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Biosurfactants have garnered increased attention lately due to their superiority of their properties over fossil-derived counterparts. While the cost of production remains a significant hurdle to surpass synthetic surfactants, biosurfactants have been anticipated to gain a larger market share in the coming decades. Among these, glycolipids, a type of low-molecular-weight biosurfactant, stand out for their efficacy in reducing surface and interfacial tension, which made them highly sought-after for various surfactant-related applications. Glycolipids are composed of hydrophilic carbohydrate moieties linked to hydrophobic fatty acid chains through ester bonds that mainly include rhamnolipids, trehalose lipids, sophorolipids, and mannosylerythritol lipids. This review highlights the current landscape of glycolipids and covers specific glycolipid productivity and the diverse range of products found in the global market. Applications such as bioremediation, food processing, petroleum refining, biomedical uses, and increasing agriculture output have been discussed. Additionally, the latest advancements in production cost reduction for glycolipid and the challenges of utilizing second-generation feedstocks for sustainable production are also thoroughly examined. Overall, this review proposes a balance between environmental advantages, economic viability, and societal benefits through the optimized integration of secondary feedstocks in biosurfactant production.

This study examined the dynamic between perceived authoritarian parenting style (PAPS), and subjective wellbeing (SWB) among purposively recruited 423 college students in China. Expectancy value beliefs (EVB), fear of failure (FOF), and competitiveness were taken as mediators. The data were analyzed using Bootstrap method of 5000 sample and 95% confidence interval. The results revealed a significant negative total effect of PAPS on SWB. Additionally, two indirect paths were found to be significant: the mediation of FOF (Path 2) and the serial mediation of FOF and competitiveness (Path 6). These findings suggest that the perception of authoritarian parenting style is a negative predictor of students' happiness, and that FOF and competitiveness played important mediating roles in this relationship. These findings have important implications for educators, parents, and policymakers who aim to promote positive academic and personal outcomes for college students. The results suggest the need for interventions that address the negative impact of PAPS on students' wellbeing, and the importance of fostering positive beliefs about the value of education and academic achievement, as well as reducing FOF and promoting healthy competition.

This study evaluated the effects of a comprehensive school-based sexuality education programme in enhancing sexual health knowledge and understanding among adolescents, parents and school personnel in six secondary schools in Hong Kong. Study outcomes were evaluated through pre- and post-tests. A total of 1588 students, 40 parents and 271 school personnel participated. Baseline student knowledge scores were highest among younger students, with significant improvements observed in both years for all grades except one. Baseline student attitude scores were = 85% for younger students, with no significant improvement, while older students showed significant improvements. Parents scored below 40% correct at baseline for knowledge items, while self-efficacy items were generally higher. Baseline teacher knowledge scores were higher than parents, but self-efficacy scores were comparable or lower. Baseline guidance counsellors' surveys indicated low confidence levels and awareness of community resources to support students. This study identified a clear need for sexuality education in Hong Kong and a special focus on students in schools traditionally serving a high proportion of non-Chinese speaking students. The programme has significant potential for expansion in Hong Kong schools as well as for dissemination in Mainland China.

With the COVID-19 outbreak, emergency remote teaching -- an unprepared distant mode of education became the only possible alternative for schools. The present large-scale survey with 3,672 Grade 3 and 9 students, their parents, and 863 teachers/principals was conducted in the metropolitan city of Hong Kong after half a year of school lockdown. Results showed teachers, principals, and parents were worried about students' inability to concentrate and learn without teachers' explanations. In contrast, students, particularly younger ones, were less affected. They perceived their academic achievement was not worsened and they were more lively. Generally, lack of computers and stable internet was not seen as problems. Notably, socially disadvantaged students were not different in their perceived challenges, affects, life satisfaction, or perceived academic achievement. For cities with adequate provision of computers and internet facilities, the pandemic probably forced a positive and giant leap in using advanced technologies and pedagogies.

