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The combined effects of ethylenediaminetetraacetic acid (EDTA) and bacteriophage (phage) treatment of foodborne pathogens were investigated. Although viable counts for Campylobacter jejuni decreased by 1.5 log after incubation for 8 h in the presence of phage PC10, re-growth was observed thereafter. The combination of phage PC10 and 1 mM EDTA significantly inhibited the re-growth of C. jejuni. The viable counts for C. jejuni decreased by 2.6 log (P < 0.05) compared with that of the initial count after 24 h. Moreover, EDTA at 0.67 or 1.3 mM, combined with the specific lytic phages, also effectively inhibited the re-growth of phage-resistant cells of Campylobacter coli, Salmonella enterica serovar Enteritidis, and Salmonella enterica serovar Typhimurium. In addition, the combined effects of lytic phages and EDTA were investigated on the viability of Campylobacter in BHI broth at low temperatures followed by the optimum growth temperature. The re-growth of C. coli was significantly inhibited by the coexistence of 1.3 mM EDTA, and the viable counts of surviving bacteria was about the same as the initial viable count after the incubation. This is the first study demonstrating the combined use of lytic phages and EDTA is effective in inhibiting the re-growth of phage-resistant bacteria in Gram-negative bacteria., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Robotic lower-limb prostheses aim to replicate the power-generating capability of biological joints during locomotion to empower individuals with lower-limb loss. However, recent clinical trials have not demonstrated clear advantages of these devices over traditional passive devices. We believe this is partly because the current designs of robotic prothesis controllers and clinical methods for fitting and training individuals to use them do not ensure good coordination between the prosthesis and user. Accordingly, we advocate for new holistic approaches in which human motor control and intelligent prosthesis control function as one system (defined as human-prosthesis symbiosis). We hope engineers and clinicians will work closely to achieve this symbiosis, thereby improving the functionality and acceptance of robotic prostheses and users' quality of life., Competing Interests: Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Objective: Sleep difficulty is one of the main concerns during the COVID-19 pandemic. This study examined factors related to vaccination and physical and psychological health conditions, and sleep difficulty in college students in China., Methods: An online, cross-sectional, anonymous survey was used to investigate college students' perceived sleep difficulty and relevant components (i.e., physical health condition, psychological distress, knowledge of vaccine, and autonomy of vaccine uptake). Hierarchical ordinal logistic regression was conducted to examine the proposed model with the control of participants' demographics (i.e., gender and age)., Results: Valid data of 3,145 students from 43 universities in mainland China was collected in January 2021. The average age of participants was 20.8 years old (S. D. = 2.09). The majority were single (97.4%), and about half were male (49.8%). Results showed that participants had less psychological distress when they had more knowledge about the COVID-19 vaccine and more autonomy to decide whether to receive it. In addition, participants with better physical health experienced less sleep difficulty. In contrast, those with more psychological distress experienced more sleep difficulty., Conclusions: These findings can inform healthcare providers about the relationship between different factors and difficulty sleeping and aid them in developing interventions addressing sleep difficulties associated with the global pandemic. Health authorities also can improve vaccine uptake and reduce hesitancies in future vaccination campaigns based on the study results showing that greater vaccine knowledge and autonomy reduced psychological distress., (© 2021 The Author(s).)

The surface intertidal sediments in the Pearl River Estuary of China were analyzed from multiple perspectives, including the distribution characteristics, potential sources, and biological risks of polycyclic aromatic hydrocarbons (PAHs). The average concentration of PAHs, ranging from 73.68 ng/g to 933.25 ng/g, was 346.78 ng/g. PAHs are mainly composed of the 2- and 3-ring PAHs, with naphthalene (Nap), phenanthrene (Phe), pyrene (Pyr), benzo(g,h, i) perylene (Dib), fluoranthene (Flua), and indeno (1,2,3-c,d) pyrene (Ind) as the dominant constituents. The principal component analysis combined with multiple linear regression showed that petroleum combustion and biomass/coal combustion have contributed 52.78% and 40.53%, respectively, to the PAHs in intertidal sediments of Pearl River Estuary. The occurrence of adverse biological effects as a result of PAH contamination in the intertidal sediments of Pearl River Estuary has increased by 8% based on the mean value of the probable effect quotient., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: The early integration of palliative care in the emergency department (ED-PC) provides several benefits, including improved quality of life with optimal comfort measures, and symptom control. Whether palliative care could affect the intensive care unit admissions, hospital care and resource utilization requires further investigation., Aim: To determine the differences in inpatient characteristics, hospital care, survival, and resource utilization between patients receiving palliative care (ED-PC) and usual care (UC)., Design: Retrospective observational study., Setting/participants: We enrolled consecutive, acute, critically ill patients admitted to the emergency intensive care unit at Taipei Veterans General Hospital from 1 February 2018 to 31 January 2020., Results: A total of 1273 patients were evaluated for unmet palliative care needs; 685 patients received ED-PC and 588 received UC. The palliative care patients were more severely frail (AOR 2.217 (1.295-3.797), p = 0.004), had functional deterioration with three ADLs (AOR 1.348 (1.040-1.748), p = 0.024), biopsychosocial discomfort (AOR 1.696 (1.315-2.187), p < 0.001), higher Taiwan Triage and Acuity Scale 1 ( p = 0.024), higher in-hospital mortality (AOR 1.983 (1.540-2.555), p < 0.001), were four times more likely to sign an DNR (AOR 4.536 (2.522-8.158), p < 0.001), and were twice as likely to sign an DNR at admission (AOR 2.1331.619-2.811), p < 0.001). Palliative care patients received less epinephrine (AOR 0.424 (0.265-0.678), p < 0.001), more frequent withdrawal of an endotracheal tube (AOR 8.780 (1.122-68.720), p = 0.038), and more narcotics (AOR1.675 (1.132-2.477), p = 0.010). Palliative care patients exhibited lower 7-day, 30-day, and 90-day survival rates ( p < 0.001). There was no significant difference in the hospital length of stay (LOS) (21.2 ± 26.6 vs. 21.7 ± 20.6, p = 0.709) nor total hospital expenses (293,169 ± 350,043 vs. 294,161 ± 315,275, p = 0.958)., Conclusion: Acute critically ill patients receiving palliative care were more frail, more critical, and had higher in-hospital mortality. Palliative care patients received less epinephrine, more endotracheal extubation, and more narcotics. There was no difference in the hospital LOS or hospital costs between the palliative and usual care groups. The synthesis of ED-PC is new but achievable with potential benefits to align care with patient goals.

A novel and simple flotation technique has been developed to prepare high-purity graphite from impure graphite. In this method, a suspension of pristine powdered graphite (PG) is dispersed and stirred in water without adding froth formers or supportive chemicals. This makes fine particles of graphite move upwards and float on water. X-ray diffraction (XRD) analysis reveals that the floated graphite (FG) has a lower c-axis parameter, indicating the removal of interlayer impurities. A notable increase in the intensity ratio of the D band to G band in the Raman spectra indicates that the FG has more edge defects due to their smaller crystallite sizes. Transmission electron microscopic (TEM) analysis shows the number of layers in FG has been reduced to 16 from 68 in PG. The absence of C=O vibration of Fourier Transformed Infrared (FT-IR) spectroscopy in treated and untreated samples suggests that their layers are not significantly oxidized. However, X-ray photoelectron spectroscopic (XPS) analysis shows the presence of C-O-C ether functionalities, possibly on edge planes. Further, the product has higher purity with increased carbon content. Therefore, the technique is helpful for the value enhancement of graphite, the reduction of the chemical cost of the conventional techniques, environmental friendliness, and improvement of its applications., (© 2021. The Author(s).)

