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Taiwan learned from its 2003 SARS experience and established multiple surveillance systems to be able to detect and respond to COVID-19. With the find, test, trace, isolate, and support (FTTIS) strategy, Taiwan was successful in containing SARS-CoV-2 from spreading for two years. During the surge of the Omicron variant in the community, COVID-19 control strategy shifted from containment to mitigation in April 2022, to reduce morbidity and mortality. Lessons learned from COVID-19 response re-emphasizes the importance of having sensitive public health surveillance and linking surveillance with public health actions.

This study proposes and demonstrates a novel label-free DNA biosensor using high quality optical microcavity functionalized by 3D DNA nanostructure probes. To achieve ultra-low limit DNA biosensing, optical sensing interface of the hollow-core, thin wall-thickness microcavity was functionalized by self-assembled DNA tetrahedral nanostructure (DTN) probes with size of 17 bp and length of ∼5.8 nm. High efficiency binding of the DTN probes with the optical sensor interface and the target ssDNA are achieved. Whispering gallery mode (WGM) spectra with high-Q factor of >107 are excited and traced for DNA detection inside the microfluidic channel of the microcavity, with a small sample volume of nL. Incorporation of nanoscale DTN probes onto surface of the optical microcavity makes it an effective way for increasing efficient probe density and eliminating entanglement between DNA probes, thus ∼1000 times lower detection limit is achieved as compared to using 1D ssDNA probes. Due to its desirable merits of label-free, ultra-low LoD, real time and compact size, the proposed DNA biosensor has broad application prospects in bioengineering and medical diagnosis.

AIM: To introduce a new technique for iridoschisis management during phacoemulsification: “capsule drape wrap”. METHODS: “Capsule drape wrap” technique was used for an 80-year-old man with idiopathic iridoschisis in the right eye during phacoemulsification. The inserted flexible nylon iris hooks to hold anterior capsule in place, the margin of the anterior capsule could act as drape wrap, tracking the fibrillary iris strands firmly from free floating and stabilizing the capsular bags simultaneously. RESULTS: The eye with iridoschisis was successfully treated. Iris fibrils remained immobile during the procedure, and despite the severity of iridoschisis, there were no intraoperative complications such as tear of the iris, hyphema, iris prolapse, loss of mydriasis, or rupture of the posterior lens capsule during phacoemulsification. The best-corrected visual acuity was increased by 0.1 (logMAR) 6mo after the surgery. CONCLUSION: “Capsule drape wrap” for iridoschisis is easily manageable, prevents further disruption to the loose iris fibers and ensures the stability of capsule–iris complex simultaneously, consequently minimizing the risk of surgical complications in phacoemulsification.

Although zeolitic imidazolate frameworks (ZIFs) have bright prospects in wide fields like gas storage/separation, catalysis and medicine, etc., their large-scale applications are bottlenecked by the absence of their low-cost commercial production technique. Here, we report an unconventional method suitable for environmentally friendly and low-cost mass-production of ZIFs. In this method, taking the synthesis of ZIF-8 as an example, ZnO was used instead of Zn(NO3)2 in traditional solvent synthesis methods and CO2 was introduced to dissolve ZnO in aqueous solution of 2-methylimidazole (HMeim) and form water soluble salt ([ZnMeim]+[MeimCOO]-) at room temperature. Then, by removing CO2 through heating or vacuuming, Meim-ions are produced and instantaneously assemble with [ZnMeim]+s to generate ZIF-8 without any by-product. Due to the absence of strong acid anions (such as NO3− and Cl− et al.) in solution, the washing of filter cake required in the conventional approaches could be omitted and the filtrate containing only water and HMeim could be reused completely. This method is really green as no waste gas or liquid generates because CO2 and water could be recycled perfectly. It overcomes almost all bottlenecks occurred in commercial production of ZIF-8 when using traditional methods. A pilot plant was established for mass-production of ZIF-8 and hundreds kilograms of ZIF-8 was produced, which indicates that the new method is not only environmentally friendly but also low cost and commercial accessibility. It is expected that the new method would open an avenue for commercial applications of ZIFs.

From the perspective of food packaging design, the interaction between packaging and consumer behaviors was explored through the analysis of their demand trends. This review analyzed the performance characteristics of consumer experience at instinct level, behavior level and reflection level between users and packaging, and discussed the design strategies of food packaging at different levels. In view of the multi-dimensional needs of consumers, the emotional responses to products from visual and non-visual sensory experience at the instinct level can be responded and thereby attract their attentions. At the behavioral level, it starts from interesting, humanized and intelligent interaction, prompt and feedback to expand the use function of the product and create a good use experience. On the reflection level, starting from creating interactive experience to stimulate users' creativity. The creation of interactive experience and stimulation of user creativity were focused on to systematically shape deep emotional experience at the reflection level. Integrating user experience into food packaging design effectively and exploring the process of information experience will be a new idea and direction of food packaging design in the future.

As detrimental byproduct waste generated during the production of fertilizers, phosphogypsum can be harmlessly treated by producing phosphogypsum-based cementitious materials (PGCs) for offshore well cementing in hydrate reservoirs. To be specific, the excellent mechanical properties of PGCs significantly promote wellbore stability. And the preeminent temperature control performance of PGCs helps to control undesirable gas channeling, increasing the formation stability of natural gas hydrate (NGH) reservoirs. Notably, to further enhance temperature control performance, foaming agents are added to PGCs to increase porosity, which however reduces the compressive strength and increases the risk of wellbore instability. Therefore, the synergetic effect between temperature control performance and mechanical properties should be quantitatively evaluated to enhance the overall performance of foamed PGCs for well cementing in NGH reservoirs. But so far, most existing studies of foamed PGCs are limited to experimental work and ignore the synergetic effect. Motivated by this, we combine experimental work with theoretical work to investigate the correlations between the porosity, temperature control performance, and mechanical properties of foamed PGCs. Specifically, the thermal conductivity and compressive strength of foamed PGCs are accurately determined through experimental measurements, then theoretical models are proposed to make up for the non-repeatability of experiments. The results show that, when the porosity increases from 6% to 70%, the 7 d and 28 d compressive strengths of foamed PGCs respectively decrease from 21.3 MPa to 0.9 MPa and from 23.5 MPa to 1.0 MPa, and the thermal conductivity decreases from 0.33 W·m−1·K−1 to 0.12 W·m−1·K−1. Additionally, an overall performance index evaluation system is established, advancing the application of foamed PGCs for well cementing in NGH reservoirs and promoting the recycling of phosphogypsum.

Multi-objective optimization is always a difficult and hot problem for the static and dynamic performance and lightweight optimization design of a body-in-white (BIW). In this regard, a hybrid method coupled with NSGA-III and entropy weighted TOPSIS methods was put forward here. Effects of each design variable on the BIW performance was studied by means of the contribution method so as to optimize various design variables. Further, an experimental design was carried out by means of a radial basis function model to approximate each performance index of the automotive body. On the base of that, a comprehensive method where the Pareto frontier is searched by means of NSGA-III while the optimal solution is selected by means of the entropy weighted TOPSIS method was proposed based on lightweight, static and dynamic performances to analyze BIW performances to determine the contradictory optimal solution among various BIW factors. Afterward, our numerical verifications demonstrate that the BIW performances are improved significantly so that it can be feasible to optimize static and dynamic BIW performances and the lightweight performance of the BIW can be guaranteed accordingly.

