Search

Using the constituent stocks of the iShares MSCI US ESG Select Index ETF, a matrix of technical indicators, returns, and covariance is incorporated to represent the inherent information characteristics of the stock market. In this study, based on the proposed Deep Reinforcement Learning for Portfolio Management on Environmental, Social, and Governance (DRLPMESG) architecture model, investors who use active portfolio management reap the greatest rewards, as the portfolio with 5 stocks performing the best, with an annualized return of 46.58%, a Sharpe ratio of 1.37, and a cumulative return of 115.18%, indicating that the results have the potential to win the market and generate excess profits. In contrast to the efficient market hypothesis, this new understanding of proven effectiveness in obtaining satisfactory rewards would help improve investment strategies for portfolio management. Furthermore, this study proposed that holding 5 stocks in a portfolio can lead to higher returns, laying the foundation for future research on the number of holdings. Moreover, when compared to previous static strategies, this model offering a dynamic strategy may generate a more stable return in the face of market fluctuations. [ABSTRACT FROM AUTHOR]

Obesity is associated with alterations in lipid metabolism and gut microbiota dysbiosis. This study investigated the effects of puerarin, a bioactive isoflavone, on lipid metabolism disorders and gut microbiota in high-fat diet (HFD)-induced obese mice. Supplementation with puerarin reduced plasma alanine aminotransferase, liver triglyceride, liver free fatty acid (FFA), and improved gut microbiota dysbiosis in obese mice. Puerarin's beneficial metabolic effects were attenuated when farnesoid X receptor (FXR) was antagonized, suggesting FXR-mediated mechanisms. In hepatocytes, puerarin ameliorated high FFA-induced sterol regulatory element-binding protein (SREBP) 1 signaling, inflammation, and mitochondrial dysfunction in an FXR-dependent manner. In obese mice, puerarin reduced liver damage, regulated hepatic lipogenesis, decreased inflammation, improved mitochondrial function, and modulated mitophagy and ubiquitin-proteasome pathways, but was less effective in FXR knockout mice. Puerarin upregulated hepatic expression of FXR, bile salt export pump (BSEP), and downregulated cytochrome P450 7A1 (CYP7A1) and sodium taurocholate transporter (NTCP), indicating modulation of bile acid synthesis and transport. Puerarin also restored gut microbial diversity, the Firmicutes/Bacteroidetes ratio, and the abundance of Clostridium celatum and Akkermansia muciniphila. This study demonstrates that puerarin effectively ameliorates metabolic disturbances and gut microbiota dysbiosis in obese mice, predominantly through FXR-dependent pathways. These findings underscore puerarin's potential as a therapeutic agent for managing obesity and enhancing gut health, highlighting its dual role in improving metabolic functions and modulating microbial communities. [ABSTRACT FROM AUTHOR]

Neuromyelitis optica spectrum disorder (NMOSD) is an uncommon antibody-mediated disease of the central nervous system. Its classic presentation includes long segments of spinal cord inflammation, optic neuritis with or without intractable vomiting, and hiccups. Here, we described a case of a 39-year-old woman with an atypical presentation of vertigo, which was finally diagnosed as NMOSD by a positive serum aquaporin-4 antibody. [ABSTRACT FROM AUTHOR]

Understanding distributions of cloud thermodynamic phases is important for accurately representing cloud radiative effects and cloud feedback in a changing climate. Satellite‐based cloud phase data have been frequently used to compare with climate models, yet few studies validated them against in situ observations at a near‐global scale. This study aims to validate three satellite‐based cloud phase products using a compositive in situ airborne data set developed from 11 flight campaigns. Latitudinal‐altitudinal cross sections of cloud phase occurrence frequencies are examined. The Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) show the most similar vertical profiles of ice phase frequencies compared with in situ observations. The CloudSat data overestimate mixed‐phase frequencies up to 15 km but provide better sampling through cloud layers than lidar data. The DARDAR (raDAR/liDAR) data show a sharp transition between ice and liquid phase and overestimate ice phase frequency at most altitudes and latitudes. The satellite data are further evaluated for various latitudes, longitudes, and seasons, which show higher ice phase frequency in the extratropics in their respective wintertime and smaller impacts from longitudinal variations. The Southern Ocean shows a thicker mixing region where liquid and ice phases have similar frequencies compared with tropics and Northern Hemisphere (NH) extratropics. Two comparison methods with different spatiotemporal windows show similar results, which demonstrates the statistical robustness of these comparisons. Overall, this study develops a near global‐scale in situ observational data set to assess the accuracy of satellite‐based cloud phase products and investigates the key factors affecting the distributions of cloud phases. Plain Language Summary: Accurate representations of cloud thermodynamic phase (i.e., ice, liquid, and mixed phase) play an important role in climate prediction. Even though satellite observations have been used to improve climate model simulations of cloud phase, few studies have validated satellite‐based cloud phase distributions on a global scale. This work develops a large data set based on in situ aircraft‐based observations from 11 flight campaigns in various regions. Three satellite‐based cloud phase products are evaluated. Satellite observations that are either in proximity to the aircraft samples or in a similar domain are used for comparisons. CALISPO data show the best comparison results for representing the fraction of ice clouds among all types of cloud phases. CloudSat overestimates mixed phase frequency and DARDAR overestimates ice phase frequency, but they penetrate through cloud layers better when radar and lidar data are combined. The impacts of seasonal variability, spatial variability among various latitudes and longitudes, as well as temporal variability from a few hours to different seasons are examined. The results of this work help to identify the key factors affecting cloud phase distributions from a near‐global perspective. The methodology developed can also guide future validations of satellite data using aircraft‐based observations. Key Points: Ice phase frequencies vary largely with altitudes, latitudes, and seasons but not much with longitudes or small spatiotemporal mismatchesCALIPSO shows most similar ice phase frequency to in situ observations, CloudSat and DARDAR overestimate mixed and ice phase, respectivelyLiquid water transitions to ice gradually with increasing altitudes over Southern Ocean but more rapidly in tropics and NH extratropics [ABSTRACT FROM AUTHOR]

It is difficult to handle the extraordinary data volume generated in many fields with current computational resources and techniques. This is very challenging when applying conventional statistical methods to big data. A common approach is to partition full data into smaller subdata for purposes such as training, testing, and validation. The primary purpose of training data is to represent the full data. To achieve this goal, the selection of training subdata becomes pivotal in retaining essential characteristics of the full data. Recently, several procedures have been proposed to select "optimal design points" as training subdata under pre-specified models, such as linear regression and logistic regression. However, these subdata will not be "optimal" if the assumed model is not appropriate. Furthermore, such subdata cannot be useful to build alternative models because it is not an appropriate representative sample of the full data. In this article, we propose a novel algorithm for better model building and prediction via a process of selecting a "good" training sample. The proposed subdata can retain most characteristics of the original big data. It is also more robust that one can fit various response model and select the optimal model. for this article are available online. [ABSTRACT FROM AUTHOR]

Background: Wearable devices have the advantage of always being with individuals, enabling easy detection of their movements. Smart clothing can provide feedback to family caregivers of older adults with disabilities who require in-home care. Methods: This study describes the process of setting up a smart technology-assisted (STA) home-nursing care program, the difficulties encountered, and strategies applied to improve the program. The STA program utilized a smart-vest, designed specifically for older persons with dementia or recovering from hip-fracture surgery. The smart-vest facilitated nurses' and family caregivers' detection of a care receiver's movements via a remote-monitoring system. Movements included getting up at night, time spent in the bathroom, duration of daytime immobility, leaving the house, and daily activity. Twelve caregivers of older adults and their care receiver participated; care receivers included persons recovering from hip fracture (n = 5) and persons living with dementia (n = 7). Data about installation of the individual STA in-home systems, monitoring, and technical difficulties encountered were obtained from researchers' reports. Qualitative data about the caregivers' and care receivers' use of the system were obtained from homecare nurses' reports, which were explored with thematic analysis. Results: Compiled reports from the research team identified three areas of difficulty with the system: incompatibility with the home environment, which caused extra hours of manpower and added to the cost of set-up and maintenance; interruptions in data transmissions, due to system malfunctions; and inaccuracies in data transmissions, due to sensors on the smart-vest. These difficulties contributed to frustration experienced by caregivers and care receivers. Conclusions: The difficulties encountered impeded implementation of the STA home nursing care. Each of these difficulties had their own unique problems and strategies to resolve them. Our findings can provide a reference for future implementation of similar smart-home systems, which could facilitate ease-of-use for family caregivers. [ABSTRACT FROM AUTHOR]

In this research, the effects of the adoption of socially interactive technologies (SIT) for shipping service in ocean freight forwarding on employees' anxiety and job performance are investigated by adopting the decomposed theory of planned behaviour model. Seven constructs are established from the literature review. Furthermore, the research data and hypotheses examined are analysed using the structural equation modelling approach. The results reveal that perceived usefulness, perceived presence, subject norms, and perceived ease of use are positively related to the adoption of SIT in shipping services, whereas the adoption of SIT is positively related to employees' job performance and the technology anxiety of using SIT in shipping services is negatively related to employees' job performance for ocean freight forwarders. Moreover, gender, age, and department have significant moderating effects in the model. The impact of technology anxiety on job performance was stronger on inside female staff than outside male sales representatives, whereas the impact of perceived useful and subjective norms on adoption was stronger on the older and inner groups. [ABSTRACT FROM AUTHOR]

