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Objective: Breast cancer treatment has evolved to the modern skin-sparing mastectomy and nipple-sparing mastectomy. To better perform these surgeries, minimally invasive techniques using the endoscope, or Da Vinci Robotic Surgery platform have been developed. The deep inferior epigastric perforator (DIEP) flap is the gold standard in breast reconstruction, but it is still not commonly performed after minimally invasive mastectomy due technical difficulty. Here the authors introduced six key steps to a successful aesthetic autologous free flap reconstruction in in minimally invasive mastectomies. Methods: There are six main steps to our technique: placement of mastectomy incision, precise flap design after angiography studies, trial of shaping, transcutaneous medial suture, footprint recreation and postoperative shaping with bra. Between November 2018 and July 2022, a total of 67 immediate breast reconstructions using free perforator flaps were performed in 63 patients after minimally invasive nipple-sparing mastectomy. Results: The results from the minimally invasive mastectomy group were compared with a group of conventional mastectomy patients (n=41) performed during the same period. There were no significant differences in flap exploration rates. One hundred percent of the flaps survived. In the minimally invasive group, the final scar was placed in the lateral region, where it would be hidden from the anterior view. Only 70.7% of the conventional mastectomy group could achieve a hidden lateral scar (P<0.001). The aesthetic revision rates were similar between two groups. Conclusion: With attention to the six steps above, autologous free flap reconstruction can be offered reliably in the setting of minimally invasive mastectomy. [ABSTRACT FROM AUTHOR]

HS-173 is a specific inhibitor of the Phosphoinositide 3-Kinase a (PI3Ka) subtype. Although it was shown to potentially inhibit tumor angiogenesis, experimental validation studies are still needed. This study provides an experimental basis for the role of HS-173 in breast cancer. A mouse model of subcutaneous transplantation breast cancer was constructed. The mice were treated with different concentrations of HS-173. Immunohistochemical staining was used to detect tumor microvessel density, and the appropriate concentration was determined. Immunofluorescence was used to detect the morphology integrity of tumor vessels' lumen, transmission electron microscopy to detect tight junctions between endothelial cells and the integrity of the basement membrane, Doppler ultrasound to detect tumor blood perfusion, and small animal live imaging to detect the penetration of doxorubicin in the tumor tissues. After HS-173 treatment, the number of tumor interstitial microvessels decreased, the lack of tumor vascular lumen was reduced, and the continuity and integrity of the vascular lumen were increased. Vascular endothelial cells showed complete morphology with good tight junctions. The extracellular matrix was rich in components and tended to form basement membranes. HS-173 also increased the blood perfusion in the tumor tissue compared with the doxorubicin treatment alone. Further, the fluorescence signal intensity of the tumor tissue doxorubicin was significantly enhanced after HS-173 treatment. The PI3K inhibitor HS-173 showed promising potential in inhibiting tumor angiogenesis and improving the structure and function of blood vessels in the tumor microenvironment. [ABSTRACT FROM AUTHOR]

Background: Free flap monitoring is essential for postmicrosurgical management and outcomes but traditionally relies on human observers; the process is subjective and qualitative and imposes a heavy burden on staffing. To scientifically monitor and quantify the condition of free flaps in a clinical scenario, we developed and validated a successful clinical transitional deep learning (DL) model integrated application. Material and Methods: Patients from a single microsurgical intensive care unit between 1 April 2021 and 31 March 2022, were retrospectively analyzed for DL model development, validation, clinical transition, and quantification of free flap monitoring. An iOS application that predicted the probability of flap congestion based on computer vision was developed. The application calculated probability distribution that indicates the flap congestion risks. Accuracy, discrimination, and calibration tests were assessed for model performance evaluations. Results: From a total of 1761 photographs of 642 patients, 122 patients were included during the clinical application period. Development (photographs =328), external validation (photographs =512), and clinical application (photographs = 921) cohorts were assigned to corresponding time periods. The performance measurements of the DL model indicate a 92.2% training and a 92.3% validation accuracy. The discrimination (area under the receiver operating characteristic curve) was 0.99 (95% CI: 0.98-1.0) during internal validation and 0.98 (95% CI: 0.97-0.99) under external validation. Among clinical application periods, the application demonstrates 95.3% accuracy, 95.2% sensitivity, and 95.3% specificity. The probabilities of flap congestion were significantly higher in the congested group than in the normal group (78.3 (17.1)% versus 13.2 (18.1)%; 0.8%; 95% CI, P<0.001). Conclusion: The DL integrated smartphone application can accurately reflect and quantify flap condition; it is a convenient, accurate, and economical device that can improve patient safety and management and assist in monitoring flap physiology. [ABSTRACT FROM AUTHOR]

