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Statins are common drugs that are clinically used to reduce elevated plasma cholesterol levels. Based on their solubility, statins are considered to be either hydrophilic or lipophilic. Amongst them, simvastatin has the highest lipophilicity to facilitate its ability to cross the blood-brain barrier. Recent studies have suggested that simvastatin could be a promising therapeutic option for different brain complications and diseases ranging from brain tumors (i.e., medulloblastoma and glioblastoma) to neurological disorders (i.e., Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease). Specific mechanisms of disease amelioration, however, are still unclear. Independent studies suggest that simvastatin may reduce the risk of developing certain neurodegenerative disorders. Meanwhile, other studies point towards inducing cell death in brain tumor cell lines. In this review, we outline the potential therapeutic effects of simvastatin on brain complications and review the clinically relevant molecular mechanisms in different cases.

DNA methylation, one of the most well-studied epigenetic modifications, is involved in a wide spectrum of biological processes. Epigenetic mechanisms control cellular morphology and function. Such regulatory mechanisms involve histone modifications, chromatin remodeling, DNA methylation, non-coding regulatory RNA molecules, and RNA modifications. One of the most well-studied epigenetic modifications is DNA methylation that plays key roles in development, health, and disease. Our brain is probably the most complex part of our body, with a high level of DNA methylation. A key protein that binds to different types of methylated DNA in the brain is the methyl-CpG binding protein 2 (MeCP2). MeCP2 acts in a dose-dependent manner and its abnormally high or low expression level, deregulation, and/or genetic mutations lead to neurodevelopmental disorders and aberrant brain function. Recently, some of MeCP2-associated neurodevelopmental disorders have emerged as neurometabolic disorders, suggesting a role for MeCP2 in brain metabolism. Of note, MECP2 loss-of-function mutation in Rett Syndrome is reported to cause impairment of glucose and cholesterol metabolism in human patients and/or mouse models of disease. The purpose of this review is to outline the metabolic abnormalities in MeCP2-associated neurodevelopmental disorders that currently have no available cure. We aim to provide an updated overview into the role of metabolic defects associated with MeCP2-mediated cellular function for consideration of future therapeutic strategies.

Methyl CpG binding protein 2 (MeCP2) is an epigenetic reader that binds to methylated CpG dinucleotides and regulates gene transcription. Mecp2/MECP2 gene has 4 exons, encoding for protein isoforms MeCP2E1 and MeCP2E2. MeCP2 plays key roles in neurodevelopment, therefore, its gain- and loss-of-function mutations lead to neurodevelopmental disorders including Rett Syndrome. Here, we describe the structure, functional domains, and evidence support for potential additional alternatively spliced MECP2 transcripts and protein isoforms. We conclude that NCBI MeCP2 isoforms 3 and 4 contain certain MeCP2 functional domains. Our in silico analysis led to identification of histone modification and accessibility profiles at the MECP2 gene and its cis-regulatory elements. We conclude that the human MECP2 gene associated histone post-translational modifications exhibit high similarity between males and females. Between brain regions, histone modifications were found to be less conserved and enriched within larger genomic segments named as “S1–S11”. We also identified highly conserved DNA accessibility regions in different tissues and brain regions, named as “A1–A9” and “B1–B9”. DNA methylation profile was similar between mid-frontal gyrus of donors 35 days–25 years of age. Based on ATAC-seq data, the identified hypomethylated regions “H1–H8” intersected with most regions of the accessible chromatin (A regions).

Colonoscopy is an essential method for diagnosing and treating colorectal cancer, relying on effective bowel preparation to thoroughly examine the large intestinal mucosa. Traditional education involves printed instructions and verbal explanations but does not guarantee clear patient understanding. Poor bowel preparation can obscure mucosal visibility, delaying cancer diagnosis and treatment. A mobile medical model using Android devices for bowel preparation education was tested in a single-blind, randomized trial. This trial enrolled outpatients undergoing colonoscopy at the Endoscopy Center for Diagnostic and Treatment between 27 October 2021 and 31 December 2022. This study introduced the ColonClean app alongside traditional methods. After examination, endoscopists rated the preparation quality using the Aronchick scale. A data analysis was conducted using SPSS 25.0 to determine if there was a significant improvement in bowel preparation quality between the control group (traditional method) and the experimental group (traditional method plus the ColonClean app). Forty patients were recruited in each group. In the experimental group, all ratings were "fair", with 75% receiving an "excellent" or "good" rating, showing statistical significance ( p = 0.016). The ColonClean app improves bowel preparation quality more effectively than traditional care instructions.

