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In China, lesbian and bisexual women face intense stigma and difficulties developing relationships with each other. Although prior research has shown that online communities help LGBT people connect and exchange social support, few studies have explored the challenges Chinese lesbian and bisexual women face when initiating, growing, and sustaining such communities, in an atmosphere of platform censorship of LGBT-related content and intense discrimination from non-LGBT people. To address this gap, we interviewed 40 Weibo users in China, four bloggers and 36 followers of their blogs, who self-identified as lesbian or bisexual women. We found that a key technique these bloggers used to initiate their online communities was helping followers publish posts seeking support, sharing personal experiences, and seeking offline relationships. Then, their followers built relationships with bloggers by journaling their daily experiences as lesbian or bisexual women via private-messaging channels. As the communities' members grew more attached to them, bloggers and their followers began to work together to protect themselves from external threats, including Weibo's censorship and non-LGBT+ infiltrators' harassment. However, such attachment to the communities sometimes might lead to conflicts within them, which in turn prompted many members to leave, raising questions about the communities' long-term prospects. Our findings foreground important design considerations for those seeking to help lesbian and bisexual women in China and other discriminatory environments to develop safe online communities.

Background Health care and well-being are 2 main interconnected application areas of conversational agents (CAs). There is a significant increase in research, development, and commercial implementations in this area. In parallel to the increasing interest, new challenges in designing and evaluating CAs have emerged. Objective This study aims to identify key design, development, and evaluation challenges of CAs in health care and well-being research. The focus is on the very recent projects with their emerging challenges. Methods A review study was conducted with 17 invited studies, most of which were presented at the ACM (Association for Computing Machinery) CHI 2020 conference workshop on CAs for health and well-being. Eligibility criteria required the studies to involve a CA applied to a health or well-being project (ongoing or recently finished). The participating studies were asked to report on their projects’ design and evaluation challenges. We used thematic analysis to review the studies. Results The findings include a range of topics from primary care to caring for older adults to health coaching. We identified 4 major themes: (1) Domain Information and Integration, (2) User-System Interaction and Partnership, (3) Evaluation, and (4) Conversational Competence. Conclusions CAs proved their worth during the pandemic as health screening tools, and are expected to stay to further support various health care domains, especially personal health care. Growth in investment in CAs also shows the value as a personal assistant. Our study shows that while some challenges are shared with other CA application areas, safety and privacy remain the major challenges in the health care and well-being domains. An increased level of collaboration across different institutions and entities may be a promising direction to address some of the major challenges that otherwise would be too complex to be addressed by the projects with their limited scope and budget.

Chromatographic separation on the liquid-state fermented products produced by the fungal strain

BackgroundPreoperative two-dimensional manual measurement of pulmonary artery diameter in a single-cut axial view computed tomography (CT) image is a commonly used non-invasive prediction method for pulmonary hypertension. However, the accuracy may be unreliable. Thus, this study aimed to evaluate the correlation of short-term surgical outcomes and pulmonary artery/aorta (PA/Ao) diameter ratio measured by automated three-dimensional (3D) segmentation in lung cancer patients who underwent thoracoscopic lobectomy.Materials and methodsWe included 383 consecutive lung cancer patients with thin-slice CT images who underwent lobectomy at a single institute between January 1, 2011 and December 31, 2019. Automated 3D segmentation models were used for 3D vascular reconstruction and measurement of the average diameters of Ao and PA. Propensity-score matching incorporating age, Charlson comorbidity index, and lobectomy performed by uniportal VATS was used to compare clinical outcomes in patients with PA/Ao ratio ≥1 and those ResultsOur segmentation method measured 29 (7.57%) patients with a PA/Ao ratio ≥1. After propensity-score matching, a higher overall postoperative complication classified by the Clavien–Dindo classification (p = 0.016) were noted in patients with 3D PA/Ao diameter ratio ≥1 than those of 3 cm (p = 0.002) both significantly predict the incidence of postoperative complications.ConclusionsPulmonary artery/aorta diameter ratio ≥ 1 measured by automated 3D segmentation may predict postoperative complications in lung cancer patients who underwent lobectomy.

The quantitative analysis of cell surface antigens has attracted increasing attention due to the antigenic variation recognition that can facilitate early diagnoses. This paper presents a novel methodology based on the optical “cell-tearing” and the especially proposed “dilution regulations” to detect variations in cell surface antigens. The cell attaches to the corresponding antibody-coated slide surface. Then, the cell-binding firmness between a single cell and the functionalized surface is assayed by optically tearing using gradually reduced laser powers incorporated with serial antibody dilutions. Groups B and B3 of red blood cells (RBCs) were selected as the experiment subject. The results indicate that a higher dilution called for lower power to tear off the cell binding. According to the proposed relative-quantitative analysis theory, antigenic variation can be intuitively estimated by comparing the maximum allowable dilution folds. The estimation result shows good consistency with the finding in the literature. This study suggests a novel methodology for examining the variation in cell surface antigens, expected to be widely capable with potential sensor applications not only in biochemistry and biophysics, but also in the micro-/nano- engineering field.