Tbe importance of organizational stressors bas been increasingly acknowledged by researchers studying psychosocial responses in atbletes. This study examined tbe association between tbe frequency of encountered organizational stressors and competitive trait anxiety, and investigated bow psychological flexibility could moderate sucb a relationship. Witbin a cori·elational study design, 526 athletes (M = 20.0 years) from tbe eastern China completed a battery of self-report measures. Data were analyzed witb a regression-based moderation analysis, using tbe PROCESS macro for SPSS. Tbe results revealed positive relationships between tbe frequency of organizational stressors and competitive trait anxiety, wbereas negative relationsbips between psychological flexibility and organizational stressors as well as competitive trait anxiety. A reduced association was observed between tbe frequency of organizational stressors and worry, and between tbe stressorfrequency and concentration disruption in athletes witb bigber levels of psychological flexibility, compared to those witb lower levels of psycbologicalflexibility. 7 be findings bigblight tbe influential role of psycbological flexibility in acting as a buffer against potential negative outcomes experienced by athletes in response to organizational stressors encountered in sport settings. -Wbere possible, sport organizations and coacbes should place emphasis on changing athletes' experiences of organizational stressors and developing atbletes' psychological flexibility. [ABSTRACT FROM AUTHOR]

Background: Medical students in Taiwan start their clerkship in their fifth year. A lack of early clinical exposure can mean they have a lack of medical professionalism and collaborative practice. This study investigates whether early engagement in hospitalbased clinical practice could improve their understanding of these requirements. Methods: From 2017 to 2019, a total of 59 medical students at the end of their third year joined a 2-week summer camp at the hospital. Every participant was assigned to work with one patient and they accompanied this patient throughout their hospital course. The students were also asked to interview other medical professionals within the hospital and to write up interview reports. In addition, they had to complete pre-and postcamp questionnaires which included 10 questions to evaluate their recognition of professionalism, doctor-patient relationships, and interprofessional collaboration. Answers to the questions were all rated using a 5-score Likert scale. Results: The total postcamp Likert scores were significantly increased after the 2-week training camp compared with the precourse scores (pre- vs postcourse: 44.08 ± 0.45 vs 46.66 ± 0.33, p < 0.001). In addition, the students' recognition of medical professionalism, the importance of communication with patients, and their respect for other medical professionals were significantly improved after the 2-week training. Conclusion: Our data showed that early clinical exposure through a preclerkship summer camp can help medical students improve their recognition of medical professionalism and interprofessional collaboration. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate whether the role-play (RP) of real patients by medical students as part of interactive clinical reasoning training can improve medical students' clinical performance. Methods: A total of 26 medical students volunteered to portray real patients within this program and were treated as the RP group while the other 72 students as the non-RP group. In the interactive morning meeting, the medical students practiced how to approach the RP student as if they were encountering a real patient. All students were evaluated by mini-clinical evaluation exercises (mini-CEX) before and after this training program. Results: We found that all students had an increased total mini-CEX score after 4-week training, especially for interviewing skills. Notably, after training, the RP students had significantly elevated total mini-CEX scores (51.23 ± 1.06 vs 53.12 ± 1.11, p = 0.028), and for counselling (7.15 ± 0.14 vs 7.54 ± 0.18, p = 0.015) and overall clinical competence (7.27 ± 0.15 vs 7.65 ± 0.16, p = 0.030). In contrast, the non-RP students had lower scores compared with the RP group, as revealed by both the pre- and post-training tests. Moreover, their mini-CEX scores were not improved after training. Conclusion: Medical students who were motivated to RP real patients had better performance scores than those who did not. In addition, RP can enhance their counselling skills and clinical competences. [ABSTRACT FROM AUTHOR]

