High-throughput screening of CO_(2) cycloaddition MOF catalyst with an explainable machine learning model

The high porosity and tunable chemical functionality of metal-organic frameworks(MOFs)make it a promising catalyst design platform.High-throughput screening of catalytic performance is feasible since the large MOF structure database is available.In this study,we report a machine learning model for high-throughput screening of MOF catalysts for the CO_(2) cycloaddition reaction.The descriptors for model training were judiciously chosen according to the reaction mechanism,which leads to high accuracy up to 97%for the 75%quantile of the training set as the classification criterion.The feature contribution was further evaluated with SHAP and PDP analysis to provide a certain physical understanding.12,415 hypothetical MOF structures and 100 reported MOFs were evaluated under 100℃ and 1 bar within one day using the model,and 239 potentially efficient catalysts were discovered.Among them,MOF-76(Y)achieved the top performance experimentally among reported MOFs,in good agreement with the prediction.

Importance of neonatal screening:A case study of sickle cell disease and cystic fibrosis coexistence

BACKGROUND Neonatal screening(NS)is a public health policy to identify genetic pathologies such as cystic fibrosis(CF),sickle cell disease,and other diseases.Sickle cell disea-se is the comprehensive term for a group of hemoglobinopathies characterized by the presence of hemoglobin S.CF is an autosomal recessive multisystemic disease with pathophysiology involving deleterious mutations in the transmembrane re-gulatory gene that encodes a protein that regulates the activity of chloride and sodium channels in the cell surface epithelium.NS is crucial for early diagnosis and management,which ensures a better quality of life.AIM To report a case of the coexistence of sickle cell anemia(SCA)and CF and perform an integrative literature review.METHODS This is an observational study and a review of the literature focusing on two rare genetic pathologies identified simultaneously in NS from the perspective of a clinical case.The authors identified only 5 cases of SCA associated with CF.No clinical trials or review articles were identified considering the rarity of the coexistence of these two pathologies.RESULTS Herein,the authors reported the case of a girl who after undergoing NS on day 8 of life was diagnosed with SCA with an alteration in the dosage of immunoreactive trypsin.The diagnosis of CF was confirmed by the Coulometry Sweat Test.The rarity of the co-occurrence of these two severe genetic pathologies(CF and SCA)is a challenge for medical science.CONCLUSION This study adds to the few case reports present in the literature that highlight the identification of two severe diseases via NS.

Independent risk factors for twin pregnancy adverse fetal outcomes before 28 gestational week by first trimester ultrasound screening

BACKGROUND The incidence of multiple pregnancies has increased worldwide recently and women with a twin pregnancy are at higher risk of adverse outcomes compared with women with a singleton pregnancy.It is important to understand the risk factors for adverse fetal outcomes in twin pregnancy in order to guide clinical management.AIM To identify the independent risk factors,including maternal personal and family medical histories and first trimester ultrasound screening findings,for adverse fetal outcomes of twin pregnancy before 28 weeks of gestation.METHODS The data of 126 twin pregnancies in our hospital,including pregnancy outcomes,first trimester ultrasound screening findings and maternal medical history,were retrospectively collected.Twenty-nine women with adverse outcomes were included in the abnormal group and the remaining 97 women were included in the control group.RESULTS Patients in the abnormal group were more likely to be monochorionic diamniotic(13/29 vs 20/97,P=0.009),with a higher mean pulsatility index(PI,1.57±0.55 vs 1.28±0.42,P=0.003;cutoff value:1.393)or a higher mean resistance index(0.71±0.11 vs 0.65±0.11,P=0.008;cutoff value:0.683)or early diastolic notch of bilateral uterine arteries(UtAs,10/29 vs 15/97,P=0.024)or with abnormal ultrasound findings(13/29 vs 2/97,P<0.001),compared with the control group.Monochorionic diamnioticity,higher mean PI of bilateral UtAs and abnormal ultrasound findings during first trimester screening were independent risk factors for adverse fetal outcomes(P<0.05).CONCLUSION First trimester ultrasound screening for twin pregnancy identifies independent risk factors and is useful for the prediction of fetal outcomes.

