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In view of the security problems of image encryption algorithms encoded by single DNA or RNA, to increase the randomness of the diffusion process and the uncertainty of the coding rules, we propose a combining dynamic RNA and DNA computing based chaotic image encryption algorithm, which has a more complicated encryption process for improving the security of the encryption algorithm and increases the difficulty of decoding. First, a new three-dimensional hyperchaotic map is proposed, which exhibits a rich set of dynamic behaviors. Second, the sequences generated by the proposed map are passed to NIST test with good randomness and implemented by digital signal processing hardware, which shows the feasibility of the proposed chaotic map for industrial applications. Second, the K-means algorithm is used to split the plaintext into two parts. Third, the chaotic sequence is used to displace and diffuse the two parts of the plaintext, respectively. Then, chaotic sequences were used to encode using dynamic DNA and RNA of these two parts, respectively. Then, the chaotic sequences were used to compute the dynamic DNA and RNA computing of these two parts, respectively. Finally, the cipher text is decoded accordingly. The experimental results show that compared with some related encryption algorithms, our method has higher security. [ABSTRACT FROM AUTHOR]

Purpose: To perform a finite element analysis (FEA) and an in vitro experiment to investigate and compare the loading effects (effects on the implant and surrounding bone) of various customized angled abutments to commercial 15-degree angled abutments (control). Materials and Methods: Four customized angled abutment models (21.9, 24.15, 20.22, and 33 degrees) were developed using CBCT images of incisor inclination measurements from patients of various age groups (20 to 23, 24 to 39, and 40 to 65 years). 3D maxillary bone models were created from the CBCT images of four individual patients: One patient from each age group with the respective average incisor inclination measurement and another patient with the overall average were selected. Then, FEA and in vitro strain gauge experiments were conducted by applying 100 N or 50 N of axial or oblique force to each model in order to assess the differences in stress/strain between the customized angled abutments (test) and the control in both the implants and surrounding bone. Results: Under axial loading, the stress values in the implant and surrounding bone were elevated due to the relatively higher angles of the customized angled abutments (21.9, 24.15, 20.22, and 33 degrees) compared to the control angled abutments. Under oblique loading, the control angled abutments exhibited higher stress values in both the implant and surrounding bone. For the in vitro experiment, there was no statistically significant difference in bone strain between the customized (21.9 degree) and the control angled abutments in axial loading. Nevertheless, the control angled abutment with oblique loading induced greater bone strains. Conclusions: Customized angled abutments offer lower stress/strain under oblique loads but higher stress/strain under axial loads compared to the control abutments. Therefore, in the design and application of angled abutments, careful consideration of the occlusal load direction is important for achieving the biomechanical success of an implant. [ABSTRACT FROM AUTHOR]

This article discusses promising avenues for integrating affective computational approaches into advertising research on emotion. We review affective computing methods for different modalities—text, visual, and audio—and present advertising research examples and computational tools for each modality. We discuss different state-of-the-art multimodal tools for emotion recognition and propose an evaluation framework for advertising researchers to compare and select appropriate affective computing models. Finally, we discuss how affective computing approaches may fill some research gaps to advance emotion-based advertising research and theory building. This paper contributes theoretical insights, ethical considerations, and practical guidelines essential for the methodological advancement of the emerging field of computational advertising research. [ABSTRACT FROM AUTHOR]

This study investigates the influence of trimming layer thickness on the performance characteristics of thin-film bulk acoustic resonators (FBARs). By adjusting the thickness of the trimming layer, we aimed to optimize the resonant (f s) and antiresonant frequencies (f p) , which are critical for the filter's performance in blocking or passing specific frequency bands. Employing theoretical modeling and experimental validation, we explored how variations in the trimming layer thickness affect the electromechanical coupling coefficient (k t 2) and the overall energy efficiency of FBARs. The study also considered the impact of piezoelectric layer thickness on the effectiveness of these adjustments, revealing that thinner piezoelectric layers are more sensitive to changes in the trimming layer, enhancing the tuning capability for high-frequency applications. Our results confirm that reducing the trimming layer thickness increases both resonant and antiresonant frequencies, with a more pronounced effect on the latter, suggesting a significant phase correction effect from the trimming layer, resulting in the quality Q factor reductions. Our experimental results show that as the trimming layer thickness increases from 200 to 300 nm, the Q factor increases by 11%, while k t 2 decreases by 4%. This research provides critical insights into the design and optimization of FBARs, offering guidelines that can help advance the development of more efficient and effective RF components for future mobile communication technologies. [ABSTRACT FROM AUTHOR]

Bond line thickness (BLT) is an essential parameter of thermal conductive composite gels as the thermal interface material (TIM). Extensive research has been performed on designing next-generation TIMs with high thermal conductivity; however, it remains elusive how to link laboratory measurements and the theoretically predicted BLT. Here, we propose a new model to estimate BLT based on a rheological property, in which the TIM is assumed to be a simple power law fluid. To avoid the unrealistic situation of the BLT tending to zero, we introduce a decaying exponential function to describe the influence from fillers during the lid attach process and rebuild the force balance equation. Compared with previously reported models, the theoretical prediction BLT based on the proposed model is in good agreement with the experimental data. Our model has a guiding significance in predicting the BLT, which may help to optimize the thermal performance of TIMs. [ABSTRACT FROM AUTHOR]

The valence and conduction band offsets at the interfaces between NiO/AlN, SiO2/AlN, Al2O3/AlN, and ITO/AlN heterointerfaces were determined via x-ray photoelectron spectroscopy using the standard Kraut technique. These represent systems that potentially would be used for p-n junctions, gate dielectrics, and improved Ohmic contacts to AlN, respectively. The band alignments at NiO/AlN interfaces are nested, type-I heterojunctions with a conduction band offset of −0.38 eV and a valence band offset of −1.89 eV. The SiO2/AlN interfaces are also nested gap, type-I alignment with a conduction band offset of 1.50 eV and a valence band offset of 0.63 eV. The Al2O3/AlN interfaces are type-II (staggered) heterojunctions with a conduction band offset of −0.47 eV and a valence band offset of 0.6 eV. Finally, the ITO/AlN interfaces are type-II (staggered) heterojunctions with conduction band offsets of −2.73 eV and valence band offsets of 0.06 eV. The use of a thin layer of ITO between a metal and the AlN is a potential approach for reducing contact resistance on power electronic devices, while SiO2 is an attractive candidate for surface passivation or gate dielectric formation on AlN. Given the band alignment of the Al2O3, it would only be useful as a passivation layer. Similarly, the use of NiO as a p-type layer to AlN does not have a favorable band alignment for efficient injection of holes into the AlN. [ABSTRACT FROM AUTHOR]

Background: Indoleamine 2,3-dioxygenase (IDO) impairs anti-pathogen and anti-tumour immunity. Mesenchymal stem cells (MSCs) modulate immunity via IDO but also suppress IFN-γ. While MSC IDO induction by IFN-γ is established, other drivers in this immunosuppressive setting remain unknown. Methods: Human bone marrow mesenchymal stem cells (MSCs) with IDO or IL-10RA knockdown were co-cultured with healthy donor T cells to assess immunosuppression. PDAC organoid anticancer activity was also tested in these co-cultures. Results: Co-culturing MSCs with T cells in an IL-10RA-enriched environment enhances IDO expression, resulting in T cell suppression. Moreover, IL-10RA-positive MSCs collected from co-cultures with IL-10 supplementation show increased IDO expression. Conversely, MSCs with IL-10RA knockdown exhibit a significant reduction in IDO RNA and protein expression, as well as STAT3 phosphorylation status, which is a known upstream signalling pathway in IDO gene regulation, in T cell co-cultures. Down-regulation of IL-10RA also inhibits IDO activity in MSCs, resulting in reduced T cell suppression, and enabling the co-cultured T cells to kill PDAC organoids. Conclusion: Our research reveals IL-10RA as a pharmacological target in stromal cells for enhancing T cell-mediated PDAC eradication by downregulating IDO via blocked IL-10/IL-10RA signalling in MSCs. This advances IL-10RA interference in the tumour microenvironment (TME) to restore T cell cytotoxicity against cancers. [ABSTRACT FROM AUTHOR]

