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Background: Anemia is a common long‐term metabolic sequela caused by anatomical changes after major gastrointestinal surgery, such as bariatric surgery and gastrectomy. Pancreaticoduodenectomy (PD) involves resection of the duodenum and enteral bypass, which may contribute to malabsorption and nutrient deficiency. Hence, PD may cause anemia. Methods: This study included 322 patients who presented with PD during the 5‐year follow‐up from 2006 to 2017. The Kaplan–Meier method and the Cox regression model were used to investigate the association between risk factors and anemia. Results: Approximately 44.4% of patients developed post‐PD anemia during the 5‐year post‐PD follow‐up. Further, 30 (9.3%) patients were treated with oral iron supplementation for anemia with associated symptoms. In the Cox multivariate model, a higher Charlson Comorbidity Index (CCI) score and pancreatic ductal adenocarcinoma were significantly associated with the development of post‐PD anemia. Conclusion: Post‐PD anemia is a common sequela among long‐term survivors. A higher CCI and pancreatic ductal adenocarcinoma diagnosis were considered as independent risk factors for post‐PD anemia. Therefore, regular monitoring of hematological profiles and appropriate management of post‐PD anemia are required during follow‐up. [ABSTRACT FROM AUTHOR]

Aims: This systematic review and network meta‐analysis compared the effects of various diabetes self‐management programs: Diabetes Self‐Management Education (DSME), Diabetes Self‐Management Support (DSMS), and Diabetes Self‐Management Education and Support (DSMES). Methods: We searched four electronic databases for eligible articles up to March 1, 2023. Only randomized controlled trials investigating the effects of DSME, DSMS, or DSMES on glycated haemoglobin (HbA1c) level, fasting blood glucose (FBG), total cholesterol (TC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) in adults with type 2 diabetes were included. Cochrane Risk of Bias 2.0 tool was used to assess each study quality, and Confidence in Network Meta‐Analysis was applied to evaluate the certainty of the evidence. Data were pooled with a random‐effects model under a frequentist framework. Results: A total of 108 studies encompassing 17,735 participants (mean age 57.4 years) were analysed. DSMES, compared with usual care, significantly reduced HbA1c level (mean difference = −0.61%, 95% confidence interval [CI] = −0.74 to −0.49; certainty of evidence = moderate), FBG (−23.33 mg/dL; −31.33 to −15.34; high), TC (−5.62 mg/dL; −8.69 to −2.55; high), SBP (−3.05 mmHg; −5.20 to −0.91; high), and DBP (−2.15 mmHg; −3.36 to −0.95; high). Compared with DSME, DSMES showed significantly greater improvements in HbA1c levels (−0.23%; −0.40 to −0.07; high) and DBP (−1.82 mmHg; −3.47 to −0.17; high). DSMES was ranked as the top treatment for improving diabetes clinical outcomes (0.82–0.97) in people with type 2 diabetes. Conclusions: DSMES, in people with type 2 diabetes, yields the greatest improvement in the key clinical outcomes of HbA1c, fasting blood glucose, and blood pressure levels. Healthcare providers should incorporate the DSMES approach into their daily care routines. Approximately 30% of the studies reviewed raised some concerns about their quality, underscoring the need for high‐quality studies in this area. [ABSTRACT FROM AUTHOR]

Sustainable development is the primary goal of the current global economic transformation. The banking industry, as an intermediary institution within the financial system, not only serves as a crucial foundation for national economic development but also plays a key role in the global transition to sustainability and a low‐carbon economy. Banks can leverage the influence of financing to direct funds towards sustainable ventures and simultaneously develop green financial products, guiding ordinary consumers to make more environmentally friendly choices. How the banking industry can effectively improve operational efficiency while considering sustainable development is one of the key focuses of ongoing development in the banking sector. The main aim of this study is to incorporate the aspect of sustainable development into the evaluation of operational efficiency, aligning with the goals of corporate sustainable development. It allows for an analysis of how decision‐makers in the banking industry can adjust resources to maintain stable and sustainable profitability while promoting sustainable development. This study selected 13 financial holding banks and 19 non‐financial holding banks in Taiwan as research subjects, covering the period from 2016 to 2021. Utilizing a meta assurance regions (AR) parallel dynamic two‐stage slacks‐based measure model with "operational stage" and "market and sustainability parallel stage," the research explores the efficiency performance of banks considering sustainable development. It examines the differences in efficiency performance at various stages among different types of banks. The research findings are as follows: (1) among the banking industry in Taiwan, operational stage efficiency ranks the highest, followed by sustainable stage efficiency, while market stage performance lags behind. (2) Financial holding banks outperform non‐financial holding banks on average in operational stage, market stage, and sustainable stage efficiency. (3) Fubon Financial, TFH, CATHAY HOLDINGS, and SKFH are benchmark performers among financial holding banks. (4) Non‐financial holding banks exhibit a higher average technical gap ratio compared to financial holding banks, indicating that non‐financial holding banks have fewer inefficient areas to improve. However, the technical efficiency of both groups of banks approaches each other over the years. (5) In the sustainable stage, financial holding banks demonstrate superior environmental indicators and corporate treatment efficiency compared to non‐financial holding banks. [ABSTRACT FROM AUTHOR]

Objective: Erythropoietin‐producing hepatocellular (Eph)/Ephrin cell–cell signaling is emerging as a key player in tissue fibrogenesis. The aim of this study was to test the hypothesis that the receptor tyrosine kinase EphB2 mediates dermal fibrosis in systemic sclerosis (SSc). Methods: We assessed normal and SSc human skin biopsies for EphB2 expression. The in vivo role of EphB2 in skin fibrosis was investigated by subjecting EphB2‐knockout mice to both bleomycin‐induced and tight skin (Tsk1/+) genetic mouse models of skin fibrosis. EphB2 kinase‐dead and overactive point mutant mice were used to evaluate the role of EphB2 forward signaling in bleomycin‐induced dermal fibrosis. In vitro studies were performed on dermal fibroblasts from patients with SSc and healthy controls, which was followed by in vivo analysis of fibroblast‐specific Ephb2‐deficient mice. Results: Expression of EphB2 is up‐regulated in SSc skin tissue and explanted SSc dermal fibroblasts compared with healthy controls. EphB2 expression is elevated in two animal models of dermal fibrosis. In mice, EphB2 drives dermal fibrosis in both the bleomycin and the Tsk1/+ models of skin fibrosis. EphB2 forward signaling is a critical mediator of dermal fibrosis. Transforming growth factor‐β (TGF‐β) cytokines up‐regulate EphB2 in dermal fibroblasts via noncanonical TGF‐β/mother against decapentaplegic signaling, and silencing EPHB2 in human dermal fibroblasts is sufficient to dampen TGF‐β–induced fibroblast‐to‐myofibroblast differentiation. Moreover, mice with fibroblast‐specific deletion of EphB2 showed impaired fibroblast‐to‐myofibroblast differentiation and reduced skin fibrosis upon bleomycin challenge. Conclusion: Our data implicate TGF‐β regulation of EphB2 overexpression and kinase‐mediated forward signaling in the development of dermal fibrosis in SSc. EphB2 thus represents a potential new therapeutic target for SSc. [ABSTRACT FROM AUTHOR]

Summary: A systematic review and meta‐analysis was conducted to evaluate the relative effectiveness of different dietary macronutrient patterns on changes in resting energy expenditure (REE) in relation to weight loss, categorized as minimal (<5%) and moderate to high (>5%). Changes in REE were assessed using a DerSimonian and Laird random‐effects meta‐analysis. A diet lower in carbohydrates (CHO) or higher in fat and protein was associated with smaller reductions in REE, with these trends being more pronounced among participants who experienced moderate to high weight loss. Adjusted meta‐regression analysis indicated that, within the participants who experienced moderate to high weight loss, each 1% increase in CHO intake was associated with a reduction of 2.30 kcal/day in REE (95% CI: −4.11 to −0.47, p = 0.013). In contrast, a 1% increase in protein and fat intake was correlated with an increase in REE by 3.00 (95% confidence interval [CI] [1.02, 5.07], p = 0.003) and 0.5 (95% CI [−2.43, 3.41], p = 0.740) kcal/day, respectively. No significant associations were found among participants who experienced minimal weight loss. These findings indicate that, under a caloric deficit, the impact of dietary macronutrient composition on REE may vary depending on the degree of weight loss and individual metabolic responses. [ABSTRACT FROM AUTHOR]

