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Objective: To study packaging design from the perspective of consumers' emotional experience and explore interactive packaging design that can not only meet consumers' practical functions but also meet consumers' emotional needs. Methods: Starting from the overview of interactive packaging design based on emotional experience, combined with the expression principles of practicability, integrity and emotional sustainability of interactive packaging design, the construction of interactive relationship of interactive packaging design was studied in three results sensory stimulation, opening mode and blending of emotion and scene. Results: The interactive packaging design, which pays attention to the response principle and sensitive characteristics of packaging materials, and uses rapid response code, electronic components and augmented reality technology, can enhance consumers' emotional experience. Conclusion: Packaging design should reasonably implant interactive elements, close the relationship between consumers and products, and empower the sustainable development of packaging industry.

BACKGROUND: Lack of n‐3 polyunsaturated fatty acids during the period of maternity drastically lowers the docosahexaenoic acid (DHA) level in the brain of offspring and studies have demonstrated that different molecular forms of DHA are beneficial to brain development. The aim of this study was to investigate the effect of short‐term supplementation with DHA‐enriched phosphatidylserine (PS) and phosphatidylcholine (PC) on DHA levels in the liver and brain of congenital n‐3‐deficient mice. RESULTS: Dietary supplementation with DHA significantly changed the fatty acid composition of various phospholipid molecules in the cerebral cortex and liver while DHA‐enriched phospholipid was more effective than DHA triglyceride (TG) in increasing brain and liver DHA. Both DHA‐PS and DHA‐PC could effectively increase the DHA levels, but DHA in the PS form was superior to PC in the contribution of DHA content in the brain ether‐linked PC (ePC) and liver lyso‐phosphatidylcholine molecular species. DHA‐PC showed more significant effects on the increase of DHA in liver TG, PC, ePC, phosphatidylethanolamine (PE) and PE plasmalogen (pPE) molecular species and decreasing the arachidonic acid level in liver PC plasmalogen, ePC, PE and pPE molecular species compared with DHA‐PS. CONCLUSION: The effect of dietary interventions with different molecular forms of DHA for brain and liver lipid profiles is different, which may provide theoretical guidance for dietary supplementation of DHA for people. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Background: Azathioprine is a purine synthesis inhibitor used as an immunosuppressive therapy for many immune-mediated diseases. Azathioprine hypersensitivity reaction is a rare, life-threatening adverse reaction characterized by a range of multisystem manifestations including fever, abdominal pain, arthralgias, erythematous cutaneous eruption, acute renal failure, neutrophilia, and more rarely, distributive shock. Although acute heart failure has been rarely described in association with azathioprine hypersensitivity syndrome, myocardial infarction has, to our knowledge, never been associated with this entity. Case Presentation: We describe a case of a 59-year-old male with Crohn's disease who developed severe azathioprine hypersensitivity syndrome that included distributive shock, neutrophilic dermatosis, and acute coronary syndrome with ST-elevation. Clinical improvement was seen after cessation of azathioprine and administration of glucocorticoid therapy. Conclusion: Prompt recognition of azathioprine hypersensitivity syndrome, which can manifest as shock and neutrophilic dermatosis, is key to ensure rapid azathioprine cessation. [ABSTRACT FROM AUTHOR]

Concurrent chemoradiotherapy (CCRT) is the standard treatment for patients with locally advanced squamous cell carcinoma of the head and neck (HNSCC). Pneumonia is a significant complication in these patients. This study aims to identify pneumonia risk factors and their impact on survival in HNSCC patients undergoing CCRT. Data from the Chang Gung Research Database (CGRD) were retrospectively reviewed for patients treated between January 2007 and December 2019. Of 6959 patients, 1601 (23.01%) developed pneumonia, resulting in a median overall survival (OS) of 1.2 years compared to 4.9 years in the non-pneumonia group (p < 0.001). The pneumonia group included older patients with advanced tumors, more patients with diabetes mellitus (DM), more patients with invasive procedures, longer chemotherapy and radiotherapy durations, and lower body weight. The 2-year, 5-year, and 10-year OS rates were significantly lower in the pneumonia group. Multivariate analysis identified alcohol consumption, DM, gastrostomy, nasogastric tube use, longer chemotherapy, and a 2-week radiotherapy delay as independent risk factors. Understanding these risks can lead to early interventions to prevent severe pneumonia-related complications. A better understanding of the risks of pneumonia enables early and aggressive interventions to prevent severe complications. [ABSTRACT FROM AUTHOR]

Objective: Nutritional and inflammatory statuses have been associated with complications in microvascular‐free flaps during head and neck surgeries. This study aimed to evaluate the potential of nutritional indicators in predicting postoperative free flap complications. Study Design: We conducted a 20‐year retrospective, case‐control study within a defined cohort. Setting: The study involved head and neck cancer patients from the Chang Gung Research Database who underwent simultaneous tumor ablation and free flap wound reconstruction between January 1, 2001, and December 31, 2019. Methods: We employed logistic regression and stratified analysis to assess the risk of free flap complications and the subsequent need for flap revision or redo in relation to nutritional indicators and other clinical variables. Results: Of the 8066 patients analyzed, 687 (8.5%) experienced free flap complications. Among these, 197 (2.4%) had free flap failures necessitating a redo of either a free flap or a pedicled flap. Beyond comorbidities such as chronic obstructive pulmonary disease, end‐stage renal disease, and a history of prior radiotherapy, every 10‐unit decrease in the preoperative prognostic nutritional index (PNI) was consistently associated with an increased risk of both free flap complications and failure. The covariate‐adjusted odds ratios were 1.90 (95% confidence interval [CI]: 1.42‐2.54) and 1.89 (95% CI: 1.13‐3.17), respectively. Conclusion: A lower preoperative PNI suggests a higher likelihood of microvascular free flap complications in head and neck surgeries. Further randomized controlled trial designs are required to establish causality. [ABSTRACT FROM AUTHOR]

