Search

The rapid advancements in Artificial Intelligence of Things (AIoT) are pivotal for the healthcare sector, especially as the world approaches an aging society which will be reached by 2050. This paper presents an innovative AIoT-enabled data fusion system implemented at the CMUH Respiratory Intensive Care Unit (RICU) to address the high incidence of medical errors in ICUs, which are among the top three causes of mortality in healthcare facilities. ICU patients are particularly vulnerable to medical errors due to the complexity of their conditions and the critical nature of their care. We introduce a four-layer AIoT architecture designed to manage and deliver both real-time and non-real-time medical data within the CMUH-RICU. Our system demonstrates the capability to handle 22 TB of medical data annually with an average delay of 1.72 ms and a bandwidth of 65.66 Mbps. Additionally, we ensure the uninterrupted operation of the CMUH-RICU with a three-node streaming cluster (called Kafka), provided a failed node is repaired within 9 h, assuming a one-year node lifespan. A case study is presented where the AI application of acute respiratory distress syndrome (ARDS), leveraging our AIoT data fusion approach, significantly improved the medical diagnosis rate from 52.2% to 93.3% and reduced mortality from 56.5% to 39.5%. The results underscore the potential of AIoT in enhancing patient outcomes and operational efficiency in the ICU setting. [ABSTRACT FROM AUTHOR]

In the present study, microstructure and cyclic tensile tests were used to measure the superelastic responses of Fe40.95Ni28Co17Al11.5Ta2.5B0.05 (at.%) shape memory alloys after 97% cold rolling. Cold-rolled samples underwent annealing heat treatment (1250 °C/1 h) followed by quenching in water or aging heat treatment (700 °C/6 h and 700 °C/12 h) followed by quenching in water. The microstructure results showed that the average grain size increased from 210 μm to 1570 μm as annealing times increased from 0.5 h to 1 h. X-ray diffraction (XRD) spectra for FeNiCoAlTaB (NCATB) showed that in cold-rolled alloys after solution, the strong peak was in the face-centered cubic (γ, FCC) <111> structure. In aged samples, a new peak (γ', FCC) emerged, the intensity of which increased as aging times rose from 6 to 12 h. Transmission electron microscope (TEM) images showed that the average precipitate size was around 10 nm in 700 °C/6 h specimens and 18 nm in 700 °C/12 h specimens. The precipitate was enriched in Ni, Al, and Ta elements and exhibited an L12 crystal structure. Tensile samples aged at 700 °C for 6 and 12 h exhibited recoverable strains of 1% and 2.6%, respectively, at room temperature. Digital image correlation (DIC) results for the sample aged at 700 °C for 12 h showed that two martensite variants were activated during the superelastic test. Such variants can form corresponding variant pairs (CVPs), which promote tensile deformation. The tensile sample exhibited a gradual cyclic degradation, and a large irrecoverable strain was observed after the test. This irrecoverable strain was the result of residual martensite, which was pinned by dislocations. [ABSTRACT FROM AUTHOR]

A series of di-functional benzoxazine (BZ) monomers was synthesized, specifically the double-decker silsesquioxane (DDSQ) cage structure (DDSQ-BZ). Comparative analyses were conducted between DDSQ-BZ monomers and the most commonly utilized bisphenol A-functionalized bifunctional benzoxazine (BPA-BZ) monomer. DDSQ-BZ compounds possess better thermal properties such as high char yield and high thermal decomposition temperature (Td10) after thermal ring-opening polymerization (ROP) because the inorganic DDSQ cage nanostructure features a nano-reinforcement effect. In addition, blending inorganic DDSQ-BZ compounds with epoxy resin was explored to form organic/inorganic hybrids with enhanced thermal and mechanical properties following thermal ROP. The improvement in mechanical properties is primarily attributed to the network structure formed by the cross-linking between DDSQ-BZ and the epoxy resin during thermal ROP, as well as hydrogen bonding interactions formed between the hydroxyl groups generated during thermal ROP and the Si-O-Si bonds in the DDSQ structure. [ABSTRACT FROM AUTHOR]

Mitochondria (MITO) and peroxisomes (PEXO) are the major organelles involved in the oxidative metabolism of cells, but detailed examination of their dynamics and functional adaptations during skeletal muscle (SKM) development (myogenesis) is still lacking. In this study, we found that during myogenesis, MITO DNA, ROS level, and redox ratio increased in myotubes, but the membrane potential (Δψm) and ATP content reduced, implying that the MITO efficiency might reduce during myogenesis. The PEXO number and density both increased during myogenesis, which probably resulted from the accumulation and increased biogenesis of PEXO. The expression of PEXO biogenesis factors was induced during myogenesis in vitro and in utero, and their promoters were also activated by MyoD. Knockdown of the biogenesis factors Pex3 repressed not only the PEXO density and functions but also the levels of MITO genes and functions, suggesting a close coupling between PEXO biogenesis and MITO functions. Surprisingly, Pex3 knockdown by the CRISPRi system repressed myogenic differentiation, indicating critical involvement of PEXO biogenesis in myogenesis. Taken together, these observations suggest that the dynamics and functions of both MITO and PEXO are coupled with each other and with the metabolic changes that occur during myogenesis, and these metabolic couplings are critical to myogenesis. [ABSTRACT FROM AUTHOR]