Qilou (arcade building) is a particular type of Chinese historical architecture combined with western and eastern building elements, which plays a significant role in the history of modern Chinese architecture. However, the recognition and classification of the qilou mainly rely on manual inspection, suppressing the cultural dissemination and protection of qilou relics. In this paper, we present a new framework that adopts multiple image processing algorithms and a deep learning network to automate qilou classification. First, image dataset of the qilou is enhanced based on the Contrast Limited Adaptive Histogram Equalization (CLAHE) algorithm. Then, an improved Faster R-CNN with ResNet50 (Faster R-CNN-R) is deployed for qilou image recognition. A total of 760 images captured in Guangzhou were used for training, validation, and accuracy check of the proposed framework and several contrastive networks under the same conditions. Compared to other networks, the proposed framework works better than Faster R-CNN with VGG16 (Faster R-CNN-V) and FCOS. The accuracy of the proposed framework embedded with the Faster R-CNN-R, Faster R-CNN-V, and FCOS are 80.12%, 65.17%, and 66.35%, respectively. Based on digital images captured under different lighting conditions, the proposed framework can be used to classify nine different types of qilous, with high robustness.

Abstract A computational search for stable structures among both α and β phases of ternary ATB4 borides (A = Mg, Ca, Sr, Ba, Al, Ga, and Zn, T is 3d or 4d transition elements) has been performed. We found that α-ATB4 compounds with A = Mg, Ca, Al, and T = V, Cr, Mn, Fe, Ni, and Co form a family of structurally stable or almost stable materials. These systems are metallic in non-magnetic states and characterized by the formation of the localized molecular-like state of 3d transition metal atom dimers, which leads to the appearance of numerous Van Hove singularities in the electronic spectrum. The closeness of such singularities to the Fermi level can be easily tuned by electron doping. For the atoms in the middle of the 3d row (Cr, Mn, and Fe), these singularities led to magnetic instabilities and magnetic ground states with a weakly metallic or semiconducting nature. Such states appear as non-trivial coexistence of the different spin ladders formed by magnetic dimers of 3d elements. These magnetic states can be characterized as an analog of the spin glass state. Experimental attempts to produce MgFeB4 and associated challenges are discussed, and promising directions for further synthetic studies are formulated.

Abstract Laser-driven coherent phonons can act as modulated strain fields and modify the adiabatic ground state topology of quantum materials. Here we use time-dependent first-principles and effective model calculations to simulate the effect of the coherent phonon induced by strong terahertz electric field on electronic carriers in the topological insulator ZrTe5. We show that a coherent A 1g Raman mode modulation can effectively pump carriers across the band gap, even though the phonon energy is about an order of magnitude smaller than the equilibrium band gap. We reveal the microscopic mechanism of this effect which occurs via Landau–Zener-Stückelberg tunneling of Bloch electrons in a narrow region in the Brillouin zone center where the transient energy gap closes when the system switches from strong to weak topological insulator. The quantum dynamics simulation results are in excellent agreement with recent pump-probe experiments in ZrTe5 at low temperature.

Background and objective: Multidrug-resistant tuberculosis (MDR-TB) requires extended treatment with regimens with multiple side effects, resulting in high treatment failure rates. Adjunctive lung resection combined with anti-tubercular agents improves outcomes. However, few studies have evaluated the potential harm from surgery and determined the optimal conditions for surgery. We aimed to analyze perioperative conditions to assess risk factors for postoperative complications in a multi-institutional setting. Methods: This retrospective study included 44 patients with MDR-TB who underwent adjunctive lung resection at three management groups of the Taiwan MDR-TB consortium between January 2007 and December 2020. Demographic data, clinical characteristics, radiological findings, sputum culture status before surgery, primary or acquired drug resistance, surgical procedure, complications, and treatment outcomes were collected and analyzed. Multivariate logistic regression was used to identify risk factors for postoperative complications. Results: Twenty-seven patients (61.4%) underwent lung resection using video-assisted thoracic surgery (VATS). The overall surgical complication rate was 20.5%, and the surgical mortality rate was 9.1%. Postsurgical hemothorax was the most common complication (11.4%). According to the univariate analysis, hilum involvement in images, positive preoperative sputum culture, and thoracotomy approach were unfavorable factors. VATS approach [adjusted OR, 0.088 (95% CI, 0.008–0.999)] was the only favorable factor identified by multivariate analysis. Conclusion: The minimally invasive approach is a growing trend, and lobectomies and sublobar resections were the main procedures for MDR-TB. The VATS approach significantly reduced the surgical complication rate. Postsurgical hemothorax was noteworthy, and meticulous hemostasis of the chest wall and residual lung surface is critical for successful resections.