Effects of Different Grinding Methods on the Quality of Soybean Bean Milk

[Objectives] This study was conducted to improve the nutritional value of soybean milk, enrich the variety and taste of soybean milk, and find healthy food that is more conducive to people s nutritional needs. [Methods] Whole soybean milk was prepared by grinding with a grinding wheel at a low concentration (low-concentration grinding) and a stainless steel mill at a high concentration (high-concentration grinding). The sensory, physical and chemical characteristics and anti-nutritional factors of whole soybean milk produced by different grinding methods were studied. [Results] Compared with low-concentration grinding, the protein content in soybean milk prepared by high-concentration grinding increased by 24%, and the dietary fiber content increased by 74.7%. Before and after high-pressure homogenization, the particle size D(4, 3) of soybean milk prepared by low-concentration grinding was 212.1 and 93.59 μm, respectively, and the particle size D(4, 3) of soybean milk prepared by high-concentration grinding was 134.0 and 64.64 μm, respectively. The trypsin inhibitor activity and phytic acid content of soybean milk prepared by high-concentration grinding were significantly lower than those of soybean milk prepared by low-concentration grinding. [Conclusions] This study improves the diet structure of the broad masses of people, strengthens people s physique, and provides a new idea for the implementation and development of China s "Soybean Action Programme".

Revolutionizing diabetic retinopathy screening and management:The role of artificial intelligence and machine learning

Diabetic retinopathy(DR)remains a leading cause of vision impairment and blindness among individuals with diabetes,necessitating innovative approaches to screening and management.This editorial explores the transformative potential of artificial intelligence(AI)and machine learning(ML)in revolutionizing DR care.AI and ML technologies have demonstrated remarkable advancements in enhancing the accuracy,efficiency,and accessibility of DR screening,helping to overcome barriers to early detection.These technologies leverage vast datasets to identify patterns and predict disease progression with unprecedented precision,enabling clinicians to make more informed decisions.Furthermore,AI-driven solutions hold promise in personalizing management strategies for DR,incorpo-rating predictive analytics to tailor interventions and optimize treatment path-ways.By automating routine tasks,AI can reduce the burden on healthcare providers,allowing for a more focused allocation of resources towards complex patient care.This review aims to evaluate the current advancements and applic-ations of AI and ML in DR screening,and to discuss the potential of these techno-logies in developing personalized management strategies,ultimately aiming to improve patient outcomes and reduce the global burden of DR.The integration of AI and ML in DR care represents a paradigm shift,offering a glimpse into the future of ophthalmic healthcare.

Grindability Evaluation of Ultrasonic Assisted Grinding of Silicon Nitride Ceramic Using Minimum Quantity Lubrication Based SiO_(2)Nanofluid

Minimum quantity Lubrication(MQL)is a sustainable lubrication system that is famous in many machining systems.It involve the spray of an infinitesimal amount of mist-like lubricants during machining processes.The MQL system is affirmed to exhibit an excellent machining performance,and it is highly economical.The nanofluids are understood to exhibit excellent lubricity and heat evacuation capability,compared to pure oil-based MQL system.Studies have shown that the surface quality and amount of energy expended in the grinding operations can be reduced considerably due to the positive effect of these nanofluids.This work presents an experimental study on the tribological performance of SiO_(2)nanofluid during grinding of Si_(3)N_(4)ceramic.The effect different grinding modes and lubrication systems during the grinding operation was also analyzed.Different concentrations of the SiO_(2)nanofluid was manufactured using canola,corn and sunflower oils.The quantitative evaluation of the grinding process was done based on the amount of grinding forces,specific grinding energy,frictional coefficient,and surface integrity.It was found that the canola oil exhibits optimal lubrication performance compared to corn oil,sunflower oil,and traditional lubrication systems.Additionally,the introduction of ultrasonic vibrations with the SiO_(2)nanofluid in MQL system was found to reduce the specific grinding energy,normal grinding forces,tangential grinding forces,and surface roughness by 65%,57%,65%,and 18%respectively.Finally,regression analysis was used to obtain an optimum parameter combinations.The observations from this work will aid the smooth transition towards ecofriendly and sustainable machining of engineering ceramics.

