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The increasing complexity of industrial systems demands more effective and intelligent maintenance approaches to address manufacturing defects arising from faults in multiple asset modules. Traditional digital twin (DT) systems, however, face limitations in interoperability, knowledge sharing, and causal inference. As such, cognitive digital twins (CDTs) can add value by managing a collaborative web of interconnected systems, facilitating advanced cross-domain analysis and dynamic context considerations. This paper introduces a CDT system that leverages industrial knowledge graphs (iKGs) to support maintenance planning and operations. By employing a design structure matrix (DSM) to model dependencies and relationships, a semantic translation approach maps the knowledge into a graph-based representation for reasoning and analysis. An automatic solution generation mechanism, utilising graph sequencing with Louvain and PageRank algorithms, derives feasible solutions, which can be validated via simulation to minimise production disruption impacts. The CDT system can also identify potential disruptions in new product designs, thus enabling preventive actions to be taken. A case study featuring a print production manufacturing line illustrates the CDT system's capabilities in causal inference and solution explainability. The study concludes with a discussion of limitations and future directions, providing valuable guidelines for manufacturers aiming to enhance reactive and predictive maintenance strategies. [ABSTRACT FROM AUTHOR]

Background: Segmental bone defects of the mandible result in the complete loss of the affected region. We had incorporated the pressure‐reducing device (PRD) designs into the customized mandible prostheses (CMP) and conducted a clinical trial to evaluate this approach. Methods: Seven patients were enrolled in this study. We examined the association among the history of radiotherapy, the number of CMP regions, the number of chin regions involved, and CMP exposure. Results: We included five men and two women with an average age of 55 years. We excised tumors with an average weight of 147.8 g and the average weight of the CMP was 68.5 g. No significant difference between the two weights was noted (p = 0.3882). Three patients received temporary dentures and the CMP remained stable in all patients. Conclusion: The use of PRD in CMP may address the previous challenges associated with CMP, but further research is necessary. [ABSTRACT FROM AUTHOR]

The inversion of substrate size specificity is an evolutionary roadblock for proteins. The Duf4243 dioxygenases GedK and BTG13 are known to catalyze the aromatic cleavage of bulky tricyclic hydroquinone. In this study, we discover a Duf4243 dioxygenase PaD that favors small monocyclic hydroquinones from the penicillic-acid biosynthetic pathway. Sequence alignments between PaD and GedK and BTG13 suggest PaD has three additional motifs, namely motifs 1-3, distributed at different positions in the protein sequence. X-ray crystal structures of PaD with the substrate at high resolution show motifs 1-3 determine three loops (loops 1-3). Most intriguing, loops 1-3 stack together at the top of the pocket, creating a lid-like tertiary structure with a narrow channel and a clearly constricted opening. This drastically changes the substrate specificity by determining the entry and binding of much smaller substrates. Further genome mining suggests Duf4243 dioxygenases with motifs 1-3 belong to an evolutionary branch that is extensively involved in the biosynthesis of natural products and has the ability to degrade diverse monocyclic hydroquinone pollutants. This study showcases how natural enzymes alter the substrate specificity fundamentally by incorporating new small motifs, with a fixed overall scaffold-architecture. It will also offer a theoretical foundation for the engineering of substrate specificity in enzymes and act as a guide for the identification of aromatic dioxygenases with distinct substrate specificities. The Duf4243 dioxygenases GedK and BTG13 are known to catalyze the aromatic cleavage of bulky tricyclic hydroquinone. Here, the authors discover a distinct Duf4243 dioxygenase PaD that favors small monocyclic hydroquinones from the penicillic-acid biosynthetic pathway and determine the structural basis for its changed substrate specificity. [ABSTRACT FROM AUTHOR]

Background: NUP98 rearrangements (NUP98-r) are rare but overrepresented mutations in pediatric acute myeloid leukemia (AML) patients. NUP98-r is often associated with chemotherapy resistance and a particularly poor prognosis. Therefore, characterizing pediatric AML with NUP98-r to identify aberrations is critically important. Methods: Here, we retrospectively analyzed the clinicopathological features, genomic and transcriptomic landscapes, treatments, and outcomes of pediatric patients with AML. Results: Nine patients with NUP98-r mutations were identified in our cohort of 142 patients. Ten mutated genes were detected in patients with NUP98-r. The frequency of FLT3-ITD mutations differed significantly between the groups harboring NUP98-r and those without NUP98-r (P = 0.035). Unsupervised hierarchical clustering via RNA sequencing data from 21 AML patients revealed that NUP98-r samples clustered together, strongly suggesting a distinct subtype. Compared with that in the non-NUP98-r fusion and no fusion groups, CMAHP expression was significantly upregulated in the NUP98-r samples (P < 0.001 and P = 0.001, respectively). Multivariate Cox regression analyses demonstrated that patients harboring NUP98-r (P < 0.001) and WT1 mutations (P = 0.030) had worse relapse-free survival, and patients harboring NUP98-r (P < 0.008) presented lower overall survival. Conclusions: These investigations contribute to the understanding of the molecular characteristics, risk stratification, and prognostic evaluation of pediatric AML patients. [ABSTRACT FROM AUTHOR]

The inherent ambiguity in reconstructed images from coherent diffraction imaging (CDI) poses an intrinsic challenge, as images derived from the same dataset under varying initial conditions often display inconsistencies. This study introduces a method that employs the Noise2Noise approach combined with neural networks to effectively mitigate these ambiguities. We applied this methodology to hundreds of ambiguous reconstructed images retrieved from a single diffraction pattern using a conventional retrieval algorithm. Our results demonstrate that ambiguous features in these reconstructions are effectively treated as inter‐reconstruction noise and are significantly reduced. The post‐Noise2Noise treated images closely approximate the average and singular value decomposition analysis of various reconstructions, providing consistent and reliable reconstructions. [ABSTRACT FROM AUTHOR]

Home- and community-based services (HCBS) are optimal ways to deal with disability problems among older adults. This study aims to analyze urban–rural disparities in the relationship between HCBS utilization and levels of disability among Chinese older adults with disabilities, so as to meet the long-term care needs of them. In applying the Andersen Behavioral Model, bivariate analysis and multivariate regression models were employed using data from 843 older adults with disabilities from the 2018 China Longitudinal Aging Social Survey (CLASS). After adjusting covariates, disability levels among Chinese older adults with disabilities were significantly correlated with HCBS utilization in urban areas but not in rural areas. The urban–rural disparities may be due to the low utilization of HCBS in rural areas (only 11.2%) among older adults with disabilities compared with their urban counterparts (22.7%). [ABSTRACT FROM AUTHOR]

The astrocyte-to-neuron lactate shuttle model entails that, upon glutamatergic neurotransmission, glycolytically derived pyruvate in astrocytes is mainly converted to lactate instead of being entirely catabolized in mitochondria. The mechanism of this metabolic rewiring and its occurrence in human brain are unclear. Here by using immunohistochemistry (4 brains) and imaging mass cytometry (8 brains) we show that astrocytes of the adult human neocortex and hippocampal formation express barely detectable amounts of mitochondrial proteins critical for performing oxidative phosphorylation (OXPHOS). These data are corroborated by queries of transcriptomes (107 brains) of neuronal versus non-neuronal cells fetched from the Allen Institute for Brain Science for genes coding for a much larger repertoire of entities contributing to OXPHOS, showing that human non-neuronal elements barely expressed mRNAs coding for such proteins. With less OXPHOS, human brain astrocytes are thus bound to produce more lactate to avoid interruption of glycolysis. Human brain astrocytes lack OXPHOS, ensuring lactate formation and shuttling to neurons. [ABSTRACT FROM AUTHOR]