We report a one-pot facile synthesis of highly photoresponsive bovine serum albumin (BSA) templated bismuth-copper sulfide nanocomposites (BSA-BiZ/Cu x S NCs, where BiZ represents in situ formed Bi 2 S 3 and bismuth oxysulfides (BOS)). As-formed surface vacancies and BiZ/Cu x S heterojunctions impart superior catalytic, photodynamic and photothermal properties. Upon near-infrared (NIR) irradiation, the BSA-BiZ/Cu x S NCs exhibit broad-spectrum antibacterial activity, not only against standard multidrug-resistant (MDR) bacterial strains but also against clinically isolated MDR bacteria and their associated biofilms. The minimum inhibitory concentration of BSA-BiZ/Cu x S NCs is 14-fold lower than that of BSA-Cu x S NCs because their multiple heterojunctions and vacancies facilitated an amplified phototherapeutic response. As-prepared BSA-BiZ/Cu x S NCs exhibited substantial biofilm inhibition (90%) and eradication (>75%) efficiency under NIR irradiation. Furthermore, MRSA-infected diabetic mice were immensely treated with BSA-BiZ/Cu x S NCs coupled with NIR irradiation by destroying the mature biofilm on the wound site, which accelerated the wound healing process via collagen synthesis and epithelialization. We demonstrate that BSA-BiZ/Cu x S NCs with superior antimicrobial activity and high biocompatibility hold great potential as an effective photosensitive agent for the treatment of biofilm-associated infections.

Motor units (MUs) are the basic unit of motor control. MU synchronization has been evaluated to identify common inputs in neural circuitry during motor coordination. Recent studies have compared common inputs between muscles in the lower limb, but further investigation is needed to compare common inputs to MUs both within a muscle and between MUs of different muscle pairs. The goal of this preliminary study was to characterize levels of common inputs to MUs in three muscle groups: MUs within a muscle, between bilateral homologous pairs, and between agonist/antagonist muscle pairs. To achieve this, surface electromyography (EMG) was recorded during bilateral ankle dorsiflexion and plantarflexion on the right and left tibiales anterior (RTA, LTA) and gastrocnemii (RGA, LGA) muscles. After decomposing EMG into active MU firings, we conducted coherence analyses of composite MU spike trains (CSTs) in each muscle group in both the beta (13-30 Hz) and gamma (30-60 Hz) frequency bands. Our results indicate MUs within a muscle have the greatest levels of common input, with decreasing levels of common input to bilateral and agonist/antagonist muscle pairs, respectively. Additionally, each muscle group exhibited similar levels of common input between the beta and gamma bands. This work may provide a way to unveil mechanisms of functional coordination in the lower limb across motor tasks.

Background: Tyrosine kinase inhibitors (TKIs) have shown long-term survival benefits in patients with chronic myeloid leukemia (CML). Nevertheless, significant concern has been raised regarding long-term TKI-associated vascular adverse events (VAEs). The objective of this retrospective cohort study was to investigate the incidence of VAEs in Taiwanese patients with CML treated with different TKIs (imatinib, nilotinib, and dasatinib) as well as potential risk factors., Materials and Methods: We conducted a retrospective cohort study using the Taiwan Cancer Registry Database and National Health Insurance Research Database. Adult patients diagnosed with CML from 2008 to 2016 were identified and categorized into three groups according to their first-line TKI treatment (imatinib, nilotinib, and dasatinib). Propensity score matching was performed to control for potential confounders. Cox regressions were used to estimate the hazard ratio (HR) of VAEs in different TKI groups., Results: In total, 1,111 patients with CML were included in our study. We found that the risk of VAEs in nilotinib users was significantly higher than that in imatinib users, with an HR of 3.13 (95% confidence interval (CI), 1.30-7.51), whereas dasatinib users also showed a nonsignificant trend for developing VAEs, with an HR of 1.71 (95% CI, 0.71-4.26). In multivariable logistic regression analysis, only nilotinib usage, older age, and history of cerebrovascular diseases were identified as significant risk factors. The annual incidence rate of VAEs was highest within the first year after the initiation of TKIs., Conclusion: These findings can support clinicians in making treatment decisions and monitoring VAEs in patients with CML in Taiwan., Implications for Practice: This study found that patients with chronic myeloid leukemia (CML) treated with nilotinib and dasatinib may be exposed to a higher risk of developing vascular adverse events (VAEs) compared with those treated with imatinib. Thus, this study suggests that patients with CML who are older or have a history of cerebrovascular diseases should be under close monitoring of VAEs, particularly within the first year after the initiation of tyrosine kinase inhibitors., (© 2021 AlphaMed Press.)

Purpose: Several multiparametric magnetic resonance imaging (mpMRI)-based models have been developed with significant improvements in diagnostic accuracy for clinically significant prostate cancer (csCaP), but lack proper external validation. We therefore sought to externally validate and compare all published mpMRI-based csCaP risk prediction models in an independent Asian population., Patients and Methods: A total of 449 men undergoing combined transperineal fusion-targeted/systematic prostate biopsy at our specialist center between 2015 to 2019 were retrospectively analyzed. csCaP was defined as lesions with ISUP (International Society of Urological Pathology) grade group ≥2. The performance of 6 mpMRI-based risk models (MRI-ERSPC-3/4, Distler, Radtke, Mehralivand, van Leeuwen and He) were evaluated in terms of discrimination, calibration and clinical utility, using area under the receiver operating characteristic curve (AUC), calibration curves and decision curve analyses., Results: A total of 202 (45%) subjects were diagnosed with csCaP. All models demonstrated excellent accuracy with AUCs ranging from 0.75 to 0.86, and most significantly outperformed mpMRI PIRADSv2.0 (Prostate Imaging Reporting and Data System version 2.0) alone. The models by Mehralivand and He showed good calibration to our validation population, with respective intercepts of -0.08 and -0.84. All models were nevertheless recalibrated to the csCaP prevalence in our population for analysis. Decision curve analysis showed that above a threshold probability of 10%, all mpMRI-based models demonstrated superior net benefit compared to mpMRI PIRADSv2.0 or a biopsy-all-men strategy. The van Leeuwen model had the greatest net benefit, avoiding 39% of unnecessary biopsies while missing only 4% of csCaP, at a threshold probability of 15%., Conclusions: The mpMRI-based risk models demonstrate excellent discrimination and clinical utility and are easy to apply in practice, suggesting that individualized risk-based approaches can be considered over mpMRI alone to avoid unnecessary biopsies., (Copyright © 2021 Elsevier Inc. All rights reserved.)