Chatbots are regarded as a promising technology for delivering guidance. Prior studies show that chatbots have the potential of coaching users to learn different skills; however, several limitations of chatbot-based approaches remain. People may become disengaged from using chatbot-guided systems and fail to follow the guidance for complex tasks. In this paper, we design chatbots with (HC) and without (OC) human support to deliver guidance for people to practice journaling skills. We conducted a mixed-method study with 35 participants to investigate their actual interaction, perceived interaction, and the effects of interacting with the two chatbots. The participants were randomly assigned to use one of the chatbots for four weeks. Our results show that the HC participants followed the guidance more faithfully during journaling practices and perceived a significantly higher level of engagement and trust with the chatbot system than the OC participants. However, after finishing the journaling-skill training session, the OC participants were more willing to keep using the learned skills than the HC participants. Our work provides new insights into the design of integrating human support into chatbot-based interventions for delivering guidance.

BACKGROUND Healthcare and wellbeing are two main interconnected application areas of conversational agents (CAs). There is a significant increase in research, development, and commercial implementations in this area. In parallel to the increasing interest, new challenges in designing and evaluating CAs have emerged. OBJECTIVE This study aims to identify key design, development, and evaluation challenges of CAs in healthcare and wellbeing research. The focus is on the very recent projects with their emerging challenges. METHODS A review study was conducted with 17 invited studies, most of which were presented at the ACM CHI2020 conference workshop on CAs for health and wellbeing. Eligibility criteria required the studies to involve a CA applied to a health or wellbeing project in an ongoing or recently finished project. The participating studies were asked to report on their projects' design and evaluation challenges. We used thematic analysis to review the studies. RESULTS The findings include a range of topics from primary care to caring for older adults to health coaching. We identified four major themes: i) domain information and integration, ii) user-system interaction and partnership, iii) evaluation, and iv) conversational competence. CONCLUSIONS While some challenges are shared with other CA application areas, safety and privacy remain the major challenges in the healthcare and wellbeing domains. An increased level of collaboration across different institutions and entities may be a promising direction to address some of the major challenges which otherwise would be too complex to be addressed by the projects with their limited scope and budget.

To prospectively evaluate the effect of benzalkonium chloride (BAK)-preserved latanoprost on ocular surface damage and identify the associated risk factors among treatment-naive glaucoma patients. The basal Schirmer’s test results, corneal Oxford staining score, non-invasive keratograph tear-breakup time, oculus hyperemia index score (objective metrics), and ocular surface disease index (OSDI) questionnaire (subjective metric) were evaluated at baseline, 1 month, and 4 months after receiving latanoprost eye drops. Associated risk factors were assessed by multivariate linear regression. Seventy-four eyes (44 patients) were enrolled. Basal Schirmer’s test tear-flow and Oxford scores gradually deteriorated (β = −0.14, P = 0.001 and β = 0.1, P < 0.001, respectively). The percentage of unstable tear-film (breakup time < 10 s) increased significantly at 4 months (6.21% vs 9.11%, P = 0.042). Hyperemic scores increased significantly at 1 month and normalized at 4 months (P = 0.01 and P = 0.16, respectively); total OSDI scores tended to improve (β = −0.76, P = 0.06). Older age was associated with additional corneal Oxford staining (P = 0.005); female sex was associated with increased unstable tear-film scores (P = 0.01). Artificial tear use was associated with a smaller decrease in basal Schirmer’s test values (P = 0.01) and a smaller increase in unstable tear-film scores (P = 0.02). Preserved latanoprost eye drops affected ocular surface changes in glaucoma patients through decreased basal tear secretion. Artificial tears represent an early intervention in vulnerable glaucoma patients with reduced tear secretion and impaired tear-film stability.

Background Cataract surgery in combination with or after trabeculectomy is often required for improving vision in glaucoma patients. Intraocular pressure (IOP) changes may influence refractive outcomes after cataract surgery. We compared refractive outcomes of the combined and sequential approaches in managing glaucoma and cataract. Methods This retrospective case–control study included 52 patients (57 eyes) who underwent phacotrabeculectomy (combined group) and 39 patients (42 eyes) who underwent phacoemulsification at least three months post-trabeculectomy (sequential group). The IOP and refraction prediction error were compared at three months after cataract surgery. Univariate regression analyses were used to assess risk factors for the postoperative refraction prediction error. Results Anti-glaucomatous medications were not administered to either group. The mean postoperative IOP (12.96 vs. 13.80 mmHg; P = .392), refraction prediction error (−0.32 ± 1.53 vs. −0.47 ± 1.14 D, P = .594), mean absolute error (1.02 ± 1.18 vs. 0.8 ± 0.93 D, P = .320), and surgically induced astigmatism (1.85 ± 1.40 vs. 2.16 ± 1.16 D, P = .161) did not differ significantly between the combined and sequential groups. In the sequential group, the refraction prediction error correlated to the IOP change, with a 1-mm Hg rise resulting in a −0.07-diopter shift between the expected and observed refraction (r = −0.380, R2 = 0.144, P = .013); no such correlation was observed in the combined group. Conclusion Both approaches resulted in similar effective IOP control and accurate intraocular lens predictability. The IOP change affected the postoperative refraction prediction error only in the sequential approach.

