Flexner's legacy and the future of medical education:Embracing challenge and opportunity

This editorial comments on the article by Alzerwi.We focus on the development course,present challenges,and future perspectives of medical education.Modern medical education is gradually undergoing significant and profound changes worldwide.The emergence of new ideas,methodologies,and techniques has created opportunities for medical education developments and brought new concerns and challenges,ultimately promoting virtuous progress in medical education reform.The sustainable development of medical education needs joint efforts and support from governments,medical colleges,hospitals,researchers,administrators,and educators.

Review of My Research Work on Ferroelectric Films and Si-Based Device Applications: Opportunity and Challenge

Ferroelectric materials have many interesting physical properties such as ferroelectricity, pyroelectricity, piezoelectricity, and opto-electricity, and applying ferroelectric materials in the forms of thin and thick films and integrating them on the silicon substrate as electronic and MEMS devices is a very attractive research area and challenging. In this paper, we report our research works on ferroelectric MEMS and ferroelectric films for electronic device applications. Pyroelectric thin film infrared sensors have been made, characterized, and a 32×32 array with its size of 1cm×1cm has been obtained on Si membrane. Ferroelectric thin films in amorphous phase have been applied to make silicon based hydrogen gas sensors with the metal/amorphous ferroelectric film/metal device structure, and its turn-on voltage of about 4.5V at ～1000 ppm in air is about 7 times of the best value reported in the literature. For the application of electron emission flat panel display, ferroelectric BST thin films with excess Ti concentrations have been coated on Si tips, the threshold voltage of those ferroelectric film coated tips has been reduced about one order from ～70 V/μm to 4～10 V/μm for different Ti concentrations, and however, the electron emission current density has been increased at least 3～4 order for those coated tips compared to that of the bare Si tips. To fulfill in the thickness gap between thin film of typical ～1 μm made by PVD/CVD and polished ceramic wafer of ～50 μm from the bulk, piezoelectric films with thickness in a range of 1～30 μm have been successfully deposited on Si substrate at a low temperature of 650oC by a novel hybridized deposition technique, and piezoelectric MEMS ultrasonic arrays have been very recently obtained with the sound pressure level up to ～120 dB. More detailed results will be presented and mechanisms will be discussed.

Editorial's note: The Opportunity and Challenge Faced by Molecular Medicine

Since 1980’s,life science has been holding a prominent place in the development ofscience and it is expected to become one of the leading disciplines in the 21 century.Currently the development of life science presents the following characteristics:1.The understanding of life was deepened to the molecule level.

A brand new opportunity and challenge for GEE

Welcome to the second issue of Green Energy&Environment(GEE).The purpose of this Editorial is to give some insight into the opportunities and challenges related to green energy and environment,and to call on more researchers participating actively in and sharing the chance.As is known today,human is currently facing the triple crises:ecological,social and economic,which have

The research on the Bangladesh-China-India-Myanmar economic corridor： opportunity and challenge

This paper discusses the opportunity and challenge faced by the Bangladesh-China-India-Myanmar economic corridor. The opportunities include the complementary of economic structure and natural resources pattern, as well as the geographic linkage. The challenges include the funding shortage, the lack of political trust, the divergence on the investment priority, and the vulnerable ethnic situation. Finally, this paper looks into the future and expresses the optimistic view on the economic corridor.

Opportunity and challenge of target-based therapy for leukemia:lessons from APL and CML

In the past two decades,target-based therapies achieve the great success in adult leukemia.Two typical examples are the applications of all-trans retinoic acid(ATRA)/arsenic trioxide(ATO)and specific tyrosine kinase inhibitor imatinib respectively in acute promyelocytic leukemia(APL)and chronic myeloid leukemia(CML).These successful clinical practices originated from our understanding on

Power and Energy,a Real Challenge and Opportunity

The International Conference of Power and Energy,Chinaunder the sponsorship of Chinese Society of ElectricalEngineering,and co-sponsorship of the Chinese Societyof Power Engineering,China Energy Research Society,East WestCenter (USA) and McGraw-Hill Publishing Company (USA),wasduly held from Oct.22 to Oct.26,!990.Over 100 experts and schol-ars from USA,USSR,France,Austria,Japan,Germany,UK,Poland,Czechoslovakia,Finland,Hungary,Switzerland,Norway,Italy

