Search

Abstract Sjögren’s syndrome (SS) is a prevalent systemic autoimmune disease with substantial impacts on women’s health worldwide. Although oral Haemophilus parainfluenzae is reduced in SS, its significance remains unclear. This study aimed to elucidate the pathophysiological role of H. parainfluenzae in SS. Reduced salivary H. parainfluenzae levels in SS patients were confirmed through quantitative PCR. Oral H. parainfluenzae inoculation in NOD mice alleviated focal sialadenitis, improved salivary function, and reduced IFN-γ+CD3+ and IFN-γ+CD8+ T cells in salivary gland-draining lymph nodes, maintaining immune homeostasis against a biased type 1 response. Inoculation also enhanced salivary microbiota diversity, balanced the Firmicutes-to-Proteobacteria ratio, and reduced the overwhelming presence of Pseudomonas mendocina. In vitro, H. parainfluenzae-preconditioned A253 cells limited CD8 T cell expansion with reduced IFN-γ production. These findings suggest that H. parainfluenzae improves oral microbial diversity, promotes homeostatic T-cell immunity, and protects against SS, supporting its potential as a next-generation probiotic.

Abstract Our aim was to develop a machine learning-based predictor for early mortality and severe intraventricular hemorrhage (IVH) in very-low birth weight (VLBW) preterm infants in Taiwan. We collected retrospective data from VLBW infants, dividing them into two cohorts: one for model development and internal validation (Cohort 1, 2016–2021), and another for external validation (Cohort 2, 2022). Primary outcomes included early mortality, severe IVH, and early poor outcomes (a combination of both). Data preprocessing involved 23 variables, with the top four predictors identified as gestational age, birth body weight, 5-min Apgar score, and endotracheal tube ventilation. Six machine learning algorithms were employed. Among 7471 infants analyzed, the selected predictors consistently performed well across all outcomes. Logistic regression and neural network models showed the highest predictive performance (AUC 0.81–0.90 in both internal and external validation) and were well-calibrated, confirmed by calibration plots and the lowest two mean Brier scores (0.0685 and 0.0691). We developed a robust machine learning-based outcome predictor using only four accessible variables, offering valuable prognostic information for parents and aiding healthcare providers in decision-making.

The production of waste glass in China was more than 20 million tonnes, but the current recycling rate was only around 30%. How to recycle this glass was a problem that urgently needed to be solved. This study used green glass and TFT-LCD glass to replace manufactured sand in 20%, 40%, 60% and 80%. Different proportions of mixed sand were composed to prepare cement-based specimens to investigate the effect of varying waste glass on the strength and pore structure of the cement-based materials through the mechanical test, porosity and water absorption test, resistivity test, mercury intrusion porosimetry. Finally, the hydration products generated in the interfacial transition zone were observed through scanning electron microscopy (SEM) to explain the mechanism of the action of waste glass on cement-based materials containing manufactured sands. The test results showed that adding the two types of glass sands reduced the flowability of the cement-based materials while adversely affecting the flexural strength of the cement-based materials. The compressive strength reached the optimum at 20% substitution, higher than the compressive strength of river sand and manufactured sand groups. From the SEM observations, the specimen mixed with 20% glass sand generated more types of hydration products than the manufactured sand group at three days and optimized the pore structures. At 28 days, the compressive strength of GG20 specimens was 8% higher than that of the RS group. Therefore, the replacement amount of GG up to 20% had optimum admixture.

Tennis is a popular sport, and integrating modern technological advancements can greatly enhance player training. Human pose estimation has seen substantial developments recently, driven by progress in deep learning. The dataset described in this paper was compiled from videos of researchers’ friend playing tennis. These videos were retrieved frame by frame to categorize various tennis movements, and human skeleton joints were annotated using COCO-Annotator to generate labelled JSON files. By combining these JSON files with the classified image set, we constructed the dataset for this paper. This dataset enables the training and validation of four tennis postures, forehand shot, backhand shot, ready position, and serves, using deep learning models (such as OpenPose). The researchers believe that this dataset will be a valuable asset to the tennis community and human pose estimation field, fostering innovation and excellence in the sport.

The 7000 series (Al–Zn–Mg) Al-alloys are renowned for their exceptional “lightweight-high strength” properties, primarily owing to nano-sized meta-stable η′ precipitate as the main strengthening phase. However, these η′ precipitates are susceptible to transforming into the stable η2 phase at elevated temperatures, resulting in a decline in strength. To mitigate this, Cu-segregation has been long proposed as a promising method for stabilizing these meta-stable precipitates. However, the mechanisms involved have not been fully understood. In this study, we conducted a thorough investigation on the structural and energetic changes between Cu-free and Cu-segregated η' and η2 precipitates. Utilizing DFT calculations and HAADF-STEM characterizations, we uncovered a distinctive alternating Cu-segregation pattern. This pattern induces significant structural modifications within the bulk of η' precipitates and at the precipitate-matrix interface, markedly enhancing their interfacial and bulk energetics. We believe these modifications are the key factor in improving precipitate stability. Based on our findings, the underlying mechanism of solute segregation was elucidated and a novel strategy for optimal design of Al–Zn–Mg alloys was proposed.

IntroductionThis study aimed to explore the relationship between the trajectories of body weight (BW) z-scores at birth, discharge, and 6 months corrected age (CA) and neurodevelopmental outcomes at 24 months CA.MethodsConducted as a population-based retrospective cohort study across 21 hospitals in Taiwan, we recruited 3,334 very-low-birth-weight (VLBW) infants born between 2012 and 2017 at 23–32 weeks of gestation. Neurodevelopmental outcomes were assessed at 24 months CA. Instances of neurodevelopmental impairment (NDI) were defined by the presence of at least one of the following criteria: cerebral palsy, severe hearing loss, profound vision impairment, or cognitive impairment. Group-based trajectory modeling was employed to identify distinct BW z-score trajectory groups. Multivariable logistic regression was used to assess the associations between these trajectories, postnatal comorbidity, and neurodevelopmental impairments.ResultsThe analysis identified three distinct trajectory groups: high-climbing, mid-declining, and low-declining. Significant associations were found between neurodevelopmental impairments and both cystic periventricular leukomalacia (cPVL) [with an adjusted odds ratio (aOR) of 3.59; p

Tennis is a popular sport, and the introduction of technology has allowed players to diversify their training. Tennis ball tracking is currently a focal point, serving not only to assist referees but also to enhance sports analysis. We introduce the Tennis Shot Side-View and Top-View Dataset, which serves as an invaluable resource for analyzing tennis movements and verifying landing positions after flight. This dataset combines side-view and top-view video clips, capturing various shot types and player movements from both outdoor and indoor fields. The dataset includes the actual ball positions of each clip for verification purposes. The Tennis Shot Side-View and Top-View Dataset represents a significant advancement in tennis research. Its multidimensional nature opens doors for in-depth player analysis, performance enhancement, and strategy development. We believe that this dataset will be a valuable asset to the tennis community, fostering innovation and excellence in the sport.