Pulmonary hypertension should be preoperatively evaluated for optimal surgical planning to reduce surgical risk in lung cancer patients. Preoperative measurement of vascular diameter in computed tomography (CT) images is a noninvasive prediction method for pulmonary hypertension. However, the current estimation method, 2D manual arterial diameter measurement, may yield inaccurate results owing to low tissue contrast in non-contrast-enhanced CT (NECT). Furthermore, it provides an incomplete evaluation by measuring only the diameter of the arteries rather than the volume. To provide a more complete and accurate estimation, this study proposed a novel two-stage deep learning (DL) model for 3D aortic and pulmonary artery segmentation in NECT. In the first stage, a DL model was constructed to enhance the contrast of NECT; in the second stage, two DL models then applied the enhanced images for aorta and pulmonary artery segmentation. Overall, 179 patients were divided into contrast enhancement model (n = 59), segmentation model (n = 120), and testing (n = 20) groups. The performance of the proposed model was evaluated using Dice similarity coefficient (DSC). The proposed model could achieve 0.97 ± 0.007 and 0.93 ± 0.002 DSC for aortic and pulmonary artery segmentation, respectively. The proposed model may provide 3D diameter information of the arteries before surgery, facilitating the estimation of pulmonary hypertension and supporting preoperative surgical method selection based on the predicted surgical risks.

Chatbots are becoming increasingly popular. One promising application for chatbots is to elicit people's self-disclosure of their personal experiences, thoughts, and feelings. As receiving one's deep self-disclosure is critical for mental health professionals to understand people's mental status, chatbots show great potential in the mental health domain. However, there is a lack of research addressing if and how people self-disclose sensitive topics to a real mental health professional (MHP) through a chatbot. In this work, we designed, implemented and evaluated a chatbot that offered three chatting styles; we also conducted a study with 47 participants who were randomly assigned into three groups where each group experienced the chatbot's self-disclosure at varying levels respectively. After using the chatbot for a few weeks, participants were introduced to a MHP and were asked if they would like to share their self-disclosed content with the MHP. If they chose to share, the participants had the option of changing (adding, deleting, and editing) the content they self-disclosed to the chatbot. Comparing participants' self-disclosure data the week before and the week after sharing with the MHP, our results showed that, within each group, the depth of participants' self-disclosure to the chatbot remained after sharing with the MHP; participants exhibited deeper self-disclosure to the MHP through a more self-disclosing chatbot; further, through conversation log analysis, we found that some participants made different edits on their self-disclosed content before sharing it with the MHP. Participants' interview and survey feedback suggested an interaction between participants' trust in the chatbot and their trust in the MHP, which further explained participants' self-disclosure behavior.

Live streaming is an emergent social medium that allows remote interaction between the streamer and an audience of any size. Major live-streaming platforms in some Asian countries have a digital gift-giving feature that allows viewers to directly reward streamers during live sessions. Streamers can later exchange the digital gifts they have received for money, and this monetary incentive appears likely to influence how they interact with their viewers and generate live-streaming content. However, the precise nature and mechanisms of such impact have not previously been explored. Therefore, this qualitative study with 13 streamer participants examines how digital gifting influences streamers' motivations and the nature of both the content that they generate and their social interactions with their audiences. It reports that the digital-gifting function serves as a major incentive for active streaming, but may also disincentivize some streamers from continuing to contribute, for reasons that will be explored. Moreover, the participants devised strategies for both content generation and social interaction with the specific objective of earning gifts from viewers: practices that, in some cases, appeared to limit the quality of their live-streaming content. It was also noted that the streamers tended to have constrained social relationships with their viewers, in part because such relationships were seen as unequal or one-sided due to gift-giving behavior. The paper concludes with a discussion of design considerations for the incorporation of gift-giving features into live-streaming platforms, and additional recommendations for future research and the design of such platforms.

Oral cavity squamous cell carcinoma (OSCC) is a leading cause of death in Taiwan. Most of the patients in the literature are male. The risk factors, cancer characteristics, and treatment outcomes were investigated in female patients and compared with male patients in this study. This retrospective study recruited 2046 OSCC patients between 1995 and 2019. The age, tumor subsites, and survival were reviewed and recorded. Overall survival and disease-free survival were the main outcomes. Female patients represented 6.7% of the entire study cohort. Females were diagnosed at an older age and an earlier local stage than male patients (P

The analysis of surface antigens on cells, especially red blood cells (RBCs), has attracted increasing attention due to the recognition of antigenic variation that can facilitate early diagnoses. This paper presents an alternative methodology to estimate the variation of surface antigen expressions using an optical cell-detachment technique to validate the binding of individual RBCs stuck on corresponding antibody-coated surfaces. The detachment tests were implemented by an optical tweezers with gradually decreasing laser powers associated with serial antibody dilutions. Then, the antigen expression variation was estimated based on the known antibody dilution folds. The B- and B3-types of RBCs were selected for the demonstration subjects. With the semi-quantitative analysis, the proposed methodology was successfully verified for evaluating the variation of the RBC surface antigen expressions. The analysis result shows good consistency with the literature’s findings.