Our previous research identified interleukin‐4 (IL‐4) as a key regulator of glucose/lipid metabolism, circulatory leptin levels, and insulin action, suggesting its potential as a therapeutic target for obesity and related complications. This study aimed to further elucidate the role of IL‐4 in regulating hypothalamic appetite‐controlling neuropeptides using leptin dysfunctional Leptin145E/145E mice as the experimental model. IL‐4 significantly reduces body weight, food intake, and serum glucose levels. Our data demonstrated that IL‐4 exhibits multiple functions in regulating hypothalamic appetite control, including downregulating orexigenic agouti‐related peptide and neuropeptide Y levels, promoting expression of anorexigenic proopiomelanocortin, alleviating microenvironmental hypothalamic inflammation, enhancing leptin and insulin pathway, and attenuating insulin resistance. Furthermore, IL‐4 promotes uncoupling protein 1 expression of white adipose tissue (WAT), suggesting its role in triggering WAT‐beige switch. In summary, this study uncovers novel function of IL‐4 in mediating food‐intake behaviors and metabolic efficiency by regulating hypothalamic appetite‐control and WAT browning activities. These findings support the therapeutic potential of targeting hypothalamic inflammation and reducing adiposity through IL‐4 intervention for tackling the pandemic increasing prevalence of obesity and associated metabolic disorders. [ABSTRACT FROM AUTHOR]

Understanding distributions of cloud thermodynamic phases is important for accurately representing cloud radiative effects and cloud feedback in a changing climate. Satellite‐based cloud phase data have been frequently used to compare with climate models, yet few studies validated them against in situ observations at a near‐global scale. This study aims to validate three satellite‐based cloud phase products using a compositive in situ airborne data set developed from 11 flight campaigns. Latitudinal‐altitudinal cross sections of cloud phase occurrence frequencies are examined. The Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) show the most similar vertical profiles of ice phase frequencies compared with in situ observations. The CloudSat data overestimate mixed‐phase frequencies up to 15 km but provide better sampling through cloud layers than lidar data. The DARDAR (raDAR/liDAR) data show a sharp transition between ice and liquid phase and overestimate ice phase frequency at most altitudes and latitudes. The satellite data are further evaluated for various latitudes, longitudes, and seasons, which show higher ice phase frequency in the extratropics in their respective wintertime and smaller impacts from longitudinal variations. The Southern Ocean shows a thicker mixing region where liquid and ice phases have similar frequencies compared with tropics and Northern Hemisphere (NH) extratropics. Two comparison methods with different spatiotemporal windows show similar results, which demonstrates the statistical robustness of these comparisons. Overall, this study develops a near global‐scale in situ observational data set to assess the accuracy of satellite‐based cloud phase products and investigates the key factors affecting the distributions of cloud phases. Plain Language Summary: Accurate representations of cloud thermodynamic phase (i.e., ice, liquid, and mixed phase) play an important role in climate prediction. Even though satellite observations have been used to improve climate model simulations of cloud phase, few studies have validated satellite‐based cloud phase distributions on a global scale. This work develops a large data set based on in situ aircraft‐based observations from 11 flight campaigns in various regions. Three satellite‐based cloud phase products are evaluated. Satellite observations that are either in proximity to the aircraft samples or in a similar domain are used for comparisons. CALISPO data show the best comparison results for representing the fraction of ice clouds among all types of cloud phases. CloudSat overestimates mixed phase frequency and DARDAR overestimates ice phase frequency, but they penetrate through cloud layers better when radar and lidar data are combined. The impacts of seasonal variability, spatial variability among various latitudes and longitudes, as well as temporal variability from a few hours to different seasons are examined. The results of this work help to identify the key factors affecting cloud phase distributions from a near‐global perspective. The methodology developed can also guide future validations of satellite data using aircraft‐based observations. Key Points: Ice phase frequencies vary largely with altitudes, latitudes, and seasons but not much with longitudes or small spatiotemporal mismatchesCALIPSO shows most similar ice phase frequency to in situ observations, CloudSat and DARDAR overestimate mixed and ice phase, respectivelyLiquid water transitions to ice gradually with increasing altitudes over Southern Ocean but more rapidly in tropics and NH extratropics [ABSTRACT FROM AUTHOR]

Currently, wide‐color gamut perovskite light‐emitting diodes (PeLEDs) are commonly controlled through halide composition tuning. However, the formation of perovskite crystals involving different ion radii of halogens often results in structural fragility and ionic defects, leading to emission instability during operation. This study showcases a novel approach to achieving a homogeneous and low‐defect crystalline state by regulating the thermodynamic nucleation mechanism of sky‐blue perovskite, thereby enhancing emission stability. Utilizing oxygen‐plasma treatment, a highly uniform surface energy is ensured for the nickel oxide acting as a hole transport layer. This treatment not only induces homogeneous nucleation of the perovskite layer but also effectively suppresses crystal defects. Simultaneously, the uniform surface energy alleviates halide phase separation caused by Ostwald ripening. Upon optimizing the fabrication conditions for sky‐blue perovskite, the resulting PeLEDs, featuring an electroluminescent peak at 486 nm, attain a luminance of 1125.3 cd m−2 with exceptional electroluminescent stability and a T50 lifetime. Furthermore, gaining insights into the thermodynamic nucleation mechanism in mix‐halides and perovskites contributes to the advancement of research on sky‐blue PeLEDs and offers valuable perspectives for future development. [ABSTRACT FROM AUTHOR]

Background: Bladder preservation therapy is an alternative to radical cystectomy in patients with muscle‐invasive bladder cancer (MIBC). The purpose of this study is to compare survival outcomes between bladder preservation therapy and radical cystectomy in MIBC patients using an Asian nationwide cancer registry database. Methods: From the Taiwan Cancer Registry database and the Taiwan National Health Insurance Research Database, we identified bladder cancer patients from 2008 to 2018. The patients with urothelial carcinoma and clinical stage T2‐T4aN0‐1 M0 were included. Propensity score matching by age, gender, clinical stage, cT classification, and Charlson Comorbidity Index score was used between those receiving bladder preservation therapy or radical cystectomy. Overall survival (OS), cancer‐specific survival (CSS), and disease‐free survival (DFS) were compared using the Kaplan–Meier method. Multivariate Cox regression models were used to determine the predictive factors of OS, CSS, and DFS. Results: Following the propensity score matching, 393 MIBC patients were analyzed, 131 (33.3%) receiving bladder preservation therapy and 262 (66.7%) receiving radical cystectomy. After 5 years of the follow‐up period the overall duration was with a median of 15.6 months. The treatment groups did not differ significantly in OS, CSS, and DFS (p = 0.2681, 0.7208, and 0.3616, respectively). In multivariable Cox regression models, bladder preservation therapy remained non‐inferior to radical cystectomy in OS (adjusted hazard ratio [aHR] 1.08; 95% confidence interval [CI], 0.77–1.50; p = 0.6689), CSS (aHR, 1.06; 95% CI, 0.72–1.57; p = 0.7728), and DFS (aHR, 0.76; 95% CI, 0.46–1.27; p = 0.2929). Additionally, among patients ≥80 years, the use of bladder preservation therapy compared with radical cystectomy resulted in an equivalent OS, CSS and DSS. Conclusion: In Asian populations, bladder preservation therapy yielded similar survival outcomes as radical cystectomy in MIBC patients. Based on the results, it is evident that a multidisciplinary approach and shared decision‐making are recommended for bladder cancer treatment. [ABSTRACT FROM AUTHOR]