Polyetheretherketone (PEEK) is an emerging thermoplastic polymer with good mechanical properties and an elastic modulus similar to that of alveolar bone. PEEK dental prostheses for computer-aided design/computer-aided manufacturing (CAD/CAM) systems on the market often have additives of titanium dioxide (TiO2) to strengthen their mechanical properties. However, the effects of combining aging, simulating a long-term intraoral environment, and TiO2 content on the fracture characteristics of PEEK dental prostheses have rarely been investigated. In this study, two types of commercially available PEEK blocks, containing 20% and 30% TiO2, were used to fabricate dental crowns by CAD/CAM systems and were aged for 5 and 10 h based on the ISO 13356 specifications. The compressive fracture load values of PEEK dental crowns were measured using a universal test machine. The morphology and crystallinity of the fracture surface were analyzed by scanning electron microscopy and an X-ray diffractometer, respectively. Statistical analysis was performed using the paired t-test (α = 0.05). Results showed no significant difference in the fracture load value of the test PEEK crowns with 20% and 30% TiO2 after 5 or 10 h of aging treatment; all test PEEK crowns have satisfactory fracture properties for clinical applications. Fracture surface analysis revealed that all test crowns fractured from the lingual side of the occlusal surface, with the fracture extending along the lingual sulcus to the lingual edge, showing a feather shape at the middle part of the fracture extension path and a coral shape at the end of the fracture. Crystalline analysis showed that PEEK crowns, regardless of aging time and TiO2 content, remained predominantly PEEK matrix and rutile phase TiO2. We would conclude that adding 20% or 30% TiO2 to PEEK crowns may have been sufficient to improve the fracture properties of PEEK crowns after 5 or 10 h of aging. Aging times below 10 h may still be safe for reducing the fracture properties of TiO2-containing PEEK crowns. [ABSTRACT FROM AUTHOR]

The high porosity of a GaN porous structure (PS) makes it mechanically semi-flexible and can shield against the stress from the thick growth template on an overgrown layer to control the lattice structure or composition within the overgrown layer. To understand this stress shield effect, we investigated the lattice constant variations among different growth layers in various samples of overgrown Al0.3Ga0.7N on GaN templates under different strain-relaxation conditions based on d-spacing crystal lattice analysis. The fabrication of a strain-damping PS in a GaN template shields against the stress from the thick GaN template on the GaN interlayer, which lies between the PS and the overgrown AlGaN layer, such that the stress counteraction of the AlGaN layer against the GaN interlayer can reduce the tensile strain in AlGaN and increase its critical thickness. If the GaN interlayer is thin, such that a strong AlGaN counteraction occurs, the increased critical thickness can become larger than the overgrown AlGaN thickness. In this situation, crack-free, thick AlGaN overgrowth is feasible. [ABSTRACT FROM AUTHOR]

Osteoporotic vertebral compression fractures are the most common manifestation of osteoporosis. Percutaneous kyphoplasty (PKP) can lead to both pain improvement and correction of kyphosis secondary to collapsed vertebral bodies. Robot-assisted (RA) PKP has been reported to provide better vertebral body fracture correction than conventional fluoroscopy-assisted (FA) PKP. The aim of this meta-analysis is to compare clinical outcomes of RA PKP versus FA PKP. The Pubmed, Embase, and MEDLINE electronic databases were searched from January 1900 to December 2022, with no language restrictions for relevant articles. We extracted the preoperative and postoperative mean pain score and standard deviation from the included studies and pooled them using an inverse variance method. Statistical analyses were performed using functions available in the metafor package in R software. The results of this meta-analysis were summarized with weighted mean differences (WMDs). Our search strategy identified 181 references from the Pubmed, Embase, and MEDLINE electronic databases. We excluded duplicates and irrelevant references, after screening titles and abstracts. The remaining 12 studies were retrieved for full-text review, and, finally, we included five retrospective cohort studies from 2015 to 2021, comprising 223 patients undergoing RA PKP and 246 patients undergoing FA PKP. No difference was found in subgroup analysis based on the timing of postoperative pain assessment, despite the overall estimate of postoperative pain indicating a significant difference between the RA PKP and FA PKP groups (WMD, −0.22; 95% CI, −0.39 to −0.05). The long-term pain assessment revealed a significantly lower VAS in the RA PKP group than the FA PKP group at six months postoperatively (WMD, −0.15; 95% CI, −0.30 to −0.01), but no difference between the subgroups at three (WMD, 0.06; 95% CI, −0.41 to −0.54) and twelve months (WMD, −0.10; 95% CI, −0.50 to 0.30) postoperatively. Our meta-analysis revealed no significant difference in postoperative pain between RA PKP and FA PKP. Patients undergoing RA PKP had better pain improvement compared to FA PKP at 6 months postoperatively. However, further studies focusing on long-term outcomes in patients undergoing RA PKP are warranted to clarify its benefit, given the small number of included studies. [ABSTRACT FROM AUTHOR]