Liposome development is of great interest owing to increasing requirements for efficient drug carriers. The structural features and thermal stability of such liposomes are crucial in drug transport and delivery. Reported here are the results of the structural characterization of PEGylated liposomes via small‐ and wide‐angle X‐ray scattering and an asymmetric flow field‐flow fractionation (AF4) system coupled with differential refractive‐index detection, multi‐angle light scattering (MALS) and dynamic light scattering. This integrated analysis of the exemplar PEGylated liposome formed from hydrogenated soy phosphatidylcholine (HSPC) with the addition of cholesterol reveals an average hydrodynamic radius (Rh) of 52 nm with 10% polydispersity, a comparable radius of gyration (Rg) and a major liposome particle mass of 118 kDa. The local bilayer structure of the liposome is found to have asymmetric electronic density profiles in the inner and outer leaflets, sandwiched by two PEGylated outer layers ca 5 nm thick. Cholesterol was found to effectively intervene in lipid chain packing, resulting in the thickening of the liposome bilayer, an increase in the area per lipid and an increase in liposome size, especially in the fluid phase of the liposome. These cholesterol effects show signs of saturation at cholesterol concentrations above ca 1:5 cholesterol:lipid molar ratio. [ABSTRACT FROM AUTHOR]

Darier disease is caused by heterozygous loss of function variants in the ATP2A2 gene encoding the endoplasmic/sarcoplasmic reticulum Ca2+ pump ATP2A2. Defective intracellular calcium signaling in the epidermis results in a loss of desmosomal adhesion and the development of characteristic skin lesions. In this study, we investigated a Shih Tzu that developed erythematous papules on the ventrum and, over time, the dorsal neck and a nodule in the right ear canal with secondary ear infection. Histopathologic examination demonstrated discrete foci of acantholysis affecting suprabasal layers of the epidermis. Whole genome sequencing of the affected dog identified a heterozygous missense variant, p.N809H, affecting an evolutionarily conserved amino acid residue of the ATP2A2 protein. The highly characteristic clinical and histopathologic findings together with a plausible variant in the only known functional candidate gene establish the diagnosis of canine Darier disease in the studied dog and highlight the potential of genetic analyses as complementary diagnostic approach in veterinary medicine. [ABSTRACT FROM AUTHOR]

Using light signals for computation and communication is a vital approach for advanced neuromorphic designs. In this study, an all‐optical‐controlled IGZO/ZrOx phototransistor is demonstrated to emulate synaptic functions via both positive and negative photoresponse arisen from the ionization of neutral oxygen vacancies (VO) and metalmetal bonding (MM) defects in IGZO at an illumination with visible light (405 and 520 nm) and near‐infrared light (750, 890, and 980 nm), respectively. With the coupling effect of photogenerated electrons and the charged MM++ defect scattering, the IGZO/ZrOx photosynaptic transistor not only shows broadband photosensing performance but also emulates the excitatory/inhibitory contrasting synaptic functions, such as learning‐ and regulating‐experience behavior of human brain, via applying 405 and 890 nm light pulses, respectively. The all‐optical‐controlled IGZO/ZrOx photosynaptic transistor therefore may convey optical information effectually for the streaming sensor processing in biologically inspired computer vision application. [ABSTRACT FROM AUTHOR]

Obesity is a well‐known risk factor for breast cancer formation and is associated with elevated mortality and a poor prognosis. An obesity‐mediated inflammatory microenvironment is conducive to the malignant progression of tumors. However, the detailed molecular mechanism is still needed to be clarified. Herein, we identified that breast cancer cells from mice with diet‐induced obesity exhibited increased growth, invasiveness, and stemness capacities. A transcriptome analysis revealed that expressions of interleukin 33 (IL33) signaling pathway‐related genes were elevated in obesity‐associated breast cancer cells. Importantly, IL33 expression was significantly associated with the yes‐associated protein (YAP) signature, and IL33 was transcriptionally regulated by YAP. Suppression of IL33 reduced tumor migration and invasion, while the addition of IL33 activated nuclear factor (NF)‐κB signaling and revived tumor mobility in YAP‐silenced cells. Furthermore, suppression of YAP attenuated IL33 expression which was accompanied by relief of obesity‐mediated immunosuppression. Clinical analyses showed that IL33 expression was markedly associated with macrophage and regulatory T cell infiltration. These findings reveal a crucial role of the YAP/IL33 axis in promoting aggressiveness and immunosuppression of obesity‐associated breast cancer progression. [ABSTRACT FROM AUTHOR]

This research presents the optimization and proposal of P- and N-type 3-stacked Si0.8Ge0.2/Si strained super-lattice FinFETs (SL FinFET) using Low-Pressure Chemical Vapor Deposition (LPCVD) epitaxy. Three device structures, Si FinFET, Si0.8Ge0.2 FinFET, and Si0.8Ge0.2/Si SL FinFET, were comprehensively compared with HfO2 = 4 nm/TiN = 80 nm. The strained effect was analyzed using Raman spectrum and X-ray diffraction reciprocal space mapping (RSM). The results show that Si0.8Ge0.2/Si SL FinFET exhibited the lowest average subthreshold slope (SSavg) of 88 mV/dec, the highest maximum transconductance (Gm, max) of 375.2 μS/μm, and the highest ON–OFF current ratio (ION/IOFF), approximately 106 at VOV = 0.5 V due to the strained effect. Furthermore, with the super-lattice FinFETs as complementary metal–oxide–semiconductor (CMOS) inverters, a maximum gain of 91 v/v was achieved by varying the supply voltage from 0.6 V to 1.2 V. The simulation of a Si0.8Ge0.2/Si super-lattice FinFET with the state of the art was also investigated. The proposed Si0.8Ge0.2/Si strained SL FinFET is fully compatible with the CMOS technology platform, showing promising flexibility for extending CMOS scaling. [ABSTRACT FROM AUTHOR]

Background: Frontline intensification (including consolidative whole‐brain radiotherapy or high‐dose chemotherapy with autologous stem‐cell transplantation after induction therapy) has been proposed to treat primary central nervous system lymphoma (PCNSL). However, no prospective randomized trials have answered whether frontline intensification can offer a survival benefit to PCNSL patients. We aim to clarify the outcomes and survival influence of frontline intensification on real‐world patients with different risk‐stratified PCNSLs. Methods: Between January 2003 and December 2016, 110 PCNSL adults were retrospectively included, and 76 patients achieved at least PR after induction therapy, including 38 patients who received frontline intensification. The median follow‐up with the 31 survivors was 7.52 years. Results: Of the 38 induction‐completed patients who had not received frontline intensification, 95% achieved post–induction therapy CR/CRu; however, all inevitably recurred. In the 38 who received frontline intensification, CR/CRu improved from 45% (pre‐frontline intensification) to 84% (post‐frontline intensification), and they achieved significantly better PFS (non‐reach vs. 522 days, p < 0.001) and OS (non‐reach vs. 899 days, p < 0.001). Additionally, patients had similar PFS and OS rates when receiving HDC‐ASCT and/or WBRT as frontline intensification. Frontline intensification significantly improved PFS and OS survival in higher‐risk patients (intermediate/high IELSG risk, MSKCC group 2/3, or Nottingham/Barcelona score ≥ 2 points) but did not improve OS in lower‐risk patients. Among the 38 patients who received frontline intensification, two had treatment‐related mortality; 14 recurred after frontline intensification. MTX‐based chemotherapy was the main salvage modality, and the median OS was 295 days after recurrence. Progressive disease and infection (especially pneumonia) are two major causes of mortality in patients who receive frontline intensification. Conclusions: When achieving CR/CRu/PR after induction chemotherapy, frontline intensification should be adopted to improve PFS and OS in real‐world PCNSL patients, especially higher‐risk patients. [ABSTRACT FROM AUTHOR]

Introduction: Sepsis is characterized by a dysregulated host response to infection that leads to multiple organ dysfunction and often complicated with metabolic acidosis. However, the associations between serum total carbon dioxide level (TCO2) and long-term clinical outcomes in sepsis survivors remains unknown. Methods: A total of 7212 sepsis survivors aged ≥ 20 years who were discharged from January 1, 2008 to December 31, 2018 were included in our analyses. The sepsis survivors were further divided into high TCO2 (≥ 18 mmol/L) and low TCO2 (< 18 mmol/L) groups, comprising 5023 and 2189 patients, respectively. The following outcomes of interest were included: all-cause mortality, myocardial infarction, ischemic stroke, hospitalization for heart failure, ventricular arrhythmia, and end-stage renal disease (ESRD). Results: After propensity score matching, the low TCO2 group was at higher risks of all-cause mortality (hazard ratio [HR] 1.28, 95% confidence interval [95% CI] 1.18–1.39), myocardial infarction (HR 1.83, 95% CI 1.39–2.43), and ESRD (HR 1.38, 95% CI 1.16–1.64) than the high TCO2 group. The results remained similar after considering death as a competing risk. Conclusion: Patients discharged from hospitalization for sepsis have higher risks of worse long-term clinical outcomes. Physicians may need to pay more attention to sepsis survivors whose TCO2 was low. [ABSTRACT FROM AUTHOR]