Aims: To compare the efficacy of digitally assisted interventions on the glycated haemoglobin (HbA1c) levels of patients with type 2 diabetes by performing a systematic review, network meta‐analysis and component network meta‐analysis. Methods: Six databases were searched to identify eligible articles from the inception of each database until 17 March 2023. We included randomized controlled trials evaluating HbA1c levels. Data were pooled with a random‐effects model under a frequentist framework. The evidence certainty was assessed using Confidence in Network MetaAnalysis (CINeMA). The PROSPERO registration number was CRD42021283815. Results: In total, 75 trials involving 9764 participants were included. Results from standard network meta‐analyses of 17 interventions revealed that compared with standard care, a mobile application (MA) combined with a professional education programme and peer support education (PSE; −1.98, 95% confidence interval = −2.90 to −1.06, CINeMA score: moderate to high) significantly reduced HbA1c levels. The component analysis found that PSE (−1.50, −2.36 to −0.64), SMS (−0.33, −0.56 to −0.11), MA (−0.30, −0.56 to −0.04) and telephone calls (−0.30, −0.53 to −0.06) most effectively reduced HbA1c levels among patients with type 2 diabetes. Conclusions: SMS and MA are the optimal digitally assisted interventions for reducing HbA1c levels. Educators can integrate digitally assisted interventions complemented by educational programmes, particularly MA combined with professional education programme and PSE, into daily care to control HbA1c. The limitations of included trials include a lack of information on allocation concealment and blinding and the fact that long‐term follow‐up effects were not investigated. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to reduce scan time in 177Lu planar scintigraphy through the use of convolutional neural network (CNN) to facilitate personalized dosimetry for 177Lu‐based peptide receptor radionuclide therapy. Methods: The CNN model used in this work was based on DenseNet, and the training and testing datasets were generated from Monte Carlo simulation. The CNN input images (IMGinput) consisted of 177Lu planar scintigraphy that contained 10–90% of the total photon counts, while the corresponding full‐count images (IMG100%) were used as the CNN label images. Two‐sample t‐test was conducted to compare the difference in pixel intensities within region of interest between IMG100% and CNN output images (IMGoutput). Results: No difference was found in IMGoutput for rods with diameters ranging from 13 to 33 mm in the Derenzo phantom with a target‐to‐background ratio of 20:1, while statistically significant differences were found in IMGoutput for the 10‐mm diameter rods when IMGinput containing 10% to 60% of the total photon counts were denoised. Statistically significant differences were found in IMGoutput for both right and left kidneys in the NCAT phantom when IMGinput containing 10% of the total photon counts were denoised. No statistically significant differences were found in IMGoutput for any other source organs in the NCAT phantom. Conclusion: Our results showed that the proposed method can reduce scan time by up to 70% for objects larger than 13 mm, making it a useful tool for personalized dosimetry in 177Lu‐based peptide receptor radionuclide therapy in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: This study examined trajectories of social support and their relationships with health outcomes over 2 years post hip-fracture surgery for older adults with diabetes mellitus (DM).Methods: This was a secondary analysis of data derived from a clinical trial, which included 158 hip fractured older adults with DM who had completed the Medical Outcomes Study Social Support Survey at 1-, 12-, 18-, and 24-months following hospital discharge. Health outcomes for self-care, physical and nutritional status, mental health, and depression were assessed at 3-month intervals up to 24-months after hospital discharge. Trajectories of social support were derived with latent class analysis while hierarchical linear models were employed to assess the associations of social-support trajectory with health outcomes.Results: Four social-support trajectories were derived for persons with DM following hip-fracture surgery: poor and declining (n = 18, 11.4%), moderate and stable (n = 29, 18.4%), high but declining (n = 34, 21.5%), and high and stable (n = 77, 48.7%). Relative to those in the poor and declining group, participants in the high and stable trajectory group performed better in Activities of Daily Living and quadriceps muscle power, had better mental Health-Related Quality of Life and nutritional status, and had fewer depressive symptoms. These differences persisted over the 2 years following hospital discharge.Conclusions: These results suggest social support for persons with DM should be continually assessed following hip-fracture surgery. [ABSTRACT FROM AUTHOR]

Liposome development is of great interest owing to increasing requirements for efficient drug carriers. The structural features and thermal stability of such liposomes are crucial in drug transport and delivery. Reported here are the results of the structural characterization of PEGylated liposomes via small‐ and wide‐angle X‐ray scattering and an asymmetric flow field‐flow fractionation (AF4) system coupled with differential refractive‐index detection, multi‐angle light scattering (MALS) and dynamic light scattering. This integrated analysis of the exemplar PEGylated liposome formed from hydrogenated soy phosphatidylcholine (HSPC) with the addition of cholesterol reveals an average hydrodynamic radius (Rh) of 52 nm with 10% polydispersity, a comparable radius of gyration (Rg) and a major liposome particle mass of 118 kDa. The local bilayer structure of the liposome is found to have asymmetric electronic density profiles in the inner and outer leaflets, sandwiched by two PEGylated outer layers ca 5 nm thick. Cholesterol was found to effectively intervene in lipid chain packing, resulting in the thickening of the liposome bilayer, an increase in the area per lipid and an increase in liposome size, especially in the fluid phase of the liposome. These cholesterol effects show signs of saturation at cholesterol concentrations above ca 1:5 cholesterol:lipid molar ratio. [ABSTRACT FROM AUTHOR]

Darier disease is caused by heterozygous loss of function variants in the ATP2A2 gene encoding the endoplasmic/sarcoplasmic reticulum Ca2+ pump ATP2A2. Defective intracellular calcium signaling in the epidermis results in a loss of desmosomal adhesion and the development of characteristic skin lesions. In this study, we investigated a Shih Tzu that developed erythematous papules on the ventrum and, over time, the dorsal neck and a nodule in the right ear canal with secondary ear infection. Histopathologic examination demonstrated discrete foci of acantholysis affecting suprabasal layers of the epidermis. Whole genome sequencing of the affected dog identified a heterozygous missense variant, p.N809H, affecting an evolutionarily conserved amino acid residue of the ATP2A2 protein. The highly characteristic clinical and histopathologic findings together with a plausible variant in the only known functional candidate gene establish the diagnosis of canine Darier disease in the studied dog and highlight the potential of genetic analyses as complementary diagnostic approach in veterinary medicine. [ABSTRACT FROM AUTHOR]

Using light signals for computation and communication is a vital approach for advanced neuromorphic designs. In this study, an all‐optical‐controlled IGZO/ZrOx phototransistor is demonstrated to emulate synaptic functions via both positive and negative photoresponse arisen from the ionization of neutral oxygen vacancies (VO) and metalmetal bonding (MM) defects in IGZO at an illumination with visible light (405 and 520 nm) and near‐infrared light (750, 890, and 980 nm), respectively. With the coupling effect of photogenerated electrons and the charged MM++ defect scattering, the IGZO/ZrOx photosynaptic transistor not only shows broadband photosensing performance but also emulates the excitatory/inhibitory contrasting synaptic functions, such as learning‐ and regulating‐experience behavior of human brain, via applying 405 and 890 nm light pulses, respectively. The all‐optical‐controlled IGZO/ZrOx photosynaptic transistor therefore may convey optical information effectually for the streaming sensor processing in biologically inspired computer vision application. [ABSTRACT FROM AUTHOR]

Obesity is a well‐known risk factor for breast cancer formation and is associated with elevated mortality and a poor prognosis. An obesity‐mediated inflammatory microenvironment is conducive to the malignant progression of tumors. However, the detailed molecular mechanism is still needed to be clarified. Herein, we identified that breast cancer cells from mice with diet‐induced obesity exhibited increased growth, invasiveness, and stemness capacities. A transcriptome analysis revealed that expressions of interleukin 33 (IL33) signaling pathway‐related genes were elevated in obesity‐associated breast cancer cells. Importantly, IL33 expression was significantly associated with the yes‐associated protein (YAP) signature, and IL33 was transcriptionally regulated by YAP. Suppression of IL33 reduced tumor migration and invasion, while the addition of IL33 activated nuclear factor (NF)‐κB signaling and revived tumor mobility in YAP‐silenced cells. Furthermore, suppression of YAP attenuated IL33 expression which was accompanied by relief of obesity‐mediated immunosuppression. Clinical analyses showed that IL33 expression was markedly associated with macrophage and regulatory T cell infiltration. These findings reveal a crucial role of the YAP/IL33 axis in promoting aggressiveness and immunosuppression of obesity‐associated breast cancer progression. [ABSTRACT FROM AUTHOR]