Topography Modeling of Surface Grinding Based on Random Abrasives and Performance Evaluation

The surface morphology and roughness of a workpiece are crucial parameters in grinding processes.Accurate prediction of these parameters is essential for maintaining the workpiece’s surface integrity.However,the randomness of abrasive grain shapes and workpiece surface formation behaviors poses significant challenges,and accuracy in current physical mechanism-based predictive models is needed.To address this problem,by using the random plane method and accounting for the random morphology and distribution of abrasive grains,this paper proposes a novel method to model CBN grinding wheels and predict workpiece surface roughness.First,a kinematic model of a single abrasive grain is developed to accurately capture the three-dimensional morphology of the grinding wheel.Next,by formulating an elastic deformation and formation model of the workpiece surface based on Hertz theory,the variation in grinding arc length at different grinding depths is revealed.Subsequently,a predictive model for the surface morphology of the workpiece ground by a single abrasive grain is devised.This model integrates the normal distribution model of abrasive grain size and the spatial distribution model of abrasive grain positions,to elucidate how the circumferential and axial distribution of abrasive grains influences workpiece surface formation.Lastly,by integrating the dynamic effective abrasive grain model,a predictive model for the surface morphology and roughness of the grinding wheel is established.To examine the impact of changing the grit size of the grinding wheel and grinding depth on workpiece surface roughness,and to validate the accuracy of the model,experiments are conducted.Results indicate that the predicted three-dimensional morphology of the grinding wheel and workpiece surfaces closely matches the actual grinding wheel and ground workpiece surfaces,with surface roughness prediction deviations as small as 2.3%.

Dressing Mechanism and Evaluations of Grinding Performance with Porous cBN Grinding Wheels

Cubic boron nitride(cBN)grinding wheels play a pivotal role in precision machining,serving as indispensable tools for achieving exceptional surface quality.Ensuring the sharpness of cBN grains and optimizing the grinding wheel’s chip storage capacity are critical factors.This paper presents a study on the metal-bonded segments and single cBN grain samples using the vacuum sintering method.It investigates the impact of blasting parameters-specifically silicon carbide(SiC)abrasive size,blasting distance,and blasting time-on the erosive wear characteristics of both the metal bond and abrasive.The findings indicate that the abrasive size and blasting distance significantly affect the erosive wear performance of the metal bond.Following a comprehensive analysis of the material removal rate of the metal bond and the erosive wear condition of cBN grains,optimal parameters for the working layer are determined:a blasting distance of 60 mm,a blasting time of 15 s,and SiC particle size of 100#.Furthermore,an advanced simulation model investigates the dressing process of abrasive blasting,revealing that the metal bond effectively inhibits crack propagation within cBN abrasive grains,thereby enhancing fracture toughness and impact resistance.Additionally,a comparative analysis is conducted between the grinding performance of porous cBN grinding wheels and vitrified cBN grinding wheels.The results demonstrate that using porous cBN grinding wheels significantly reduces grinding force,temperature,and chip adhesion,thereby enhancing the surface quality of the workpiece.

Reliability of a computerized system for strabismus screening

AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visual acuity measurement and use of the computerized system.Visual acuity was measured,and strabismus testing was performed using two flash photographs.All data from the three primary observers were sent to an experienced assistant researcher,who was blinded to the primary results,for re-evaluation.The primary and re-evaluation results of the Photo-Hirschberg screenings using weighted kappa for agreement were compared.RESULTS:The study included 181 participants(88 males and 93 females)and the results for primary and re-evaluation screenings were corresponded.Ten participants with contrasting results presented with unclear corneal light reflex.Sensitivity and specificity were 100%[95%confidence interval(CI):29.0%-100%]and 99.4%(95%CI:96.6%-100%),respectively,based on the Agresti test of the primary evaluation,considering the re-evaluated classification as true.CONCLUSION:The computerized system can be used for primary strabismus screening by non-specialized personnel,with 98.8%agreement with specialists.However,it cannot be used as a substitute for professional examination.

Utilization of molecular genetic approaches for colorectal cancer screening

The feasibility of population screening for colorectal cancer has been demonstrated in several studies.Most of these studies have considered individual characteristics,diagnostic approaches,epidemiological data,and socioeconomic factors.In this article,we comment on an editorial by Metaxas et al published in the recent issue of the journal.The authors emphasized the need to raise public awareness through health education programs and the possibility of using easily accessible non-invasive screening methods.Here,we focus on non-invasive molecular genetic approaches that can aid in colorectal cancer screening.On the one hand,we highlighted the use of tumor DNA/RNA markers directly for screening and,on the other hand,underline the use of polygenic risk assessment and hereditary predisposition to select individuals for more thorough cancer screening.