A facilitated and effective gender recognition approach is desirable for various applications such as for intelligent surveillance systems, human-computer interactions, and consumer behavior analysis. Since the human face conveys clear sexual dimorphism, the use of facial features seems an intuitive way to recognize gender. This paper proposes an efficient gender classification method using multiple classifiers to overcome the occlusion problem. The experiment is tested via 5-fold cross validation on the FERET and AR databases to evaluate the performance. The results show the proposed approach achieves higher accuracy than previous methods. [ABSTRACT FROM AUTHOR]

PURPOSE: Based on the theory of cognitive and motor development, this study examined the mediating role of critical thinking in relation to peer interaction, learning motivation, and motor skill performance. METHODS: Fifth- and sixth- grade students from 23 elementary schools completed measures regarding critical thinking, learning motivation, and peer interaction, and motor skill tests. RESULTS: The findings showed that positive peer relationships and learners' motivation exhibited facilitative impacts on critical thinking skills, whereas negative peer relationships yielded a debilitating influence. Moreover, critical thinking was found to be a mediating factor among the relationships of learning motivation, peer interaction, and motor Skill Performance. CONCLUSION: The findings suggest that physical education teachers should create a supportive learning environment and emphasize positive peer interactions to increase learners' motivation and critical thinking skills, which in turn can improve students' motor skill performance. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the relationship between competitive trait anxiety and attentional bias among college and high school archers. The study used State-Trait Anxiety Inventory (STAI-T) and Sport Competition Anxiety Test (SCAT) to determine the factors of sports-specific and life-related cues. The study also prospective directions to develop interventions for efficiently regulating attentional bias patterns of athletes with high competitive trait anxiety.

Objective To determine the benefit of newborn screening for the long-term prognosis of patients with classic infantile-onset Pompe disease (IOPD). Study design A cohort of patients with classic IOPD were diagnosed by newborn screening, treated with recombinant human acid α-glucosidase (rhGAA), and followed prospectively. Outcome measurements included survival, left ventricular mass, serum creatinine kinase, motor function, mental development, and systemic manifestations. Results Ten patients who presented with left ventricular hypertrophy at diagnosis received rhGAA infusions starting at a median age of 16 days (6-34 days). All patients were cross-reactive immunologic material-positive. After a median treatment time of 63 months (range 28-90 months), all could walk independently, and none required mechanical ventilation. All patients had motor capability sufficient for participating in daily activities, but muscle weakness over the pelvic girdle appeared gradually after 2 years of age. Ptosis was present in one-half of the patients, and speech disorders were common. Anti-rhGAA antibody titers were low (median maximal titer value 1:1600, range: undetectable ~ 1:12 800). Conclusion By studying patients treated since birth who have no significant anti-rhGAA antibody interference, this prospective study demonstrates that the efficacy of rhGAA therapy is high and consistent for the treatment of classic IOPD. This study also exposes limitations of rhGAA treatment. The etiology of the manifestations in these early-treated patients will require further study. [ABSTRACT FROM AUTHOR]