The current limiting function enables the solid-state circuit breaker (SSCB) to have proper protection coordination. It allows sustained overcurrent for a certain period while preventing the fast fault current increase in dc systems. For the conventional method of using switches alone to limit the current, the high loss results in a short withstand time and low current limiting capability of the SSCBs. In this letter, a control strategy is proposed to utilize the energy absorption component to handle the major part of the energy during the current limiting stage to increase the current limiting capability for series-connected SSCB switching cells. The proposed method is experimentally verified to have more than 3X current limiting withstand time compared to the conventional control strategy in a case study. [ABSTRACT FROM AUTHOR]

Frequent consumption of diet drinks was associated with oocyte dysmorphism, decreased embryo quality, and an adverse effect on pregnancy rate. We investigated the harmful effects of aspartame and potential mechanisms through which it increases infertility risk through clinical observations and in vivo and in vitro studies. Methods: We established a cohort of 840 pregnant women and retrospectively determined their time to conceive. We assessed the estrus cycle, the anti-Mullerian hormone level, ovarian oxidative stress, and ovarian mitochondrial function in an animal study. We also evaluated mitochondria function, mitochondrial biogenesis, and progesterone release with in vitro studies. Aspartame consumption was associated with increased infertility risk in the younger women (Odds ratio: 1.79, 95% confidence interval: 1.00, 3.22). The results of the in vivo study revealed that aspartame disrupted the estrus cycle and reduced the anti-Mullerian hormone level. Aspartame treatment also suppressed antioxidative activities and resulted in higher oxidative stress in the ovaries and granulosa cells. This phenomenon is caused by an aspartame-induced decline in mitochondrial function (maximal respiration, spare respiratory capacity, and ATP production capacity) and triggered mitochondrial biogenesis (assessed by examining the energy depletion signaling-related factors sirtuin-1, phosphorylated adenosine monophosphate-activated protein kinase, peroxisome proliferator-activated receptor-gamma coactivator-1α, and nuclear respiratory factor 1 expression levels). Aspartame may alter fertility by reserving fewer follicles in the ovary and disrupting steroidogenesis in granulosa cells. Hence, women preparing for pregnancy are suggested to reduce aspartame consumption and avoid oxidative stressors of the ovaries. [ABSTRACT FROM AUTHOR]

Background: Obesity and asthma are highly associated, but the mechanisms underlying the association remain unknown. We examined five mediators linking obesity with childhood asthma: (1) pulmonary function impairment, (2) airway inflammation, (3) physical fitness, (4) sleep‐disordered breathing (SDB), and (5) early puberty. Methods: A Mendelian randomization (MR) study with mediation analysis of data obtained from 5965 children as part of the Taiwan Children Health Study. Observational analysis, MR two‐stage least‐squares method, and MR sensitivity analysis were carried out to investigate each causal pathway. Prospective cohort analyses were used to strengthen the findings. Results: The increased asthma risk associated with obesity was found to be mostly mediated through impaired pulmonary function, low physical fitness, and early puberty. In the MR analysis, body mass index was negatively associated with FEV1/FVC and physical fitness index (β = −2.17 and −0.71; 95% CI, −3.92 to −0.42 and −1.30 to −0.13, respectively) and positively associated with early puberty (OR, 1.09; 95% CI, 1.02–1.17). High FEV1/FVC and physical fitness index reduced asthma risk (OR, 0.98 and 0.93; 95% CI, 0.97–0.99 and 0.88–0.98, respectively), whereas SDB and early puberty increased the risk of asthma (OR, 1.03 and 1.22; 95% CI, 1.01–1.05 and 1.05–1.42, respectively). Temporal causality was strengthened in prospective cohort analyses. The three main mediators were low physical fitness, impaired pulmonary function, and early puberty, with mediation proportions of 73.76%, 61.63%, and 27.66%, respectively. Conclusions: Interventions promoting physical fitness and pulmonary function might effectively reduce obesity‐induced asthma risk. [ABSTRACT FROM AUTHOR]

Exosomes are extracellular vesicles that play a role in intercellular communication through the transportation of their cargo including mRNAs, microRNAs, proteins, and nucleic acids. Exosomes can also regulate glucose homeostasis and insulin secretion under diabetic conditions. However, the role of exosomes in insulin secretion in islet β-cells under physiological conditions remains to be clarified. The aim of this study was to investigate whether exosomes derived from pancreatic islet β-cells could affect insulin secretion in naïve β-cells. We first confirmed that exosomes derived from the RIN-m5f β-cell line interfered with the glucose-stimulated insulin secretion (GSIS) of recipient β-cells without affecting cell viability. The exosomes significantly reduced the protein expression levels of phosphorylated Akt, phosphorylated GSK3α/β, CaMKII, and GLUT2 (insulin-related signaling molecules), and they increased the protein expression levels of phosphorylated NFκB-p65 and Cox-2 (inflammation-related signaling molecules), as determined by a Western blot analysis. A bioinformatics analysis of Next-Generation Sequencing data suggested that exosome-carried microRNAs, such as miR-1224, -122-5p, -133a-3p, -10b-5p, and -423-5p, may affect GSIS in recipient β-cells. Taken together, these findings suggest that β-cell-derived exosomes may upregulate exosomal microRNA-associated signals to dysregulate glucose-stimulated insulin secretion in naïve β-cells. [ABSTRACT FROM AUTHOR]

