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This study aimed to explore the traffic safety evaluation model for downstream intersections of urban expressway exits and make up for the shortcomings in safety research on downstream intersections of urban expressway exits. We constructed a comprehensive traffic safety evaluation index system, established a traffic safety evaluation model, and divided precise safety evaluation levels using the AHP–Matter-Element analysis method, establishing a traffic safety evaluation index system consisting of eleven indicators. The effectiveness of this method was validated through an assessment of traffic safety at the intersection of Dongsheng Street and Free Road in Changchun City. A theoretical basis for improving traffic safety at downstream intersections of urban expressways and a reference for subsequent related research were provided. [ABSTRACT FROM AUTHOR]

Traditionally, users have perceived that only manual laborers or those in repetitive jobs would be subject to technological substitution. However, with the emergence of technologies like Midjourney, ChatGPT, and Notion AI, known as Artificial Intelligence-Generated Content (AIGC), we have come to realize that cognitive laborers, particularly creative designers, also face similar professional challenges. Yet, there has been relatively little research analyzing the acceptance and trust of artificial intelligence from the perspective of designers. This study integrates the TAM/TPB behavioral measurement model, incorporating intrinsic characteristics of designers, to delineate their perceived risks of AIGC into functional and emotional dimensions. It explores how these perceived characteristics, risks, and trust influence designers' behavioral intentions, employing structural equation modeling for validation. The findings reveal the following: (1) designer trust is the primary factor influencing their behavioral choices; (2) different dimensions of perceived risks have varying degrees of impact on trust, with functional risks significantly positively affecting trust compared to emotional risks; (3) only by enhancing the transparency and credibility of Artificial Intelligence-Generated Content (AIGC) can the perceived characteristics of designers be elevated; and (4) only by effectively safeguarding designers' legitimate rights and interests can perceived risks be significantly reduced, thereby enhancing trust and subsequently prompting actual behavioral intentions. This study not only enhances the applicability and suitability of AIGC across various industries but also provides evidence for the feasibility of intelligent design in the creative design industry, facilitating the transition of AIGC to Artificial Intelligence-Generated Design (AIGD) for industrial upgrading. [ABSTRACT FROM AUTHOR]

Necking and barreling deformation behaviors occurred simultaneously during the bending test of a single-crystal gold micro-cantilever (sample A) with the loading direction parallel to the [1-10] orientation and the neutral plane parallel to the [110] orientation. In contrast, for another single-crystal gold micro-cantilever, sample B, with the loading direction aligned parallel to the [0.37 −0.92 0.05] orientation and the neutral plane parallel to the [0.54 0.28 0.78] orientation, predominant slip band deformation was noted. Sample A exhibited activation of four slip systems, whereas sample B demonstrated activity in only a single-slip system. This difference suggests that the presence of multiple slip systems contributes to the concurrent occurrence of necking and barreling deformations. Furthermore, variations in the thickness of the micro-cantilevers resulted in observable strengthening, indicating that the effect of sample size is intricately linked to the geometry of the cross-section, which we have termed the "sample geometry effect". [ABSTRACT FROM AUTHOR]

Iron (Fe) is a crucial trace element in marine ecosystems, playing a vital role in regulating marine primary productivity and driving marine biogeochemical cycling processes. However, understanding seasonal iron variations and the response of chlorophyll-a (Chl-a) to coastal waters remains limited. The aim of this study was to find out about the spatial and seasonal variations in iron concentrations and their impact on chlorophyll-a levels in Zhanjiang Bay. We conducted seasonal monitoring of surface seawater for iron in 2019, alongside assessments of terrestrial iron inputs during three precipitation seasons. The monitoring results showed that the iron content in Zhanjiang Bay ranged from 0.83 to 339.2 μg·L−1 with an average of 54.34 ± 75.91 μg·L−1. The annual average iron content in the central bay is higher than that in the bay mouth and inner bay. The iron content in autumn is much higher than that in other seasons, which may be due to the influence of river dredging. Correlation analysis revealed that temperature and pH are the main factors affecting the iron content in Zhanjiang Bay and the spatial distribution of iron is influenced by rainfall, river inputs, and human activities, particularly channel dredging. Iron content and chlorophyll-a were negatively correlated between different seasons, which was more significant with the increase in iron content. This may mean that the increase in iron concentration may inhibit the synthesis of chlorophyll-a, thus affecting primary productivity. We need to carry out more research experiments to verify this hypothesis. This study reveals the spatial and temporal changes in iron in urban coastal waters and its relationship with environmental factors, which is of great significance for understanding the marine biogeochemical cycle of iron in coastal eutrophic waters and specifying effective environmental management strategies. [ABSTRACT FROM AUTHOR]

This review explores the complex challenges and advancements in the treatment of traumatic brain injury (TBI) and spinal cord injury (SCI). Traumatic injuries to the central nervous system (CNS) trigger intricate pathophysiological responses, frequently leading to profound and enduring disabilities. This article delves into the dual phases of injury—primary impacts and the subsequent secondary biochemical cascades—that worsen initial damage. Conventional treatments have traditionally prioritized immediate stabilization, surgical interventions, and supportive medical care to manage both the primary and secondary damage associated with central nervous system injuries. We explore current surgical and medical management strategies, emphasizing the crucial role of rehabilitation and the promising potential of stem cell therapies and immune modulation. Advances in stem cell therapy, gene editing, and neuroprosthetics are revolutionizing treatment approaches, providing opportunities not just for recovery but also for the regeneration of impaired neural tissues. This review aims to emphasize emerging therapeutic strategies that hold promise for enhancing outcomes and improving the quality of life for affected individuals worldwide. [ABSTRACT FROM AUTHOR]

To address challenges in locating high-impedance grounding faults (HIGFs) and isolating fault areas in resonant grounding systems, this paper proposes a novel fault identification method based on coordinating a Peterson coil and a resistance grounding system. This method ensures power supply reliability by extinguishing the fault arc during transient faults with the Peterson coil. When a fault is determined to be permanent, the neutral point switches to a resistance grounding mode, ensuring regular distribution of zero-sequence currents in the network, thereby addressing the challenges of HIGF localization and fault area isolation. Fault calibration and nature determination rely on recognizing neutral point displacement voltage waveforms and dynamic characteristics, eliminating interference from asymmetric phase voltage variations. Fault area identification involves assessing the polarity of zero-sequence current waveforms attenuation during grounding mode switching, preventing misjudgments in grounding protection due to random initial fault angles and Peterson coil compensation states. Field experiments validate the feasibility of this fault location method and its control strategy. [ABSTRACT FROM AUTHOR]

The study aimed to validate a newly developed postoperative stability score for evaluating clinical follow-up in elderly patients with low-energy hip fractures. From 1 January 2020 to 31 December 2021, we enrolled patients aged over 65 who underwent cephalomedullary nail fixation using proximal femoral nail antirotation II (PFNAII) and had at least 6 months of follow-up; excluding multiple fractures, pathological fractures, and periprosthetic fractures. We collected general patient data. Parameters such as TAD, Parker's ratio (AP and lateral), and the new postoperative stability score were recorded. A loss of reduction was defined using the decline in the Chang reduction quality criteria (CRQC) score within one month. Among the 108 enrolled patients, 23 (21.3%) experienced a loss of reduction, with a mean age of 82.1 years and a mean follow-up time of 7.4 months. Univariate analysis showed no significant association between loss of reduction and general data. However, the new postoperative stability score correlated significantly with loss of reduction (mean scores: 6.68 vs. 4.83, p = 0.045). Multivariate analysis confirmed this association (odds ratio: 0.076, 95% confidence interval: 0.022–0.263, p < 0.05). The newly developed postoperative stability score, incorporating surgical technique assessment, improves prediction accuracy for loss of reduction in elderly intertrochanteric fracture (ITF) patients. [ABSTRACT FROM AUTHOR]