A supercritical carbon dioxide (SCCO2) fluid, characterized by gas‐like diffusivity, near‐zero surface tension, and excellent mass transfer properties, is used as a precursor to produce silicon oxycarbide (SiOC) coating. SCCO2 disperses and reacts with Si particles to form an interfacial layer consisting of Si, O, and C. After an 850 °C annealing process, a conformal SiOC coating layer forms, resulting in core‐shell Si@SiOC particles. High‐resolution transmission electron microscopy and its X‐ray line‐scan spectroscopy, X‐ray photoelectron spectroscopy, Fourier‐transform infrared spectroscopy, and Raman spectroscopy, are used to examine the SiOC formation mechanism. Effects of SCCO2 interaction time on the SiOC properties are investigated. The SiOC layer connects the Si@SiOC particles, improving electron and Li+ transport. Cyclic voltammetry, galvanostatic intermittent titration technique, and electrochemical impedance spectroscopy are employed to examine the role of SiOC during charging/discharging. Operando X‐ray diffraction data reveal that the SiOC coating reduces crystal size of the formed Li15Si4 and increases its formation/elimination reversibility during cycling. The Si@SiOC electrode shows a capacitiy of 2250 mAh g−1 at 0.2 A g−1. After 500 cycles, the capacity retention is 72% with Coulombic efficiency above 99.8%. A full cell consisting of Si@SiOC anode and LiNi0.8Co0.1Mn0.1O2 cathode is constructed, and its performance is evaluated. [ABSTRACT FROM AUTHOR]

This study aimed to explore the traffic safety evaluation model for downstream intersections of urban expressway exits and make up for the shortcomings in safety research on downstream intersections of urban expressway exits. We constructed a comprehensive traffic safety evaluation index system, established a traffic safety evaluation model, and divided precise safety evaluation levels using the AHP–Matter-Element analysis method, establishing a traffic safety evaluation index system consisting of eleven indicators. The effectiveness of this method was validated through an assessment of traffic safety at the intersection of Dongsheng Street and Free Road in Changchun City. A theoretical basis for improving traffic safety at downstream intersections of urban expressways and a reference for subsequent related research were provided. [ABSTRACT FROM AUTHOR]

Traditionally, users have perceived that only manual laborers or those in repetitive jobs would be subject to technological substitution. However, with the emergence of technologies like Midjourney, ChatGPT, and Notion AI, known as Artificial Intelligence-Generated Content (AIGC), we have come to realize that cognitive laborers, particularly creative designers, also face similar professional challenges. Yet, there has been relatively little research analyzing the acceptance and trust of artificial intelligence from the perspective of designers. This study integrates the TAM/TPB behavioral measurement model, incorporating intrinsic characteristics of designers, to delineate their perceived risks of AIGC into functional and emotional dimensions. It explores how these perceived characteristics, risks, and trust influence designers' behavioral intentions, employing structural equation modeling for validation. The findings reveal the following: (1) designer trust is the primary factor influencing their behavioral choices; (2) different dimensions of perceived risks have varying degrees of impact on trust, with functional risks significantly positively affecting trust compared to emotional risks; (3) only by enhancing the transparency and credibility of Artificial Intelligence-Generated Content (AIGC) can the perceived characteristics of designers be elevated; and (4) only by effectively safeguarding designers' legitimate rights and interests can perceived risks be significantly reduced, thereby enhancing trust and subsequently prompting actual behavioral intentions. This study not only enhances the applicability and suitability of AIGC across various industries but also provides evidence for the feasibility of intelligent design in the creative design industry, facilitating the transition of AIGC to Artificial Intelligence-Generated Design (AIGD) for industrial upgrading. [ABSTRACT FROM AUTHOR]

Necking and barreling deformation behaviors occurred simultaneously during the bending test of a single-crystal gold micro-cantilever (sample A) with the loading direction parallel to the [1-10] orientation and the neutral plane parallel to the [110] orientation. In contrast, for another single-crystal gold micro-cantilever, sample B, with the loading direction aligned parallel to the [0.37 −0.92 0.05] orientation and the neutral plane parallel to the [0.54 0.28 0.78] orientation, predominant slip band deformation was noted. Sample A exhibited activation of four slip systems, whereas sample B demonstrated activity in only a single-slip system. This difference suggests that the presence of multiple slip systems contributes to the concurrent occurrence of necking and barreling deformations. Furthermore, variations in the thickness of the micro-cantilevers resulted in observable strengthening, indicating that the effect of sample size is intricately linked to the geometry of the cross-section, which we have termed the "sample geometry effect". [ABSTRACT FROM AUTHOR]

Iron (Fe) is a crucial trace element in marine ecosystems, playing a vital role in regulating marine primary productivity and driving marine biogeochemical cycling processes. However, understanding seasonal iron variations and the response of chlorophyll-a (Chl-a) to coastal waters remains limited. The aim of this study was to find out about the spatial and seasonal variations in iron concentrations and their impact on chlorophyll-a levels in Zhanjiang Bay. We conducted seasonal monitoring of surface seawater for iron in 2019, alongside assessments of terrestrial iron inputs during three precipitation seasons. The monitoring results showed that the iron content in Zhanjiang Bay ranged from 0.83 to 339.2 μg·L−1 with an average of 54.34 ± 75.91 μg·L−1. The annual average iron content in the central bay is higher than that in the bay mouth and inner bay. The iron content in autumn is much higher than that in other seasons, which may be due to the influence of river dredging. Correlation analysis revealed that temperature and pH are the main factors affecting the iron content in Zhanjiang Bay and the spatial distribution of iron is influenced by rainfall, river inputs, and human activities, particularly channel dredging. Iron content and chlorophyll-a were negatively correlated between different seasons, which was more significant with the increase in iron content. This may mean that the increase in iron concentration may inhibit the synthesis of chlorophyll-a, thus affecting primary productivity. We need to carry out more research experiments to verify this hypothesis. This study reveals the spatial and temporal changes in iron in urban coastal waters and its relationship with environmental factors, which is of great significance for understanding the marine biogeochemical cycle of iron in coastal eutrophic waters and specifying effective environmental management strategies. [ABSTRACT FROM AUTHOR]

Soft-matter-based photonic crystals like blue-phase liquid crystals (BPLC) have potential applications in wide-ranging photonic and bio-chemical systems. To date, however, there are limitations in the fabrication of large monocrystalline BPLCs. Traditional crystal-growth process involves the transition from a high-temperature disordered phase to an ordered (blue) phase and is generally slow (takes hours) with limited achievable lattice structures, and efforts to improve molecular alignment through post-crystallization field application typically prove ineffective. Here we report a systematic study on the molecular self-assembly dynamics of BPLC starting from a highly ordered phase in which all molecules are unidirectionally aligned by a strong electric field. We have discovered that, near the high-temperature end of the blue phase, if the applied field strength is then switched to an intermediate level or simply turned off, large-area monocrystalline BPLCs of various symmetries (tetragonal, orthorhombic, cubic) can be formed in minutes. Subsequent temperature tuning of the single crystal at a fixed applied field allows access to different lattice parameters and the formation of never-before-seen monoclinic structures. The formed crystals remain stable upon field removal. The diversity of stable monocrystalline BPLCs with widely tunable crystalline symmetries, band structures, and optical dispersions will significantly improve and expand their application potentials. Soft-matter-based photonic crystals like blue-phase liquid crystals (BPLC) have potential applications but face fabrication limitations for large monocrystalline structures. The authors report a method to rapidly form large-area monocrystalline BPLCs with various symmetries and tunable properties through an application of electric fields and temperature control. [ABSTRACT FROM AUTHOR]