As Taiwan's population ages, the need for long-term care, such as home care, is increasing due to improved medical services and longer life expectancy; however, the current coverage rate for home care services is only 50%, highlighting the importance of retaining home care workers. This study applies job embeddedness, organizational commitment, and psychological safety as variables to explore the retention intention of Taiwan's home care workers. A questionnaire survey was distributed among home care workers using convenience sampling, resulting in 547 collected questionnaires, of which 458 were valid. Data analysis was conducted with SPSS 22.0 and AMOS 22.0, and a structural equation model (SEM) was used to test the hypotheses. Our findings suggest that job embeddedness has a positive impact on organizational commitment (γ = 0.649, γ = 0.607, and γ = 0.628; p < 0.001) and retention intention (γ = 0.253, γ = 0.242, γ = 0.271; p < 0.001), similar to organizational commitment (γ = 0.721, p < 0.001). Additionally, organizational commitment mediates job embeddedness and retention intention, while psychological safety moderated organizational commitment and retention intention (β = 0.639; p < 0.001). This study aims to provide information for the development of more effective human resource policies and contribute to practical advancements in the home care service environment and management structure of home care organizations. By analyzing and exploring the main factors contributing to home care workers' retention intention, we hope to enhance the overall benefits of home service organizations and the industry.

Recently, interest in animal welfare has steadily increased, driven by a growing focus on environmental, social, and governance (ESG) issues. This trend aligns with the Sustainable Development Goals (SDGs) set by the United Nations. This underscores the importance of comprehending consumer attitudes towards products that are respectful to animal welfare. This research aims to employ the Value-Attitude-Behavior (VAB) model as a theoretical basis to explore the behavioral intentions of Taiwanese consumers to buy cage-free eggs. To provide comprehensive insights into consumer behavior in this domain, the study examines key variables such as 'human-nature connectedness', 'trust in labels', and 'attitude towards animal welfare'. By addressing an existing research gap in the literature and exploring consumer behavior in relation to animal welfare-friendly products, the research contributes to an area that has received limited attention. We gathered a total of 341 valid questionnaires for this research. Employing Structural Equation Modeling (SEM) along with Maximum Likelihood Estimation (MLE), we investigated the causal connections between variables. The study presents three key observations: First, consumers who value sustainability and ethics tend to maintain a positive perspective on free-range eggs. Second, a favorable stance towards cage-free eggs directly correlates with positive future behaviors. Lastly, label trustworthiness and a supportive view towards animal welfare heavily affect behavioral intentions in consumers. Given these insights and the growing significance of animal welfare in consumer choices, we recommend that participants in the food and livestock sector earnestly advocate for and back practices that prioritize animal well-being.

The concepts of culinary sustainability and avoiding the waste of surplus food have become important sustainability trends today. How the handling of surplus food can be integrated into the catering industry is a topic of concern in the industry. Kitchen staff are the vital soul of any restaurant, and we intend to discuss how kitchen staff actually behave and explore factors that influence their behaviors in order to develop an implementation model for food waste prevention. Therefore, this study explored a model of ethical sustainability, professional competence, self-efficacy, sustainable food preparation objectives, and sustainable food promotion and behavior focused on limiting food waste, using structural equation modeling (SEM) to understand the relationship between various constructs. This study used a questionnaire and surveyed employees who had been employed for more than 6 months in Taiwan. From May to August 2022, 500 questionnaires were distributed; 415 valid questionnaires were retrieved, yielding a 90.2% recovery rate. According to the structural equation modeling analysis between the dimensions, ethical sustainability should have a positive influence on professional competence in food waste prevention and self-efficacy. Professional competence in food waste prevention affected self-efficacy and behavioral intentions during food preparation; self-efficacy also significantly affected behavioral intentions towards sustainable food preparation. Similarly, behavioral intention had a positive influence on promoting sustainable behaviors. There is a significant relationship between all constructs in this study. Professional competence in food waste prevention was found to be the mediating factor between ethical sustainability and behavioral intentions toward sustainable food preparation, and self-efficacy was the mediating factor between professional competence in food waste prevention and behavioral intentions toward sustainable food preparation.