This study synthesized two azide-functionalized monomers through p-dichloro xylene and double-decker silsesquioxane (DDSQ) units with NaN3 to form DB-N3 and DDSQ-N3 monomers, respectively. In addition, five different propargyl-functionalized monomers were also prepared from hydroquinone, bisphenol A, bis(4-hydroxyphenyl)methanone, 2,4-dihydroxybenzaldehyde (then reacted with hydrazine hydrate solution) and 1,2-bis(4-hydroxyphenyl)-1,2-diphenylethene with propargyl bromide to form P-B, P-BPA, P-CO, P-NP, and P-TPE monomers, respectively. As a result, various DDSQ-based main chain copolymers could be synthesized using Cu(I)-catalyzed click polymerization through DDSQ-N3 with different propargyl-functionalized monomers, of which the chemical structure and molecular weight could be confirmed by using Fourier-transform infrared spectroscopy (FTIR), nuclear magnetic resonance (NMR), and gel permeation chromatography (GPC) analyses. Differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), scanning electron microscope (SEM), transmission electron microscopy (TEM), and photoluminescence (PL) spectroscopy analyses also could characterize the thermal stability, morphology, and optical behaviors of these DDSQ-based copolymers. All results indicate that the incorporation of an inorganic DDSQ cage could improve the thermal stability such as thermal decomposition temperature and char yield, because of the DDSQ dispersion homogeneously in the copolymer matrix, and this would then affect the optical properties of NP and TPE units in this work. [ABSTRACT FROM AUTHOR]

To further enhance the color conversion from a quantum-well (QW) structure into a color-converting colloidal quantum dot (QD) through Förster resonance energy transfer (FRET), we designed and implemented a device structure with QDs inserted into a GaN nano-porous structure near the QWs to gain the advantageous nanoscale-cavity effect. Additionally, surface Ag nanoparticles were deposited for inducing surface plasmon (SP) coupling with the QW structure. Based on the measurements of time-resolved and continuous-wave photoluminescence spectroscopies, the FRET efficiency from QW into QD is enhanced through the SP coupling. In particular, performance in the polarization perpendicular to the essentially extended direction of the fabricated pores in the nano-porous structure is more strongly enhanced when compared with the other linear polarization. A numerical simulation study was undertaken, and showed consistent results with the experimental observations. [ABSTRACT FROM AUTHOR]

New treatments for chondrosarcoma are extremely important. Chondrosarcoma is a primary malignant bone tumor with a very unfavorable prognosis. High-grade chondrosarcoma has a high potential to metastasize to any organ in the body. Platelet-derived growth factor (PDGF) is a potent angiogenic factor that promotes tumor angiogenesis and metastasis. The adipocytokine visfatin promotes metastatic potential of chondrosarcoma; however, the role of visfatin in angiogenesis in human chondrosarcoma is unclear. We report that the levels of PDGF-C expression were positively correlated with tumor stages, significantly higher than the levels of expression in normal cartilage. Visfatin increased PDGF-C expression and endothelial progenitor cell (EPC) angiogenesis through the PI3K/Akt/mTOR signaling pathway, and dose-dependently down-regulated the synthesis of miR-1264, which targets the 3′-UTR of PDGF-C. Additionally, we discovered inhibition of visfatin or PDGF-C in chondrosarcoma tumors significantly reduced tumor angiogenesis and size. Our results indicate that visfatin inhibits miR-1264 production through the PI3K/Akt/mTOR signaling cascade, and thereby promotes PDGF-C expression and chondrosarcoma angiogenesis. Visfatin may be worth targeting in the treatment of chondrosarcoma angiogenesis. [ABSTRACT FROM AUTHOR]

In this study, we prepared a difunctionalized cyanate ester double-decker silsesquioxane (DDSQ-OCN) cage with a char yield and thermal decomposition temperature (Td) which were both much higher than those of a typical bisphenol A dicyanate ester (BADCy, without the DDSQ cage) after thermal polymerization. Here, the inorganic DDSQ nanomaterial improved the thermal behavior through a nano-reinforcement effect. Blending the inorganic DDSQ-OCN cage into the epoxy resin improved its thermal and mechanical stabilities after the ring-opening polymerization of the epoxy units during thermal polymerization. The enhancement in the physical properties arose from the copolymerization of the epoxy and OCN units to form the organic/inorganic covalently bonded network structure, as well as the hydrogen bonding of the OH groups of the epoxy with the SiOSi moieties of the DDSQ units. For example, the epoxy/DDSQ-OCN = 1/1 hybrid, prepared without Cu(II)-acac as a catalyst, exhibited a glass transition temperature, thermal decomposition temperature (Td), and char yield (166 °C, 427 °C, and 51.0 wt%, respectively) that were significantly higher than those obtained when applying typical organic curing agents in the epoxy resin. The addition of Cu(II)-acac into the epoxy/BADCy and epoxy/DDSQ-OCN hybrids decreased the thermal stability (as characterized by the values of Td and the char yields) because the crosslinking density and post-hardening also decreased during thermal polymerization; nevertheless, it accelerated the thermal polymerization to a lower curing peak temperature, which is potentially useful for real applications as epoxy molding compounds. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a degenerative and painful inflammatory joint disease affecting the cartilage, bone, and synovial membranes, without any effective treatment that targets the underlying mechanisms of OA. Our study evaluated the therapeutic effects of a live probiotic strain, Clostridium butyricum GKB7, administered for 6 weeks to rats with knee OA (KOA) induced by anterior cruciate ligament transection (ACLT) of the right knee. All rats underwent weekly weight-bearing behavioral testing and body weight measurements. At 6 weeks, all rats were sacrificed, and the right hind knees were collected for micro-computed tomography imaging and histopathological and immunohistochemical analyses. Compared with rats in the ACLT-only group, ACLT rats administered the probiotic exhibited dramatic improvements in pain-related behavior from postoperative week 2, had significantly less osseous and cartilaginous damage at week 6, and significantly lower levels of the inflammatory markers interleukin 1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) in cartilage and synovium sections. C. butyricum GKB7 appeared to slow or even reverse OA progression and is worth investigating as a novel therapeutic for OA. [ABSTRACT FROM AUTHOR]

