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Religion has become an increasingly pronounced force in American politics, most notably among White evangelicals, nearly two-thirds of whom identify with Christian nationalism. This group contends that conservative, biblically rooted Christian values should determine the social and cultural landscape of our society and seeks to pass laws that help actualize this goal. This article explores the fundamental beliefs that enable White evangelicalism’s compatibility with Christian nationalism. More specifically, it considers how the myth of America’s Christian origins prompts a yearning for Christendom that—when coupled with a theological shift from a strict non-interventionist two kingdoms doctrine to a more fluid conception of kingdoms and laws—allows White evangelicals to cordon off Jesus’s life and teachings from their political activities. This relegation of Jesus to the Christian’s spiritual life enables White evangelicals to pursue a Christian ordering of society that is estranged from the person of Christ.

Assessing sleep posture, a critical component in sleep tests, is crucial for understanding an individual’s sleep quality and identifying potential sleep disorders. However, monitoring sleep posture has traditionally posed significant challenges due to factors such as low light conditions and obstructions like blankets. The use of radar technolsogy could be a potential solution. The objective of this study is to identify the optimal quantity and placement of radar sensors to achieve accurate sleep posture estimation. We invited 70 participants to assume nine different sleep postures under blankets of varying thicknesses. This was conducted in a setting equipped with a baseline of eight radars—three positioned at the headboard and five along the side. We proposed a novel technique for generating radar maps, Spatial Radio Echo Map (SREM), designed specifically for data fusion across multiple radars. Sleep posture estimation was conducted using a Multiview Convolutional Neural Network (MVCNN), which serves as the overarching framework for the comparative evaluation of various deep feature extractors, including ResNet-50, EfficientNet-50, DenseNet-121, PHResNet-50, Attention-50, and Swin Transformer. Among these, DenseNet-121 achieved the highest accuracy, scoring 0.534 and 0.804 for nine-class coarse- and four-class fine-grained classification, respectively. This led to further analysis on the optimal ensemble of radars. For the radars positioned at the head, a single left-located radar proved both essential and sufficient, achieving an accuracy of 0.809. When only one central head radar was used, omitting the central side radar and retaining only the three upper-body radars resulted in accuracies of 0.779 and 0.753, respectively. This study established the foundation for determining the optimal sensor configuration in this application, while also exploring the trade-offs between accuracy and the use of fewer sensors.

This paper aims to uncover a hidden history of Cantonese Christian literature. Written Cantonese has been present since the late Ming dynasty in parallel to the emergence of a distinct Cantonese identity. Western missionaries, for the sake of evangelism, facilitated the development of written Cantonese in South China since the mid-nineteenth century. At that time, missionaries put a lot of effort into translating religious leaflets and booklets, the Bible, the book of prayers, and even Cantonese–English dictionaries. These works contributed to standardizing written Cantonese and indirectly helped to develop Cantonese identity. I will critically examine how Cantonese Christian literature declined for the sake of nationalism, as the first publication of Heheben 和合本 (Mandarin Union Version) in Protestant Christianity in 1919 represented the unification of the Church by using written Mandarin. After elaborating on the unintentional alliance of missionaries with Cantonese in the nineteenth century, in conclusion, I will make a brief comparison of Hong Kong Church in the twentieth and twenty-first centuries, which is inactive in the continuous written Cantonese movement in Hong Kong.

The Asian clam Corbicula fluminea is a native aquatic species in Eastern Asia and Africa but has become one of the ecologically and economically harmful invasive species in aquatic ecosystems in Europe, North America, and South America. Due to their natural characteristics as a hermaphroditic species with a high fecundity and dispersal capacity, Asian clams are extremely difficult to eradicate once they have infiltrated a waterbody. This is an emerging issue for states in the Northeastern United States, as Asian clams expand their range farther North due to climate change. There has been extensive research conducted to develop chemical treatments for reactively controlling invasive mollusc populations and proactively preventing their further spread. However, treatments are mostly targeted toward biofouling bivalves in industrial settings. A comprehensive review of Asian clam chemical treatments used in natural open-water systems was performed to evaluate molluscicides and identify the toxicity ranges of emerging treatments that maximize Asian clam mortality and minimize the negative impact on water quality and non-target species. The potential chemical applications in Asian clam control and management are summarized in this report to assist resource managers and practitioners in invasive Asian clam management.

A special vibration damper is proposed for Young’s modulus and hardness identification through a scratching process on extruded aluminum. This paper presents the design and working principle of a scratching damper based on a scratching device. A non-contact electromagnetic shaker is used to generate the shaking force for test sample vibration. The required forces on the scratched material during the scratching process are generated by an adjustable compression spring. The proposed damper is designed and tested on an extruded aluminum 3004 sample for the determination of its Young’s modulus and hardness, and validation is performed using the standard test instruments. The physical dimensions of the scratching tracks are measured using a microscope and utilized to compute the scratching energy factor. Load curves are obtained at different divisions of the scratching process. The loop energy during the scratching process of the tested object is measured and used for the determination of sample material properties. Furthermore, the energy conservation law, scratch energy release rate of semi-conical scratch head, and loop energy release rate are established to determine the Young’s modulus and hardness of the sample. Their estimation accuracies are evaluated. The proposed method has several advantages over the traditional methods, including low cost, directness, and high repeatability. The results suggest this to be used as an alternative to the standard modulus and hardness tester.

Find AGA's NASH Clinical Care Pathway App for iOS and Android mobile devices at nash.gastro.org. Scan this QR code to be taken directly to the website.Nonalcoholic fatty liver disease (NAFLD) is becoming increasingly common, currently affecting approximately 37% of US adults. NAFLD is most often managed in primary care or endocrine clinics, where clinicians must determine which patients might benefit from secondary care to address hepatic manifestations, comorbid metabolic traits, and cardiovascular risks of the disease. Because NAFLD is largely asymptomatic, and because optimal timing of treatment depends on accurate staging of fibrosis risk, screening at the primary care level is critical, together with consistent, timely, evidence-based, widely accessible, and testable management processes. To achieve these goals, the American Gastroenterological Association assembled a multidisciplinary panel of experts to develop a Clinical Care Pathway providing explicit guidance on the screening, diagnosis, and treatment of NAFLD. This article describes the NAFLD Clinical Care Pathway they developed and provides a rationale supporting proposed steps to assist clinicians in diagnosing and managing NAFLD with clinically significant fibrosis (stage F2-F4) based on the best available evidence. This Pathway is intended to be applicable in any setting where care for patients with NAFLD is provided, including primary care, endocrine, obesity medicine, and gastroenterology practices.