The concept of chronic kidney disease (CKD) originated in the 2000s, and an estimated 850 million patients are currently suffering from health threats from different degrees of CKD. However, it is unclear whether the existing CKD care systems are optimal for improving patient prognosis and outcomes, so this review summarizes the burden, existing care models, effectiveness, challenges, and developments of CKD care. Even under the general care principles, there are still significant gaps in our understanding of the causes of CKD, prevention or care resources, and care burdens between countries worldwide. Receiving care from multidisciplinary teams rather than only a nephrologist shows potential profits in comprehensive and preferable outcomes. In addition, we propose a novel CKD care structure that combines modern technologies, biosensors, longitudinal data visualization, machine learning algorithms, and mobile care. The novel care structure could simultaneously change the care process, significantly reduce human contact, and make the vulnerable population less likely to be exposed to infectious diseases such as COVID-19. The information offered should be beneficial, allowing us to rethink future CKD care models and applications to reach the goals of health equality and sustainability.

The administration of viral vectored vaccines remains one of the most effective ways to respond to the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. However, pre-existing immunity to the viral vector hinders its potency, resulting in a limited choice of viral vectors. Moreover, the basic batch mode of manufacturing vectored vaccines does not allow one to cost-effectively meet the global demand for billions of doses per year. To date, the exposure of humans to VSV infection has been limited. Therefore, a recombinant vesicular stomatitis virus (rVSV), which expresses the spike protein of SARS-CoV-2, was selected as the vector. To determine the operating upstream process conditions for the most effective production of an rVSV-SARS-CoV-2 candidate vaccine, a set of critical process parameters was evaluated in an Ambr 250 modular system, whereas in the downstream process, a streamlined process that included DNase treatment, clarification, and a membrane-based anion exchange chromatography was developed. The design of the experiment was performed with the aim to obtain the optimal conditions for the chromatography step. Additionally, a continuous mode manufacturing process integrating upstream and downstream steps was evaluated. rVSV-SARS-CoV-2 was continuously harvested from the perfusion bioreactor and purified by membrane chromatography in three columns that were operated sequentially under a counter-current mode. Compared with the batch mode, the continuous mode of operation had a 2.55-fold increase in space-time yield and a reduction in the processing time by half. The integrated continuous manufacturing process provides a reference for the efficient production of other viral vectored vaccines.

Varicocele is a frequently encountered urological disorder, which has a prevalence rate of 8 to 15% among healthy men. However, the incidence is higher in male patients with primary or secondary infertility, with up to 35 to 80% of varicocele cases occurring in this population. The clinical manifestations of varicocele typically include the presence of an asymptomatic mass that feels like a "bag of worms", chronic scrotal pain, and infertility. Most patients with varicocele only undergo varicocelectomy after conservative treatments have failed. Unfortunately, some patients may still experience persistent scrotal pain due to a recurrence of varicocele, the development of hydrocele, neuralgia, referred pain, ureteral lesions, or nutcracker syndrome. Therefore, clinicians should consider these conditions as potential causes of postoperative scrotal pain, and take measures to address them. Several factors can assist in predicting surgical outcomes for patients with varicocele. Clinicians should consider these factors when deciding whether to perform surgery and what type of surgical intervention to use. By doing so, they can increase the likelihood of a successful surgical outcome and minimize the risk of complications such as postoperative scrotal pain.

Lungs and kidneys are two vital and frequently injured organs among critically ill patients. In this study, we attempt to develop a weaning prediction model for patients with both respiratory and renal failure using an explainable machine learning (XML) approach. We used the eICU collaborative research database, which contained data from 335 ICUs across the United States. Four ML models, including XGBoost, GBM, AdaBoost, and RF, were used, with weaning prediction and feature windows, both at 48 h. The model's explanations were presented at the domain, feature, and individual levels by leveraging various techniques, including cumulative feature importance, the partial dependence plot (PDP), the Shapley additive explanations (SHAP) plot, and local explanation with the local interpretable model-agnostic explanations (LIME). We enrolled 1789 critically ill ventilated patients requiring hemodialysis, and 42.8% (765/1789) of them were weaned successfully from mechanical ventilation. The accuracies in XGBoost and GBM were better than those in the other models. The discriminative characteristics of six key features used to predict weaning were demonstrated through the application of the SHAP and PDP plots. By utilizing LIME, we were able to provide an explanation of the predicted probabilities and the associated reasoning for successful weaning on an individual level. In conclusion, we used an XML approach to establish a weaning prediction model in critically ill ventilated patients requiring hemodialysis.