For high-power silicon carbide (SiC) devices, breakdown voltage analysis is an important parameter, especially for guard ring design. This work explores the implementation of machine learning on SiC guard ring parameters such as ion implanted dose and energy. In this work, the reinforcement learning method has been successfully implemented on the 1.7 kV SiC guard ring device TCAD simulated data for the prediction of parameters. Our work has predicted the parameters successfully for the 2.5 kV guard ring design. For training, proximal policy optimization (PPO) and advantage actor-critic (A2C) RL agents were deployed. The network architecture was kept at “auto” with 3 hidden layers of 128 neurons in each layer. Our method is practically feasible and easily implemented as compared to other works, and has been shown in this paper. By using the limited design parameters of the 1.7 kV guard ring device, the trained agent has successfully predicted the design parameters for the 2.5 kV guard ring device, which has been confirmed using TCAD simulations. This work is more accurate, practical, and result-oriented, and we believe that this can significantly minimize the computational cost as compared to the standalone TCAD simulations. Also, this implementation of ML on TCAD data can substantially accelerate the design exploration for the power devices and ultimately lower product-to-market time.

Abstract The drug discovery of G protein-coupled receptors (GPCRs) superfamily using computational models is often limited by the availability of protein three-dimensional (3D) structures and chemicals with experimentally measured bioactivities. Orphan GPCRs without known ligands further complicate the process. To enable drug discovery for human orphan GPCRs, multitask models were proposed for predicting half maximal effective concentrations (EC50) of the pairs of chemicals and GPCRs. Protein multiple sequence alignment features, and physicochemical properties and fingerprints of chemicals were utilized to encode the protein and chemical information, respectively. The protein features enabled the transfer of data-rich GPCRs to orphan receptors and the transferability based on the similarity of protein features. The final model was trained using both agonist and antagonist data from 200 GPCRs and showed an excellent mean squared error (MSE) of 0.24 in the validation dataset. An independent test using the orphan dataset consisting of 16 receptors associated with less than 8 bioactivities showed a reasonably good MSE of 1.51 that can be further improved to 0.53 by considering the transferability based on protein features. The informative features were identified and mapped to corresponding 3D structures to gain insights into the mechanism of GPCR-ligand interactions across the GPCR family. The proposed method provides a novel perspective on learning ligand bioactivity within the diverse human GPCR superfamily and can potentially accelerate the discovery of therapeutic agents for orphan GPCRs.

This study aimed to verify the role and feasibility of co-fired fly ash (CFA) as an alternative construction material. It also demonstrated the engineering properties of CFA mortar and compared them with those of pulverized coal fly ash (PCFA) mortar. Further, CFA-PCFA-cement mortar specimens were mixed to produce ternary eco-binder mortars and find the optimal application proportion. The results pointed out that the pozzolanic strength activity index of CFA was 76 %, with only a slight pozzolanic reaction. The sum of the chemical composition (SiO2+Al2O3+Fe2O3) of CFA was insufficient to meet ASTM C618 requirements, and it was deduced that a small amount of CFA should be used as the substitute for cement or fine aggregates. Specimens with CFA replacing fine aggregates contributed to lower water absorption, improved sulfate resistance, and increased compressive strength; Specimens with CFA replacing cement reduced shrinkage and improved sulfate resistance but decreased compressive strength and increased absorption. Blended CFA-cement mortars consisting of 5 % CFA as a replacement material for cement and fine aggregates had excellent engineering properties. Ternary blended CFA-PCFA-cement mortar exhibits superior engineering properties. The optimum proportion is an economy-friendly binder composed of 10 % CFA (5 % as cement and 5 % as fine aggregates) and 10% PCFA (as a replacement for cement).

Acute lung injury (ALI) is a life-threatening condition with limited treatment options. The pathogenesis of ALI involves macrophage-mediated disruption and subsequent repair of the alveolar barriers, which ultimately results in lung damage and regeneration, highlighting the pivotal role of macrophage polarization in ALI. Although exosomes derived from mesenchymal stromal cells have been established as influential modulators of macrophage polarization, the specific role of exosomal microRNAs (miRNAs) remains underexplored. This study aimed to elucidate the role of specific exosomal miRNAs in driving macrophage polarization, thereby providing a reference for developing novel therapeutic interventions for ALI. We found that miR-7704 is the most abundant and efficacious miRNA for promoting the switch to the M2 phenotype in macrophages. Mechanistically, we determined that miR-7704 stimulates M2 polarization by inhibiting the MyD88/STAT1 signaling pathway. Notably, intra-tracheal delivery of miR-7704 alone in a lipopolysaccharide-induced murine ALI model significantly drove M2 polarization in lung macrophages and remarkably restored pulmonary function, thus increasing survival. Our findings highlight miR-7704 as a valuable tool for treating ALI by driving the beneficial M2 polarization of macrophages. Our findings pave the way for deeper exploration into the therapeutic potential of exosomal miRNAs in inflammatory lung diseases.

In recent years, 3D printing of structural components and elements has become a popular method of construction automation. The key to the development of 3D printing was its diversity of printable spraying materials, which offered fast construction, material savings, and stable quality. A cementless blended material was made from three industrial by-products (fly ash, ultra-fine fly ash and ground-granulated blast furnace slag) without adding an alkaline activator. Various tests were conducted to compile the results, including viscosity, setting time, spray, and flow tests. The test results showed that viscoelastic solid pastes with viscosities of more than 6000 cP could be used as spraying materials for 3D printers. 3D printing can be accomplished with a ternary cementless blend consisting of 10 % ground-granulated blast furnace slag, 40 % ultra-fine fly ash and 50 % fly ash at a water to cementitious ratio of 0.25. Furthermore, the printer's spray flow rate should be set at 40 % to achieve the best aesthetic integrity. The compressive strength test verified that the 3D printed specimens had similar compressive strengths to conventional molded specimens and it confirmed that the source of strength of cementless materials was C-A-S-H colloids. According to the study, the cementless blended material developed can be used in 3D printing as a spraying material and is consistent with promoting high-value industrial by-product technology.