Background & aimsIncreased de novo lipogenesis creates excess intrahepatic fat and lipotoxins, propagating liver damage in nonalcoholic steatohepatitis. TVB-2640, a fatty acid synthase inhibitor, was designed to reduce excess liver fat and directly inhibit inflammatory and fibrogenic pathways. We assessed the safety and efficacy of TVB-2640 in patients with nonalcoholic steatohepatitis in the United States.Methods3V2640-CLIN-005 (FASCINATE-1) was a randomized, placebo-controlled, single-blind study at 10 US sites. Adults with ≥8% liver fat, assessed by magnetic resonance imaging proton density fat fraction, and evidence of liver fibrosis by magnetic resonance elastography ≥2.5 kPa or liver biopsy were eligible. Ninety-nine patients were randomized to receive placebo or 25 mg or 50 mg of TVB-2640 (orally, once-daily for 12 weeks). The primary end points of this study were safety and relative change in liver fat after treatment.ResultsLiver fat increased in the placebo cohort by 4.5% relative to baseline; in contrast TVB-2640 reduced liver fat by 9.6% in the 25-mg cohort (n = 30; least squares mean: -15.5%; 95% confidence interval, -31.3 to -0.23; P = .053), and 28.1% in the 50-mg cohort (n = 28; least squares mean: -28.0%; 95% confidence interval, -44.5 to -11.6; P = .001). Eleven percent of patients in the placebo group achieved a ≥30% relative reduction of liver fat compared to 23% in the 25-mg group, and 61% in the 50-mg group (P < .001). Secondary analyses showed improvements of metabolic, pro-inflammatory and fibrotic markers. TVB-2640 was well tolerated; adverse events were mostly mild and balanced among the groups.ConclusionsTVB-2640 significantly reduced liver fat and improved biochemical, inflammatory, and fibrotic biomarkers after 12 weeks, in a dose-dependent manner in patients with nonalcoholic steatohepatitis. ClinicalTrials.gov, Number NCT03938246.

Background/Aims Chronic hepatitis B (CHB) and fatty liver (FL) often co-exist, but natural history data of this dual condition (CHB-FL) are sparse. Via a systematic review, conventional meta-analysis (MA) and individual patient-level data MA (IPDMA), we compared liver-related outcomes and mortality between CHB-FL and CHB-no FL patients. Methods We searched 4 databases from inception to December 2021 and pooled study-level estimates using a random-effects model for conventional MA. For IPDMA, we evaluated outcomes after balancing the two study groups with inverse probability treatment weighting (IPTW) on age, sex, cirrhosis, diabetes, ALT, HBeAg, HBV DNA, and antiviral treatment. Results We screened 2,157 articles and included 19 eligible studies (17,955 patients: 11,908 CHB-no FL; 6,047 CHB-FL) in conventional MA, which found severe heterogeneity (I2=88–95%) and no significant differences in HCC, cirrhosis, mortality, or HBsAg seroclearance incidence (P=0.27–0.93). IPDMA included 13,262 patients: 8,625 CHB-no FL and 4,637 CHB-FL patients who differed in several characteristics. The IPTW cohort included 6,955 CHB-no FL and 3,346 CHB-FL well-matched patients. CHB-FL patients (vs. CHB-no FL) had significantly lower HCC, cirrhosis, mortality and higher HBsAg seroclearance incidence (all P≤0.002), with consistent results in subgroups. CHB-FL diagnosed by liver biopsy had a higher 10-year cumulative HCC incidence than CHB-FL diagnosed with non-invasive methods (63.6% vs. 4.3%, P

Phantom limb is a disabling neuropsychiatric condition among amputees resulting in pain and disturbance that impact their functions, quality of life, and autonomy. While pharmacological approaches appeared to be ineffective, the emergence and integration of X-reality, including virtual reality, augmented reality, and mixed reality, might elevate the effectiveness of mirror therapy in managing phantom limb. The objective of this study is to review X-reality for managing phantom pain. A systematic search was conducted on PubMed, Scopus, Web of Science, PsycINFO, Embase, and CINAHL. Sixteen (n = 16) studies containing 66 lower-limb and 53 upper-limb amputees were included for the review over the thematic framework of amputee characteristics and intervention designs, while thirteen (n = 13) studies were further proceeded for the meta-analysis. We found eleven studies on virtual reality (n = 11), four studies on marker-based augmented reality (n = 4) and one study on mixed reality (n = 1) with a total of 40 game/task themes involving, motor skills, motor control, and stimulus-sensing. Regardless, all these interventions adopted the movement representation strategies with different techniques. Overall, the X-reality interventions reduced the pain level of the amputees (mean difference: -2.30, 95% CI, -3.38 to -1.22), especially the virtual reality subgroup (mean difference: -2.83, 95% CI, -4.43 to -1.22). However, there were substantial heterogeneity and partially explained by the subgroup analysis on publication year. The strength of evidence was limited by case reports and case series in this review.

Stroke rehabilitation, which demands consistent, intensive, and adaptable intervention in the long term, faced significant challenges due to the COVID-19 pandemic. During this time, telerehabilitation emerged as a noteworthy complement to traditional rehabilitation services, offering the convenience of at-home care delivery and overcoming geographical and resource limitations. Self-help rehabilitation robots deliver repetitive and intensive physical assistance, thereby alleviating the labor burden. However, robots have rarely demonstrated long-term readiness for poststroke telerehabilitation services. The transition from research trials to general clinical services presents several challenges that may undermine the rehabilitative gains observed in these studies. This perspective discusses the technological readiness of personal use robots in the context of telerehabilitation and identifies the potential challenges for their clinical translation. The goal is to leverage technology to seamlessly integrate it into standard clinical workflows, ultimately enhancing the outcomes of stroke rehabilitation.

The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventy-four percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms “nonalcoholic” and “fatty” were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction–associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction–associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction–associated steatotic liver disease, who consume greater amounts of alcohol per week (140–350 g/wk and 210–420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification.

Background: Early post-operative medial tibial bone loss in both unicompartmental knee replacement and total knee replacement has been reported in our previous studies and many other studies. Significant bone loss can contribute to a tibial stress fracture, bone pain and early implant failure. The bone loss appeared to be greater in total knee replacement. Therefore, the aim of the study is to look for any significant difference in medial tibial bone loss in both unicompartmental knee replacement and total knee replacement in the first 3 years and to investigate the underlying pathophysiology. Methods: Cases of fixed-bearing unicompartmental knee replacement and posterior stabilising total knee replacement performed in 2015–2016 were recruited. The change in medial tibial bone loss (expressed in grayscale Gy) over a three-year post-operative period was measured using the method of digital radiological densitometry. Potential predictors and correlations were analysed. Results: Forty-four cases of unicompartmental knee replacement and 52 cases of total knee replacement were recruited. The cumulative drop in 3 years was 23.3% in unicompartmental knee replacement and 33.7% in total knee replacement, respectively, a difference of up to 10%. The cumulative drop between the two groups at 12 months ( p < 0.05) and 36 months ( p < 0.05), respectively, were significantly different. Angle correction has not been shown to affect medial tibial bone loss in this study. No surgical complication was documented during the follow-up period. Conclusion: Total knee replacement results in 10% greater medial tibial bone loss than unicompartmental knee replacement at the three-year time. The effect is greatest in the first year. In addition to possible stress shielding, early physiological bone remodelling in response to surgical trauma can contribute to the difference in medial tibial bone loss of unicompartmental knee replacement and total knee replacement. This is supported by the insignificant correlation between angle correction and medial tibial bone loss in the result.