Background: Myocardial bridging (MB) is a congenital coronary anomaly and an important cause of chest pain. The long-term effects of MB on cardiovascular events remain elusive. Methods: We used the National Health Insurance Research Database of Taiwan to conduct an analysis. All patients who had undergone coronary angiography were considered for inclusion. The primary endpoint was a composite of nonfatal myocardial infarction, nonfatal ischemic stroke, and cardiovascular death. Results: We identified 10,749 patients from 2008 to 2018 and matched them with an equal number of controls by propensity-score matching. The mean follow-up period was 5.78 years. In patients without coronary artery disease, MB increased the risk of the composite endpoint (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.44–1.72, p < 0.001), which was driven by increased risks of nonfatal myocardial infarction and cardiovascular death. In patients with significant coronary artery disease, MB did not increase the risk of major adverse cardiovascular events. MB was identical to insignificant coronary artery disease from the viewpoint of clinical outcomes. Conclusions: The presence of MB significantly increases cardiovascular risks in patients with normal coronary vessels. Atherosclerotic coronary artery disease mitigates the effect of MB on cardiovascular outcomes. MB can be considered an insignificant coronary artery disease equivalent. [ABSTRACT FROM AUTHOR]

Background: Endocrine-disrupting chemicals (EDCs) are pervasive in everyday environments. The impacts of these chemicals, along with EDC-related lifestyle and dietary habits on neurocognitive function, are not well understood. Methods: The Chang Gung Community Medicine Research Center conducted a cross-sectional study involving 887 participants. From this initial cohort, 120 individuals were selected based on their EDC exposure scores for detailed analysis. Among these, 67 participants aged 55 years or older were further chosen to undergo cognitive impairment assessments using the Ascertain Dementia-8 (AD-8) questionnaire. Results: These 67 older participants did not significantly differ in age, albuminuria, or estimated glomerular filtration rate compared to those with lower impairment scores. This study revealed that mono-(2-ethylhexyl) phthalate (MEHP) levels (8.511 vs. 6.432 µg/g creatinine, p = 0.038) were associated with greater risk of cognitive impairment (AD-8 ≥ 2). Statistical models adjusting for age, gender, and diabetes indicated that MEHP levels positively correlated with AD-8 scores, achieving statistical significance in more comprehensive models (β ± SE: 0.160 ± 0.076, p = 0.042). Logistic regression analysis underscored a significant positive association between high MEHP levels and higher AD-8 scores (odds ratio: 1.217, p = 0.006). Receiver operating characteristic curves highlighted the association of high MEHP levels and EDC exposure scores for significant cognitive impairment, with areas under the curve of 66.3% and 66.6%, respectively. Conclusion: Exposure to EDCs, specifically di-(2-ethylhexyl) phthalate, the precursor to MEHP, may be associated with neurocognitive impairment in middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Due to a unique cortical venous drainage pattern without sinus drainage, ethmoidal dural arteriovenous fistula (DAVF) are uncommon cerebral vascular lesions that carry a high risk of brain bleeding and neurologic deficit. Surgical intervention has been found to have a lower complication rate and a more satisfactory obliteration rate than endovascular treatment among the various DAVF treatment options. The supraorbital keyhole subfrontal approach is one of the least invasive and appropriate surgical techniques for addressing the anterior fossa vascular lesion in eDAVFs. We describe two men, ages 60 and 71, who underwent this surgical intervention to treat asymptomatic Cognard type IV eDAVFs. Complete obliteration with a detached fistulous point and skeletonization was accomplished with the aid of intraoperative neuronavigation. Thus, we suggest that a suitable surgical method for the treatment of eDAVFs would be to use a supraorbital keyhole subfrontal approach. [ABSTRACT FROM AUTHOR]

Calcium silicate (CaSi) bone cement with antibacterial and osteogenic properties has attracted significant interest. However, there is a need to develop a variety of new premixed bone cement to meet the clinical requirements of fast setting time, ease of handling, and efficient antibacterial properties. In this study, different volume ratios of polyethylene glycol (PEG) and lactic acid liquids were added to calcium silicate, and the effects of varying liquid-to-powder ratios (L/P) were examined. This study assessed the physicochemical properties, cytotoxicity, and antibacterial activity against S. aureus and E. coli of this premixed cement. The results from the experiments indicated that lactic acid significantly reduced the setting time of the CaSi-based cement and enhanced its mechanical strength. Furthermore, the appropriate concentration of lactic acid and matching L/P ratio improved its washout resistance. The cell viability of all premixed cement was found to be over 80%. The premixed cement containing PEG and lactic acid exhibited superior antibacterial properties compared to the CaSi control. Based on its setting time, washout resistance, and antibacterial activity, a premixed cement with a liquid phase of 80% PEG and 20% lactic acid at an L/P ratio of 0.4 appeared promising for use in dental and orthopedic practice. [ABSTRACT FROM AUTHOR]

Bandstop filters (BSFs) have many applications in suppressing interference signals and shielding specific bands. Among them, reconfigurable BSFs that cover more frequency bands by switching modes have great research value. In this paper, a novel synthesis approach for compact reconfigurable BSFs with controllable equal-ripple performance is proposed. By switching the ON/OFF state of the positive intrinsic negative (PIN) diode, the proposed reconfigurable BSF can be switched between single-BSF (S-BSF) and dual-BSF (D-BSF). Based on the synthesis approach, the equal-ripple levels of stopband and passband for S-BSF and D-BSF can be independently controlled. To verify, the equal-ripple levels of stopband and passband for S-BSF state and D-BSF state are independently controlled in four groups of examples. Finally, a reconfigurable BSF with a miniaturized size is designed and fabricated. The fabricated reconfigurable BSF behaves with 15 dB and 10 dB return loss (RL) in two different passbands of the D-BSF state, and 25 dB bandpass RL and controllable stopband rejection (SR) for the S-BSF state. The measured results are in good agreement with the electromagnetic (EM) simulation results. [ABSTRACT FROM AUTHOR]