Introduction: The evidence showed that the risk of falls was higher in women, and yoga was considered an effective rehabilitation method for preventing falls. However, there had been no previous attempts to synthesize the evidence specifically for the use of yoga in preventing falls among older women. Objectives: This systematic review aimed to strengthen the existing body of evidence by focusing exclusively on the impact of yoga in improving fall-related physical functions among older women. Methods: A systematic review was conducted following the PRISMA guidelines. The protocol was developed in advance of the study and registered on PROSPERO (Registration number: CRD42024506550). Results: The effects of yoga on balance, gait, and lower-limb strength were inconsistent. It showed that yoga programs designed to prevent falls in older women might not demonstrate the same effectiveness as those identified in previous systematic reviews for the general older adult population. Conclusions: This systematic review is the first to exclusively explore the impact of yoga on fall-related physical functions in older women. However, this review did not directly observe a definitive effect of yoga on fall prevention in older women. Future studies should delve deeper into identifying appropriate yoga postures and determining the optimal dose required to enhance physical function and prevent falls. [ABSTRACT FROM AUTHOR]

This study conducts a comprehensive analysis of observations related to the ML6.2 Hualien earthquake that struck eastern Taiwan on 6 February 2018, focusing particularly on gamma-ray emissions and total electron content (TEC) as earthquake precursors. Prior research has shown that significant gamma-ray enhancements are frequently detected at the YMSG (Yangmingshan gamma-ray) station prior to major earthquakes in eastern and northeastern Taiwan, suggesting that gamma-ray anomalies may serve as reliable indicators for identifying seismic precursors in this area. Our findings reveal a significant rise in gamma-ray emissions at the YMSG station from 19 January to 4 February 2018, which corresponds to a precursor period of approximately 18 days before the Hualien earthquake. Positive and negative TEC anomalies were observed in Taiwan on 20–21 January and 5 February, respectively, and may be considered as ionospheric precursors to the earthquake. Additionally, deep-learning techniques applied to TEC data facilitate the detection of ionospheric precursors associated with the Hualien earthquake, enabling forecasts of an approaching seismic event. Collectively, these observations indicate that all identified anomalies are regarded as short-term precursors, explicable through the theoretical framework of lithosphere–ionosphere coupling (LIC). [ABSTRACT FROM AUTHOR]

Vitamin D, essential for growth and health, is often deficient in Taiwan despite abundant sunlight. Plant-derived vitamin D2 (ergocalciferol) is bioavailable, environmentally friendly, and cost-effective. This study evaluated the efficacy of enhancing Pleurotus citrinopileatus (PC) mushrooms' vitamin D2 content through pulsed ultraviolet (PUV) light and its impact on vitamin D status in humans. In a four-week randomized parallel trial, 36 healthy participants were assigned to three groups: a control group, a group consuming 10 g/day PUV-treated PC (PC-10 g), and a group consuming 100 g/day PUV-treated PC (PC-100 g). Blood samples collected pre- and post-intervention measured serum 25(OH)D2, 25(OH)D3, and biochemical parameters. After four weeks, serum 25(OH)D2 levels significantly increased in the PC-10 g group (1.47 ± 1.42 ng/mL to 9.50 ± 7.10 ng/mL, p = 0.001) and in the PC-100 g group (1.94 ± 2.15 ng/mL to 21.82 ± 16.75 ng/mL, p = 0.002), showing a 10.2-fold rise. The PC-100 g group also experienced a 37.6% reduction in serum intact parathyroid hormone (I-PTH) levels (26.26 ± 9.84 pg/mL to 16.38 ± 5.53 pg/mL). No adverse effects were reported. PUV-treated PC mushrooms significantly increase serum 25(OH)D2 levels and reduce I-PTH, particularly at higher doses. These findings underscore the potential of vitamin-D-enriched PC as a sustainable, fungi-derived food source for addressing vitamin D deficiency. [ABSTRACT FROM AUTHOR]

Background: Large-scale coral bleaching events have become increasingly frequent in recent years. This process occurs when corals are exposed to high temperatures and intense light stress, leading to an overproduction of reactive oxygen species (ROS) by their endosymbiotic dinoflagellates. The ROS buildup prompts corals to expel these symbiotic microalgae, resulting in the corals' discoloration. Reducing ROS production and enhancing detoxification processes in these microalgae are crucial to prevent the collapse of coral reef ecosystems. However, research into the cell physiology and genetics of coral symbiotic dinoflagellates has been hindered by challenges associated with cloning these microalgae. Results: A procedure for cloning coral symbiotic dinoflagellates was developed in this study. Several species of coral symbionts were successfully cloned, with two of them further characterized. Experiments with the two species isolated from Turbinaria sp. showed that damage from light intensity at 340 μmol photons/m2/s was more severe than from high temperature at 36 °C. Additionally, preincubation in high salinity conditions activated their endogenous tolerance to bleaching stress. Pretreatment at 50 ppt salinity reduced the percentage of cells stained for ROS by 59% and 64% in the two species under bleaching stress compared to those incubated at 30 ppt. Furthermore, their Fv'/Fm' during the recovery period showed a significant improvement compared to the controls. Conclusions: These findings suggest that intense light plays a more important role than high temperatures in coral bleaching by enhancing ROS generation in the symbiotic dinoflagellates. The findings also suggest the genomes of coral symbiotic dinoflagellates have undergone evolutionary processes to develop mechanisms, regulated by gene expression, to mitigate damages caused by high temperature and high light stress. Understanding this gene expression regulation could contribute to strengthening corals' resilience against the impact of global climate change. [ABSTRACT FROM AUTHOR]

Background: Up to 23% of breast cancer patients recurred within a decade after trastuzumab treatment. Conversely, one trial found that patients with low HER2 expression and metastatic breast cancer had a positive response to trastuzumab-deruxtecan (T-Dxd). This indicates that relying solely on HER2 as a single diagnostic marker to predict the efficacy of anti-HER2 drugs is insufficient. This study highlights the interaction between histamine N-methyltransferase (HNMT) and HER2 as an adjunct predictor for trastuzumab response. Furthermore, modulation of HER2 expression by HNMT may explain why those with low HER2 expression still respond to T-Dxd. Methods: We investigated the impact of HNMT protein expression on the efficacy of anti-HER2 therapy in both in vivo and ex vivo models of patient-derived xenografts and cell line-derived xenografts. Our analysis included Förster resonance energy transfer (FRET) to assess the interaction strength between HNMT and HER2 proteins in trastuzumab-resistant and sensitive tumor tissues. Additionally, we used fluorescence lifetime imaging microscopy (FLIM), cleaved luciferase, and immunoprecipitation to study the interaction dynamics of HNMT and HER2. Furthermore, we evaluated the influence of HNMT activity on the binding of anti-HER2 antibodies to their targets through flow cytometry. We also observed the nuclear translocation of HNMT/HER2-ICD cells using fluorescent double staining and DeltaVision microscopy. Finally, ChIP sequencing was employed to identify target genes affected by the HNMT/HER2-ICD complex. Results: This study highlights HNMT as a potential auxiliary biomarker for diagnosing HER2 + breast cancer. FRET analysis demonstrated a significant interaction between HNMT and HER2 protein in trastuzumab-sensitive tumor tissue (n = 50), suggesting the potential of HNMT as a predictor of treatment response. Mechanistic studies revealed that the interaction between HNMT and HER2 contributes to increased HER2 protein expression at the transcriptional level, thereby impacting the efficacy of anti-HER2 therapy. Furthermore, a subset of triple-negative breast cancers characterized by HNMT overexpression was found to be sensitive to HER2 antibody–drug conjugates such as T-Dxd. Conclusions: These findings offer crucial insights for clinicians evaluating candidates for anti-HER2 therapy, especially for HER2-low breast cancer patients who could gain from T-Dxd treatment. Identifying HNMT expression could help clinicians pinpoint patients who would benefit from anti-HER2 therapy. [ABSTRACT FROM AUTHOR]