Stress cardiovascular magnetic resonance (CMR) imaging is a well-validated non-invasive stress test to diagnose significant coronary artery disease (CAD), with higher diagnostic accuracy than other common functional imaging modalities. One-stop assessment of myocardial ischemia, cardiac function, and myocardial viability qualitatively and quantitatively has been proven to be a cost-effective method in clinical practice for CAD evaluation. Beyond diagnosis, stress CMR also provides prognostic information and guides coronary revascularisation. In addition to CAD, there is a large body of literature demonstrating CMR's diagnostic performance and prognostic value in other common cardiovascular diseases (CVDs), especially coronary microvascular dysfunction (CMD). This review focuses on the clinical applications of stress CMR, including stress CMR scanning methods, practical interpretation of stress CMR images, and clinical utility of stress CMR in a setting of CVDs with possible myocardial ischemia.

Approximately 1 in 20 people develops kidney stones at some point in their life. Although the surgical removal of stones is common, the recurrence rate remains high and it is therefore important to prevent the occurrence of kidney stones. We chose Astragalus membranaceus (AM), which is a traditional Chinese medicine, to study the prevention of urolithiasis using a Drosophila model based on our previous screening of traditional Chinese herbs. Wild-type Drosophila melanogaster Canton-S adult fruit flies were used in this study. Ethylene glycol (EG, 0.5%) was added to food as a lithogenic agent. The positive control agent (2% potassium citrate (K-citrate)) was then compared with AM (2, 8, and 16 mg/mL). After 21 days, the fruit flies were sacrificed under carbon dioxide narcotization, and the Malpighian tubules were dissected, removed, and processed for polarized light microscopy examination to observe calcium oxalate (CaOx) crystallization. Then, the ex vivo dissolution of crystals in the Malpighian tubules was compared between K-citrate and AM. Survival analysis of the EG, K-citrate, and AM groups was also performed. Both 2% K-citrate and AM (16 mg/mL) significantly inhibited EG-induced CaOx crystal formation. Mean lifespan was significantly reduced by the administration of EG, and the results were significantly reversed in the AM (8 and 16 mg/mL) groups. However, AM extract did not directly dissolve CaOx crystals in Drosophila Malpighian tubules ex vivo. In conclusion, AM extract decreased the ratio of CaOx crystallization in the Malpighian tubules and significantly ameliorated EG-induced reduction of lifespan. AM prevented CaOx crystal formation in the Drosophila model.

Cultural competence refers to a healthcare provider’s ability to consider cultural factors that affect an individual’s health and attitudes toward disease and disability. Nurse practitioners (NPs) are increasingly important in healthcare, practicing culturally competent care strategies to improve the quality of patient care. The aim of this study was to explore cultural competence and its related factors among NPs. A cross sectional study design with a structured questionnaire survey was used. Purposive sampling was employed, for which 86 NPs were recruited from a medical center in northern Taiwan. A T-test, one-way ANOVA, and Pearson’s product-moment correlation coefficient were used for data analysis. The results were as follows: (1) overall, the total score for cultural competence was above-average, with a score of 3.75; (2) years of experience as a NP was found to have a statistically significant correlation with overall clinical competence, with r = 0.23, p < 0.05; (3) there were significant differences in clinical awareness and cultural sensitivity related to the clinical ladder system (t = −2.42, p = 0.01; t = −2.04, p = 0.04). The findings of this study can provide information for directors of medical institutions to design an in-service educational program for NPs to enhance their cultural competence and nursing quality.

Denosumab is approved for osteoporosis treatment in subjects with and without chronic kidney disease (CKD). Confirmation is required for its safety, treatment adherence, renal function effect, and mortality in patients with CKD. A retrospective cohort study was conducted to compare new users of denosumab in terms of their two-year drug adherence in all participants (overall cohort) and CKD participants (CKD subcohort), which was defined as baseline estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m 2 . The eGFR was calculated using the 2021 CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. We defined high adherence (HA) users as receiving three or four doses and low adherence (LA) users as receiving one or two doses. All-cause mortality was analyzed using Kaplan-Meier curves and Cox regression models. In total, there were 1142 subjects in the overall cohort and 500 subjects in the CKD subcohort. HA users had better renal function status at baseline than LD users in the overall cohort. A decline in renal function was only observed among LD users in the overall cohort. In the CKD subcohort, no baseline renal function difference or renal function decline was demonstrated. The all-cause mortality rate of HA users was lower than LA users in both the overall cohort and CKD. A randomized control trial is warranted to target this unique population to confirm our observations.