Purpose: Pseudomonas aeruginosa is the predominant bacterial pathogen colonizing the cystic fibrosis (CF) lung. Mixed populations of nonmucoid and mucoid variants of P. aeruginosa have been isolated from the CF airway. While the association between mucoid variants and pulmonary function decline is well-established, their impact on inflammation and tissue damage in advanced CF lung disease remains unclear.This pilot study utilized 1 non-CF and 3 CF lung explants to examine lobar distribution, inflammation, and histopathology related to nonmucoid and mucoid P. aeruginosa infection. To study tissue damage, we developed a novel lung histopathology scoring system, the first applied to human CF lung biopsies, which is comprised of five indicators: bronchiolar epithelial infiltrate, luminal inflammation, peribronchial/bronchiolar infiltrate, peribronchiolar fibrosis, and alveolar involvement.Mucoid P. aeruginosa variants were distributed throughout the CF lung but associated with greater concentrations of proinflammatory cytokines, IL-1β, TNF-α, IL-6, IL-8, and IFN-γ, and one anti-inflammatory cytokine, IL-10, compared to nonmucoid variants. CF lung explants exhibited higher histopathology scores compared to a non-CF lung control. In mixed-variant infection, nonmucoid constituents associated with increased bronchiolar epithelial infiltration, one indicator of histopathology.This pilot study suggests ongoing interplay between host and bacterial elements in late-stage CF pulmonary disease. Mucoid P. aeruginosa infection correlates with inflammation regardless of lung lobe, whereas nonmucoid P. aeruginosa is associated with increased inflammatory cell infiltration. The development of a novel lung histopathology scoring system lays the groundwork for future large-cohort investigations.Methods: Pseudomonas aeruginosa is the predominant bacterial pathogen colonizing the cystic fibrosis (CF) lung. Mixed populations of nonmucoid and mucoid variants of P. aeruginosa have been isolated from the CF airway. While the association between mucoid variants and pulmonary function decline is well-established, their impact on inflammation and tissue damage in advanced CF lung disease remains unclear.This pilot study utilized 1 non-CF and 3 CF lung explants to examine lobar distribution, inflammation, and histopathology related to nonmucoid and mucoid P. aeruginosa infection. To study tissue damage, we developed a novel lung histopathology scoring system, the first applied to human CF lung biopsies, which is comprised of five indicators: bronchiolar epithelial infiltrate, luminal inflammation, peribronchial/bronchiolar infiltrate, peribronchiolar fibrosis, and alveolar involvement.Mucoid P. aeruginosa variants were distributed throughout the CF lung but associated with greater concentrations of proinflammatory cytokines, IL-1β, TNF-α, IL-6, IL-8, and IFN-γ, and one anti-inflammatory cytokine, IL-10, compared to nonmucoid variants. CF lung explants exhibited higher histopathology scores compared to a non-CF lung control. In mixed-variant infection, nonmucoid constituents associated with increased bronchiolar epithelial infiltration, one indicator of histopathology.This pilot study suggests ongoing interplay between host and bacterial elements in late-stage CF pulmonary disease. Mucoid P. aeruginosa infection correlates with inflammation regardless of lung lobe, whereas nonmucoid P. aeruginosa is associated with increased inflammatory cell infiltration. The development of a novel lung histopathology scoring system lays the groundwork for future large-cohort investigations.Results: Pseudomonas aeruginosa is the predominant bacterial pathogen colonizing the cystic fibrosis (CF) lung. Mixed populations of nonmucoid and mucoid variants of P. aeruginosa have been isolated from the CF airway. While the association between mucoid variants and pulmonary function decline is well-established, their impact on inflammation and tissue damage in advanced CF lung disease remains unclear.This pilot study utilized 1 non-CF and 3 CF lung explants to examine lobar distribution, inflammation, and histopathology related to nonmucoid and mucoid P. aeruginosa infection. To study tissue damage, we developed a novel lung histopathology scoring system, the first applied to human CF lung biopsies, which is comprised of five indicators: bronchiolar epithelial infiltrate, luminal inflammation, peribronchial/bronchiolar infiltrate, peribronchiolar fibrosis, and alveolar involvement.Mucoid P. aeruginosa variants were distributed throughout the CF lung but associated with greater concentrations of proinflammatory cytokines, IL-1β, TNF-α, IL-6, IL-8, and IFN-γ, and one anti-inflammatory cytokine, IL-10, compared to nonmucoid variants. CF lung explants exhibited higher histopathology scores compared to a non-CF lung control. In mixed-variant infection, nonmucoid constituents associated with increased bronchiolar epithelial infiltration, one indicator of histopathology.This pilot study suggests ongoing interplay between host and bacterial elements in late-stage CF pulmonary disease. Mucoid P. aeruginosa infection correlates with inflammation regardless of lung lobe, whereas nonmucoid P. aeruginosa is associated with increased inflammatory cell infiltration. The development of a novel lung histopathology scoring system lays the groundwork for future large-cohort investigations.Conclusion: Pseudomonas aeruginosa is the predominant bacterial pathogen colonizing the cystic fibrosis (CF) lung. Mixed populations of nonmucoid and mucoid variants of P. aeruginosa have been isolated from the CF airway. While the association between mucoid variants and pulmonary function decline is well-established, their impact on inflammation and tissue damage in advanced CF lung disease remains unclear.This pilot study utilized 1 non-CF and 3 CF lung explants to examine lobar distribution, inflammation, and histopathology related to nonmucoid and mucoid P. aeruginosa infection. To study tissue damage, we developed a novel lung histopathology scoring system, the first applied to human CF lung biopsies, which is comprised of five indicators: bronchiolar epithelial infiltrate, luminal inflammation, peribronchial/bronchiolar infiltrate, peribronchiolar fibrosis, and alveolar involvement.Mucoid P. aeruginosa variants were distributed throughout the CF lung but associated with greater concentrations of proinflammatory cytokines, IL-1β, TNF-α, IL-6, IL-8, and IFN-γ, and one anti-inflammatory cytokine, IL-10, compared to nonmucoid variants. CF lung explants exhibited higher histopathology scores compared to a non-CF lung control. In mixed-variant infection, nonmucoid constituents associated with increased bronchiolar epithelial infiltration, one indicator of histopathology.This pilot study suggests ongoing interplay between host and bacterial elements in late-stage CF pulmonary disease. Mucoid P. aeruginosa infection correlates with inflammation regardless of lung lobe, whereas nonmucoid P. aeruginosa is associated with increased inflammatory cell infiltration. The development of a novel lung histopathology scoring system lays the groundwork for future large-cohort investigations. [ABSTRACT FROM AUTHOR]

Introduction: Nasopharyngeal carcinoma (NPC) is the most common malignant tumor in southern China and Southeast Asia. Although substantial research on NPC has been conducted, the resulting improvement in clinical outcomes remains very disappointing. NPC treatment typically involves radiation therapy and chemotherapy, but the high incidence of metastasis and recurrence in NPC patients result in poor survival. Therefore, identifying potential biomarkers and discovering therapeutic targets are necessary to design tailored treatments based on the genetic profiles of NPC patients. Methods: Correlations of protein immunostaining with clinicopathological features were analyzed by Pearson's χ2 test. The Kaplan-Meier method with a log-rank test was used to generate survival curves. Multivariate analysis was performed using the Cox proportional hazards model. Results: In this study, we comparatively analyzed cytoskeletal organization and biogenesis (GO:0007010) and tumorigenesis in the NPC transcriptome (GSE12452) and found that formin-like 2 (FMNL2) expression was significantly upregulated in NPC tumor tissues. Moreover, high FMNL2 expression was significantly correlated with primary tumor stage (p = 0.001), lymph node status (p = 0.004), cancer stage (p = 0.006), and histological grade (p = 0.040). More importantly, high FMNL2 expression was significantly correlated with poor survival in NPC patients according to univariate analysis and multivariate analysis. Conclusion: This study reveals that FMNL2 may be an important potential biomarker for evaluating the prognosis of NPC patients. [ABSTRACT FROM AUTHOR]

Background: Since the policy of "keeping trash off of the ground" in Taiwan, long-term exposure to repetitive motion in waste collection process results in high risk of upper extremity musculoskeletal disorders (UEMDs). Thus, we assessed the moderation and mediation effects of job-related stress and job support on work-related UEMDs among municipal waste collectors.Methods: A cross-sectional study was conducted in two cities located at northern Taiwan during 2018-2019. 626 municipal waste collectors voluntarily participated and anonymously filled out a structured questionnaire. The moderation and mediation effects of effort-reward imbalance (ERI) and social support on UEMDs were analyzed by Haye's Process Macro Model.Results: Prevalence of UEMDs in municipal waste collectors were 43.4% for neck, 56.0% for shoulder, 24.1% for upper back, and 33.1% for hand/wrist. There was high prevalence of shoulder (72.2%), neck (48%), and upper back (30%) in female workers compared to male, most significantly in shoulders. In univariate and multivariate analysis, high ERI and low job support were significantly associated with ORs of 3.11 (95% CI:1.58-6.13) for elbow, 2.79 (95% CI:1.39-5.56) for shoulder, 3.39 (95% CI:1.64-7.00) for upper back and 3.83 (95% CI:1.98-7.41) for hand/wrist. Prevalent UEMDs were positively associated with high ERI in municipal waste collectors but negatively with job support. The moderation effects of ERI and job support on UEMDs, of which the measured synergy index exceeded one, were 18.24 for shoulder, 3.32 for elbow, and 2.45 for hand/wrist, but mediation effects were not significant.Conclusions: This study found municipal waste collectors with work-related upper extremity disorders were significantly associated with work-related psychological risk factors. Therefore, waste collection cannot only to be improved by semi-automatic and automatic processes but immediate intervention programs for the reduction of psychological risk factors is needed promptly. [ABSTRACT FROM AUTHOR]

Background: Nasopharyngeal carcinoma (NPC) is a malignant tumor originating from the nasopharynx with high morbidity and mortality in Southeast Asia and south of China. Roundabout guidance receptor 1 (ROBO1) can regulate axonogenesis (axon-like protrusion), which may play an important role in migration. However, the roles of ROBO1 in NPC have not been clarified. Methods: A comparative analysis employing the NPC transcriptome (GSE12452) and the axonogenesis-related genes (GO: 0050772) was performed. In total, 124 tissue blocks from patients primarily diagnosed as NPC (1993-2002) were examined using immunohistochemical staining. The connections between clinicopathological variables and protein immunoexpression were analyzed by Pearson's chi-square test. The Kaplan–Meier method with a log-rank test was employed to plot survival curves. Multivariate analysis was performed using the Cox proportional hazards model to identify independent prognostic biomarker. Results: According to transcriptome analysis, we found that ROBO1 is significantly highly expressed in NPC tissues compared with normal tissues. The immunohistochemistry (IHC) staining showed that high expression of ROBO1 was significantly related to primary tumor (T1T2 and T3T4) (P =.024), nodal metastasis status (N0N1 and N2N3) (P =.030), stage (I-II and III-IV) (P =.019), and histological grade (keratinizing, non-keratinizing, and undifferentiated) (P =.065). Importantly, NPC patients with high ROBO1 expression had poorer disease-specific survival (DSS) (P =.0001), distal metastasis-free survival (DMeFS) (P <.0001), and local recurrence-free survival (LRFS) (P =.0001) compared with NPC patients with low ROBO1 expression through the uni-/multivariate and the Kaplan–Meier survival analyses. Conclusion: Our report indicates that ROBO1 might be a potential prognostic biomarker for NPC. [ABSTRACT FROM AUTHOR]

This paper proposes a new method of finding the Thevenin equivalent circuits for the transformer and partial–ideal operational amplifier systems that have not been systematically solved by traditional approaches now. This paper also exploits some strong improvements to solve the complicated dependent source circuit and mutual coupling circuit. Five comparative examples are demonstrated to show the significant merits that our method owns over the traditional approaches including the open-circuit voltage and short-circuit current method, matrix node voltage (mesh current) method, modified nodal (mesh) analysis, reference node r model, reflected impedance method, and virtual ground method. [ABSTRACT FROM AUTHOR]