The potential of zinc metal anodes (ZMAs) for use in emerging aqueous electrochemical devices like rechargeable zinc-ion batteries and hybrid capacitors is substantial, owing to their high theoretical capacity, low redox potential, non-toxicity, abundant availability, and cost-effectiveness. However, the practical application of ZMAs faces limitations due to issues such as uncontrolled zinc dendrite growth and side reactions. In this study, we demonstrate that simultaneously incorporating scandium ions (Sc3+) and acetate anions (Ac−) as electrolyte additives into a common ZnSO4 solution significantly enhances the cycling stability and reversibility of ZMAs. Our findings reveal that the Ac− acts as a pH regulator, dynamically buffering the electrolyte pH to be around 4.3, effectively suppressing water-induced side reactions. Additionally, the synergistic effect of Sc3+ and Ac− (Sc3+/Ac−) facilitates the desolation process of Zn2+ and lowers the energy barrier for electrochemical Zn plating, resulting in uniform Zn plating without noticeable zinc dendrite growth. Consequently, Zn‖Zn symmetric cells utilizing the Sc3+/Ac− electrolyte additive exhibit an ultra-long lifespan exceeding 1000 hours at 2.0 mA cm−2 and 1.0 mA h cm−2. Moreover, the Zn‖Cu cell demonstrates a high average coulombic efficiency of 99.4% after 400 plating/stripping cycles at 1.0 mA cm−2 and 1.0 mA h cm−2. Notably, when paired with an activated carbon (AC) cathode, Zn‖AC hybrid capacitors maintain a high-specific capacity of 62 mA h g−1 after 10 000 cycles at 1.0 A g−1. The research outcomes indicate that Sc3+ in combination with Ac− are promising electrolyte additives for achieving highly stable aqueous ZMAs. [ABSTRACT FROM AUTHOR]

This review explores the complex challenges and advancements in the treatment of traumatic brain injury (TBI) and spinal cord injury (SCI). Traumatic injuries to the central nervous system (CNS) trigger intricate pathophysiological responses, frequently leading to profound and enduring disabilities. This article delves into the dual phases of injury—primary impacts and the subsequent secondary biochemical cascades—that worsen initial damage. Conventional treatments have traditionally prioritized immediate stabilization, surgical interventions, and supportive medical care to manage both the primary and secondary damage associated with central nervous system injuries. We explore current surgical and medical management strategies, emphasizing the crucial role of rehabilitation and the promising potential of stem cell therapies and immune modulation. Advances in stem cell therapy, gene editing, and neuroprosthetics are revolutionizing treatment approaches, providing opportunities not just for recovery but also for the regeneration of impaired neural tissues. This review aims to emphasize emerging therapeutic strategies that hold promise for enhancing outcomes and improving the quality of life for affected individuals worldwide. [ABSTRACT FROM AUTHOR]

In digital microfluidics, actuation voltage is critical in droplet manipulation using electrowetting-on-dielectric. Compared to parallel electrode devices, the droplet manipulation on coplanar electrodes requires a higher actuation voltage due to its structure. This study derives an equation related to the threshold actuation voltage and many critical parameters (applied frequency, surface tension, fluid conductivity, droplet volume, dielectric thickness, etc.). Our developed model has three innovations: (1) liquid and device parameters related to the threshold actuation voltage are integrated into the model, (2) the absolute value of the complex permittivity of the fluid is added into our model to clarify the conductivity-dependent and frequency-dependent threshold actuation voltage, and (3) the extrand model is used to derive the effects of the surface tension, contact angles, and droplet radius on the threshold actuation voltage. Additionally, we used many solutions for biochemical and biomedical assays—DI (Deionized) water, DMEM (Dulbecco's Modified Eagle Medium), PBS (phosphate buffered saline), glycerol–water solutions, ethanol–water solutions, potassium chloride solutions, and sodium chloride solutions—to verify the developed Vth in our model. By using the model and conducting an experiment, we investigated the Vth of different liquids on coplanar electrodes. Our model can successfully explain the difference of Vth between these solutions on coplanar electrode devices. The model and experimental data can be utilized to predict the actuation voltage for a broad range of buffers and organic solvents on coplanar electrodes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the relationship between food insecurity (FI) and eating disorder psychopathology in a large sample of rural Chinese adolescents. Methods: Analyses included 1654 adolescents (55.4% girls; Mage = 16.54 years, SD = 1.45) from a rural high school in southwestern China. FI, eating disorder psychopathology, and psychological distress (i.e., symptoms of depression, anxiety, and stress) were assessed. Data were analyzed by sex. Pearson correlation analysis was performed to investigate the zero‐order association between FI and eating disorder psychopathology. Hierarchical linear regressions were used to explore whether FI could explain meaningful variance in eating disorder psychopathology beyond psychological distress and demographic covariates (e.g., socioeconomic status). Results: FI was significantly associated with higher eating disorder psychopathology for boys (r = 0.44, p < 0.001) and girls (r = 0.43, p < 0.001), with medium‐to‐large effect sizes. FI accounted for significant unique variance in eating disorder psychopathology beyond psychological distress and demographic covariates for boys (ΔR2 = 0.14, p < 0.001) and girls (ΔR2 = 0.10, p < 0.001). Discussion: Using a large sample of rural Chinese adolescents, this study extends the connection between FI and eating disorder pathology in adolescents beyond the Western context. Future investigations on the mechanisms underlying FI and eating disorder psychopathology are warranted for developing prevention strategies for eating disorders among rural Chinese adolescents. Public Significance: This is the first investigation that examined the link between FI and eating disorder psychopathology among rural Chinese adolescents. Our findings highlight the importance of incorporating FI as a potential risk factor to screen for the prevention and intervention of eating disorders among rural Chinese adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Generalized pustular psoriasis (GPP) is a rare and severe psoriasis subtype characterized by the rapid onset of coalescing sterile pustules over broad body areas and systemic inflammation. Data on its clinical course and outcomes in Taiwan are limited. We evaluated the clinical profile and outcomes of patients with GPP flares in Taiwan. Methods: This retrospective analysis included adult patients with moderate-to-severe GPP flares occurring in January 2008–December 2021. Data were extracted from medical charts and electronic health records in the Chang Gung Research Database. Statistical analyses were performed using SAS for Windows (version 9.4). Multivariate Poisson regression models were built to investigate different predictors of GPP flare rate. Results: Thirty-four patients with 81 moderate-to-severe GPP flares were identified. Of the 14 patients undergoing genetic analysis, 10 (71.4%) had an IL36RN mutation. Patients' mean age at the index GPP flare was 47.1 ± 16.5 years; 58.0% of the flares were severe, while 42.0% were moderate. Overall, 96.3% of GPP flares were treated with at least one systemic therapy, acitretin being the most prescribed (85.2%), followed by cyclosporine (45.7%) and methotrexate (18.5%). After treatment, the proportion of flares responding positively increased from 0% on day 2 to 6.2% by week 12. Patients were newly diagnosed with psoriasis (23.5%), hypertension (20.6%), diabetes mellitus (14.7%), psoriatic arthritis (2.9%), malignant tumor (8.8%), and depression/anxiety (2.9%) after enrollment. Complications occurring within 12 weeks of GPP flares included arthritis (25.9% of the flares), skin infection (8.6%), and other infections (2.5%). No fatalities were reported. In the multivariate model, former smokers, patients with hepatic disease, and patients with psoriatic arthritis had an increased GPP rate ratio (RR) of 13.33 (95% confidence interval, CI, 2.87–61.78), 14.08 (95% CI 3.04–65.29), and 34.84 (95% CI 4.77- 254.42), respectively. Contrarily, obese and rheumatoid arthritis patients had a lower GPP rate ratio of 0.21 (95% CI 0.08–0.54) and 0.07 (95% CI 0.006–0.78), respectively. Conclusions: Our findings highlight the complexity of GPP flare presentations and the need for individualized, patient-centered management approaches and continued research to improve affected individuals' care and outcomes. [ABSTRACT FROM AUTHOR]