Background: Frontline intensification (including consolidative whole‐brain radiotherapy or high‐dose chemotherapy with autologous stem‐cell transplantation after induction therapy) has been proposed to treat primary central nervous system lymphoma (PCNSL). However, no prospective randomized trials have answered whether frontline intensification can offer a survival benefit to PCNSL patients. We aim to clarify the outcomes and survival influence of frontline intensification on real‐world patients with different risk‐stratified PCNSLs. Methods: Between January 2003 and December 2016, 110 PCNSL adults were retrospectively included, and 76 patients achieved at least PR after induction therapy, including 38 patients who received frontline intensification. The median follow‐up with the 31 survivors was 7.52 years. Results: Of the 38 induction‐completed patients who had not received frontline intensification, 95% achieved post–induction therapy CR/CRu; however, all inevitably recurred. In the 38 who received frontline intensification, CR/CRu improved from 45% (pre‐frontline intensification) to 84% (post‐frontline intensification), and they achieved significantly better PFS (non‐reach vs. 522 days, p < 0.001) and OS (non‐reach vs. 899 days, p < 0.001). Additionally, patients had similar PFS and OS rates when receiving HDC‐ASCT and/or WBRT as frontline intensification. Frontline intensification significantly improved PFS and OS survival in higher‐risk patients (intermediate/high IELSG risk, MSKCC group 2/3, or Nottingham/Barcelona score ≥ 2 points) but did not improve OS in lower‐risk patients. Among the 38 patients who received frontline intensification, two had treatment‐related mortality; 14 recurred after frontline intensification. MTX‐based chemotherapy was the main salvage modality, and the median OS was 295 days after recurrence. Progressive disease and infection (especially pneumonia) are two major causes of mortality in patients who receive frontline intensification. Conclusions: When achieving CR/CRu/PR after induction chemotherapy, frontline intensification should be adopted to improve PFS and OS in real‐world PCNSL patients, especially higher‐risk patients. [ABSTRACT FROM AUTHOR]

Hemophagocytic lymphohistiocytosis (HLH) is a heterogeneous group of hyperinflammatory statuses that are difficult to diagnose and can be life‐threatening. Bone marrow (BM) hemophagocytosis is one of the diagnostic criteria according to HLH 2004 diagnostic criteria and HS score. Limited studies have focused on the prognostic factors of BM hemophagocytosis and its association with hematologic malignancies. We aimed to analyze the clinical significance of BM hemophagocytosis. Patients with BM hemophagocytosis, either by cytology or pathology, were enrolled at Taipei Veterans General Hospital from January 2002 to July 2021. Relevant clinical and laboratory data were extracted from medical records. Of 119 patients with BM hemophagocytosis, 57 were diagnosed with hematologic malignancies. The median age of the patients was 58, ranging from 21 to 90. Splenomegaly (adjusted odds ratio [aOR] 2.96; 95% confidence interval [CI] 1.13–7.79) was a risk factor for hematologic malignancies, while autoimmune disease (aOR 0.07; 95% CI 0.01–0.39) and increased D‐dimer (aOR 0.25; 95% CI 0.07–0.92) were protective factors. Risk factors for mortality in patients with BM hemophagocytosis were hematologic malignancies (adjusted hazard ratio [aHR] 2.34; 95% CI 1.24–4.44), Eastern Cooperative Oncology Group score ≥3 (aHR 2.42; 95% CI 1.20–4.89) and thrombocytopenia (aHR 3.09; 95% CI 1.04–9.16). In conclusion, among patients with BM hemophagocytosis, splenomegaly was a predictor of hematologic malignancies. Patients with hematologic malignancies, poor performance status, or thrombocytopenia had a higher mortality risk. Further validation studies are warranted. [ABSTRACT FROM AUTHOR]

Background: Although we previously proposed a nomogram to predict malignancy in intraductal papillary mucinous neoplasms (IPMN) and validated it in an external cohort, its application is challenging without data on tumor markers. Moreover, existing nomograms have not been compared. This study aimed to develop a nomogram based on radiologic findings and to compare its performance with previously proposed American and Korean/Japanese nomograms. Methods: We recruited 3708 patients who underwent surgical resection at 31 tertiary institutions in eight countries, and patients with main pancreatic duct >10 mm were excluded. To construct the nomogram, 2606 patients were randomly allocated 1:1 into training and internal validation sets, and area under the receiver operating characteristics curve (AUC) was calculated using 10‐fold cross validation by exhaustive search. This nomogram was then validated and compared to the American and Korean/Japanese nomograms using 1102 patients. Results: Among the 2606 patients, 90 had main‐duct type, 900 had branch‐duct type, and 1616 had mixed‐type IPMN. Pathologic results revealed 1628 low‐grade dysplasia, 476 high‐grade dysplasia, and 502 invasive carcinoma. Location, cyst size, duct dilatation, and mural nodule were selected to construct the nomogram. AUC of this nomogram was higher than the American nomogram (0.691 vs 0.664, P =.014) and comparable with the Korean/Japanese nomogram (0.659 vs 0.653, P =.255). Conclusions: A novel nomogram based on radiologic findings of IPMN is competitive for predicting risk of malignancy. This nomogram would be clinically helpful in circumstances where tumor markers are not available. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN. [ABSTRACT FROM AUTHOR]

Numerous studies have reported that long‐term musical training can affect brain functionality and induce structural alterations in the brain. Singing is a form of vocal musical expression with an unparalleled capacity for communicating emotion; however, there has been relatively little research on neuroplasticity at the network level in vocalists (i.e., noninstrumental musicians). Our objective in this study was to elucidate changes in the neural network architecture following long‐term training in the musical arts. We employed a framework based on graph theory to depict the connectivity and efficiency of structural networks in the brain, based on diffusion‐weighted images obtained from 35 vocalists, 27 pianists, and 33 nonmusicians. Our results revealed that musical training (both voice and piano) could enhance connectivity among emotion‐related regions of the brain, such as the amygdala. We also discovered that voice training reshaped the architecture of experience‐dependent networks, such as those involved in vocal motor control, sensory feedback, and language processing. It appears that vocal‐related changes in areas such as the insula, paracentral lobule, supramarginal gyrus, and putamen are associated with functional segregation, multisensory integration, and enhanced network interconnectivity. These results suggest that long‐term musical training can strengthen or prune white matter connectivity networks in an experience‐dependent manner. [ABSTRACT FROM AUTHOR]

Background: This study investigated the effects of adjuvant radiotherapy on outcomes in early‐stage major salivary gland cancers. Methods: A total of 655 patients were identified, including 355 (54.2%) received adjuvant radiotherapy and 300 (45.8%) had surgery alone. The effect of adjuvant radiotherapy on 5‐year locoregional recurrence and disease‐specific survival (DSS) was calculated using the Kaplan–Meier method, Wilcoxon rank sum test, and Cox proportional hazards model. Results: There were no significant differences in locoregional recurrence and DSS between patients receiving adjuvant radiotherapy and those not in both univariate and multivariable analysis. Although patients with positive margin status had a higher locoregional recurrence and those with moderate/poor differentiation had a worse DSS, stratified analysis still indicated there were no protective effects from the use of adjuvant radiotherapy. Conclusions: The use of adjuvant radiation therapy was not associated with improved locoregional recurrence and DSS, even for those with high‐risk histopathological factors. [ABSTRACT FROM AUTHOR]