Abstract Background Crosstalk between the aryl hydrocarbon receptor (AhR) and nuclear factor (erythroid-derived 2)-like 2 (Nrf2) signaling is called the “AhR–Nrf2 gene battery”, which works synergistically in detoxification to support cell survival. Nrf2-dependent phase II gene promoters are controlled by coordinated recruitment of the AhR to adjacent dioxin responsive element (DRE) and Nrf2 recruitment to the antioxidative response element (ARE). The molecular interaction between AhR and Nrf2 members, and the regulation of each target, including phase I and II gene complexes, and their mediators are poorly understood. Methods Knockdown and forced expression of AhR–Nrf2 battery members were used to examine the molecular interactions between the AhR–Nrf2 axis and AhR promoter activation. Sequential immunoprecipitation, chromatin immunoprecipitation, and histology were used to identify each protein complex recruited to their respective cis-elements in the AhR promoter. Actin fiber distribution, cell spreading, and invasion were examined to identify functional differences in the AhR–Jdp2 axis between wild-type and Jdp2 knockout cells. The possible tumorigenic role of Jdp2 in the AhR–Nrf2 axis was examined in mutant Kras-Trp53-driven pancreatic tumors. Results Crosstalk between AhR and Nrf2 was evident at the transcriptional level. The AhR promoter was activated by phase I ligands such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) through the AhR–Jdp2–Nrf2 axis in a time- and spatial transcription-dependent manner. Jdp2 was a bifunctional activator of DRE- and ARE-mediated transcription in response to TCDD. After TCDD exposure, Jdp2 activated the AhR promoter at the DRE and then moved to the ARE where it activated the promoter to increase reactive oxygen species (ROS)-mediated functions such as cell spreading and invasion in normal cells, and cancer regression in mutant Kras-Trp53-driven pancreatic tumor cells. Conclusions Jdp2 plays a critical role in AhR promoter activation through the AhR–Jdp2–Nrf2 axis in a spatiotemporal manner. The AhR functions to maintain ROS balance and cell spreading, invasion, and cancer regression in a mouse model of mutant Kras–Trp53 pancreatic cancer. These findings provide new insights into the roles of Jdp2 in the homeostatic regulation of oxidative stress and in the antioxidation response in detoxification, inflammation, and cancer progression.

Abstract Herein, this work aims to develop a facile method for the fabrication of metallic mechanical metamaterial with a well-ordered diamond structure from a bottom-up approach using a self-assembled block copolymer for templated electrochemical deposition. By controlling the effective volume fraction of PDMS in PS-b-PDMS via solvent annealing followed by HF etching of PDMS, it is feasible to obtain nanoporous PS with diamond-structured nanochannels and used it as a template for templated electrochemical deposition. Subsequently, well-ordered nanonetwork gold (Au) can be fabricated. As evidenced by nanoindentation and micro-compression tests, the mechanical properties of the diamond-structured Au after removal of PS give the combination of lightweight and mechanically robust characteristics with an exceptionally high reduced elastic modulus of 11.9 ± 0.6 GPa and yield strength of 193 ± 11 MPa above the Hashin-Shtrikman upper bound of 72 MPa with a bending-dominated structure at equivalent density. The corresponding deformation mechanism can be elucidated by morphological observations experimentally and finite element analysis (FEA) numerically. This work demonstrates the bottom-up approach to fabricating metallic monolith with diamond structure in the nanoscale, giving a superior performance as mechanical metamaterials.

We demonstrate the successful synthesis of linear and non-linear star block copolymers consisting of the highly segregated polystyrene (PS) and poly(dimethylsiloxane) (PDMS) blocks through sequential anionic polymerization combined with chlorosilane chemistry. To study the macromolecular architecture effect on the adopted morphology star block copolymers with six equivalent diblock arms [(PS-b-PDMS)6] were synthesized and compared with their linear diblock copolymer precursors as well as with the corresponding star block copolymers with smaller arm number (2, 3, 4) but identical molecular characteristics. After verifying the molecular and thermal characteristics, bulk studies were carried out through transmission electron microscopy and small angle X-ray scattering. Well-defined structures with enhanced order and similar domain spacing values, irrespective of the architecture complexity of the samples, were observed. The better order of star block copolymers suggests an alternative way to further reduce the lower limit of repeating period by tuning the architecture which is important for the potential future use of the copolymers for nanotechnology related applications. The findings of the specific study are related to the effects of the increased conformational restriction of the inner block. Herein, we show morphological transformations in the (PS-b-PDMS)6 copolymers having non symmetric volume fraction ratios when compared to their linear diblock precursors and triblock copolymers which has not been observed in previous relevant (PS-b-PDMS)n studies that involved stars with less than six arms. To establish the structure/property relationship as a function of arm number, a series of samples involving the diblock precursor, the triblock, the three-, four- and six- arm star block copolymers was prepared, and a systematic comparison was conducted.