It is known that the determination of the good-dice-in-bad-neighborhoods (GDBNs) has been regarded as an effective technique to reduce the value of the defect parts per million (DPPM) by identifying and rejecting the suspicious dice even though they are good in testing. Instead of examining eight immediate neighbors in a small-sized $3\times 3$ window or exploiting simple linear regression, a large-sized window can be used to recognize the broad-sighted neighborhoods and accurately infer the suspiciousness level for any given die. In this paper, the artificial neural networks (ANN)-based method can be proposed to solve the GDBN identification. Furthermore, two enhanced techniques can be further presented to improve the inference accuracy of the original ANN-based method by considering the variation of the time-dependent wafer patterns and the wafer-to-wafer relationship between two adjacent wafers. After applying the two enhanced techniques, the business profits can be improved in the new ANN-based method. Various experiments on two datasets clearly reveal the superiority of the proposed ANN-based method over the other existing methods. In addition to the reduction of the DPPM value, the new ANN-based method can achieve the 1.5X–2X better reduction in the cost of the return merchandise authorization (RMA). On the other hand, the experimental results show that the similar result can also be obtained in the other lower-yield products. By using the new ANN-based method, the relationships on bad dice cross wafers can be captured and the highly-accurate inference results can be simultaneously maintained. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is associated with cardiac conduction defects and is a strong risk factor for heart failure. Complete left bundle branch block (cLBBB), a cardiac conduction abnormality, may have an unfavorable effect on ventricular mechanical synchrony and lead to the progression of heart failure. Once heart failure develops, it seems to act together with underlying CKD in a vicious circle. Therefore, this study aimed to explore the influence of CKD in patients with cLBBB by assessing the estimated glomerular filtration rate (eGFR). We examined a hospital-based sample of 416 adult patients with cLBBB from 2010 to 2013. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Cox proportional hazard models were used to estimate the hazard ratio for all-cause mortality and cardiovascular mortality. A total of 416 adult patients with a mean age of 71 ± 13 years were enrolled. The median follow-up period was 3.6 years. After adjusting for clinical, electrocardiographic parameters, and medication use, cox regression analysis showed that total mortality was significantly associated with older age (Hazard Ratio (HR) = 1.03, 95% CI = 1.01–1.05, p = 0.002), presence of congestive heart failure (HR = 2.39, 95% CI = 1.63–3.49, p < 0.001), advanced CKD (HR = 2.48, 95% CI = 1.71–3.59, p < 0.001), higher HR (HR = 1.02, 95% CI = 1.01–1.03, p < 0.001) and without use of ACEI/ARB (HR = 0.59, 95% CI = 0.41–0.85, p = 0.005) were independent predictors of the total mortality. Multivariate Cox hazard regression analysis demonstrated that, in comparison to patients lacking cLBBB, the coexistence of CKD (eGFR < 60 mL/min/1.73 m2) among those with LBBB significantly heightened the risks of both total mortality (HR ratio of 5.01 vs. 2.40) and CV death (HR ratio of 61.78 vs. 14.41) even following adjustment for clinical covariates and ECG parameters. In summary, within patients exhibiting cLBBB, the presence of CKD serves as a significant risk factor for all-cause mortality. [ABSTRACT FROM AUTHOR]

Aims: The PIONEER‐HF and PARAGLIDE‐HF trials aimed to determine the efficacy and safety of the in‐hospital initiation of sacubitril/valsartan in patients hospitalized for AHF. However, whether the inclusion and exclusion criteria of the trials apply to patients encountered in real‐world routine care is unclear. This study aimed to investigate the applicability of the PIONEER‐HF and PARAGLIDE‐HF trials to real‐world AHF patients. Methods and results: We identified 28 293 AHF hospitalized patients between August 2008 to August 2017 from the Chang Gung Research Database and classified them into four groups based on left ventricular ejection fraction (LVEF) and trial criteria. Cox proportional hazards models were used to compare the risk of HF hospitalization and cardiovascular (CV) death. We defined PIONEER‐HF eligible (n = 3683) and non‐eligible (n = 3502) patients with an LVEF ≤40%, and PARAGLIDE‐HF eligible (n = 5191) and non‐eligible (n = 5832) patients with an LVEF >40%. Over a mean follow‐up of 3.5 years, the PIONEER‐HF non‐eligible and eligible groups exhibited similar rates of HF hospitalization and CV death (41.1% vs. 41.8%, adjusted hazard ratio [aHR]: 0.95; 95% CI: 0.88–1.04). No significant difference was found in the composite outcome between PARAGLIDE‐HF non‐eligible and eligible groups (36.7% vs. 38.6%; aHR: 0.97; 95% CI: 0.90–1.04). Conclusions: Using trial criteria, only 31.3% of AHF patients were eligible for sacubitril–valsartan. Yet, non‐eligible patients demonstrated similar outcomes to eligible patients, indicating a need for further evaluation of sacubitril–valsartan benefits in non‐eligible AHF patients. [ABSTRACT FROM AUTHOR]

The recent rapid advancements in both sensing and machine learning technologies have given rise to the universal collection and utilization of people's biometrics, such as fingerprints, voices, retina/facial scans, or gait/motion/gestures data, enabling a wide range of applications including authentication, health monitoring, or much more sophisticated analytics. While providing better user experiences and deeper business insights, the use of biometrics has raised serious privacy concerns due to their intrinsic sensitive nature and the accompanying high risk of leaking sensitive information such as identity or medical conditions. In this paper, we propose a novel modality-agnostic data transformation framework that is capable of anonymizing biometric data by suppressing its sensitive attributes while retaining features relevant to downstream machine learning-based analyses that are of research and business values. We carried out a thorough experimental evaluation using publicly available facial, voice, motion, and EEG datasets. Results show that our proposed framework can achieve a high suppression level for sensitive information, while at the same time retain underlying data utility such that subsequent analyses on the anonymized biometric data could still be carried out to yield satisfactory accuracy. [ABSTRACT FROM AUTHOR]

To reduce environmental pollution and conserve natural resources, calcined oyster shell ash (COSA), class F fly ash (FFA) and flue gas desulfurisation gypsum (FGDG) were used in an attempt to improve the engineering properties of alkali-activated ternary cementitious paste. The COSA – obtained by calcining crushed oyster shells at 800°C for 3 h and then grinding to pass through a no. 100 sieve – was used to substitute FFA at rates of 2.5, 5.0 and 7.5 mass%. The alkali solution used was 10M sodium hydroxide and sodium silicate with a modulus of 2.5. The hardened paste with 7.5% COSA, 1% FGDG and ratio of weight of added water to dry binder of 0.09 at 56 days had the highest compressive strength of 62 MPa. Microstructural analyses (scanning electron microscopy and energy-dispersive X-ray spectroscopy) showed that the resulting calcium aluminosilicate hydrate gel was found to have a compact microstructure, which improved the compressive strength of specimens. In summary, COSA successfully replaced natural limestone as a calcium oxide activator to manufacture an alkali-activated ternary cementitious paste containing FFA and FGDG. [ABSTRACT FROM AUTHOR]

Objectives: Manual compression (MC) or vascular closure devices (VCDs) are used to achieve hemostasis after percutaneous transluminal angioplasty (PTA). However, limited data on the comparative safety and effectiveness of VCDs vs MC in patients with end-stage renal disease (ESRD) undergoing PTA are available. Accordingly, this study compared the safety and effectiveness of VCD and MC in patients with ESRD undergoing PTA. Methods: This single-center retrospective cohort study included the data of patients with ESRD undergoing peripheral intervention at Chang Gung Memorial Hospital, Taiwan, from January 1, 2019, to June 30, 2022. The patients were divided into VCD and MC groups. The primary endpoint was a composite of puncture site complications, including acute limb ischemia, marked hematoma, pseudoaneurysm, and puncture site bleeding requiring blood transfusion. Results: We included 264 patients with ESRD undergoing PTA, of whom 60 received a VCD and 204 received MC. The incidence of puncture site complications was 3.3% in the VCD group and 4.4% in the MC group (hazard ratio:.75; 95% confidence interval:.16-3.56 L P = 1.000), indicating no significant between-group difference. Conclusion: VCDs and MC had comparable safety and effectiveness for hemostasis in patients with ESRD undergoing peripheral intervention. [ABSTRACT FROM AUTHOR]