Summary: Background: Currently, assessment of candidate pharmacotherapies in patients with non-alcoholic steatohepatitis (NASH) involves invasive liver biopsy. Non-invasive scores, such as the FibroScan-aspartate aminotransferase (FAST) score, are used to identify candidates for therapy, but their ability to assess disease progression or treatment effect is unknown. We aimed to assess the association between FAST score and histological endpoints. Methods: We conducted a post-hoc analysis using data from a prior randomised, double-blind, placebo-controlled, phase 2b trial at 143 sites across 16 countries. Patients (aged 18–75 years) with biopsy-confirmed NASH, fibrosis stage 1–3, and a Non-alcoholic fatty liver disease Activity Score (NAS) ≥4 were enrolled between January 2017 and September 2018, and randomly assigned to receive once-daily subcutaneous semaglutide 0.1, 0.2, or 0.4 mg or placebo for 72 weeks. A subgroup analysis of patients with FAST score and histological data in the pooled semaglutide treatment and placebo arms at baseline and week 72 was performed. The original trial is registered at ClinicalTrials.gov, NCT02970942. Findings: A total of 122 patients were included in this post-hoc analysis (93 received semaglutide and 29 received placebo). FAST score reduction was associated with achieving the primary endpoint of NASH resolution without worsening of fibrosis in the pooled semaglutide group (area under the receiver operating curve 0.69; 95% confidence interval [CI] 0.58, 0.81). Mean FAST score reduction from baseline to week 72 was greatest in patients who met the primary endpoint vs those who did not in both the semaglutide (−0.40 [95% CI –0.84, 0.04] vs −0.22 [95% CI –0.74, 0.30] points; p = 0.002) and placebo groups (−0.25 [95% CI –0.72, 0.23] vs 0.00 [95% CI –0.50, 0.50] points; p = 0.047). Similarly, mean reductions in FAST score at week 72 were greater in those with NAS improvement vs those without in the semaglutide and placebo groups (≥1 point, −0.36 [95% CI –0.82, 0.11] vs −0.08 [95% CI –0.53, 0.38] points [p

Abstract Urinary incontinence is one of the common clinical problems of females passing middle age. Traditional pelvic floor muscle training to alleviate urinary incontinence is too dull and unpleasant. Therefore, we were motivated to purpose a modified lumbo-pelvic exercise training incorporating simplified dancing components with pelvic floor muscle training. The objective of this study was to evaluate the 16-week modified lumbo-pelvic exercise program that incorporated dance and abdominal drawing-in maneuvers. Middle-aged females were randomly assigned into the experimental (n = 13) and control (n = 11) groups. Compared to the control group, the exercise group significantly reduced body fat, visceral fat index, waistline, waist-hip ratio, perceived incontinence score, frequency of urine leakage, and pad testing index (p

Abstract Background Many deep-sea invertebrates largely depend on chemoautotrophic symbionts for energy and nutrition, and some of them have reduced functional digestive tracts. By contrast, deep-sea mussels have a complete digestive system although symbionts in their gills play vital roles in nutrient supply. This digestive system remains functional and can utilise available resources, but the roles and associations among gut microbiomes in these mussels remain unknown. Specifically, how the gut microbiome reacts to environmental change is unclear. Results The meta-pathway analysis showed the nutritional and metabolic roles of the deep-sea mussel gut microbiome. Comparative analyses of the gut microbiomes of original and transplanted mussels subjected to environmental change revealed shifts in bacterial communities. Gammaproteobacteria were enriched, whereas Bacteroidetes were slightly depleted. The functional response for the shifted communities was attributed to the acquisition of carbon sources and adjusting the utilisation of ammonia and sulphide. Self-protection was observed after transplantation. Conclusion This study provides the first metagenomic insights into the community structure and function of the gut microbiome in deep-sea chemosymbiotic mussels and their critical mechanisms for adapting to changing environments and meeting of essential nutrient demand.

Optical coherence tomography (OCT) is widely used to probe retinal structure and function. This study investigated the outer retina band (ORB) pattern and reflective intensity for the region between bands 2 and 3 (Dip) in three mouse models of inherited retinal degeneration (Rs1KO, TTLL5KO, RPE65KO) and in human AMD patients from the A2A database. OCT images were manually graded, and reflectivity signals were used to calculate the Dip ratio. Qualitative analyses demonstrated the progressive merging band 2 and band 3 in all three mouse models, leading to a reduction in the Dip ratio compared to wildtype (WT) controls. Gene replacement therapy in Rs1KO mice reverted the ORB pattern to one resembling WT and increased the Dip ratio. The degree of anatomical rescue in these mice was highly correlated with level of transgenic RS1 expression and with the restoration of ERG b-wave amplitudes. While the inner retinal cavity was significantly enlarged in dark-adapted Rs1KO mice, the Dip ratio was not altered. A reduction of the Dip ratio was also detected in AMD patients compared with healthy controls and was also positively correlated with AMD severity on the AMD score. We propose that the ORB and Dip ratio can be used as non-invasive early biomarkers for retina health, which can be used to probe therapeutic gene expression and to evaluate the effectiveness of therapy.

Abstract Tetraphenylethylene (TPE)‐conjugated porphyrin TPE‐ZnPF is synthesized in high yield and characterized by single‐crystal X‐ray diffraction. The propeller‐shaped TPE groups not only enable exceptional aggregation‐induced emission (AIE) in the solid state but also abolish the strong π‐π stacking of porphyrin moieties and thus prohibit aggregation‐caused quenching (ACQ). TPE‐ZnPF aggregates feature long‐lived photoexcited states, which subsequently suppress non‐radiative decay channels and enhance emission intensity. Moreover, its aggregates show more efficient light‐harvesting ability due to the Förster resonance energy transfer from the TPE energy donor to the porphyrin core energy acceptor, well‐defined nanosphere morphology, and more efficient photoinduced charge separation than the porphyrin Ph‐ZnPF, which possesses ACQ and agglomerated morphology. As a result, an excellent photocatalytic hydrogen evolution rate (ηH2) of 56.20 mmol g‒1 h‒1 is recorded for TPE‐ZnPF aggregates, which is 94‐fold higher than that of the aggregates of Ph‐ZnPF (0.60 mmol g‒1 h‒1) without the TPE groups.