The surge in demand for energy has resulted in a significant transformation of the worldwide energy sector, causing a shift toward the advancement of energy sources that are both efficient and sustainable. In order to address environmental issues and advance a sustainable energy future, renewable energy (RE) sources and carbon dioxide (CO2) utilisation are crucial. Greenhouse gas (GHG) emissions increments are driven by economic and population growth, which are increasing. The rise in growth has led to an increase in the atmospheric concentration of CO2. Due to this situation, carbon capture, utilisation, and storage (CCUS) seems to be a promising approach to reducing CO2 emissions. Among all the carbon utilisation strategies available, CO2 methanation is promising for producing fuel for future energy. This project aims to develop an optimisation model for a mobile pilot facility for CO2 methanation using green hydrogen (H2) generated from solar photovoltaic (PV). In this project, an energy model for the design of a solar energy source for hydrogen production integrated with battery energy storage to ensure optimum usability of the renewable energy source for CO2 utilisation will be developed.

The electric bus can replace the continuously increasing number of diesel buses in the public transport sector as a result of strong travel demand, making it a promising alternative for reducing carbon emissions. The constraint in implementing the electric bus is the limited energy storage and high capital cost of batteries. A mathematical model is developed to minimize the total cost of electric buses, including capital costs and operation costs, by optimizing the bus charging schedule. A scenario analysis is carried out to determine the impact of battery costs on bus charging schedules. The results show that battery cost will have a huge impact on the charging pattern of electric buses and charger layout. In normal conditions, the model will prefer low battery capacity and charging during peak hours. When the battery price goes down from BAU to 10%, the battery capacity increases from 3,200 to 3,600 kWh, reducing the number of chargers built in a bus stop. This model can be a reference for transit planners.

ABSTRACTSingle-chain fragment variable (scFv) domains play an important role in antibody-based therapeutic modalities, such as bispecifics, multispecifics and chimeric antigen receptor T cells or natural killer cells. However, scFv domains exhibit lower stability and increased risk of aggregation due to transient dissociation (“breathing”) and inter-molecular reassociation of the two domains (VL and VH). We designed a novel strategy, referred to as stapling, that introduces two disulfide bonds between the scFv linker and the two variable domains to minimize scFv breathing. We named the resulting molecules stapled scFv (spFv). Stapling increased thermal stability (Tm) by an average of 10°C. In multiple scFv/spFv multispecifics, the spFv molecules display significantly improved stability, minimal aggregation and superior product quality. These spFv multispecifics retain binding affinity and functionality. Our stapling design was compatible with all antibody variable regions we evaluated and may be widely applicable to stabilize scFv molecules for designing biotherapeutics with superior biophysical properties.

Summary: RNA N6-methyladenosine (m6A) modification is implicated in cancer progression, yet its role in regulating long noncoding RNAs during cancer progression remains unclear. Here, we report that the m6A demethylase fat mass and obesity-associated protein (FTO) stabilizes long intergenic noncoding RNA for kinase activation (LINK-A) to promote cell proliferation and chemoresistance in esophageal squamous cell carcinoma (ESCC). Mechanistically, LINK-A promotes the interaction between minichromosome maintenance complex component 3 (MCM3) and cyclin-dependent kinase 1 (CDK1), increasing MCM3 phosphorylation. This phosphorylation facilitates the loading of the MCM complex onto chromatin, which promotes cell-cycle progression and subsequent cell proliferation. Moreover, LINK-A disrupts the interaction between MCM3 and hypoxia-inducible factor 1α (HIF-1α), abrogating MCM3-mediated HIF-1α transcriptional repression and promoting glycolysis and chemoresistance. These results elucidate the mechanism by which FTO-stabilized LINK-A plays oncogenic roles and identify the FTO/LINK-A/MCM3/HIF-1α axis as a promising therapeutic target for ESCC.

Summary: Calcific tendinopathy (CT) is defined by the progressive accumulation of calcium crystals in tendonic regions that results in severe pain in patients. The etiology of CT is not fully elucidated. In this study, we elucidate the role of PPP1R3A in CT. A significant decrease in PPP1R3A expression was observed in CT patient tissues, which was further confirmed in tissues from a CT-induced rat model. Overexpression of PPP1R3A ex vivo reduced the expression of osteo/chondrogenic markers OCN and Sox9, improved tendon tissue architecture, and reduced intracellular Ca2+ levels. Overexpression of SERCA2 and knockdown of Piezo1 decreased expression of osteo/chondrogenic markers and intracellular calcium in PPP1R3A-knockdown tendon cells. Lastly, PPP1R3A expression was regulated at the posttranscriptional level by binding of HuR. Collectively, the present study indicates that PPP1R3A plays an important role in regulating calcium homeostasis in tendon cells via Piezo1/SERCA2, rendering it a promising target for therapeutic interventions of CT.

Tujuan Penelitian: Kajian ini bertujuan untuk mengetahui bagaimana tingkat kepuasan siswa dan kesesuaian pelayanan bimbingan dan konseling (BK) dengan menggunakan metode Importance Perfomance Analysis (IPA).Metode Penelitian: Kajian ini menggunakan metode kuantitatif deskriptif dan metode IPA. Kajian ini memiliki populasi sebanyak 454 siswa yang berasal dari sekolah SMKN 1 Langsa dengan besaran sampel 213 siswa yang diproleh melalui teknik cluster random sampling. Adapun instrument yang digunakan ialah kuesioner kepuasan pelayanan konseling yang di adaptasi dari IPA dengan r sebesar 0,92 pada 18 item pernyataan. Selanjutnya data dianalisis dengan rujukan metode IPA.Hasil Penelitian: Kajian ini menggambarkan bahwa tingkat kepuasan siswa pada pelayanan BK berada dalam kategori cukup memuaskan apabila dibandingkan dengan kesesuaian pelayanan bimbingan dan konseling yang diselengggarakan oleh guru BK di sekolah. Kesimpulan: kepuasan siswa berada dalam kategori cukup sehingga berbanding lurus dengan pelayanan BK yang diselenggarakan oleh guru BK di SMKN 1 Kota Langsa, yang artinya siswa memperoleh rasa senang, ketenangan dan mendapatkan perasaan bahagia setelah mendapat pelayanan konseling yang diberikan oleh setiap guru BK disekolah.Implikasi: Guru BK disekolah selayaknya melaksanakan pelayanan BK dengan memprioritas kebutuhan, kewajiban dan hak siswa sebagai konseli, sehingga siswa merasakan kebahagiaan dan kepuasan terhadap pelayanan yang diterimanya