Background Sepsis surveillance using electronic health record (EHR)–based data may provide more accurate epidemiologic estimates than administrative data, but experience with this approach to estimate population-level sepsis burden is lacking. Methods This was a retrospective cohort study including all adults admitted to publicly funded hospitals in Hong Kong between 2009 and 2018. Sepsis was defined as clinical evidence of presumed infection (clinical cultures and treatment with antibiotics) and concurrent acute organ dysfunction (≥2-point increase in baseline Sequential Organ Failure Assessment [SOFA] score). Trends in incidence, mortality, and case fatality risk (CFR) were modeled by exponential regression. Performance of the EHR-based definition was compared with 4 administrative definitions using 500 medical record reviews. Results Among 13 540 945 hospital episodes during the study period, 484 541 (3.6%) had sepsis by EHR-based criteria with 22.4% CFR. In 2018, age- and sex-adjusted standardized sepsis incidence was 756 per 100 000 (relative change: +2.8%/y [95% CI: 2.0%–3.7%] between 2009 and 2018) and standardized sepsis mortality was 156 per 100 000 (relative change: +1.9%/y; 95% CI:.9%–2.8%). Despite decreasing CFR (relative change: −0.5%/y; 95% CI: −1.0%, −.1%), sepsis accounted for an increasing proportion of all deaths (relative change: +3.9%/y; 95% CI: 2.9%–4.8%). Medical record reviews demonstrated that the EHR-based definition more accurately identified sepsis than administrative definitions (area under the curve [AUC]:.91 vs.52–.55; P <.001). Conclusions An objective EHR-based surveillance definition demonstrated an increase in population-level standardized sepsis incidence and mortality in Hong Kong between 2009 and 2018 and was much more accurate than administrative definitions. These findings demonstrate the feasibility and advantages of an EHR-based approach for widescale sepsis surveillance. [ABSTRACT FROM AUTHOR]

Concerns about the safety of traditional preservatives in personal care products are driving interest toward self-preserving alternatives. This study explores the potential of B. stenostachya leaf extracts, a natural and biodegradable material, for use in cosmetics. B. stenostachya, a fast-growing bamboo species native to Taiwan, is rich in bioactive compounds, including flavonoids with antimicrobial properties. Leaves were obtained from the Industrial Technology Research Institute (ITRI) in Tainan, Taiwan, and extracted using ultrasonic and Soxhlet methods with water, 50% ethanol, and 95% ethanol. The highest yield was achieved with 50% ethanol at 100 °C. Cytotoxicity was evaluated using the NIH/3T3 mouse fibroblast cell line, with no toxicity observed at dilutions between 1/3200 and 1/400, indicating the extract's safety for cosmetic use. Antimicrobial activity was tested in accordance with ISO 11930:2019 standards. The extract effectively inhibited Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus pathogens, meeting preservative efficacy Standards A and B for long-term microbial control. Bamboo is a sustainable resource with lower environmental impacts, and its products show promising biodegradability and reduced environmental footprints. This research indicates that the B. stenostachya leaf extract offers a sustainable alternative to chemical preservatives, promoting both environmental sustainability and public health, with the potential for expanded use in natural personal care formulations. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury (TBI) research often focuses on mortality rates or functional recovery, yet the critical need for long-term care among patients dependent on institutional or Respiratory Care Ward (RCW) support remains underexplored. This study aims to address this gap by employing machine learning techniques to develop and validate predictive models that analyze the prognosis of this patient population. Method: Retrospective data from electronic medical records at Chi Mei Medical Center, encompassing 2020 TBI patients admitted to the ICU between January 2016 and December 2021, were collected. A total of 44 features were included, utilizing four machine learning models and various feature combinations based on clinical significance and Spearman correlation coefficients. Predictive performance was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and validated with the DeLong test and SHAP (SHapley Additive exPlanations) analysis. Result: Notably, 236 patients (11.68%) were transferred to long-term care centers. XGBoost with 27 features achieved the highest AUC (0.823), followed by Random Forest with 11 features (0.817), and LightGBM with 44 features (0.813). The DeLong test revealed no significant differences among the best predictive models under various feature combinations. SHAP analysis illustrated a similar distribution of feature importance for the top 11 features in XGBoost, with 27 features, and Random Forest with 11 features. Conclusions: Random Forest, with an 11-feature combination, provided clinically meaningful predictive capability, offering early insights into long-term care trends for TBI patients. This model supports proactive planning for institutional or RCW resources, addressing a critical yet often overlooked aspect of TBI care. [ABSTRACT FROM AUTHOR]

Simple Summary: An investigation into the prokaryotic picoplankton ecology and their assimilation ability in dissolved inorganic carbon was conducted in the shallow-sea hydrothermal vent at Guishan Islet, located off the coast of Taiwan in April 2019. We found that the thiosulfate-oxidizing bacteria, Thiomicrorhabdus, were the dominant primary producer in the waters mixing with the hydrothermal vent plume. In waters with less influence from hydrothermal vent emissions, picocyanobacteria (i.e., Synechococcus and Prochlorococcus) acted as the primary prokaryotic photoautotrophs. The combined contributions of Thiomicrorhabdus and picocyanobacteria were vital in sustaining primary production and supporting the shallow-sea hydrothermal ecosystem. The shallow-sea hydrothermal vent at Guishan Islet, located off the coast of Taiwan, serves as a remarkable natural site for studying microbial ecology in extreme environments. In April 2019, we investigated the composition of prokaryotic picoplankton communities, their gene expression profiles, and the dissolved inorganic carbon uptake efficiency. Our results revealed that the chemolithotrophs Thiomicrorhabdus spp. contributed to the majority of primary production in the waters affected by the hydrothermal vent plume. The metatranscriptomic analysis aligned with the primary productivity measurements, indicating the significant gene upregulations associated with carboxysome-mediated carbon fixation in Thiomicrorhabdus. Synechococcus and Prochlorococcus served as the prokaryotic photoautotrophs for primary productivity in the waters with lower influence from hydrothermal vent emissions. Thiomicrorhabdus and picocyanobacteria jointly provided organic carbon for sustaining the shallow-sea hydrothermal vent ecosystem. In addition to the carbon fixation, the upregulation of genes involved in the SOX (sulfur-oxidizing) pathway, and the dissimilatory sulfate reduction indicated that energy generation and detoxification co-occurred in Thiomicrorhabdus. This study improved our understanding of the impacts of shallow-sea hydrothermal vents on the operation of marine ecosystems and biogeochemical cycles. [ABSTRACT FROM AUTHOR]

Background: Motorcycle traffic accidents rate remained high in Taiwan letting posttrauma care an imperative issue. This study investigates the spiritual, psychological, and physical impacts of motorcycle traffic accidents in Taiwan, focusing on the role of the Injury Severity Score (ISS) in influencing quality of life (QOL) and spiritual well-being outcomes, aiming to enhance holistic recovery strategies for trauma survivors. Materials and Methods: A prospective study was conducted from April 2022 to March 2024 in a level I trauma center. Patients aged 20 and above with trauma from motorcycle accidents were enrolled and divided into major (ISS ≥ 16) and nonmajor (ISS < 16) trauma groups. QOL and spiritual health were assessed using 36-item short-form general health survey measures (SF-36) and spiritual scale before discharge and 6 months later. Results: Of 98 patients, we observed significant postdischarge declines in both physical and mental QOL scores, regardless of ISS. However, spiritual scores improved significantly after discharge, with notable enhancements in interpersonal relationships and adversity transcendence observed in patients with ISS < 16, but not in those with ISS ≥ 16. SF-36 analysis revealed that nonreligious groups experienced significant declines in mental health scores postdischarge, unlike religious groups, which remained stable. In addition, religious individuals showed significant postdischarge improvements in interpersonal relationships and adversity transcendence, while nonreligious showed no improvement. This suggests a beneficial link between religious adherence and enhanced spiritual well-being. Conclusions: Motorcycle accidents reduce QOL and heighten spiritual needs for survivors, regardless of accident severity categorized by ISS score. Integrating spirituality into rehabilitation processes can positively impact overall well-being. Holistic care, addressing physical, psychological, social, and spiritual needs, is vital for optimizing long-term recovery and improving prognosis in trauma survivors, especially in regions with high rates of traffic accidents like Taiwan. [ABSTRACT FROM AUTHOR]