Many-body localization (MBL) of a disordered interacting boson system in one dimension is studied numerically at the filling faction one-half. The von Neumann entanglement entropy SvN is commonly used to detect the MBL phase transition but remains challenging to be directly measured. Based on the U(1) symmetry from the particle number conservation, SvN can be decomposed into the particle number entropy SN and the configuration entropy SC. In light of the tendency that the eigenstate’s SC nears zero in the localized phase, we introduce a quantity describing the deviation of SN from the ideal thermalization distribution; finite-size scaling analysis illustrates that it shares the same phase transition point with SvN but displays the better critical exponents. This observation hints that the phase transition to MBL might largely be determined by SN and its fluctuations. Notably, the recent experiments [A. Lukin, et al., Science 364, 256 (2019); J. Léonard, et al., Nat. Phys. 19, 481 (2023)] demonstrated that this deviation can potentially be measured through the SN measurement. Furthermore, our investigations reveal that the thermalized states primarily occupy the low-energy section of the spectrum, as indicated by measures of localization length, gap ratio, and energy density distribution. This low-energy spectrum of the Bose model closely resembles the entire spectrum of the Fermi (or spin XXZ) model, accommodating a transition from the thermalized to the localized states. While, owing to the bosonic statistics, the high-energy spectrum of the model allows the formation of distinct clusters of bosons in the random potential background. We analyze the resulting eigenstate properties and briefly summarize the associated dynamics. To distinguish between the phase regions at the low and high energies, a probing quantity based on the structure of SvN is also devised. Our work highlights the importance of symmetry combined with entanglement in the study of MBL. In this regard, for the disordered Heisenberg XXZ chain, the recent pure eigenvalue analyses in [J. Suntajs, et al., Phys. Rev. E 102, 062144 (2020)] would appear inadequate, while methods used in [A. Morningstar, et al., Phys. Rev. B 105, 174205 (2022)] that spoil the U(1) symmetry could be misleading. [ABSTRACT FROM AUTHOR]

In recent years, airlines have been expanding their fleets, but this has posed a challenge in terms of limited airport space for maintenance facilities. Maintenance, repair, and overhaul provider (MRO) enhances the efficiency of existing space utilization by reducing the distance between parked aircraft. However, it is often necessary to change the position of parked aircraft during maintenance and if there are other aircraft blocking this movement it is necessary to interrupt the original maintenance work to allow the aircraft to pass. Unnecessary relocation of aircraft could reduce maintenance efficiency and increase costs. This study adopts mathematical programming with a network flow technique to develop an MRO stand allocation model. The effectiveness of the proposed model is evaluated in a case study performed using the data collected from a Taiwan aircraft MRO service provider. The results demonstrate that the proposed model could be a useful and practical planning support tool. [ABSTRACT FROM AUTHOR]

Background: The global prospective surveillance data showed the re-emergence of mycoplasma pneumoniae pneumonia (MPP) in Europe and Asia after the coronavirus disease 2019 pandemic. We sought to observe the effect of macrolide antibiotics in the treatment of MPP carrying a macrolide-resistant mutation gene and the potential of targeted next-generation sequencing (tNGS) as a front-line diagnostic in MPP patients. Methods: The baseline characteristics of 91 children with MPP hospitalized from January to October 2023 were retrospectively analyzed. They were divided into two groups according to whether carrying the macrolide-resistant mutation or not. The logistic and linear regression analyses were used to determine whether the mutation was a standalone predictive predictor of the duration of fever and hospital length of stay. Results: First, no patients had a fever for ≥ 7 days after macrolide treatment. But length of stay and hormone concentration were significantly different between the two groups (P < 0.05). There were also no statistical association between the mutation and the duration of fever and hospital length of stay. Conclusion: Macrolides can be administered to MPP children carrying a macrolide-resistant mutation. tNGS can be seen as a front-line diagnostic in MPP. [ABSTRACT FROM AUTHOR]

Radiation proctopathy (RP) is a common complication of radiotherapy for pelvic malignancies with high incidence. RP accompanies by microbial dysbiosis. However, how the gut microbiota affects the disease remains unclear. Here, metabolomics reveals that the fecal and serous concentrations of microbiota‐derived 3‐hydroxybutyrate (3HB) are significantly reduced in RP mice and radiotherapeutic patients. Moreover, the concentration of 3HB is negatively associated with the expression of proinflammatory IL6 that is increased along with the severity of radiation damage. 3HB treatment significantly downregulates IL6 expression and alleviates IL6‐mediated radiation damage. Irradiated cell‐fecal microbiota co‐culture experiments and in vivo assays show that such a radioprotection of 3HB is mediated by GPR43. Microbiome analysis reveals that radiation leads to a distinct bacterial community compared to untreated controls, in which Akkermansia muciniphila is significantly reduced in RP mice and radiotherapeutic patients and is associated with lower 3HB concentration. Gavage of A. muciniphila significantly increases 3HB concentration, downregulates GPR43 and IL6 expression, and ameliorates radiation damage. Collectively, these results demonstrate that the gut microbiota, including A. muciniphila, induce higher concentrations of 3HB to block GPR43‐mediated IL6 signaling, thereby conferring radioprotection. The findings reveal a novel implication of the gut‐immune axis in radiation pathophysiology, with potential therapeutic applications. [ABSTRACT FROM AUTHOR]

Background: Recently, there have been conflicting results reporting an increased risk of AR or MR associated with oral fluoroquinolones (FQs).This study investigated whether the use of FQs increases the risk of mitral regurgitation (MR) or aortic regurgitation (AR). Methods: A retrospective cohort study was conducted by using the Taiwan National Health Insurance research database. A unidirectional case-crossover design without selecting controls from an external population was adopted in this study. A total of 26,650 adult patients with new onset of AR or MR between January 1, 2000, and December 31, 2012, were identified. The risk of outcomes was compared between the hazard period and one of the randomly selected referent periods of the same individuals. Results: Before exclusion of pneumonia diagnosed within 2 months before the index date, patients who took FQs had a significantly greater risk of AR or MR (adjusted odds ratio [aOR] 1.51, 95% confidence interval [CI] 1.30–1.77), any AR (combined AR and MR) (aOR 1.50, 95% CI 1.10–2.04), and any MR (combined AR and MR) (aOR 1.37, 95% CI 1.16–1.62). After exclusion of pneumonia, FQs exposure remained significantly associated with a greater risk of MR (aOR 1.38, 95% CI 1.17–1.62) and any MR (aOR 1.25, 95% CI 1.05–1.48). Conclusions: The findings suggested that patients treated with FQs could be warned about the potential risk for MR even after considering the possibility of protopathic bias. Reducing unnecessary FQs prescriptions may be considered to reduce the risk of valvular heart disease. [ABSTRACT FROM AUTHOR]

To address challenges in locating high-impedance grounding faults (HIGFs) and isolating fault areas in resonant grounding systems, this paper proposes a novel fault identification method based on coordinating a Peterson coil and a resistance grounding system. This method ensures power supply reliability by extinguishing the fault arc during transient faults with the Peterson coil. When a fault is determined to be permanent, the neutral point switches to a resistance grounding mode, ensuring regular distribution of zero-sequence currents in the network, thereby addressing the challenges of HIGF localization and fault area isolation. Fault calibration and nature determination rely on recognizing neutral point displacement voltage waveforms and dynamic characteristics, eliminating interference from asymmetric phase voltage variations. Fault area identification involves assessing the polarity of zero-sequence current waveforms attenuation during grounding mode switching, preventing misjudgments in grounding protection due to random initial fault angles and Peterson coil compensation states. Field experiments validate the feasibility of this fault location method and its control strategy. [ABSTRACT FROM AUTHOR]