Background & Aims: The latest Baveno VII consensus has provided guidance for identifying patients who have truly recompensated from those with hepatic decompensation. This study aimed to evaluate patients’ transplant-free survival in three different stages of cirrhosis. Methods: All patients with chronic HBV infection and liver cirrhosis treated with oral nucleos(t)ide analogues from March 2006 to December 2022 were identified from a territory-wide database in Hong Kong. Patients with follow-up duration of

Background & Aims: We aimed to evaluate the impact of oesophageal varices (OV) and their evolution on the risk of complications of compensated advanced chronic liver disease (cACLD) caused by non-alcoholic fatty liver disease (NAFLD). We also assessed the accuracy of non-invasive scores for predicting the development of complications and for identifying patients at low risk of high-risk OV. Methods: We performed a retrospective assessment of 629 patients with NAFLD-related cACLD who had baseline and follow-up oesophagogastroduodenoscopy and clinical follow-up to record decompensation, portal vein thrombosis (PVT), and hepatocellular carcinoma. Results: Small and large OV were observed at baseline in 30 and 15.9% of patients, respectively. The 4-year incidence of OV from absence at baseline, and that of progression from small to large OV were 16.3 and 22.4%, respectively. Diabetes and a ≥5% increase in BMI were associated with OV progression. Multivariate Cox regression revealed that small (hazard ratio [HR] 2.24, 95% CI 1.47–3.41) and large (HR 3.86, 95% CI 2.34–6.39) OV were independently associated with decompensation. When considering OV status and trajectories, small (HR 2.65, 95% CI 1.39–5.05) and large (HR 4.90, 95% CI 2.49–9.63) OV at baseline and/or follow-up were independently associated with decompensation compared with the absence of OV at baseline and/or follow-up. The presence of either small (HR 2.8, 95% CI 1.16–6.74) or large (HR 5.29, 95% CI 1.96–14.2) OV was also independently associated with incident PVT. Conclusion: In NAFLD-related cACLD, the presence, severity, and evolution of OV stratify the risk of developing decompensation and PVT. Impact and implications: Portal hypertension is the main driver of liver decompensation in chronic liver diseases, and its non-invasive markers can help risk prediction. The presence, severity, and progression of oesophageal varices stratify the risk of complications of non-alcoholic fatty liver disease. Easily obtainable laboratory values and liver stiffness measurement can identify patients at low risk for whom endoscopy may be withheld, and can also stratify the risk of liver-related complications.

Abstract. Background:. Liver biopsy for the diagnosis of non-alcoholic steatohepatitis (NASH) is limited by its inherent invasiveness and possible sampling errors. Some studies have shown that cytokeratin-18 (CK-18) concentrations may be useful in diagnosing NASH, but results across studies have been inconsistent. We aimed to identify the utility of CK-18 M30 concentrations as an alternative to liver biopsy for non-invasive identification of NASH. Methods:. Individual data were collected from 14 registry centers on patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD), and in all patients, circulating CK-18 M30 levels were measured. Individuals with a NAFLD activity score (NAS) ≥5 with a score of ≥1 for each of steatosis, ballooning, and lobular inflammation were diagnosed as having definite NASH; individuals with a NAS ≤2 and no fibrosis were diagnosed as having non-alcoholic fatty liver (NAFL). Results:. A total of 2571 participants were screened, and 1008 (153 with NAFL and 855 with NASH) were finally enrolled. Median CK-18 M30 levels were higher in patients with NASH than in those with NAFL (mean difference 177 U/L; standardized mean difference [SMD]: 0.87 [0.69–1.04]). There was an interaction between CK-18 M30 levels and serum alanine aminotransferase, body mass index (BMI), and hypertension (P

Abstract Background To investigate the impact of a serious illness communication skills training course on medical students’ attitudes regarding clinical empathy, self-efficacy in empathic communication, and learning on different dimensions of empathy. Methods A mixed-methods design was used. A blended learning Serious Illness Communication Skills Training (SI-CST) course was delivered to sixth-year medical students. Students (n=185) completed questionnaires with the 20-item Jefferson Scale of Empathy (JSE) and self-rated preparedness level for five empathic communication tasks at baseline (T1), six weeks (T2), and three-to-six months post-training (T3). Written reflections on key lessons learned were analyzed using inductive thematic analysis. Results Total JSE scores significantly improved from T1 to T2 (111.4 vs 113.9, P=.01) and from T1 to T3 (111.4 vs 113.9, P=.01). There was an increase in Standing in Patient’s Shoes subscale of the JSE with an effect size of 0.56 whereas the Perspective-Taking and Compassionate Care subscales showed no significant changes. Self-rated preparedness for all five empathic communication tasks significantly improved from T1 to T2 (P ≤ .001) and from T1 to T3 (P ≤ .001) with large effect sizes (1.09-1.41). Four key themes emerged from the qualitative analysis. They were appreciating the important role of empathy in clinical care (moral empathy), learning skills in detecting and understanding patient emotions (cognitive empathy), learning skills in responding to emotion with empathy (behavioral empathy), and appreciating that communication skills can be improved with continual practice and self-reflection. Conclusions Our results revealed that SI-CST improved medical students’ empathic attitudes and self-efficacy in empathic communication. Qualitative results found learning on the cognitive, behavioral and moral dimensions of empathy.

Abstract Purpose To investigate the geometric and dosimetric impacts of intra-fractional movement for patients with single or multiple brain metastasis treated using Varian Hyperarc™ mono-isocentric radiosurgery. Methods A total of 50 single or hypo-fractionated Hyperarc™ treatment courses (118 lesions) were included in the analysis. Intra-fractional translational and rotational movements were quantified according to the post-treatment cone-beam CT (CBCT). Geometric displacements of all targets were calculated individually based on the assessed head movement in each treatment fraction and their relationships with treatment time and target-to-isocenter distances were studied. For dosimetric analysis, only single-fraction treatments (56 lesions) were included. Re-planning was performed with 0, 1, and 2 mm planning target volume (PTV) margins. Doses were then re-calculated on rotated CT images with isocenter shifted which emulate the change in patient treatment position. Target coverage, target and normal brain doses before and after intra-fractional movement were compared. Results The mean 3D target displacements was 0.6 ± 0.3 (SD) mm. Target shifts for patients treated within 10 min were significantly smaller than those treated in longer sessions. No correlation was found between target shift and target-to-isocenter distance as the origin of head rotation was not located at the isocenter. Loss of target coverage and minimum Gross Tumor Volume (GTV) dose due to intra-fractional movement were apparent only when no margin was used, leading to an extra 23% of the targets violating the dose acceptance criteria, in contrast, the effects on normal brain V 12Gy were negligible regardless of the margin used. The use of 1 mm PTV margin can compensate clinically significant geographical miss caused by intra-fractional movements while limiting V 12Gy to within dose criteria for 88% of the cases. The plan acceptance rate (fulfillment of both target and normal brain dose criteria) after intra-fractional movement was also the highest with the 1 mm margin. Conclusion Although intra-fractional movements during Hyperarc™ treatments were small, there were substantial dosimetric effects due to the sharp dose fall-off near target boundaries. These effects could be mitigated by using a 1 mm PTV margin and maintaining the effective treatment time to within 10 min.