Background: Limited data are available to examine the effects of intensity‐modulated proton therapy (IMPT) on patient‐reported outcomes in patients with nasopharyngeal carcinoma (NPC). Thus, we assessed whether patients receiving IMPT reported a better short‐term quality of life (QoL) than those receiving volumetric‐modulated arc therapy (VMAT). Methods: We consecutively invited newly diagnosed NPC patients who had undergone standard treatment protocol within 2 years post‐radiotherapy at our institute between 2021 and 2023 to participate in the observational study. All participants completed the EuroQol five‐dimension, World Health Organization Quality‐of‐Life—Brief, Sinonasal Outcome Test 22, Eustachian Tube Dysfunction Questionnaire‐7, and Eating Assessment Tool‐10 (EAT‐10) questionnaires. QoL functions were estimated using a kernel‐smoothing method. A linear mixed model introducing the inverse probability of treatment weighting was constructed to estimate the effect of IMPT versus VMAT. Results: We identified 94 patients who completed 120 QoL assessments. Participants receiving IMPT were younger and had higher levels of education and higher household income. QoL functions showed that post‐treatment EAT‐10 scores consistently appeared significantly lower for IMPT than VMAT. After adjusting for factors including age, gender, education, household income, and cancer stages, patients receiving IMPT consistently showed significantly better QoL scores in EAT‐10, indicative of a medium effect. Additionally, factors such as age, household income level, and treatment regimen might influence either generic or condition‐specific QoL. Conclusions: Patients receiving IMPT demonstrated potentially improved eating‐related QoL compared to those receiving VMAT within a 2‐year post‐radiotherapy period. However, larger head‐to‐head comparison studies are warranted to confirm these findings. [ABSTRACT FROM AUTHOR]

Purpose: To compare the oncologic outcomes of prophylactic extended-field radiation therapy (EFRT) and whole pelvic radiation therapy (WPRT) in cervical patients at high risk of para-aortic lymph node (PALN) recurrence. Patients and Methods: From July 1999 to May 2022, a total of 115 patients with cervical cancer and high-risk features of PALN recurrence based on tumor markers, positive LNs and extensive parametrial invasion were retrospectively analyzed. All patients had received EFRT or WPRT at a dose of 39.6– 45 Gy and concurrent chemotherapy. In EFRT, coverage was extended to include the para-aortic region below the level of the left renal vein or T12. Results: Twenty-eight and 87 patients underwent EFRT and WPRT, respectively. For patients who survived, the median follow-up time was 60.8 months (range 9.2– 131.6 months) in the EFRT group and 115.9 months (range 16.9– 212.1 months) in the WPRT group. The 5-year overall survival (OS) and pelvic, extrapelvic and PALN recurrence rates were 87.7% vs 60.8% (p=0.019), 10.9% vs 25.3% (p=0.119), 18.1% vs 45.8% (p=0.011), and 0% vs 30.4% (p=0.005), respectively, between the EFRT and WPRT groups. Multivariate analysis revealed that EFRT and 2018 FIGO stage IV disease status were significant predictors of OS and extrapelvic recurrence. Conclusion: Compared to WPRT, EFRT significantly improved OS and reduced extrapelvic and PALN recurrence in patients with cervical cancer with high-risk recurrence features. [ABSTRACT FROM AUTHOR]

Simple Summary: A low prognostic nutritional index (PNI) is linked to poor survival in patients with nasopharyngeal carcinoma (NPC), but existing research primarily examines the pre- or post-treatment PNI at single timepoints. Our study employs joint modeling to investigate the relationship between longitudinal PNI data from routine visits and overall survival. This approach addresses biases inherent in traditional time-varying covariate Cox models. Our findings indicate that decreased PNI levels during follow-up correlate with a reduced overall survival. Specifically, a post-treatment PNI below 38.1 markedly increases the risk of 90-day mortality. This emphasizes the importance of routine longitudinal PNI data in predicting survival outcomes for patients with NPC, offering a comprehensive perspective compared to isolated timepoint measurements. Background: a low PNI in patients with NPC is linked to poor survival, but prior studies have focused on single-timepoint measurements. Our study aims to employ joint modeling to analyze longitudinal PNI data from each routine visit, exploring its relationship with overall survival. Methods: In this retrospective study using data from the Chang Gung Research Database (2007–2019), we enrolled patients with NPC undergoing curative treatment. We analyzed the correlation between patient characteristics, including the PNI, and overall survival. A joint model combining a longitudinal sub-model with a time-to-event sub-model was used to further evaluate the prognostic value of longitudinal PNI. Results: A total of 2332 patient were enrolled for the analysis. Separate survival analyses showed that longitudinal PNI was an independent indicator of a reduced mortality risk (adjusted HR 0.813; 95% CI, 0.805 to 0.821). Joint modeling confirmed longitudinal PNI as a consistent predictor of survival (HR 0.864; 95% CI, 0.850 to 0.879). An ROC analysis revealed that a PNI below 38.1 significantly increased the risk of 90-day mortality, with 90.0% sensitivity and 89.6% specificity. Conclusions: Longitudinal PNI data independently predicted the overall survival in patients with NPC, significantly forecasting 90-day survival outcomes. We recommend routine PNI assessments during each clinic visit for these patients. [ABSTRACT FROM AUTHOR]