A new two-dimensional (2D) coordination polymer, namely, poly[[diaqua-[μ 4 -2,2'-[terephthaloylbis(azanediyl)]diacetato]calcium(II)] monohydrate], {[Ca(C 12 H 10 N 2 O 6 )(H 2 O) 2 ]·H 2 O} n , (I), has been synthesized by the reaction of CaCl 2 with 2,2'-[terephthaloylbis(azanediyl)]diacetic acid (H 2 L). The title compound was structurally characterized by single-crystal X-ray diffraction analysis, elemental analysis and IR spectroscopy. In the crystal structure of (I), each Ca II cation binds to six carboxylate groups from four symmetry-related L 2- dianions. The hexadentate L 2- ligand links four symmetry-related calcium cations into a 2D layer-like structure, which can be simplified as a uninodal SP 2-periodic (3,6)III net with the point symbol (4 3 ·6 3 ). In the lattice, all layers pack in parallel arrays through weak interlayer hydrogen bonding and π-π interactions. The thermal stability and photoluminescence properties of (I) have been investigated. Thermogravimetric analysis reveals the different thermal stabilities of the two coordinated water molecules due to their different hydrogen-bonding interactions. The title coordination polymer exhibits an excitation-wavelength-dependent fluorescence in the solid state.

Aims: Hepatocellular carcinoma (HCC) is a primary malignancy of the hepatocyte. Interleukin enhancer binding factor 2 (ILF2) plays a role in the development of HCC. However, the regulatory mechanisms of ILF2 expression in HCC remain unclear. In this study, we aimed to identify ILF2-targeting microRNAs (miRNAs) and to explore how they affect ILF2 expression in HCC., Main Methods: The tissue specimens were collected from 25 HCC patients. The underlying regulatory mechanism of ILF2 expression in HCC progression was determined using luciferase reporter assay, quantitative real-time PCR, Western blotting, and BrdU incorporation assay., Key Findings: Of predicted miRNA candidates (miR-122-5p, miR-425-5p, miR-136-5p, miR-7-5p, miR-421 and miR-543), a statistically significant inverse correlation by linear correlation analysis was observed between miR-136-5p and ILF2 mRNA expressions in patients with HCC (r = -0.627, P < 0.001). Further analysis demonstrated that ILF2 was directly regulated by miR-136-5p. In addition, we showed that long noncoding RNA colorectal neoplasia differentially expressed-h (lncRNA CRNDE-h) transcript expression was significantly up-regulated in HCC, and a miR-136-5p binding site was newly found in the lncRNA CRNDE-h transcript sequence using IntaRNA tool. In terms of mechanism, highly-expressed lncRNA CRNDE-h transcript can sponge miR-136-5p, thereby preventing it from interacting with target ILF2 mRNA while promoting the proliferation of HCC cells., Significance: The lncRNA CRNDE-h/miR-136-5p/ILF2 axis plays a significant regulatory role in HCC progression, which may partly explain the pathogenic mechanisms of HCC and may provide promising potential targets for the diagnosis, treatment, and prognosis of HCC., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Gastric bypass (GB) and sleeve gastrectomy (SG) were found to achieve different remission rates in the treatment of type 2 diabetes (T2DM). The alteration in several gut hormones after bariatric surgery has been demonstrated to play a key role for T2DM remission. Nevertheless, amylin, one of the diabetes-associated peptides, so far has an undetermined position on T2DM remission after bariatric surgery., Methods: Sixty eligible patients with T2DM (GB, 30; SG, 30) were initially enrolled in the hospital-based randomized trial. Twenty patients (GB, 10; SG, 10) who met the inclusion criteria and agreed to undergo 75-g oral glucose tolerance test (OGTT) were recruited. The recruited subjects underwent anthropometric measurements, routine laboratory tests, and 75-g OGTT before and 1 year after bariatric surgery. Enzyme immunoassays for plasma amylin were analyzed., Results: All subjects that underwent GB and half of those who underwent SG achieved T2DM remission. Plasma amylin levels significantly decreased 60-90 min after OGTT in the GB group (p < 0.05) and 30-60 minutes after OGTT in the SG group (p < 0.05). Significantly decreased plasma amylin levels were observed at 30-90 minutes after OGTT in the noncomplete remitters of the GB group (p < 0.05). Plasma amylin levels initially increased (p < 0.05) within 30 minutes after OGTT and then decreased (p < 0.05) in the next 30-minute interval in the nonremitters of the SG group., Conclusion: Postoral glucose challenge amylin levels could be as one of the parameters to evaluate T2DM remission after bariatric surgery, especially in those after SG., Competing Interests: Conflicts of interest: Dr Chih-Yen Chen, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article., (Copyright © 2021, the Chinese Medical Association.)

Background: Nonintubated thoracoscopic lobectomy has been described as a feasible surgical treatment for early-stage lung cancer since 2011. Despite promising perioperative results, studies on tumor recurrence and long-term survival are very limited. This study was aimed to compare outcomes after thoracoscopic lobectomy with versus without intubation for stage I non-small cell lung cancer., Methods: A retrospective data set including 115 and 155 patients who underwent nonintubated and intubated thoracoscopic lobectomy, respectively, between January 2011 and December 2013 was used to identify matched nonintubated and intubated cohorts (n = 97 per group) using a propensity score matching algorithm that accounted for confounding effects of preoperative patient variables. Primary outcome variables included freedom from recurrence and overall survival. Factors affecting survival were assessed using Cox regression analysis and Kaplan-Meier survival estimates., Results: No perioperative mortality occurred in both groups. At an average follow-up of 74 months, comparing nonintubated thoracoscopic lobectomy with intubated procedure, no differences were observed in recurrence rates (14.4% vs. 25.8%, respectively; p = .057). Furthermore, no significant differences were noted in overall survival (97.9% vs. 93.8%, respectively; p = .144). Nonintubated thoracoscopic lobectomy was not found to be an independent predictor of recurrence (hazard ratio, .53; 95% confidence interval [CI], .28-1.02) or overall survival (hazard ratio, .33; 95% CI, .07-1.61)., Conclusion: In this propensity-matched comparison, nonintubated thoracoscopic lobectomy was not associated with an increased risk for recurrence and overall survival during the 5-year follow-up. However, more randomized trials should be conducted for further validation of these results., Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article., (Copyright © 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Objectives: To evaluate the clinically-significant prostate cancer (csCaP) detection rate of systematic (SBx) vs. targeted biopsy (TBx), after accounting for the overlapping systematic cores within the MRI regions of interest., Materials and Methods: We identified 398 consecutive men who underwent both transperineal systematic and targeted biopsy between January 2015 to January 2019. We reclassified overlapping systematic cores in the MRI regions of interest as target cores. The detection rates of SBx and TBx were compared using McNemar's test., Results: Detection rate of csCaP (grade group ≥2) was 42% (168/398). Median number of systematic and targeted cores were 23 (IQR 19-29) and 9 (IQR 6-12) respectively. A median of 3 (IQR 2-4) overlapping systematic cores were reclassified as targeted cores. After accounting for overlap, csPC detection rate on SBx decreased from 37% and 21% while the csCaP detection rate of TBx increased from 34% to 39% (both P < 0.001), with TBx having a better detection rate (39% vs. 21%, P < 0.001). A previous negative biopsy was associated with a lower risk of having csCaP on non-targeted SBx (OR 0.27, 95% CI: 0.12 - 0.58, P = 0.001). Only 5% (13/243) of those who had no cancer detected on TBx had csCaP on non-targeted SBx compared to 45% (70/155) of those who had csCaP on TBx (P< 0.001)., Conclusions: The utility of SBx in detecting csCaP decreases after accounting for overlap into the MRI region of interest, especially in men with a prior negative biopsy. Overlapping systematic cores improve the csCaP detection rate on TBx., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Prostheses with direct EMG control could restore amputee's biomechanics structure and residual muscle functions by using efferent signals to drive prosthetic ankle joint movements. Because only feedforward control is restored, it is unclear 1) what neuromuscular control mechanisms are used in coordinating residual and intact muscle activities and 2) how this mechanism changes over guided training with the prosthetic ankle. To address these questions, we applied functional connectivity analysis to an individual with unilateral lower-limb amputation during postural sway task. We built functional connectivity networks of surface EMGs from eleven lower-limb muscles during three sessions to investigate the coupling among different function modules. We observed that functional network was reshaped by training and we identified a stronger connection between residual and intact below knee modules with improved bilateral symmetry after amputee acquired skills to better control the powered prosthetic ankle. The evaluation session showed that functional connectivity was largely preserved even after nine months interval. This preliminary study might inform a unique way to unveil the potential neuromechanic changes that occur after extended training with direct EMG control of a powered prosthetic ankle.