ABSTRACTIn preclinical studies, a new antituberculosis drug regimen markedly reduced the time required to achieve relapse-free cure. This study aimed to preliminarily evaluate the efficacy and safety of this four-month regimen, consisting of clofazimine, prothionamide, pyrazinamide and ethambutol, with a standard six-month regimen in patients with drug-susceptible tuberculosis. An open-label pilot randomized clinical trial was conducted among the patients with newly diagnosed bacteriologically-confirmed pulmonary tuberculosis. The primary efficacy end-point was sputum culture negative conversion. Totally, 93 patients were included in the modified intention-to-treat population. The rates of sputum culture conversion were 65.2% (30/46) and 87.2% (41/47) for short-course and standard regimen group, respectively. There was no difference on two-month culture conversion rates, time to culture conversion, nor early bactericidal activity (P > 0.05). However, patients on short-course regimen were observed with lower rates of radiological improvement or recovery and sustained treatment success, which was mainly attributed to higher percent of patients permanently changed assigned regimen (32.1% vs. 12.3%, P = 0.012). The main cause for it was drug-induced hepatitis (16/17). Although lowering the dose of prothionamide was approved, the alternative option of changing assigned regimen was chosen in this study. While in per-protocol population, sputum culture conversion rates were 87.0% (20/23) and 94.4% (34/36) for the respective groups. Overall, the short-course regimen appeared to have inferior efficacy and higher incidence of hepatitis but desired efficacy in per-protocol population. It provides the first proof-of-concept in humans of the capacity of the short-course approach to identify drug regimens that can shorten the treatment time for tuberculosis.

Abstract Bioinspired from structural coloration of butterfly wing structure, this work aims to fabricate nanoporous chitosan for UVC reflection. By taking advantage of self-assembled polystyrene-b-polydimethylsiloxane (PS-b-PDMS) with double gyroid texture followed by hydrofluoric acid etching of PDMS block, nanoporous PS with well-defined nanochannels can be fabricated, and used as a template for templated crosslinking reaction of chitosan through a multiple pore-filling process. Well-ordered nanoporous chitosan with shifting networks in nanoscale can be successfully fabricated after removal of the PS template. With the low absorption of chitosan in the ultraviolet region and the shifting networks for opening the bandgap, it is appealing to exploit the nanonetwork chitosan as high reflective materials for UVC optical devices, as evidenced by finite-difference time-domain (FDTD) simulation and optical measurements experimentally.

Abstract We study the time-dependence of Hawking radiation for a black hole in the Unruh vacuum, and find that it is not robust against certain UV and IR effects. If there is a UV cutoff at the Planck scale, Hawking radiation is turned off after the scrambling time. In the absence of a UV cutoff, Hawking radiation is sensitive to the IR cutoff through a UV/IR connection due to higher-derivative interactions in the effective theory. Furthermore, higher-derivative interactions with the background contribute to a large amplitude of particle creation that changes Hawking radiation. This unexpected large effect is related to a peculiar feature of the Hawking particle wave packets.

Abstract This paper aims to probe the influence of innovation spillovers in the artificial intelligence (AI) and financial technology (Fin-tech) industries on the value of the internet of things (IoT) companies. Python was utilized to download public information from Yahoo Finance, and then the GARCH model was used to extract the fluctuations of cross-industry innovation spillovers. Next, the Fama–French three-factor model was used to explore the interactive changes between variables. The panel data regression analysis indicates that the more firms accept innovation spillovers from other industries, the better the excess return; however, this effect differs because of industrial attributes and the environmental changes induced by COVID-19. Additionally, this study finds that investing in large-cap growth stocks of IoT firms is more likely to yield excess returns. Finally, the study yields lessons for policy leverage to accelerate the upgrading and transformation of innovation-interactive industries by referring to the practices of Singapore and South Korea.