This paper proposed a voice control based smart home electrical appliances for visually impaired person. This voice control smart home system decreases the time taken for visually impaired person to control their home electrical appliances by giving specific voice command compared to traditional switch or remote control. Besides, the voice control smart home system also contained a mini speaker to provide a feedback audio and ensure the correct electrical applianceswere controlled. The implementation of this voice control smart home system provides a more convenient and efficient way for visually impaired person to control their electrical appliances.An experiment was conductedby 50 participantsto collect the data of the accuracy of the developed systemwithtesting 100 timesvoice commandsfor each participants. The participants achieved 96.74 times correctly on average, with the accuracy 96.74% onthis system.79.33% of the participants agree or strongly agree that would use this system in the future for controlling their home electrical appliances.

Summary: This study examined the influence of set-interval and repetition-interval rest time of virtual reality (VR) boxing game in supine-lying posture. Fifty healthy middle-aged adults were randomly assigned into VR and non-VR groups to perform six different exercise protocols with varying set-interval and repetition-interval rest times (S0R0, S0R1/3, S0R2/3, S40R0, S40R1/3, and S40R2/3). Analysis on the non-VR group showed significant differences between exercise protocols for average heart rate (p

Objective: To examine the feasibility and acceptability of a multi-modal intervention for managing the cancer-related fatigue–sleep disturbance–depressed mood (F-S-D) symptom cluster in patients with breast cancer (BC) and receiving chemotherapy in Hong Kong, and the preliminary effects of such intervention on the occurrence of the F-S-D symptom cluster in these patients. Methods: This study was a single-blind randomized controlled trial. Patients with BC scheduled for chemotherapy were recruited. Intervention participants received a weekly nurse-led multi-modal intervention lasting 7 weeks. The feasibility parameters and adverse events were assessed using logbook records. Acceptability was evaluated using a program evaluation questionnaire. F-S-D symptoms and quality of life (QOL) were measured at baseline (T0), upon intervention completion (T1), and 3 months after intervention completion (T2). Generalized estimating equation analyses were used. Results: Fifty participants were enrolled. The eligibility and enrollment rates were 11% and 87.7%, respectively. The rate of adherence to the intervention was 96%. No adverse events were reported. All participants were satisfied with the intervention, which had significant effects in terms of reducing the occurrence of the F-S-D symptom cluster at T2 (P ​= ​0.035) and improving QOL at T1 and T2 (T1: P ​= ​0.035; T2: P ​= ​0.012). Conclusions: The multi-modal intervention is a feasible, acceptable, and safe intervention that demonstrated preliminary positive effects in managing the F-S-D symptom cluster and improving QOL in patients with BC and receiving chemotherapy in Hong Kong. This study provides key insights into F-S-D symptom cluster management in patients with BC. Trial registration: ChiCTR2100047819 (Chinese Clinical Trial Register).

4D printed photo-triggered liquid crystal elastomers (LCEs) microactuators by direct laser writing via two-photon polymerization (DLW-TPP) have attracted increasing attention due to their manipulation flexibility, reversible and rapid actuation capabilities. However, their development is hampered by the lack of room-temperature printable liquid crystal (LC) photoresists. Here, we developed new light-responsive LC photoresists by incorporating novel conjugated polymers (CPs) as photothermal agents for the DLW-TPP technology. The CPs displayed a remarkable photothermal effect and effectively avoided the aggregation problems that always happened for inorganic nanoparticles in photoresists. Moreover, the CPs incorporation lowered the nematic-to-isotropic temperature of the LC photoresists which is beneficial for room-temperature DLW-TPP. The printing parameters, including laser power and scanning speed, were investigated using the developed LC photoresists. It was found the range of printing parameters decreased with the increase of the CPs loading fraction from 0.1 to 0.5 wt%, which was attributed to the high photothermal conversion efficiency (52.7%). A well-defined CPs/LCEs microactuator with CPs as low as 0.3 wt% was printed, which could achieve a large 25.0% actuation strain in 5 s upon near-infrared (NIR) light stimulation. It could be used for thriving soft micro-robotics and micro-membranes with controllable separation capabilities.

Objectives Direct comparisons between COVID-19 and influenza A in the critical care setting are limited. The objective of this study was to compare their outcomes and identify risk factors for hospital mortality.Design and setting This was a territory-wide, retrospective study on all adult (≥18 years old) patients admitted to public hospital intensive care units in Hong Kong. We compared COVID-19 patients admitted between 27 January 2020 and 26 January 2021 with a propensity-matched historical cohort of influenza A patients admitted between 27 January 2015 and 26 January 2020. We reported outcomes of hospital mortality and time to death or discharge. Multivariate analysis using Poisson regression and relative risk (RR) was used to identify risk factors for hospital mortality.Results After propensity matching, 373 COVID-19 and 373 influenza A patients were evenly matched for baseline characteristics. COVID-19 patients had higher unadjusted hospital mortality than influenza A patients (17.5% vs 7.5%, p

Longitudinal studies on upper respiratory tract microbiome in coronavirus disease 2019 (COVID-19) without potential confounders such as antimicrobial therapy are limited. The objective of this study is to assess for longitudinal changes in the upper respiratory microbiome, its association with disease severity, and potential confounders in adult hospitalized patients with COVID-19. Serial nasopharyngeal and throat swabs (NPSTSs) were taken for 16S rRNA gene amplicon sequencing from adults hospitalized for COVID-19. Alpha and beta diversity was assessed between different groups. Principal coordinate analysis was used to assess beta diversity between groups. Linear discriminant analysis was used to identify discriminative bacterial taxa in NPSTS taken early during hospitalization on need for intensive care unit (ICU) admission. A total of 314 NPSTS samples from 197 subjects (asymptomatic = 14, mild/moderate = 106, and severe/critical = 51 patients with COVID-19; non–COVID-19 mechanically ventilated ICU patients = 11; and healthy volunteers = 15) were sequenced. Among all covariates, antibiotic treatment had the largest effect on upper airway microbiota. When samples taken after antibiotics were excluded, alpha diversity (Shannon, Simpson, richness, and evenness) was similar across severity of COVID-19, whereas beta diversity (weighted GUniFrac and Bray–Curtis distance) remained different. Thirteen bacterial genera from NPSTS taken within the first week of hospitalization were associated with a need for ICU admission (area under the receiver operating characteristic curve, 0.96; 95% CI, 0.91–0.99). Longitudinal analysis showed that the upper respiratory microbiota alpha and beta diversity was unchanged during hospitalization in the absence of antimicrobial therapy.