Seven new triterpenoids including two cycloartanes (1-2), a lanostane (3), a tirucallane (4), a dammarane (5), an ursane (6), and an oleanane (7), along with nineteen known triterpenoids (8-26), have been obtained from the roots of Euphorbia fischeriana. Their structures were established by NMR, HRESIMS, single-crystal X-ray diffraction analysis, Mosher's method, NMR calculations, ECD analysis, and comparison with structurally related known analogues. Among them, compounds 1 and 8 were a pair of cycloartane-type triterpenoids epimers. Our bioassays have established that compounds 1-5 and 10 displayed moderate cytotoxic effects, and the structure-activity relationships of cycloartane-type triterpenoids (CTTs) were further examined. Notably, some triterpenoids displayed moderate inhibitory effects against AChE by an in vitro screened experiment. Triterpenoid 7 (Euphorfistrine G, ETG) displayed the potent inhibitory effect with IC 50  = 2.45 and K i  = 2.30 μM (inhibition kinetic). And, in silico docking analyses have been performed to investigate the inhibitory mechanism of compound 7., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The goal of this research was to develop an intuitive wearable human-machine interface (HMI), utilizing an optical sensor. The proposed system quantifies wrist pronation and supination using an optical displacement sensor. Compared with existing systems, this HMI ensures intuitiveness by relying on direct measurement of forearm position, minimizes involved sensors, and is expected to be long-lasting. To test for feasibility, the developed HMI was implemented to control a prosthetic wrist based on forearm rotation of able-bodied subjects. Performance of optical sensor system (OSS) prosthesis control was compared to electromyography (EMG) based direct control, for six able-bodied individuals, using a clothespin relocation task. Results showed that the performance of OSS control was comparable to direct control, therefore validating the feasibility of the OSS HMI.

Thoracic aortic aneurysm (TAA) formation is a multifactorial process that results in diverse clinical manifestations and drug responses. Identifying the critical factors and their functions in Marfan syndrome (MFS) pathogenesis is important for exploring personalized medicine for MFS. Methylenetetrahydrofolate reductase (MTHFR) , methionine synthase ( MTR) , and methionine synthase reductase ( MTRR) polymorphisms have been correlated with TAA severity in MFS patients. However, the detailed relationship between the folate-methionine cycle and MFS pathogenesis remains unclear. Fbn1 C1039G/+ mice were reported to be a disease model of MFS. To study the role of the folate-methionine cycle in MFS, Fbn1 C1039G/+ mice were treated orally with methionine or vitamin B mixture (VITB), including vitamins B6, B9, and B12, for 20 weeks. VITB reduced the heart rate and circumference of the ascending aorta in Fbn1 C1039G/+ mice. Our data showed that the Mtr and Smad4 genes were suppressed in Fbn1 C1039G/+ mice, while VITB treatment restored the expression of these genes to normal levels. Additionally, VITB restored canonical transforming-growth factor β (TGF-β) signaling and promoted Loxl1 -mediated collagen maturation in aortic media. This study provides a potential method to attenuate the pathogenesis of MFS that may have a synergistic effect with drug treatments for MFS patients.

Introduction: Peritoneal dialysis (PD) is a kind of renal replacement therapy for end-stage renal disease (ESRD). While PD has many advantages, various complications may arise. Methods: This retrospective study analyzed the complications of ESRD patients who received PD catheter implantation in a single medical center within 15 years. Results: This study collected 707 patients. In the first 14 days after PD implantation, 54 patients experienced bleeding complications, while 47 patients experienced wound infection. Among all complications, catheter-related infections were the most common complication 14 days after PD implantation (incidence: 38.8%). A total of 323 patients experienced PD catheter removal, of which 162 patients were due to infection, while 96 were intentional due to kidney transplantation. Excluding those whose catheters were removed due to transplantation, the median survival of the PD catheter was 4.1 years; among them, patients without diabetes mellitus (DM) were 7.4 years and patients with DM were 2.5 years ( p < 0.001). Further, 50% probability of surviving was beyond 3.5 years in DM patients with HbA1CC < 7 and 1.6 years in DM patients with HbA1C <7 ( p ≥ 0.001). Conclusions: Catheter-related infections were the most common complications following PD catheter implantation. DM, especially with HbA1C ≥7, significantly impacted on the catheter-related infection and the survival probability of the PD catheter., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Chang, Chang, Hsiao, Kao, Chen, Chen and Tsai.)

Enzymatic time-temperature indicators (TTIs) usually suffer from instability and inefficiency in practical use as food quality indicator during storage. The aim of this study was to address the aforementioned problem by immobilizing laccase on electrospun chitosan fibers to increase the stability and minimize the usage of laccase. The addition of NaN 3 , as and enzyme inhibitor, was intended to extend this laccase TTI coloration rate and activation energy ( Ea ) range, so as to expand the application range of TTIs for evaluating changes in the quality of foods during storage. A two-component time-temperature indicator was prepared by immobilizing laccase on electrospun chitosan fibers as a TTI film, and by using guaiacol solution as a coloration substrate. The color difference of the innovative laccase TTI was discovered to be <3, and visually indistinguishable when OD 500 reached 3.2; the response reaction time was regarded as the TTI's coloration endpoint. Enzyme immobilization and the addition of NaN 3 increased coloration Km and reduced coloration Vmax . The coloration Vmax decreased to 64% when 0.1 mM NaN 3 was added to the TTI, which exhibited noncompetitive inhibition and a slower coloration rate. Coloration hysteresis appeared in the TTI with NaN 3 , particularly at low temperatures. For TTI coloration, the Ea increased to 29.92-66.39 kJ/mol when 15-25 μg/cm 2 of laccase was immobilized, and the endpoint increased to 11.0-199.5 h when 0-0.10 mM NaN 3 was added. These modifications expanded the applicability of laccase TTIs in intelligent food packaging.