Background: Obesity and asthma are highly associated, but the mechanisms underlying the association remain unknown. We examined five mediators linking obesity with childhood asthma: (1) pulmonary function impairment, (2) airway inflammation, (3) physical fitness, (4) sleep‐disordered breathing (SDB), and (5) early puberty. Methods: A Mendelian randomization (MR) study with mediation analysis of data obtained from 5965 children as part of the Taiwan Children Health Study. Observational analysis, MR two‐stage least‐squares method, and MR sensitivity analysis were carried out to investigate each causal pathway. Prospective cohort analyses were used to strengthen the findings. Results: The increased asthma risk associated with obesity was found to be mostly mediated through impaired pulmonary function, low physical fitness, and early puberty. In the MR analysis, body mass index was negatively associated with FEV1/FVC and physical fitness index (β = −2.17 and −0.71; 95% CI, −3.92 to −0.42 and −1.30 to −0.13, respectively) and positively associated with early puberty (OR, 1.09; 95% CI, 1.02–1.17). High FEV1/FVC and physical fitness index reduced asthma risk (OR, 0.98 and 0.93; 95% CI, 0.97–0.99 and 0.88–0.98, respectively), whereas SDB and early puberty increased the risk of asthma (OR, 1.03 and 1.22; 95% CI, 1.01–1.05 and 1.05–1.42, respectively). Temporal causality was strengthened in prospective cohort analyses. The three main mediators were low physical fitness, impaired pulmonary function, and early puberty, with mediation proportions of 73.76%, 61.63%, and 27.66%, respectively. Conclusions: Interventions promoting physical fitness and pulmonary function might effectively reduce obesity‐induced asthma risk. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this work was to investigate the lesion detectability of Tc‐99m planar scintigraphy acquired with a low‐energy high‐resolution and sensitivity (LEHRS) collimator and processed by Clarity 2D for patients with different body sizes through phantom study. Methods: A NEMA IEC body phantom set was covered by two layers of 25‐mm‐thick bolus to construct phantom in three different sizes. All image data were performed on a Discovery NM/CT 870 DR with an LEHRS collimator and processed by Clarity 2D with blend ratio a of 0%, 20%, 40%, 60%, 80%, and 100%. The lesion detectability in gamma scintigraphy was evaluated by calculating the contrast‐to‐noise ratio (CNR). Multiple linear regression methods were used to analyze the impact of body size, target size, and Clarity 2D blending weight on the lesion detectability of Tc‐99m planar scintigraphy. Results: It was found that changing the blend ratio could improve CNR, and this phenomenon was more significant in anterior view than in posterior view. Our results also suggested that the blend ratio should be selected according to patient body size in order to maintain consistent CNR. Hence, when a blend ratio of 60% was used for a patient before cancer treatment, a lower blend ratio should be used for the same patient experiencing treatment‐related weight loss to achieve consistent lesion detectability in Tc‐99m planar scintigraphy acquired with LEHRS and processed by Clarity 2D. Conclusion: The magnitude of photon attenuation and scattering is higher in patients with larger body size, so Tc‐99m planar scintigraphy usually has lower lesion detectability in obese patients. Although photon attenuation and scattering are inevitable during image formation, their impacts on image quality can be eased by employing appropriate image protocol parameters. [ABSTRACT FROM AUTHOR]

Bacteria use signal transduction systems to sense and respond to their external environment. The two‐component system CpxA/CpxR senses misfolded envelope protein stress and responds by up‐regulating envelope protein factors and down‐regulating virulence factors in several animal pathogens. Dickeya dadantii is a phytopathogen equipped with a type III secretion system (T3SS) for manipulating the host immune response. We found that deletion of cpxR enhanced the expression of the T3SS marker gene hrpA in a designated T3SS‐inducing minimal medium (MM). In the ∆cpxR mutant, multiple T3SS and c‐di‐GMP regulators were also up‐regulated. Subsequent analysis revealed that deletion of the phosphodiesterase gene egcpB in ∆cpxR abolished the enhanced T3SS expression. This suggested that CpxR suppresses EGcpB levels, causing low T3SS expression in MM. Furthermore, we found that the ∆cpxR mutant displayed low c‐di‐GMP phenotypes in biofilm formation and swimming. Increased production of cellular c‐di‐GMP by in trans expression of the diguanylate cyclase gene gcpA was negated in the ∆cpxR mutant. Here, we propose that CpxA/CpxR regulates T3SS expression by manipulating the c‐di‐GMP network, in turn modifying the multiple physiological activities involved in the response to environmental stresses in D. dadantii. [ABSTRACT FROM AUTHOR]

Background: Oxaliplatin is frequently used in the treatment of metastatic colorectal cancer. However, peripheral neuropathy is a severe adverse effect of oxaliplatin that may persist and impact quality of life.Objective: To assess the potential effects of ultrasound acupuncture for the alleviation of symptoms related to oxaliplatin-induced peripheral neuropathy (OIPN) among patients with metastatic colorectal cancer.Design: Prospective cohort pilot study.Setting: Education and research hospital.Participants: Patients with a diagnosis of stage II-IV colorectal cancer undergoing oxaliplatin-based treatment regimens who experienced OIPN symptoms (n = 17).Interventions: Pulsed therapeutic ultrasound (1 MHz) at bilateral acupuncture points of PC6, PC7, BL60, and KI1 was administered for 5 minutes per point daily for 12 days.Main Outcome Measurements: Pain Quality Assessment Scale (PQAS), Chemotherapy-induced Neurotoxicity Questionnaire (CINQ), quantitative touch-detection threshold, cold-trigger pain withdrawal latency, and quality of life (EORTC QLQ-C30) were measured at baseline (day 0), pre-intervention (day 12, post wash-out period), post-intervention (day 24), and final follow-up (day 54). A P value of less than .05 was considered statistically significant.Results: Scores of PQAS and CINQ significantly improved after ultrasound acupuncture at post-intervention and follow-up compared to both baseline and pre-intervention. Similar trends were also observed for the quantitative sensory testing, where touch-detection threshold significantly decreased and cold-trigger pain withdrawal latency significantly increased after ultrasound acupuncture. Patients also showed an improvement on quality of life outcomes as measured by QLQ-C30 post-intervention and at follow-up.Conclusions: Ultrasound acupuncture could be an effective intervention for OIPN symptoms for patients with colorectal cancer. However, larger and randomized clinical trials with placebo controls are needed to confirm such effects. [ABSTRACT FROM AUTHOR]

Objective: The Depression and Somatic Symptoms Scale (DSSS), a free scale, includes depression (DS) and somatic (SS) subscales. This study aimed to compare the associations of the baseline DSSS, Hamilton Depression Rating Scale (HAMD) and Hospital Anxiety and Depression Scale (HADS) scores with the outcome of depression over a 10‐year follow‐up period. Methods: Two hundred ninety outpatients with major depressive disorder (MDD) were enrolled and were followed‐up at the 6‐month, 2‐year, and 10‐year points. The three scales were administered at each follow‐up. Multiple linear regressions were used to compare the associations. Results: In a comparison of the HAMD, DS, and HADS‐depression, the HAMD and DS scores at baseline were most strongly associated with the HAMD score at two (6‐month and 2‐year) and one (10‐year) follow‐up points, respectively. In a comparison of the HAMD, DS, SS, HADS‐depression, and HADS‐anxiety, the SS and HAMD scores at baseline were most strongly associated with the HAMD score at two (6‐month and 10‐year) and one (2‐year) follow‐up points, respectively. Conclusions: The DS, SS, and HAMD scores at baseline were significantly associated with the long‐term outcome of depression. Scales or subscales assessing somatic symptoms might be more strongly associated with the outcome of depression. [ABSTRACT FROM AUTHOR]

Background: We tested the hypothesis that multiple obesity‐related risk factors (obesity, physical activity, cardiopulmonary physical fitness, sleep‐disorder breathing (SDB), and sleep quality) are associated with childhood asthma using a Mendelian randomization (MR) design. Furthermore, we aim to investigate whether these risk factors were associated with incident asthma prospectively. Methods: In total, 7069 children aged 12 from the Taiwan Children Health Study were enrolled in the current study. Cross‐sectional logistic regression, one‐sample MR, summary‐level MR sensitivity analyses, and prospective survival analyses were used to investigate each causal pathway. Results: In MR analysis, three of the five risk factors (obesity, SDB, and sleep quality) were associated with asthma, with the highest effect sizes per inter‐quartile range (IQR) increase observed for sleep quality (odds ratio [OR] = 1.42; 95% confidence interval [CI]: 1.06 to 1.92) and the lowest for obesity (OR = 1.08; 95% CI: 1.00–1.16). In the prospective survival analysis, obesity showed the highest risk of incident asthma per IQR increase (hazard ratio [HR] = 1.28; 95% CI: 1.05 to 1.56), followed by SDB (HR = 1.18; 95% CI: 1.08 to 1.29) and sleep quality (HR = 1.10; 95% CI: 1.03 to 1.17). Conclusion: Among the examined factors, the most plausible risk factors for asthma were obesity, SDB, and poor sleep quality. For the prevention of childhood asthma, relevant stakeholders should prioritize improving children's sleep quality and preventing obesity comorbidities such as SDB. [ABSTRACT FROM AUTHOR]