The obesity paradox, referring to the association of high body mass index (BMI) with low all-cause mortality risk, is found in patients with chronic kidney disease (CKD). Central obesity is associated with metabolic syndrome and may have better prognostic value than BMI for all-cause mortality. Whether central obesity is associated with all-cause mortality in cases of obesity paradox in CKD patients remains unknown. We included 3262 patients with stage 3-5 CKD, grouped into five quintiles (Q1-5) by waist-to-hip ratio (WHR). Low WHR and BMI were associated with malnutrition and inflammation. In Cox regression, high BMI was not associated with all-cause mortality, but BMI < 22.5 kg/m 2 increased the mortality risk. A U-shaped association between central obesity and all-cause mortality was found: WHR Q1, Q4, and Q5 had higher risk for all-cause mortality. The hazard ratio (95% confidence interval) of WHR Q5 and Q1 for all-cause mortality was 1.39 (1.03-1.87) and 1.53 (1.13-2.05) in male and 1.42 (1.02-1.99) and 1.28 (0.88-1.85) in female, respectively. Waist-to-height ratio and conicity index showed similar results. Low WHR or low BMI and high WHR, but not high BMI, are associated with all-cause mortality in advanced CKD.

Long-term and continuous nephrology care effects on post-dialysis mortality remain unclear. This study aims to systematically explore the causal effect of nephrology care on mortality for patients with dialysis initiation. We conducted a retrospective cohort study to include incident patients with dialysis for ≥ 3 months in Taiwan from 2004 through 2011. The continuous nephrology care of incident patients in the three years before their dialysis was measured every six months. Continuous nephrology care was determined by 0-6, 0-12, …, 0-36 months and their counterparts; and none, intermittent, 0-6 months, …, and 0-36 months. Simple and weighted hazards ratio (HR) and 95% confidence interval (CI) for one-year mortality were estimated after propensity score (PS) matching. We included a total of 44,698 patients (mean age 63.3 ± 14.2, male 51.9%). Receiving ≥ 1 year predialysis nephrology care was associated with a 22% lower post-dialysis mortality hazard. No different effects were found (ranges of PS matching HR: 0.77-0.80) when comparing the defined duration of nephrology care with their counterparts. Stepped survival benefits were newly identified in the intermittent care, which had slightly lower HRs (weighted HR: 0.88, 95% CI: 0.79-0.97), followed by reviving care over six months to two years (ranges of weighted HR: 0.60-0.65), and reviving care over two years (ranges of weighted HR: 0.48-0.52). There was no existing critical period of nephrology care effect on post-dialysis, but there were extra survival benefits when extending nephrology care to >2 years, which suggests that continuous and long-term care during pre-dialysis/chronic kidney disease phase is required.

There is an emerging trend to employ dynamic sonography in the diagnosis of entrapment neuropathy, which exhibits aberrant spatiotemporal characteristics of the entrapped nerve when adjacent tissues move. However, the manual tracking of the entrapped nerve in consecutive images demands tons of human labors and impedes its popularity clinically. Here we evaluated the performance of automated median nerve segmentation in dynamic sonography using a variety of deep learning models pretrained with ImageNet, including DeepLabV3+, U-Net, FPN, and Mask-R-CNN. Dynamic ultrasound images of the median nerve at across wrist level were acquired from 52 subjects diagnosed as carpal tunnel syndrome when they moved their fingers. The videos of 16 subjects exhibiting diverse appearance and that of the remaining 36 subjects were used for model test and training, respectively. The centroid, circularity, perimeter, and cross section area of the median nerve in individual frame were automatically determined from the inferred nerve. The model performance was evaluated by the score of intersection over union (IoU) between the annotated and model-predicted data. We found that both DeepLabV3+ and Mask R-CNN predicted median nerve the best with averaged IOU scores close to 0.83, which indicates the feasibility of automated median nerve segmentation in dynamic sonography using deep learning.

Background: The aim was to investigate the effect of inferior oblique (IO) operation (IO myectomy or graded recession and anteriorization) for unilateral and bilateral superior oblique muscle palsy (SOP); Methods: A total of 167 eyes undergoing IO surgery by a single surgeon between 2008 and 2015 were retrospectively reviewed. The method for treating symmetric bilateral SOP was bilateral IO myectomy ( n = 102) and the method for treating unilateral SOP or non-symmetric bilateral SOP was IO-graded recession and anteriorization ( n = 65). Associated clinical results and other factors were analyzed; Results: Head tilt, vertical deviation, IO overaction, SO underaction degree and ocular torsion angle were all clearly changed, but there was no statistically significance between these two procedures. Mean preoperative torsional angle was 15.3 ± 6.4 degree, which decreased to 5.3 ± 2.7 degree after surgery. Preoperative torsional angle, IOOA and SOUA degree were all significantly affected in postoperative torsional angle ( p = 0.025, 0.003 and 0.038). Horizontal rectus muscle and IO muscle operation did not interfere with each other's results ( p = 0.98); Conclusions: Symmetric bilateral SOP could be treated with bilateral IO myectomy and IO-graded recession and anteriorization should be reserved for unilateral SOP or non-symmetric bilateral SOP.