Nitrogen-doped carbon quantum dots (N-CQDs) exhibit a high quantum yield with controllable emission wavelength and intensity in the blue-green regime. N-CQDs were tested and determined to be thermally and optically stable during 150 °C heat treatment and prolonged UV irradiation. Potential applications of N-CQDs were demonstrated, including excellent Fe 3+ sensing in aqueous solution, fluorescent polymer fibres, and stealth quick response coding at visible wavelengths., Competing Interests: The authors declare no competing financial interests., (This journal is © The Royal Society of Chemistry.)

Electrocatalysts have been developed to improve the efficiency of gas release for oxygen evolution reaction (OER), and finding a simple and efficient method for efficient electrocatalysts has inspired research enthusiasm. Herein, we report bimetallic metal-organic gels derived from phytic acid (PA) and mixed transition metal ions to explore their performance in electrocatalytic oxygen evolution reaction. PA is a natural phosphorus-rich organic compound, which can be obtained from plant seeds and grains. PA reacts with bimetallic ions (Fe 3+ and Co 2+ ) in a facile one-pot synthesis under mild conditions to form PA-FeCo bimetallic gels, and the corresponding aerogels are further partially reduced with NaBH 4 to improve the electrocatalytic activity. Mixed valence states of Fe(II)/Fe(III) and Co(III)/Co(II) are present in the materials. Excellent OER performance in terms of overpotential (257 mV at 20 mA cm -2 ) and Tafel slope (36 mV dec -1 ) is achieved in an alkaline electrolyte. This reduction method is superior to the pyrolysis method by well maintaining the gel morphology structure. This strategy is conducive to the further improvement of the performance of metal-organic electrocatalysts, and provides guidance for the subsequent application of metal-organic gel electrocatalysts., (© 2021 Wiley-VCH GmbH.)

There is great interest in understanding the cellular mechanisms controlling autophagy, a tightly regulated catabolic and stress-response pathway. Prior work has uncovered links between autophagy and the Golgi reassembly stacking protein of 55 kDa (GRASP55), but their precise interrelationship remains unclear. Intriguingly, both autophagy and GRASP55 have been functionally and spatially linked to the endoplasmic reticulum (ER)---Golgi interface, broaching this compartment as a site where GRASP55 and autophagy may intersect. Here, we uncover that loss of GRASP55 enhances LC3 puncta formation, indicating that GRASP55 restricts autophagosome formation. Additionally, using proximity-dependent biotinylation, we identify a GRASP55 proximal interactome highly associated with the ER-Golgi interface. Both nutrient starvation and loss of GRASP55 are associated with coalescence of early secretory pathway markers. In light of these findings, we propose that GRASP55 regulates spatial organization of the ER-Golgi interface, which suppresses early autophagosome formation., Competing Interests: Competing interests J.Y.L., Y.T.L, H.H.H., A.M.L., J.Y., A.P.W.: No competing interests declared. J.D.: Scientific Advisory Board Member for Vescor Therapeutics, LLC., (© 2021. Published by The Company of Biologists Ltd.)

Exhaustion of HIV-1-specific CD8 + T cells prevents optimal control of HIV-1 infection. Identifying unconventional CD8 + T cell subsets to effectively control HIV-1 replication is vital. In this study, the role of CD11c + CD8 + T cells during HIV-1 infection was evaluated. The frequencies of CD11c + CD8 + T cells significantly increased and were negatively correlated with viral load in HIV-1-infected treatment-naïve patients. HIV-1-specific cells were enriched more in CD11c + CD8 + T cells than in CD11c - CD8 + T cells, which could be induced by HIV-1-derived overlapping peptides, marking an HIV-1-specific CD8 + T cell population. This subset expressed higher levels of activating markers (CD38 and HLA-DR), cytotoxic markers (granzyme B, perforin, and CD107a), and cytokines (IL-2 and TNF-α), with lower levels of PD-1 compared to the CD11c - CD8 + T cell subset. In vitro analysis verified that CD11c + CD8 + T cells displayed a stronger HIV-1-specific killing capacity than the CD11c - counterparts. These findings indicate that CD11c + CD8 + T cells have potent immunotherapeutic efficacy in controlling HIV-1 infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Guo, Zhao, Gao, Huang, Zhang, Zhang, Song, Xu, Fan, Shi, Jiao and Wang.)

Statement of Problem: High-translucency monolithic multilayer precolored zirconia provides acceptable esthetics and eliminates chipping of the veneering porcelain. However, the color is not always consistent with the standard Vita shade guide, and the color saturation may vary with the thickness of the zirconia., Purpose: The purpose of this in vitro study was to characterize the effect of thickness on the color accuracy of high-translucency monolithic multilayer precolored zirconia., Material and Methods: Plate-shaped (20×20 mm) Vita A2 shade high-translucency monolithic multilayer precolored zirconia specimens of 3 types (SHT Multilayer, AT Multilayer, and 3D Multilayer) in 4 thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were fabricated (N=120, n=10). A spectrophotometer was used to measure the color attributes (CIELab) against gray or A2 substrates to evaluate the color accuracy based on differences in color (ΔE) (versus the Vita shade guide) and chroma. Statistical analysis was performed by using the Pearson correlation, 2-way ANOVA, and post hoc Scheffé test (α=.05)., Results: Against gray substrates, thickness was significantly positively correlated with all color attributes. Against A2 substrates, L∗ values increased with an increase in thickness; however, a∗, b∗, and chroma values remained stable. Zirconia with a thickness of 1.0 mm exhibited the lowest ΔE, regardless of the type, except for AT Multilayer against A2 substrates, where the lowest ΔE was achieved at 0.5 mm. At thicknesses ≥1.0 mm, the ΔE between the 2 substrates was imperceivable., Conclusions: Thickness affected the color accuracy of different high-translucency monolithic multilayer precolored zirconia types. It appears that the optimal thickness in terms of color accuracy is 1.0 mm. These results could be used as a reference for the selection and preparation of abutments in clinical applications., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Introduction: Patients with lung cancer (LC) are susceptible to severe outcomes from COVID-19. This study evaluated disruption to care of patients with LC during the COVID-19 pandemic., Methods: The COVID-19 and Cancer Outcomes Study (CCOS) is a prospective cohort study comprised of patients with a current or past history of hematological or solid malignancies with outpatient visits between March 2 and March 6, 2020, at two academic cancer centers in the Northeastern United States (US). Data was collected for the three months prior to the index week (baseline period) and the following three months (pandemic period)., Results: 313 of 2365 patients had LC, 1578 had other solid tumors, and 474 had hematological malignancies. Patients with LC were not at increased risk of COVID-19 diagnosis compared to patients with other solid or hematological malignancies. When comparing data from the pandemic period to the baseline period, patients with LC were more likely to have a decrease in in-person visits compared to patients with other solid tumors (aOR 1.94; 95% CI, 1.46-2.58), but without an increase in telehealth visits (aOR 1.13; 95% CI 0.85-1.50). Patients with LC were more likely to experience pandemic-related treatment delays than patients with other solid tumors (aOR 1.80; 95% CI 1.13-2.80) and were more likely to experience imaging/diagnostic procedure delays than patients with other solid tumors (aOR 2.59; 95% CI, 1.46-4.47) and hematological malignancies (aOR 2.01; 95% CI, 1.02-3.93). Among patients on systemic therapy, patients with LC were also at increased risk for decreased in-person visits and increased treatment delays compared to those with other solid tumors., Discussion: Patients with LC experienced increased cancer care disruption compared to patients with other malignancies during the early phase of the COVID-19 pandemic. Focused efforts to ensure continuity of care for this patient population are warranted., (Copyright © 2021. Published by Elsevier B.V.)