In this article, the multidisciplinary team of the Taiwan Academy of Tumor Ablation, who have expertise in treating lung cancer, present their perspectives on percutaneous image‐guided thermal ablation (IGTA) of lung tumors. The modified Delphi technique was applied to reach a consensus on clinical practice guidelines concerning ablation procedures, including a comprehensive literature review, selection of panelists, creation of a rating form and survey, and arrangement of an in‐person meeting where panelists agreed or disagreed on various points. The conclusion was a final rating and written summary of the agreement. The multidisciplinary expert team agreed on 10 recommendations for the use of IGTA in the lungs. These recommendations include terms and definitions, line of treatment planning, modality, facility rooms, patient anesthesia settings, indications, margin determination, post‐ablation image surveillance, qualified centers, and complication ranges. In summary, IGTA is a safe and feasible approach for treating primary and metastatic lung tumors, with a relatively low complication rate. However, decisions regarding the ablation technique should consider each patient's specific tumor characteristics. [ABSTRACT FROM AUTHOR]

Self-assembled DNA nanostructures hold great promise in biosensing, drug delivery and nanomedicine. Nevertheless, challenges like instability and inefficiency in cellular uptake of DNA nanostructures under physiological conditions limit their practical use. To tackle these obstacles, this study proposes a novel approach that integrates the cationic polymer polyethyleneimine (PEI) with DNA self-assembly. The hypothesis is that the positively charged linear PEI can facilitate the self-assembly of DNA nanostructures, safeguard them against harsh conditions and impart them with the cellular penetration characteristic of PEI. As a demonstration, a DNA nanotube (PNT) was successfully synthesized through PEI mediation, and it exhibited significantly enhanced stability and cellular uptake efficiency compared to conventional Mg2+-assembled DNA nanotubes. The internalization mechanism was further found to be both clathrin-mediated and caveolin-mediated endocytosis, influenced by both PEI and DNA. To showcase the applicability of this hybrid nanostructure for biomedical settings, the KRAS siRNA-loaded PNT was efficiently delivered into lung adenocarcinoma cells, leading to excellent anticancer effects in vitro. These findings suggest that the PEI-mediated DNA assembly could become a valuable tool for future biomedical applications. [ABSTRACT FROM AUTHOR]

Organophosphate hydrolysis is important for degrading environmentally harmful compounds and recovering phosphate ions in biological molecules. CeO2 nanoparticles have been well-studied for dephosphorylation via hydrolysis owing to the accessible and tunable distribution of Ce3+ and Ce4+ ions. However, there remains uncertainty in the literature regarding which surface defect properties direct catalytic activity, such as the Ce3+/Ce4+ distribution, oxygen vacancies, faceting, and dopants, and to what degree they contribute to efficient hydrolysis. Trivalent (M3+) dopants serve as a tool for manipulating defects, including the concentration of Ce3+ and oxygen vacancies, thereby influencing the hydrolytic activity of CeO2. Herein, trivalent metal ions (M = Y3+, Cr3+, In3+, and Gd3+) were employed to modulate the active sites on the CeO2 nanoparticle surface, and their effects on organophosphate hydrolysis were investigated. M-doped CeO2 nanoparticles were synthesized via hydrothermal methods, followed by annealing to remove ligands and prime the nanocrystal surface for catalysis. Catalytic performance was evaluated using dimethyl-p-nitrophenyl phosphate (DMNP) as a model organophosphate substrate, with degradation monitored over time using ultraviolet–visible (UV–vis) absorption spectroscopy. Powder X-ray diffraction (PXRD), X-ray photoelectron spectroscopy (XPS), and Raman spectroscopy revealed successful doping of CeO2 in all cases, albeit with distinctive characteristics demonstrating how M3+ dopants affect catalysis. We show that CeO2 exhibits high sensitivity to dopants that generate Ce3+ ions, oxygen vacancy defects, and lattice strain. Consequently, achieving high catalytic efficiency within CeO2 requires a balanced active site ensemble, wherein defects are maintained at optimal concentrations and distributions on the nanocrystal surface. [ABSTRACT FROM AUTHOR]

Carbon-based materials have large specific surface area, well-developed pores, and a large number of oxygencontaining functional groups on the surface, which have excellent mechanical properties. Introducing carbon-based materials into the hydrogel system can increase adsorption sites, improve mechanical properties, enrich network structure, realize complementary advantages, and overcome performance defects, which is the main idea for developing highperformance hydrogel adsorbents. In this paper, the structural characteristics of different types of carbon based composite hydrogels were summarized, and the mechanism of carbon based materials to enhance the performance of hydrogels was emphatically introduced. The preparation methods of composite hydrogels and their applications in the field of water purification were reviewed. The prospects, limitations and future research potential of carbon based composite hydrogels adsorbents were analyzed. [ABSTRACT FROM AUTHOR]

Introduction: Post-thrombectomy intraparenchymal hyperdensity (PTIH) in patients with acute ischemic stroke is a common CT sign, making it difficult for physicians to distinguish intracerebral hemorrhage in the early post-thrombectomy period. The aim of this study was to develop an effective model to differentiate intracerebral hemorrhage from contrast extravasation in patients with PTIH. Methods: We retrospectively collected information on patients who underwent endovascular thrombectomy at two stroke centers between August 2017 and January 2023. A total of 222 patients were included in the study, including 118 patients in the development cohort, 52 patients in the internal validation cohort, and 52 patients in the external validation cohort. The nomogram was constructed using R software based on independent predictors derived from the multivariate logistic regression analysis, including clinical factors and CT texture features extracted from hyperdense areas on CT images. The performance and accuracy of the derived nomogram were assessed by the area under the receiver operating characteristic curve (AUC-ROC) and calibration curves. Additionally, decision curve analysis was conducted to appraise the clinical utility of the nomogram. Results: Our nomogram was derived from two clinical factors (ASPECT score and onset to reperfusion time) and two CT texture features (variance and uniformity), with AUC-ROC of 0.943, 0.930, and 0.937 in the development, internal validation, and external validation cohorts, respectively. Furthermore, the calibration plot exhibited a strong agreement between the predicted outcome and the actual outcome. In addition, the decision curve analysis revealed the clinical utility of the nomogram in accurately predicting hemorrhage in patients with PTIH. Conclusion: The developed nomogram, based on clinical factors and CT texture features, proves to be effective in distinguishing intracerebral hemorrhage from contrast extravasation in patients with PTIH. [ABSTRACT FROM AUTHOR]

OBJECTIVES Thoracoscopic segmentectomy is the recommended treatment option for small peripheral pulmonary nodules. To assess the ability of preoperative three-dimensional (3D) reconstruction computed tomography (CT) to shorten the operative time and improve perioperative outcomes in thoracoscopic segmentectomy compared with standard chest CT, we conducted this randomized controlled trial. METHODS The DRIVATS study was a multicentre, randomized controlled trial conducted in 3 hospitals between July 2019 and November 2023. Patients with small peripheral pulmonary nodules not reaching segment borders were randomized in a 1:1 ratio to receive either 3D reconstruction CT or standard chest CT before thoracoscopic segmentectomy. The primary end-point was operative time. The secondary end-points included incidence of postoperative complications, intraoperative blood loss and operative accident event. RESULTS A total of 191 patients were enrolled in this study: 95 in the 3D reconstruction CT group and 96 in the standard chest CT group. All patients underwent thoracoscopic segmentectomy except for 1 patient in the standard chest CT group who received a wedge resection. There is no significant difference in operative time between the 3D reconstruction CT group (median, 100 min [interquartile range (IQR), 85–120]) and the standard chest CT group (median, 100 min [IQR, 81–140]) (P  =   0.82). Only 1 intraoperative complication occurred in the standard chest CT group. No significant difference was observed in the incidence of postoperative complications between the 2 groups (P  =   0.52). Other perioperative outcomes were also similar. CONCLUSIONS In patients with small peripheral pulmonary nodules not reaching segment borders, the use of 3D reconstruction CT in thoracoscopic segmentectomy was feasible, but it did not result in significant differences in operative time or perioperative outcomes compared to standard chest CT. [ABSTRACT FROM AUTHOR]