Background: Early injection laryngoplasty (EIL) using hyaluronic acid (HA) is an effective treatment for glottic insufficiency in patients with acute unilateral vocal fold paralysis (UVFP). Most patients benefit by showing improvement in voice and quality of life and implied reduced need for permanent laryngoplasty. However, injected HA might resolve within a short period, so its long-term outcomes and the need for secondary procedures need to be clarified. Methods: Patients who underwent EIL with HA for acute UVFP from January 2015 to December 2018 were included. The factors that may associate with the prognosis including voice performance and laryngeal configuration at presentation, the cause of UVFP, and the type of HA for EIL were analyzed. Results: Ninety-four patients were included for analysis, with a mean follow-up period of 25.1 months (95% CI: 22.8–27.4 months). After primary HA injection, 22 patients (23.4%) underwent secondary procedures (rate: 13.1% per person-year), and most (63.6%) of the events occurred after one year from the first injection. The rate of secondary procedures within the first 12 months was 9.0% (14.1% and 4.3% for low-concentrated HA (LHA) and high-concentrated HA (HHA), respectively). The incidence of the secondary procedures was higher in the LHA group (18.2%) (p = 0.026) than in the HHA group (7.5%). Conclusions: The rate of secondary procedures was lower than the prediction based on the resorption time of HA, a finding that could be partly accounted for by both natural nerve recovery and a long-lasting effect of EIL. EIL with HHA had a lower rate of re-treatment than that with LHA, suggesting a better clinical utility for acute UVFP.

Diagnosis of the Human Immunodeficiency Virus (HIV) remains challenging due to non-specific clinical presentations and mostly flu-like symptoms, e.g., fever, headache, sore throat, and general weakness. Oral lesions, such as oral candidiasis and Kaposi sarcoma, are also frequently associated with HIV infection, whereas laryngeal manifestations are rare. We report two cases of newly diagnosed HIV patients with clinical presentations of sore throat, and endoscopy revealed an epiglottic ulcerative tumor-like lesion. A laryngomicrosurgical biopsy of the lesions was performed for persistent symptoms and suspicion of malignancy. The result revealed acute and chronic inflammation without a conclusive pathology diagnosis. Further laboratory analysis was arranged in consideration of autoimmune diseases, Epstein–Barr virus (EBV), and HIV infection due to their persistent and atypical symptoms. The results were positive for HIV infection. These patients were treated successfully with antiviral treatment and the laryngeal symptoms improved within weeks. In patients with idiopathic and persistent epiglottitis or an epiglottic ulcer after medical treatment, HIV infection needs to be considered as a potential etiology in order to institute proper treatment.

Background: Many patients with obstructive sleep apnea (OSA) are mouth-breathers. Mouth-breathing not only narrows the upper airway, consequently worsening the severity of OSA, but also it affects compliance with nasal continuous positive airway pressure (CPAP) treatment. This study aimed to investigate changes in OSA by the use of mouth tape in mouth-breathers with mild OSA. Method: Mouth-breathers with mild OSA who met inclusion criteria and tolerated the sealing of the mouth were enrolled in the study. We used 3M silicone hypoallergenic tape was used to seal the mouths of the participants during sleep. The home sleep test (HST) used in this study was ApneaLink®. Subjects received both a baseline HST and an outcome HST to be used 1 week later while their mouths were taped. The changes between the baseline and the outcome HSTs were compared, and the factors that influenced the differences in the sleep-test parameters after the shift of the breathing route were analyzed. A “responder” was defined as a patient who experienced a reduction from the baseline snoring index of at least 50% under mouth-taping in the HST; otherwise, patients were considered as having a poor response. Results: A total of 20 patients with mild OSA were included. Following the taping of the mouth, a good response was found in 13 patients (65%). The median apnea/hypopnea index (AHI) decreased significantly, from 8.3 to 4.7 event/h (by 47%, p = 0.0002), especially in supine AHI (9.4 vs. 5.5 event/h, p = 0.0001). The median snoring index (SI) was also improved (by 47%, 303.8 vs. 121.1 event/h, p = 0.0002). Despite no significant difference in the mean saturation, improvements in the oxygen desaturation index (8.7 vs. 5.8, p = 0.0003) and the lowest saturation (82.5% vs. 87%, p = 0.049) were noted. The change in AHI was associated with baseline AHI (r = −0.52, p = 0.02), oxygen desaturation index (ODI) (r = −0.54, p = 0.01), and SI (r = −0.47, p = 0.04). The change in SI was strongly associated with baseline SI (r = −0.77, p = 0.001). Conclusions: Mouth-taping during sleep improved snoring and the severity of sleep apnea in mouth-breathers with mild OSA, with AHI and SI being reduced by about half. The higher the level of baseline AHI and SI, the greater the improvement was shown after mouth-taping. Mouth-taping could be an alternative treatment in patients with mild OSA before turning to CPAP therapy or surgical intervention.

Errors occurred in the standard deviation of the Dice similarity coefficient (DSC) described in the original publication [...]