Objective: Based on our previous research, which demonstrated that elevated plasma endoglin (ENG) levels in lung cancer patients were associated with a better prognosis, increased sensitivity to pemetrexed, and enhanced tumor suppression, this study aims to validate these findings at the cellular level. The focus is on membrane and extracellular ENG and their influence on drug response and tumor cell behavior in non-small cell lung cancer (NSCLC) cells. Methods: The correlation between ENG expression and pemetrexed-induced cytotoxicity in eight human non-squamous subtype NSCLC cell lines was analyzed. ENG in A549 and H1975 cells was knocked down using shRNA. MTT assay, cell cycle assay, western blot analysis, and boyden chamber assay were used to detect the effect of ENG on pemetrexed-induced cytotoxicity, cell cycle distribution, and cell migration. Results: The expression of membrane ENG was positively correlated with pemetrexed-induced cytotoxicity in human NSCLC cells. Compared to pemetrexed-sensitive A549 cells, the A549/a400 (pemetrexed-resistant subline) cells exhibited a reduced accumulation of cells in the S phase, making them less susceptible to cell death. ENG knockdown also alleviated pemetrexed-induced S phase arrest and regulated G1/S phase-related proteins (p53, p21, CDK2, and Cyclin A). Additionally, co-treatment with recombinant ENG enhanced pemetrexed-induced migration inhibition in the sensitive cel1 line and cytotoxicity in the resistance cell line. Conclusion: The present results strengthened our prior clinical findings, showing that higher membrane ENG expression enhances pemetrexed-induced cytotoxicity and S phase arrest, which may involve the ENG-p21 pathway. Additionally, microenvironmental ENG enhanced the anti-migration of pemetrexed. These findings highlight the potential of ENG as a biomarker and therapeutic target, opening new avenues to improve the outcomes of non-squamous cell NSCLC treatment. [ABSTRACT FROM AUTHOR]

Sarcopenic obesity, encompassing both muscle wasting and obesity, is relevant across individuals. Toona sinensis (TS) has been shown to regulate glucose and lipid metabolisms. However, the efficacy and mechanisms of TS fruit (TSF) in sarcopenic obesity are unclear. This study investigated impacts of TSF extract on skeletal muscle atrophy in C57BL/6 mice fed a high-fat diet (HFD). After 25 weeks of TSF pre-treatment and supplementation, it reversed loss of skeletal muscle mass and grip strength in HFD-fed mice, independent of body weight changes. TSF treatment notably increased the phosphorylation of Akt, mTOR, and P70S6K, while suppressing nuclear localization of NFκB, FoxO1a, and transcription of atrogin-1, MuRF-1, and myostatin expression in HFD-fed muscle. Additionally, TSF influenced autophagic flux and mitochondria quality control, emphasizing its role in balancing protein synthesis and degradation. In conclusion, TSF alleviates HFD-induced sarcopenia via protein turnover, autophagic flux and mitochondria quality control, highlighting its potential therapeutic value for sarcopenic obesity. [ABSTRACT FROM AUTHOR]

Alcohol use attenuates successful smoking cessation. We examined the feasibility, acceptability, and preliminary efficacy of a brief alcohol intervention in smokers. In this two-arm, assessor-blinded randomized controlled trial, we randomized 100 daily smokers (82.0% male, mean age = 43.7 years) with past-year alcohol use in smoking cessation clinics. Both intervention (n = 51) and control (n = 49) groups received conventional smoking cessation treatment, the intervention group additionally received a brief alcohol intervention. Primary outcome was biochemically validated tobacco abstinence at 2 months. Secondary outcomes included Alcohol Use Disorders Identification Test (AUDIT) scores, self-reported past 7-day alcohol consumption in alcohol units, feasibility, and acceptability scores at 2 months. By intention-to-treat, the intervention group showed higher validated abstinence (11.8% vs. 10.2%, Risk Ratio = 1.15, 95%CI = 0.38–3.53), lower AUDIT score (5.3 vs. 6.5), and lower alcohol consumption (5.6 vs. 7.1) than the control group, but the differences were not significant. Overall, the feasibility was high (4.2/5.0), and the acceptability was modest (5.0/7.0). In all participants, reduction in smoking relapse risk due to alcohol use from baseline to 2-month follow-up was associated with higher biochemically validated abstinence (Adjusted odds ratio: 1.55, 95% CI = 1.05–2.28). Our brief alcohol intervention is feasible, acceptable, and potentially efficacious to promote tobacco abstinence and alcohol reduction. [ABSTRACT FROM AUTHOR]

Background: The pTNM staging system is widely recognized as the most effective prognostic indicator for cancer. The latest update of this staging system introduced a new pathological staging system (ypTNM) for patients receiving neoadjuvant chemoradiotherapy (NACRT). However, whether the prognostic value of the ypTNM staging system for rectal cancer is similar to that of the pTNM staging system remains unclear. This study was conducted to compare the ypTNM and pTNM staging systems in terms of their prognostic value for patients with nonmetastatic rectal cancer undergoing proctectomy. Material and Methods: This study was conducted at a large teaching hospital. Between January 2014 and December 2022, 542 patients with rectal cancer were analyzed (median follow-up period, 60 months; range, 6–105 months). Of them, 258 and 284 were included in the pTNM and ypTNM groups, respectively. Inverse probability of treatment weighting (IPTW) was performed to account for the effects of confounders. Cox proportional-hazards regression was performed for the between-group comparison of overall survival (OS). Results: The crude model revealed that OS was similar between the two groups (p = 0.607). After performing IPTW, we found that patients with the same ypTNM- and pTNM-classified stages had similar overall survival (hazard ratio = 1.15; 95% CI = 0.76–1.73; p = 0.5074). Conclusions: For patients with rectal cancer who have received preoperative NACRT, the prognostic value of ypTNM staging appears to be similar to that of pTNM staging, mostly because of the downstaging effect of neoadjuvant chemoradiotherapy. [ABSTRACT FROM AUTHOR]

Background: The caries severity in childhood may predict caries conditions in the future and even in adulthood in caries risk models. Nevertheless, the rate of recurrent caries after treatment of severe early childhood caries is high and correlated with behavioural factors, rather than clinical indicators. Compliance with the caries control programme has been demonstrated to prevent root caries development in head and neck cancer patients, suggesting that compliance with treatment protocols is a more important key to bringing about successful outcomes than treatment protocols themselves. However, only few studies defined the triggers of compliance in patients with long-term successful treatment outcomes, especially in children. Furthermore, driven forces of compliant behaviours from patients' aspects have not been described in the dental literature before. Regarding the need to improve current caries control interventions for children, in this study, behavioural determinants that shaped compliance of resilient children were investigated with a qualitative study design, for its advantage in revealing what an individual really feels which incorporates their experience without restriction from previous literature. Resilience was defined as improvement in caries conditions between primary and mixed or permanent dentitions. Methods: Interviews were performed with the patient group, including eight resilient children (M/F = 5/3) and their ten caregivers (M/F = 2/8), and the dentist group, including ten paediatric dentists (M/F = 6/4; clinical experience mean = 26.9 years, minimum = 16 years). Thematic analysis was used to identify main themes. Results: Four themes were identified: (1) dental things/teeth are their priority, (2) normalising, (3) tiger parenting/conscientiousness, and (4) trust. These determinants were identically described by both the patient and dentist groups. Dentists' suggestions were the priority, providing the norms in daily life of resilient patients and their caregivers. These patients found no excuses for failing to take dentists' advice, not only because they trusted their dentists, but also because they and their caregivers were conscientious about putting dentists' orders into practice. Conclusions: It is implementing suggested oral health behaviours daily, but not merely agreeing with professional advice, that alters the fate of teeth in these resilient patients. [ABSTRACT FROM AUTHOR]