Abstract Bronchopulmonary dysplasia (BPD) has been a critical morbidity in preterm infants. To improve our definition and prediction of BPD is challenging yet indispensable. We aimed to apply machine learning (ML) to investigate effective models by using the recently-proposed and data-driven definition to predict late respiratory support modalities at 36 weeks’ post menstrual age (PMA). We collected data on very-low-birth-weight infants born between 2016 and 2019 from the Taiwan Neonatal Network database. Twenty-four attributes associated with their early life and seven ML algorithms were used in our analysis. The target outcomes were overall mortality, death before 36 weeks’ PMA, and severity of BPD under the new definition, which served as a proxy for respiratory support modalities. Of the 4103 infants initially considered, 3200 were deemed eligible. The logistic regression algorithm yielded the highest area under the receiver operating characteristic curve (AUROC). After attribute selection, the AUROC of the simplified models remain favorable (e.g., 0.801 when predicting no BPD, 0.850 when predicting grade 3 BPD or death before 36 weeks’ PMA, and 0.881 when predicting overall mortality). By using ML, we developed models to predict late respiratory support. Estimators were developed for clinical application after being simplified through attribute selection.

Aim This meta-analysis aimed to assess the usefulness of colchicine in patients with COVID-19.Methods PubMed, Web of Science, Ovid MEDLINE, the Cochrane Library, Embase, and Clinicaltrials.gov were searched for relevant randomised controlled trials (RCTs) published between database inception and November 12, 2021. Only RCTs that compared the clinical efficacy and safety of colchicine with other alternative treatments or placebos in patients with COVID-19 were included.Results Overall, 7 RCTs involving 16,024 patients were included; 7,794 patients were in the study group receiving colchicine and 8,230 were in the control group receiving placebo or standard treatment. The study and control groups had similar risk of mortality (odds ratio [OR], 1.00; 95% CI, 0.91–1.09; I2 = 0%). No significant difference was observed between the study and control groups in terms of the need for non-invasive ventilation (OR, 0.92; 95% CI, 0.83–1.03; I2 = 0%), the need for mechanical ventilation (OR, 0.64; 95% CI, 0.32–1.32; I2 = 58%), and length of hospital stay (mean difference, −0.42 days; 95% CI, −1.95 to 1.11; I2 = 62%). In addition, colchicine was associated with significantly higher risks of gastrointestinal adverse events (OR, 1.81; 95% CI, 1.56–2.11; I2 = 0%) and diarrhoea (OR, 2.12; 95% CI, 1.75–2.56; I2 = 9%).Conclusions Colchicine does not improve clinical outcomes in patients with COVID-19, so it did not support the additional use of colchicine in the treatment of patients with COVID-19.Key messageColchicine could not reduce the mortality of patients with COVID-19.No significant difference was observed between the colchicine and comparators in terms of the need for non-invasive ventilation, need for mechanical ventilation, and length of hospital stay.Colchicine was associated with a higher risk of gastrointestinal adverse events.

Background: This study was conducted to compare the number of cases of non-airborne/droplet-transmitted notifiable infectious disease (NID) before and after COVID-19 pandemic. Methods: This study used an open database - National Notifiable Diseases Surveillance System to collect the epidemiological data of NIDs. Ten fecal-oral-, six vector-borne-, four direct-contact, and four sexually-transmitted NIDs between pandemic period (defined as from January 2020 to December 2021) and the pre-pandemic period (defined as the period from January 2018 to December 2019) were included for the analysis. Results: Overall, the annual case number of these 24 non-airborne/droplet-transmitted NIDs was 19,186, 19,101, 19,567, and 19,863 in 2018, 2019, 2020 and 2021, respectively. The overall case number in the pandemic period was higher than those in pre-pandemic period (39,430 vs 38,287) and the monthly case number was significantly higher in pandemic period than pre-pandemic period (1643 vs 1595, p

Introduction: The regenerative capacity of mesenchymal stromal cells or medicinal signaling cells (MSCs) is largely mediated by their secreted small extracellular vesicles (sEVs), and the therapeutic efficacy of sEVs can be enhanced by licensing approaches (e.g., cytokines, hypoxia, chemicals, and genetic modification). Noncoding RNAs within MSC-derived sEVs (MSC-sEVs) have been demonstrated to be responsible for tissue regeneration. However, unlike miRNA fingerprints, which have been explored, the landscape of long noncoding RNAs (lncRNAs) in MSC-sEVs remains to be described. Objectives: To characterize lncRNA signatures in sEVs of human adipose-derived MSCs with or without inflammatory cytokine licensing and depict MSC-sEV-specific and MSC-enriched lncRNA repertoires. Methods: sEVs were isolated from MSCs with or without TNF-α and IFN-γ (20 ng/mL) stimulation. High-throughput lncRNA sequencing and an in silico approach were employed to analyze the profile of lncRNAs in sEVs and predict lncRNA-protein interactomes. Results: sEVs derived from human MSCs and fibroblasts carried a unique landscape of lncRNAs distinct from the lncRNAs inside these cells. Compared with fibroblast-derived sEVs (F-sEVs), 194 MSC-sEV-specific and 8 upregulated lncRNAs in MSC-sEVs were considered “medicinal signaling lncRNAs”; inflammatory cytokines upregulated 27 lncRNAs in MSC-sEVs, which were considered “licensing-responsive lncRNAs”. Based on lncRNA-protein interactome prediction and enrichment analysis, we found that the proteins interacting with medicinal signaling lncRNAs or licensing-responsive lncRNAs have a tight interaction network involved in chromatin remodeling, SWI/SNF superfamily type complexes, and histone binding. Conclusion: In summary, our study depicts the landscape of lncRNAs in MSC-sEVs and predicts their potential functions via the lncRNA-protein interactome. Elucidation of the lncRNA landscape of MSC-sEVs will facilitate defining the therapeutic potency of MSC-sEVs and the development of sEV-based therapeutics.