Abstract Objective Acute kidney injury (AKI) is one of the most frequent complications in patients treated with extracorporeal membrane oxygenation (ECMO) support. The aim of this study was to investigate the risk factors of AKI in patients undergoing ECMO support. Methods We performed a retrospective cohort study which included 84 patients treated with ECMO support at intensive care unit in the People’s Hospital of Guangxi Zhuang Autonomous Region from June 2019 to December 2020. AKI was defined as per the standard definition proposed by the Kidney Disease Improving Global Outcome (KDIGO). Independent risk factors for AKI were evaluated through multivariable logistic regression analysis with stepwise backward approach. Results Among the 84 adult patients, 53.6% presented AKI within 48 h after initiation of ECMO support. Three independent risk factors of AKI were identified. The final logistic regression model included: left ventricular ejection fraction (LVEF) before ECMO initiation (OR, 0.80; 95% CI, 0.70–0.90), sequential organ failure assessment (SOFA) score before ECMO initiation (OR, 1.41; 95% CI, 1.16–1.71), and serum lactate at 24 h after ECMO initiation (OR, 1.27; 95% CI, 1.09–1.47). The area under receiver operating characteristics of the model was 0.879. Conclusion Severity of underlying disease, cardiac dysfunction before ECMO initiation and the blood lactate level at 24 h after ECMO initiation were independent risk factors of AKI in patients who received ECMO support.

The fruit of Acanthopanax senticosus (Rupr. and Maxim.) has been newly developed for the treatment of blood deficiency syndrome clinically, but the effective constituents are still unclear, restricting its quality control and the new medicinal development based on it. This study elucidated the efficacy of A. senticosus fruit (ASF) for treating blood deficiency syndrome and accurately characterize the constituents. Chinmedomics strategy was used to identify the metabolic biomarkers of the model and the overall effect of ASF was evaluated based on the biomarker when it showed intervention effects for blood deficiency syndrome. ultrahigh performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to analyze the components in the blood absorbed from A. senticosus fruit, and the components highly relevant to the biomarker are regarded as potential effective constituents for blood deficiency syndrome. Twenty-two of the 28 urine metabolites of blood deficiency syndrome were significantly regulated by A. senticosus fruit, 97 compounds included 20 prototype components, and 77 metabolites were found in vivo under the acting condition. The highly relevant constituents were isofraxidin, eleutheroside B, eleutheroside B1, eleutheroside E, and caffeic acid, which might be the effective constituents of A. senticosus fruit. It is a promising new medicinal resource that can be used for treating blood deficiency syndrome.

Distributed machine learning at the network edge has emerged as a promising new paradigm. Various machine learning (ML) technologies will distill Artificial Intelligence (AI) from enormous mobile data to automate future wireless networking and a wide range of Internet-of-Things (IoT) applications. In distributed edge learning, multiple edge devices train a common learning model collaboratively without sending their raw data to a central server, which not only helps to preserve data privacy but also reduces network traffic. However, distributed edge training and edge inference typically still require extensive communications among devices and servers connected by wireless links. As a result, the salient features of wireless networks, including interference and channels’ heterogeneity, time-variability, and unreliability, have significant impacts on the learning performance.

With the rapid development of autonomous driving, robotics, and intelligent transportation, multi-sensor-based environment sensing technology for intelligent vehicles has become a popular research direction. In order to better fuse the data acquired by multi-sensors, accurate external parameter calibration becomes one of the critical issues. According to the method of external parameter calibration, this paper first introduces the offline calibration technology based on target and targetless methods. However, once these two methods change the relative position between the camera and the LiDAR, it can only be returned to the field to re-calibrate. The computational complexity is high, which makes it necessary to use the online calibration directly. Hence, this paper follows up with the introduction of online calibration technology based on deep learning. Unlike previous methods that need to extract features from calibration boards or environments, various types of networks can directly learn the mapping relationship between images and point clouds, From the calibration results, the average error of translation and rotation of traditional methods can reach 0.34cm and 0.45°, the average error of using deep learning networks such as LCCNet, which is the most widely used in existing networks and has good calibration effect, can reach 0.297cm and 0.017°. Compared with the traditional method, the accuracy of online calibration technology is respectively improved by 12.6% and 96.2%, which shows the results of online calibration technology are better than the traditional offline method, and there are some recently proposed methods incorporate an attention mechanism and use an optimization algorithm instead of a loss function to refine the outer parameters. From the review, learning the relative relationships between sensors through neural networks works best, and the process is relatively free of human intervention. Contrary to the existing reviews, this paper provides a general structure of calibration methods universally used in various environments and compares various methods based on this general structure.

Abstract Both current live, attenuated, and killed virus vaccines for bovine viral diarrhea virus (BVDV) have their limitations. Here, we report the development of a BVDV subunit vaccine by (i) the expression of a secreted form of a recombinant E2 glycoprotein using BHK21 cells and (ii) determination of the immune responses in mice. The E2 glycoprotein was modified by deletion of the C-terminal transmembrane anchor domain and fusion to a V5 epitope tag. This allowed detection using anti-V5 monoclonal antibodies together with simple purification of the expressed, secreted, form of E2 from the cell media. Furthermore, we genetically fused green fluorescent protein (GFP) linked to E2 via a Thosea asigna virus 2A (T2A) ribosome skipping sequence thereby creating a self-processing polyprotein [GFP-T2A-BVDV-E2trunk-V5], producing discrete [GFP-T2A] and [E2trunk-V5] translation products: GFP fluorescence acts, therefore, as a surrogate marker of E2 expression, BALB/c mice were inoculated with [E2trunk-V5] purified from cell media and both humoral and cellular immune responses were observed. Our antigen expression system provides, therefore, both (i) a simple antigen purification protocol together with (ii) a feasible strategy for further, large-scale, production of vaccines.

ObjectiveTo analyze the quality of life and related factors in patients with depression， and to provide evidence for formulating the corresponding measures to improve the patients' quality of life.MethodsA total of 117 inpatients who met the International Classification of Diseases， tenth edition（ICD-10） for depression were selected in Central People's Hospital of Zhanjiang， Affiliated Hospital of Guangdong Medical University and Guangdong 999 Brain Hospital from November 19， 2018 to September 7， 2019. The values of patients' clinical objective indicators consisted of routine blood test， routine urine examination， blood biochemical tests and blood gas analysis were collected by reviewing their medical records， and all subjects were assessed using Quality of Life Instruments for Chronic Diseases-Depression V2.0 ［QLICD-DE（V2.0）］. Simple correlation analysis was used to explore the correlation between the QLICD-DE （V2.0） scores and various clinical objective indicators， and multiple linear regression was adopted to further screen factors affecting quality of life of patients with depression.ResultsSimple correlation analysis suggested that QLICD-DE （V2.0） total score was positively correlated with total protein and platelet distribution width in patients with depression （r=0.198， 0.281， P

Tiger nut (Cyperus esculentus L., TN), is a perennial sedge plant of the family Salicaceae, native to Africa, and has been introduced to China as an emerging crop that integrates food, oil, pasture and forage. The tubers are not only nutritious, but also have medical health functions such as lowering blood pressure, blood lipids and cholesterol. In this paper, the latest research progress of processing non-oil products of Olea europaea was described from several fields, such as Olea europaea staple food products, Olea europaea beverage products, Olea europaea fermented products, and other products. The future of processing development was also outlined to provide reference for the exploitation and utilization of Olea europaea tubers and its oil extraction by-products.