Simple Summary: The study examined the relationship between Human Papillomavirus (HPV) and various types of skin cancer, including squamous cell carcinoma, basal cell carcinoma, and melanoma. It aimed to assess how HPV influenced the likelihood of developing these cancers, considering factors such as age, gender, urbanization, and existing health conditions. Through statistical models, the research quantified the risk of skin cancer in individuals with HPV compared to those without, underscoring how behaviors related to sun exposure and protection practices could alter these risks. The findings were crucial for guiding prevention and treatment strategies and were of significant interest to medical professionals and public health policymakers. Overall, the study enhanced our understanding of the risks associated with HPV, potentially leading to more effective health interventions. Human papillomavirus (HPV) has been implicated in various cancers, including those affecting the skin. The study assessed the long-term risk of skin cancer associated with HPV infection in Taiwan region, using data from the National Health Insurance Research Database between 2007 and 2015. Our analysis revealed a significant increase in skin cancer risk among those with HPV, particularly for squamous cell carcinoma (SCC), the subtype with the highest observed adjusted hazard ratio (aHR) = 5.97, 95% CI: 4.96–7.19). The overall aHR for HPV-related skin cancer was 5.22 (95% CI: 4.70–5.80), indicating a notably higher risk in the HPV-positive group. The risk of skin cancer was further stratified by type, with basal cell carcinoma (aHR = 4.88, 95% CI: 4.14–5.74), and melanoma (aHR = 4.36, 95% CI: 2.76–6.89) also showing significant associations with HPV. The study also highlighted regional variations, with increased risks in southern Taiwan and the Kaohsiung-Pingtung area. Key findings emphasize the importance of sun protection, particularly in regions of high UV exposure and among individuals in high-risk occupations. This research contributes to a better understanding of the complex interactions between HPV and skin cancer risk, reinforcing the importance of preventive strategies in public health. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is a global health concern, necessitating adjuvant chemotherapy post-curative surgery to mitigate recurrence and enhance survival, particularly in intermediate-stage patients. However, existing therapeutic disparities highlight the need for biomarker-guided adjuvant chemotherapy to achieve better CRC inhibition. This study explores the molecular mechanisms underlying the inhibition of CRC through a genome-wide association study (GWAS) focused on 5-fluorouracil (5-FU)-based adjuvant therapy in intermediate-stage CRC patients, a domain previously unexplored. We retrospectively included 226 intermediate-stage CRC patients undergoing surgical resection followed by 5-FU-based adjuvant chemotherapy. The exploration cohort comprised 31 patients, and the validation cohort included 195 individuals. Genotyping was carried out using either Axiom Genome-Wide TWB 2.0 Array Plate-based or polymerase chain reaction-based methods on genomic DNA derived from collected tissue samples. Statistical analyses involved descriptive statistics, Kaplan–Meier analyses, and Cox proportional hazard analyses. From the GWAS, potential genetic predictors, GALNT14-rs62139523 and DNMBP-rs10786578 genotypes, of 5-FU-based adjuvant therapy following surgery in intermediate-stage CRC patients were identified. Validation in a larger cohort of 195 patients emphasized the predictive significance of GALNT14-rs62139523 genotypes, especially the "A/G" genotype, for improved overall and progression-free survival. This predictive association remained robust across various subgroups, with exceptions for specific demographic and clinical parameters such as age < 58 years old, CEA ≤ 2.5 ng/mL, tumor diameter > 44.0 mm, and tumor-free margin ≥ 50 mm. This study identifies that the GALNT14-rs62139523 "A/G" genotype modulates therapeutic outcomes, establishing it as a promising biomarker for predicting favorable responses to 5-FU-based adjuvant chemotherapy in intermediate-stage CRC patients, although further investigations are needed to detail these mechanisms. [ABSTRACT FROM AUTHOR]

Background: Acute appendicitis is a common abdominal emergency observed in emergency departments (ED). Distinguishing between uncomplicated and complicated appendicitis is important in determining a treatment strategy. Serum soluble vascular cell adhesion molecule-1 (VCAM-1) is an inflammatory biomarker. We aimed to determine the role of VCAM-1 in predicting complicated appendicitis in children. Methods: Pediatric patients with suspected appendicitis admitted to the ED were enrolled in this prospective study. Pre-surgical serum VCAM-1 was tested in children with acute appendicitis within 72 h of symptoms (from day 1 to day 3). Serum VCAM-1 levels were further analyzed and compared between patients with and without complicated appendicitis. Results: Among the 226 pediatric appendicitis patients, 70 had uncomplicated appendicitis, 138 had complicated appendicitis, and 18 had normal appendices. The mean serum VCAM-1 levels in patients with perforated appendicitis were higher than in those with simple appendicitis (p < 0.001). On day 1 to day 3, the mean VCAM-1 levels in patients with complicated appendicitis were all significantly higher than in those with uncomplicated appendicitis (all p < 0.001). Conclusion: Serum VCAM-1 levels may be helpful in differentiating uncomplicated and complicated appendicitis in children and could predict appendiceal perforation. [ABSTRACT FROM AUTHOR]

Social innovation has emerged as a transformative force in businesses, particularly in the context of cultural and creative hotels. This study aims to explore the relationship between social innovation and value co-creation in cultural and creative hotels, compare the intrinsic characteristics of social innovation and value co-creation within these hotels, and investigate the key factors driving social innovation in this sector. Employing a qualitative research methodology based on the theory of social innovation, this paper examines the process of value co-creation and analyzes the three key drivers within the social innovation ecosystem: establishing interdependence and identity among organizations; enhancing cognitive and value exchanges between organizations; and generating consensus through the role transformation of participants. The findings suggest that the key drivers of the social innovation ecosystem not only enhance the innovation capabilities of businesses but also motivate them to collaboratively create mutually beneficial and symbiotic value. [ABSTRACT FROM AUTHOR]

Consumer decision-making behaviors play a pivotal role in the realm of purchasing sustainable products. It is crucial for businesses to understand the key factors that influence consumers' choices in this context, especially if they aim to align with eco-friendly trends. Conventional methods are inadequate for accurately and successfully identifying the importance of factors that influence consumers' decision-making behaviors in purchasing sustainable products and stem from a lack of holistic consideration. Conventional methods, like AHP, surveys, questionnaires, interviews, and focus groups, often do not fully consider the many aspects of consumer behavior related to sustainability. To address this gap, our study aims to (1) employ a hybrid approach, integrating conventional methods with cutting-edge machine-learning technology for predicting consumer's decision-making behaviors in purchasing sustainable products; (2) demonstrate the practical application of this hybrid approach through the example of green furniture; and (3) provide a practical guide for identifying the importance of factors influencing consumers' decision-making behaviors in purchasing sustainable products. This study will map out implications for the future of consumer decision-making behaviors in purchasing sustainable products. The hybrid approach to studying consumer decision making in sustainable product purchases, combining quantitative and AI methods. This methodology provides a comprehensive analysis of factors influencing environmentally friendly choices, fostering awareness and informed decision making. Businesses can use these insights to tailor strategies, enhance offerings, and meet the rising demand for sustainable products, contributing to environmentally responsible consumer behaviors and promoting economies of scale for sustainable products and innovation. This holistic understanding is crucial for creating a sustainable and socially responsible marketplace. [ABSTRACT FROM AUTHOR]

Vertically transmitted endophytes (VTEs) with multi-host-supporting functions are considered plant-acquired heritable traits, which can be manipulated to develop plants with the stable inheritance of these VTEs, defined here as 'plant endophytic modification (PEM)'. To translate this hypothetical strategy into agricultural and horticultural practice, a PEM was carried out by introducing an anti-fungal pathogenic bacterium, Bacillus cereus (strain ID: ZX-2), into grapevine cuttings and growing the cuttings into vine plants. Bacterial strain XZ-2 is highly efficient in infecting grapevine cuttings and colonizing the interior of the infected cuttings, various parts of the subsequently established vine plants, and next year's emerging vine shoots and leaves. Profiling the endophytic microbiota by high-throughput sequencing to the grapevines revealed that the colonization with exogenous ZX-2 slightly affected endophytic diversity, while significantly altering the composition and the predicted phenotypes of endophytic microbiota in ZX-2-modified grapevines (ZX-2mg). Most importantly, leaves (from both first- and second-year grapevines) of ZX-2mg conferred significantly higher (p < 0.001) anti-fungal pathogen abilities and a reduction in naturally occurring lesion area than leaves compared to the control grapevines. For all detected vines, a significant correlation (N = 37, r = 0.418; p < 0.01) between fungal pathogen inhibition rates and B. cereus (ZX-2) isolation rates was observed. In addition, ZX-2mg showed some growth promotion and a delay (15–20 days) in leaf abscission. The work established an alternative strategy to create plant lines with functions of specific VTEs via PEM, confirming the practical value of PEM in future organic farming systems. [ABSTRACT FROM AUTHOR]