Objectives: This study assessed the efficacy and safety of novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations in adult patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). Methods: PubMed, Web of Science, the Cochrane Library, Ovid MEDLINE, Embase and EBSCO databases were searched for randomised controlled trials (RCTs) published before 13 September 2020. Only RCTs comparing the treatment efficacy of novel BL/BLI combinations with other antibiotics for HAP/VAP in adult patients were included in this integrated analysis. Results: Three RCTs were included and no significant difference in clinical cure rate of test of cure was observed between the novel BL/BLI combinations and comparators [odds ratio (OR) = 1.01, 95% confidence interval (CI) 0.81–1.27; I2 = 35%]. The 28-day all-cause mortality was 16.2% and 17.6% for patients receiving novel BL/BLI combinations and comparators, respectively, and no significant difference was noted (OR = 0.90, 95% CI 0.69–1.16; I2 = 11%). Compared with comparators, novel BL/BLI combinations were associated with a similar microbiological response (OR = 1.06, 95% CI 0.73–1.54; I2 = 64%) and a similar risk of adverse events (AEs) [treatment-emergent AEs (TEAEs): OR = 1.04, 95% CI 0.83–1.30; I2 = 0%; serious AEs: OR = 1.14, 95% CI 0.79–1.63; I2 = 68%; treatment discontinuation for TEAE: OR = 0.90, 95% CI 0.62–1.31; I2 = 11%). Conclusion: Clinical and microbiological responses of novel BL/BLI combinations in the treatment of HAP/VAP were similar to those of other available antibiotics. These combinations also shared a similar safety profile to comparators.

Background/Purpose: The in-hospital length of stay (LOS) among very-low-birth-weight (VLBW, BW

The purpose of this study is to assess the mechanical and microscopic properties of concrete containing different dosages of polyolefin fibers and slag through tests of compressive strength, resistivity, water absorption, mercury intrusion porosimetry and scanning electron microscopy. Test results indicate that the specimens containing slag have higher compressive strength, lower absorption, lower resistivity and denser porestructures than the control and specimen made with fibers. The specimens containing slag and polyolefin fiber demonstrated better performances in fiber reinforced concrete. Scanning electron microscopy illustrates that the polyolefin fiber acts to arrest the propagation of internal cracks. Still, there are cracks and weaknesses between fiber and paste that cause harmful ions penetrated easier.

Abstract Surgical management of post‐esophagojejunostomy aortoesophageal fistula (AEF) has been scarcely reported, but is universally fatal. This report described a case of AEF after total gastrectomy with Roux‐en‐Y esophagojejunostomy and adjuvant chemoradiotherapy for gastric cardiac cancer. A three‐stage hybrid approach was used to successfully manage this complication. First, thoracic endovascular aortic repair curbed bleeding. Second, radical fistula resection eradicated infected areas and adjacent structures. Third, esophageal reconstruction using an ileocolonic conduit restored gastrointestinal continuity. This strategy could be safely feasible for managing post‐esophagojejunostomy AEF.

Sarcopenia is an age-related progressive loss of skeletal muscle mass, quality, and strength disease. In addition, sarcopenia is tightly correlated with age-associated pathologies, such as sarcopenic obesity and osteoporosis. Further understanding of disease mechanisms and the therapeutic strategies in muscle regeneration requires a deeper knowledge of the interaction of skeletal muscle and other cells in the muscle tissue. Skeletal muscle regeneration is a complex process that requires a series of highly coordinated events involving communication between muscle stem cells and niche cells, such as muscle fibro/adipogenic progenitors and macrophages. Macrophages play a critical role in tissue regeneration and the maintenance of muscle homeostasis by producing growth factors and cytokines that regulate muscle stem cells and myofibroblast activation. Furthermore, the aging-related immune dysregulation associated with the release of trophic factors and the polarization in macrophages transiently affect the inflammatory phase and impair muscle regeneration. In this review, we focus on the role and regulation of macrophages in skeletal muscle regeneration and homeostasis. The aim of this review is to highlight the important roles of macrophages as a therapeutic target in age-related sarcopenia and the increasing understanding of how macrophages are regulated will help to advance skeletal muscle regeneration.

Abstract Salivary gland epithelial cells (SGECs) have been implicated in the pathogenesis of Sjögren’s syndrome due to aberrant antigen-presentation function. This study examined the hypothesis that oral dysbiosis modulates the antigen-presentation function of SGECs, which regulates CD4 T cell proliferation in primary Sjögren’s syndrome (pSS). Saliva samples from 8 pSS patients and 16 healthy subjects were analyzed for bacterial 16S ribosomal DNA. As a result, 39 differentially abundant taxa were identified. Among them, the phylum Proteobacteria comprised 21 taxa, and this phylum was mostly enriched in the healthy controls. The proteobacterium Haemophilus parainfluenzae was enriched in the healthy controls, with the greatest effect size at the species level. Treatment of A253 cells in vitro with H. parainfluenzae upregulated PD-L1 expression, and H. parainfluenzae-pretreated A253 cells suppressed CD4 T cell proliferation. The suppression was partially reversed by PD-L1 blockade. Among low-grade xerostomia patients, salivary abundance of H. parainfluenzae decreased in pSS patients compared to that in non-pSS sicca patients. Our findings suggest that H. parainfluenzae may be an immunomodulatory commensal bacterium in pSS.

Low thermal conductivity materials are now an essential direction for construction material applications as the public has become more aware of global warming over the past few years. The development of cementless binders is also helping to improve the problem of global warming. This study uses reactive ultra-fine fly ash (RUFA) and co-fired fly ash (CFA) to develop an innovative cementless binder. The RUFA-CFA mixture undergoes hardening without alkali activators at a temperature of 50 °C before it is de-molded for air curing. The resulting lightweight cementless specimens present excellent thermal insulation, mainly due to the formation of interstitial pores between RUFA particles. The porosity of RUFA-CFA cementless specimens ranges from 41% to 50% with minimum thermal conductivity of 0.10 W/m·K. Our analysis reveals that the ultra-fine RUFA particles adhere to the CFA surface formed C-S-H colloids and ettringite via continuous hydrated reactions maintained by the CFA. The results obtained in this study provide a valuable reference for developing cementless composites based on industrial waste materials.