Objective To assess the incidence of atrial fibrillation (AF) in patients with atrial septal defect (ASD)before and after interventional closure, and analyze the related risk factors. Methods A retrospective study was carried out in the ASD patients over 40 years old undergoing interventional closure in our hospital from August 2014 to June 2021. According the presence of AF or not before interventional closure, they were divided into ASD plus AF group and ASD plus sinus rhythm group. Based on the occurrence of new-onset AF or not after interventional closure, they were also assigned into new-onset AF group and sinus rhythm group. The related factors were analyzed by comparing those in the ASD plus AF group, new-onset AF group and the sinus rhythm groups. Results A total of 280 patients were recruited in this study, including 75 males and 205 females, at a mean age of 40~83(54.51±10.02) years. The incidence of AF in ASD patients before interventional closure was 16.07% (45/280). Of the 235 patients who were in sinus rhythm before interventional closure, 15 (6.38%) patients developed new-onset AF during the follow-up of 42.40±23.98 months. In comparison to the patients who did not have AF, the patients who had AF before interventional closure were significantly older (P < 0.001), and with NYHA functional class Ⅱ or worse (P=0.004), dilated both left and right atriums (P < 0.001) and higher right ventricular pressure (P < 0.001). Compared to the patients with sinus rhythm after interventional closure, those with new-onset AF were older (P < 0.001), and with dilated left atrium (P=0.008), right atrium (P=0.003) and right ventricle (P=0.042), but a lower left ventricular ejection fraction (LVEF, P=0.004). Logistic regression analysis showed that older age, dilated left atriums, NYHA functional class ≥Ⅱ and elevated right ventricular pressure were risk factors of AF, and age was the main risk factors of new-onset AF in ASD patients after interventional closure. Conclusion The incidence of AF is quite high in ASD patients over 40 years old no matter before or after interventional occlusion. Older age, dilated atriums, worse NYHA functional class and higher right ventricular pressure may be the risk factors for the occurrence of AF, and among them, age is the main risk factor of new-onset AF.

Abstract Background and Aim Thiopurines are recommended for maintenance of steroid‐free remission (SFR) in inflammatory bowel disease (IBD). Thiopurine metabolite monitoring (MM) is increasingly used in the West but remains novel in Singapore, with limited information on its therapeutic and economic benefits. Hence, this study aims to investigate MM's clinical utility and its impact on healthcare resource utilization in Singaporean IBD patients. Methods A retrospective observational study was conducted at Singapore General Hospital outpatient IBD Centre. Patients with IBD, baseline MM during 2014–2017, and weight‐based thiopurine doses for ≥4 weeks were followed up for 1 year. Actions were taken to optimize therapy, and metabolite levels before and after the first action were documented. Outcomes assessed included SFR, no therapy escalation or surgery, healthcare resource utilization, and direct healthcare costs. Results Ninety IBD patients (50 Crohn's disease, 40 ulcerative colitis) were included. Among them, 40% had baseline metabolite levels within therapeutic range, 31.1% sub‐therapeutic, 21.1% supra‐therapeutic, and 7.8% shunters. Repeated MM with subsequent dose optimization helped 67.2% of patients achieve therapeutic levels after 1 year. Overall, 87.8% of patients achieved SFR and 90% had no therapy escalation or surgery. Despite greater outpatient visits and laboratory investigations with MM, the median total healthcare costs at 1 year only increased marginally (S$6407.66 [shunters] vs S$5215.20 [supra‐therapeutic] vs S$4970.80 [sub‐therapeutic] vs S$4370.48 [control (within therapeutic range)], P = 0.592). Conclusion MM guided timely therapy escalation for non‐responders, identification of non‐adherence, and reversal of shunting. Therefore, it is a useful clinical tool to optimize thiopurines without significantly increasing healthcare costs.

Not all pit viper species are present in every state of Malaysia and their distribution varies according to altitude. There is limited information on pit viper bite incidence and its geographical distribution. This was a cross-sectional study of confirmed pit viper bite cases referred to Remote Envenomation Consultancy Services (RECS) from January 2017 to December 2020. Data was collected following the approval of institutional research ethics committee. Universal sampling methods were used. Confirmed pit viper bite cases in each state, geographical location and the antivenom used were reported. A total of 523 confirmed pit viper bite injuries occurred over the 4-year study period. The majority were Malaysians, male and young adults. Most were non-occupational related (83.9%) and involved the upper limbs (46.8%). The commonest pit viper species involved was Trimeresurus purpureomaculatus (23.7%). Green pit viper antivenom (GPAV) was the most frequent antivenom used (n = 51) with the majority of patients requiring only one dose (3 vials). This study provides a better appreciation of indigenous pit viper species distribution for each state and reflects the requirement of appropriate antivenom to be stocked in each state or district hospital.

Renewable energy is crucial for facilitating the shift towards a more sustainable society. It plays a significant role in establishing a clean energy system, mitigating greenhouse gas emissions, and enhancing the well-being of both current and future generations. The study included field observation and data analysis approaches. The study utilized IoT-based automatic fish feed spreaders, photovoltaic units, batteries, SCC (solar charge controller), Android phones, thermometers, multimeter tester, LCDs, ultrasonic sensors, and a microcontroller circuit. This study aims to acquire power, electrical energy, and efficiency measurements from solar systems employed in an Internet of Things (IoT) enabled automatic fish feeder apparatus. The results show that the power consumption needed to operate the IoT-based automatic fish feeder gadget is 48.75 watts. The peak of solar irradiance was recorded at 12.00 WIT, averaging 900.27 W/m2. The lowest intensity was at 09.00 WIT, averaging 422.78 W/m2. Photovoltaics can produce electrical power at 22.75 watts per hour, leading to a daily electrical energy output of 159.25 Wh. The highest photovoltaics efficiency was 16.37% with 465.3 W/m2 of solar irradiance, 30.7°C of temperature and 2.144 m/s of wind speed. The temperature and wind speed has significantly affected on photovoltaics efficiency.