Recent advancements in nanotechnology have improved our understanding of cancer treatment and allowed the opportunity to develop novel delivery systems for cancer therapy. The biological complexities of cancer and tumour micro-environments have been shown to be highly challenging when treated with a single therapeutic approach. Current co-delivery systems which involve delivering small molecule drugs and short-interfering RNA (siRNA) have demonstrated the potential of effective suppression of tumour growth. It is worth noting that a considerable number of studies have demonstrated the synergistic effect of co-delivery systems combining siRNA and small molecule drugs, with promising results when compared to single-drug approaches. This review focuses on the recent advances in co-delivery of siRNA and small molecule drugs. The co-delivery systems are categorized based on the material classes of drug carriers. We discuss the critical properties of materials that enable co-delivery of two distinct anti-tumour agents with different properties. Key examples of co-delivery of drug/siRNA from the recent literature are highlighted and discussed. We summarize the current and emerging issues in this rapidly changing field of research in biomaterials for cancer treatments.

Mobile health (mHealth) management is an emerging strategy of care for patients with chronic diseases. However, the effect of mHealth management on clinical outcomes of patients with chronic kidney disease (CKD) has not been well-studied. The aim of this study was to investigate the additional influence of mHealth on disease knowledge and self-care behavior in CKD patients who had received traditional education. We designed and developed a new healthcare mobile application, called iCKD, which has several major features, including home-based physiological signal monitoring, disease health education, nutrition analysis, medication reminder, and alarms and a warning system. Trained nurses interviewed patients with CKD using structured questionnaires of disease knowledge and self-care behavior. After propensity score matching, we analyzed 107 patients who used iCKD and traditional education, and 107 who received traditional education. The patients who used iCKD had higher disease knowledge scores than those who received traditional education. In multivariate analysis, iCKD was significantly and positively associated with disease knowledge scores. Patients with high education levels could have greater disease knowledge through using mHealth. There was no significant difference in total scores of self-care behavior between the two groups. In conclusion, mHealth can significantly increase disease knowledge in patients with CKD.

Extracellular vesicles (EVs) are secreted by various cells in the body fluid system and have been found to influence vessel formation and inflammatory responses in a variety of diseases. However, which EVs and their subtypes are involved in vascular retinal diseases is still unclear. Therefore, the aim of this study was to explore the particle distribution of EVs in retinal neovascular diseases, including age-related macular degeneration, polypoidal choroidal vasculopathy, and central retinal vein occlusion. The aqueous humor was harvested from 20 patients with different retinal neovascular diseases and six patients with cataracts as the control group. The particle distribution was analyzed using nanoparticle tracking analysis (NTA) and transmitting electron microscopy (TEM). The results revealed that the disease groups had large amounts of EVs and their subtypes compared to the control group. After isolating exosomes, a higher expression of CD81 + exosomes was shown in the disease groups using flow cytometry. The exosomes were then further classified into three subtypes of exomeres, small exosomes, and large exosomes, and their amounts were shown to differ depending on the disease type. To the best of our knowledge, this is the first study to elucidate the dynamics of EVs in retinal neovascular diseases using clinical cases. Our findings demonstrated the possible functionality of microvesicles and exosomes, indicating the potential of exosomes in the diagnosis and therapy of retinal neovascular diseases.