OBJECTIVES The evaluation of Fontan-associated liver disease is often challenging. Diffusion-weighted magnetic resonance imaging can detect hepatic fibrosis from capillary perfusion and diffusion abnormalities from extracellular matrix accumulation. This study investigated its role in the evaluation of liver disease in Fontan patients and explored possible diagnostic methods for early detection of advanced liver fibrosis. METHODS Stable adult Fontan patients who could safely be examined with magnetic resonance imaging were enrolled, and blood biomarkers, transient elastography were also examined. RESULTS Forty-six patients received diffusion-weighted imaging; and 58.7% were diagnosed with advanced liver fibrosis (severe liver fibrosis, 37.0%, and cirrhosis 21.7%). Two parameters of hepatic dysfunction, platelet counts (Spearman's ρ: –0.456, P  = 0.001) and cholesterol levels (Spearman's ρ: –0.383, P  = 0.009), decreased with increasing severity of fibrosis. Using transient elastography, a cut-off value of 14.2 kPa predicted the presence of advanced liver fibrosis, but with a low positive predictive value. When we included platelet count, cholesterol, post-Fontan years and transient elastography values as a composite, the capability of predicting advanced liver fibrosis was the most satisfactory (C statistic 0.817 ± 0.071, P  < 0.001). A cut-off value of 5.0 revealed a sensitivity of 78% and a specificity of 82%. CONCLUSIONS In Fontan patients, diffusion-weighted imaging was helpful in detecting liver fibrosis that was correlated with hepatic dysfunction. A simple score was proposed for long-term surveillance and early detection of advanced liver disease in adult Fontan patients. For adult Fontan patients with a calculated score > 5.0, we may consider timely diffusion-weight imaging and early management for liver complications. [ABSTRACT FROM AUTHOR]

Gene therapy based on the CRISPR/Cas9 system has emerged as a promising strategy for treating the monogenic fragile skin disorder recessive dystrophic epidermolysis bullosa (RDEB). With this approach problematic wounds could be grafted with gene edited, patient‐specific skin equivalents. Precise gene editing using homology‐directed repair (HDR) is the ultimate goal, however low efficiencies have hindered progress. Reframing strategies based on highly efficient non‐homologous end joining (NHEJ) repair aimed at excising dispensable, mutation‐harboring exons offer a promising alternative approach for restoring the COL7A1 open reading frame. To this end, we employed an exon skipping strategy using dual single guide RNA (sgRNA)/Cas9 ribonucleoproteins (RNPs) targeted at three novel COL7A1 exons (31, 68, and 109) containing pathogenic heterozygous mutations, and achieved exon deletion rates of up to 95%. Deletion of exon 31 in both primary human RDEB keratinocytes and fibroblasts resulted in the restoration of type VII collagen (C7), leading to increased cellular adhesion in vitro and accurate C7 deposition at the dermal‐epidermal junction in a 3D skin model. Taken together, we extend the list of COL7A1 exons amenable to therapeutic deletion. As an incidental finding, we find that long‐read Nanopore sequencing detected large on‐target structural variants comprised of deletions up to >5 kb at a frequency of ~10%. Although this frequency may be acceptable given the high rates of intended editing outcomes, our data demonstrate that standard short‐read sequencing may underestimate the full range of unexpected Cas9‐mediated editing events. [ABSTRACT FROM AUTHOR]

The study aimed to validate a newly developed postoperative stability score for evaluating clinical follow-up in elderly patients with low-energy hip fractures. From 1 January 2020 to 31 December 2021, we enrolled patients aged over 65 who underwent cephalomedullary nail fixation using proximal femoral nail antirotation II (PFNAII) and had at least 6 months of follow-up; excluding multiple fractures, pathological fractures, and periprosthetic fractures. We collected general patient data. Parameters such as TAD, Parker's ratio (AP and lateral), and the new postoperative stability score were recorded. A loss of reduction was defined using the decline in the Chang reduction quality criteria (CRQC) score within one month. Among the 108 enrolled patients, 23 (21.3%) experienced a loss of reduction, with a mean age of 82.1 years and a mean follow-up time of 7.4 months. Univariate analysis showed no significant association between loss of reduction and general data. However, the new postoperative stability score correlated significantly with loss of reduction (mean scores: 6.68 vs. 4.83, p = 0.045). Multivariate analysis confirmed this association (odds ratio: 0.076, 95% confidence interval: 0.022–0.263, p < 0.05). The newly developed postoperative stability score, incorporating surgical technique assessment, improves prediction accuracy for loss of reduction in elderly intertrochanteric fracture (ITF) patients. [ABSTRACT FROM AUTHOR]

Background: Myocardial bridging (MB) is a congenital coronary anomaly and an important cause of chest pain. The long-term effects of MB on cardiovascular events remain elusive. Methods: We used the National Health Insurance Research Database of Taiwan to conduct an analysis. All patients who had undergone coronary angiography were considered for inclusion. The primary endpoint was a composite of nonfatal myocardial infarction, nonfatal ischemic stroke, and cardiovascular death. Results: We identified 10,749 patients from 2008 to 2018 and matched them with an equal number of controls by propensity-score matching. The mean follow-up period was 5.78 years. In patients without coronary artery disease, MB increased the risk of the composite endpoint (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.44–1.72, p < 0.001), which was driven by increased risks of nonfatal myocardial infarction and cardiovascular death. In patients with significant coronary artery disease, MB did not increase the risk of major adverse cardiovascular events. MB was identical to insignificant coronary artery disease from the viewpoint of clinical outcomes. Conclusions: The presence of MB significantly increases cardiovascular risks in patients with normal coronary vessels. Atherosclerotic coronary artery disease mitigates the effect of MB on cardiovascular outcomes. MB can be considered an insignificant coronary artery disease equivalent. [ABSTRACT FROM AUTHOR]

Background: Endocrine-disrupting chemicals (EDCs) are pervasive in everyday environments. The impacts of these chemicals, along with EDC-related lifestyle and dietary habits on neurocognitive function, are not well understood. Methods: The Chang Gung Community Medicine Research Center conducted a cross-sectional study involving 887 participants. From this initial cohort, 120 individuals were selected based on their EDC exposure scores for detailed analysis. Among these, 67 participants aged 55 years or older were further chosen to undergo cognitive impairment assessments using the Ascertain Dementia-8 (AD-8) questionnaire. Results: These 67 older participants did not significantly differ in age, albuminuria, or estimated glomerular filtration rate compared to those with lower impairment scores. This study revealed that mono-(2-ethylhexyl) phthalate (MEHP) levels (8.511 vs. 6.432 µg/g creatinine, p = 0.038) were associated with greater risk of cognitive impairment (AD-8 ≥ 2). Statistical models adjusting for age, gender, and diabetes indicated that MEHP levels positively correlated with AD-8 scores, achieving statistical significance in more comprehensive models (β ± SE: 0.160 ± 0.076, p = 0.042). Logistic regression analysis underscored a significant positive association between high MEHP levels and higher AD-8 scores (odds ratio: 1.217, p = 0.006). Receiver operating characteristic curves highlighted the association of high MEHP levels and EDC exposure scores for significant cognitive impairment, with areas under the curve of 66.3% and 66.6%, respectively. Conclusion: Exposure to EDCs, specifically di-(2-ethylhexyl) phthalate, the precursor to MEHP, may be associated with neurocognitive impairment in middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Due to a unique cortical venous drainage pattern without sinus drainage, ethmoidal dural arteriovenous fistula (DAVF) are uncommon cerebral vascular lesions that carry a high risk of brain bleeding and neurologic deficit. Surgical intervention has been found to have a lower complication rate and a more satisfactory obliteration rate than endovascular treatment among the various DAVF treatment options. The supraorbital keyhole subfrontal approach is one of the least invasive and appropriate surgical techniques for addressing the anterior fossa vascular lesion in eDAVFs. We describe two men, ages 60 and 71, who underwent this surgical intervention to treat asymptomatic Cognard type IV eDAVFs. Complete obliteration with a detached fistulous point and skeletonization was accomplished with the aid of intraoperative neuronavigation. Thus, we suggest that a suitable surgical method for the treatment of eDAVFs would be to use a supraorbital keyhole subfrontal approach. [ABSTRACT FROM AUTHOR]