In 2020, the COVID-19 pandemic has spread worldwide. To alleviate this spread, various blockade policies have been implemented in many areas. This has led to a sluggish demand in the world's major economies, sharp drop in the trade index, and negative growth in energy consumption. To formulate a better epidemic prevention policy for urban energy consumption of commercial tourism cities, this study summarizes the major statistics of energy supply and demand before and during the epidemic period based on actual data. The characteristics of energy consumption in different sectors, including hotels, transportation, tourism culture, and public utilities, are then analyzed in detail. Finally, the energy consumption features of commercial tourism cities represented by Macao are compared to those of other typical countries (e.g., Italy, United States, Japan, and Brazil). These analyses demonstrate the impact of COVID-19 on the energy consumption in commercial tourism cities, which provides insights for the government or energy providers to formulate policies to adapt to this pandemic., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Elsevier Ltd. All rights reserved.)

Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide in 2020. Colonoscopy and the fecal immunochemical test (FIT) are commonly used as CRC screening tests, but both types of tests possess different limitations. Recently, liquid biopsy-based DNA methylation test has become a powerful tool for cancer screening, and the detection of abnormal DNA methylation in stool specimens is considered as an effective approach for CRC screening. The aim of this study was to develop a novel approach in biomarker selection based on integrating primary biomarkers from genome-wide methylation profiles and secondary biomarkers from CRC comorbidity analytics. A total of 125 differential methylated probes (DMPs) were identified as primary biomarkers from 352 genome-wide methylation profiles. Among them, 51 biomarkers, including 48 hypermethylated DMPs and 3 hypomethylated DMPs, were considered as suitable DMP candidates for CRC screening tests. After comparing with commercial kits, three genes ( ADHFE1 , SDC2 , and PPP2R5C ) were selected as candidate epigenetic biomarkers for CRC screening tests. Methylation levels of these three biomarkers were significantly higher for patients with CRC than normal subjects. The sensitivity and specificity of integrating methylated ADHFE1 , SDC2 , and PPP2R5C for CRC detection achieved 84.6% and 92.3%, respectively. Through an integrated approach using genome-wide DNA methylation profiles and electronic medical records, we could design a biomarker panel that allows for early and accurate noninvasive detection of CRC using stool samples.

Acne vulgaris is a highly prevalent skin disorder requiring treatment and management by dermatologists. Antibiotics such as clindamycin are commonly used to treat acne vulgaris. However, from both medical and public health perspectives, the development of alternative remedies has become essential due to the increase in antibiotic resistance. Topical therapy is useful as a single or combined treatment for mild and moderate acne and is often employed as maintenance therapy. Thus, the current study investigated the anti-inflammatory, antibacterial, and restorative effects of sesquiterpene farnesol on acne vulgaris induced by Cutibacterium acnes ( C. acnes ) in vitro and in a rat model. The minimum inhibitory concentration (MIC) of farnesol against C. acnes was 0.14 mM, and the IC 50 of 24 h exposure to farnesol in HaCaT keratinocytes was approximately 1.4 mM. Moreover, 0.8 mM farnesol exhibited the strongest effects in terms of the alleviation of inflammatory responses and abscesses and necrotic tissue repair in C. acnes -induced acne lesions; 0.4 mM farnesol and clindamycin gel also exerted similar actions after a two-time treatment. By contrast, nearly doubling the tissue repair scores, 0.4 mM farnesol displayed great anti-inflammatory and the strongest reparative actions after a four-time treatment, followed by 0.8 mM farnesol and a commercial gel. Approximately 2-10-fold decreases in interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, found by Western blot analysis, were predominantly consistent with the histopathological findings and tissue repair scores. The basal hydroxypropyl methylcellulose (HPMC) gel did not exert anti-inflammatory or reparative effects on rat acne lesions. Our results suggest that the topical application of a gel containing farnesol is a promising alternative remedy for acne vulgaris.

As the major source of energy for colonic mucosal cells and as an important regulator of gene expression, inflammation, differentiation, and apoptosis in host cells, microbiota-derived butyrate can enhance the intestinal mucosal immune barrier, modulate systemic immune response, and prevent infections. Maintaining a certain level of butyrate production in the gut can help balance intestinal microbiota, regulate host immune response, and promote the development and maintenance of the intestinal mucosal barrier. Butyrate-producing bacteria act as probiotics and play important roles in a variety of normal biological functions. Bacteriotherapeutic supplementation by using fecal microbiota transplantation to restore butyrate-producing commensal bacteria in the gut has been very successful in the treatment of recurrent and refractory Clostridium difficile ( C. difficile ) infection or C. difficile -negative nosocomial diarrhea. Administration of probiotics that include butyrate-producing bacteria may have a role in the treatment of inflammatory bowel diseases and in the prevention of necrotizing enterocolitis and late-onset sepsis in premature infants. Furthermore, modulating gut microbiota with dietary approaches may improve intestinal dysbiosis commonly seen in patients with obesity-associated metabolic disorders. Supplementation with a butyrate-producing bacterial stain might be used to increase energy expenditure, improve insulin sensitivity, and to help control obesity and metabolic syndrome., Competing Interests: Conflict-of-interest statement: All authors declare no conflicts of interest., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

The objective in this study was to enhance osteogenic responses (in vitro and in vivo) to roughened titanium (Ti) dental implants through the formation of superhydrophilic TiO 2 nanonetwork surface structure. Sandblasting and acid etching (SLA) was used to roughen the Ti surface. An electrochemical anodization process was then used to form a superhydrophilic TiO 2 nanonetwork on the SLA Ti surfaces. The pore size of the nanonetwork structure ranged from a few nanometers to more than 100 nm, which is on the same scale as many biological species. Human bone marrow mesenchymal stem cells were used as an in vitro test model. The TiO 2 nanonetwork structure was shown to have a significantly positive effect on hydrophilicity, protein adsorption, cell adhesion, cell migration, cell mineralization, and the gene and protein expression of osteogenic markers. The osseointegration of an anodized SLA screw-type Ti dental implant was investigated in vivo via implantation in the femur of New Zealand white rabbits for durations of 4 or 12 wk. The presence of a superhydrophilic surface TiO 2 nanonetwork was shown to significantly enhance the bone-to-implant contact of the roughened SLA screw-type Ti dental implants. Overall, the proposed superhydrophilic TiO 2 nanonetwork structure on the roughened SLA Ti surface proved highly effective in enhancing osteogenic responses in vitro and in vivo.