Objectives: This systematic review and meta-analysis of randomized controlled trials (RCTs) investigated whether the clinical efficacy of a 5-day antibiotic course is comparable to that of a longer (≥7 d) course for treating adults with community-acquired bacterial pneumonia (CABP). Methods: The PubMed, Web of Science, Cochrane Library, Ovid MEDLINE, and Embase. were searched before January 18, 2020. RCTs comparing the efficacy of a 5-day antibiotic course with a longer course (≥7 d) for CABP treatment were included. Primary outcomes included the clinical response, microbiological response, and risk of adverse events (AEs). Results: In this meta-analysis, 7 RCTs were included, and the 5-day antibiotic courses group, and a longer course group comprised 1499 and 1522 patients, respectively. The difference in the overall clinical response rates between the 5-day and longer courses (88.3% vs 88.8%, odds ratio [OR], 0.95, 95% confidence interval [CI], 0.70–1.28, I2 = 19%) was nonsignificant. Additionally, the microbiological eradication rates did not differ significantly between the groups, at 94.8% and 95.8% in the 5-day and longer courses groups, respectively (OR, 0.84, 95% CI, 0.38–1.87, I2 = 0%). Finally, all-cause mortality did not differ between the 2 groups (OR, 0.91, 95% CI, 0.31–2.66, I2 = 0%). Conclusions: Five-day treatment and longer antibiotic courses for CABP yield similar clinical and microbiological responses and exhibit similar safety profiles.

Background: China is the largest tobacco producer and has the highest number of tobacco consumers in the world. Extensive research has demonstrated the utility of social media for smoking cessation. WeChat is the most commonly used social media platform in China, but has not yet been utilized for smoking cessation interventions. The objectives of this study are (1) to evaluate the efficacy of a WeChat-based smoking cessation intervention; and (2) to examine a possible additive effect of integrating oral health and smoking-related information into a tailored, Transtheoretical Model (TTM) guided smoking cessation intervention. Methods: Eligible adults were recruited through WeChat from July 1 to August 6, 2019, to participate in a 3-arm, single-blinded, randomized controlled trial. We enrolled and randomized 403 participants into three groups: the Standard Group, Enhanced Group, or a Waitlist-Control Group. Participants in the Standard Group received 20 smoking cessation-related messages for 2 weeks; participants in the Enhanced Group received this same protocol plus 6 oral health-related messages over an additional week. Participants in the Control Group received smoking cessation-related messages, after the post-intervention assessment. The primary outcome was TTM Stage of Change, and the secondary outcomes were 7-day Point Prevalence Abstinence (PPA), 24-h PPA, daily cigarette use, and nicotine dependence at 4 weeks follow-up post intervention, comparing intervention groups with the control group. The overall program attrition rate was 46%. Paired t-tests, McNemar tests, and linear and logistic regression were used to examine differences in smoking cessation outcomes within and between groups. Results: Participants in the Enhanced Group (β = −1.28, 95%CI: −2.13, −0.44) and the Standard Group (β = −1.13, 95%CI: −1.95, −0.30) reported larger changes in nicotine dependence scores, compared to participants in the Waitlist Group. No statistically significant differences were found between the Enhanced Group and the Standard Group. Discussion: This WeChat-based intervention was effective for smoking cessation overall. The addition of oral health information did not significantly improve the intervention.

The design of sustainable construction materials is continuously gaining increasing importance in civil engineering. Geopolymers are attractive alternatives to cementitious materials in terms of environmental impact and specific material properties, such as durability, an initial increase in mechanical properties, or chemical and thermal resistance. Such favorable properties can be advantageously utilized within various applications involving the design of materials for heavily stressed industrial floors. The research presented in the paper was focused on the design of a geopolymer composite based on metashale MEFISTO L05 and waste metashale RON D460HR binders. The 1:4 raw/waste mix of binders activated by potassium hydroxide/silicate was supplemented by 0.11 wt.% of graphite fibers to optimize electrical properties and bestow on it some new material functions, such as self-heating. The further utilization of fine waste aggregate (crushed defective concrete products, waste concrete from auto-mixers) resulted in an ~85% utilization of input waste materials. An acceptable mechanical performance of the mortar for particular civil engineering applications was observed (28d: Rf ~ 2.5 MPa, Rc ~ 15 MPa), as well as favorable thermal and DC/AC electrical properties, predicting the self-heating potential.

In this study, three industrial by-products (ultrafine fly ash, ground granulated blast-furnace slag (ggbs) and circulating fluidized bed co-fired fly ash) were used to produce ternary cementless composites without using alkali activators. The finenesses of ultrafine fly ash, ggbs and co-fired fly ash were 33,800, 5830 and 5130 cm2/g, respectively. The composite material was developed by mixing supplementary cementing materials of different particle sizes and exploiting the high-alkaline properties of the co-fired fly ash to develop a substantial hardening property like cement. The test specimens were made in the form of pastes and the water-to-cementitious-material ratio for the test was fixed at 0.55. The test results show that the flowability of the six different mixtures could be up to 120% and the setting time could be controlled within 24 h. At 60% of the ggbs proportion, the setting time could be held for 8 h. The compressive strength of each proportion reached 7 MPa at 7 days and 14 MPa at 28 days. The water-cured specimens exhibited better strength behavior than the air-cured specimens. Scanning electron microscopy found the main components of strength growth of the specimens to be hydrated reactants of C-A-S-H or ettringite. The results of the XRF analysis show that the specimens responded to higher compressive strengths as the Ca/Si and Ca/Al ratios increased.

The waste gypsum used in this study was a by-product of petroleum coke burning by petrochemical companies which has been treated with hydration. The waste gypsum has been stored in the atmosphere for over ten years and can be considered an inert filler. Its main chemical components were calcium sulfate dihydrate (47.90%), calcium hydroxide (21.64%) and calcium carbonate (14.80%). In this study, Portland cement and fly ash were used as cementitious materials, and waste gypsum of the particle size from 9.53 mm to 0.149 mm was selected as the fine aggregate to produce a controlled low-strength material (CLSM) and to verify the suitability of reusing waste gypsum. The water to binder ratio of 0.65 was used for the specimen. The test results showed that the CLSM specimen with a high amount of waste gypsum had air-hardening properties. The placement of the specimen in water caused abnormalities, such as cracking and disintegration of the specimens. The compressive strength of atmospherically maintained specimens increased with age, with 4.71 MPa and 6.08 MPa at 28 and 56 days, respectively. No significant changes in weight or volume were measured after the specimens had been left for 56 days and then immersed in seawater and water for 28 days. As specimens were immersed in seawater for up to 100 days, needle-shaped ettringite and C-S-H colloids filled the interface between the pores and the colloids. In accordance with the concept of eco-engineering, special consideration should be given to avoid long-term contact with water and to ensure the safety and durability of waste gypsum reuse through the design of multiple protective layers.