Evidence for the Reliability and Validity of the Arabic Version of the Student Risk Screening Scale for Internalizing and Externalizing Behaviors (SRSS-IE)

School-based universal screening for behavioral/emotional risk is a necessary first step to providing services in an educational setting for students with emotional and behavioral disorders (EBDs). Psychometric properties are critical to making decisions about choosing a screening instrument. The purpose of the present study was to examine the psychometric properties of the student risk screening scale for internalizing and externalizing behaviors (SRSS-IE). Participants included 3145 students and their teachers. Item-level analyses of the current sample supported the retention of all items. The internal consistency of the SRSS items ranged from 0.83 to 0.85. Convergent validity between the SRSS-IE and a well-established screening tool, the strength and difficulties questionnaire (SDQ), was found for the total score (r = 0.70). Additionally, the results of this study demonstrate strong social validity, suggesting the SRSS-IE to be a useful and functional screening tool. We conclude that the SRSS-IE is a valid and reliable instrument for assessing the level of emotional and behavioral difficulties among elementary students.

New cheaper human papilloma virus mass screening strategy reduces cervical cancer incidence in Changsha city:A clinical trial

BACKGROUND Cervical cancer is the second leading cause of death in women worldwide,second only to breast cancer.Around 80%of women have been infected with human papillomavirus(HPV)in their lifetime.Early screening and treatment are effective means of preventing cervical cancer,but due to economic reasons,many parts of the world do not have free screening programs to protect women’s health.AIM To increase HPV cervical cancer screening in Changsha and reduce the incidence of cervical cancer.METHODS Cervical cancer screening included gynecological examination,vaginal secretion examination and HPV high-risk typing testing.Cervical cytology examination(ThinPrep cytology test)was performed for individuals who test positive for HPV types other than 16 and 18.Vaginal colposcopy examination was performed for HPV16 and 18 positive individuals,as well as for those who were positive for ThinPrep cytology test.If the results of vaginal colposcopy examination were abnormal,histopathological examination was performed.We conducted a cost-benefit analysis after 4 years.RESULTS From 2019 to 2022,523437 women aged 35-64 years in Changsha city were screened and 73313 were positive,with a 14%positive rate.The detection rate of precancerous lesions of cervical cancer was 0.6%and the detection rate of cervical cancer was 0.037%.Among 311212 patients who underwent two cancers examinations,the incidence rate was reduced by more than half in the second examination.The average screening cost per woman was 120 RMB.The average cost of detecting early cases was 10619 RMB,with an early detection cost coefficient of 0.083.CONCLUSION Our screening strategy was effective and cost-effective,making it valuable for early diagnosis and treatment of cervical cancer.It is worth promoting in economically limited areas.

Damage evolution and removal behaviors of GaN crystals involved in double-grits grinding

Elucidating the complex interactions between the work material and abrasives during grinding of gallium nitride(GaN)single crystals is an active and challenging research area.In this study,molecular dynamics simulations were performed on double-grits interacted grinding of GaN crystals;and the grinding force,coefficient of friction,stress distribution,plastic damage behaviors,and abrasive damage were systematically investigated.The results demonstrated that the interacted distance in both radial and transverse directions achieved better grinding quality than that in only one direction.The grinding force,grinding induced stress,subsurface damage depth,and abrasive wear increase as the transverse interacted distance increases.However,there was no clear correlation between the interaction distance and the number of atoms in the phase transition and dislocation length.Appropriate interacted distances between abrasives can decrease grinding force,coefficient of friction,grinding induced stress,subsurface damage depth,and abrasive wear during the grinding process.The results of grinding tests combined with cross-sectional transmission electron micrographs validated the simulated damage results,i.e.amorphous atoms,high-pressure phase transition,dislocations,stacking faults,and lattice distortions.The results of this study will deepen our understanding of damage accumulation and material removal resulting from coupling between abrasives during grinding and can be used to develop a feasible approach to the wheel design of ordered abrasives.

Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still not optimistic.In China,the incidence of CRC in the Yangtze River Delta region is increasing dramatically,but few studies have been conducted.Therefore,it is necessary to develop a simple and efficient early screening model for CRC.AIM To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.METHODS Data of 64448 participants obtained from Ningbo Hospital,China between 2014 and 2017 were retrospectively analyzed.The cohort comprised 64448 individuals,of which,530 were excluded due to missing or incorrect data.Of 63918,7607(11.9%)individuals were considered to be high risk for CRC,and 56311(88.1%)were not.The participants were randomly allocated to a training set(44743)or validation set(19175).The discriminatory ability,predictive accuracy,and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic(ROC)curves and calibration curves and by decision curve analysis.Finally,the model was validated internally using a bootstrap resampling technique.RESULTS Seven variables,including demographic,lifestyle,and family history information,were examined.Multifactorial logistic regression analysis revealed that age[odds ratio(OR):1.03,95%confidence interval(CI):1.02-1.03,P<0.001],body mass index(BMI)(OR:1.07,95%CI:1.06-1.08,P<0.001),waist circumference(WC)(OR:1.03,95%CI:1.02-1.03 P<0.001),lifestyle(OR:0.45,95%CI:0.42-0.48,P<0.001),and family history(OR:4.28,95%CI:4.04-4.54,P<0.001)were the most significant predictors of high-risk CRC.Healthy lifestyle was a protective factor,whereas family history was the most significant risk factor.The area under the curve was 0.734(95%CI:0.723-0.745)for the final validation set ROC curve and 0.735(95%CI:0.728-0.742)for the training set ROC curve.The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.CONCLUSION The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age,BMI,WC,lifestyle,and family history exhibited high accuracy.

Enhancing the Performance of Perovskite Light-Emitting Diodes via Synergistic Effect of Defect Passivation and Dielectric Screening

Metal halide perovskites,particularly the quasi-two-dimensional perovskite subclass,have exhibited considerable potential for next-generation electroluminescent materials for lighting and display.Nevertheless,the presence of defects within these perovskites has a substantial influence on the emission efficiency and durability of the devices.In this study,we revealed a synergistic passivation mechanism on perovskite films by using a dual-functional compound of potassium bromide.The dual functional potassium bromide on the one hand can passivate the defects of halide vacancies with bromine anions and,on the other hand,can screen the charged defects at the grain boundaries with potassium cations.This approach effectively reduces the probability of carriers quenching resulting from charged defects capture and consequently enhances the radiative recombination efficiency of perovskite thin films,leading to a significant enhancement of photoluminescence quantum yield to near-unity values(95%).Meanwhile,the potassium bromide treatment promoted the growth of homogeneous and smooth film,facilitating the charge carrier injection in the devices.Consequently,the perovskite light-emitting diodes based on this strategy achieve a maximum external quantum efficiency of~21%and maximum luminance of~60,000 cd m^(-2).This work provides a deeper insight into the passivation mechanism of ionic compound additives in perovskite with the solution method.

Non-participation of asymptomatic candidates in screening protocols reduces early diagnosis and worsens prognosis of colorectal cancer

The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of those affected are diagnosed later,in advanced stages.The efficacy of screening programs has been well-established for several years,which reduces the risk of CRC morbidity and mortality,without taking into account the test used for screening,or other tools.Nevertheless,a significant proportion of patients remain unscreened,so understanding the factors involved,as well as the barriers of the population to adherence is the first step to possibly modify the participation rate.These barriers could include a full range of social and political aspects,especially the type of financial provision of each health service.In Japan,health services are universal,and this advantageous situation makes it easier for citizens to access to these services,contributing to the detection of various diseases,including CRC.Interestingly,the symptomatic CRC group had a lower early-stage diagnosis rate than the patients detected during follow-up for other comorbidities,and symptomatic and cancer screening groups showed similar early-stage diagnosis.

Genetic screening of liver cancer:State of the art

Liver cancer,primarily hepatocellular carcinoma,remains a global health challenge with rising incidence and limited therapeutic options.Genetic factors play a pivotal role in the development and progression of liver cancer.This state-of-the-art paper provides a comprehensive review of the current landscape of genetic screening strategies for liver cancer.We discuss the genetic underpinnings of liver cancer,emphasizing the critical role of risk-associated genetic variants,somatic mutations,and epigenetic alterations.We also explore the intricate interplay between environmental factors and genetics,highlighting how genetic screening can aid in risk stratification and early detection via using liquid biopsy,and advancements in high-throughput sequencing technologies.By synthesizing the latest research findings,we aim to provide a comprehensive overview of the state-of-the-art genetic screening methods for liver cancer,shedding light on their potential to revolutionize early detection,risk assessment,and targeted therapies in the fight against this devastating disease.