In this study, we modified the previously proposed X2CT-GAN to build a 2Dto3D-GAN of the spine. This study also incorporated the radiologist's perspective in the adjustment of input signals to prove the feasibility of the automatic production of three-dimensional (3D) structures of the spine from simulated bi-planar two-dimensional (2D) X-ray images. Data from 1012 computed tomography (CT) studies of 984 patients were retrospectively collected. We tested this model under different dataset sizes (333, 666, and 1012) with different bone signal conditions to observe the training performance. A 10-fold cross-validation and five metrics—Dice similarity coefficient (DSC) value, Jaccard similarity coefficient (JSC), overlap volume (OV), and structural similarity index (SSIM)—were applied for model evaluation. The optimal mean values for DSC, JSC, OV, SSIM_anteroposterior (AP), and SSIM_Lateral (Lat) were 0.8192, 0.6984, 0.8624, 0.9261, and 0.9242, respectively. There was a significant improvement in the training performance under empirically enhanced bone signal conditions and with increasing training dataset sizes. These results demonstrate the potential of the clinical implantation of GAN for automatic production of 3D spine images from 2D images. This prototype model can serve as a foundation in future studies applying transfer learning for the development of advanced medical diagnostic techniques. [ABSTRACT FROM AUTHOR]

Infection is a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) especially cytomegalovirus (CMV) infection and invasive fungal infection (IFI). Taiwan is a high CMV seroprevalence area. Our study aimed to evaluate the incidence, risk factors, the impact on survival of CMV infection (including reactivation and disease) and the association of CMV infection and IFI in recipients after allo-HSCT during the first 100 days after transplantation. This was a retrospective study including 180 recipients of allo-HSCT. A total of 99 patients had CMV reactivation, and nine patients had CMV diseases. There were more mismatched donors, more ATG usage and more transplantation from CMV IgG-negative donor in patients with CMV reactivation. There was no survival difference in patients with or without CMV reactivation. A total of 34 patients had IFIs, and IFI after allo-HSCT was associated with significantly inferior survival. Patients with CMV reactivation did not increase the incidence of overall IFI, but they did result in more late-onset (>40 days) IFI (p = 0.056). In this study, we demonstrated real-world data of CMV infection and IFI from a high CMV seroprevalence area. [ABSTRACT FROM AUTHOR]

With the burgeoning membrane market focusing on moisture control applications, air/water filtered membranes find increasing use in diverse fields from electronics to food preservation. Fabrication and investigations of lithium chloride (LiCl)/Polyvinyl Alcohol (PVA)/sulfone composite films designed to dehumidify the surrounding air have been conducted. These films combine hydrophilic PVA with sulfone, a material known for its water vapor selectivity. Additionally, this research analyzes the impact of LiCl concentration on the film's performance, revealing that an optimal balance between water permeability and air blockage can be achieved by adjusting material compositions. Various material characterizations, including X-ray diffraction (XRD), secondary ion mass spectrometry (SIMS), Raman spectroscopy, photoluminescence (PL) spectroscopy, transmission electron microscopy (TEM), optical microscopy (OM), and confocal optical surface measurements, shed light on the film's surface morphology, lattice structure, and optical properties. The results demonstrate that the LiCl/PVA/sulfone composite films hold promise as effective dehumidifying components with potential applications in air conditioning and smart wearable garments. • Novel PVA Sulfone composite films exhibit superior water vapor selectivity. • LiCl incorporation enhances water separation in composite films. • Material characterizations reveal optimization for moisture control and air blockage. • Compactness adjustment enhances membrane blockage against air permeation. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) has triggered an enormous number of discussion topics on social media Twitter. It has an impact on the global health system and citizen responses to the pandemic. Multiple responses (replies, favorites, and retweets) reflect the followers' attitudes and emotions towards these tweets. Twitter data such as these have inspired substantial research interest in sentiment and social trend analyses. To date, studies on Twitter data have focused on the associational relationships between variables in a population. There is a need for further discovery of causality, such as the influence of sentiment polarity of tweet response on further discussion topics. These topics often reflect the human perception of COVID-19. This study addresses this exact topic. It aims to develop a new method to unveil the causal relationships between the sentiment polarity and responses in social media data. We employed sentiment polarity, i.e., positive or negative sentiment, as the treatment variable in this quasi-experimental study. The data is the tweets posted by nine authoritative public organizations in four countries and the World Health Organization from December 1, 2019, to May 10, 2020. Employing the inverse probability weighting model, we identified the treatment effect of sentiment polarity on the multiple responses of tweets. The topics with negative sentiment polarity on COVID-19 attracted significantly more replies (69±49) and favorites (688±677) than the positive tweets. However, no significant difference in the number of retweets was found between the negative and positive tweets. This study contributes a new method for social media analysis. It generates new insight into the influence of sentiment polarity of tweets about COVID-19 on tweet responses. [ABSTRACT FROM AUTHOR]

Background: We tested the hypothesis that multiple obesity‐related risk factors (obesity, physical activity, cardiopulmonary physical fitness, sleep‐disorder breathing (SDB), and sleep quality) are associated with childhood asthma using a Mendelian randomization (MR) design. Furthermore, we aim to investigate whether these risk factors were associated with incident asthma prospectively. Methods: In total, 7069 children aged 12 from the Taiwan Children Health Study were enrolled in the current study. Cross‐sectional logistic regression, one‐sample MR, summary‐level MR sensitivity analyses, and prospective survival analyses were used to investigate each causal pathway. Results: In MR analysis, three of the five risk factors (obesity, SDB, and sleep quality) were associated with asthma, with the highest effect sizes per inter‐quartile range (IQR) increase observed for sleep quality (odds ratio [OR] = 1.42; 95% confidence interval [CI]: 1.06 to 1.92) and the lowest for obesity (OR = 1.08; 95% CI: 1.00–1.16). In the prospective survival analysis, obesity showed the highest risk of incident asthma per IQR increase (hazard ratio [HR] = 1.28; 95% CI: 1.05 to 1.56), followed by SDB (HR = 1.18; 95% CI: 1.08 to 1.29) and sleep quality (HR = 1.10; 95% CI: 1.03 to 1.17). Conclusion: Among the examined factors, the most plausible risk factors for asthma were obesity, SDB, and poor sleep quality. For the prevention of childhood asthma, relevant stakeholders should prioritize improving children's sleep quality and preventing obesity comorbidities such as SDB. [ABSTRACT FROM AUTHOR]

Thread lifting has gained popularity in recent years because of its minimally invasive properties. Regardless of the technique used, the key is threading in the optimal anatomical plane and suspending the correct target tissue. Failure to meet these objectives may result in chronic pain; contour irregularity; thread migration or exposure; and nerve, vessel, and gland injuries. The knowledge of facial anatomy alone is insufficient to corroborate the anatomical variations of a patient. Ultrasound-guided thread lifting can be performed because the trocar presents a hyperechogenic signal with bayonet and reverberation artifacts. Ultrasound is an effective tool because it can provide real-time images of the layers of the facial anatomy, fat pads, muscles, fascia, ligaments, superficial muscular aponeurotic system, arteries, and parotid duct. Transillumination, however, can be conducted to verify the presence of superficial vessels and prevent venipuncture and injury to homonymous arteries. The combination of transillumination and ultrasound provides three-dimensional information. In this study, to evaluate facial anatomy and guide threading, reconfirm the position of the thread, and prevent malpractices, practical strategies such as transillumination, ultrasound, and Doppler imaging are recommended for improving patient safety during, before, and after the procedure. [ABSTRACT FROM AUTHOR]

Since a portion of patients with nasopharyngeal carcinoma (NPC) do not benefit much from current standard treatments, it is still needed to discover new therapeutic drugs to improve the prognosis of the patients. Considering that Chinese traditional medicine plays a role in inhibiting tumor progression, in this study, we aimed to investigate whether a Chinese herbal formula, Qing Yan Li Ge Tang (QYLGT), has the anticancer activity in NPC cells and explore the underlying mechanism as well. MTT assay, colony formation assay, immunoblotting assay, and DNA laddering assay were performed to assess cell viability, cell colony formation, protein expression, and DNA fragmentation, respectively. Results show that QYLGT was able to inhibit the cell viability and decrease colony formation ability in NPC cells. QYLGT could also increase the formation of intracellular vacuoles and induce the autophagy-related protein expressions, including Atg3, Atg6, and Atg12-Atg5 conjugate in NPC cells. Treatment with an autophagy inhibitor, 3-methyladenine, could significantly recover QYLGT-inhibited cell viability of NPC cells. In addition, QYLGT did not significantly induce apoptosis in NPC cells. We also found that QYLGT had the ability to activate phosphoinositide 3-kinase (PI3K)/Akt/mammalian target of the rapamycin (mTOR) pathway. Treatment with PI3K inhibitors, LY294002 and wortmannin, or mTOR inhibitors, rapamycin and Torin 1, could not only recover QYLGT-inhibited cell viability of NPC cells but also inhibit Atg3 expression. Taken together, our results demonstrated that QYLGT could induce autophagic cell death in NPC cells through the PI3K/Akt/mTOR pathway. [ABSTRACT FROM AUTHOR]