Objective: The purpose of this study was to examine the influence of access to care on the uptake of low-dose computed tomography (LDCT) lung cancer screening among a diverse sample of screening-eligible patients.Methods: We utilized a cross-sectional study design. Our sample included patients evaluated for lung cancer screening at a large academic medical center (AMC) between 2015 and 2017 who met 2013 USPSTF guidelines for LDCT screening eligibility. The completion of LDCT screening (yes, no) was the primary dependent variable. The independent variable was access to care (insurance type, living within the AMC service area). We utilized binary logistic regression analyses to examine the influence of access to care on screening completion after adjusting for demographic factors (age, sex, race) and smoking history (current smoking status, smoking pack-year history).Results: A total of 1,355 individuals met LDCT eligibility criteria, and of those, 29.8% (n = 404) completed screening. Regression analysis results showed individuals with Medicaid insurance (OR, 1.51; 95% CI, 1.03-2.22), individuals living within the AMC service area (OR, 1.71; 95% CI, 1.21–2.40), and those aged 65–74 years (OR, 1.49; 95% CI, 1.12–1.98) had higher odds of receiving LDCT lung cancer screening. Lower odds of screening were associated with having Medicare insurance (OR, 0.30; 95% CI, 0.22–0.41) and out-of-pocket (OR, 0.27; 95% CI, 0.15–0.47).Conclusion: Access to care was independently associated with lowered screening rates. Study results are consistent with prior research identifying the importance of access factors on uptake of cancer early detection screening behaviors.

Objective(s): The aim of this study was to conduct a meta-analysis to assess the clinical safety of ceftolozane-tazobactam for the treatment of acute bacterial infections in adult patients. Methods: The PubMed, Embase, and Cochrane databases were searched from their inception until May 2020 for relevant randomized controlled trials (RCTs). Only RCTs evaluating the risk of adverse events (AEs) for ceftolozane-tazobactam and comparative treatments for acute bacterial infections in adult patients were included. Results: Overall, four RCTs including a total of 2924 patients (1475 in the ceftolozane-tazobactam group and 1449 in the control group) were included in the meta-analysis. The rate of treatment-emergent AEs was 51.3% (748/1458) in the ceftolozane-tazobactam group, which was comparable to the control group, 49.9% [714/1430; odd’s ratio (OR), 1.06; 95% confidence interval (CI), 0.91–1.25; I 2 = 0%]. In addition, no difference was observed between the ceftolozane-tazobactam and control groups in terms of the risk of serious AEs (OR, 1.22; 95% CI, 0.93–1.61; I 2 = 15.5%) and the risk of discontinuing the study drug due to AEs (OR, 0.85; 95% CI, 0.55–1.33; I 2 = 0%). The rate of all-cause mortality did not significantly differ between the ceftolozane-tazobactam and control groups (OR, 1.11; 95% CI, 0.82–1.50; I 2 = 0%). The only exception was the risk of Clostridiodes difficile ( C. difficile ) colitis, where ceftolozane-tazobactam treatment was associated with a significantly higher risk compared with the control group [0.72% (10/1376) versus 0.14% (2/1391), OR, 3.84; 95% CI, 1.23–11.97; I 2 = 0%]. Conclusion: Ceftolozane-tazobactam treatment is as tolerable as comparative treatment options for acute bacterial infections in adult patients, however it has an increased risk of C. difficile infection. As a novel broad-spectrum antibiotic, ceftolozane-tazobactam could be a safe therapeutic option for use in common clinical practice. Plain language summary The safety of ceftolozane-tazobactam (an antibiotics) for the treatment of acute bacterial infections Objective(s): Ceftolozane-tazobactam is an effective antibiotic for the treatment of acute bacterial infections. This study conducts a meta-analysis to assess the clinical safety (side effects) of ceftolozane-tazobactam for the treatment of acute bacterial infections in adult patients compared with other drugs. Methods: We extracted data from four randomized controlled trials, including a total of 2924 patients (1475 in the ceftolozane-tazobactam group and 1449 in the control group). Results: The rate of treatment related adverse events (AEs) was similar in the ceftolozane-tazobactam group (51.3%) and control group (49.9%). There was also no difference in risk of serious adverse events, the risk of discontinuing the study drug due to AEs, and all-cause mortality. The only exception was the risk of Clostridiodes difficile colitis (a cause of antibiotic-associated diarrhea), where ceftolozane-tazobactam treatment was associated with a significantly higher risk compared with the control group. Conclusion: In conclusion, as a novel broad-spectrum antibiotic, ceftolozane-tazobactam could be a safe therapeutic option for use in clinical practice.

Abstract Background Circulating tumor cells (CTCs) comprise the high metastatic potential population of cancer cells in the blood circulation of humans; they have become the established biomarkers for cancer diagnosis, individualized cancer therapy, and cancer development. Technologies for the isolation and recovery of CTCs can be powerful cancer diagnostic tools for liquid biopsies, allowing the identification of malignancies and guiding cancer treatments for precision medicine. Methods We have used an electrospinning process to prepare poly(lactic-co-glycolic acid) (PLGA) nanofibrous arrays in random or aligned orientations on glass slips. We then fabricated poly(methyl methacrylate) (PMMA)-based microfluidic chips embedding the PLGA nanofiber arrays and modified their surfaces through sequential coating with using biotin–(PEG)7–amine through EDC/NHS activation, streptavidin (SA), and biotinylated epithelial-cell adhesion-molecule antibody (biotin-anti-EpCAM) to achieve highly efficient CTC capture. When combined with an air foam technology that induced a high shear stress and, thereby, nondestructive release of the captured cells from the PLGA surfaces, the proposed device system operated with a high cell recovery rate. Results The morphologies and average diameters of the electrospun PLGA nanofibers were characterized using scanning electron microscopy (SEM) and confocal Raman imaging. The surface chemistry of the PLGA nanofibers conjugated with the biotin–(PEG)7–amine was confirmed through time-of-flight secondary ion mass spectrometry (ToF–SIMS) imaging. The chip system was studied for the effects of the surface modification density of biotin–(PEG)7–amine, the flow rates, and the diameters of the PLGA nanofibers on the capture efficiency of EpCAM-positive HCT116 cells from the spiked liquid samples. To assess their CTC capture efficiencies in whole blood samples, the aligned and random PLGA nanofiber arrays were tested for their abilities to capture HCT116 cells, providing cancer cell capture efficiencies of 66 and 80%, respectively. With the continuous injection of air foam into the microfluidic devices, the cell release efficiency on the aligned PLGA fibers was 74% (recovery rate: 49%), while it was 90% (recovery rate: 73%) on the random PLGA fibers, from tests of 200 spiked cells in 2 mL of whole blood from healthy individuals. Our study suggests that integrated PMMA microfluidic chips embedding random PLGA nanofiber arrays may be suitable devices for the efficient capture and recovery of CTCs from whole blood samples.