Three climate models are evaluated using in situ airborne observations from the Southern Ocean Clouds, Radiation, Aerosol Transport Experimental Study (SOCRATES) campaign. The evaluation targets cloud phases, microphysical properties, thermodynamic conditions, and aerosol indirect effects from −40°C to 0°C. Compared with 580‐s averaged observations (i.e., 100 km horizontal scale), the Community Atmosphere Model version 6 (CAM6) shows the most similar result for cloud phase frequency distribution and allows more liquid‐containing clouds below −10°C compared with its predecessor—CAM5. The Energy Exascale Earth System Model (E3SM) underestimates (overestimates) ice phase frequencies below (above) −20°C. CAM6 and E3SM show liquid and ice water contents (i.e., LWC and IWC) similar to observations from −25°C to 0°C, but higher LWC and lower IWC than observations at lower temperatures. Simulated in‐cloud RH shows higher minimum values than observations, possibly restricting ice growth during sedimentation. As number concentrations of aerosols larger than 500 nm (Na500) increase, observations show increases of LWC, IWC, liquid, and ice number concentrations (Nliq, Nice). Number concentrations of aerosols larger than 100 nm (Na100) only show positive correlations with LWC and Nliq. From −20°C to 0°C, higher aerosol number concentrations are correlated with lower glaciation ratio and higher cloud fraction. From −40°C to −20°C, large aerosols show positive correlations with glaciation ratio. CAM6 shows small increases of LWC and Nliq with Na500 and Na100. E3SM shows small increases of Nice with Na500. Overall, CAM6 and E3SM underestimate aerosol indirect effects on ice crystals and supercooled liquid droplets over the Southern Ocean. Plain Language Summary: Clouds can be collections of entirely liquid droplets, ice particles, or both. Whether clouds are liquid, ice, or a mixture, particularly over the Southern Ocean, contributes to large uncertainties in climate model simulations. This study uses aircraft observations to evaluate the performance of three climate models. The evaluation compares model simulations with the observation data in terms of environmental conditions (temperature and relative humidity), small‐scale properties (amount of liquid and ice), and the relationship between aerosols and clouds at temperatures from −40°C to 0°C. A commonly used model (CAM5) does not allow supercooled liquid water at temperatures <−10°C, while a newer version of it (CAM6), produces distributions of the three cloud phases comparable to observations. Another climate model (E3SM), on the other hand, produces too many liquid clouds and too few ice clouds from −35°C to −20°C. CAM6 and E3SM show an insufficient amount of ice and a surplus of supercooled liquid water compared with observations between −40°C and −25°C. As aerosol number concentrations increase, observations show more ice crystals and supercooled liquid droplets; such trends are not as evident in simulations. Key Points: CAM6 and E3SM show similar liquid water content (LWC) and ice water content (IWC) compared to observations from −25°C to 0°C, but show higher (lower) LWC (IWC) at lower temperaturesHigher LWC, IWC, Nliq, and Nice were observed with higher aerosol concentrations, yet such correlations are weaker in modelsCAM6 shows the most similar ice, liquid, and mixed phase frequency compared to 100‐km observations; CAM5 and E3SM show less similarity [ABSTRACT FROM AUTHOR]

Summary: Adults with obesity exhibit a restrictive pattern, whereas children with obesity exhibit an obstructive pattern. However, the transition process remains unclear. We performed a systematic search for studies reporting on body mass index and pulmonary function in children. The main outcomes were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and their ratio (FEV1/FVC). We compared individuals with overweight or with obesity with individuals with normal weight. Random‐effects models were used to calculate pooled estimates. A total of 17 studies were included. Individuals with obesity had a lower FEV1/FVC ratio (mean difference [MD] = −3.61%; 95% confidence interval [CI] = −4.58%, −2.64%) and a higher percent‐predicted FVC (MD = 3.33%; 95% CI = 0.79%, 5.88%) than those with normal weight. Obesity impaired pulmonary function in the obstructive pattern during childhood to young adulthood, and the maximum obstruction was observed at the age of 16 years in boys and 20 years in girls. The effects attenuated at approximately 30 years and then shifted to the restrictive pattern after 35 years of age in men and 40 years in women. The effects of obesity on pulmonary function change from the obstructive pattern in childhood to the restrictive pattern in adulthood. [ABSTRACT FROM AUTHOR]

Although our research showed that n-3 fatty acid has no significant protective effect other than feno and EIB, future studies including genetic analyses may better define the effect of n-3 fatty acid on asthma.2 N-3 fatty acid supplementation may provide a protective effect on FeNO and a decrease in postexercise FEV SB 1 sb decline. The effect of n-3 fatty acid supplementation on forced vital capacity (FVC), FEV SB 1 sb /FVC, peak expiratory flow, asthma symptoms, or bronchodilator use remained inconclusive (Table 1). Although the relationship of n-3 fatty acids and NO production in the airway is not yet fully established, evidence strongly suggests that n-3 fatty acids may be effective in asthma treatment through NO inhibition, as indicated by our finding of a significant reduction in FeNO after n-3 fatty acid supplementation. [Extracted from the article]

A 7‐month‐old, male castrated mixed‐breed pig presented for evaluation of a 3‐month history of cutaneous pigmented nodular lesions, multifocal leukoderma and leukotrichia. Skin biopsies were performed from pigmented nodules and depigmented skin for histopathology. Additional skin biopsies were collected aseptically for bacterial and fungal tissue cultures. Histopathologic diagnosis was a benign melanocytic neoplasm (melanocytoma) and marked vitiligo. Spontaneous regression of melanocytomas did not occur after 1 year of age as previously reported to occur in several swine breeds. Topical imidazoquinoline amine cream was applied to one melanocytoma three times a week for a month. No clinical improvement in either the melanocytoma or vitiligo occurred. In humans, vitiligo is associated with both neoplastic and benign melanocytic neoplasms; this case illustrates the presence of melanoma‐associated leukoderma in a domestic mixed‐breed pig and emphasises the importance of meticulous skin examination in swine patients with the development of vitiligo. [ABSTRACT FROM AUTHOR]

Triple‐negative breast cancer (TNBC) exhibits a higher level of glycolytic capacity and are commonly associated with an inflammatory microenvironment, but the regulatory mechanism and metabolic crosstalk between the tumor and tumor microenvironment (TME) are largely unresolved. Here, we show that glucose transporter 3 (GLUT3) is particularly elevated in TNBC and associated with metastatic progression and poor prognosis in breast cancer patients. Expression of GLUT3 is crucial for promoting the epithelial‐to‐mesenchymal transition and enhancing invasiveness and distant metastasis of TNBC cells. Notably, GLUT3 is correlated with inflammatory gene expressions and is associated with M1 tumor‐associated macrophages (TAMs), at least in part by C‐X‐C Motif Chemokine Ligand 8 (CXCL8). We found that expression of GLUT3 regulates CXCL8 production in TNBC cells. Secretion of CXCL8 participates in GLUT3‐overexpressing TNBC cells‐elicited activation of inflammatory TAMs, which further enhances GLUT3 expression and mobility of TNBC cells. Our findings demonstrate that aerobic glycolysis in TNBC not only promotes aggressiveness of tumor cells but also initiates a positive regulatory loop for enhancing tumor progression by modulating the inflammatory TME. [ABSTRACT FROM AUTHOR]

The RGB micro‐LED display has been demonstrated to withstand mechanical strain during out‐of‐plane periodically deformation. In this work, the high pixel density (>139‐PPI) and high strain tolerance of circuits were achieved by utilizing the novel design of the island‐bridge structure under the compact pixel arrangement. Light absorbent was adopted into a stretchable display to reduce ambient back light and ambient reflection for the dark mode of a panel [ABSTRACT FROM AUTHOR]

Xanthomonas oryzae pathovars oryzae (Xoo) and oryzicola (Xoc) infect rice, causing bacterial blight and bacterial leaf streak, respectively, which are two economically important bacterial diseases in paddy fields. The interactions of Xoo and Xoc with rice can be used as models for studying fundamental aspects of bacterial pathogenesis and host tissue specificity. However, an improved vector system for gene expression analysis is desired for Xoo and Xoc because some broad host range vectors that can replicate stably in X. oryzae pathovars are low‐copy number plasmids. To overcome this limitation, we developed a modular plasmid assembly system to transfer the functional DNA modules from the entry vectors into the pHM1‐derived backbone vectors on a high‐copy number basis. We demonstrated the feasibility of our vector system for protein detection, and quantification of virulence gene expression under laboratory conditions and in association with host rice and nonhost tobacco cells. This system also allows execution of a mutant complementation equivalent to the single‐copy chromosomal integration system and tracing of pathogens in rice leaf. Based on this assembly system, we constructed a series of protein expression and promoter‐probe vectors suitable for classical double restriction enzyme cloning. These vector systems enable cloning of all genes or promoters of interest from Xoo and Xoc strains. Our modular assembly system represents a versatile and highly efficient toolkit for gene expression analysis that will accelerate studies on interactions of X. oryzae with rice. [ABSTRACT FROM AUTHOR]