Abstract Nuclear cataract (NC) is a priority ocular disease of blindness and vision impairment globally. Early intervention and cataract surgery can improve the vision and life quality of NC patients. Anterior segment coherence tomography (AS-OCT) imaging is a non-invasive way to capture the NC opacity objectively and quantitatively. Recent clinical research has shown that there exists a strong opacity correlation relationship between NC severity levels and the mean density on AS-OCT images. In this paper, we present an effective NC classification framework on AS-OCT images, based on feature extraction and feature importance analysis. Motivated by previous clinical knowledge, our method extracts the clinical global–local features, and then applies Pearson’s correlation coefficient and recursive feature elimination methods to analyze the feature importance. Finally, an ensemble logistic regression is employed to distinguish NC, which considers different optimization methods’ characteristics. A dataset with 11,442 AS-OCT images is collected to evaluate the method. The results show that the proposed method achieves 86.96% accuracy and 88.70% macro-sensitivity, respectively. The performance comparison analysis also demonstrates that the global–local feature extraction method improves about 2% accuracy than the single region-based feature extraction method.

The separation of butane isomers, raw materials in petrochemical industry, is challenging. Here the authors report the separation of n-butane and isobutane using a metal-organic framework slurry; the separation can be performed at large scale in a pilot-scale separation tower.

Abstract Background and Aim Patients with inflammatory bowel disease (IBD) requiring infliximab frequently spend hours to attend treatment. Through quality improvement (QI) methodology, we aimed to shorten the time spent in the biologics infusion center using the accelerated infusion protocol and describe patient outcomes, safety, and associated cost savings. Methods From September 2018 through December 2019, eligible IBD patients receiving infliximab were recruited. We implemented interventions including the accelerated infusion protocol, and modifying collection location of infliximab. Statistical process control charts were created. Patients' clinical outcome and cost savings data were analyzed using descriptive statistics and Pearson's chi‐square. Results During the study period, a total of 60 patients with IBD receiving infliximab were recruited. A total of 315 infusions were administered—152 were under accelerated infusion protocol and 163 under standard protocol. The mean infliximab infusion time was reduced by 47%, from 2.4 h (142 ± 14 min) to 1.2 h (75 ± 10 min) (142 min vs 75 min, P

We demonstrate spatial modification of the optical properties of thin-film metal oxides, zinc oxide (ZnO) and vanadium dioxide (VO2) as representatives, using a commercial focused ion beam (FIB) system. Using a Ga+ FIB and thermal annealing, we demonstrated variable doping of a wide-bandgap semiconductor, ZnO, achieving carrier concentrations from 1018 cm−3 to 1020 cm−3. Using the same FIB without subsequent thermal annealing, we defect-engineered a correlated semiconductor, VO2, locally modifying its insulator-to-metal transition (IMT) temperature by up to ∼25 °C. Such area-selective modification of metal oxides by direct writing using a FIB provides a simple, mask-less route to the fabrication of optical structures, especially when multiple or continuous levels of doping or defect density are required.

AIM: To investigate the ocular development of patients who had unilateral congenital cataract (CC) combined with persistent fetal vasculature (PFV). METHODS: This cross-sectional, observational study included patients who had unilateral CC and PFV and those with isolated unilateral CC. Axial length (AL), keratometry, anterior chamber depth (ACD), lens thickness, and vitreous length were obtained. The ocular biometric parameters of the affected eyes of patients with CC and PFV were compared with the fellow eyes and with the affected eyes of patients with isolated CC. RESULTS: A total of 110 patients were included and divided into 4 groups: group 1 (18 patients with CC and PFV, 0.05). CONCLUSION: Compared with the fellow eyes, the ALs of the eyes with unilateral CC and PFV are shorter in patients younger than 24mo and longer in those older than 24mo; the keratometries of the eyes with unilateral CC and PFV are steeper in patients older than 24mo and similar with those younger than 24mo. These findings provide further understanding of ocular development in patients with both CC and PFV.

Abstract Background The ability of plants to withstand and thrive in an adverse environment is crucial to ensure their survivability and yield performance. The WRKY transcription factors (TFs) have crucial roles in plant growth, development and stress response, particularly drought stress. In oil palm, drought is recognized as one of the major yield limiting factors. However, the roles of WRKY TFs in the drought response of oil palm is unclear. Results Herein, we studied the transcriptome of drought treated oil palm leaf and identified 40 differentially expressed genes (DEGs) of WRKY TFs, of which 32 DEGs were upregulated and 8 DEGs were downregulated in response to drought stress in oil palm. They were categorized into Groups I to IV based on the numbers of WRKY domain and the structural difference in the zinc finger domain. Multiple stress- and hormone-responsive cis-regulatory elements were detected in the drought responsive oil palm EgWRKY (Dro-EgWRKY) genes. Fourteen of the 15 selected oil palm WRKY (EgWRKY) genes demonstrated a tissue-specific expression profile except for EgWRKY28 (Group I), which was expressed in all tissues tested. The expression levels of 15 candidate EgWRKYs were upregulated upon salinity and heat treatments, while several genes were also inducible by abscisic acid, methyl jasmonate, salicylic acid and hydrogen peroxide treatments. Members of the Group III WRKY TFs including EgWRKY07, 26, 40, 52, 59, 73 and 81 displayed multiple roles in drought- and salinity-response under the modulation of phytohormones. Conclusions EgWRKY TFs of oil palm are involved in phytohormones and abiotic stress responses including drought, salinity and heat. EgWRKY07, 26, 59 and 81 from Group III maybe important regulators in modulating responses of different abiotic stresses. Further functional analysis is required to understand the underlying mechanism of WRKY TFs in the regulatory network of drought stress.

AIM: To assess the effectiveness of core vitrectomy-phacoemulsification-intraocular lens (IOL) implantation-capsulo-hyaloidotomy in treating phakic eye at least 1mo after the onset of malignant glaucoma. METHODS: A retrospective analysis were performed on malignant glaucoma patients treated in Zhongshan Ophthalmic Center between 2016 and 2018. Demographic and clinical data were described. The preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), number of IOP-lowering medications used, and anterior chamber depth (ACD) of the case series were compared by Wilcoxon signed-rank test. RESULTS: Thirteen phakic eyes with long time intervals between onset and surgery were identified in this case series. Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy reduced the IOP (P=0.046) and the number of IOP-lowering medications used (P=0.004), deepened the ACD (P=0.005). Complete success was achieved in 38.5% of the eyes, and anatomical success was achieved in 100% of the eyes without any recurrence. The only postoperative complication observed is corneal endothelial decompensation. It occurred in two cases. CONCLUSION: Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy is safe and effective for treatment of long onset phakic malignant glaucoma.