Oxidative damage of retinal pigment epithelium (RPE) cells plays an important role in the pathogenesis of blindness-related diseases, such as age-related macular degeneration (AMD). Quercetin, a bioactive flavonoid compound, has been shown to have a protective effect against oxidative stress-induced cell apoptosis and inflammation in RPE cells; however, the detailed mechanism underlying this protective effect is unclear. Therefore, the aim of this study was to investigate the regulatory mechanism of quercetin in a sodium iodate (NaIO 3 )-induced retinal damage. The clinical features of the mice, the production of oxidative stress, and the activity of autophagy and mitochondrial biogenesis were examined. In the mouse model, NaIO 3 treatment caused changes in the retinal structure and reduced pupil constriction, and quercetin treatment reversed the oxidative stress-related pathology by decreasing the level of superoxide dismutase 2 (SOD2) while enhancing the serum levels of catalase and glutathione. The increased level of reactive oxygen species in the NaIO 3 -treated ARPE19 cells was improved by treatment with quercetin, accompanied by a reduction in autophagy and mitochondrial biogenesis. Our findings indicated that the effects of quercetin on regulating the generation of mtROS were dependent on increased levels of deacetyl-SOD2 through the Nrf2-PGC-1α-Sirt1 signaling pathway. These results demonstrated that quercetin may have potential therapeutic efficacy for the treatment of AMD through the regulation of mtROS homeostasis.

Chronic kidney disease (CKD) is a global public health issue that is associated with high rates of morbidity and mortality. Self-care behavior has been associated with clinical outcomes in chronic diseases, and adequate self-care behavior may mitigate adverse outcomes. Health literacy may be an important factor associated with self-care. The aim of this study was to examine the relationships between different domains of self-care behavior and health literacy in patients with CKD. This study enrolled 208 patients with CKD stages 1-5 who were not undergoing renal replacement therapy at Kaohsiung Medical University Hospital from April 2019 to January 2020. Health literacy was measured using a multidimensional health literacy questionnaire covering the following five dimensions: accessing, understanding, appraising, and applying health information, and communication/interaction. The CKD Self-Care scale, which is a 16-item questionnaire with five domains including medication adherence, diet control, exercise, smoking behavior, and home blood pressure monitoring was used to assess self-care behavior. Among the 208 patients, 97 had sufficient or excellent health literacy, and 111 had inadequate or limited/problematic health literacy. A higher health literacy score was significantly correlated with greater self-care behavior. Among the five domains of self-care behavior, the patients who had sufficient or excellent health literacy had higher diet, exercise, and home blood pressure monitoring scores than those who had inadequate or limited/problematic health literacy. This study demonstrated that health literacy was significantly and positively correlated with self-care behavior in patients with CKD.

In this study, a polydopamine (PDA) and polyethyleneimine (PEI)-assisted approach was developed to generate well-distributed PDA/PEI/silver (PDA/PEI/Ag) nanocomplexes on the surfaces of commercial cellulose filter papers to achieve substantial bacterial reduction under gravity-driven filtration. PDA can bind to cellulose paper and act as a reducer to produce silver nanoparticles (AgNPs), while PEI can react with oxidative dopamine and act as a dispersant to avoid the aggregation of AgNPs. The successful immobilization of PDA/PEI/Ag nanocomplexes was confirmed by scanning electron microscopy (SEM), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). Staphylococcus aureus ( S. aureus ) and Escherichia coli ( E. coli ) were used as pathogen models to test the efficacy of the PDA/PEI/Ag nanocomplex-incorporated filter papers. The PDA/PEI/Ag nanocomplex-incorporated filter papers provided a substantial bacterial removal of up to 99% by simple gravity filtration. This work may be useful to develop a feasible industrial production process for the integration of biocidal AgNPs into cellulose filter paper and is recommended as a local-condition water-treatment technology to treat microbial-contaminated drinking water.

Field emission air-channel (FEAC) devices can work under atmospheric pressure with a low operation voltage when the electron channel is far less than the mean free path (MFP) in the air, thereby making them a practical component in circuits. Forward and reverse electron emissions of the current FEAC devices demonstrated symmetric Fowler-Nordheim (F-N) plots owing to the symmetric cathode and anode electrodes. This research aimed to demonstrate the arithmetic application of the FEAC devices, their substrate effect, and reliability. A voltage adder was composed of two FEAC devices whose two inputs were connected to two separate function generators, and one output was wire-connected to an oscilloscope. The devices were on a thin dielectric film and low-resistivity silicon substrate to evaluate the parasitic components and substrate effect, resulting in frequency-dependent impedance. The results show that the FEAC devices possessed arithmetic function, but the output voltage decreased. The FEAC devices were still capable of serving as a voltage adder after the reliability test, but electric current leakage increased. Finite element analysis indicated that the highest electrical fields and electron trajectories occur at the apices where the electrons travel with the shortest route less than the MFP in the air, thereby meeting the FEAC devices' design. The modeling also showed that a sharp apex would generate a high electric field at the tip-gap-tip, enhancing the tunneling current.