Endometrial cancer (EC) diagnosis traditionally relies on tumor morphology and nuclear grade, but personalized therapy demands a deeper understanding of tumor mutational burden (TMB), i.e., a key biomarker for immune checkpoint inhibition and immunotherapy response. Traditional TMB prediction methods, such as sequencing exomes or whole genomes, are costly and often unavailable in clinical settings. We present the first TR-MAMIL deep learning framework to predict TMB status and classify the EC cancer subtype directly from H&E-stained WSIs, enabling effective personalized immunotherapy planning and prognostic refinement of EC patients. Our models were evaluated on a large dataset from The Cancer Genome Atlas. TR-MAMIL performed exceptionally well in classifying aggressive and non-aggressive EC, as well as predicting TMB, outperforming seven state-of-the-art approaches. It also performed well in classifying normal and abnormal p53 mutations in EC using H&E WSIs. Kaplan–Meier analysis further demonstrated TR-MAMIL's ability to differentiate patients with longer survival in the aggressive EC. [ABSTRACT FROM AUTHOR]

Objectives: To explore the short- and long-term effects of glycemic management—through glycemic treatment and blood glucose monitoring (BGM)—on stroke recurrence and mortality specifically in patients experiencing a first-ever ischemic stroke (FIS) with hyperglycemia (FISHG) who have not previously been diagnosed with diabetes mellitus (DM). Methods: We gathered data on patients who were registered on Taiwan's National Health Insurance Research Database from 2000 to 2015. We one-fold propensity-score-matched (by sex, age, and index date) 207,054 patients into 3 cohorts: those with FIS (1) without hyperglycemia, (2) hyperglycemia without glycemic treatment, and (3) hyperglycemia with glycemic treatment. We used Cox proportional hazard regression to evaluate the short- (within 1 year after FIS) and long-term (9.3 ± 8.6 years after FIS) prognostic effects of glycemic management on stroke recurrence and mortality of FISHG. Results: Stroke recurrence and mortality were significantly more likely in the patients with FISHG than their counterparts without hyperglycemia (p < 0.05). Under glycemic treatment, patients with FISHG demonstrated lower risk of mortality at every follow-up than those without (p < 0.001) but were not less likely to have stroke recurrence (p > 0.05). Integrating BGM with glycemic treatment in the FISHG cohort significantly reduced the risk of stroke recurrence compared to patients receiving only glycemic treatment at 1-month, 3-month, 6-month, and 1-year post-stroke follow-ups (adjusted hazard ratios = 0.84, 0.90, 0.88, and 0.92, respectively); additionally, this approach significantly decreased mortality risk at each post-stroke follow-up period (p < 0.05). Conclusions: BGM combined with glycemic treatment significantly improves prognosis in patients with FISHG who have not been previously diagnosed with DM, reducing the risks of stroke recurrence and mortality. [ABSTRACT FROM AUTHOR]

Background: Esophageal achalasia, a primary disorder impacting the lower esophageal sphincter (LES), presents symptoms such as dysphagia, regurgitation, chest pain, and weight loss. Traditional treatments, including calcium channel blockers and nitrates, offer limited relief, prompting exploration into alternative therapies. This study examines the efficacy of Traditional Chinese Medicine (TCM), focusing on Coptis chinensis (C. chinensis) and its principal component, berberine, for modulating LES relaxation, offering a new perspective on treatment possibilities. Methods: This research evaluated the impact of C. chinensis extract and berberine on the relaxation of LES contraction pre-induced by carbachol, observing the effects across different concentrations. We employed a series of inhibitors, including tetrodotoxin, ω-conotoxin GVIA, rolipram, vardenafil, KT5823, KT5720, NG-nitro-L-arginine, tetraethylammonium (TEA), apamine, iberiotoxin, and glibenclamide, to investigate the underlying mechanisms of berberine-induced LES relaxation. Results: Both C. chinensis extract and berberine induced significant, concentration-dependent relaxation of the LES. The relaxation effect of berberine was significantly reduced by TEA, indicating the involvement of potassium channels in this process. Conclusions: This study demonstrates that C. chinensis and berberine significantly promote LES relaxation, primarily through potassium channel activation. These findings provide a foundation for further investigation of these compounds' potential therapeutic applications in esophageal motility disorders, such as achalasia. [ABSTRACT FROM AUTHOR]

Importance: Patients with a primary cutaneous melanoma (PCM) are at increased risk of developing a second primary melanoma (SPM). Earlier stage at diagnosis is associated with better 5-year mortality, yet low compliance with recommended follow-up after treatment for PCM and high rates of patients lost to follow-up are reported in the literature. Strategies to enhance population-based surveillance for SPM have not been well described. Objective: To determine whether the implementation of a systematic automated population-based program (SAPP) to ensure dermatologist total body skin exams (TBSEs) in the PCM population compared to the pre-automated period and pre-database periods improves compliance with follow-up, detects more SPMs, or affects mortality? Design: Quality Improvement Study. Setting: Large integrated health care system with internalized Dermatology services. Participants: Members with a PCM prior to, or during the study periods of interest, were included in this quality improvement study. There were 6317 eligible individuals with PCMs in 3 study periods: pre-Database (1/1/2005-11/1/2009), pre-Automation (11/1/09-7/31/15), and post-Automation (8/1/15-12/31/2021), respectively. Intervention(s) or Exposure(s): Manual registry for melanoma patients (pre-Automation) and systematic automated population-based program for PCM patients (post-Automation). Main Outcome(s) and Measure(s): Mean number of TBSE per person-year. Time Between TBSE. Incidence of SPM detection. Stage of SPM at diagnosis. Melanoma Death and All-Cause Mortality. Results: In patients with PCM, a SAPP to ensure dermatologist TBSE, reduces median time (months) between TBSEs from 12.3 pre-Database to 8.2 post-Automation (stage 0-2a PCM) and from 10.3 to 6.8 (stage 2b-4 PCM; P <.0001), improves number of TBSEs per person-year with each successive study period (pre-Database mean [SD] 0.56 [1.07]; pre-Automation 0.80 [1.25]; post-Automation 1.78 [4.17]; P <.0001), and improves SPM detection rates per 1000 person-years (pre-Database 20.2 [95% CI 12.2-30.9]; pre-Automation 27.5 [18.2-39.9]; post-Automation 27.5 [26.6-51.8], P <.0001 for trend) at earlier cancer stages. There is an associated annual reduction in all-cause (1.4 per 1000 person-years, P =.0004) and melanoma-cause mortality (0.2 per 1000 person-years, P =.0197). Conclusion: Implementing a systematic, automated population-based Melanoma program to ensure dermatologist TBSEs improves compliance with follow-up in patients with PCM. More patients received at least annual dermatologist TBSEs and more SPMs were detected at earlier stages. Improvements were sustained and there were significantly lower all-cause and melanoma-cause mortality. The system facilitates prioritization of higher risk patients for intervention and is a unique strategy enhancing patient safety, efficiency, and timeliness of care. [ABSTRACT FROM AUTHOR]

This paper presents a systematic antenna design methodology that integrates machine learning, leveraging the progressive growth technique of Progressive Growing of GANs (PGGAN) to generate images of various dual‐band PIFA‐like antenna structures. The process involves using data augmentation methods to generate 4180 antenna samples. In the latent space, the authors employ Latin Hypercube Sampling to maintain diversity and combine it with the Hough Transform to enhance the edge features of the antennas while providing labelling functionality. This labelling method strengthens the relationship between antenna frequency and wavelength characteristics. The paper clearly outlines the design process, starting from the simulation of two types of single‐frequency PIFA‐like antennas (2.45 and 5.2 GHz, respectively) to the completion of PGGAN's generation task, resulting in a novel dual‐band Wi‐Fi PIFA‐like antenna structure. The measurement results of the dual‐band antennas exhibit excellent consistency with the simulation results. [ABSTRACT FROM AUTHOR]

Intracellular trafficking, an extremely complex network, dynamically orchestrates nearly all cellular activities. A versatile method that enables the manipulation of target transport pathways with high spatiotemporal accuracy in vitro and in vivo is required to study how this network coordinates its functions. Here, a new method called RIVET (Rapid Immobilization of target Vesicles on Engaged Tracks) is presented. Utilizing inducible dimerization between target vesicles and selective cytoskeletons, RIVET can spatiotemporally halt numerous intracellular trafficking pathways within seconds in a reversible manner. Its highly specific perturbations allow for the real‐time dissection of the dynamic relationships among different trafficking pathways. Moreover, RIVET is capable of inhibiting receptor‐mediated endocytosis. This versatile system can be applied from the cellular level to whole organisms. RIVET opens up new avenues for studying intracellular trafficking under various physiological and pathological conditions and offers potential strategies for treating trafficking‐related disorders. [ABSTRACT FROM AUTHOR]