Persistent chronic liver diseases increase the scar formation and extracellular matrix accumulation that further progress to liver fibrosis and cirrhosis. Nevertheless, there is no antifibrotic therapy to date. The ketogenic diet is composed of high fat, moderate to low-protein, and very low carbohydrate content. It is mainly used in epilepsy and Alzheimer’s disease. However, the effects of the ketogenic diet on liver fibrosis remains unknown. Through ketogenic diet consumption, β-hydroxybutyrate (bHB) and acetoacetate (AcAc) are two ketone bodies that are mainly produced in the liver. It is reported that bHB and AcAc treatment decreases cancer cell proliferation and promotes apoptosis. However, the influence of bHB and AcAc in hepatic stellate cell (HSC) activation and liver fibrosis are still unclear. Therefore, this study aimed to investigate the effect of the ketogenic diet and ketone bodies in affecting liver fibrosis progression. Our study revealed that feeding a high-fat ketogenic diet increased cholesterol accumulation in the liver, which further enhanced the carbon tetrachloride (CCl4)- and thioacetamide (TAA)-induced liver fibrosis. In addition, more severe liver inflammation and the loss of hepatic antioxidant and detoxification ability were also found in ketogenic diet-fed fibrotic mouse groups. However, the treatment with ketone bodies (bHB and AcAc) did not suppress transforming growth factor-β (TGF-β)-induced HSC activation, platelet-derived growth factor (PDGF)-BB-triggered proliferation, and the severity of CCl4-induced liver fibrosis in mice. In conclusion, our study demonstrated that feeding a high-fat ketogenic diet may trigger severe steatohepatitis and thereby promote liver fibrosis progression. Since a different ketogenic diet composition may exert different metabolic effects, more evidence is necessary to clarify the effects of a ketogenic diet on disease treatment.

Persistent chronic liver diseases increase the scar formation and extracellular matrix accumulation that further progress to liver fibrosis and cirrhosis. Nevertheless, there is no antifibrotic therapy to date. The ketogenic diet is composed of high fat, moderate to low-protein, and very low carbohydrate content. It is mainly used in epilepsy and Alzheimer’s disease. However, the effects of the ketogenic diet on liver fibrosis remains unknown. Through ketogenic diet consumption, β-hydroxybutyrate (bHB) and acetoacetate (AcAc) are two ketone bodies that are mainly produced in the liver. It is reported that bHB and AcAc treatment decreases cancer cell proliferation and promotes apoptosis. However, the influence of bHB and AcAc in hepatic stellate cell (HSC) activation and liver fibrosis are still unclear. Therefore, this study aimed to investigate the effect of the ketogenic diet and ketone bodies in affecting liver fibrosis progression. Our study revealed that feeding a high-fat ketogenic diet increased cholesterol accumulation in the liver, which further enhanced the carbon tetrachloride (CCl4)- and thioacetamide (TAA)-induced liver fibrosis. In addition, more severe liver inflammation and the loss of hepatic antioxidant and detoxification ability were also found in ketogenic diet-fed fibrotic mouse groups. However, the treatment with ketone bodies (bHB and AcAc) did not suppress transforming growth factor-β (TGF-β)-induced HSC activation, platelet-derived growth factor (PDGF)-BB-triggered proliferation, and the severity of CCl4-induced liver fibrosis in mice. In conclusion, our study demonstrated that feeding a high-fat ketogenic diet may trigger severe steatohepatitis and thereby promote liver fibrosis progression. Since a different ketogenic diet composition may exert different metabolic effects, more evidence is necessary to clarify the effects of a ketogenic diet on disease treatment.

The quantitative analysis of surface antigens on cells, especially red blood cells (RBCs), has attracted increasing attention due to the recognition of antigenic changes that can facilitate early diagnoses. This paper presents an alternative methodology developed using the optical cell-detachment technique to evaluate antibody-antigen interactions and quantitatively analyze the RBC surface antigen expression. RBC subtyping was used to verify the proposed detection principle based on a comparison of the bonding strengths between individual RBCs and antibody coatings. The bonding strengths were measured with serial antibody dilutions with gradually decreasing laser powers, for which a single cell was optically detached from the corresponding antibody-coated surface. With the quantitatively analysis, the proposed alternative methodology was verified as a highly sensitive technique for detecting antigen expression on the RBC surface.

Myocardial infarction is the leading cause of morbidity and mortality worldwide. Although myocardial reperfusion after ischemia (I/R) is an effective method to save ischemic myocardium, it can cause adverse reactions, including increased oxidative stress and cardiomyocyte apoptosis. Mitochondrial fission and mitophagy are essential factors for mitochondrial quality control, but whether they play key roles in cardiac I/R injury remains unknown. New pharmacological or molecular interventions to alleviate reperfusion injury are currently considered desirable therapies. Vitamin D3 (Vit D3) regulates cardiovascular function, but its physiological role in I/R-exposed hearts, especially its effects on mitochondrial homeostasis, remains unclear. An in vitro hypoxia/reoxygenation (H/R) model was established in H9c2 cells to simulate myocardial I/R injury. H/R treatment significantly reduced H9c2 cell viability, increased apoptosis, and activated caspase 3. In addition, H/R treatment increased mitochondrial fission, as manifested by increased expression of phosphorylated dynein-related protein 1 (p-Drp1) and mitochondrial fission factor (Mff) as well as increased mitochondrial translocation of Drp1. Treatment with the mitochondrial reactive oxygen species scavenger MitoTEMPO increased cell viability and decreased mitochondrial fission. H/R conditions elicited excessive mitophagy, as indicated by increased expression of BCL2-interacting protein 3 (BNIP3) and light chain (LC3BII/I) and increased formation of autolysosomes. In contrast, Vit D3 reversed these effects. In a mouse model of I/R, apoptosis, mitochondrial fission, and mitophagy were induced. Vit D3 treatment mitigated apoptosis, mitochondrial fission, mitophagy, and myocardial ultrastructural abnormalities. The results indicate that Vit D3 exerts cardioprotective effects against I/R cardiac injury by protecting mitochondrial structural and functional integrity and reducing mitophagy.