This paper summarized the management experience in construction and practice of the outpatient clinic with Traditional Chinese Medicine(TCM) appropriate nursing technology. Issues about management on patient attendance, outpatient treatment prescription, diagnosis and treatment area, process of visiting doctor and nursing quality were analyzed. The establishment of outpatient clinic helps achieve the closed-loop management of TCM preventive treatment of disease, consisting of health management, education and intervention, and aiming to provide better quality of TCM nursing. (本文总结了中医适宜技术护理门诊建设的思路与方法, 包括就诊人群管理、门诊治疗处方管理、就诊区域管理、就诊流程管理、护理质量管理等, 通过建设中医适宜技术护理门诊, 实现了健康管理、健康教育、健康干预于一体的中医“治未病”闭环化管理, 并以此为患者提供更优质的中医护理服务。)

Introduction and Objectives: Tenofovir Alafenamide (TAF) is a preferred treatment in the most recent EASL and AASLD HBV Guidelines, especially in patients with risk factors for TDF-associated renal and bone effects. In 2 identically-designed double-blind (DB), randomized (2:1), Phase 3 studies (HBeAg-negative patients [N = 425] and HBeAg-positive patients [N = 873]), TAF demonstrated antiviral efficacy non-inferior to that of TDF with superior renal and bone safety. After completing three years of DB treatment, all patients were eligible to receive open-label (OL) TAF through Year eight. Here we present study results for Year five. Materials and Methods: Efficacy was assessed by serial virologic, biochemical, and serologic assessments, while safety data included changes in renal function and changes in hip and spine bone mineral density. Resistance testing and phenotyping were performed annually through Year 5. Results: Of 1298 randomized and treated patients, 1157 (89%; 775 TAF; 382 TDF) entered OL, at year 5, 999 (77%; 675 TAF, 136 TDFTAF OL 3y, 188 TDF-TAF OL 2y) patients remained on treatment. High rates of virologic control were achieved and maintained in patients receiving TAF throughout and for TDF patients who switched to TAF at Weeks 96 or 144. Rates of ALT normalization and serologic responses were also comparable among groups. Eight patients are undergoing phenotypic testing to assess resistance. Adverse events (AEs) leading to discontinuation were low and similar among groups. Renal and bone outcomes were improved following the switch to OL TAF from TDF. Conclusions: After five years of treatment, virologic suppression rates remained high, and TAF was safe and well tolerated, with improved renal and bone safety in patients switching from TDF.

Pit vipers from the genus Tropidolaemus are identified as one of the common causes of snake bite from venomous species in Malaysia. All Tropidolaemus species bite cases referred to the Remote Envenomation Consultation Services (RECS) between 2015-2021 were included. A total of 4,718 snake-related injuries cases consulted to RECS with 310 (6.6%) involved Tropidolaemus species; of these 190 (61.3%) were T. subannulatus and 120 (38.7%) T. wagleri. All the T. subannulatus cases occurred in Sabah and Sarawak while all cases of T. wagleri occurred in Peninsular Malaysia. The majority of patients were male (74.8%) and adults between 18-59 years old (61.2%). The upper limb (56.6%) was the most frequent anatomical region involved. Most cases were non-occupationally related (75.4%). Bites from both species caused local pain (77.1%) and swelling (27.2%). Most patients complained of mild pain (48.0%). Paracetamol (40.0%) was the most common analgesic prescribed. Antivenom was not indicated in all cases. Two patients were given antivenom inappropriately before RECS consultation. Most patients (54.7%) needed hospital observation for less than 24 hours. No deaths occurred in the group studied.

Background. Tendon injuries are common clinical disorders. Due to the limited regeneration ability of tendons, tissue engineering technology is often used as an adjuvant treatment. This study explored the molecular pathways underlying micropattern SF film-regulated TSPC propensity and their repairing effects to highlight the application value of micropattern SF films. Methods. First, we characterized the physical properties of the micropattern SF films and explored their repairing effects on the injured tendons in vivo. Then, we seeded TSPCs on SF films in vitro and determined the micropattern SF film-induced gene expression and activation of signaling pathways in TSPCs through high-throughput RNA sequencing and proteomics assays. Results. The results of in vivo studies suggested that micropattern SF films can promote remodeling of the injured tendon. In addition, immunohistochemistry (IHC) results showed that tendon marker genes were significantly increased in the micropattern SF film repair group. Transcriptomic and proteomic analyses demonstrated that micropattern SF film-induced genes and proteins in TSPCs were mainly enriched in the focal adhesion kinase (FAK)/actin and phosphoinositide 3-kinase (PI3K)/AKT pathways. Western blot analysis showed that the expression of integrins α2β1, tenascin-C (TNC), and tenomodulin (TNMD) and the phosphorylation of AKT were significantly increased in the micropattern SF film group, which could be abrogated by applying PI3K/AKT inhibitors. Conclusion. Micropattern SF films modified by water annealing can promote remodeling of the injured tendon in vivo and regulate the tendon differentiation of TSPCs through the α2β1/FAK/PI3K/AKT signaling pathway in vitro. Therefore, they have great medical value in tendon repair.

People often form different aesthetic preferences for natural and built environments, which affects their behavioral intention; however, it remains unknown whether this difference in aesthetic preference is due to differences in thinking styles. However, whether tourists’ aesthetic preferences differ when using different visual attention processes has not been studied further. This study used eye-tracking and self-reporting to investigate these questions. The results show that natural environment images are more favored visually because they can evoke in tourists larger pupil diameters and longer scan paths, but we found no significant difference in fixation duration and fixation counts. We also found that the scanning path of tourists who predominantly rely on intuitive thinking is modulated by the bottom-up attention process, while the scanning path of tourists who prefer rational thinking is modulated by the top-down attention process. In the bottom-up process, tourists who prefer rational thinking exhibit more positive aesthetic preferences and emotional arousal. In summary, the present study verified that aesthetic preference is more likely to be influenced by both thinking style and visual attention processing. The results of the present work provide preliminary evidence that the aesthetic preference of the environment is not only related to visual attention but also affected by the individual visual attention process and thinking style.

The effects of storage temperature on postharvest storability, quality attributes and antioxidant enzyme activities of harvested Ponkan mandarins were investigated. Fresh fruits were randomly divided into four groups and stored at different temperatures [5 ± 1 °C (S5), 10 ± 1 °C (S10), 15 ± 1 °C (S15), and 20 ± 1 °C (S20 or control)] for 120 days. The results indicated that, compared with the control fruit, low-temperature storage at 10 °C significantly delayed the increase in fruit decay rate, weight loss, citrus colour index, respiration intensity, relative electrical conductivity, the accumulation of hydrogen peroxide and malondialdehyde, retarded the decline in L* value, retained high contents of total soluble solid, titratable acid, vitamin C, total phenol and total flavonoid, as well as higher activities of antioxidant enzymes – superoxide dismutase, catalase, peroxidase and ascorbic peroxidase. The principal component analysis results showed that low-temperature storage significantly maintained the postharvest quality of Ponkan mandarins, with fruit stored at 10 °C having no significant difference from the fruit stored at 5 °C, but markedly higher than those fruit stored at 15 °C. The comprehensive result of single-factor analysis and PCA showed that 10 °C could be used as the optimum storage temperature for improving the postharvest storability of Ponkan mandarins.