Background: Proteinuria is an independent risk factor for morbidity and mortality in dogs. An association between proteinuria and gallbladder mucocele formation in dogs is unknown. Objective: Determine if gallbladder mucocele formation or clinicopathologic comorbidities are associated with proteinuria. Animals Twenty‐five dogs with mucocele formation and 25 breed and age‐matched control dogs from a prior study. Methods: Retrospective case control study. Proteinuria defined by calculated urine dipstick protein concentration (mg/mL) to urine specific gravity (USG) ratio. Clinicopathologic findings, postcosyntropin cortisol concentration, thyroid function profile, and illness severity score were recorded. Results: Median urine dipstick protein concentration to USG ratio and number of dogs having a ratio ≥1.5 were significantly higher for dogs with mucocele formation compared to control dogs. Proteinuria was not significantly associated with CBC or serum biochemistry profile abnormalities but increased in relation to severity of illness. Conclusions and Clinical Importance: Gallbladder mucocele formation is significantly associated with proteinuria in dogs. Diagnosis and treatment of proteinuria in dogs with mucocele formation might minimize long term kidney morbidity in these patients. [ABSTRACT FROM AUTHOR]

The aim of the study is to investigate the ability of phytochemicals to overcome the multiple drug resistance (MDR) of bladder cancer. 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) assay was used to evaluate the cytotoxic sensitivity of T24‐GCB cells, a GCB resistant cell line, to different phytochemicals, including capsaicin, quercetin, curcumin, and resveratrol, and their combination with gemcitabine. Western blot analysis was used to detect the expression of membranous ABCC2 and metabolic proteins, DCK, TK1, and TK2 in tumor cells. Animal models were used to confirm the treatment efficacy of phytochemicals in combination with gemcitabine to bladder cancer. The observed/expected ratio of cytotoxicity analysis revealed that capsaicin has synergistic effect with gemcitabine to T24‐GCB cells in a dose‐dependent pattern. Quercetin, curcumin, and resveratrol have additive effect with gemcitabine to T24‐GCB cells. Capsaicin and quercetin alone and combination with gemcitabine decreased the expression of ABCC2 and DCK and TKs, in T24‐GCB cells. On the contrary, resveratrol and curcumin alone and combination with gemcitabine increased the expression of ABCC2 but decreased cytoplasmic kinases simultaneously. In xenografted subcutaneous tumor model on nude mice, combination treatment of capsaicin and gemcitabine demonstrated the highest tumor suppression effect when compared to capsaicin or gemcitabine treatment alone. The MDR of bladder cancer is closely related to membranous ABCC2, cytoplasmic DCK, and TKs expression. Capsaicin owns the strongest synergistic cytotoxic effect of gemcitabine to T24‐GCB cells. This combination regimen may provide as an adjunctive treatment for overcoming MDR in bladder cancer. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the feasibility of generating pseudo dual‐energy CT (DECT) from one 120‐kVp CT by using convolutional neural network (CNN) to derive additional information for quantitative image analysis through phantom study. Methods: Dual‐energy scans (80/140 kVp) and single‐energy scans (120 kVp) were performed for five calibration phantoms and two evaluation phantoms on a dual‐source DECT scanner. The calibration phantoms were used to generate training dataset for CNN optimization, while the evaluation phantoms were used to generate testing dataset. A CNN model which takes 120‐kVp images as input and creates 80/140‐kVp images as output was built, trained, and tested by using Caffe CNN platform. An in‐house software to quantify contrast enhancement and synthesize virtual monochromatic CT (VMCT) for CNN‐generated pseudo DECT was implemented and evaluated. Results: The CT numbers in 80‐kVp pseudo images generated by CNN are differed from the truth by 11.57, 16.67, 13.92, 12.23, 10.69 HU for syringes filled with iodine concentration of 2.19, 4.38, 8.75, 17.5, 35 mg/ml, respectively. The corresponding results for 140‐kVp CT are 3.09, 9.10, 7.08, 9.81, 7.59 HU. The estimates of iodine concentration calculated based on the proposed method are differed from the truth by 0.104, 0.603, 0.478, 0.698, 0.795 mg/ml for syringes filled with iodine concentration of 2.19, 4.38, 8.75, 17.5, 35 mg/ml, respectively. With regards to image quality enhancement, VMCT synthesized by using pseudo DECT shows the best contrast‐to‐noise ratio at 40 keV. Conclusion: In conclusion, the proposed method should be a practicable strategy for iodine quantification in contrast enhanced 120‐kVp CT without using specific scanner or scanning procedure. [ABSTRACT FROM AUTHOR]

Purpose: This study was undertaken to develop a theoretical framework explaining family caregiving processes for older persons with cognitive impairment recovering from hip fracture surgery. Design and Methods: In this grounded theory study, data were collected in audio‐recorded face‐to‐face interviews with 21 family caregivers. Among these caregivers, 14 cared for hip‐fractured persons with cognitive impairment, and seven cared for those without cognitive impairment. Caregivers were interviewed five times after patients' discharge: at 1 week and at 1, 3, 6, and 12 months. Data were analyzed by constant comparative analysis. Findings: The core category explaining the family caregiving process for hip‐fractured persons with cognitive impairment was "resuming normal life during drip‐like recovery." This category captures the slowness of the recovery process, as slow as dripping water. During the early postoperative period, caregivers attempted to gain control of the postoperative situation, using various maintenance and improvement strategies to deal with the chaos in individuals and the family and to protect hip‐fractured persons with cognitive impairment from further harm. The goal of recovery was to get back to their original life. Conclusions: Family caregivers of hip‐fractured older persons with cognitive impairment needed to deal with more complex chaotic situations, exerted more efforts to administer safety measures, and required more time to achieve a stable life pattern. Clinical Relevance: Since postoperative recovery was perceived as extremely slow, family caregivers of hip‐fractured older persons with cognitive impairment should be patient regarding recovery and be informed before hospital discharge of different strategies to resume normal life during postoperative recovery. [ABSTRACT FROM AUTHOR]

Background: Studies on early puberty and incident asthma have reported inconsistent results and are mainly performed in females. In this longitudinal study, we investigated the causal relationship between pubertal maturation and asthma through Mendelian randomization (MR) and explored the joint effect of overweightness and early pubertal maturation on asthma. Methods: We used data from the Taiwan Children Health Study with longitudinal follow‐ups of 2991 children aged 11‐17 years. Six puberty‐related single‐nucleotide polymorphisms (combined into a weighted allelic score) were used to yield genetic instrumental variables for early puberty. Early pubertal maturation was defined as reaching a certain pubertal stage earlier than the median age for that stage. Incident asthma cases were calculated by excluding children with a history of asthma prior to that age. Results: The results of MR analysis revealed that early pubertal maturation was associated with active asthma (OR = 1.18; 95% CI: 1.08‐1.28); this effect was significant in male children. Early pubertal maturation significantly increased the risk of incident asthma outcomes at 12 and 17 years of age in both sexes (hazard ratio = 2.15; 95% CI: 1.21‐3.84). Taking non‐overweight and non–early puberty children as the reference group, we observed a synergistic effect of overweightness and early pubertal maturation on asthma risk (OR = 1.08; 95% CI: 1.04‐1.11) in children of both sexes. Conclusions: Early screening and intervention for obesity are recommended to prevent future early pubertal onset and asthma occurrence. [ABSTRACT FROM AUTHOR]

Cell adhesion affects carcinogenesis, tumor progression, and metastasis. We datamined a published transcriptome (GSE12452) of nasopharyngeal carcinoma (NPC) and identified SSX2IP as a significantly upregulated gene in NPC carcinogenesis among genes associated with cell adhesion (GO:0007155). Consequently, we assessed SSX2IP protein expression and its prognostic significance in 124 patients with NPC using immunohistochemistry and the H‐score method. The status of SSX2IP immunoexpression correlated with clinical and pathological characteristics, as well as oncological outcomes. High levels of SSX2IP expression were significantly associated with more advanced primary tumor and TNM stages. Kaplan–Meier and log‐rank analyses revealed that high levels of SSX2IP expression, and advanced tumor stage and lymph node metastasis were significantly associated with lower rates of local recurrence‐free survival (LRFS), distant metastasis‐free survival (DMeFS), and disease‐specific (DSS) survival. Multivariate analysis showed that high levels of SSX2IP expression significantly predicted DSS (hazard ratio [HR], 4.290; 95% confidence interval [CI], 2.271–8.102; p < 0.001), DMeFS (HR, 4.159' 95% CI, 2.072–8.345; p < 0.001), and LRFS (HR, 3.007' 95% CI,: 1.418–6.378; p = 0.004). We associated high levels of SSX2IP immunoexpression with aggressive pathological features and worse oncological outcomes, suggesting its potential therapeutic value for patients with NPC. [ABSTRACT FROM AUTHOR]