Evaluating several vital signs and chest X-ray (CXR) reports regularly to determine the recovery of the pneumonia patients at general wards is a challenge for doctors. A recent study shows the identification of pneumonia by the history of symptoms and signs including vital signs, CXR, and other clinical parameters, but they lack predicting the recovery status after starting treatment. The goal of this paper is to provide a pneumonia status prediction system for the early affected patient's discharge from the hospital within 7 days or late discharge more than 7 days. This paper aims to design a multimodal data analysis for pneumonia status prediction using deep learning classification (MDA-PSP). We have developed a system that takes an input of vital signs and CXR images of the affected patient with pneumonia from admission day 1 to day 3. The deep learning then classifies the health status improvement or deterioration for predicting the possible discharge state. Therefore, the scope is to provide a highly accurate prediction of the pneumonia recovery on the 7th day after 3-day treatment by the SHAP (SHapley Additive exPlanation), imputation, adaptive imputation-based preprocessing of the vital signs, and CXR image feature extraction using deep learning based on dense layers-batch normalization (BN) with class weights for the first 7 days' general ward patient in MDA-PSP. A total of 3972 patients with pneumonia were enrolled by de-identification with an adult age of 71 mean ± 17 sd and 64% of them were male. After analyzing the data behavior, appropriate improvement measures are taken by data preprocessing and feature vectorization algorithm. The deep learning method of Dense-BN with SHAP features has an accuracy of 0.77 for vital signs, 0.92 for CXR, and 0.75 for the combined model with class weights. The MDA-PSP hybrid method-based experiments are proven to demonstrate higher prediction accuracy of 0.75 for pneumonia patient status. Henceforth, the hybrid methods of machine and deep learning for pneumonia patient discharge are concluded to be a better approach. [ABSTRACT FROM AUTHOR]

In this study, we synthesized bismaleimide into a functionalized double-decker silsesquioxane (DDSQ) cage. This was achieved by hydrosilylation of DDSQ with nadic anhydride (ND), reacting it with excess p-phenylenediamine to obtain DDSQ-ND-NH2, and treating with maleic anhydride (MA), which finally created a DDSQ-BMI cage structure. We observed that the thermal decomposition temperature (Td) and char yield were both increased upon increasing the thermal polymerization temperature, and that these two values were both significantly higher than pure BMI without the DDSQ cage structure since the inorganic DDSQ nanoparticle could strongly enhance the thermal stability based on the nano-reinforcement effect. Based on FTIR, TGA, and DMA analyses, it was found that blending epoxy resin with the DDSQ-BMI cage to form epoxy/DDSQ-BMI hybrids could also enhance the thermal and mechanical properties of epoxy resin due to the organic/inorganic network formation created by the ring-opening polymerization of the epoxy group and the addition polymerization of the BMI group due to the combination of the inorganic DDSQ cage structure and hydrogen bonding effect. The epoxy/DDSQ-BMI = 1/1 hybrid system displayed high Tg value (188 °C), Td value (397 °C), and char yield (40.4 wt%), which was much higher than that of the typical DGEBA type epoxy resin with various organic curing agents. [ABSTRACT FROM AUTHOR]

The human–machine interface with head control can be applied in many domains. This technology has the valuable application of helping people who cannot use their hands, enabling them to use a computer or speak. This study combines several image processing and computer vision technologies, a digital camera, and software to develop the following system: image processing technologies are adopted to capture the features of head motion; the recognized head gestures include forward, upward, downward, leftward, rightward, right-upper, right-lower, left-upper, and left-lower; corresponding sound modules are used so that patients can communicate with others through a phonetic system and numeric tables. Innovative skin color recognition technology can obtain head features in images. The barycenter of pixels in the feature area is then quickly calculated, and the offset of the barycenter is observed to judge the direction of head motion. This architecture can substantially reduce the distraction of non-targeted objects and enhance the accuracy of systematic judgment. [ABSTRACT FROM AUTHOR]