Abstract Introduction Tendon diseases and injuries are a serious problem for the aged population, often leading to pain, disability and a significant decline in quality of life. The purpose of this study was to determine the influence of aging on biochemistry and histology during tendon healing and to provide a new strategy for improving tendon healing. Method A total of 24 Sprague-Dawley rats were equally divided into a young and an aged group. A rat patellar tendon defect model was used in this study. Tendon samples were collected at weeks 2 and 4, and hematoxylin-eosin, alcian blue and immunofluorescence staining were performed for histological analysis. Meanwhile, reverse transcription-polymerase chain reaction (RT-PCR) and western blot were performed to evaluate the biochemical changes. Results The histological scores in aged rats were significantly lower than those in young rats. At the protein level, collagen synthesis-related markers Col-3, Matrix metalloproteinase-1 and Metallopeptidase Inhibitor 1(TIMP-1) were decreased at week 4 in aged rats compared with those of young rats. Though there was a decrease in the expression of the chondrogenic marker aggrecan at the protein level in aged tendon, the Micro-CT results from weeks 4 samples showed no significant difference(p>0.05) on the ectopic ossification between groups. Moreover, we found more adipocytes accumulated in the aged tendon defect with the Oil Red O staining and at the gene and protein levels the markers related to adipogenic differentiation. Conclusions Our findings indicate that tendon healing is impaired in aged rats and is characterized by a significantly lower histological score, decreased collagen synthesis and more adipocyte accumulation in patellar tendon after repair.

A novel frameshift mutation in the KCNH2 gene for long QT syndrome type 2 (LQTS2) was identified after torsades des pointes ventricular tachycardia in a 49-year-old patient managed with octreotide and nadolol for an acute variceal bleed. In spite of removal of offending medications, and correction of underlying electrolyte abnormalities, the patient’s QT interval remained prolonged—at 521 ms—raising the suspicion of an underlying channelopathy. Genetic studies confirmed heterozygosity for a novel frameshift mutation for the KCNH2 gene, D896Rfs X79. We explore the pathogenicity and clinical impact of this variant mutation. Résumé: Une nouvelle mutation de changement de phase du gène KCNH2 impliqué dans le syndrome du QT long de type 2 (SQTL2) a été trouvée après une tachycardie ventriculaire à torsades de pointes chez un patient de 49 ans traité par octréotide et nadolol en raison d’un saignement variqueux en phase aiguë. En dépit du retrait des médicaments mis en cause et de la correction des anomalies électrolytiques sous-jacentes, l’intervalle du QT du patient qui demeurait prolongé (à 521 ms) a suscité la suspicion d’une canalopathie sous-jacente. Des études génétiques ont permis de confirmer l’hétérozygosité d’une nouvelle mutation de changement de phase du gène KCNH2, D896Rfs X79. Nous examinons la pathogénicité et les répercussions cliniques de cette mutation du variant.

We experimentally generate cylindrically polarized wavepackets with transverse orbital angular momentum, demonstrating the coexistence of spatiotemporal optical vortex with spatial polarization singularity. The results in this paper extend the study of spatiotemporal wavepackets to a broader scope, paving the way for its applications in various areas such as light–matter interaction, optical tweezers, spatiotemporal spin–orbit angular momentum coupling, etc.

Paeonia lactiflora Pall. is an important ornamental plant with high economic and medicinal value, which has considerable development prospects worldwide. The lack of efficient tissue culture techniques and genetic transformation systems has become a master obstacle for P. lactiflora research. The purpose of the present study focuses on obtaining an efficient and stable genetic transformation method using callus as the receptor and exploring an efficient protocol for callus induction and proliferation associated with P. lactiflora. Callus induction and proliferation were performed using MS medium with various concentrations of 2,4-Dichlorophenoxyacetic acid (2,4-D), 1-Naphthaleneacetic acid (NAA), 6-Benzylaminopurine (6-BA) and thidiazuron (TDZ). The sensitivity of callus to kanamycin and cefotaxime was determined. Several parameters such as Agrobacterium cell density, infection time and co-culture duration were studied to optimize transformation efficiency. Agrobacterium strains EHA105 and pBI121 binary vector harboring the β-glucuronidase (GUS) gene were used for transformation. Expression of the GUS reporter gene was detected by GUS assay, polymerase chain reaction (PCR) and Quantitative Real-time PCR (RT-qPCR). The MS medium containing 1.0 mg·L-1 NAA, 0.5 mg·L-1 2,4-D and 0.5 mg·L-1 TDZ was optimal for callus induction and MS medium containing 0.5 mg·L-1 NAA, 1.0 mg·L-1 2,4-D and 0.5 mg·L-1 TDZ was the best for callus proliferation. The concentrations of kanamycin and cefotaxime used for screening positive callus were 125 mg·L-1 and 200 mg·L-1, respectively. Among various combinations analyzed, the best transformation result was obtained via the 25 min of infection of Agrobacterium at 0.6 OD600 and 3 d of co-culture. Overall, this study provided technical support and theoretical guidance for improving the callus induction and proliferation efficiency and the study of gene function in P. lactiflora.

The increasing demand for world paper consumption stimulates the growth of paper and pulp industries and lead to high carbon emission. Electricity and thermal energy are critically demanded by the paper and pulp industries. The premises utilizing grid electricity are carbon intensive as the grid energy mainly generates electricity from burning coal. Alternative energy resources that are less carbon-intensive such as natural gas and solar energy, can be used to generate electricity to fulfil the energy demand of the pulp and paper industry and mitigate carbon emissions. This study implemented cogeneration natural gas boilers and solar energy to substitute the dependency on grid electricity from Tenaga National Berhad as they are less carbon intensive than coal fuel. Carbon and economic analysis were conducted on the case studies that replaced grid electricity supply from TNB by implementing cogeneration natural gas boilers and solar energy. The results show that the total savings/kWh of energy produced from cogeneration natural gas boiler range from 0.155 MYR/kWh to 0.164 MYR/kWh. The total savings per kWh of energy produced from solar energy is higher, which was 0.207 MYR/kWh of solar energy produced. Solar has better operation cost savings per unit of electricity generated, but a limited installation area restricts the implementation. In the future, the increasing efficiency of solar technology will make the option viable while achieving more cost savings and carbon emission reduction.

Organic waste is one of the major components found in solid waste disposal. The increasing production of solid wastes reflects the great potential of organic wastes as one of the green energy resources. The organic wastes can be used to generate green energy resources such as biomethane via designated bioprocesses. Each bioprocess is unique and requires an optimum range of carbon-to-nitrogen ratio to obtain the optimum production energy resources. The composition of organic wastes varies across different origins and different types. A non-linear programming mathematical model was developed to allocate the resources and satisfy the carbon-to-nitrogen ratio among the sources and sinks via General Algebraic Modelling System. The objective function of the model is to minimize the utilization of external supply to reduce the necessary of transporting external resources from a distant location. To satisfy a biomethane digester demanding daily 40 kg/d feedstock with carbon-to-nitrogen ratio of 28.1, 193.387 kg/week of external supplies were required to mix with 2212.572 kg/week of organic waste locally available to produce 115.2 m3 CH4/d. A biogas storage with capacity of 52.86 m3 was determined from the model. A storage with a capacity of 689.43 m3 was identified to store the unutilized corn stover but the storage does not show practical usage as the daily accumulation of corn stover increases from day 1 to day 7, where the unutilized organic waste will be disposed at the end of the week due to unavoidable composition change during biodegradation. The results obtained from the developed mathematical mode can be a preliminary analytic tool that provides governments, agencies and industries intended to invest and contribute to the green and sustainable waste management sectors.