Objective: Methicillin-resistant Staphylococcus aureus (MRSA) strains are a leading cause of communicable disease in community and nosocomial settings. They are responsible for high morbidity and mortality. Researchers currently pursue novel antimicrobials from natural sources against non-traditional drug targets of staphylococci to ensure a pipeline of potent drugs, in the face of rising drug resistance. The focus of this study was to screen compounds from a freshwater isolate of Chlorella sorokiniana for anti-staphylococcal activity, using traditional microbiology, phytochemical analysis and bioinformatics approaches. Methods: Chlorella sorokiniana methanol extract was investigated for its antimicrobial potential on Staphylococcus aureus strains (ATCC and MRSA isolates) by Kirby Bauer disc diffusion, broth microdilution, cell cytotoxicity and thin layer chromatography-bioautography (TLC-BA). Two antimicrobial TLC-BA antimicrobial fractions (A and B) were subject to gas chromatography mass spectrometry (GCMS). The structures of 9 compounds representing GCMS peaks were tested in silico, for their pharmacokinetic properties and binding energy efficiency with the target, using Molinspiration tool and Autodock 4.2. Results: Mean zone diameter of inhibition of growth by CSME (20 mg) was 21 mm, MIC/MBC was 0.31/2.5 mg/L. GCMS analysis of TLC fraction-A revealed 31 phytochemicals, of which 2-pentanone,4-hydroxy-4-methyl- had the highest area % (65.61) and TLC fraction-B revealed 4 peaks of which pentadecanoic acid and 1-(+)-ascorbic acid 2,6-dihexadecanoate had the highest area % (45.57, 48.09).In silico analysis of 9 peak compounds on the target of interest showed that compound 2: 2-pentanone,4-hydroxy-4-methyl- and compound 7: 1,2 – benzene dicarboxylic acid, mono (2- ethylhexyl) ester, satisfied Lipinski’s rule of 5, and displayed the least binding energies −6.93 and −5.74 with ClpP protease, thus holding pharmaceutical potential, and supporting further investment into in vitro and in vivo studies. Conclusions: C. sorokiniana, a less studied microalga thus offers a promising natural resource for anti-MRSA phytochemicals, capable of targeting ClpP1 protease.(290 words)

Abstract Inspired by the significant advantages of the bottom‐up synthesis whose structures and functionalities can be customized by the selection of molecular components, a 2D metal‐organic framework (MOF) nanosheet Co‐BTB‐LB has been synthesized by a liquid–liquid interface‐assisted method. The as‐prepared Co‐BTB‐LB is identified by scanning electron microscopy/energy dispersive spectroscopy (SEM/EDX) and X‐ray photoelectron spectroscopy (XPS), and the sheet‐like structure is verified by scanning electron microscopy (SEM), high‐resolution transmission electron microscopy (HRTEM), and atomic force microscopy (AFM). Co‐BTB‐LB electrode exhibits an excellent capacity of 4969.3 F g−1 at 1 A g−1 and good cycling stability with 75% capacity retention after 1000 cycles. The asymmetric supercapacitor device with Co‐BTB‐LB as the positive electrode shows a maximum energy density of 150.2 Wh kg−1 at a power density of 1619.2 W kg−1 and good cycling stability with a capacitance retention of 97.1% after 10000 cycles. This represents a state‐of‐the‐art performance reported for asymmetric supercapacitor device using electroactive bottom‐up metal‐complex nanosheet, which will clearly lead to a significant expansion of the applicability of this type of 2D nanomaterials.

Aspiration caused by dysphagia is a prevalent problem that causes serious health consequences and even death. Traditional diagnostic instruments could induce pain, discomfort, nausea, and radiation exposure. The emergence of wearable technology with computer-aided screening might facilitate continuous or frequent assessments to prompt early and effective management. The objectives of this review are to summarize these systems to identify aspiration risks in dysphagic individuals and inquire about their accuracy. Two authors independently searched electronic databases, including CINAHL, Embase, IEEE Xplore® Digital Library, PubMed, Scopus, and Web of Science (PROSPERO reference number: CRD42023408960). The risk of bias and applicability were assessed using QUADAS-2. Nine (n = 9) articles applied accelerometers and/or acoustic devices to identify aspiration risks in patients with neurodegenerative problems (e.g., dementia, Alzheimer’s disease), neurogenic problems (e.g., stroke, brain injury), in addition to some children with congenital abnormalities, using videofluoroscopic swallowing study (VFSS) or fiberoptic endoscopic evaluation of swallowing (FEES) as the reference standard. All studies employed a traditional machine learning approach with a feature extraction process. Support vector machine (SVM) was the most famous machine learning model used. A meta-analysis was conducted to evaluate the classification accuracy and identify risky swallows. Nevertheless, we decided not to conclude the meta-analysis findings (pooled diagnostic odds ratio: 21.5, 95% CI, 2.7–173.6) because studies had unique methodological characteristics and major differences in the set of parameters/thresholds, in addition to the substantial heterogeneity and variations, with sensitivity levels ranging from 21.7% to 90.0% between studies. Small sample sizes could be a critical problem in existing studies (median = 34.5, range 18–449), especially for machine learning models. Only two out of the nine studies had an optimized model with sensitivity over 90%. There is a need to enlarge the sample size for better generalizability and optimize signal processing, segmentation, feature extraction, classifiers, and their combinations to improve the assessment performance.Systematic Review Registration: (https://www.crd.york.ac.uk/prospero/), identifier (CRD42023408960).

Abstract One of the major obstacles of porphyrins is the aggregation‐caused quenching (ACQ) of photoluminescence due to the strong intermolecular π–π interaction of the planar porphyrin core in the solid state. However, ACQ leads to the nonradiative deactivation of the photoexcited states which results in short‐lived charge‐separated states and thus low photoluminescence and singlet quantum yields. This phenomenon would limit the utilization of porphyrins in near‐infrared fluorescent bioimaging, photodynamic therapy, photocatalytic hydrogen evolution, electrochemiluminescence, and chiroptical applications. Hence, to address the ACQ property of porphyrins and enhance the performance of the above applications, a limited number of AIEgen‐decorated porphyrins have been designed, synthesized, and tested for their applications. It has been found that the introduction of AIEgens, such as tetraphenylethylene, diphenylacrylonitrile, (3,6‐bis‐(1‐methyl‐4‐vinylpyridinium)‐carbazole diiodide, and iridium motif into the porphyrin core, transformed the porphyrins from ACQ to aggregation‐induced emission (AIE) in their solid state due to the reduced strong intermolecular π–π stacking of porphyrins. Consequently, such porphyrins containing AIE features are employed as potential candidates in the above‐mentioned applications. In this review, we summarize the AIEgen‐decorated porphyrins which have been published to date, and also discuss the benefits of converting porphyrins from ACQ to AIE for enhanced performance within each application. As far as we know, there is no review that summarizes the structures and applications of AIEgen‐decorated porphyrins to date. Therefore, we presume that this review would be helpful to design more efficient AIEgen‐decorated porphyrins for a wide range of applications in the future.