Summary: Background: Colletotrichum is a rare cause of human infection. Previous reports about Colletotrichum keratitis were limited, and most diagnoses from past reports were based on morphological distinction, which could have led to underestimation of the prevalence of Colletotrichum species. Objective: We reported phylogenetic analysis, clinical feature and treatment outcome of molecularly diagnosed Colletotrichum keratitis in our hospital. Patients/Methods: We recruited 65 patients with culture‐proven filamentous fungal keratitis between January 1, 2015 and December 30, 2018. Through molecular sequencing including internal transcribed spacer (ITS) and multi‐locus phylogenetic analysis of fungal DNA, seven patients were verified as infected with Colletotrichum species, and their medical records were reviewed to determine the clinical characteristics. Results: Six of seven patients had predisposing factors including trauma (5) and immunosuppressive status (1). Six isolates were initially misidentified as other fungi through morphological identification. ITS sequencing identified the isolates belonged to two species complex (SC): C. truncatum and C. gloeosporioides; multi‐locus phylogenetic analysis enabled species identification including C. tropicale (3), C. fructicola (2), C. truncatum (1) and C. fusiforme (1). Five patients with C. gloeosporioides SC responded well to medical treatment and two patients with C truncatum SC underwent evisceration because of either no visual potential or intractable pain. Conclusions: The molecular approach provides accurate diagnosis and raises epidemiological awareness of Colletotrichum keratitis. Through multi‐locus phylogenetic analysis, we report the human infections caused by C. tropicale, C. fructicola and C. fusiforme. We also highlight the different clinical outcomes between C. gloeosporioides SC and C. truncatum SC. [ABSTRACT FROM AUTHOR]

Background: Although various prognostic models for primary central nervous system lymphoma (PCNSL) have been developed, there is no consensus regarding the optimal prognostic index. We aimed to evaluate potential prognostic factors and construct a novel predictive model for PCNSL patients. Methods: We enrolled newly diagnosed PCNSL patients between 2003 and 2015. The primary endpoint was progression‐free survival (PFS), and the secondary endpoint was overall survival (OS). The prognostic factors identified using multivariate Cox proportional hazards models were used to develop a predictive model. We subsequently validated the prognostic model in an independent cohort. We also evaluated the validity of the existing scores: the International Extranodal Lymphoma Study Group (IELSG), the Nottingham/Barcelona (NB), and the Memorial Sloan‐Kettering Cancer Center models (MSKCC). Results: We identified 101 patients with newly diagnosed PCNSL at our center. Multivariate analysis showed that age ≥80, deep brain lesions, and ECOG ≥2 were independent risk factors of PFS. Assigning one point for each factor, we constructed a novel prognostic model, the Taipei Score, with four distinct risk groups (0‐3 points). The performances of the Taipei Score in discriminating both PFS and OS in the training cohort were significant, and the score was validated in the external validation cohort. The IELSG, NB and MSKCC models had insufficient discriminative ability for either PFS or OS in both cohorts. Conclusion: The Taipei Score is a simple model that discriminates PFS and OS for PCNSL patients. The score may offer disease risk stratification and facilitate clinical decision‐making. [ABSTRACT FROM AUTHOR]

A 6‐year‐old, spayed female, mixed shorthair cat presented to the emergency service at The Ohio State University Veterinary Medical Center for evaluation of hypercalcemia, a right eye mass, and multiple intrathoracic and intra‐abdominal masses. Cytologic evaluation of one of the abdominal masses revealed a uniform population of large, anaplastic mesenchymal cells found individually, in loose aggregates, and occasionally associated with pink, extracellular matrix. The cytology was consistent with a malignant mesenchymal neoplasm, with primary consideration given to fibrosarcoma and hemangiosarcoma. The cat was euthanized and histopathology confirmed disseminated fibrosarcoma. Fibrosarcoma comprises 12%‐41% of feline cutaneous tumors and affects cats at a mean age of 9.6 years. Three manifestations of fibrosarcoma predominate in cats: spontaneous solitary fibrosarcoma, vaccine‐induced/injection site fibrosarcoma, and oncogene‐induced (FSV) fibrosarcoma. The history, signalment, and results from diagnostics performed did not support solitary fibrosarcoma or injection‐induced sarcoma. Although some criteria fit with virally induced fibrosarcoma, such as age and the presence of multiple fibrosarcomas, the neoplastic population was negative for FeLV IHC. The presence of fibrosarcomas throughout the pleural and peritoneal cavity was most compatible with sarcomatosis and the distant metastasis of an unidentified primary neoplasm. To the authors' knowledge, this is the first reported case of sarcomatosis in a FeLV‐negative cat. [ABSTRACT FROM AUTHOR]

Purpose: This work investigated the simultaneous influence of tube voltage, tube current, body size, and HU threshold on calcium scoring reconstructed at 0.5‐mm slice thickness using iterative reconstruction (IR) through multivariate analysis. Regression results were used to optimize the HU threshold to calibrate the resulting Agatston scores to be consistent with those obtained from the conventional protocol. Methods: A thorax phantom set simulating three different body sizes was used in this study. A total of 14 coronary artery calcium (CAC) protocols were studied, including 1 conventional protocol reconstructed at 3‐mm slice thickness, 1 FBP protocol, and 12 statistical IR protocols (3 kVp values*4 SD values) reconstructed at 0.5‐mm slice thickness. Three HU thresholds were applied for calcium identification, including 130, 150, and 170 HU. A multiple linear regression method was used to analyze the impact of kVp, SD, body size, and HU threshold on the Agatston scores of three calcification densities for IR‐reconstructed CAC scans acquired with 0.5‐mm slice thickness. Results: Each regression relationship has R2 larger than 0.80, indicating a good fit to the data. Based on the regression models, the HU thresholds as a function of SD estimated to ensure the quantification accuracy of calcium scores for 120‐, 100‐, and 80‐kVp CAC scans reconstructed at 0.5‐mm slice thickness using IR for three different body sizes were proposed. Our results indicate that the HU threshold should be adjusted according to the imaging condition, whereas a 130‐HU threshold is appropriate for 120‐kVp CAC scans acquired with SD = 55 for body size of 24.5 cm. Conclusion: The optimized HU thresholds were proposed for CAC scans reconstructed at 0.5‐mm slice thickness using IR. Our study results may provide a potential strategy to improve the reliability of calcium scoring by reducing partial volume effect while keeping radiation dose as low as reasonably achievable. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to identify the genetic features of appendiceal epithelial neoplasms and correlate the genetic features with morphology. Methods and results: We analysed the genetic features of a series of 47 appendiceal epithelial neoplasms of various morphologies by using targeted next‐generation sequencing of 11 genes commonly mutated in gastrointestinal neoplasms. Seven of nine serrated polyps harboured BRAF mutations, which are rare in other types of appendiceal tumours. Most cases of low‐grade appendiceal mucinous neoplasms (LAMNs) exhibited GNAS and KRAS mutations. LAMNs with a coexisting serrated polyp were all KRAS mutated. Four LAMNs with mutations in the Wnt/β‐catenin pathway, either through inactivating mutations in APC or RNF43 or activating mutations in CTNNB1, had focal proliferation of mucin‐poor low‐grade tumour cells, reminiscent of colorectal adenomas. Mutations in the Wnt/β‐catenin pathway were also identified in high‐grade appendiceal mucinous neoplasms, suggesting that Wnt/β‐catenin pathway activation is the driving force for the progression of LAMN to a higher‐grade lesion. Adenomatous polyps of the appendix frequently had APC, KRAS and TP53 mutations and were morphologically and molecularly similar to adenomatous polyps of the colorectum. Conclusions: Our results indicate a close association between morphology and genetic events in appendiceal neoplasms and suggest a phylogenetic relationship between different entities. [ABSTRACT FROM AUTHOR]