Aims: This study aims to compare the outcomes of immediate (followed by closed-incision negative-pressure therapy use) versus delayed ORIF in patients with Schatzker type IV–VI TPFs. Patients and Methods: A prospective study of patients undergoing ORIF between January 2018 and December 2019 was performed. The inclusion criteria were patients (>18 years) with a closed fracture sent to the emergency room (ER) within 24 h of injury. All the patients underwent preoperative image evaluation. Two senior orthopedic trauma surgeons evaluated the soft tissue condition in the ER by 5P's of the compartment syndrome, judging the timing of the operation of definitive ORIF. Group 1 (n = 16) received delayed ORIF. Group 2 (n = 16) received immediate ORIF and ciNPT use. Patient follow-up occurred after 2 and 6 weeks and 3, 6, and 12 months after surgery. The assessments included the time to definitive fixation, the length of hospital stay, the time to bone union, surgical site complications, and reoperation within 12 months. A universal goniometer was used to measure the postoperative 3 m, 6 m, and 12 m ROM. Results: The patient demographics were similar between the groups (p > 0.05). Group 2 displayed significantly a shorter time to definitive fixation (5.94 ± 2.02 vs. 0.61 ± 0.28, p < 0.0001) and hospital stay (14.90 ± 8/78 vs. 10.30 ± 6.78, p = 0.0016). No significant difference was observed in the time to bone union, surgical site complication incidence, and reoperation rates (p > 0.05). Flexion and flexion–extension knee ROM were demonstrated to be significantly improved in Group 2, 3, 6, and 12 months postoperatively (p < 0.0001). Conclusions: In this study, early ORIF and ciNPT use resulted in a shorter hospital length of stay, a reduced time to early active motion of the knee, and improved knee ROM. These results suggest that early ORIF with ciNPT for Schatzker type IV–VI TPFs is safe and effective in some patients. However, further research to confirm these findings across larger and more diverse populations is needed. [ABSTRACT FROM AUTHOR]

Appendicitis is primarily diagnosed based on intraoperative or histopathological findings, and few studies have explored pre-operative markers of a perforated appendix. This study aimed to identify systemic biomarkers to predict pediatric appendicitis at various time points. The study group comprised pediatric patients with clinically suspected appendicitis between 2016 and 2019. Pre-surgical serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), intercellular cell-adhesion molecule-1 (ICAM-1), and endothelial selectin (E-selectin) levels were tested from day 1 to day 3 of the disease course. The biomarker values were analyzed and compared between children with normal appendices and appendicitis and those with perforated appendicitis (PA) and non-perforated appendicitis. Among 226 pediatric patients, 106 had non-perforated appendicitis, 102 had PA, and 18 had normal appendices. The levels of all serum proinflammatory biomarkers were elevated in children with acute appendicitis compared with those in children with normal appendices. In addition, the serum IL-6 and TNF-α levels in children with PA were significantly higher, with an elevation in TNF-α levels from days 1 and 2. In addition, serum IL-6 levels increased significantly from days 2 and 3 (both p < 0.05). Serum ICAM-1 and E-selectin levels were elevated in the PA group, with consistently elevated levels within the first three days of admission (all p < 0.05). These results indicate that increased serum levels of proinflammatory biomarkers including IL-6, TNF-α, ICAM-1, and E-selectin could be used as parameters in the prediction and early diagnosis of acute appendicitis, especially in children with PA. [ABSTRACT FROM AUTHOR]

Acanthamoeba, a widely distributed free-living amoeba found in various environments, is an opportunistic pathogen responsible for causing Acanthamoeba keratitis, a condition that may lead to blindness. However, identifying the pathogenicity of Acanthamoeba is challenging due to its complex life cycle, ability to adapt to different environments, variable virulence factors, and intricate interactions with the host immune system. Additionally, the development of an effective model for studying Acanthamoeba pathogenicity is limited, hindering a comprehensive understanding of the mechanisms underlying its virulence and host interactions. The aim of this study was to develop an ex vivo model for Acanthamoeba infection using porcine eyeballs and to evaluate the pathogenicity of the Acanthamoeba isolates. Based on slit lamp and biopsy analysis, the developed ex vivo model is capable of successfully infecting Acanthamoeba within 3 days. Histopathological staining revealed that clinical isolates of Acanthamoeba exhibited greater corneal stroma destruction and invasion in this model than environmental isolates. Our results highlight the importance of an ex vivo porcine eye model in elucidating the pathogenesis of Acanthamoeba infection and its potential implications for understanding and managing Acanthamoeba-related ocular diseases. [ABSTRACT FROM AUTHOR]

This study reports on the use of supercritical CO2 (scCO2) for the metallization of ultrahigh-molecular-weight polyethylene (UHMW-PE) filaments, which are used as functional components in weavable devices. UHMW-PE is well known for its chemical and impact resistance, making it suitable for use in bulletproof clothing and shields. However, its chemical resistance poses a challenge for metallization. By utilizing scCO2 as the solvent in the catalyzation process, a uniform and defect-free layer of Ni-P is successfully deposited on the UHMW-PE filaments. The deposition rate of Ni-P is enhanced at higher temperatures during the scCO2 catalyzation. Importantly, the durability of the Ni-P-metalized UHMW-PE filaments is improved when the scCO2 catalyzation is carried out at 120 °C, as evidenced by minimal changes in electrical resistivity after a rolling test. [ABSTRACT FROM AUTHOR]

With the ever-increasing focus on sustainable development, recycling waste and renewable use of waste products has earned immense consideration from academics and policy makers. The serious pollution, complex types, and strong infectivity of medical waste have brought serious challenges to management. Although several researchers have addressed the issue by optimizing medical waste management networks and systems, there is still a significant gap in systematically evaluating the efficiency of medical waste recycling systems. Therefore, this paper proposes a two-stage data envelopment analysis (DEA) approach that combines the virtual frontier and the global bounded adjustment measure (BAM-VF-G), considering both undesirable inputs and outputs. In the first stage, the BAM-G model is used to evaluate the efficiency of medical waste recycling systems, and the BAM-VF-G model is used to further rank super-efficient medical waste recycling systems. In the second stage, two types of efficiency decomposition models are proposed. The first type of models decompose unified efficiency into production efficiency (PE) and environment efficiency (EE). Depending upon the system structure, the second type of models decompose unified efficiency into the efficiency of the medical waste collection and transport subsystem (MWCS) and the efficiency of the medical waste treatment subsystem (MWTS). The novel approach is used to measure the efficiency of the medical waste recycling systems in China's new first-tier cities, and we find that (1) Foshan ranks the highest in efficiency, followed by Tianjin and Qingdao, with efficiency values of 0.386, 0.180, and 0.130, respectively; (2) the EE lacks resilience and fluctuated the most from 2017 to 2022; and (3) the efficiency of MWCSs has always been lower than that of MWTSs and is a critical factor inhibiting the overall efficiency of medical waste recycling systems. [ABSTRACT FROM AUTHOR]

In plants, nucleotide-binding site and leucine-rich repeat proteins (NLRs) play pivotal roles in effector-triggered immunity (ETI). However, the precise mechanisms underlying NLR-mediated disease resistance remain elusive. Previous studies have demonstrated that the NLR gene pair Pik-H4 confers resistance to rice blast disease by interacting with the transcription factor OsBIHD1, consequently leading to the upregulation of hormone pathways. In the present study, we identified an RNA recognition motif (RRM) protein, OsRRM2, which interacted with Pik1-H4 and Pik2-H4 in vesicles and chloroplasts. OsRRM2 exhibited a modest influence on Pik-H4-mediated rice blast resistance by upregulating resistance genes and genes associated with chloroplast immunity. Moreover, the RNA-binding sequence of OsRRM2 was elucidated using systematic evolution of ligands by exponential enrichment. Transcriptome analysis further indicated that OsRRM2 promoted RNA editing of the chloroplastic gene ndhB. Collectively, our findings uncovered a chloroplastic RRM protein that facilitated the translocation of the NLR gene pair and modulated chloroplast immunity, thereby bridging the gap between ETI and chloroplast immunity. [ABSTRACT FROM AUTHOR]