An online parameter estimation methodology using the d-axis current injection, which can estimate the distorted voltage of the current-controlled voltage source inverter (CCVSI), the varying dq-axis inductances, and the rotor flux, is proposed in this study for interior permanent magnet synchronous motor (IPMSM) drives in the constant torque region. First, a d-axis current injection-based parameter estimation methodology considering the nonlinearity of a CCVSI is proposed. Then, during current injection, a simple linear model is developed to model the cross- and self-saturation of the dq-axis inductances. Since the d-axis unsaturated inductance is difficult to obtain by merely using the recursive least square (RLS) method, a novel tuning method for the d-axis unsaturated inductance is proposed by using the theory of the maximum torque per ampere (MTPA) with the combination of the RLS method. Moreover, to improve the bandwidth of the current loop, an intelligent proportional-integral-derivative (PID) neural network controller with improved online learning algorithm is adopted to replace the traditional PI controller. The estimated the dq-axis inductances and the rotor flux are adopted in the decoupled control of the current loops. Finally, the experimental results at various operating conditions of the IPMSM in the constant torque region are given.

From the environmental perspective, wooden structures are favorable insulators that are suitable for carbon fixation and wooden-related products are considered the most sustainable material. Research has indicated that wooden structures have superior energy-saving performance compared to reinforced concrete (RC) structures. In this study, a CLT-based hybrid structure system that potentially improves the efficiency of energy consumption is proposed. The proposed hybrid structure system, which preserved original RC beams, columns and replaced CLT floors and walls, has less building weight compared to the original RC building. Additionally, less energy required for the manufacturing of building materials in the renovation of the aged building is achieved, compared to building a new CLT building. The energy consumptions for buildings with heights of 10 stories were compared. CLT and RC were selected as benchmark building materials to compare the energy-saving efficiencies with the proposed hybrid structure system. In addition, to examine the energy consumption differences at different latitudes, the energy consumptions in Taipei, Tokyo, Harbin, and Singapore were compared as well. The simulation results indicate the proposed hybrid structure system, which comprises RC beams and columns and CLT floors and walls, and has an energy-saving efficiency close to that of a CLT structure, by approximately 3–5% higher, however, had a superior energy consumption performance to the RC structure. In general, the proposed hybrid structure system can be effectively used for old building renewal in the selected Asian cities.

In this paper, we improve the state-of-the-art ECAPA-TDNN model for speaker verification with CNN stem, self-calibration (SC) block, and deep layer aggregation. The proposed architecture is called Emphasized Channel Attention Propagation and Deep Layer Aggregation with Pre-activated CNN Stem in Time Delay Neural Network, which is abbreviated as ECAPDLA CNNv2-TDNN. First, we add a pre-activated stemming convolution layer in front of the main ECAPA-TDNN architecture. This ensures that the input to our main model architecture is a stable feature representation. Next, we change the multi-layer aggregation of ECAPA-TDNN to deep layer aggregation and replace the SE-Res2block in ECAPA-TDNN with SC block. Thus, the proposed implementation enhances feature extraction on multiple time scales and spectral channels and improves the overall training efficacy. On the VoxCelebl-O dataset, the proposed model achieves an equal error rate (EER) of 0.95%. This is significantly better than the EER of 1.23% achieved by the ECAPA-TDNN baseline. [ABSTRACT FROM AUTHOR]

We designed and manufactured a pneumatic-driven robotic passive gait training system (PRPGTS), providing the functions of body-weight support, postural support, and gait orthosis for patients who suffer from weakened lower limbs. The PRPGTS was designed as a soft-joint gait training rehabilitation system. The soft joints provide passive safety for patients. The PRPGTS features three subsystems: a pneumatic body weight support system, a pneumatic postural support system, and a pneumatic gait orthosis system. The dynamic behavior of these three subsystems are all involved in the PRPGTS, causing an extremely complicated dynamic behavior; therefore, this paper applies five individual interval type-2 fuzzy sliding controllers (IT2FSC) to compensate for the system uncertainties and disturbances in the PRGTS. The IT2FSCs can provide accurate and correct positional trajectories under passive safety protection. The feasibility of weight reduction and gait training with the PRPGTS using the IT2FSCs is demonstrated with a healthy person, and the experimental results show that the PRPGTS is stable and provides a high-trajectory tracking performance.

Background/Purpose: To investigate the clinical manifestations and bacteriological features of culture-proven, Gram-negative bacterial arthritis. Methods: This study was conducted at the Chi Mei Medical Center, a 1300-bed teaching hospital located in southern Taiwan. Patients with synovial fluid cultures positive for Gram-negative bacilli (GNB) during the period January 2009 to May 2014 were identified from the hospital's computerized microbiology database. Results: During the study period, a total of 48 patients with culture-confirmed, GNB septic arthritis were identified. In the majority of patients (n = 33, 68.8%), the knee was the most commonly involved joint. The most common causative pathogen was Pseudomonas spp. (n = 16, 33.3%), followed by Escherichia coli (n = 13, 28.1%). Among the 29 clinical isolates of Enterobacteriaceae, eight (27.6%) were resistant to ceftriaxone and six (20.7%) were resistant to cefpirome. Three E. coli isolates and three Klebsiella pneumoniae isolates were extended-spectrum beta-lactamase producers (n = 6, 20.7%). Among the nonfermenting GNB (NFGNB), 21.1% were resistant to ceftazidime, 21.1% were resistant to ciprofloxacin, 26.3% were resistant to piperacillin-tazobactam, and 15.8% were resistant to imipenem. The overall mortality rate was 10.4%, and the significant risk factors for death were concomitant bacteremia [odds ratio (OR): 14.6, 95% confidence interval (CI): 1.9–115.2, p = 0.011] and liver cirrhosis (OR: 20.0, 95% CI: 2.4–169.9, p = 0.006). Conclusion: Approximately 25% of cases of septic arthritis were due to GNB and resistance to commonly used antimicrobial agents was common. Liver cirrhosis and concomitant bacteremia were significant risk factors for death.