Background/purpose Limited data are available on the role of illicit non-injecting drug use in a prolonged HIV outbreak that predominantly affected men who have sex with men (MSM) in Taiwan since 2006. We aimed to assess associations between specific types of drug use and incident HIV infections in this outbreak. Methods We conducted a retrospective case–control study among MSM clients at voluntary counselling and testing (VCT) service at National Taiwan University Hospital (Taipei, Taiwan). We used BED IgG-capture enzyme immunoassay to identify incident HIV infection (cases), individually matched to HIV-negative MSM clients (controls) by HIV testing date. We used a structured questionnaire to obtain the information on illicit drug use and sexual risk behaviors. Results From a total of 15,305 MSM client visits during 2006–2015, 387 cases were matched to 1012 controls. Use of inhaled nitrites (adjusted odds ratio [aOR] 2.1), MDMA (aOR 2.9), amphetamines (aOR 1.6), and ketamine (aOR 1.5) were independently associated with incident HIV infection. Polydrug (≥2 drugs) use was associated with the highest risk (aOR 4.3; 95% CI 2.6–7.2). While the proportion of MSM VCT clients who reported use of any recreational drug remained stable during 2006–2015 (average: 9.7%, P: 0.38), there was a shift in specific types of drug use, from MDMA/ketamine to inhaled nitrites/amphetamine, after 2011 (all Ps Conclusion Non-opioid recreational drugs use is associated with incident HIV infection in this prolonged HIV outbreak. There is an urgent need to formulate an effective public health response to mitigate the risk.

To prospectively evaluate the effect of benzalkonium chloride (BAK)-preserved latanoprost on ocular surface damage and identify the associated risk factors among treatment-naive glaucoma patients.The basal Schirmer's test results, corneal Oxford staining score, non-invasive keratograph tear-breakup time, oculus hyperemia index score (objective metrics), and ocular surface disease index (OSDI) questionnaire (subjective metric) were evaluated at baseline, 1 month, and 4 months after receiving latanoprost eye drops. Associated risk factors were assessed by multivariate linear regression.Seventy-four eyes (44 patients) were enrolled. Basal Schirmer's test tear-flow and Oxford scores gradually deteriorated (β = -0.14, P = 0.001 and β = 0.1, P0.001, respectively). The percentage of unstable tear-film (breakup time10 s) increased significantly at 4 months (6.21% vs 9.11%, P = 0.042). Hyperemic scores increased significantly at 1 month and normalized at 4 months (P = 0.01 and P = 0.16, respectively); total OSDI scores tended to improve (β = -0.76, P = 0.06). Older age was associated with additional corneal Oxford staining (P = 0.005); female sex was associated with increased unstable tear-film scores (P = 0.01). Artificial tear use was associated with a smaller decrease in basal Schirmer's test values (P = 0.01) and a smaller increase in unstable tear-film scores (P = 0.02).Preserved latanoprost eye drops affected ocular surface changes in glaucoma patients through decreased basal tear secretion. Artificial tears represent an early intervention in vulnerable glaucoma patients with reduced tear secretion and impaired tear-film stability.

Chatbots (conversational agents) are increasingly receiving attention in mental health domains because they elicit honest self-disclosure about personal experiences and emotions. Although such self-disclosure contents can be useful for gauging mental status, little research has addressed how to automatically assess mental status from self-disclosures to a chatbot. If a chatbot can automatically assess the mental status of users, it can help them improve their mental wellness or facilitate access to mental professionals. In this paper, we examine whether indicators that identify depression from written texts (e.g., social media posts) are also useful for assessing mental status from disclosures to a chatbot. We first ran a study with 30 participants who engaged in daily journaling with a chatbot that prompted them to record their moods and experiences for three weeks. We then divided the participants' self-disclosure data into three groups based on their mental state changes before and after the study: improved vs. deteriorated vs. no change. Comparing the data among the three groups, participants whose mental states deteriorated during the study gradually used fewer positive emotion and concrete words but more negative emotion words when describing their daily experiences and feelings to the chatbot.

Our goal was to investigate the changes in artificial short-linear chromosome average copy numbers per cell arising from partial or full loss of Mitotic Arrest-Deficient 2 (MAD2) spindle checkpoint function in budding yeast Saccharomyces cerevisiae. Average artificial linear chromosome copy numbers in a population of cells, as measured by quantitative polymerase chain reactions (qPCR), and retention rates, as measured by fluctuation analyses, were performed on a total of 62 individual wild type and mad2∆ mutant haploid and diploid clones. Wild type cells, both haploids and diploids, displayed phenotypically unique clone-to-clone differences: one group of 15 clones displayed low-copy numbers per cell and high retention rates, were 1 clone was found to have undergone a genomic integration event, and the second group of 15 clones displayed high copy numbers per cell and low retention rates, with the latter values being consistent with the previously published results where only a single clone had been measured. These chromosome states were observed to be unstable when propagated for 10 days under selection, where high copy-low retention rate clones evolved into low copy-high retention rate clones, but no evidence for integration events was observed. By contrast, mad2∆ haploid and mad2∆/mad2∆ diploids displayed a suppression of the clone-to-clone differences, where 20 out of 21 clones had mid-level artificial linear chromosome copy numbers per cell, but maintained elevated chromosome retention rates. The elevated levels in retention rates in mad2∆ and mad2∆/mad2∆ cells were also maintained even in the absence of selection during growth over 3 days. MAD2/mad2∆ heterozygous diploids displayed multiple clonal groups: 4 with low copy numbers, 5 with mid-level copy numbers, and 1 with a high copy number of artificial linear chromosomes, but all 10 clones uniformly displayed low retention rates. Our observations reveal that MAD2 function contributes to the ability of yeast cells to maintain a high number of artificial linear chromosomes per cell in some clones, but, counter-intuitively, mad2∆ suppresses clone-to-clone differences and leads to an improvement in artificial linear chromosome retention rates yielding a more uniform and stable clonal population with mid-level chromosome copy numbers per cell.