Aqueous zinc‐ion batteries possess great potential in stationary energy storage devices. Nevertheless, the occurrence of zinc dendrite growth and hydrogen evolution reaction severely hinders the utilization efficiency and service life of zinc‐metal anodes. Herein, an in situ etching strategy is proposed to construct an interfacial layer with porous structure on the surface of zinc foil under the assistance of tartaric acid (denoted as TA@Zn). The optimized anode surface is beneficial to not only achieve uniform Zn deposition behavior due to the low nucleation overpotential, but also enhance the interfacial reaction kinetics due to the reduced activation energy barrier. As expected, the TA@Zn‐based symmetric cell delivers small voltage hysteresis and superior stability for 5000 h at the current density of 1 mA cm−2. Moreover, the TA@Zn|NH4V4O10 cell also exhibits high specific capacity and long‐term cycling stability.

Delivering bioactive proteins into cells without carriers presents significant challenges in biomedical applications due to limited cell membrane permeability and the need for targeted delivery. Here, we introduce a novel carrier-free method that addresses these challenges by chemically modifying proteins with an acid-responsive cell-penetrating peptide (CPP) for selective intracellular delivery within tumours. Cytochrome C, a protein known for inducing apoptosis, served as a model for intracellular delivery of therapeutic proteins for cancer treatment. The CPP was protected with 2,3-dimethyl maleic anhydride (DMA) and chemically conjugated onto the protein surface, creating an acid-responsive protein delivery system. In the acidic tumour microenvironment, DMA deprotects and exposes the positively charged CPP, enabling membrane penetration. Both in vitro and in vivo assays validated the pH-dependent shielding mechanism, demonstrating the modified cytochrome C could induce apoptosis in cancer cells in a pH-selective manner. These findings provide a promising new approach for carrier-free and tumour-targeted intracellular delivery of therapeutic proteins for a wide range of potential applications.

Life skill-based training is essential for intellectual disabled individuals to regain autonomy and social inclusion. Virtual reality (VR) could deliver a nascent application that is more engaging and secure. The objective of this study was to evaluate the training effects of the VR-based multiple life skill training program on life skill performance, self-efficacy, memory, cognitive and behavioral functions via a multicenter randomized controlled trial. A total of 145 intellectual disabled participants were recruited for a randomized controlled trial with three intervention arms: VR (n = 42); traditional (n = 53); and control (n = 50). The life skill tasks for the interventions included 1) grocery shopping, 2) cooking, and 3) kitchen cleaning. Outcome measures were performance scores for the three tasks, self-efficacy scale, digit span score, and Frontal Assessment Battery score, graded by blinded assessors. Before-after effects of each group were evaluated using separated Wilcoxon Signed-rank tests. VR significantly improved cooking, cleaning performance, and memory span, while traditional training significantly improved shopping, cooking, and cleaning tasks. The generalized estimating equation evaluated effects between groups adjusted for age, gender and intelligence quotient (IQ). VR had significantly larger improvement effects in cooking and cleaning than the control group and memory span compared to traditional training and controls groups. IQ appeared to be a significant confounder on the training effect. Future work may consider developing artificial intelligence to customize programs depending on IQ level.

Forecasting wind structure of tropical cyclone (TC) is vital in assessment of impact due to high winds using Numerical Weather Prediction (NWP) model. The usual verification technique on TC wind structure forecasts are based on grid-to-grid comparisons between forecast field and the actual field. However, precision of traditional verification measures is easily affected by small scale errors and thus cannot well discriminate the accuracy or effectiveness of NWP model forecast. In this study, the Method for Object-Based Diagnostic Evaluation (MODE), which has been widely adopted in verifying precipitation fields, is utilized in TC's wind field verification for the first time. The TC wind field forecast of deterministic NWP model and Ensemble Prediction System (EPS) of the European Centre for Medium-Range Weather Forecasts (ECMWF) over the western North Pacific and the South China Sea in 2020 were evaluated. A MODE score of 0.5 is used as a threshold value to represent a skillful (or good) forecast. It is found that the R34 (radius of 34 knots) wind field structure forecasts within 72 h are good regardless of DET or EPS. The performance of R50 and R64 is slightly worse but the R50 forecasts within 48 h remain good, with MODE exceeded 0.5. The R64 forecast within 48 h are worth for reference as well with MODE of around 0.5. This study states that the TC wind field structure forecast by ECMWF is skillful for TCs over the western North Pacific and the South China Sea.

Background Previous research indicates that personal mental health experiences (e.g. one's current mental health status) and interpersonal mental health experiences (e.g. one's familiarity with someone with mental illness) are associated with stigma-related outcomes. These outcomes include knowledge, attitudes and desire for social distance from people with mental illness. Aims To explore the extent to which current personal mental health status and familiarity with mental illness predict stigma-related outcomes in Hong Kong. Method Data were drawn from a larger research project examining mental well-being in Hong Kong citizens. Citizens (N = 1010) aged ≥18 years were surveyed between August and September 2021. Results Multiple regression analyses revealed that immediate family and friends showed better attitudinal outcomes and lower desire for social distance compared with people who did not know anyone with mental illness (all β > 1.00, all P < 0.05), whereas people with personal experience of mental illness showed higher prejudicial attitudes compared with people who did not know anyone with mental illness (β = −0.744, P = 0.016). Better current personal mental health predicted lower prejudicial attitudes (β = 0.488, P < 0.001) and mixed outcomes on different realms of mental health knowledge. Conclusions Cultural concerns surrounding ‘saving face’ and emphasis on collectivistic values may explain the nonlinear relationship between personal and interpersonal mental health experiences and stigma-related outcomes. Future anti-stigma interventions should tailor their approaches to the needs of people with different levels of familiarity with mental illness and include efforts to support the mental health of the overall population.

The aim of this article is to find diversification opportunities by examining the time-varying and time-scale-based volatility and correlation of the US and Chinese stock market indices with crude oil, gold and Bitcoin price returns, as well as the exchange rate of the Chinese Yuan Renminbi against the US Dollar (CNY/USD) using a vector error correction model (VECM), namely, maximum overlap discrete wavelet transformation (MODWT). Furthermore, individual and institutional investors may also reduce the risk of their investment portfolio by investing in commodities and stock markets from countries with a negative or substantially low correlation. Our VECM result shows that Bitcoin, crude oil and CNY/USD lead the other variables under consideration, indicating that changes in the prices of Bitcoin, crude oil and CNY/USD affect the US and Chinese stock market indices, as well as gold. Our research utilising the MODWT technique shows that Bitcoin leads crude oil at almost all levels, indicating that crude oil prices will respond to Bitcoin price movement in the long and medium term. However, investors may be deterred from using Bitcoin as a diversification tool due to its extreme volatility. The research also indicates that diversification with gold may help US investors. However, the continuous wavelet transformation finding shows that the diversification benefit effects will persist for a holding period of little more than 64 days. Our study results tend to emphasise the significance of using reasonably modern methods to identify diversification possibilities for investors with diverse investment horizons or holding stocks for various periods.