Optimization of colorectal cancer screening strategies: New insights

In this editorial,we discuss the article by Agatsuma et al.We concentrate specifically on the current routinely used screening tests recommended by society guidelines and delve into the significance of early diagnosis of colorectal cancer(CRC)and its substantial impact on both incidence and mortality rates.Screening is highly recommended,and an early diagnosis stands out as the most crucial predictor of survival for CRC patients.Therefore,it is essential to identify and address the barriers hindering adherence to screening measures,as these barriers can vary among different populations.Furthermore,we focus on screening strategy optimization by selecting high-risk groups.Patients with comorbidities who regularly visit hospitals have been diagnosed at an early stage,showing no significant difference compared to patients undergoing regular screening.This finding highlights the importance of extending screening measures to include patients with comorbidities who do not routinely visit the hospital.

Towards Sustainable Grinding of Difficult-to-Cut Alloys-A Holistic Review and Trends

Grinding,a critical precision machining process for difficult-to-cut alloys,has undergone continual technological advancements to improve machining efficiency.However,the sustainability of this process is gaining heightened attention due to significant challenges associated with the substantial specific grinding energy and the extensive heat generated when working with difficult-to-cut alloys,renowned for their exceptional physical and mechanical properties.In response to these challenges,the widespread application of massive coolant in manufacturing industries to dissipate grinding heat has led to complex post-cleaning and disposal processes.This,in turn,has resulted in issues such as large energy consumption,a considerable carbon footprint,and concerns related to worker health and safety,which have become the main factors that restrict the development of grinding technology.This paper provides a holistic review of sustainability in grinding difficult-to-cut alloys,encompassing current trends and future directions.The examination extends to developing grinding technologies explicitly tailored for these alloys,comprehensively evaluating their sustainability performance.Additionally,the exploration delves into innovative sustainable technologies,such as heat pipe/oscillating heat pipe grinding wheels,minimum quantity lubrication,cryogenic cooling,and others.These groundbreaking technologies aim to reduce dependence on hazardous coolants,minimizing energy and resource consumption and carbon emissions associated with coolant-related or subsequent disposal processes.The essence of these technologies lies in their potential to revolutionize traditional grinding practices,presenting environmentally friendly alternatives.Finally,future development trends and research directions are put forward to pursue the current limitation of sustainable grinding for difficult-to-cut alloys.This paper can guide future research and development efforts toward more environmentally friendly grinding operations by understanding the current state of sustainable grinding and identifying emerging trends.

Risk assessment and triage strategy of cervical cancer primary screening on HPV integration status:5-year follow-up of a prospective cohort study

Objective:We investigated the relation between man papillomavirus(HPV)integration status and the immediate risk of cervical intraepithelial neoplasia(CIN),as well as the triage strategy based on HPV integration test.Methods:4086 women aged 20 to 65 years in China were enrolled in 2015 for a prospective,population-based,clinical observational study to evaluate the triage performance of HPV integration.Cervical exfoliated cells were collected for HPV testing and cytologic test.If high-risk HPV was positive,HPV integration test was performed at baseline,2-year and 5-year follow-up.Results:At baseline,HPV integration was positively correlated with the severity of cervical pathology,ranging from 5.0%(15/301)in normal diagnosis,6.9%(4/58)in CIN1,31.0%(9/29)in CIN2,70%(14/20)in CIN3,and 100%(2/2)in cervical cancer(P<0.001).Compared with cytology,HPV integration exhibits comparable sensitivity and negative predictive value for the diagnosis of CIN3+,higher specificity(92.8%[90.2%-95.4%]vs.75.5%[71.2%-79.8%],P<0.001)and higher positive predictive value(36.4%[22.1%-50.6%]vs.15.2%[8.5%-21.8%],P<0.001).HPV integration testing strategy yielded a significantly lower colposcopy referral rate than cytology strategy(10.7%[44/410]vs.27.3%[112/410],P<0.001).The HPV integration-negative group exhibited the lowest immediate risk for CIN3+(1.6%)and accounted for the largest proportion of the total population(89.3%),when compared with the normal cytology group(risk,1.7%;proportion,72.7%).Conclusion:As a key molecular basis for the development of cervical cancer,HPV integration might be a promising triage strategy for HPV-positive patients.