To evaluate the potential benefit of HyperArc (HA) fractionated stereotactic radiotherapy (FSRT) for the benign brain lesion. Sixteen patients with a single deep-seated, centrally located benign brain lesion treated by CyberKnife (CK, G4 cone-based model) were enrolled. Treatment plans for HA with two different optimization algorithms (SRS NTO and ALDO) and coplanar RapidArc (RA) were generated for each patient to meet the corresponding treatment plan criteria. These four FSRT treatment plans were divided into two groups—the homogeneous delivery group (HA-SRS NTO and coplanar RA) and the inhomogeneous delivery group (HA-ALDO and cone-based CK)—to compare for dosimetric outcomes. For homogeneous delivery, the brain V5, V12, and V24 and the mean brainstem dose were significantly lower with the HA-SRS NTO plans than with the coplanar RA plans. The conformity index, high and intermediate dose spillage, and gradient radius were significantly better with the HA-SRS NTO plans than with the coplanar RA plans. For inhomogeneous delivery, the HA-ALDO exhibited superior PTV coverage levels to the cone-based CK plans. Almost all the doses delivered to organs at risk and dose distribution metrics were significantly better with the HA-ALDO plans than with the cone-based CK plans. Good dosimetric distribution makes HA an attractive FSRT technique for the treatment of benign brain lesions. [ABSTRACT FROM AUTHOR]

Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved therapy in major depressive disorder. However, its treatment efficacy on depression after traumatic brain injury (TBI) remains inconclusive. We conducted a meta-analysis to assess the effectiveness of executing rTMS over dorsolateral prefrontal cortex (DLPFC) on depression, cognitive impairment and post-concussion syndrome in individuals with traumatic brain injury. This study contained seven randomized controlled trials that published before April 5, 2020 in PubMed, Embase, Scopus, Cochrane, and Web of Science databases. The rTMS had significant anti-depressant effect (SMD = 1.03, p = 0.02), but the effects dissipated at 1-month follow-up (SMD = 0.39, p = 0.62). In the subgroup analysis, only applying rTMS to left DLPFC area of post-TBI patients showed significant anti-depressant effect (SMD = 0.98, p = 0.04). Moreover, current data observed that rTMS on post-TBI patients possessed substantial improvement in visuospatial memory (SMD = 0.39, p < 0.0001), but wasn't in processing speed (SMD = − 0.18, p = 0.32) and selective attention (SMD = 0.21, p = 0.31). In addition, the effect of rTMS is not superior to sham on postconcussion syndrome. In conclusion, the short-term antidepressant effect of left DLPFC rTMS in patients with TBI was significant. However, the effectiveness of rTMS on cognition and postconcussion syndrome in patients with post-TBI depression was limited. [ABSTRACT FROM AUTHOR]

The aim of the study was to use a previously proposed mask region–based convolutional neural network (Mask R-CNN) for automatic abnormal liver density detection and segmentation based on hepatocellular carcinoma (HCC) computed tomography (CT) datasets from a radiological perspective. Training and testing datasets were acquired retrospectively from two hospitals of Taiwan. The training dataset contained 10,130 images of liver tumor densities of 11,258 regions of interest (ROIs). The positive testing dataset contained 1,833 images of liver tumor densities with 1,874 ROIs, and negative testing data comprised 20,283 images without abnormal densities in liver parenchyma. The Mask R-CNN was used to generate a medical model, and areas under the curve, true positive rates, false positive rates, and Dice coefficients were evaluated. For abnormal liver CT density detection, in each image, we identified the mean area under the curve, true positive rate, and false positive rate, which were 0.9490, 91.99%, and 13.68%, respectively. For segmentation ability, the highest mean Dice coefficient obtained was 0.8041. This study trained a Mask R-CNN on various HCC images to construct a medical model that serves as an auxiliary tool for alerting radiologists to abnormal CT density in liver scans; this model can simultaneously detect liver lesions and perform automatic instance segmentation. [ABSTRACT FROM AUTHOR]

The onset of ice nucleation in mixed-phase clouds determines the lifetime and microphysical properties of ice clouds. In this work, we develop a novel method that differentiates between various phases of mixed-phase clouds, such as clouds dominated by pure liquid or pure ice segments, compared with those having ice crystals surrounded by supercooled liquid water droplets or vice versa. Using this method, we examine the relationship between the macrophysical and microphysical properties of Southern Ocean mixed-phase clouds at -40 to 0 °C (e.g. stratiform and cumuliform clouds) based on the in situ aircraft-based observations during the US National Science Foundation Southern Ocean Clouds, Radiation, Aerosol Transport Experimental Study (SOCRATES) flight campaign. The results show that the exchange between supercooled liquid water and ice crystals from a macrophysical perspective, represented by the increasing spatial ratio of regions containing ice crystals relative to the total in-cloud region (defined as ice spatial ratio), is positively correlated with the phase exchange from a microphysical perspective, represented by the increasing ice water content (IWC), decreasing liquid water content (LWC), increasing ice mass fraction, and increasing ice particle number fraction (IPNF). The mass exchange between liquid and ice becomes more significant during phase 3 when pure ice cloud regions (ICRs) start to appear. Occurrence frequencies of cloud thermodynamic phases show a significant phase change from liquid to ice at a similar temperature (i.e. -17.5 °C) among three types of definitions of mixed-phase clouds based on ice spatial ratio, ice mass fraction, or IPNF. Aerosol indirect effects are quantified for different phases using number concentrations of aerosols greater than 100 or 500 nm (N>100 and N>500 , respectively). N>500 shows stronger positive correlations with ice spatial ratios compared with N>100. This result indicates that larger aerosols potentially contain ice-nucleating particles (INPs), which facilitate the formation of ice crystals in mixed-phase clouds. The impact of N>500 is also more significant in phase 2 when ice crystals just start to appear in the mixed phase compared with phase 3 when pure ICRs have formed, possibly due to the competing aerosol indirect effects on primary and secondary ice production in phase 3. The thermodynamic and dynamic conditions are quantified for each phase. The results show stronger in-cloud turbulence and higher updraughts in phases 2 and 3 when liquid and ice coexist compared with pure liquid or ice (phases 1 and 4, respectively). The highest updraughts and turbulence are seen in phase 3 when supercooled liquid droplets are surrounded by ice crystals. These results indicate both updraughts and turbulence support the maintenance of supercooled liquid water amongst ice crystals. Overall, these results illustrate the varying effects of aerosols, thermodynamics, and dynamics through various stages of mixed-phase cloud evolution based on this new method that categorizes cloud phases. [ABSTRACT FROM AUTHOR]

With the expansion of network bandwidth and the rise of social networks, image sharing on open networks has become a trend. The ensuing privacy leakage events have aroused widespread concerns. Therefore, image sharing that protects privacy is desired. Progressive Secret Image Sharing (PSIS), a multilevel privacy protection technology for images, offers a promising solution. However, the progressivity of the majority of PSIS schemes depends on the preprocessing of a secret image, which increases the calculation costs. In addition, a block-based PSIS may have information leakage security risks when processing highly confidential images. Many existing PSIS schemes use a single operation to share secret images, which makes the schemes inflexible and limits the application scenarios. Therefore, we propose a PSIS based on Boolean operations and Polynomial interpolations (PSIS-BP). The proposed scheme divides the bit-plane of the pixel into two parts. One part is utilized to perform the Boolean operation, and the other part is used to perform the polynomial interpolation. Different assignment strategies can produce different progressive reconstruction levels and expand the application scenarios of the scheme. Theoretical analyses and experimental results demonstrate that the proposed scheme is secure, low-cost, and flexible. [ABSTRACT FROM AUTHOR]

The devastating Chichi earthquake in Taiwan in 1999 highlighted the importance of disaster prevention and relief operations. In response to the challenge of extreme events and compound disasters, the National Science and Technology Center for Disaster Reduction (NCDR) contributes to operations at the Central Emergency Operation Center (CEOC) of Taiwan by providing integrated information and timely suggestions, and it delivers a common operational picture to central and local governments through a decision support system. This study was undertaken to explore the emergency response towards the reconnaissance of earthquake disasters in Taiwan to illustrate how resilient cities ensure rapid crisis response with a focus on the NCDR disaster response decision support system. This study examines the decision support system used following the 2016 ML 6.6 Meinong earthquake. The results demonstrate that the first line of relief for the emergency response commander is data-driven decision-making. [ABSTRACT FROM AUTHOR]