This study aimed to elucidate how consumers engage in cultural activities in Quanzhou and analyze innovative service experiences in this ancient city. We also sought to create a model integrating humanistic innovations into the enhancement of service experiences. We used an exploratory case study approach, combining secondary data analysis with on-site observations. The findings include the following: (1) The tourist experience in cultural tourism involves six stages: "Connect and Attract", "Orientate", "Interact", "Extend and Retain", "Advocate", and "Recollect". (2) We developed the TESP model for innovative cultural tourism services in Quanzhou, with four dimensions: Technological, Experiential, Systemic, and Platform. The Platform dimension introduces the Hub and Service Process sub-dimensions. Additionally, the study suggests that creating a sense of place in historic districts relies on traditional culture, emphasizing the core competitiveness, identity, and culture of a locality. (3) Integrating "humanistic innovation" into cultural tourism is essential, utilizing digital platforms and interpersonal networks to promote core values and thus foster local economic prosperity. The research outcomes hold practical significance for cultural heritage tourism in Quanzhou, as well as for the study and implementation of service and experience innovations among experience providers, practitioners, managers, and marketing professionals in the field. [ABSTRACT FROM AUTHOR]

The motion responses, mooring tensions, and submergence depth are the dominant factors for the arrangement of the Submerged Floating Tunnel (SFT) subjected to waves. Generally, the maximum values of motion responses, mooring tensions, and absolute submergence depth are mainly focused on. In the present study, experiments are implemented to measure the motion responses and mooring tensions of the SFT with different mooring patterns and submergence depths under waves with different characteristic wave heights and periods. In order to evaluate the arrangement of the SFT more effectively and comprehensively, besides the maximum values, several new characteristic parameters are introduced. Such parameters account for the motion responses in the frequency domain, the uniformity of the tension distribution, the length of time during which the cable reaches a relaxed condition during wave action, the KC number, the dimensionless period, the wave height, and the submergence depth. The results from the optimization analysis show the following: according to the characteristic values of motion responses and mooring tensions, the pattern of diagonal cables is better than that of diagonal cables + vertical cables; and within the range of the present experiments, there are optimal dimensionless parameters—the dimensionless submergence depth d0/LP ≥ 0.15, the KC number ≤ 0.8, or the dimensionless wave height Hs/d0 ≤ 0.10—for the condition of which the dynamic responses and mooring tensions vary slightly. [ABSTRACT FROM AUTHOR]

This study used artificial intelligence techniques to identify clinical cancer biomarkers for recurrent gastric cancer survivors. From a hospital-based cancer registry database in Taiwan, the datasets of the incidence of recurrence and clinical risk features were included in 2476 gastric cancer survivors. We benchmarked Random Forest using MLP, C4.5, AdaBoost, and Bagging algorithms on metrics and leveraged the synthetic minority oversampling technique (SMOTE) for imbalanced dataset issues, cost-sensitive learning for risk assessment, and SHapley Additive exPlanations (SHAPs) for feature importance analysis in this study. Our proposed Random Forest outperformed the other models with an accuracy of 87.9%, a recall rate of 90.5%, an accuracy rate of 86%, and an F1 of 88.2% on the recurrent category by a 10-fold cross-validation in a balanced dataset. We identified clinical features of recurrent gastric cancer, which are the top five features, stage, number of regional lymph node involvement, Helicobacter pylori, BMI (body mass index), and gender; these features significantly affect the prediction model's output and are worth paying attention to in the following causal effect analysis. Using an artificial intelligence model, the risk factors for recurrent gastric cancer could be identified and cost-effectively ranked according to their feature importance. In addition, they should be crucial clinical features to provide physicians with the knowledge to screen high-risk patients in gastric cancer survivors as well. [ABSTRACT FROM AUTHOR]

Plasmonic metal nanomaterials have been extensively investigated for their utilizations in biomedical sensing and treatment. In this study, plasmonic Au@Ag core–shell nanoisland films (Au@AgNIFs) were successfully grown onto a glass substrate using a seed-mediated growth procedure. The nanostructure of the Au@AgNIFs was confirmed through scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and atomic force microscopy (AFM). The UV-Vis spectra of the Au@AgNIFs exhibited a broad absorption in the visible range from 300 to 800 nm because of the surface plasmon absorption. Under simulated sunlight exposure, the temperature of optimal Au@AgNIF was increased to be 66.9 °C to meet the requirement for photothermal bacterial eradication. Furthermore, the Au@AgNIFs demonstrated a consistent photothermal effect during the cyclic on/off exposure to light. For photothermal therapy, the Au@AgNIFs revealed superior efficiency in the photothermal eradication of Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). With their unique nanoisland nanostructure, the Au@AgNIFs exhibited excellent growth efficiency of bacteria in comparison with that of the bare glass substrate. The Au@AgNIFs were also validated as a surface-enhanced Raman scattering (SERS) substrate to amplify the Raman signals of E. coli and S. aureus. By integrating photothermal therapy and SERS detection, the Au@AgNIFs were revealed to be a potential platform for bacterial theranostics. [ABSTRACT FROM AUTHOR]

The reconstruction of residences has led to an increase in the use of single-use materials in the construction industry. In the context of the circular economy, with the implementation of circular housing from a cradle-to-cradle perspective, the field of housing construction is changing rapidly. Innovation and sharing improve the consumer experience and increase consumers' purchase intention. This research integrates design attributes, sharing attributes, perceived value, and affective value to study the impact of circular housing on acceptance and identification. The framework of SOR theory framework is used to analyze the predictive factors of consumer intention. The results emphasize that emotional responses in terms of affective value, perceived value, and social equity are the most prominent. This research also utilizes the KJ method. The research methods include a literature review, field observations, expert interviews, questionnaire surveys, and triangulation validation. Moreover, this research uses PLS-SEM to analyze the data of 568 participants. The structural analysis shows that consumers' acceptance and identification of circular housing are strongly influenced by social equity. A total of 16 out of 17 hypotheses are established, with eight partial mediating effects, including the mediating role of social equity. Perceived value is found to affect consumers' cognition and attitudes Perceived value and design attributes, as well as these factors combined, influence consumer acceptance and identification. This research provides strategies to enhance the design of circular housing and promote its development. This research explores the relationship between consumers' acceptance and identification of circular design and the development of circular housing. It first establishes a structural model based on the SOR theory. Adding the mental map of interview results to the model, the results of this research analyzes the design attribute value, and the SEM-PLS analysis influences highlights the identification and acceptance of circular housing. [ABSTRACT FROM AUTHOR]

Eutectic high-entropy alloy (EHEA) has an outstanding combination of high strength and excellent ductility due to its dual-phase structure. In this study, AlCoCrFeNi2.1 coatings on stainless steel substrates and bulk AlCoCrFeNi2.1 alloys were prepared by mechanical alloying (MA). The results show that EHEA coatings with a dual-phase microstructure of BCC-AlNi/FCC-CoCrFe were obtained. A long milling duration promotes a uniform microstructure and homogeneous distribution of composition in the EHEA coatings, increasing hardness. Furthermore, annealing treatment encourages the formation of Cr-rich phases and Al-rich oxides, which affect the mechanical properties of coatings and bulk materials. Additionally, the presence of oxide dispersoids can cause the embrittlement of materials due to the formation of Al-Y-O oxide pores, resulting in the degradation of the mechanical properties of materials. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effects of window films on indoor environmental conditions and electricity consumption of air conditioning. The research focused on the performance of different window films (HAG, RG), taking into account variations from different building orientations. The findings of this research indicated that building orientation could significantly influence the duration of direct sunlight entering the interior, with the areas closer to the glass being more susceptible to the effects of outdoor temperature and solar radiation. The clear glass with heat-absorbing film (HAG) and reflective film (RG) both reduced the indoor temperature and indoor illuminance while increasing indoor comfort. The RG could accumulate less heat on the glass surface compared with the HAG. The glass temperature of the RG will be lower than the HAG. The electricity-saving ratios of the HAG were 1.4%, 1.9%, 1.4%, and 1.2%, respectively, when facing the east, south, west, and northwest orientations compared with the clear glass (OG). The electricity-saving ratios of the RG were 3%, 4.2%, 4.2%, and 10.3%, respectively. [ABSTRACT FROM AUTHOR]