Hepatic osteodystrophy (HOD) is a metabolic bone disease that is often associated with chronic liver disease and is marked by bone loss. Here, we demonstrate that hepatic expression of the phosphatase PP2Acα is upregulated during HOD, leading to the downregulation of expression of the hepatokine lecithin-cholesterol acyltransferase (LCAT). Loss of LCAT function markedly exacerbates the bone loss phenotype of HOD in mice. In addition, we found that alterations in cholesterol levels are involved in the regulation of osteoblast and osteoclast activities. We also found that LCAT improves liver function and relieves liver fibrosis in the mouse HOD model by promoting reversal of cholesterol transport from the bone to the liver. In summary, defects in a liver-bone axis occur during HOD that can be targeted to ameliorate disease progression. [Display omitted] • High levels of PP2Acα in the liver correlate with bone loss in individuals with HOD • Upregulation of LCAT expression in the liver ameliorates bone loss in HOD mice • PP2Acα downregulates LCAT expression through dephosphorylation of USF1 • LCAT improves liver function by reversing cholesterol transport from bone to liver Hepatic osteodystrophy (HOD) is a metabolic bone disease caused by chronic liver injuries. Lu et al. discovered a novel liver-bone axis in the pathogenesis of HOD involving the upregulation of hepatic PP2Acα that leads to reduced expression of the hepatokine lecithin-cholesterol acyltransferase (LCAT) and defects in reverse cholesterol transport from the bone to the liver. [ABSTRACT FROM AUTHOR]

The purpose of this study was based on our WiiRemote system study results to improve the human-machine interface and to develop the tangible augmented reality system for the learning effects on museum artifacts. The system prototype of tangible augmented reality system for butterfly's specimens was examined in National Museum of Natural Science. Through the research method of questionnaire, interview and observation, we gathered the different aspects of the data and the information from visitors of National Museum of Natural Science. Based on the analysis of research data, the important conclusions are as follows: 1. All visitors highly satisfied with the tangible augmented reality system and met their needs of use: high interaction, easy to use and enjoyment; 2. The system usability impacted the system utility. Furthermore both of system usability and system utility affected the users' attention in tangible augmented reality system. [ABSTRACT FROM AUTHOR]

The article discusses the result of a retrospective study evaluating the radiographic results of a minimally invasive distal metatarsal osteotomy for correction of hallux valgus, which is a common foot deformity with a multifactorial etiology. Topics include an overview of the controversy of using a minimally invasive surgical technique for hallux valgus and the limitations of minimal incision distal metatarsal osteotomy.

An abstract of the article "Science Communication Studies between Science and Media: The Needs and Roles of the Contemporary Public," by Chun-Ju Huang and Miao-Ju Jian is presented.

Background: The purpose of this study was to explore the expression and biological functions of glycoprotein 130 (gp130) in Epstein-Barr virus (EBV)-associated nasopharyngeal carcinoma (NPC). A prospective study was performed. Methods: Ten patients with NPC and 10 patients with nasopharyngeal lymphoid hyperplasia (LH) were enrolled in this study. The transcripts of IL-27 receptors (gp130 and WSX-1) in the biopsy specimens derived from NPC were compared with that from LH by using reverse-transcription polymerase chain reaction. Cell lines including EBV-, Burkitt-like lymphoma (BJAB) cells, human adult peripheral blood mononuclear cells, and lymphoblastoid cell lines were used to provide evidence of the biological function of gp130. In addition, killing assay for natural killer (NK) cells was performed in the presence of gp130. Results: There was significantly stronger expression of gp130 on the LH specimens than on the NPC specimens. The levels of gp130 mRNA were reduced in the EBV-transformed cells. The cytotoxicity ratio against gp130-deficient B cells was diminished compared with gp130-existent B cells. Conclusion: The expression of gp130 is down-regulated in patients with NPC. We presume that EBV controls the functions of NK cells through regulation of gp130 cytokine receptor. [ABSTRACT FROM AUTHOR]

Many modern handheld devices feature functions of taking pictures, shooting video clips, or recording audio sounds. However, such devices are usually equipped with small display panels and poor acoustic equipments. In order to achieve better user experience with high quality panel or audio stereo, users often need to transfer or copy digital media contents to external powerful devices, like personal computers and home theater devices. Nevertheless, it can be awkward or difficult for users to follow up a series of operations of connection setup and media content transfer. In this paper, we present a mobile media content sharing mechanism based the UPnP framework and wireless communication technology in home network environments. As a result, users could conveniently share media contents stored in mobile devices and play them by other home networked player devices. The demonstration result shows that the developed mechanism is attractive and of practicability and ease of use. [ABSTRACT FROM AUTHOR]