Calcium silicate (CaSi) bone cement with antibacterial and osteogenic properties has attracted significant interest. However, there is a need to develop a variety of new premixed bone cement to meet the clinical requirements of fast setting time, ease of handling, and efficient antibacterial properties. In this study, different volume ratios of polyethylene glycol (PEG) and lactic acid liquids were added to calcium silicate, and the effects of varying liquid-to-powder ratios (L/P) were examined. This study assessed the physicochemical properties, cytotoxicity, and antibacterial activity against S. aureus and E. coli of this premixed cement. The results from the experiments indicated that lactic acid significantly reduced the setting time of the CaSi-based cement and enhanced its mechanical strength. Furthermore, the appropriate concentration of lactic acid and matching L/P ratio improved its washout resistance. The cell viability of all premixed cement was found to be over 80%. The premixed cement containing PEG and lactic acid exhibited superior antibacterial properties compared to the CaSi control. Based on its setting time, washout resistance, and antibacterial activity, a premixed cement with a liquid phase of 80% PEG and 20% lactic acid at an L/P ratio of 0.4 appeared promising for use in dental and orthopedic practice. [ABSTRACT FROM AUTHOR]

Background: Patients with autoimmune diseases (AD) generally carry an increased risk of developing cancer. However, the effect of AD in hepatocellular carcinoma (HCC) patients receiving surgical treatment is uncertain. The present study aimed to investigate the potential influence of AD on the survival of HCC patients undergoing hepatectomies. Methods: Operated HCC patients were identified from the Chang Gung Research Database, and the survival outcomes of HCC patients with or without AD were analyzed ad compared. Cox regression model was performed to identify significant risk factors associated with disease recurrence and mortality. Results: From 2002 to 2018, a total of 5532 patients underwent hepatectomy for their HCC. Among them, 229 patients were identified to have AD and 5303 were not. After excluding cases who died within 30 days of surgery, the estimated median overall survival (OS) was 43.8 months in the AD (+) group and 47.4 months in the AD (–) group (P = 0.367). The median liver-specific survival and disease-free survival (DFS) were also comparable between the two groups. After Cox regression multivariate analysis, the presence of AD did not lead to a higher risk of all-cause mortality, liver-specific mortality, or disease recurrence. Conclusion: Our study demonstrated that autoimmune disease does not impair the OS and DFS of HCC patients undergoing liver resections. AD itself is not a risk factor for tumor recurrence after surgery. Patients eligible for liver resections, as a result, should be considered for surgery irrespective of the presence of AD. Further studies are mandatory to validate our findings. [ABSTRACT FROM AUTHOR]

Bandstop filters (BSFs) have many applications in suppressing interference signals and shielding specific bands. Among them, reconfigurable BSFs that cover more frequency bands by switching modes have great research value. In this paper, a novel synthesis approach for compact reconfigurable BSFs with controllable equal-ripple performance is proposed. By switching the ON/OFF state of the positive intrinsic negative (PIN) diode, the proposed reconfigurable BSF can be switched between single-BSF (S-BSF) and dual-BSF (D-BSF). Based on the synthesis approach, the equal-ripple levels of stopband and passband for S-BSF and D-BSF can be independently controlled. To verify, the equal-ripple levels of stopband and passband for S-BSF state and D-BSF state are independently controlled in four groups of examples. Finally, a reconfigurable BSF with a miniaturized size is designed and fabricated. The fabricated reconfigurable BSF behaves with 15 dB and 10 dB return loss (RL) in two different passbands of the D-BSF state, and 25 dB bandpass RL and controllable stopband rejection (SR) for the S-BSF state. The measured results are in good agreement with the electromagnetic (EM) simulation results. [ABSTRACT FROM AUTHOR]

Background Atezolizumab plus bevacizumab (atezo-bev) has been recommended for advanced hepatocellular carcinoma (HCC). High-dose external beam radiotherapy (RT) is recognized for its excellent local tumor control. The efficacy and safety of concurrent atezo-bev with RT for highly advanced HCC has been minimally explored. Methods In this preliminary retrospective study, we assessed patients with highly advanced HCC, characterized by Vp4 portal vein thrombosis or tumors exceeding 50% of liver volume, who received concurrent atezo-bev and RT (group A). Group A included 13 patients who received proton radiation at a dose of 72.6 GyE in 22 fractions, and one patient who received photon radiation at a dose of 54 Gy in 18 fractions. This group was compared with 34 similar patients treated atezo-bev alone as a control (group B). The primary objectives were to evaluate the objective response rate (ORR), overall survival (OS), and safety. Results Baseline characteristics were similar between groups, except for a higher incidence of Vp4 portal vein thrombosis in group A (78.6% vs. 21.4%, P  = .05). Group A achieved a higher ORR (50.0% vs. 11.8%, P  < .01) and a longer OS (not reached vs. 5.5 months, P  = .01) after a median follow-up of 5.2 months. Multivariate analysis indicated that concurrent RT independently favored longer OS (hazard ratio: 0.18; 95% CI, 0.05-0.63, P  < .01). Group A did not increase any grade adverse events (78.6% vs. 58.8%, P  = .19) or severe adverse events of grade ≥ 3 (14.3% vs. 14.7%, P  = .97) compared to group B. Conclusions The concurrent high-dose external beam radiotherapy appears to safely enhance the effectiveness of atezolizumab plus bevacizumab for highly advanced patients with HCC. Further studies are warranted to confirm these findings. [ABSTRACT FROM AUTHOR]

The electrolytes of lithium-ion batteries (LIBs) directly affect their performance, safety, and reliability. However, existing electrolytes are still limited in terms of safety, performance, and environmental friendliness, constraining further development and application of LIBs. Herein, novel electrolytes based on a deep eutectic solvent consisting of LiTFSI [lithium bis(trifluoromethane)sulfonylimide] and DMA(N,N'-dimethylacetamide) were developed for LIBs. The results from thermogravimetry analysis, infrared spectroscopy, Raman scattering, UV-visible NIR diffuse reflectance, optical and scanning electron microscopy, and electrochemistry all showed safe, nonflammable, nontoxic, and environmentally friendly electrolytes with good thermal stability, enhanced electrochemical stability, and excellent lithium-ion conductivity. Cyclic voltammetry and electrochemical impedance spectroscopy confirmed electrolytes with rapid transport of lithium ions and stable electrochemical interface formation. The electrolytes showed good compatibility with the LiFePO4 cathode, effectively protecting the structure of the LiFePO4 electrode. The first discharge capacity of LiTFSI-DMA deep eutectic electrolyte reached as high as 156.6 mAh g−1, with a discharge capacity after 365 cycles at 1C current density reaching 142.6 mAh g−1 and a capacity retention rate of more than 91%. Overall, LiTFSI-DMA deep eutectic electrolytes with superior performance and compatibility have the potential as high-performance nonflammable electrolytes for improved LIBs. [ABSTRACT FROM AUTHOR]