Simple Summary: In order to explore the effect of amorphous calcium carbonate (ACC) supplementation on bone growth in growing rats, 3-week-old male Wistar rats were divided into four groups as follows: a control group (C), low-dose group (L, 20.65 mg/kg of body weight (BW) ACC), a medium-dose group (M, 206.5 mg/kg of BW ACC), and a high-dose group (H, 413 mg/kg of BW ACC) administered by gavage for 12 weeks. The results indicated that ACC supplementation can enhance osteoblast metabolism and inhibit osteoclast metabolism, resulting in a higher bone formation rate compared to bone resorption. This led to increased trabecular bone thickness and a higher bone mineral density (BMD) and supported bone growth. By increasing peak bone mass, it is speculated that the risk of future osteoporosis could be reduced. To build upon the positive results of our study on skeletal health, future follow-up studies could be conducted on older rodents treated with ACC supplementation during the growth period. Objectives: This study aimed to investigate the effect of amorphous calcium carbonate (ACC) supplementation on bone growth in growing rats. Methods: We used 3-week-old male Wistar rats to simulate childhood and adolescent growth stages. Rats were divided into four groups as follows: a control group (C), a low-dose group (L, 20.65 mg/kg body weight (BW) ACC), a medium-dose group (M, 206.5 mg/kg BW ACC), and a high-dose group (H, 413 mg/kg BW ACC) administered by gavage. Body length (BL) and BW were measured weekly. The bone mineral density (BMD) of two lumbar vertebrae (L3 and L4) and the left femur were analyzed by micro-computed tomography (μCT) at 0, 4, 8, and 12 weeks. At the end of 12 weeks, the rats were sacrificed. After that, blood samples were collected from the abdominal aorta. Femurs and tibias were collected and weighed, and their lengths were measured. Then, bone samples were used to perform histopathological and histomorphometric analyses. Results: It showed that ACC supplementation in growing rats increased the trabecular bone thickness and serum bone formation biomarkers. Furthermore, high-dose ACC decreased serum bone resorption biomarkers and increased BMD. Conclusions: ACC supplementation can enhance osteoblast metabolism and inhibit osteoclast metabolism, resulting in a higher bone formation rate compared to bone resorption. This led to increased trabecular bone thickness, a higher BMD, and supported bone growth. [ABSTRACT FROM AUTHOR]

Chitinase-3-like protein-1 (CHI3L1), also known as YKL40, is a glycoprotein that belongs to the chitinase protein family. It is involved in various biological functions, including cell proliferation and tissue remodeling, with inflammatory and immunomodulatory capabilities. Several studies have shown that CHI3L1(YKL40) is upregulated in various diseases, such as cancer, asthma, and inflammatory bowel disease, among others. Although the expression level of CHI3L1(YKL40) is associated with disease activity, severity, and prognosis, its potential as a therapeutic target is still under investigation. In this review, we summarize the biological functions, pathological roles, and potential clinical applications of specific inhibitors and targeted therapies related to CHI3L1(YKL40). [ABSTRACT FROM AUTHOR]

This paper examines how businesses in Taiwan's servicescapes are adapting to the growing trend of mobile payments and innovation ecosystems. Through the analysis of four case studies, we uncover the strategies these firms employ to address the challenges posed by changing consumer payment habits. Our research reveals that these companies are establishing efficient mechanisms within their ecosystems, supported by well-structured organizational frameworks. By leveraging innovation ecosystems, they are reshaping financial services and promoting collaborative growth among participants through technology, platforms, resource sharing, and knowledge exchange. This collaborative approach is driving significant changes in the sector, helping these businesses navigate through various challenges while fostering innovation and growth. Additionally, the scarcity of comprehensive observations of the digital payment ecosystem highlights the necessity for further exploration of actor interactions, regulatory mechanisms, and ecosystem management strategies. Such research efforts are crucial for enhancing our understanding of the evolving landscape of digital payments and innovation ecosystems, facilitating informed decision-making and promoting sustainable development in this dynamic industry. [ABSTRACT FROM AUTHOR]

Through the actions and interactions of video platform users, talent shows have expanded from the entertainment sphere to the social sphere and become an everyday part of life. Watching talent shows on online platforms, especially through participation in multi-platform interaction, is an ever developing and innovative field in many regions. This study adopts a multiple case analysis approach. We analyze and compare three cases of talent shows, examining aspects of their value co-creation, digital platform, dynamic capability and value network through an exploration of a series of creative activities on digital video platforms. Talent shows provide a unique environment in which different actors interact, co-exist and co-create value, i.e., another form of O2O marketing. These actors include producers, entertainment companies, sponsors and fans, and fan value co-creation currently takes many different forms, which are experienced, engaged and interacted with through different platforms. The findings contribute to examining the underlying dynamics of TV talent shows, in addition to explaining how they are achieving sustainable advantages in the media market. Furthermore, this study aims to understand the service ecosystem of network talent shows from the perspective of industrial innovation strategy; consequently, this research can help to promote the implications of this new form of digital content services and its innovation strategies. [ABSTRACT FROM AUTHOR]

Simple Summary: Undifferentiated embryonal sarcoma of the liver is a rare pediatric tumor with a traditionally poor prognosis. Dual treatment with a combination of surgery and chemotherapy has produced much improved outcomes. The sharing and consolidation of various case series and clinical experiences allow for the prompt design of appropriate treatment advice. Even in the event of unresectable or recurrent diseases, other treatment modalities such as orthotopic liver transplantation and radiotherapy can be offered. This review of treatment recommendations for rare undifferentiated embryonal sarcoma of the liver has important clinical use. Undifferentiated embryonal sarcoma of the liver is a rare mesenchymal tumor with a highly malignant potential. It occurs almost exclusively in the pediatric population and typically has a poor outcome. Although previous studies have reported dismal prognoses, recent advances in combined treatment modalities, e.g., surgery and chemotherapy, have given cause for optimism. Even in those diseases not amenable to complete surgical resection or refractory diseases, other treatment modalities, such as liver transplant, have yielded promising results. This paper provides a review of the current treatment modalities for hepatic undifferentiated embryonal sarcoma in children. [ABSTRACT FROM AUTHOR]

The success of sustainable product strategies is widely recognized as pivotal to the successful development of sustainable products. Despite some existing research on sustainable product strategies, there is a notable lack of investigation into the tools necessary for their effective development. To address this gap, our study aims to (1) introduce a methodological framework that systematically shapes sustainable product strategy, incorporating key technologies like a Sustainable Product Strategies Focus Group (SPSFG), Brainstorming, Weighted Decision Matrix (WDM), and Genetic Algorithm (GA); (2) demonstrate the practical application of this framework through the example of 3C products; and (3) contribute theoretically by proposing a tool for creating sustainable product strategies that integrates management principles, providing a practical guide for the development of control systems and tools. This study also maps out implications for the future of sustainable 3C products. The development of optimal sustainable product strategies across various sectors requires a comprehensive hybrid approach. This method combines diverse methodologies to create a robust framework addressing unique challenges in health systems, education, environment, industry, agriculture, energy, and resource management. Leveraging quantitative analysis, qualitative assessment, and systems thinking, the hybrid approach provides a nuanced understanding of interdependencies within these sectors. Integrating data-driven insights and qualitative considerations facilitates sustainable strategies, optimizing resource utilization for long-term environmental, social, and economic benefits. This holistic methodology enables a more effective response to interconnected challenges in health systems, education, environmental preservation, industry, agriculture, energy, and resource management, promoting a more sustainable future. [ABSTRACT FROM AUTHOR]