Metaverse for mental health disorders:Opportunities and challenges

Several articles on the mental health impact of the metaverse and the need to balance its potential benefits with the risks of metaverse use has recently published.The metaverse consists of a combination of immersive technologies and artificial intelligence algorithms.The metaverse differs from the preceding digital psychiatric interventions due to its complex structure and interactions between components.The diverse functions of the metaverse ensure that it may have a substantial impact on mental health.However,the evidence for its efficacy in treating mental health disorders is limited to a few trials.The mental health benefits of immersive technologies are well-documented and suggest that metaverse-based psychiatric treatment may be similarly efficacious.The mental health risks of the metaverse are largely unknown,and it is not clear whether they will be greater than other digital psychiatric interventions.Much more research is needed to determine whether metaverse-based psychiatric treatment will meet the standards of appropriate mental healthcare.

Challenge and opportunity of ionic liquidsdAn interview with Prof.Douglas R.Macfarlane

Expert Profile:Prof.Douglas R.MacFarlane is an Australian Laureate Fellow at Monash University's School of Chemistry and leader of the Energy Program in the Australian Centre for Electromaterials Science.He is the Australian Academy of Science's Craig Medalist 2018 and winner of the Victoria Prize for Science and Innovation 2018.

Bird species composition and conservation challenges in the Gaoligong Mountains, one of the most diverse bird areas in the world

The Gaoligong Mountains(GLGM),located in southwestern China,extend north to south along the western border of the Hengduan Mountains,spanning approximately 600 km.In this study,we consolidated findings from 17 bird surveys conducted in the GLGM between 2010 and 2022.We found that the GLGM harbors tremendous bird diversity,with a total of 796 documented bird species in the region.Nearly a quarter(23.0%)of these species are listed as state key protected species or as Chinese and global threatened species.Analysis of species richness at the county level showed a decreasing trend with increasing latitude,with the greatest diversity in Yingjiang(661 species).Observations indicated that the GLGM belongs to the Oriental realm,primarily composed of bird species from southern and southwestern China.The GLGM plays an important role in avian conservation by sheltering exceptional bird diversity,providing corridors and flyways for bird migration and dispersal,and mitigating the effects of climate change.In response to the conservation needs of birds and other wildlife,the Chinese government has established numerous protected areas within the GLGM.Despite these efforts,avian conservation still faces considerable challenges in the GLGM due to limitations in the protected area network,transboundary nature of the regions,and existing gaps in monitoring and research.

Navigating interdisciplinary research:Historical progression and contemporary challenges

Interdisciplinary research plays a crucial role in addressing complex problems by integrating knowledge from multiple disciplines.This integration fosters innovative solutions and enhances understanding across various fields.This study explores the historical and sociological development of interdisciplinary research and maps its evolution through three distinct phases:pre-disciplinary,disciplinary,and post-disciplinary.It identifies key internal dynamics,such as disciplinary diversification,reorganization,and innovation,as primary drivers of this evolution.Additionally,this study highlights how external factors,particularly the urgency of World War II and the subsequent political and economic changes,have accelerated its advancement.The rise of interdisciplinary research has significantly reshaped traditional educational paradigms,promoting its integration across different educational levels.However,the inherent contradictions within interdisciplinary research present cognitive,emotional,and institutional challenges for researchers.Meanwhile,finding a balance between the breadth and depth of knowledge remains a critical challenge in interdisciplinary education.