BackgroundHope can affect the thinking habits, emotional regulations, and behaviors of individuals. Hope is considered as a positive trait by clinicians, who often assess the level of hope in psychological evaluations. Previous measurements of hope were largely based on self-reported questionnaires leading to the problem of subjectivity. Heart Rate Variability (HRV) is a bio index that is an objective, quick, cost effective, and non-invasive measurement. HRV has been used in the evaluation of physical health and some psychiatric conditions. However, it has not been tested for its potential to be a bio-index of the level of hope.MethodThis pilot cross-sectional observational study aimed to examine the relationships between HRV and the level of hope among adult Chinese people in Hong Kong. Convenience sampling was used and 97 healthy participants were recruited. Their level of hope was measured by the Dispositional Hope Scale-Chinese (DHS-C), and their HRV was quantified by emWave Pro Plus, a reliable sensor of HRV. Spearman’s correlation coefficient analysis was performed on the HRV measurements and DHS-C.ResultsThe DHS-C’s overall mean score was 45.49. The mean scores of the subscale DHS-C (Agency) was 22.46, and the mean scores of DHS-C (Pathway) was 23.03. It was also revealed that there were significant, weak, and negative correlations between the level of hope and four out of ten HRV metrics. One HRV metric was found to have a significant, weak, and positive correlation with the level of hope.ConclusionThis study provided initial evidence to support the use of HRV as a bio-index of hope. Implications of the current study and recommendations for future research directions are discussed.

Abstract Graphdiyne (GDY), an emerging two‐dimensional all‐carbon allotrope, features the coexistence of sp and sp2 hybridized planar carbon atoms. GDY and GDY‐based materials exhibit unique physical and chemical properties, such as well‐defined molecular skeleton, π‐conjugated structure, high specific surface area with porosity, and good electrical conductivity, which have aroused widespread interest in various disciplines. As an emerging field, in this work, we summarize important synthesis strategies of GDY and GDY‐based materials including classical synthesis, chemical vapor deposition, explosion approach, and interface‐assisted methods. We also elaborate the recent modifications to regulate the structure and properties of GDY from the viewpoint of metal doping, non‐metal doping, and heterostructure construction. Meanwhile, recent achievements and progress in the development of energy and environmental applications in photocatalysis are highlighted. Lastly, the challenges and potential developments of GDY in the catalytic research are given at the end of this article.

Abstract. For the detection of steatosis, quantitative ultrasound imaging techniques have achieved great progress in past years. Magnetic resonance imaging proton density fat fraction is currently the most accurate test to detect hepatic steatosis. Some blood biomarkers correlate with non-alcoholic steatohepatitis, but the accuracy is modest. Regarding liver fibrosis, liver stiffness measurement by transient elastography (TE) has high accuracy and is widely used across the world. Magnetic resonance elastography is marginally better than TE but is limited by its cost and availability. Several blood biomarkers of fibrosis have been used in clinical trials and hold promise for selecting patients for treatment and monitoring treatment response. This article reviews new developments in the non-invasive assessment of non-alcoholic fatty liver disease (NAFLD). Accumulating evidence suggests that various non-invasive tests can be used to diagnose NAFLD, assess its severity, and predict the prognosis. Further studies are needed to determine the role of the tests as monitoring tools. We cannot overemphasize the importance of context in selecting appropriate tests.

Efficiency and comfort in buildings rely on on well-functioning HVAC systems. However, system faults can compromise performance. Modern data-driven fault detection methods, considering diverse techniques, encounter challenges in understanding intricate interactions and adapting to dynamic conditions present in HVAC systems during occupancy periods. Implementing fault detection during active operation, which aligns with real-world scenarios and captures dynamic interactions and environmental changes, is considered highly valuable. To address this, utilizing the dynamic simulation system HVAC SIMulation PLUS (HVACSIM+), an HVAC fault model was developed using 194 sensor signals from each HVAC component within a single-story, four-room building. The advanced HVAC fault detection framework, leveraging simulated HVAC operational scenarios with the Gramian angular field (GAF) and two-dimensional convolutional neural networks (GAF-2DCNNs), offers a robust and proactive solution. By utilizing the GAF capacity to convert time-series sensor data into informative 2D images, integrated with 2DCNN for automated feature extraction, hidden temporal relationships within 1D signals are captured. After training on nine significant HVAC faults and normal conditions during occupancy, the effectiveness of the proposed GAF-2DCNN is evaluated through comparisons with support vector machine (SVM), random forest (RF), and hybrid RF-SVM, one-dimensional convolutional neural networks (1D-CNNs). The results demonstrates an impressive overall accuracy of 97%, accompanied by precision, recall, and F1 scores that surpass 90% for individual HVAC faults. Through the introduction of the unified approach that integrates HVACSIM+ simulated data and GAF-2DCNN, a notable enhancement in robustness and reliability for handling substantial HVAC faults is achieved.

Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease nowadays. Currently, there is no officially approved drug to treat NAFLD. In view of the increasing global prevalence of NAFLD and an absence of treatments, the development of effective treatments is of utmost importance. β-glucan, a natural bioactive polysaccharide, has demonstrated hepatoprotective effects in NAFLD prevention and treatment. This review solely focuses on gathering the published preclinical animal studies that demonstrated the anti-liver injury, anti-steatotic, anti-inflammatory, anti-fibrotic, and antioxidant activities of β-glucan. The impact of β-glucan on gut microbiota and its metabolites including short-chain fatty acids and bile acids as the underlying mechanism for its bioactive beneficial effect on NAFLD is also explored. Given the limited knowledge of β-glucan on anti-fibrotic activity, bile acid metabolism, and gut microbiota function, additional relevant research is highly encouraged to lay a solid foundation for the use of food-derived β-glucan as a functional food for NAFLD. It is envisaged that further investigation of food-derived β-glucan in human clinical studies should be carried out for its wider utilization.

Background: Endometrial cancer is the most common gynecological cancer among women in developed countries. Sono-elastography is an extended ultrasonographic technique that has been shown to be useful in a wide range of conditions ranging from breast, prostate, and thyroid nodules to chronic liver disease and musculoskeletal conditions. The aim of this study is to compare the sonoelastographic features of endometrial malignancy and normal endometrium. Methods: This case–control observational study was conducted at a single institution. Participants with histologically proven endometrial cancer according to the results from microcurettage or hysteroscopic biopsy and scheduled for total hysterectomy were included as cases, while asymptomatic women scheduled for routine screening ultrasound examination were recruited as controls. Both cases and controls underwent conventional B-mode transvaginal ultrasonography and strain elastography. Demographic, ultrasonographic, and histopathologic findings were analyzed. Results: A total of 29 endometrial cancer patients (cases) and 28 normal females (controls) were included in the analysis. There was no significant difference in the mean age between the two groups, but the mean body weight was significantly higher in the case group (P < 0.001). The strain ratio and elastographic thickness ratio of the endometrium were statistically significantly different between the case and the control group (P ≤ 0.05) due to increased endometrial stiffness in cancer patients as compared to the normal group. Conclusion: Our results suggest that endometrial cancer can result in increased stiffness that is detectable by transvaginal sonoelastography. Sonoelastography may serve as an adjunct to conventional ultrasound in evaluating the endometrium of women with abnormal uterine bleeding.