Antibiotic cement articulating spacers eradicate infection during a two-stage revision for advanced septic hip arthritis (ASHA); however, mechanical complications have been reported. We hypothesized that the rate of mechanical complications would be lower in medullary-sparing (MS) than in non-medullary-sparing (n-MS) articulating spacers. A retrospective study of ASHA using n-MS or MS spacers was conducted between 1999 and 2019. The rate of mechanical complications and reoperation and risk factors for mechanical complications were analyzed. The cohort included 71 n-MS and 36 MS spacers. All patients were followed up for 2 years. The rate of spacer dislocation was lower in MS (0%) than in n-MS spacers (14.1%; p = 0.014). The reoperation rate for mechanical complications was lower in MS (0%) than in n-MS spacers (12.7%; p = 0.019). The rate of a diaphyseal stem during reimplantation was lower in MS (0%) than in n-MS spacers (19.4%; p = 0.002). The identified risk factors for n-MS spacer dislocation were postoperative under-restored femoral head diameter ≥3 mm, femoral offset ≥3 mm, and surgical volume (≤6 resection arthroplasties per year). Both spacers controlled infection. However, MS spacers had a lower spacer dislocation and reoperation rate and avoided the diaphyseal stem during reimplantation. We recommend using MS spacers to restore native femoral head diameter and femoral offset when ASHA is treated by surgeons with lower surgical volumes. [ABSTRACT FROM AUTHOR]

Introduction: Hematuria is a worrisome symptom in children and is sometimes associated with urinary tract infections (UTIs). This study aimed to identify useful clinical factors that can predict UTIs in hematuria patients without pyuria in the pediatric emergency department (ED). Methods: We retrospectively recruited patients with hematuria from the pediatric ED. Clinical symptoms, urine biochemistry and microscopic examination results, and blood laboratory tests were analyzed to identify the predictors of UTIs. Patients were divided into the verbal group (age ≥ 2 years) and non-verbal group (age < 2 years) for identifying predictors of UTIs. Causes of hematuria were also investigated. Results: A total of 161 patients with hematuria without pyuria were evaluated. Among symptoms, dysuria was significantly correlated with UTIs. Regarding urine biochemistry data, urine esterase and urine protein > 30 mg/dl were found to be significant parameters for predicting UTIs, while urine esterase and urine nitrite showed significant differences in children with age < 2 years. In the urine microscopic examinations, urine red blood cells (RBC) > 373/µL in children aged ≥ 2 years and urine RBC > 8/µL in children aged < 2 years were associated with UTIs. In addition, UTIs and urinary tract stones were found to be the top two causes of hematuria. Conclusions: Dysuria, urine esterase, urine nitrite, and urine protein may be useful parameters for predicting UTIs in pediatric patients with hematuria but no pyuria in the ED. In addition, a UTI was the most commonly identified etiology of hematuria without pyuria, followed by urinary tract stones. [ABSTRACT FROM AUTHOR]

Background: Acute infectious diarrhea is a common cause of hospitalization in children. Hence, early identification of acute bacterial gastroenteritis with suspected sepsis in pediatric emergency departments (EDs) is important. This study aimed to describe the clinical spectrum and initial characteristics of children who were presented to a pediatric ED with acute infectious diarrhea and suspected sepsis. Methods: Between April 2020 to March 2021, children with clinical diagnoses of acute bacterial colitis and suspected sepsis who were admitted to the pediatric ED were prospectively enrolled. The following data were obtained and compared between different age groups of children: including demographics, presentation, laboratory tests, culture results, treatment modalities, complications, and short-term outcomes. Results: A total of 105 patients (70 males and 35 females; mean age: 3.75 ± 3.52 years) were enrolled in this study. Of them, 89 (84.8%) patients were <6 years of age, and 80 (76.2%) patients required hospitalization for a duration of 4.7 ± 2.08 days. C-reactive protein (CRP) and procalcitonin (PCT) levels were significantly higher in the admission (both p < 0.001) and anti-biotic treatment groups (both p < 0.001). Salmonella enteritidis was the most common organism cultured from the stool and blood samples (39 of 91 (38.5%) and 2 of 105 (1.9%), respectively). Conclusions: The primary causative organism of acute infectious diarrhea identified in this study was S. enteritidis. Age and elevated serum CRP or PCT levels could be important factors in the decisions of emergency physicians regarding hospitalization and antibiotic therapies for pediatric acute infectious diarrhea. [ABSTRACT FROM AUTHOR]

This study integrates circular economy (CE) metrics with machine learning techniques, specifically XGBoost and Shapley additive explanations (SHAP), to forecast municipal solid waste (MSW) in the EU, analyzing data from 2010 to 2020. It examines key economic and consumption indicators, including GDP per capita and energy consumption, along with CE metrics such as resource productivity, the municipal waste recycling rate, and the circular material use rate. The model demonstrates high predictive accuracy, with an R2 of 99% for in-sample data and 75% for out-of-sample data. The results indicate a significant correlation between a higher GDP per capita and an increased gross municipal waste per capita (GMWp). Conversely, lower energy consumption is associated with reduced GMWp. Notably, the circular material use rate emerges as a crucial factor for sustainability, with increased use significantly decreasing the GMWp. In contrast, a higher resource productivity correlates with an increased GMWp, suggesting complex implications for waste generation. The recycling rate, while impactful, shows a more modest effect compared to the other factors. The culminating insights from this study emphasize the need for sustainable, integrated waste management and support the adoption of circular economy-aligned policies. They underscore the efficacy of merging CE metrics with advanced predictive models to bolster regional sustainability efforts. [ABSTRACT FROM AUTHOR]

Stachydrine, a prominent bioactive alkaloid derived from Leonurus heterophyllus, is a significant herb in traditional medicine. It has been noted for its anti-inflammatory and antioxidant characteristics. Consequently, we conducted a study of its hepatoprotective effect and the fundamental mechanisms involved in acetaminophen (APAP)-induced liver injury, utilizing a mouse model. Mice were intraperitoneally administered a hepatotoxic dose of APAP (300 mg/kg). Thirty minutes after APAP administration, mice were treated with different concentrations of stachydrine (0, 2.5, 5, and 10 mg/kg). Animals were sacrificed 16 h after APAP injection for serum and liver tissue assays. APAP overdose significantly elevated the serum alanine transferase levels, hepatic pro-inflammatory cytokines, malondialdehyde activity, phospho-extracellular signal-regulated kinase (ERK), phospho-protein kinase B (AKT), and macrophage-stimulating protein expression. Stachydrine treatment significantly decreased these parameters in mice with APAP-induced liver damage. Our results suggest that stachydrine may be a promising beneficial target in the prevention of APAP-induced liver damage through attenuation of the inflammatory response, inhibition of the ERK and AKT pathways, and expression of macrophage-stimulating proteins. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate developmental changes in the female pharyngeal airway from adolescence to adulthood, considering variations in the anatomical structures related to the airway dimensions. Methods: Lateral cephalograms of 214 females were analyzed and categorized into five developmental stages: early adolescence (10–13 years), middle adolescence (14–17 years), late adolescence (18–21 years), early adulthood (22–30 years), and middle adulthood (31–50 years). The focus of the analysis included the point A-Nasion-point B (ANB) angle, tongue pharyngeal airway space (TPS), epiglottis pharyngeal airway space (EPS), soft palate airway space (SPS), and the horizontal and vertical positions of the hyoid bone. Results: The ANB angle exhibited significant variation across groups, being significantly larger in the early-adolescence group (4.22°) compared to the middle-adolescence, late-adolescence, and early-adulthood groups. The TPS and EPS were significantly shorter in the early-adolescence group. Negative correlations were observed between the ANB angle and the lengths of the pharyngeal airway spaces (SPS, TPS, and EPS). The horizontal and vertical positions of the hyoid bone remained stable after middle adolescence. Conclusion: The maturation of the ANB angle and pharyngeal airway in females seems nearly completed during middle adolescence (14–17 years). Additionally, a significant and negative correlation was identified between the ANB angle and the lengths of various pharyngeal airway spaces (SPS, TPS, and EPS). The horizontal and vertical positions of the hyoid bone showed stability after middle adolescence. [ABSTRACT FROM AUTHOR]