Our goal was to investigate the changes in artificial short-linear chromosome average copy numbers per cell arising from partial or full loss of Mitotic Arrest-Deficient 2 (MAD2) spindle checkpoint function in budding yeast Saccharomyces cerevisiae. Average artificial linear chromosome copy numbers in a population of cells, as measured by quantitative polymerase chain reactions (qPCR), and retention rates, as measured by fluctuation analyses, were performed on a total of 62 individual wild type and mad2∆ mutant haploid and diploid clones. Wild type cells, both haploids and diploids, displayed phenotypically unique clone-to-clone differences: one group of 15 clones displayed low-copy numbers per cell and high retention rates, were 1 clone was found to have undergone a genomic integration event, and the second group of 15 clones displayed high copy numbers per cell and low retention rates, with the latter values being consistent with the previously published results where only a single clone had been measured. These chromosome states were observed to be unstable when propagated for 10 days under selection, where high copy-low retention rate clones evolved into low copy-high retention rate clones, but no evidence for integration events was observed. By contrast, mad2∆ haploid and mad2∆/mad2∆ diploids displayed a suppression of the clone-to-clone differences, where 20 out of 21 clones had mid-level artificial linear chromosome copy numbers per cell, but maintained elevated chromosome retention rates. The elevated levels in retention rates in mad2∆ and mad2∆/mad2∆ cells were also maintained even in the absence of selection during growth over 3 days. MAD2/mad2∆ heterozygous diploids displayed multiple clonal groups: 4 with low copy numbers, 5 with mid-level copy numbers, and 1 with a high copy number of artificial linear chromosomes, but all 10 clones uniformly displayed low retention rates. Our observations reveal that MAD2 function contributes to the ability of yeast cells to maintain a high number of artificial linear chromosomes per cell in some clones, but, counter-intuitively, mad2∆ suppresses clone-to-clone differences and leads to an improvement in artificial linear chromosome retention rates yielding a more uniform and stable clonal population with mid-level chromosome copy numbers per cell.

Objectives: Oral cavity squamous cell carcinoma (OSCC) is a leading cause of death in Taiwan, and most of the patients are male. Little is known about the differences in risk factors, cancer characteristics and treatment outcomes in female patients. The study aim is to investigate the clinicopathological and outcome differences between gender in patients affected by oral cancer in Taiwan.Methods: This is a retrospective study based on data obtained between 1995 and 2019. A total of 2,046 patients were recruited for analysis. Cancer characteristics, risk factors and treatment outcomes in patients with oral cancer between genders were collected. Results: Female patients represented the 6.7% of the entire cohort of study. Females were diagnosed at an older age and at an earlier local stage compared to male patients (p < 0.001). The female patients were less exposed to cigarette, alcohol, and betel-nut (BQ) (all p-values < 0.001). Tongue (55.1%) was the most frequent subsite involved in the female group, while buccal (38.4%) and tongue (35.3%) were more likely (p < 0.001) to be associated with male gender. In tongue cancer subgroup, female patients presented less frequently extra-nodal extension compared with male patients (p = 0.040). During the follow-up period, there was no significant difference in recurrence and overall deaths between genders.Conclusion:In Taiwan, the male to female ratio in OSCC is 14:1. The tumor subsite distribution, environment exposure and stage distribution are different between females and male. There are no differences in term of survival between female and male OSCC patients.

Objectives Real-world experience regarding the effectiveness of co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide (EVG/C/FTC/TAF) as a switch regimen is sparse among people living with HIV (PLWH) harbouring the M184V/I mutation with or without thymidine analogue-associated mutations (TAMs). Methods In this retrospective multicentre study, PLWH who were switched to EVG/C/FTC/TAF after having achieved viral suppression (plasma HIV RNA Results Overall, 100 case patients with the M184V/I mutation were identified, including 6 (6.0%) with K65R and 13 (13.0%) with at least one TAM, and were matched to 400 controls in terms of gender, age (mean = 40.3 versus 39.7 years) and cumulative exposure duration to tenofovir disoproxil fumarate (median = 146 versus 143 weeks). At Week 48, the rate of virological non-success for the case patients and controls was 5.0% (5/100) and 3.3% (13/400), respectively (difference = 1.7%; 95% CI = −2.9%–6.3%), while the rate of virological success was 88.0% and 89.5% for the case patients and controls, respectively. The presence of the K65R mutation or TAMs was not associated with virological non-response. Conclusions Among virally suppressed PLWH, EVG/C/FTC/TAF is effective in maintaining viral suppression at Week 48 despite archived M184V/I mutation with or without TAMs.