In this study we have developed an automatic monitoring system based on wireless communication networks in both dairy and pig farms to replace traditional manual data collection of the environmental conditions and manual controls of fans and water control valves in livestock farms to solve the man-power shortage problem for livestock farming. Firstly, sensors for detecting temperature, humidity, illumination, wind speed and the control circuit and communication system were installed. The monitoring programs were subsequently designed to transmit the data back to the user interface display of the office through RFU-400 wireless communication modules, and the data collected from the farm environment have been stored in a database for data analysis. Finally, the fans and water spray valves have been automatically activated duly to improve the temperature and humidity of the livestock farms. We analyzed the data collected from the sensors with regard to the lactation yields for dairy cows, and suggested optimized environmental parameters for dairy cows to increase their appetite and lactation yield, or increase the feed conversion rate of the pigs. We expect the process and results of this study can result in helpful reference to livestock farming, and help to achieve the best economic benefits in raising cattle, pigs and so forth. [ABSTRACT FROM AUTHOR]

A series of poly(vinylphenol-co-methacryisobutyl polyhedral oligomeric silsesquioxane) (PVPh-co-PMAPOSS) random copolymers have been synthesized through free radical copolymerizations of acetoxystyrene with methacryisobutyl POSS monomer and subsequent hydrazine monohydratemediated hydrolysis of the acetoxyl units. These random copolymers were characterized using nuclear magnetic resonance spectroscopy (NMR), Fourier transform infrared spectroscopy (FTIR), gel permeation chromatography (GPC), and differential scanning calorimetry (DSC), which revealed that the POSS content in the random copolymers could be varied by changing the POSS monomer feed ratio by ¹H NMR analyses. This molecular design approach allowed us to investigate the thermal properties and hydrogen bonding interactions of these PVPh-co-PMAPOSS random copolymers in comparison with those of PVPh/PMAPOSS blend systems. Hydrogen bonding interactions were absent in the PVPh/PMAPOSS blend system, because of a strong screening effect; in contrast, the PVPh-co-PMAPOSS random copolymers experienced enhanced intramolecular hydrogen bonding that minimized the strong screening effect of the POSS nanoparticles. [ABSTRACT FROM AUTHOR]

Portulaca oleracea is a well-known species for traditional medicine and food homology in Taiwan. In traditional medicine, P. oleracea is also used to treat gastrointestinal disorders, liver inflammation, fever, severe inflammation, and headaches. We investigated antioxidant, anti-tyrosinase, and anti-α-glucosidase activities of various solvent extracts and major bioactive components from P. oleracea. Ethanol and acetone extracts showed potent DPPH, ABTS, and hydroxyl radical scavenging activities. Chloroform and n-hexane extracts displayed significant superoxide radical scavenging activity. Furthermore, ethyl acetate and acetone extracts of P. oleracea showed potent anti-tyrosinase and anti-α-glucosidase activities. Examined and compared to the various solvent extracts for their chemical compositions using HPLC analysis, we isolated seven major compounds and analyzed their antioxidant, anti-tyrosinase, and anti-α-glucosidase activities. Seven active compounds of P. oleracea, especially quercetin, rosmarinic acid, and kaempferol, exhibited obvious antioxidant, anti-tyrosinase, and anti-α-glucosidase activities. The molecular docking model and the hydrophilic interactive mode of tyrosinase and α-glucosidase revealed that active compounds might have a higher antagonistic effect than commonly inhibitors. Our result shows that the active solvent extracts and their components of P. oleracea have the potential as natural antioxidants, tyrosinase and α-glucosidase inhibitors. Our results suggest that the active solvent extracts of P. oleracea and their components have potential as natural antioxidants, tyrosinase and α-glucosidase inhibitors. [ABSTRACT FROM AUTHOR]

The shape memory properties and microstructure of Fe41Ni28Co17Al11.5(Ti+Nb)2.5 (at.%) cold-rolled alloys were studied at the first time using the values reported in constant stress thermal cycling experiments in a three-point bending test. Thermo-magnetization curves of 97% cold-rolled and solution-treated sample aged at 600 °C for 24, 48 and 72 h showed evidence of the martensitic transformation, and the transformation temperatures increased their values from 24 to 72 h. The alloy cold-rolled to 97% and then solution-treated at 1277 °C for 1 h showed that most grains were aligned near <100> in the rolling direction in the recrystallization texture. The intensity of texture was 13.54, and an average grain size was around 400 μm. The sample aged at 600 °C for 48 h showed fully recoverable strain up to 1.6% at 200 MPa stress level in the three-point bending test. However, the experimental recoverable strain values were lower than the theoretical values, possibly due to the small volume fraction of low angle grain boundary, the formation of brittle grain boundary precipitates, and a grain boundary constraint lower than the expected intensity of texture in the samples. [ABSTRACT FROM AUTHOR]