The electric bus is a promising solution for tackling carbon emissions, as it can replace the steadily growing numbers of diesel buses in the public transportation sector resulting from high travel demand. An electric bus has lower energy storage compared to a diesel bus and requires a longer refueling time. The charging schedule for an electric bus must be well organized to fulfill bus energy demand and passenger travel demand. This study developed a mathematical model to schedule the charging times of electric buses on multiple routes, based on a 24-hr day with a single charging station and a limited number of chargers. The model helps to minimize overall costs, including the charger cost (based on the number of chargers installed) and operating cost (based on the electric tariff). The results indicate that 2 chargers are sufficient to provide energy for 8 buses on 3 different routes. This model can assist transit planners in determining the optimal number of chargers to install at a bus depot and planning bus charging schedules. However, the electric buses’ limited battery storage capacity inhibits savings incurred by the electricity tariff.

Background Delays in producing discharge prescriptions have hindered the provision of bedside dispensing services (BEDISC) that enable medication reconciliation and pharmaceutical intervention, which is an important element in transitional care medication safety. We aimed to assess the impact of early medication discharge planning on the delivery of BEDISC in terms of the rate of bedside dispensing, medication errors, and cost-saving from medication reconciliation by reusing patient’s own medicines (POMs). Methods A pre–post intervention study was conducted at medical wards in a public tertiary hospital. During the intervention phase, a structured bedside dispensing process was delineated and conveyed to the doctors, nurses, and pharmacists. Regular verbal reminders were given to the doctors to prioritize discharge patients by producing the prescriptions once discharge decisions had been made and nurses to hand the prescriptions to ward pharmacists and not patients. Throughout the study, ward pharmacists were involved in medication reconciliation via screening of discharge prescriptions and reusing POMs, performed pharmaceutical interventions for any medication errors detected, and provided bedside dispensing with discharge counseling. Comparisons were made between bedside versus counter-dispensing at pre–post intervention phases using the chi-square test. Results A total of 1097 and 817 discharge prescriptions were dispensed in the pre-intervention and post-intervention phases, respectively. The bedside dispensing rate increased by 13.5% following remedial actions (p

IntroductionTranslation of evidence into clinical practice for use of intravenous thrombolysis in acute stroke care has been slow, especially across low- and middle-income countries. In Malaysia where the average national uptake was poor among the public hospitals in 2018, one hospital intriguingly showed comparable thrombolysis rates to high-income countries. This study aimed to explore and provide in-depth understanding of factors and explanations for the high rates of intravenous stroke thrombolysis in this hospital.MethodsThis single case study sourced data using a multimethod approach: (1) semi-structured in-depth interviews and focus group discussions, (2) surveys, and (3) review of medical records. The Tailored Implementation of Chronic Diseases (TICD) framework was used as a guide to understand the determinants of implementation. Twenty-nine participants comprising the Hospital Director, neurologists, emergency physicians, radiologists, pharmacists, nurses and medical assistants (MAs) were included. Thematic analyses were conducted inductively before triangulated with quantitative analyses and document reviews.ResultsFavorable factors contributing to the uptake included: (1) cohesiveness of team members which comprised of positive interprofessional team dynamics, shared personal beliefs and values, and passionate leadership, and (2) facilitative work process through simplification of workflow and understanding the rationale of the sense of urgency. Patient factors was a limiting factor. Almost two third of ischemic stroke patients arrived at the hospital outside the therapeutic window time, attributing patients' delayed presentation as a main barrier to the uptake of intravenous stroke thrombolysis. One other barrier was the availability of resources, although this was innovatively optimized to minimize its impact on the uptake of the therapy. As such, potential in-hospital delays accounted for only 3.8% of patients who missed the opportunity to receive thrombolysis.ConclusionsDespite the ongoing challenges, the success in implementing intravenous stroke thrombolysis as standard of care was attributed to the cohesiveness of team members and having facilitative work processes. For countries of similar settings, plans to improve the uptake of intravenous stroke thrombolysis should consider the inclusion of interventions targeting on these modifiable factors.

Dispersal from the natal site or familial group is a core milestone of adolescent development in many species. A wild species of mouse, Mus spicilegus, presents an exciting model in which to study adolescent development and dispersal because it shows different life history trajectory depending on season of birth. M. spicilegus born in spring and summer on long days (LD) disperse in the first 3 months of life, while M. spicilegus born on shorter autumnal days (SD) delay dispersal through the wintertime. We were interested in using these mice in a laboratory context to compare age-matched mice with differential motivation to disperse. To first test if we could find a proxy for dispersal related behavior in the laboratory environment, we measured open field and novel object investigation across development in M. spicilegus raised on a LD 12 h:12 h light:dark cycle. We found that between the first and second month of life, distance traveled and time in center of the open field increased significantly with age in M. spicilegus. Robust novel object investigation was observed in all age groups and decreased between the 2nd and 3rd month of life in LD males. Compared to male C57BL/6 mice, male M. spicilegus traveled significantly longer distances in the open field but spent less time in the center of the field. However, when a novel object was placed in the center of the open field, Male M. spicilegus, were significantly more willing to contact and mount it. To test if autumnal photoperiod affects exploratory behavior in M. spicilegus in a laboratory environment, we reared a cohort of M. spicilegus on a SD 10 h:14 h photoperiod and tested their exploratory behavior at P60-70. At this timepoint, we found SD rearing had no effect on open field metrics, but led to reduced novel object investigation. We also observed that in P60-70 males, SD reared M. spicilegus weighed less than LD reared M. spicilegus. These observations establish that SD photoperiod can delay weight gain and blunt some, but not all forms of exploratory behavior in adolescent M. spicilegus.

Abstract Corneal injury can lead to severe vision impairment or even blindness. Although numerous methods are developed to accelerate corneal wound healing, most of them are passive treatments that rarely participate in controlling endogenous cell behaviors or are incompatible with nontransparent bandage. In this work, a wireless‐powered electrical bandage contact lens (EBCL) is developed to generate a localized external electric field to accelerate corneal wound healing and vision recovery. The wireless electrical stimulation circuit employed a flower‐shaped layout design that can be compactly integrated on bandage contact lens without blocking the vision. The role of the external electric field in promoting corneal wound healing is examined in vitro, where the responses of directional migration and corneal cells alignment to the electric field are observed. The RNA sequencing (RNA‐seq) analysis indicates that the electrical stimulation can participate in controlling cell division, proliferation, and migration. Furthermore, the wireless EBCL is demonstrated to accelerate the completed recovery of corneal wounds on rabbits’ eyes by electrical stimulation, while the control group exhibits delayed recovery and obvious corneal defects. As a new generation of intelligent device, the wireless and patient‐friendly EBCL can provide a promising therapeutic strategy for ocular diseases.