Abstract Ternary compounds with an immiscible pair of elements are relatively unexplored but promising for novel quantum materials discovery. Exploring what third element and its ratio that can be added to make stable ternary compounds out of an immiscible pair of elements remains a great challenge. In this work, we combine a machine learning (ML) method with ab initio calculations to efficiently search for the energetically favorable ternary La-Co-Pb compounds containing immiscible elements Co and Pb. Three previously reported structures are correctly captured by our approach. Moreover, we predict a ground state La3CoPb compound and 57 low-energy La-Co-Pb ternary compounds. Attempts to synthesize La3CoPb via multiple techniques produce mixed or multi-phases samples with, at best, ambiguous signals of the predicted lowest-energy La3CoPb and the second lowest-energy La18Co28Pb3 phases. The calculated results of Gibbs free energy are consistent with experiments, and will provide very useful guidance for further experimental synthesis.

IntroductionThe psychological health of healthcare workers (HCWs) has become a significant concern, particularly during the initial stage of a pandemic. This study compared the depressive symptoms among HCWs in high-risk areas (HRAs) and low-risk areas (LRAs) with matching demographics.MethodsA cross-sectional study was employed to compare the depressive symptoms (Patient Health Questionnaire score ≥ 10), workplace environment characteristics, the Health Belief Model (HBM) and socio-demographics of the HCWs working in HRAs and LRAs in several accessible regions (mainly Hubei Province and Guangdong–Hong Kong–Macao Greater–Bay–Area) in China. Eight hundred eighty-five HCWs were recruited for unmatched analysis between March 6 and April 2, 2020. After matching with occupation and years of service using a 1:2 ratio, 146 HCWs in HRAs and 290 HCWs in LRAs were selected for matched analysis. Subgroup analyzes were performed using two individual logistic regressions to delineate the associated factors in LRAs and HRAs, respectively.ResultsHCWs in LRAs (Prevalence = 23.7%) had 1.96 times higher odds of depressive symptoms than those in HRAs (Prevalence = 15.1%) after adjusting for occupation and years of service (p

Abstract Background Preoperative risk stratification is used to derive an optimal treatment plan for patients requiring cancer surgery. Patients with reversible risk factors are candidates for prehabilitation programmes. This pilot study explores the impact of preoperative covariates of comorbid disease (Charlson Co-morbidity Index), preoperative serum biomarkers, and traditional cardiopulmonary exercise testing (CPET)-derived parameters of functional capacity on postoperative outcomes after major colorectal cancer surgery. Methods Consecutive patients who underwent CPET prior to colorectal cancer surgery over a 2-year period were identified and a minimum of 2-year postoperative follow-up was performed. Postoperative assessment included: Clavien-Dindo complication score, Comprehensive Complication Index, Days at Home within 90 days (DAH-90) after surgery, and overall survival. Results The Charlson Co-morbidity Index did not discriminate postoperative complications, or overall survival. In contrast, low preoperative haemoglobin, low albumin, or high neutrophil count were associated with postoperative complications and reduced overall survival. CPET-derived parameters predictive of postoperative complications, DAH-90, and reduced overall survival included measures of VCO2 kinetics at anaerobic threshold (AT), peakVO2 (corrected to body surface area), and VO2 kinetics during the post-exercise recovery phase. Inflammatory parameters and CO2 kinetics added significant predictive value to peakVO2 within bi-variable models for postoperative complications and overall survival (P < 0.0001). Conclusion Consideration of modifiable ‘triple low’ preoperative risk (anaemia, malnutrition, deconditioning) factors and inflammation will improve surgical risk prediction and guide prehabilitation. Gas exchange parameters that focus on VCO2 kinetics at AT and correcting peakVO2 to body surface area (rather than absolute weight) may improve CPET-derived preoperative risk assessment.