Background: Diabetic neuropathic pain (DNP), a complication of diabetes, has serious impacts on human health. As the pathogenesis of DNP is very complex, clinical treatments for DNP is limited. Koumine (KM) is an active ingredient extracted from Gelsemium elegans Benth. that exerts an inhibitory effect on neuropathic pain (NP) in several animal models., Purpose: To clarify the anti-NP effect of KM on rats with DNP and the molecular mechanisms involving the Notch- Jκ recombination signal binding protein (RBP-Jκ) signaling pathway., Methods: Male Sprague-Dawley rats were administered streptozocin (STZ) by intraperitoneal injection to induce DNP. The effect of KM on mechanical hyperalgesia in rats with DNP was evaluated using the Von Frey test. Microglial polarization in the spinal cord was examined using western blotting and quantitative real-time PCR. The Notch-RBP-Jκ signaling pathway was analysed using western blotting., Results: KM attenuated DNP during the observation period. In addition, KM alleviated M1 microglial polarization in STZ-induced rats. Subsequent experiments revealed that Notch-RBP-Jκ signaling pathway was activated in the spinal cord of rats with DNP, and the activation of this pathways was decreased by KM. Additionally, KM-mediated analgesia and deactivation of the Notch-RBP-Jκ signaling pathway were inhibited by the Notch signaling agonist jagged 1, indicating that the anti-DNP effect of KM may be regulated by the Notch-RBP-Jκ signaling pathway., Conclusions: KM is a potentially desirable candidate treatment for DNP that may inhibit microglial M1 polarization through the Notch-RBP-Jκ signaling pathway., (Copyright © 2021. Published by Elsevier GmbH.)

The gene encoding LysSTG2, an endolysin from Salmonella-lytic bacteriophage STG2, was cloned, overexpressed, and characterized. LysSTG2 consists of a single domain belonging to the Peptidase&#95;M15 superfamily. LysSTG2 showed strong lytic activity against chloroform-treated S. Typhimurium cells after incubation at 4-50 °C for 30 min, at pH ranging from 7.0 to 11.0, and in the presence of NaCl from 0 to 300 mmol/L. It also showed lytic activity against all the 14 tested Gram-negative strains treated with chloroform, including Salmonella, E. coli, and Pseudomonas aeruginosa, but not against the Gram-positive bacteria tested. In addition, LysSTG2 (100 μg/mL) reduced the viability of S. Typhimurium NBRC 12529 planktonic cells by 1.2 log and that of the biofilm cells after 1-h treatment. Sequential treatment of slightly acidic hypochlorous water (SAHW) containing 40 mg/L available chlorine and LysSTG2 (100 μg/mL) was effective on S. Typhimurium NBRC 12529 biofilm cells, removing more than 99% of biofilm cells. These results demonstrate that LysSTG2 alone can effectively kill S. Typhimurium cells after permeabilization treatment and successfully control S. Typhimurium in biofilms in combination with SAHW, suggesting that the combined use of LysSTG2 and SAHW might be a novel and promising method for combating S. Typhimurium in food industries., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The Cox proportional hazards model is a popular method to study the connection between feature and survival time. Because of the high-dimensionality of genomic data, existing Cox models trained on any specific dataset often generalize poorly to other independent datasets. In this paper, we suggest a novel strategy for the Cox model. This strategy is included a new learning technique, self-paced learning (SPL), and a new gene selection method, SCAD-Net penalty. The SPL method is adopted to aid to build a more accurate prediction with its built-in mechanism of learning from easy samples first and adaptively learning from hard samples. The SCAD-Net penalty has fixed the problem of the SCAD method without an inherent mechanism to fuse the prior graphical information. We combined the SPL with the SCAD-Net penalty to the Cox model (SSNC). The simulation shows that the SSNC outperforms the benchmark in terms of prediction and gene selection. The analysis of a large-scale experiment across several cancer datasets shows that the SSNC method not only results in higher prediction accuracies but also identifies markers that satisfactory stability across another validation dataset. The demo code for the proposed method is provided in supplemental file.

Neutrophils are characterized by their heterogeneity. They fight against pathogens and are involved in tissue injury repair and immune system regulation. Neutrophils have an extremely short life span in the peripheral blood and undergo aging after being released from the bone marrow. The over-aggregation of aged neutrophils is associated with phenotypical and functional changes. Here, we aimed to investigate the dynamics of neutrophil aging and its relationship with T cell exhaustion in HIV-1 infection, as they are not well understood. In this study, we enrolled 23 treatment naïve (TN) patients, 23 individuals that had received antiretroviral therapy (ART), and 21 healthy controls (HC). In these cohorts, we measured the degree of neutrophil aging, and its possible correlation with T cell dysfunction. In TN patients, peripheral neutrophils showed a more distinct aging phenotype and were over-activated compared to those in ART-treated patients. The degree of neutrophil aging was positively correlated with HIV-1 RNA viral load and negatively correlated with CD4+ T cell count. Moreover, aged neutrophils had impaired reactive oxygen species (ROS) production after lipopolysaccharide (LPS) stimulation, and were characterized by increased PD-L1 and arginase-1 expression in a time-dependent manner. Aged neutrophils demonstrated an increased inhibition of IFN-γ and TNF-α secretion by CD8+ T cell compared to non-aged neutrophils. The inhibition effect could be partially reversed by blocking PD-L1 and arginase-1 in vitro , and LPS was identified as an important activator of neutrophil aging. These results provide evidence that dampening neutrophil aging may provide a novel approach to recover T cell dysfunction in patients with HIV-1 infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Liu, Huang, Yang, Jiao, Zhang, Song, Zhang, Zhou, Yuan, Cao, Mu, Zhou, Li, Shi, Xu and Wang.)

Immune deficiency is one of the hallmarks of HIV infection and a major cause of adverse outcomes in people living with HIV (PLWH). Long-lived memory CD8 + T cells (LLMCs) are essential executors of long-term protective immunity; however, the generation and maintenance of LLMCs during chronic HIV infection are not well understood. In the present study, we analyzed circulating LLMCs in healthy controls (HCs) and PLWH with different disease statuses, including treatment naïve patients (TNs), complete responders (CRs), and immunological nonresponders (INRs). We found that both TNs and INRs showed severely compromised LLMCs compared with HCs and CRs, respectively. The decrease of LLMCs in TNs correlated positively with the reduction of their precursors, namely memory precursor effector T cells (MPECs), which might be associated with elevated pro-inflammatory cytokines. Strikingly, INRs showed an accumulation of MPECs, which exhibited diminished responsiveness to interleukin 7 (IL-7), thereby indicating abrogated differentiation into LLMCs. Moreover, in vitro studies showed that treatment with dexamethasone could improve the IL7-phosphorylated (p)-signal transducer and activator of transcription (STAT5) response by upregulating the expression of the interleukin 7 receptor (IL-7Rα) on MPECs in INRs. These findings provide insights that will encourage the development of novel therapeutics to improve immune function in PLWH., (© 2021 Wiley-VCH GmbH.)