Recognizing and addressing the challenges of gastrointestinal tuberculosis

In this editorial,we comment on the article by Ali et al published in the recent issue of the World Journal of Clinical Cases.This case report shed light on a particularly rare manifestation of this disease-primary gastrointestinal tuberculosis(GTB)presenting as gastric outlet obstruction.GTB presents diagnostic challenges due to its nonspecific symptoms and lack of highly accurate diagnostic algorithms.This editorial synthesizes epidemiological data,risk factors,pathogenesis,clinical presentations,diagnostic methods,and therapies to raise awareness about GTB.GTB constitutes 1%-3%of all tuberculosis cases globally,with 6%-38%of patients also having pulmonary tuberculosis.Pathogenesis involves various modes of Mycobacterium tuberculosis complex entry into the gastrointestinal system,with the terminal ileum and ileocecal valve commonly affected.Clinical presentation varies,often resembling other intra-abdominal pathologies,necessitating a high index of suspicion.Diagnostic tools include a combination of biochemical,microbiological,radiological,and endoscopic assessments.Antitubercular medication remains the cornerstone of treatment,supplemented by surgical intervention in severe cases.Multidisciplinary management involving gastroenterologists,surgeons,pulmonologists,and infectious disease specialists is crucial for optimal outcomes.Despite advancements,timely diagnosis and management challenges persist,underscoring the need for continued research and collaboration in addressing primary GTB.

Stem cell-based ischemic stroke therapy:Novel modifications and clinical challenges

Ischemic stroke(IS)causes severe disability and high mortality worldwide.Stem cell(SC)therapy exhibits unique therapeutic potential for IS that differs from current treatments.SC’s cell homing,differentiation and paracrine abilities give hope for neuroprotection.Recent studies on SC modification have enhanced therapeutic effects for IS,including gene transfection,nanoparticle modification,biomaterial modification and pretreatment.Thesemethods improve survival rate,homing,neural differentiation,and paracrine abilities in ischemic areas.However,many problems must be resolved before SC therapy can be clinically applied.These issues include production quality and quantity,stability during transportation and storage,as well as usage regulations.Herein,we reviewed the brief pathogenesis of IS,the“multi-mechanism”advantages of SCs for treating IS,various SC modification methods,and SC therapy challenges.We aim to uncover the potential and overcome the challenges of using SCs for treating IS and convey innovative ideas for modifying SCs.

Tuberculosis-diabetes comorbidities: Mechanistic insights for clinical considerations and treatment challenges

Tuberculosis(TB)remains a leading cause of death among infectious diseases,particularly in poor countries.Viral infections,multidrug-resistant and ex-tensively drug-resistant TB strains,as well as the coexistence of chronic illnesses such as diabetes mellitus(DM)greatly aggravate TB morbidity and mortality.DM[particularly type 2 DM(T2DM)]and TB have converged making their control even more challenging.Two contemporary global epidemics,TB-DM behaves like a syndemic,a synergistic confluence of two highly prevalent diseases.T2DM is a risk factor for developing more severe forms of multi-drug resistant-TB and TB recurrence after preventive treatment.Since a bidirectional relationship exists between TB and DM,it is necessary to concurrently treat both,and promote recommendations for the joint management of both diseases.There are also some drug-drug interactions resulting in adverse treatment outcomes in TB-DM patients including treatment failure,and reinfection.In addition,autophagy may play a role in these comorbidities.Therefore,the TB-DM comorbidities present several health challenges,requiring a focus on multidisciplinary collaboration and integrated strategies,to effectively deal with this double burden.To effectively manage the comorbidity,further screening in affected countries,more suitable drugs,and better treatment strategies are required.

Diagnostic and management challenges in primary cutaneous anaplastic large cell lymphoma with necrosis,inflammation,and surgical intervention:A case report