Prevention of cardiorenal syndrome through treatment with inotropic agents remains challenging. This network meta-analysis evaluated the safety and renoprotective effects of inotropes on patients with advanced heart failure (HF) using a frequentist random-effects model. A systematic database search was performed until 31 January 2021, and a total of 37 trials were included. Inconsistency, publication bias, and subgroup analyses were conducted. The levosimendan group exhibited significantly decreased mortality compared with the control (odds ratio (OR): 0.62; 95% confidence interval (CI): 0.46–0.84), milrinone (OR: 0.50; 95% CI: 0.30–0.84), and dobutamine (OR: 0.75; 95% CI: 0.57–0.97) groups. In terms of renal protection, levosimendan (standardized mean difference (SMD): 1.67; 95% CI: 1.17–2.18) and dobutamine (SMD: 1.49; 95% CI: 0.87–2.12) more favorably improved the glomerular filtration rate (GFR) than the control treatment did, but they did not significantly reduce the incidence of acute kidney injury. Furthermore, levosimendan had the highest P-score, indicating that it most effectively reduced mortality and improved renal function (e.g., GFR and serum creatinine level), even in patients with renal insufficiency. In conclusion, levosimendan is a safe alternative for protecting renal function on cardiorenal syndrome in patients with advanced HF. [ABSTRACT FROM AUTHOR]

Background: Evaluating the options for antibiotic treatment for carbapenem-resistant Gram-negative bacteria (CR-GNB)-associated pneumonia remains crucial. We compared the therapeutic efficacy and nephrotoxicity of two combination therapies, namely, colistin + carbapenem (CC) versus colistin + tigecycline (CT), for treating CR-GNB-related nosocomial pneumonia in critically ill patients. Methods: In this multicenter, retrospective, and cohort study, we recruited patients admitted to intensive care units and diagnosed with CR-GNB-associated nosocomial pneumonia. We divided the enrolled patients into CC (n = 62) and CT (n = 59) groups. After propensity score matching (n = 39), we compared the therapeutic efficacy by mortality, favorable outcome, and microbiological eradication and compared nephrotoxicity by acute kidney injury between groups. Results: There was no significant difference between the CC and CT groups regarding demographic characteristics and disease severities as assessed using the Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, and other organ dysfunction variables. Therapeutic efficacy was non-significantly different between groups in all-cause mortality, favorable outcomes, and microbiological eradication at days 7, 14, and 28; as was the Kaplan-Meier analysis of 28-day survival. For nephrotoxicity, both groups had similar risks of developing acute kidney injury, evaluated using the Kidney Disease Improving Global Outcomes criteria (p = 1.000). Conclusions: Combination therapy with CC or CT had similar therapeutic efficacy and risk of developing acute kidney injury for treating CR-GNB-associated nosocomial pneumonia in critically ill patients. [ABSTRACT FROM AUTHOR]

Chondrosarcoma is a malignant bone tumor that is characterized by high metastatic potential and marked resistance to radiation and chemotherapy. The knowledge that adipokines facilitate the initiation, progression, metastasis, and treatment resistance of various tumors has driven several in vitro and in vivo investigations into the effects of adipokines resistin, leptin, and adiponectin upon the development and progression of chondrosarcomas. Another adipokine, visfatin, is known to regulate tumor progression and metastasis, although how this molecule may affect chondrosarcoma metastasis is unclear. Here, we found that visfatin facilitated cellular migration via matrix metalloproteinase-2 (MMP-2) production in human chondrosarcoma cells and overexpression of visfatin enhanced lung metastasis in a mouse model of chondrosarcoma. Visfatin-induced stimulation of MMP-2 synthesis and activation of the AP-1 transcription factor facilitated chondrosarcoma cell migration via the ERK, p38, and JNK signaling pathways. This evidence suggests that visfatin is worth targeting in the treatment of metastatic chondrosarcoma. [ABSTRACT FROM AUTHOR]

A sewer dynamic model (SDM), an innovative use of combined models, was established to describe the reactions of compounds in a pilot sewer pipe. The set of ordinary differential equations in the SDM was solved simultaneously using the fourth-order Runge–Kutta algorithm. The SDM was validated by calculating the consistency between the simulation and observation values. After the SDM was validated, the reaction rate was analyzed. For heterotrophs in the water phase and biofilm, their growth rates were greater than the organism decay rate. For ammonia, the supply rate was greater than the consumption rate at the initial time, but the supply rate was smaller than the consumption rate from the 3rd hour. The supply rate was smaller than the consumption rate for the other six compounds. The supply rate of oxygen was smaller than the consumption rate before the 4th hour because of the microorganism activities, and, subsequently, the supply rate was greater than the consumption rate after the 4th hour because of reaeration. The results of this study provide an insight into the reaction rates of different compounds in urban sewer pipes and an urban water network modeling reference for policymaking and regulation. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) frequently shows early invasion into blood vessels as well as intrahepatic metastasis. Innovations of novel small-molecule agents to block HCC invasion and subsequent metastasis are urgently needed. Moscatilin is a bibenzyl derivative extracted from the stems of a traditional Chinese medicine, orchid Dendrobium loddigesii. Although moscatilin has been reported to suppress tumor angiogenesis and growth, the anti-metastatic property of moscatilin has not been elucidated. The present results revealed that moscatilin inhibited metastatic behavior of HCC cells without cytotoxic fashion in highly invasive human HCC cell lines. Furthermore, moscatilin significantly suppressed the activity of urokinase plasminogen activator (uPA), but not matrix metalloproteinase (MMP)-2 and MMP-9. Interestingly, moscatilin-suppressed uPA activity was through down-regulation the protein level of uPA, and did not impair the uPA receptor and uPA inhibitory molecule (PAI-1) expressions. Meanwhile, the mRNA expression of uPA was inhibited via moscatilin in a concentration-dependent manner. In addition, the expression of phosphorylated Akt, rather than ERK1/2, was inhibited by moscatilin treatment. The expression of phosphor-IκBα, and -p65, as well as κB-luciferase activity were also repressed after moscatilin treatment. Transfection of constitutively active Akt (Myr-Akt) obviously restored the moscatilin-inhibited the activation of NF-κB and uPA, and cancer invasion in HCC cells. Taken together, these results suggest that moscatilin impedes HCC invasion and uPA expression through the Akt/NF-κB signaling pathway. Moscatilin might serve as a potential anti-metastatic agent against the disease progression of human HCC. [ABSTRACT FROM AUTHOR]