Chatbots have great potential to serve as a low-cost, effective tool to support people's self-disclosure. Prior work has shown that reciprocity occurs in human-machine dialog; however, whether reciprocity can be leveraged to promote and sustain deep self-disclosure over time has not been systematically studied. In this work, we design, implement and evaluate a chatbot that has self-disclosure features when it performs small talk with people. We ran a study with 47 participants and divided them into three groups to use different chatting styles of the chatbot for three weeks. We found that chatbot self-disclosure had a reciprocal effect on promoting deeper participant self-disclosure that lasted over the study period, in which the other chat styles without self-disclosure features failed to deliver. Chatbot self-disclosure also had a positive effect on improving participants' perceived intimacy and enjoyment over the study period. Finally, we reflect on the design implications of chatbots where deep self-disclosure is needed over time.

Digital gifting in live streaming, in which viewers buy digital gifts to reward the streamers, was worth over $200 million in 2018 in China and its growth has been accelerating. This paper explores what motivates people to tip and how it impacts interactions between viewers and streamers. Through a survey, we identified the main categories of viewers' tipping motivations. We found that viewers were motivated by the reciprocal acts of streamers, who would engage in various types of social interactions with tippers during the live streams. The styles of interactions and contents of live stream based on the tipping are differently influenced by the motivations of viewers and streamers. For example, viewers often tip large to attract attentions from the crowd or promote preferred live-streaming content. These findings provide more knowledge on the social interaction in live streaming platforms.

In this paper, we explored the potential of using a conversational chatbot interface to guide students to perform peer assessments. Our results show that our chatbot interface is in general successful in guiding graders, as reflected by students' grading consistencies across multiple assessments and correlated with teaching assistants' grading. Our results provide insights into how conversational interface can be used to support peer assessments.

Attention detection is important for many applications. Automatic determination of users' visual attention state is challenging because attention involves numerous complex and internal human cognitive functions. Behavioral observations, such as eye gaze or response to external stimuli, can provide clues for users' visual attention state; however, users' cognitive state cannot be easily known. Conventional electroencephalography-based methods detect attention by observing the dynamic changes in the frontal lobe of the brain, especially in the anterior cingulate cortex (ACC). However, that area in the brain is associated with many functions, some of which correlate with conscious experience but are not directly related to attention. In this paper, we design an attention monitoring system to detect whether the brain experiences a visual stimulus consciously. Our experiments verified the feasibility of our design, and the average classification rate ranged from 72% to 82%.

Over the years, it was getting attention to hepatitis C virus (HCV) and human immu-nodeficiency virus (HIV) infection among injected drug users (IDUs) in Taiwan. This study investigated the frequency of risky behaviors for HCV carriers and IDUs who were HIV carriers in methadone maintenance treatment program. The subjects, intravenously injected heroin abusers, were collected from a special methadone maintenance treatment clinic. The survey included characteristics of participants, sexual activity and attitude towards condom usage. The total number of subjects was 151. Data were analyzed using the statistical package SPSS 15.0. The analytical methods included descriptive analysis, Fisher’s exact test, and the logistic regression model. The study showed that 82% of intravenously injected heroin abusers were hepatitis C virus (HCV)-positive, and 44.4% were hepatitis B virus (HBV)-positive; 89.5% of HIV-positive heroin abusers were type C hepatitis positive. Only 21.2% of these intra-venously injected heroin abusers always used a condom, and 39.7% never used a condom during sexual activity. Logistic regression analysis showed smoking, sharing syringes needles, HBV status and condom use status were four main risk factors on HIV infection. Sharing or using contaminated syringes needles was the main cause of HIV, HBV, and HCV infection in the drug addiction group. Since our government has the policy of providing a methadone maintenance treatment program, the spread of HIV is under control, but knowledge about HIV and safe sex education still needs improvement.

Health care researchers have recently developed several home-based sleep monitoring systems and mobile applications that support healthy sleep by monitoring a user’s sleep environment, activities, or sleep quality. This study describes the design and evaluation of an electrooculogram (EOG)-based system for an automatic sleep monitoring. Compared with polysomnogram or electroencephalogram recordings, EOG has the advantage of easy placement and can be operated by the users themselves. We also design an intelligent eye mask that is user friendly for measuring sleep stage and quality. Two user experiments were carried out to demonstrate that the proposed system produces valid measurements of sleep stage and sleep quality and has good usability and reliability while not disturbing sleep significantly. These findings suggest that our system can also be applied to long-term sleep monitoring or sleep environment control to improve the user’s sleep quality and make sleep more comfortable.

Live streaming is a proliferating social media generating special social interactions on the platforms especially in China. For example, tipping in live streaming, in which viewers buy virtual gifts to reward the streamers. This paper explores people's tipping behaviors and how it impacts interactions between viewers and streamers. We analyzed 12 videos of live streams by labeling the viewer-streamer interactions, and found that viewers were motivated by the reciprocal acts of streamers. Furthermore, we interviewed 5 streamers to understand their motivations behind the viewer-streamer interactions. Our future study would investigate tipping motivations from the viewers' perspective.