BACKGROUND Primary cutaneous anaplastic large cell lymphoma(PC-ALCL)poses significant diagnostic difficulties due to its similarity in the appearance of skin lesions with chronic inflammatory disorders and other dermatological conditions.This study aims to investigate these challenges by conducting a comprehensive analysis of a case presenting with PC-ALCL,emphasizing the necessity of accurate differentiation for appropriate management.CASE SUMMARY An 89-year-old female patient with diabetes and hypertension presented with arm and abdominal ulcerated mass lesions.Diagnostic procedures included skin biopsies,histopathological assessments,and immunohistochemistry,complemented by advanced imaging techniques to confirm the diagnosis.The patient’s lesions were determined as PC-ALCL,characterized by necrosis,chronic inflammation,and a distinct immunophenotypic profile,including CD30,CD3,CD4,and EBER,CD56,MUM-1,Ki 67-positive in>80%of tumor cells,CD10,but negative for anaplastic lymphoma kinase,CD5,CD20,PAX-5,Bcl-2,Bcl-6,CD8,and CD15.Recurrence was not reported at the 6-month follow-up.CONCLUSION Accurate PC-ALCL differentiation from similar conditions is crucial for effective management and requires a multidisciplinary approach.

Colorectal cancer screening:The value of early detection and modern challenges

The screening of colorectal cancer(CRC)is pivotal for both the prevention and treatment of this disease,significantly improving early-stage tumor detection rates.This advancement not only boosts survival rates and quality of life for patients but also reduces the costs associated with treatment.However,the adoption of CRC screening methods faces numerous challenges,including the technical limitations of both noninvasive and invasive methods in terms of sensitivity and specificity.Moreover,socioeconomic factors such as regional disparities,economic conditions,and varying levels of awareness affect screening uptake.The coronavirus disease 2019 pandemic further intensified these challenges,leading to reduced screening participation and increased waiting periods.Additionally,the growing prevalence of early-onset CRC necessitates innovative screening approaches.In response,research into new methodologies,including artificial intelligence-based systems,aims to improve the precision and accessibility of screening.Proactive measures by governments and health organizations to enhance CRC screening efforts are underway,including increased advocacy,improved service delivery,and international cooperation.The role of technological innovation and global health collaboration in advancing CRC screening is undeniable.Technologies such as artificial intelligence and gene sequencing are set to revolutionize CRC screening,making a significant impact on the fight against this disease.Given the rise in early-onset CRC,it is crucial for screening strategies to continually evolve,ensuring their effectiveness and applicability.

Impact of Social Media Challenges on Pediatric Single-Use Detergent Sacs and Diphenhydramine Ingestions Reported to United States Poison Control Centers

Background: Social media platforms are popular among children and often feature challenges that become viral. Notably, the Tide Pod® and Benadryl® challenges encouraged viewers to ingest these substances for their visual appeal and hallucinogenic effects, respectively. This study aimed to assess the clinical impact and outcomes of single-use detergent sacs (SUDS) and diphenhydramine challenges on pediatric ingestions reported to United States (U.S.) Poison Control Centers (PCCs). Methods: We conducted a retrospective review of pediatric exposures reported to U.S. PCCs using data from the National Poison Data System (NPDS). The study included intentional single-substance ingestions of both brand-name and generic forms of SUDS and diphenhydramine among children ≤ 19 years. We compared the number of calls, clinical effects, disposition, and management strategies for SUDS (pre: 01/01/17 to 12/31/17 vs. post: 01/01/18 to 12/31/18) and diphenhydramine (pre: 08/01/19 to 07/31/20 vs. post: 08/01/20 to 07/31/21) ingestions 12 months before and after the introduction of the respective social media challenges. Differences in proportions were compared using the Chi-square test. Results: During the study period, 469 ingestions of SUDS and 5,702 ingestions of diphenhydramine were reported. Post-challenge periods saw an increase in both SUDS (pre: 82 vs. post: 387;372% increase) and diphenhydramine ingestions (pre: 2,672 vs. post: 3,030;13% increase). While there were no significant changes in moderate or major clinical outcomes, hospitalizations increased post-challenge for both SUDS [pre: 4 (4.9%) vs. post: 33 (8.5%);p = 0.25] and diphenhydramine [pre: n = 904 (33.8%) vs. post: 1,190 (39.3%);p Conclusion: Pediatric ingestions reported to U.S. PCCs and hospitalizations increased coinciding with the introduction of Tide Pod® and Benadryl® challenges. While causality cannot be definitively established, it is essential for pediatricians and parents to be aware of these challenges and educate vulnerable children about the harmful effects of participation in such challenges.