Several kinds of inotropes have been used in critically ill patients to improve hemodynamics and renal dysfunction after cardiac surgery; however, the treatment strategies for reducing mortality and increasing renal protection in patients who underwent cardiac surgery remain controversial. Therefore, we performed a comprehensive network meta-analysis to overcome the lack of head-to-head comparisons. A systematic database was searched up to 31 December 2020, for randomized controlled trials that compared different inotropes on mortality outcomes and renal protective effects after cardiac surgery. A total of 29 trials were included and a frequentist network meta-analysis was performed. Inconsistency analyses, publication bias, and subgroup analyses were also conducted. Compared with placebo, use of levosimendan significantly decreased the risks of mortality (odds ratio (OR): 0.74; 95% confidence interval (CI): 0.56–0.97) and risk of acute renal injury (OR: 0.61; 95% CI: 0.45–0.82), especially in low systolic function patients. Use of levosimendan also ranked the best treatment based on the P-score (90.1%), followed by placebo (64.5%), milrinone (49.6%), dopamine (49.5%), dobutamine (29.1%), and fenoldopam (17.0%). Taking all the available data into consideration, levosimendan was a safe renal-protective choice for the treatment of patients undergoing cardiac surgery, especially for those with low systolic function. [ABSTRACT FROM AUTHOR]

Glutamine synthetase (GS) catalyzes the condensation of ammonia and glutamate, along with ATP, to form glutamine. Despite extensive studies on GSs from eukaryotes and prokaryotes, the roles of the N-terminus and other structural features in catalysis remain unclear. Here we report the decameric structure of Drosophila melanogaster GS 2 (DmGS2). The N-terminal short helices, α1 and α2, constitute a meander region, and form hydrogen bonds with residues 3–5 in the N-terminal loop, which are not present in the GSs of other species. Deletion of α1 or α1-α2 inactivates DmGS2. Notably, the Arg4 in each monomer of one pentamer forms hydrogen bonds with Glu7, and Asp8 in the adjacent monomer of the other pentamer. Replacement of Arg4 with Asp (R4D) abolishes activity. Analytical ultracentrifugation revealed that Arg4 is crucial for oligomerization. Circular dichroism spectra revealed that R4D may alter the secondary structure. We mutated key residues to identify the substrate-binding site. As Glu140 binds glutamate and Glu311 binds ammonia, mutants E140A and E311A have little activity. Conversely, mutant P214A (P contributes to ATP binding) has higher activity than wild-type DmGS2. These findings expand the understanding of the structural and functional features of the N-terminal meander region of DmGS2 and the residues important for catalytic efficiency. [ABSTRACT FROM AUTHOR]

In this study we incorporated various amounts of a double-decker silsesquioxane (DDSQ) into phenolic/DDSQ hybrids, which we prepared from a bifunctionalized phenolic DDSQ derivative (DDSQ-4OH), phenol, and CH2O under basic conditions (with DDSQ-4OH itself prepared through hydrosilylation of nadic anhydride with DDSQ and subsequent reaction with 4-aminophenol). We characterized these phenolic/DDSQ hybrids using Fourier transform infrared spectroscopy; 1H, 13C, and 29Si nuclear magnetic resonance spectroscopy; X-ray photoelectron spectroscopy (XPS); and thermogravimetric analysis. The thermal decomposition temperature and char yield both increased significantly upon increasing the DDSQ content, with the DDSQ units providing an inorganic protection layer on the phenolic surface, as confirmed through XPS analyses. We obtained carbon/DDSQ hybrids from the phenolic/DDSQ hybrids after thermal curing and calcination at 900 °C; these carbon/DDSQ hybrids displayed electrochemical properties superior to those of previously reported counterparts. [ABSTRACT FROM AUTHOR]