Background: Trauma has a profound impact on mortality as well as short- and long-term health outcomes. For trauma patients to receive medical care in a timely manner, early identification and risk assessment are essential. The Geriatric Trauma Outcome Score (GTOS), which was created by combining age, the Injury Severity Score (ISS), and the requirement for packed red blood cell transfusion, has proven to be a valuable prognostic tool for elderly trauma patients, though its applicability to general trauma patients is still understudied. Methods: This retrospective study analyzed data from the Trauma Registry System at a Level I trauma center in southern Taiwan, covering the period from 1 January 2009 to 31 December 2021. This study included 40,068 trauma patients aged 20 years and older. Statistical analyses included chi-square tests, ANOVA, Mann–Whitney U tests, and multivariate analyses to identify independent risk factors for mortality. The predictive performance of the GTOS was assessed using the area under the curve (AUC) of the receiver operating characteristic curve. Results: The final study population included 40,068 patients, with 818 deaths and 39,250 survivors. Deceased patients had higher GTOS scores (mean 132.8 vs. 76.1, p < 0.001) and required more blood transfusions (mean 4.0 vs. 0.3 units, p < 0.001) compared to survivors. The optimal GTOS cut-off value for predicting mortality was 104.5, with a sensitivity of 82.6% and a specificity of 84.3% (AUC = 0.917). A high GTOS score was associated with increased mortality (9.6 vs. 0.4%, p < 0.001) compared with a low GTOS score, even after adjusting for confounding factors (adjusted mortality rate of 2.86, p < 0.001), and a longer hospital stay (14.0 vs. 7.7 days, p < 0.001). Conclusions: The GTOS is a valuable prognostic tool for predicting mortality in trauma patients, providing a simple and rapid assessment method. Its high predictive accuracy supports its use in broader trauma patient populations beyond the elderly. Further studies are recommended to refine and validate the GTOS in diverse trauma settings to enhance its clinical utility. [ABSTRACT FROM AUTHOR]

The genus Sarocladium comprises fungal species closely related to Acremonium, with S. kiliense and S. strictum being medically important. These species can cause infections in both immunocompetent and immunocompromised individuals. The current detection methods are limited, prompting the need for rapid and specific diagnostic tools. We developed a colorimetric loop-mediated isothermal amplification (LAMP) assay targeting S. kiliense (SK-LAMP). The initial prototype assay faced challenges with cross-reactivities with closely related species. To address this, we incorporated two additives, pullulan and tetramethylammonium chloride (TMAC), which are known to reduce non-specific signals in amplification assays. Our study found that a combination of 1% (v/v) pullulan and 0.03 M TMAC enhanced the specific detection of S. kiliense in a 45 min reaction, without non-specific false-positive results for other fungal species. This optimised LAMP assay demonstrated high sensitivity and specificity, offering a reliable and rapid method for detecting S. kiliense. The novel approach of combining additives to enhance assay specificity presents a promising strategy for improving LAMP assays targeting closely related fungal species. This advancement can aid in the timely diagnosis and management of infections caused by S. kiliense, contributing to better patient outcomes and infection control. [ABSTRACT FROM AUTHOR]

Purpose: During and after treatment, esophageal cancer (EC) patients experience changes in body mass index (BMI), performance status, nutrition status, symptom distress, and physical fitness. This study aims to evaluate temporal changes and their associated factors in BMI, performance status, nutrition status, symptom distress, physical fitness, and functional ability in EC patients during and after treatment. Methods: This prospective longitudinal study recruited EC patients from a medical center in Northern Taiwan. The 100 EC patients were assessed before treatment (T0), 1 month after starting treatment (T1), 3 months after starting treatment (end of treatment) (T2), and 6 months after starting treatment (T3). Generalized estimating equation analysis was used to determine the factors associated with changes in functional ability over time. Results: Patient nutrition status was lowest before treatment and then increased by 6 months after treatment. Symptom distress slightly decreased from before treatment to 3 months after treatment, rising at 6 months after treatment but not reaching baseline (T0). Functional ability increased from before treatment to 1 month after treatment and then declined at 3 months after starting treatment, increasing at 6 months to below baseline (T0). Patients who had a BMI less than 25 kg/m2, engaged less in physical activity, and were less physically fit were more likely to have worse functional ability. Conclusion: BMI, level of physical activity, and the degree of physical fitness were the important factors associated with functional ability in EC patients. Healthcare professionals should design patient-tailored prehabilitation programs in advance to strengthen physical fitness. [ABSTRACT FROM AUTHOR]

This article aims to implement a skew magnetization fixture for an annular magnet using a three-dimensional optimized design executed via the innovative magnetic metal additive manufacturing technique known as selective laser melting. Traditionally, fabricating magnetization fixtures involves creating molds or using wire-cut silicon steel sheets, both of which incur substantial prototyping costs and time. Additionally, designing such fixtures with skewed configurations using wire-cut silicon steel poses challenges, as the sharp corners produced by this process, are prone to damaging the insulation layer of the wire at winding terminations. This study designed the magnetization fixture for a coaxial magnetic gear to produce a skewed shape and a 3D tooth round-shaped configuration of the winding part through additive manufacturing. This enables more efficient utilization of energy for magnetizing annular magnets. Finite element analysis was employed to simulate and validate the three-dimensional magnetization fixture. This approach eliminates the need for traditional mold-making or wire-cutting of silicon steel, facilitating rapid and precise fabrication. Experimental results from the prototype of the three-dimensional magnetization fixture are presented to validate its designed performance. [ABSTRACT FROM AUTHOR]

Genetic variants of deregulated long noncoding RNAs (lncRNAs) have been implicated in tumorigenesis, cancer progression and cancer recurrence. Single‐nucleotide polymorphisms (SNPs) of the lncRNA cyclin‐dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B‐AS1) have been associated with the risk and progression of various cancers; however, their role in prostate cancer (PCa) remains underexplored. In this case–control study, we investigated the associations of CDKN2B‐AS1 expression levels and variants with PCa risk and progression. For this, five SNPs of CDKN2B‐AS1—rs564398, rs1333048, rs1537373, rs2151280 and rs8181047—were genotyped using a TaqMan allelic discrimination assay; data were collected from 695 patients with PCa and 695 healthy controls. Our findings revealed that, under a dominant model, patients with PCa carrying at least one minor C allele of rs1333048 exhibited an increased risk of developing tumours with high Gleason grades; this risk was particularly high in patients without biochemical recurrence. Data from the Genotype‐Tissue Expression database indicated upregulated CDKN2B‐AS1 expression in the prostates of individuals carrying the polymorphic C allele of rs1333048. Genotype screening of rs1333048 in PCa cell lines showed that cells with at least one minor C allele had higher CDKN2B‐AS1 levels than those with the AA genotype. Furthermore, data from The Cancer Genome Atlas indicated that higher CDKN2B‐AS1 levels in PCa tissues were correlated with larger tumour sizes (T3 + T4), more lymph node metastasis (N1), higher Gleason scores and shorter progression‐free survival. In conclusion, the polymorphic variants of CDKN2B‐AS1 at rs1333048 may modulate CDKN2B‐AS1 expression, thus accelerating PCa progression. [ABSTRACT FROM AUTHOR]