Background: Most gastrointestinal stromal tumors (GISTs) harbor c-KIT or PDGFRA mutations. Administration of tyrosine kinase inhibitors (TKIs) has significantly improved the survival of patients with GISTs. We aimed to evaluate the clinical outcome of advanced or recurrent GIST patients in Taiwan. Methods: Patients diagnosed between 2010 and 2020 were enrolled. The collected data included baseline characteristics, treatment pattern, treatment outcome, genetic aberrations and survival status. Progression-free survival (PFS) and overall survival (OS) were analyzed and plotted with the Kaplan–Meier method. Cox regression analysis was used to analyze the prognostic factors of survival. Results: A total of 224 patients with advanced or recurrent GISTs treated with TKIs were enrolled. All patients received imatinib treatment. Ninety-three and 42 patients received sunitinib and regorafenib treatment, respectively. The 48-month PFS and OS rates for patients treated with imatinib were 50.5% and 79.5%, respectively. c-KIT exon 9 and PDGFRA mutations were prognostic factors for a poor PFS and PDGFRA mutation was a prognostic factor for a poor OS in patients treated with imatinib in multivariate Cox regression analysis. The median PFS of patients who received sunitinib treatment was 12.76 months (95% confidence interval (CI), 11.01–14.52). Patients with c-KIT exon 9 mutations had a longer PFS than those with other genetic aberrations. The median PFS of patients treated with regorafenib was 7.14 months (95% CI, 3.39–10.89). Conclusions: We present real-world clinical outcomes for advanced GIST patients treated with TKIs and identify mutational status as an independent prognostic factor for patient survival. [ABSTRACT FROM AUTHOR]

Triple‐negative breast cancer (TNBC) exhibits a higher level of glycolytic capacity and are commonly associated with an inflammatory microenvironment, but the regulatory mechanism and metabolic crosstalk between the tumor and tumor microenvironment (TME) are largely unresolved. Here, we show that glucose transporter 3 (GLUT3) is particularly elevated in TNBC and associated with metastatic progression and poor prognosis in breast cancer patients. Expression of GLUT3 is crucial for promoting the epithelial‐to‐mesenchymal transition and enhancing invasiveness and distant metastasis of TNBC cells. Notably, GLUT3 is correlated with inflammatory gene expressions and is associated with M1 tumor‐associated macrophages (TAMs), at least in part by C‐X‐C Motif Chemokine Ligand 8 (CXCL8). We found that expression of GLUT3 regulates CXCL8 production in TNBC cells. Secretion of CXCL8 participates in GLUT3‐overexpressing TNBC cells‐elicited activation of inflammatory TAMs, which further enhances GLUT3 expression and mobility of TNBC cells. Our findings demonstrate that aerobic glycolysis in TNBC not only promotes aggressiveness of tumor cells but also initiates a positive regulatory loop for enhancing tumor progression by modulating the inflammatory TME. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the feasibility and efficacy of HyperArc (HA) for recurrent nasopharyngeal cancer (NPC) by comparing it with the CyberKnife system (CK). Fifteen patients with recurrent nasopharyngeal cancer who were treated using the noncoplanar cone-based robotic CK system were enrolled. CK was delivered with a median dose of 37.5 Gy in 5 fractions. The delivered CK treatment plans were the sources for the corresponding homogeneous HA (HA-H) and inhomogeneous HA (HA-IH) plans. The HA-H plans were generated to meet the corresponding treatment plan criteria for the CK plans. The HA-IH plans were designed to emulate the corresponding inhomogeneous CK isodose distributions. These three SBRT treatment plans were compared with target coverage, sparing of organs at risk (OARs), and dose distribution metrics. The HA-H and HA-IH plans consistently exhibited CTV and PTV coverage levels similar or better to those of the CK plans but significantly reduced the dose to OARs. Using the HA techniques (both HA-H and HA-IH plans), the mean maximal doses to the spinal cord, brainstem, optic nerves, and optic chiasm were reduced by approximately 60%, compared to the CK plans. The high dose spillage, conformity, and homogeneity indices of the HA-H plans were significantly better than those of the CK plans. The HA-IH plans showed faster dose falloff and similar conformity of the HA-H plans and dose heterogeneity of the CK plans. Here we demonstrated the HA treatment plan system for recurrent NPC is feasible, either homogeneous or inhomogeneous delivery. Excellent sparing of OARs and dosimetric distribution and very efficient delivery make HA an attractive SBRT technique for recurrent NPC treatment. [ABSTRACT FROM AUTHOR]

Background: Primary spontaneous pneumothorax (PSP) prevalence is typically higher in juvenile patients than in adults. We aimed to evaluate the optimal treatment for primary spontaneous pneumothorax and its efficacy and safety in juveniles. Materials and methods: We searched PubMed, Embase, and Cochrane databases for eligible studies published from database inception to October 10, 2020, and conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary and secondary outcomes were recurrence rate and hospital stay length, respectively. Odds ratios (OR) and mean differences were used for quantitatively analyzing binary and continuous outcomes, respectively. In total, nine retrospective studies with 1,452 juvenile patients (aged <21) were included for the quantitative analysis. The surgical approach led to a lower recurrence rate than did conservative approaches (OR: 1.95, 95% confidence interval: 1.15–3.32). Moreover, the recurrence rate was low in patients who underwent conservative treatment first and received surgery later. Conclusions: Surgical approach for first-line management might have a greater effect on recurrence prevention than do conservative approaches. An upfront surgery might be an optimal choice for juvenile primary spontaneous pneumothorax. [ABSTRACT FROM AUTHOR]

Background: To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection.Methods: In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were included between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival (DSS) among different quality of neck dissection.Results: Of the 1765 patients identified, 1108 (62.8%) had oral cancer, 1141 (64.6%) were men, and 1067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval [CI] 0.49-0.84) in those with < 18 lymph nodes (LNs) removed, but not in those with 19-24 LNs removed (aHR 0.78; 95% CI 0.73-1.13), and in those with ≥ 25 LNs removed (aHR 0.96; 95% CI 0.75-1.24). For 5-year DSS, similar effect was observed. The adjusted hazard ratio was 0.66 (95% confidence interval, 0.45-0.97) in those with < 18 LNs. The protective effect was not seen in those with 18-24 LNs (aHR 1.07; 95% CI 0.59-1.96), and in those with ≥ 25 LNs (aHR 1.12; 95% CI 0.81-1.56). Sensitivity testing also showed a robust protective effect of postoperative radiotherapy in patients with < 18 LNs removed.Conclusion: Radiotherapy was associated with improved survival in pT1-2N1M0 oral and oropharyngeal cancer patients without adequate neck dissection. [ABSTRACT FROM AUTHOR]

KAIKObase was established in 2009 as the genome database of the domesticated silkworm Bombyx mori. It provides several gene sets and genetic maps as well as genome annotation obtained from the sequencing project of the International Silkworm Genome Consortium in 2008. KAIKObase has been used widely for silkworm and insect studies even though there are some erroneous predicted genes due to misassembly and gaps in the genome. In 2019, we released a new silkworm genome assembly, showing improvements in gap closure and covering more and longer gene models. Therefore, there is a need to include new genome and new gene models to KAIKObase. In this article, we present the updated contents of KAIKObase and the methods to generate, integrate and analyze the data sets. Database URL : https://kaikobase.dna.affrc.go.jp [ABSTRACT FROM AUTHOR]

Background and Purpose. Allergic rhinitis (AR) is a highly prevalent disease, and Chinese herbal medicine (CHM) is commonly used for treating AR. This study aims to demonstrate the CHM network for AR and possible molecular pathways. Materials and Methods. Patients with a primary diagnosis of AR (ICD-9-CM code: 477.9) in 2010 were included, and the National Health Insurance Research Database in Taiwan was used as the data source. Association rule mining and social network analysis were used to establish and explore the CHM network. Possible molecular pathways of the CHM network were summarized and compared with commonly used western medicine (WM) by conducting overrepresentation analysis in the Reactome pathway database. The potential proteins acted by CHMs were obtained from the CHM ingredient-protein databases, including STITCH, TCMSP, TCMID, and TCM@Taiwan. Results. There were 89,148 AR subjects found in 2010, and a total of 33,507 patients ever used CHM. On an average, 5.6 types of CHMs were utilized per prescription. Xin-Yi-Qing-Fei-Tang was used most frequently (25.5% of 222,279 prescriptions), while Xiao-Qing-Long-Tang with Xin-Yi-San was the most commonly prescribed CHM-CHM combination. Up to six distinctive clusters could be found among the CHM network, and core CHMs could be found for AR, such as Xiao-Qing-Long-Tang and Xin-Yi-Qing-Fei-Tang. A total of 140 molecular pathways were covered by the CHM network (2,432 ingredients from 31 kinds of CHMs), while 39 WMs covered 55 pathways. Among pathways responding to the immune system, WM mainly acted on cytokine signaling-related pathways, while CHM mostly acted on neutrophil/macrophage-related innate pathways and dendritic cell-related adaptive immunity pathways. Conclusion. Our study demonstrated and analyzed the CHM network for AR. Core CHM for AR and possible molecular pathways were presented as well, and this information is crucial for researchers to select candidates for CHM-related studies. [ABSTRACT FROM AUTHOR]

