practice and scientific research. Calcific aortic valve stenosis is the most prevalent type of aortic stenosis (AS) in industrialized countries, and due to the aging population, its prevalence is increasing. While transthoracic echocardiography (TTE) remains the gold standard, AVCS stands out as an essential complementary tool in evaluating patients with AS. The advantage of AVCS is its independence from flow; this allows for a more precise evaluation of patients with discordant findings in TTE. Further clinical applications of AVCS include in the assessment of patients before transcatheter aortic valve replacement (TAVR), as it helps in predicting outcomes and provides prognostic information post-TAVR. Additionally, we describe different AVCS thresholds regarding gender and the anatomical variations of the aortic valve. Finally, we discuss various scientific studies where AVCS was applied. As AVCS has some limitations, due to the pathophysiologies of AS extending beyond calcification and gender differences, scientists strive to validate contrast-enhanced AVCS. Furthermore, research on developing radiation-free methods of measuring calcium content is ongoing.

Crossing Between Clinical Work and Scholarly Publishing: Early-Career Neurosurgeons as Clinician-Researchers

Medical professionals who assume multiple roles as clinicians and researchers are commonly found in hospitals worldwide. Likewise, in many Chinese hospitals, particularly among early-career medical professionals with MD and PhD degrees, active engagement in both clinical practice and scientific research is expected. In the current ethnographic study, the cultural-historical activity theory is used to explore how three early-career neurosurgeons at a tier-one northern Chinese hospital conduct and write research for publishing in Science Citation Index (SCI)-indexed journals in addition to handling their heavy clinical workload. Drawing on multiple sources of qualitative data, including semi-structured interviews, two-week naturalistic observations, field notes, photographs, and daily activity logs with three neurosurgeons, the study findings highlight Chinese neurosurgeons conduct and write up their research using patient data and collaborating with laboratories while seeking academic language editing and peer feedback. Ethical considerations of clinician-researchers’ scholarly publishing process, implications for researching medical professionals’ boundary crossings, and future research directions are also discussed.

Immunotherapies Targeting Tumor-Associated Macrophages (TAMs) in Cancer.

Tumor-associated macrophages (TAMs) are one of the most plentiful immune compositions in the tumor microenvironment, which are further divided into anti-tumor M1 subtype and pro-tumor M2 subtype. Recent findings found that TAMs play a vital function in the regulation and progression of tumorigenesis. Moreover, TAMs promote tumor vascularization, and support the survival of tumor cells, causing an impact on tumor growth and patient prognosis. Numerous studies show that reducing the density of TAMs, or modulating the polarization of TAMs, can inhibit tumor growth, indicating that TAMs are a promising target for tumor immunotherapy. Recently, clinical trials have found that treatments targeting TAMs have achieved encouraging results, and the U.S. Food and Drug Administration has approved a number of drugs for use in cancer treatment. In this review, we summarize the origin, polarization, and function of TAMs, and emphasize the therapeutic strategies targeting TAMs in cancer treatment in clinical studies and scientific research, which demonstrate a broad prospect of TAMs-targeted therapies in tumor immunotherapy.

Hand function assessment: tests for adult patients with central nervous system disorders

Upper limb dysfunction is a very common and severe problem in patients with central nervous system disorders. The restoration of arm and hand functions is one of the priority goals of medical rehabilitation in these patients. The development of new and effective rehabilitation technologies, implementation of a patient-centered approach, and objective assessment of rehabilitation outcomes require validated tools. This review aimed to introduce specialists to those tools that evaluate the rehabilitation outcomes based on the patient’s performance in standardized tasks (tests). Functional abilities of the upper extremities should be assessed based on the International Classification of Functioning, Disability and Health. The general concepts of these tests are discussed. Standard requirements for measurement tools (validity, reliability, and sensitivity) ensure the reliability of test results. The tests that focused on the hand and arm function are briefly described. Only tests that have good psychometric characteristics and are suitable for the monitoring of rehabilitation outcomes for patients with stroke, multiple sclerosis, and spinal cord injury are also presented in the review. In conclusion, the choice of a specific test is based on the purpose and objectives of the study (clinical practice or scientific research), motor deficit peculiarities, and rehabilitation unit resources. However, new and validated tools that focus on the assessment of hand function abilities in patients with central nervous system disorders are needed.