Background: Hemophilia A (HA) treatment strategies aim to manage bleeding episodes and improve patients' quality of life. This study investigates the effectiveness of a preventative approach using intermediate-dose prophylaxis with standard half-life FVIII products in reducing bleeding rates and enhancing the quality of life for patients with severe HA. Methods: A 4-year prospective longitudinal study followed 35 patients with severe HA (without FVIII inhibitors) who transitioned from a reactive treatment approach to intermediate-dose prophylaxis in Taiwan from 2014 until 2018. The study tracked annual bleeding rates (ABR) and annual joint bleeding rates (AjBR) alongside associated costs and patient-reported quality-of-life measures. Results: Prophylaxis significantly reduced both ABR and AjBR compared with the previous treatment. After one year, ABR and AjBR decreased by 76.9% and 72.5%, respectively, with further reductions to 91.0% and 90.8% after 4 years (p < 0.001). While the average annual cost of factor VIII concentrate increased by 41.0% in the first year, the incremental cost-effectiveness ratio demonstrated ongoing benefits from ABR avoidance over the 4 years. Additionally, patients reported significant improvements in quality-of-life measures following the switch to prophylaxis (p = 0.036). Conclusion: Intermediate-dose prophylaxis effectively reduced bleeding rates and improved quality of life in patients with severe HA. Despite initial cost increases, the intervention became cost effective over time. This study provides valuable data for healthcare policymakers, highlighting the long-term benefits of prophylaxis as a preventative approach for managing bleeding and improving overall well-being in patients with severe HA. [ABSTRACT FROM AUTHOR]

Background: Intracorporeal anastomosis offers notable advantages over extracorporeal techniques, including reduced tissue manipulation leading to faster recovery and potentially lower risks of surgical site infections and complications. However, it also involves several challenges, such as increased operative time and the need for experienced assistants and multiple trocars. Our novel technique addresses these problems. Methods: We present a novel approach for closing common enterotomies during intracorporeal anastomosis by using a linear stapler. This technique involves the use of a 6-cm straight needle, which facilitates closure of the common enterotomy. The technique can be performed independently by a single surgeon without the need for additional trocars or assistants. Results: This technique was applied for 20 patients undergoing laparoscopic gastrointestinal surgery between June 2023 and February 2024. The median age of the enrolled patients was 65 years, with laparoscopic right hemicolectomy with intracorporeal ileocolostomy being the most common procedure (60% of cases). The median anastomosis time was 22.5 min. No occurrence of anastomotic leakage was reported, and only one patient (5%) developed temporary postoperative bowel obstruction, which was managed conservatively. Conclusions: Our technique enables efficient and safe closure of common enterotomies during intracorporeal anastomosis, minimizing reliance on additional trocars and experienced assistants. It simplifies the procedure and ensures fullthickness stapling, potentially reducing the likelihood of complications. Because of its broad applicability across various laparoscopic surgeries, this technique offers substantial benefits and is worth recommending for intracorporeal anastomosis. [ABSTRACT FROM AUTHOR]

This article examines the role of fair value gains or losses related to Level 3 valuations in CEO cash compensation for U.S. financial firms. Our results show that Level 3 income is compensation-relevant. By separating Level 3 income into unrealized and realized Level 3 income, we find that CEO cash compensation is less sensitive to unrealized than realized Level 3 income, which indicates that compensation committees have a higher concern for the clawback problem associated with unrealized Level 3 income. A further analysis separating Level 3 income into positive and negative components shows that Level 3 losses are more compensation-relevant than Level 3 gains, thereby validating the argument that Level 3 losses are more credible than Level 3 gains. Overall, we find that Level 3 income is relevant for CEO cash compensation and that this phenomenon is mainly driven by its realized and loss components. [ABSTRACT FROM AUTHOR]

This study explores the aerodynamic performance of a wing and propeller system through experiments and numerical simulations. Three configurations, including a single tip propeller and four distributed propellers with the same or alternative rotational directions, are tested. The findings demonstrate that the distributed propulsion technique enhances wing performance by generating higher lift but may also increase drag and reduce cruising efficiency. The effects of propeller slipstream on pressure distribution, lift distribution, and boundary layer separation are analyzed, providing insights into the underlying mechanisms. The presence of a single tip propeller improves overall performance, whereas four propellers distributed in front of the leading edge delay stall and enhance the lift-to-drag ratio at high angles of attack. At these high angles of attack, an interesting phenomenon occurs in which the propeller slipstream is deflected upward toward the upper surface of the wing. This upward deflection of the slipstream plays a crucial role in suppressing separation of the boundary layer above the wing. This phenomenon effectively delays stall and significantly enhances the overall aerodynamic performance of the wing. Practical Applications: This study provides valuable insights into the aerodynamic performance of unmanned aerial vehicle (UAV) wings using distributed propulsion (DP). The findings demonstrate that a DP system, in which multiple small propellers are strategically placed along the leading edge of the wing, significantly enhances lift and delays stall, particularly at high angles of attack. This configuration proves highly beneficial for UAVs that require high lift and stability during critical flight phases such as takeoff, landing, and low-speed flight operations. This study also identifies the following trade-off: whereas the DP system offers enhanced lift and improved control during these phases, the result may be increased drag and reduced efficiency during cruising, affecting overall flight range and endurance. The insights gained from this study can inform future designs of UAVs for specific uses such as cargo delivery, surveillance, and agricultural monitoring. Additionally, the results can aid in developing new aircraft models, such as air taxis, for which enhanced lift, reduced noise, and improved performance in particular phases of flight are critical for urban air mobility solutions. [ABSTRACT FROM AUTHOR]

Background: Weight control behaviors are commonly observed among adolescents and emerging adults. However, the high prevalence of overweight and obesity in both these age groups remains an imperative health concern. Adolescents and emerging adults represent the most vulnerable groups facing the health burden of obesity. Methods: This study was designed to articulate the underlying beliefs concerning weight control behaviors among adolescents and emerging adults living with obesity by an elicitation qualitative study based on the integrated behavioral model (IBM). Semi-structured and individual interviewing was utilized. Eligible participants were recruited during September and November 2020. All interviews were audio-recorded, transcribed verbatim, and analyzed using a hybrid inductive and deductive content analysis approach. Results: Twenty-seven participants, comprising 12 adolescents and 15 emerging adults living with obesity, were interviewed to explore their beliefs and strategies regarding weight control behaviors. Emerging adults were more likely to engage in extreme weight control methods. Three overarching themes emerged across both age groups: eating-centered concerns, focus on physical appearance, and social interference. Significant differences were noted while adolescents and emerging adults shared some common beliefs. Emerging adults expressed more economic concerns about weight control, whereas adolescents identified food restriction as the primary barrier to their weight management efforts. These findings highlight the nuanced differences in beliefs about the weight control practice of these two developmental groups. Conclusion: More beliefs-tailored and theoretically driven interventions are needed for these two unique age groups. Healthcare providers should address dietary and economic concerns while engaging adolescents and emerging adults in weight management. Future obesity interventions should incorporate shared and unique beliefs identified in each group to promote healthy weight management effectively. [ABSTRACT FROM AUTHOR]