Pulmonary pleomorphic carcinoma (PPC) generally lacks actionable driver mutations such as epidermal growth factor receptor mutations or anaplastic lymphoma kinase or c-ros oncogene 1 (ROS1) rearrangements. The response to crizotinib, ceritinib, brigatinib, and lorlatinib in ROS1-positive advanced non-small cell lung carcinoma is well established; however, there is little mention of their successful administration in pulmonary pleomorphic carcinoma cases. We report a case of a stage II PPC with recurrence after surgical resection and developed multiple distant metastasis. The tumor was refractory to chemotherapy and immunotherapy with progressive disease. EZR-ROS1 fusion was detected by next-generation sequencing and showed a good response to serial ROS1 inhibitors combined with surgery and radiotherapy. Now under lorlatinib, all her lesions responded well during the follow-up with sustained partial remission for more than 18 months. A sustainable treatment effect can be achieved in pulmonary pleomorphic carcinoma with driver mutations with tyrosine kinase inhibitor treatment. Driver mutations should be regularly tested in pulmonary pleomorphic carcinomas. [ABSTRACT FROM AUTHOR]

Q-Switched laser devices have been a standard treatment modality for dermal pigmentary disorders since the 1990s. However, the adverse events are sometimes intolerable even if the efficacy has been well accepted. These adverse events stop the patient from continuing the treatment and cause other cosmetic issues. Since 2012, the first picosecond laser for cosmetic applications was approved; it seems promising for treating pigmentary disorders in a new way, but lack strong evidence. We evaluated the efficacy and safety of a 755-nm picosecond laser for treatment of dermal pigmentary disorders in Asians. This is a 2-year retrospective study. We reviewed 36 female cases, including 8 cases of nevus of Ota and 28 cases of acquired bilateral nevus of Ota-like macules. Institutional Review Board (IRB) approval was granted by the Chang Gung Memorial Hospital medical research ethics committee (IRB 201900833B0). The epidemiologic data was collected. These patients have been treated with the 755-nm picosecond laser for 1 to 4 sessions at variable treatment interval. Our parameter settings were fluence of 2.73–3.98 J/cm2, with a spot size of 2.9 to 2.4 mm under the 650-ps mode. The pulse duration is 650 ps and fluence range is from 2.73 to 3.98 J/cm. Photographs were taken prior to every treatment and 1 month following the treatment. Two dermatologists conducted the clinical evaluation independently. Clinical improvement was observed in all with a minimal side effect. A total of 88.89% of patients had moderate to marked improvement in following 1 to 4 sessions. Transient swelling and erythema were observed in all patients but resolved within 24 h. Only one patient (2.78%) developed hypopigmentation and two patients (5.56%) had hyperpigmentation temporarily. Faster clearance could be achieved by the picosecond 755-nm laser for treating dermal pigmentary disorders in Asians. The treatment course is well tolerable and has minimal side effects. [ABSTRACT FROM AUTHOR]

In this study, the crystallization process in a directional solidification furnace is studied by using the transient numerical simulation. The flow field in melt silicon in conjunction with different solidification stages is investigated. A separated side-heater design is proposed, showing a pronounced improvement on temperature gradient in axial direction normal to the solidification interface at late period. Result shows that the Voronkov ratio which can reflect the crystal quality is reduced by 16.5–24.8% and the energy consumption can be saved by 6% simultaneously. On the other hand, the airflow management for argon gas in the crucible chamber, which contains advantage to reduce chemical impurity in crystal during solidification process, is also numerically studied. By installing a guiding plate beneath the graphite cover can appreciably lower the oxygen mass fraction in contact with the cover plate and reduce the potential chemical reaction accordingly. The plate diameter and the spacing between the plate and graphite cover are optimized. Compared to the original design, the oxygen mass fraction at the graphite cover can be pronouncedly reduced by 10.6–33.3%, which can be further improved by combining a corner outlet configuration. Meanwhile, under the same volumetric flow rate of argon gas, yet the argon gas could be saved by almost half (e.g., from 40 SLM to 20 SLM) for the same chemical concentration with the optimized configuration. [ABSTRACT FROM AUTHOR]

Purpose: This study was undertaken to develop a theoretical framework explaining family caregiving processes for older persons with cognitive impairment recovering from hip fracture surgery. Design and Methods: In this grounded theory study, data were collected in audio‐recorded face‐to‐face interviews with 21 family caregivers. Among these caregivers, 14 cared for hip‐fractured persons with cognitive impairment, and seven cared for those without cognitive impairment. Caregivers were interviewed five times after patients' discharge: at 1 week and at 1, 3, 6, and 12 months. Data were analyzed by constant comparative analysis. Findings: The core category explaining the family caregiving process for hip‐fractured persons with cognitive impairment was "resuming normal life during drip‐like recovery." This category captures the slowness of the recovery process, as slow as dripping water. During the early postoperative period, caregivers attempted to gain control of the postoperative situation, using various maintenance and improvement strategies to deal with the chaos in individuals and the family and to protect hip‐fractured persons with cognitive impairment from further harm. The goal of recovery was to get back to their original life. Conclusions: Family caregivers of hip‐fractured older persons with cognitive impairment needed to deal with more complex chaotic situations, exerted more efforts to administer safety measures, and required more time to achieve a stable life pattern. Clinical Relevance: Since postoperative recovery was perceived as extremely slow, family caregivers of hip‐fractured older persons with cognitive impairment should be patient regarding recovery and be informed before hospital discharge of different strategies to resume normal life during postoperative recovery. [ABSTRACT FROM AUTHOR]

Background: Studies on early puberty and incident asthma have reported inconsistent results and are mainly performed in females. In this longitudinal study, we investigated the causal relationship between pubertal maturation and asthma through Mendelian randomization (MR) and explored the joint effect of overweightness and early pubertal maturation on asthma. Methods: We used data from the Taiwan Children Health Study with longitudinal follow‐ups of 2991 children aged 11‐17 years. Six puberty‐related single‐nucleotide polymorphisms (combined into a weighted allelic score) were used to yield genetic instrumental variables for early puberty. Early pubertal maturation was defined as reaching a certain pubertal stage earlier than the median age for that stage. Incident asthma cases were calculated by excluding children with a history of asthma prior to that age. Results: The results of MR analysis revealed that early pubertal maturation was associated with active asthma (OR = 1.18; 95% CI: 1.08‐1.28); this effect was significant in male children. Early pubertal maturation significantly increased the risk of incident asthma outcomes at 12 and 17 years of age in both sexes (hazard ratio = 2.15; 95% CI: 1.21‐3.84). Taking non‐overweight and non–early puberty children as the reference group, we observed a synergistic effect of overweightness and early pubertal maturation on asthma risk (OR = 1.08; 95% CI: 1.04‐1.11) in children of both sexes. Conclusions: Early screening and intervention for obesity are recommended to prevent future early pubertal onset and asthma occurrence. [ABSTRACT FROM AUTHOR]

A new energy harvesting circuit for battery-less IoT beacon tags is developed herein to maximize power conversion efficiency as well as high throughput power with a wide input–output range. This design energy harvest (EH) circuit incorporates a charge pump (CP) with shoot-through current suppression, a body selector circuit, a maximum power point tracking circuit (MPPT), a timing control circuit, a hysteresis control circuit and a low dropout regulator. Also in this MPPT circuit is a gated clock tuned in a self-adaptive fashion to match the input impedance of the EH circuit to the output impedance of the photovoltaic (PV) panel, thus achieving successfully maximum power point. The circuit is implemented in an integrated chip in an area of 1.2 mm2 via the TSMC 0.18 process. Experiments on the chip are conducted and the results show that the input voltage range is allowed from 0.55 to 1.7 V to effectively harvest the solar power from a flexible dye-sensitized solar cell. The achieved peak power conversion efficiency (PCE) is 77% at the input power of 52 μW. For a wide range of lighting luminance (300–1300 lx,) the achieved average PCE is more than 70%. The achieved wide input–output range and the maximum throughput power of 200 μW is much larger than others reported, while the 77% of PCE is close to that best power conversion efficiency reported. [ABSTRACT FROM AUTHOR]

Traditional (k, n) secret image sharing provides all-or-nothing decoding model and (k, n) scalable secret image sharing provides progress decoding model during image reconstruction. Both these two decoding models are significance in various applications. However, the security level for real applications would change due to the dynamical environment, only one single decoding model cannot satisfy the changeable security requirement. In this work, we construct scalable secret image sharing schemes that provides both all-or-nothing and progress decoding models to satisfy the dynamical secure requirement. Each participant in our schemes only needs to keep one initial-shadow. During image reconstruction, the dealer selects the decoding model according to current security requirement, if progress model is chosen, initial shadows can achieve image reconstruction in progress model without any modification; else if all-or-nothing model is chosen, the dealer does not need to resent new shadows to participants, the initial-shadows can be updated to satisfy all-or-nothing model efficiently. [ABSTRACT FROM AUTHOR]