In this study, ultra-fine spherical particles of silica fume and reactive ultra-fine fly ash were added to a mixture of commercial ultra-high-performance grout (UHPG) with the aim of enhancing the rheological properties, compressive strength, compactness, and permeability. This commercial UHPG study was conducted in collaboration with Triaxis Corporation (Changsha city, Hunan province, China). A water-to-binder ratio of 0.21 and a binder-to-fine aggregates ratio of 1.17 were used as fixed parameters, and the binders were a combination of type-II Portland cement, sulphoaluminate cement, silica fume, and reactive ultra-fine fly ash (RUFA). Polycarboxylate superplasticizer powder was used to control the rheology. The results revealed excellent compressive strength, volume stability, and resistance to chloride penetration. Mercury intrusion porosimetry and scanning electron microscopy tests revealed that the medium-sized RUFA particles with small silica fume particles completely filled the spaces between large cement particles to achieve optimal densification. This mixture also produced dense hydration and calcium-silicate-hydrates colloids, which filled the microstructures of the UHPG resulting in excellent engineering properties and durability. This commercially available UHPG mix responded to excellent compressive strengths approaching 120 MPa and exhibited good workability with a loss of slump-flow rate up to 33% after 60 min. It also exhibited very low abrasion resistance (0.5%), stable shrinkage and expansion rates (stabilization over 10 days), very low chloride diffusion coefficient (less than 0.1 × 10−14 m2/s) with a denser microstructure. This commercial UHPG (UHPG-120) has been developed to meet the needs of the market.

In this study, ultrasound was used to accelerate two-stage (esterification–transesterification) catalytic synthesis of biodiesel from used cooking oil, which originally had a high acid value (4.35 mg KOH/g). In the first stage, acid-catalyzed esterification reaction conditions were developed with a 9:1 methanol/oil molar ratio, sulfuric acid dosage at 2 wt %, and a reaction temperature of 60 °C. Under ultrasound irradiation for 40 min, the acid value was effectively decreased from 4.35 to 1.67 mg KOH/g, which was decreased to a sufficient level (

Previously, we successfully identified oral cancer stem cells (OCSC) displaying enhanced stemness and tumorigenic potentials. In the study, we investigated the chemotherapeutic effect of the flavonoid luteolin, commonly found in fruits and vegetables, on targeting OCSC. Methods: Oralspheres was applied to isolate OCSC. aldehyde dehydrogenase 1 activity and CD44 positivity of OCSC with luteolin treatment were assessed by flow cytometry analysis. Radio-sensitivity of OCSC treated with luteolin was examined. Invasion and colony-forming assays were performed to assess oncogenicity in OCSC. The expression of interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (STAT3) was examined by enzyme-linked immunosorbent assay and western blot analysis. Results: We showed that luteolin effectively inhibited the proliferation rate, self-renewal, aldehyde dehydrogenase 1 activity, and CD44 positivity of OCSC but did not cause significant cytotoxicity of normal epithelial cells. Moreover, luteolin restored radio-sensitivity in OCSC. Combined treatment with luteolin and radiation displayed synergistic effect on invasiveness and clonogenicity of OCSC. Mechanistically, treatment of luteolin resulted in inactivation of IL-6/STAT3 signaling. Conclusion: These results suggest that combined treatment of luteolin and radiation therapy can attenuate tumorigenicity of OCSC through IL-6/STAT3 signaling inactivation.

An interior permanent magnet synchronous motor (IPMSM) drive system with machine learning-based maximum torque per ampere (MTPA) as well as flux-weakening (FW) control was developed and is presented in this study. Since the control performance of IPMSM varies significantly due to the temperature variation and magnetic saturation, a machine learning-based MTPA control using a Petri probabilistic fuzzy neural network with an asymmetric membership function (PPFNN-AMF) was developed. First, the d-axis current command, which can achieve the MTPA control of the IPMSM, is derived. Then, the difference value of the dq-axis inductance of the IPMSM is obtained by the PPFNN-AMF and substituted into the d-axis current command of the MTPA to alleviate the saturation effect in the constant torque region. Moreover, a voltage control loop, which can limit the inverter output voltage to the maximum output voltage of the inverter at high-speed, is designed for the FW control in the constant power region. In addition, an adaptive complementary sliding mode (ACSM) speed controller is developed to improve the transient response of the speed control. Finally, some experimental results are given to demonstrate the validity of the proposed high-performance control strategies.

Calcium ions and phosphate ions are usually present in biological organisms and human bodies. Different ratios of calcium to phosphorus result in different types of calcium-to-phosphorus crystals. Hydroxyapatite (HA) is the main component of human hard bony tissues. It has good biocompatibility and is often used in bone repair. With the addition of cobalt ions, it can act as a hypoxia-inducing factor to accelerate the regeneration of hard bony tissues. At present, the laser-assisted biomimetic (LAB) method can very quickly deposit calcium phosphate coatings, which can be used on polymer and titanium surfaces. In this study, we first used anodization treatment (with TiO2 nanotubes (TNTs)), alkali treatment (with NaOH), and acid treatment (with HCl) to form nanopore structures on titanium surfaces in the laboratory. Subsequently, LAB treatment was used to deposit calcium phosphate and cobalt-substituted hydroxyapatite onto titanium pieces with different surface treatments. The results showed that smaller holes resulted in better deposition (TNTs), and controlling the pH value in the solution changed the crystal morphology. LAB treatment imbued the titanium surface with super-hydrophilic properties and improved biocompatibility. A human osteoblast cell line (MG-63) used for the cell viability test showed that LAB treatment can improve cell growth. In particular, TNT-CoHA (cobalt-substituted hydroxyapatite) cells grew the best. Immersion in simulated bodily fluid confirmed that LAB treatment with a CoHA solution improved the hydrophilicity, biocompatibility, and bioactivity of titanium surfaces. It is hoped that this study provides useful information for surface coating of biomedical materials in the future.