Key Points: Question: Among people invited for colon cancer screening with fecal immunochemical testing (FIT), does adding a Helicobacter pylori stool antigen test to FIT reduce rates of gastric cancer incidence and gastric cancer mortality, compared with FIT alone? Findings: In a randomized clinical trial that included 152 503 people, there were no significant differences in incidence of gastric cancer or gastric cancer mortality between people invited to undergo screening with H pylori stool antigen and FIT compared with people invited to undergo FIT screening alone (0.032% vs 0.037%, respectively, for gastric cancer incidence and 0.015% vs 0.013%, respectively, for gastric cancer mortality). Meaning: An invitation to test for H pylori stool antigen in combination with FIT did not significantly reduce rates of gastric cancer, compared with an invitation for FIT alone, but results may have been affected by differences in screening participation and length of follow-up between the 2 groups. Importance: Effects of screening for Helicobacter pylori on gastric cancer incidence and mortality are unknown. Objective: To evaluate the effects of an invitation to screen for H pylori on gastric cancer incidence and mortality. Design, Setting, and Participants: A pragmatic randomized clinical trial of residents aged 50 to 69 years in Changhua County, Taiwan, eligible for biennial fecal immunochemical tests (FIT) for colon cancer screening. Participants were randomized to either an invitation for H pylori stool antigen (HPSA) + FIT assessment or FIT alone. The study was conducted between January 1, 2014, and September 27, 2018. Final follow-up occurred December 31, 2020. Intervention: Invitation for testing for H pylori stool antigen. Main Outcomes and Measures: The primary outcomes were gastric cancer incidence and gastric cancer mortality. All invited individuals were analyzed according to the groups to which they were randomized. Results: Of 240 000 randomized adults (mean age, 58.1 years [SD, 5.6]; 46.8% female), 63 508 were invited for HPSA + FIT, and 88 995 were invited for FIT alone. Of the 240 000 randomized, 38 792 who were unreachable and 48 705 who did not receive an invitation were excluded. Of those invited, screening participation rates were 49.6% (31 497/63 508) for HPSA + FIT and 35.7% (31 777/88 995) for FIT alone. Among 12 142 participants (38.5%) with positive HPSA results, 8664 (71.4%) received antibiotic treatment, and eradication occurred in 91.9%. Gastric cancer incidence rates were 0.032% in the HPSA + FIT group and 0.037% in the FIT-alone group (mean difference, −0.005% [95% CI, −0.013% to 0.003%]; P =.23). Gastric cancer mortality rates were 0.015% in the HPSA + FIT group and 0.013% in the FIT-alone group (mean difference, 0.002% [95% CI, −0.004% to 0.007%]; P =.57). After adjusting for differences in screening participation, length of follow-up, and patient characteristics in post hoc analyses, an invitation for HPSA + FIT was associated with lower rates of gastric cancer (0.79 [95% CI, 0.63-0.98]) but not with gastric cancer mortality (1.02 [95% CI, 0.73-1.40]), compared with FIT alone. Among participants who received antibiotics, the most common adverse effects were abdominal pain or diarrhea (2.1%) and dyspepsia or poor appetite (0.8%). Conclusions and Relevance: Among residents of Taiwan, an invitation to test for HPSA combined with FIT did not reduce rates of gastric cancer or gastric cancer mortality, compared with an invitation for FIT alone. However, when differences in screening participation and length of follow-up were accounted for, gastric cancer incidence, but not gastric cancer mortality, was lower in the HSPA + FIT group, compared with FIT alone. Trial Registration: ClinicalTrials.gov Identifier: NCT01741363 This randomized clinical trial evaluates the effects of Helicobacter pylori stool antigen assessment plus fecal immunochemical testing (FIT), vs FIT alone, on gastric cancer incidence and mortality among adults in Taiwan. [ABSTRACT FROM AUTHOR]

Understanding platelet protein functions facilitates better assessment of platelet disorders. Megakaryocyte lineage-restricted human Disabled-2 knock-in (hDAB2-KI) mice are generated to delineate the functions of hDab2, a regulator of platelet function, in the control of bleeding associated with thrombocytopenia. Here we show that hDab2-KI mice with thrombocytopenia display decreased bleeding time when compared to the control mice. hDab2 augments thromboxane A2 (TxA2) mimetic U46619- but not other agonists-stimulated granule secretion, integrin activation, and aggregation at a lower platelet concentration in vitro. Binding of hDab2 to phosphatidic acid (PA) facilitates formation of the PA-hDab2-AKT complex leading to an increase in U46619-stimulated AKT-Ser473 phosphorylation and the first wave of ADP/ATP release. Consistent with these findings, hDab2 expression in platelets from patients with immune thrombocytopenic purpura is positively correlated with U46619-stimulated ATP release, which in turn inversely correlated with their bleeding tendency. hDab2 appears crucial in regulating bleeding severity associated with thrombocytopenia by a functional interplay with ADP/ATP release underlying TxA2 signaling. Human Disabled-2 (hDab2) is a key regulator of bleeding severity associated with thrombocytopenia. Here the authors show this is facilitated by the functional interplays of hDab2 with phosphatidic acid, AKT, and ADP/ATP release underlying thromboxane A2 signaling. [ABSTRACT FROM AUTHOR]

This paper introduces a novel approach for reconstructing microwave imaging by combining the Whale Optimization Algorithm (WOA) with deep learning techniques. In it, electromagnetic waves are used to illuminate inhomogeneous dielectric objects in free space, and the scattered field is recorded. Due to the highly nonlinear nature of microwave imaging, the WOA is first employed to calculate an initial guess from the measured scattered field of dielectric objects. This step significantly reduces the training complexity for machine learning. Subsequently, the initial guess provided by the WOA is fed into a U-Net to accurately reconstruct the microwave image. Numerical simulation results indicate that the combination of the WOA and machine learning outperforms traditional methods under varying noise levels, enhancing the precision and effectiveness of the reconstruction process. In detail, the RMSE can be reduced 4–10% for dielectric constant distribution from 1 to 2.5 and SSIM can be increased about 30% for most cases. [ABSTRACT FROM AUTHOR]

Key message: Desiccation-stage transcription factors perform similar functions, with early ones focused on desiccation tolerance and later ones on development. Gene networks governing late embryo development diverge between soybean and Arabidopsis. To understand gene activities programming seed embryo development, we profiled the soybean embryo transcriptome across embryonic morphogenesis through post-germination. Transcriptomic landscapes across embryo development feature highly prevalent transcripts, categorized into early and late groups, with shared and distinct functions. During the mid-storage reserve accumulation stage, the upregulated genes are enriched with regulatory tasks at both the transcriptional and chromatin levels, including DNA methylation and chromatin remodeling. The epigenetic-related functions also dominate in the upregulated genes during germination, involving core histone variants and histone chaperones. Gene network analysis reveals both stage-specific modules and modules active across multiple stages. The desiccation-associated gene module integrates diverse transcription factors (TFs) that are sequentially active during different desiccation stages, transitioning from abiotic stress functions early on to developmental functions later. Two TFs, active during the early and mid-desiccation stages were functionally assessed in Arabidopsis overexpression lines to uncover their potential roles in desiccation processes. Interestingly, nearly half of the Arabidopsis orthologs of soybean TFs active in the desiccation-associated module are inactive during Arabidopsis desiccation. Our results reveal that chromatin and transcriptional regulation coordinate during mid-storage reserve accumulation, while distinct epigenetic mechanisms drive germination. Additionally, gene modules either perform stage-specific functions or are required across multiple stages, and gene networks during late embryogenesis diverge between soybean and Arabidopsis. Our studies provide new information on the biological processes and gene networks underlying development from embryonic morphogenesis to post-germination. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed unprecedented challenges to global public health, particularly for vulnerable populations like pregnant women. This study delves into the T cell immune responses in pregnant women with confirmed SARS-CoV-2 infection, all of whom received three doses of a COVID-19 vaccine. Using the ELISpot assay, we measured T cell responses against SARS-CoV-2 spike S1 and nucleocapsid peptides in two groups: those infected before and during pregnancy. Our results showed weak to moderate correlations between T cell responses and neutralizing antibody levels, with no statistically significant differences between the two groups. T cell reactivity appeared to decrease over time post-diagnosis, regardless of infection timing. Intriguingly, over half of the participants maintained detectable T cell memory responses beyond one year post-infection, suggesting the long-term persistence of cellular immunity. These insights contribute to the understanding of COVID-19 immunology in pregnant women, highlighting the importance of considering both humoral and cellular immune responses in this high-risk population. [ABSTRACT FROM AUTHOR]

(1) Background: Eustachian tube dysfunction (ETD) is a frequently observed clinical manifestation of chronic rhinosinusitis (CRS). This systematic review aimed to evaluate the function of the Eustachian tube following endoscopic sinus surgery (ESS) in adult CRS patients with confirmed preoperative ETD symptoms. (2) Methods: A systematic search of PubMed, Cochrane, Embase, and MEDLINE electronic databases was conducted. The review was performed following the PRISMA guidelines. Studies investigating concurrent ETD in CRS patients who underwent ESS were retrieved. The changes in ETD outcomes were measured by the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7). We employed a random-effects model to conduct the meta-analysis (3) Results: We included seven observational studies that involved a total of 436 CRS patients with concurrent ETD. The pooled results revealed a statistically significant reduction (Standardized mean difference = −1.24; 95% CI = −1.64 to −0.84) in ETDQ-7 scores among the CRS with ETD patient cohort at the 3-month postoperative follow-up. (4) Conclusions: ESS serves as an effective intervention for improving E-tube function in adult CRS patients with concurrent ETD. Future prospective randomized controlled trials that incorporate various outcome predictors should be conducted to explore potential clinical factors for greater ETD improvement and normalization after ESS. [ABSTRACT FROM AUTHOR]