The development of osteoarthritis (OA) is characterized by synovial inflammation and the upregulation of vascular cell adhesion molecule type 1 (VCAM-1) in human osteoarthritis synovial fibroblasts (OASFs). This increase in VCAM-1 expression promotes monocyte adhesion to OASFs. The adipokine resistin is known to promote the release of inflammatory cytokines during OA progression. In this study, we identified significantly higher levels of resistin and CD68 (a monocyte surface marker) expression in human OA tissue compared with in healthy control tissue. We also found that resistin enhances VCAM-1 expression in human OASFs and facilitates the adhesion of monocytes to OASFs. These effects were attenuated by inhibitors of PKCα, p38, and JNK; their respective siRNAs; and by a microRNA-381 (miR-381) mimic. In our anterior cruciate ligament transection (ACLT) rat model of OA, the inhibition of resistin activity prevented ACLT-induced damage to the OA rat cartilage and pathological changes in resistin and monocyte expression. We also found that resistin affects VCAM-1 expression and monocyte adhesion in human OASFs by inhibiting miR-381 synthesis via the PKCα, p38, and JNK signaling pathways. Our clarification of the crucial role played by resistin in the pathogenesis of OA may lead to more effective therapy that reduces OA inflammation. [ABSTRACT FROM AUTHOR]

In this study, we synthesized two main chain–type block copolymers featuring hydrogen bond donor and acceptor segments through atom transfer radical polymerization (ATRP) using a bifunctionalized polyhedral oligomeric silsesquioxane (POSS) nanoparticle as the initiator. Hydrosilylation of vinylbenzyl chloride at the two corners of a double-decker silsesquioxane (DDSQ) provided the bifunctionalized benzyl chloride initiator VBC-DDSQ-VBC, which we applied as a platform to prepare a main chain–type polystyrene homopolymer (PS-DDSQ-PS), the diblock copolymer poly(styrene–b–4-vinylpyridine) (P4VP-b-PS-DDSQ-PS-b-P4VP), and the diblock copolymer poly(styrene–b–tert-butoxystyrene) (PtBuOS-b-PS-DDSQ-PS-b-PtBuOS) through sequential ATRP. Selective hydrolysis of the tert-butoxyl units of PtBuOS-b-PS-DDSQ-PS-b-PtBuOS yielded the strongly hydrogen bonding diblock copolymer poly (styrene-b-vinylphenol) (PVPh-b-PS-DDSQ-PS-b-PVPh). We used Fourier transfer infrared spectroscopy, nuclear magnetic resonance spectroscopy, size exclusion chromatography, differential scanning calorimetry, mass-analyzed laser desorption ionization mass spectrometry, and transmission electron microscopy to investigate the chemical structures, thermal behavior, and self-assembled nanostructures formed by these main chain–type block copolymers based on DDSQ. [ABSTRACT FROM AUTHOR]

Lymphangiogenesis is an important biological process associated with cancer metastasis. The development of new drugs that block lymphangiogenesis represents a promising therapeutic strategy. Marine fungus-derived compound phomaketide A, isolated from the fermented broth of Phoma sp. NTOU4195, has been reported to exhibit anti-angiogenic and anti-inflammatory effects. However, its anti-lymphangiogenic activity has not been clarified to date. In this study, we showed that phomaketide A inhibited cell growth, migration, and tube formation of lymphatic endothelial cells (LECs) without an evidence of cytotoxicity. Mechanistic investigations revealed that phomaketide A reduced LECs-induced lymphangiogenesis via vascular endothelial growth factor receptor-3 (VEGFR-3), protein kinase Cδ (PKCδ), and endothelial nitric oxide synthase (eNOS) signalings. Furthermore, human proteome array analysis indicated that phomaketide A significantly enhanced the protein levels of various protease inhibitors, including cystatin A, serpin B6, tissue factor pathway inhibitor (TFPI), and tissue inhibitor matrix metalloproteinase 1 (TIMP-1). Importantly, phomaketide A impeded tumor growth and lymphangiogenesis by decreasing the expression of LYVE-1, a specific marker for lymphatic vessels, in tumor xenograft animal model. These results suggest that phomaketide A may impair lymphangiogenesis by suppressing VEGFR-3, PKCδ, and eNOS signaling cascades, while simultaneously activating protease inhibitors in human LECs. We document for the first time that phomaketide A inhibits lymphangiogenesis both in vitro and in vivo, which suggests that this natural product could potentially treat cancer metastasis. [ABSTRACT FROM AUTHOR]

A series of di-functional benzoxazine (BZ) monomers was synthesized, specifically the double-decker silsesquioxane (DDSQ) cage structure (DDSQ-BZ). Comparative analyses were conducted between DDSQ-BZ monomers and the most commonly utilized bisphenol A-functionalized bifunctional benzoxazine (BPA-BZ) monomer. DDSQ-BZ compounds possess better thermal properties such as high char yield and high thermal decomposition temperature ( T d10 ) after thermal ring-opening polymerization (ROP) because the inorganic DDSQ cage nanostructure features a nano-reinforcement effect. In addition, blending inorganic DDSQ-BZ compounds with epoxy resin was explored to form organic/inorganic hybrids with enhanced thermal and mechanical properties following thermal ROP. The improvement in mechanical properties is primarily attributed to the network structure formed by the cross-linking between DDSQ-BZ and the epoxy resin during thermal ROP, as well as hydrogen bonding interactions formed between the hydroxyl groups generated during thermal ROP and the Si-O-Si bonds in the DDSQ structure.