With the increasing incidence and mortality of human hepatocellular carcinoma (HCC) worldwide, revealing innovative targets to improve therapeutic strategies is crucial for prolonging the lives of patients. To identify innovative targets, we conducted a comprehensive comparative transcriptome analysis of 5,410 human HCCs and 974 mouse liver cancers to identify concordantly expressed genes associated with patient survival. Among the 664 identified prognostic comparative HCC (pcHCC) genes, upregulated pcHCC genes were associated with prognostic clinical features, including large tumor size, vascular invasion and late HCC stages. Interestingly, after validating HCC patient prognoses in multiple independent datasets, we matched the 664 aberrant pcHCC genes with the sorafenib-altered genes in TCGA_LIHC patients and found these 664 pcHCC genes were enriched in sorafenib-related functions, such as downregulated xenobiotic and lipid metabolism and upregulated cell proliferation. Therapeutic agents targeting aberrant pcHCC genes presented divergent molecular mechanisms, including suppression of sorafenib-unrelated oncogenic pathways, induction of sorafenib-unrelated ferroptosis, and modulation of sorafenib transportation and metabolism, to potentiate sorafenib therapeutic effects in HCC combination therapy. Moreover, the pcHCC genes NCAPG and CENPW, which have not been targeted in combination with sorafenib treatment, were knocked down and combined with sorafenib treatment, which reduced HCC cell viability based on disruption to the p38/STAT3 axis, thereby hypersensitizing HCC cells. Together, our results provide important resources and reveal that 664 pcHCC genes represent innovative targets suitable for developing therapeutic strategies in combination with sorafenib based on the divergent synergistic mechanisms for HCC tumor suppression.

Abstract In the background of a gravitational collapse, we compute the transition amplitudes for the creation of particles for distant observers due to higher-derivative interactions in addition to Hawking radiation. The amplitudes grow exponentially with time and become of order 1 when the collapsing matter is about a Planck length outside the horizon. As a result, the effective theory breaks down at the scrambling time, invalidating its prediction of Hawking radiation. Planckian physics comes into play to decide the fate of black-hole evaporation.

How to rapidly disseminate a large-sized file to many recipients in flash crowd arrival patterns is a fundamental challenge in many applications, such as distributing multimedia content. To tackle this challenge, we present the Bee, which is a time-critical peer-to-peer data dissemination system aiming at minimizing the maximum dissemination time for all peers to obtain the complete file in flash crowd arrival patterns. Bee is a decentralized system that organizes peers into a randomized mesh-based overlay, and each peer only works with local knowledge. We introduce the slowest peer first strategy to boost the speed of dissemination and present a topology adaptation algorithm that adapts the number of connections based on upload bandwidth capacity of a peer. Bee is designed to support network heterogeneity and deals with the flash crowd arrival pattern without sacrificing the dissemination speed. We also show the lower bound analysis of the data dissemination problem, and present the experimental results to demonstrate that the performance of Bee can roughly approximate the lower bound of the data dissemination problem under flash crowd traffic.

Microsatellite-instability-high (MSI-H) cancers form a spectrum of solid organ tumors collectively known as Lynch Syndrome cancers, occurring not only in a subset of colorectal, endometrial, small bowel, gastric, pancreatic, and biliary tract cancers but also in prostate, breast, bladder, and thyroid cancers. Patients with Lynch Syndrome harbor germline mutations in mismatch repair genes, with a high degree of genomic instability, leading to somatic hypermutations and, therefore, oncogenesis and cancer progression. MSI-H cancers have unique clinicopathological characteristics compared to their microsatellite-stable (MSS) counterparts, marked by a higher neoantigen load, immune cell infiltration, and a marked clinical response to immune checkpoint blockade. Patients with known Lynch Syndrome may be detected early through surveillance, but some patients present with disseminated metastatic disease. The treatment landscape of MSI-H cancers, especially colorectal cancers, has undergone a paradigm shift and remains to be defined, with immune checkpoint blockade coming to the forefront of treatment strategies in the stage IV setting. We summarize in this review the clinical features of MSI-H cancers with a specific interest in the pattern of spread or recurrence, disease trajectory, and treatment strategies. We also summarize the tumor-immune landscape and genomic profile of MSI-H cancers and potential novel therapeutic strategies.