Sisal fiber exhibits a fibrous and porous structure with significant surface roughness, making it highly suitable for storing phase change materials (PCMs). Its intricate morphology further aids in mitigating the risk of PCM leakage. This research successfully employs vacuum adsorption to encapsulate paraffin within sisal fiber, yielding a potentially cost-effective, durable, and environmentally friendly phase change energy storage medium. A systematic investigation was carried out to evaluate the effects of sisal-to-paraffin mass ratio, fiber length, vacuum level, and negative pressure duration on the loading rate of paraffin. The experimental results demonstrate that a paraffin loading rate of 8 wt% can be achieved by subjecting a 3 mm sisal fiber to vacuum adsorption with 16 wt% paraffin for 1 h at −0.1 MPa. Through the utilization of nano-CT imaging enhancement technology, along with petrographic microscopy, this study elucidates the mechanism underlying paraffin storage within sisal fiber during vacuum adsorption. The observations reveal that a substantial portion of paraffin is primarily stored within the pores of the fiber, while a smaller quantity is firmly adsorbed onto its surface, thus yielding a durable phase change energy storage medium. The research findings contribute to both the theoretical foundations and the available practical guidance for the fabrication and implementation of paraffin/sisal fiber composite phase change energy storage mediums. [ABSTRACT FROM AUTHOR]

Few studies have reported weight gain in patients with hepatitis C virus (HCV) infection treated with direct-acting antiviral agents (DAAs). This retrospective cohort study identified factors associated with substantial weight gain after DAA treatment in Taiwan. This study involved patients treated using DAAs at the Chiayi and Yunlin branches of Chang Gung Memorial Hospital from 1 January 2017 to 31 October 2020. Body weight data were collected at the start of DAA therapy and 2 years after the confirmation of a sustained virologic response. We performed multiple logistic regression to evaluate the clinical and laboratory parameters associated with a large body mass index (BMI) increase (≥5%). The mean BMI was 25.56 ± 4.07 kg/m2 at baseline and 25.77 ± 4.29 kg/m2 at the endpoint (p = 0.005). A considerable reduction in fibrosis-4 (FIB-4) score was a significant predictor of a large BMI increase (OR: 1.168; 95% CI: 1.047–1.304, p = 0.006). By contrast, older age (OR: 0.979; 95% CI: 0.963–0.996, p = 0.013) and a higher baseline BMI (OR: 0.907; 95% CI: 0.863–0.954, p < 0.001) were associated with a reduced risk of a large increase in BMI at the endpoint. In summary, a larger BMI increase was closely associated with a younger age, lower baseline BMI, and higher FIB-4 score reduction. Notably, differences in DAA regimens did not affect outcomes. Future studies are needed to elucidate the long-term effects and metabolic outcomes associated with this body weight change and investigate the exact underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) and functional fitness (FF) are crucial for promoting independent living and healthy aging in older adults. However, there is a lack of normative values for the Senior Fitness Test (SFT) among older adults (aged 55–90) living in southern rural Taiwan, particularly in the Chiayi region, which has been relatively underserved in terms of health-related resources compared to northern Taiwan. Purpose: This study aimed to determine the age- and gender-specific normative fitness scores for a large representative population of community-dwelling older adults in southern rural Taiwan. Methods: A cross-sectional descriptive study was conducted to obtain normative FF scores for 3332 community-dwelling elderly people (1057 men and 2275 women) in Chiayi, through the implementation of functional fitness tests across 72 Chiayi communities. The developed normative data served as a reference for exercise prescription for the elderly in southern Taiwan. Results: The study showed that the average normative values of all functional fitness tests declined significantly with increasing age (p < 0.05). Sex differences were also found in all measures of FF tests, with elderly women scoring significantly better than men on flexibility (scratch back: −1.34 ± 9.03 vs. −6.54 ± 11.07; chair sit and reach: 6.56 ± 9.44 vs. 0.56 ± 10.40) (p < 0.05), while men scored significantly higher than women on strength (grip strength: 30.83 ± 8.06 vs. 21.82 ± 5.32; bicep curl: 19.25 ± 5.44 vs. 17.64 ± 4.98) (p < 0.05). Furthermore, four FF normative scores in southern rural Taiwan were found to be significantly higher than their counterparts living in northern Taiwan. Conclusion: These findings contribute positively to the evaluation of fitness levels among older adults in southern rural Taiwan and provide a concrete reference for developing sound PA programs for this population. The results suggest that strategies aimed at promoting increased participation in PA among older adults need to consider age-, sex-, and region-specific factors. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects individuals of all age groups, manifesting as a spectrum of symptoms varying from mild to severe. Allergen immunotherapy (AIT) involves the administration of allergen extracts and has emerged as a potential treatment strategy for modifying immune responses. Its pathogenesis involves epidermal barrier dysfunction, microbiome imbalance, immune dysregulation, and environmental factors. Existing treatment strategies encompass topical steroids to systemic agents, while AIT is under investigation as a potential immune-modifying alternative. Several studies have shown reductions in the severity scoring of atopic dermatitis (SCORAD) scores, daily rescue medication use, and visual analog scale (VAS) scores following AIT. Biomarker changes include increased IgG4 levels and decreased eosinophil counts. This review provides valuable insights for future research and clinical practice, exploring AIT as a viable option for the management of AD. [ABSTRACT FROM AUTHOR]

Simple Summary: The development of proprietary drugs targeting KRAS-mutant tumors has historically been a formidable challenge. This difficulty stems from the high affinity of RAS proteins for GTP and the lack of a hydrophobic "pocket" conducive to drug binding. However, the emergence of CRISPR technology, a groundbreaking gene-editing tool, has revolutionized tumor studies, particularly those focusing on KRAS mutations. This article offers a review of both fundamental and translational research leveraging the CRISPR system in the context of KRAS-mutant cancer. It encapsulates recent strides made in understanding KRAS biology's mechanistic nuances, shedding light on pivotal themes such as drug resistance, anti-tumor immune responses, epigenetic regulation, and the exploitation of synthetic lethality by mutant KRAS. In conclusion, the article touches upon the current limitations of employing CRISPR technology in KRAS-related research, while also suggesting avenues for future refinement and optimization in this dynamic field. Once considered "undruggable" due to the strong affinity of RAS proteins for GTP and the structural lack of a hydrophobic "pocket" for drug binding, the development of proprietary therapies for KRAS-mutant tumors has long been a challenging area of research. CRISPR technology, the most successful gene-editing tool to date, is increasingly being utilized in cancer research. Here, we provide a comprehensive review of the application of the CRISPR system in basic and translational research in KRAS-mutant cancer, summarizing recent advances in the mechanistic understanding of KRAS biology and the underlying principles of drug resistance, anti-tumor immunity, epigenetic regulatory networks, and synthetic lethality co-opted by mutant KRAS. [ABSTRACT FROM AUTHOR]