ZnO nanowire-based surface plasmon polariton (SPP) nanolasers with metal-insulator-semiconductor hierarchical nanostructures have emerged as potential candidates for integrated photonic applications. In the present study, we demonstrated an SPP nanolaser consisting of ZnO nanowires coupled with a single-crystalline aluminum (Al) film and a WO 3 dielectric interlayer. High-quality ZnO nanowires were prepared using a vapor phase transport and condensation deposition process via catalyzed growth. Subsequently, prepared ZnO nanowires were transferred onto a single-crystalline Al film grown by molecular beam epitaxy (MBE). Meanwhile, a WO 3 dielectric interlayer was deposited between the ZnO nanowires and Al film, via e-beam technique, to prevent the optical loss from dominating the metallic region. The metal-oxide-semiconductor (MOS) structured SPP laser, with an optimal WO 3 insulating layer thickness of 3.6 nm, demonstrated an ultra-low threshold laser operation (lasing threshold of 0.79 MW cm -2 ). This threshold value was nearly eight times lower than that previously reported in similar ZnO/Al 2 O 3 /Al plasmonic lasers, which were ≈2.4 and ≈3 times suppressed compared to the SPP laser, with WO 3 insulating layer thicknesses of 5 nm and 8 nm, respectively. Such suppression of the lasing threshold is attributed to the WO 3 insulating layer, which mediated the strong confinement of the optical field in the subwavelength regime.

Increasing attention has been paid to two-dimensional (2D) materials because of their superior performance and wafer-level synthesis methods. However, the large-area characterization, precision, intelligent automation, and high-efficiency detection of nanostructures for 2D materials have not yet reached an industrial level. Therefore, we use big data analysis and deep learning methods to develop a set of visible-light hyperspectral imaging technologies successfully for the automatic identification of few-layers MoS 2 . For the classification algorithm, we propose deep neural network, one-dimensional (1D) convolutional neural network, and three-dimensional (3D) convolutional neural network (3D-CNN) models to explore the correlation between the accuracy of model recognition and the optical characteristics of few-layers MoS 2 . The experimental results show that the 3D-CNN has better generalization capability than other classification models, and this model is applicable to the feature input of the spatial and spectral domains. Such a difference consists in previous versions of the present study without specific substrate, and images of different dynamic ranges on a section of the sample may be administered via the automatic shutter aperture. Therefore, adjusting the imaging quality under the same color contrast conditions is unnecessary, and the process of the conventional image is not used to achieve the maximum field of view recognition range of ~1.92 mm 2 . The image resolution can reach ~100 nm and the detection time is 3 min per one image.

Background: Interstitial cystitis/painful bladder syndrome (IC/PBS) could be treated to ameliorate urothelial injury. Here, we investigated the efficacy of intravesical instillation with platelet-rich plasma (PRP) and hyaluronic acid for acute IC/PBS., Methods: The effects of PRP and hyaluronic acid on the proliferation of normal human fibroblast cells (HFCs) were assessed. Additionally, thirty virgin female rats were randomized into five groups: group 1, saline-injected control; group 2, cyclophosphamide (CYP) plus intravesical instillation with normal saline; group 3, CYP plus intravesical instillation with hyaluronic acid (1 mg/mL); group 4, CYP plus intravesical instillation with PRP; and group 5, CYP plus intravesical instillation with PRP plus hyaluronic acid. A cystometry and histological assessments were performed. The expression of cell junction-associated protein zonula occludens-2 (ZO-2) and inflammatory cytokine interleukin 6 (IL-6) was also measured., Results: Low dose PRP increased proliferation in HFCs. The acute IC/PBS rats showed significantly lower voiding interval values. Voiding interval values were significantly higher in the CYP plus intravesical instillation with PRP group than in the CYP-induced acute IC/PBS group. Additionally, the expression of ZO-2 was increased and IL-6 was decreased in the CYP plus intravesical instillation with PRP group compared with the CYP-induced acute IC/PBS group., Conclusion: These findings suggest that PRP modulate urothelial repair, which ameliorate the increase in urination frequency in rats treated with CYP. Overall, PRP may confer potential benefits by acting as urothelial repair modulators.

Emerging roles of exosomes in the pathogenesis of major blindness-threatening diseases, such as age-related macular degeneration, glaucoma, and corneal dystrophy, were discovered by aqueous humor analysis. A new diagnostic method using cellulose-based devices and microfluidic chip techniques for the isolation of exosomes from aqueous humor is less cumbersome and saves time. This method will enable more investigations for aqueous humor analysis in the future., Competing Interests: The authors declare no conflict of interest.