Secreted by the anterior pituitary gland, growth hormone (GH) is a peptide that plays a critical role in regulating cell growth, development, and metabolism in multiple targeted tissues. Studies have shown that GH and its functional receptor are also expressed in the female reproductive system, including the ovaries and uterus. The experimental data suggest putative roles for GH and insulin-like growth factor 1 (IGF-1, induced by GH activity) signaling in the direct control of multiple reproductive functions, including activation of primordial follicles, folliculogenesis, ovarian steroidogenesis, oocyte maturation, and embryo implantation. In addition, GH enhances granulosa cell responsiveness to gonadotropin by upregulating the expression of gonadotropin receptors (follicle-stimulating hormone receptor and luteinizing hormone receptor), indicating crosstalk between this ovarian regulator and the endocrine signaling system. Notably, natural gene mutation of GH and the age-related decline in GH levels may have a detrimental effect on female reproductive function, leading to several reproductive pathologies, such as diminished ovarian reserve, poor ovarian response during assisted reproductive technology (ART), and implantation failure. Association studies using clinical samples showed that mature GH peptide is present in human follicular fluid, and the concentration of GH in this fluid is positively correlated with oocyte quality and the subsequent embryo morphology and cleavage rate. Furthermore, the results obtained from animal experiments and human samples indicate that supplementation with GH in the in vitro culture system increases steroid hormone production, prevents cell apoptosis, and enhances oocyte maturation and embryo quality. The uterine endometrium is another GH target site, as GH promotes endometrial receptivity and pregnancy by facilitating the implantation process, and the targeted depletion of GH receptors in mice results in fewer uterine implantation sites. Although still controversial, the administration of GH during ovarian stimulation alleviates age-related decreases in ART efficiency, including the number of oocytes retrieved, fertilization rate, embryo quality, implantation rate, pregnancy rate, and live birth rate, especially in patients with poor ovarian response and recurrent implantation failure.

BackgroundAccidental injuries are the leading cause of deaths and disabilities in children globally and most of them occur at home. To save life and prevent sequelae, domestic helpers (DHs) require providing emergency management (i.e., first aid) to children involved in home accidents. However, their self-efficacy in emergency management for children is rarely investigated. Hence, this study aimed to tap that research gap.MethodsThis study adopted a cross-sectional descriptive survey design. A convenience sample of 385 DHs was obtained in Hong Kong. DHs' self-efficacy in emergency management for children involved in home accidents was measured using a 12-item well-validated survey instrument “Self-Efficacy of First Aid in Unintentional Injury at Home”. The total score ranged from 0 to 48. A higher score indicates greater confidence in emergency management for children involved in home accidents.ResultsAll the participants were women and most of them were aged between 31 and 35 years (N = 103, 26.8%). The mean score for DHs' self-efficacy in emergency management was 29.0 (SD 10.1). The three items with the lowest self-efficacy were managing bone fractures, performing cardiopulmonary resuscitation, and providing artificial respiration. Bivariate analysis showed that DHs' self-efficacy was significantly related to their educational level, first aid training, caring experience, and working experience. Multiple linear regression indicated that DHs' educational level (β = 0.136, p = 0.001) and first aid training (β = 0.532, p

BackgroundAcute ST-elevation myocardial infarction (STEMI) elicits a robust cardiomyocyte death and inflammatory responses despite timely revascularization.ObjectivesThis phase 1, open-label, single-arm, first-in-human study aimed to assess the safety and efficacy of combined intracoronary (IC) and intravenous (IV) transplantation of umbilical cord-derived mesenchymal stem cells (UMSC01) for heart repair in STEMI patients with impaired left ventricular ejection fraction (LVEF 30-49%) following successful reperfusion by percutaneous coronary intervention.MethodsConsenting patients received the first dose of UMSC01 through IC injection 4-5 days after STEMI followed by the second dose of UMSC01 via IV infusion 2 days later. The primary endpoint was occurrence of any treatment-related adverse events and the secondary endpoint was changes of serum biomarkers and heart function by cardiac magnetic resonance imaging during a 12-month follow-up period.ResultsEight patients gave informed consents, of whom six completed the study. None of the subjects experienced treatment-related serious adverse events or major adverse cardiovascular events during IC or IV infusion of UMSC01 and during the follow-up period. The NT-proBNP level decreased (1362 ± 1801 vs. 109 ± 115 pg/mL, p = 0.0313), the LVEF increased (52.67 ± 12.75% vs. 62.47 ± 17.35%, p = 0.0246), and the wall motion score decreased (26.33 ± 5.57 vs. 22.33 ± 5.85, p = 0.0180) at the 12-month follow-up compared to the baseline values. The serial changes of LVEF were 0.67 ± 3.98, 8.09 ± 6.18, 9.04 ± 10.91, and 9.80 ± 7.56 at 1, 3, 6, and 12 months, respectively as compared to the baseline.ConclusionThis pilot study shows that combined IC and IV transplantation of UMSC01 in STEMI patients with impaired LVEF appears to be safe, feasible, and potentially beneficial in improving heart function. Further phase 2 studies are required to explore the effectiveness of dual-route transplantation of UMSC01 in STEMI patients.