Background: The dynamics of viral reservoir decay and naïve CD4 T-cell recovery between immunological non-responders (INR) and complete responders (CR) during long-term antiretroviral treatment (ART) are not fully known., Methods: Twenty-eight chronic HIV-infected individuals on 5-year ART were divided into two groups: INR (CD4 counts ≤350 cells/μL, n = 13) and CR (CD4 counts ≥500 cells/μL, n = 15). The levels of HIV DNA and cell-associated HIV RNA (CA-RNA), CD4 counts, naïve CD4 counts and their correlations were analyzed at baseline, years 1, 3 and 5 of ART between the two groups. Expression of PD-1 on CD4 T-cells was quantified by flow cytometry. Linear mixed effect models were used to estimate the change procession in repeated measurements over 5 years. Slopes of the above-mentioned indicators were estimated using participant-specific linear regressions, respectively., Results: INR maintained higher levels of HIV DNA and CA-RNA with higher percentages of PD-1 + CD4 T-cells compared with CR during 5-year ART, concurrent with lower naïve CD4 T-cells. However, the rates of HIV DNA and CA-RNA decay in INR were not different from that in CR over time, and INR had higher rates of naïve CD4 T-cell percentage recovery. The baseline levels of HIV DNA were positively associated with the 5-year levels of HIV DNA, but negatively associated with the 5-year naïve CD4 counts., Conclusions: INR maintained significantly higher viral reservoir and lower naïve CD4 T-cells compared with CR during 5-year ART, however, the rates of reservoir decay and naïve CD4 T-cell percentage growth within INR were not lower than that in CR over time., (Copyright © 2021. Published by Elsevier Inc.)

Aim/objective: Chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) is one of the most frequent types of leukaemia/lymphoma in adults in Western countries. However, there are few studies regarding its epidemiology and treatment patterns in Asian countries., Methods: To investigate CLL/SLL in Asian populations, we identified CLL/SLL patients diagnosed during 2006 to 2015 from the Taiwan Cancer Registry Database and estimated the incidence. Further, patients diagnosed during 2008 to 2015 were included for the analysis of treatment patterns and survivals. Treatments for CLL/SLL were retrieved from the Taiwan's National Health Insurance Research Database and survival data from the National Death Registry., Results: In total, 1497 patients who were older than 20 years and had newly diagnosed CLL/SLL during 2006-2015 were identified. The age-standardized incidence rates of CLL/SLL (0.36 per 100 000 persons in 2006, and 0.54 in 2015) increased during the 10-year period. The sex ratio was ranged from 1.21 to 2.63 with male predominant during 2006 and 2015. For the analysis of treatment patterns (n = 1236), 72.8% patients received chemotherapies. The median duration between the diagnosis and start of treatments was 27 days, and monotherapy of chlorambucil, bendamustine or cyclophosphamide was the most common regimen in initial treatments. The median follow-up duration for the patients receiving therapies was 29.6 months, and 45.0% patients experienced relapse or refractory. In patients with relapse/refractory CLL/SLL, 34.1% received rituximab-containing chemotherapies. Three hundred and ninety-nine (32.3%) patients received intensive treatments, and 175 (43.9%) of them received rituximab-containing chemotherapies. The 5-year overall survival (OS) rate was 61%, and age was an important prognostic factor for CLL/SLL patients., Conclusions: This study is the first population-based study in Asia and provides comprehensive evidence of epidemiology, treatment patterns and survivals of CLL/SLL in an Asian population., (© 2021 John Wiley & Sons Ltd.)

Background: Acute myeloid leukemia (AML) is a hematological malignancy originating from myeloid precursor cells, with different cytogenetic abnormalities, genetic mutations and diverse clinical prognoses. We investigated the clinical characteristics, treatment patterns, and outcomes of adult AML patients in Taiwan., Materials and Methods: We retrospectively included 3851 patients with AML in the Taiwan Cancer Registry Database from 2011 to 2015. We excluded patients younger than 20 years, with acute promyelocytic leukemia, and with no pathological confirmation., Results: Among the 3292 patients included, 2179 received induction chemotherapy and 1113 did not, because of older age and higher Charlson comorbidity index (CCI) score. Among the 2179 treated patients, 162 received high-dose cytarabine-based chemotherapy, 1535 received standard-dose cytarabine with anthracyclines, 209 received low-dose cytarabine-based chemotherapy, and 273 received chemotherapy without cytarabine. Patients in the low-dose cytarabine group had the oldest age and highest CCI scores compared with the other groups. In the analysis of overall survival (OS), the median OS of the overall study population was 6.27 months. Treated patients with AML had a longer OS than untreated ones (12.43 months treated vs. 2.03 months not treated; P < .0001). In the multivariate analyses of the treated patients with AML, several factors indicated better prognosis, including receiving standard-dose or high-dose cytarabine, female sex, younger age, lower CCI score, treatment at a medical center, favorable cytogenetic abnormalities, and allogeneic hematopoietic stem cell transplantation., Conclusion: Our study was a population-based study that illustrates the real-world outcomes of adult patients with AML in Taiwan., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The purpose of this study was to assess the anatomy of antroliths and its influence on the thickness of the maxillary sinus membrane. Cone beam computed tomography (CBCT) was performed on 239 patients (478 sinuses). The prevalence of antroliths per sinus was 8.4%. Regarding their distribution, antroliths were predominantly unilateral (82.5%), single (67.5%), and in a dentate area (60.0%). The antroliths were mainly located in the molar region (95.0%) and in the sinus floor (77.5%). The measured dimensions of the antroliths were as follows: length 5.6±4.4mm, width 4.1±2.9mm, height 3.5±2.1mm. The relationships between the antroliths and the sinus membrane (type 1, 34.1%; type 2, 52.3%; type 3, 13.6%) indicated that sinus membranes tended to encircle antroliths, which resulted in a gradual increase in membrane thickness. The sinus membrane was found to be significantly thicker in the presence of antrolith(s) (P<0.001). Antroliths which are sufficiently large or are located adjacent to the sinus floor or lateral wall increase the risk of sinus membrane perforation during sinus augmentation procedures. Therefore, a thorough CBCT evaluation is needed to minimize the risk of complications prior to sinus augmentation procedures., (Copyright © 2020 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Our objective in this study was to promote the growth of bone cells on biomedical titanium (Ti) implant surfaces via surface modification involving sandblasting, alkaline etching, and type I collagen immobilization using the natural cross-linker genipin. The resulting surface was characterized in terms topography, roughness, wettability, and functional groups, respectively using field emission scanning electron microscopy, 3D profilometry, and attenuated total reflection-Fourier transform infrared spectroscopy. We then evaluated the adhesion, proliferation, initial differentiation, and mineralization of human bone marrow mesenchymal stem cells (hMSCs). Results show that sandblasting treatment greatly enhanced surface roughness to promote cell adhesion and proliferation and that the immobilization of type I collagen using genipin enhanced initial cell differentiation as well as mineralization in the extracellular matrix of hMSCs. Interestingly, the nano/submicro-scale pore network and/or hydrophilic features on sandblasted rough Ti surfaces were insufficient to promote cell growth. However, the combination of all proposed surface treatments produced ideal surface characteristics suited to Ti implant applications.

Objective. Advanced robotic lower limb prostheses are mainly controlled autonomously. Although the existing control can assist cyclic movements during locomotion of amputee users, the function of these modern devices is still limited due to the lack of neuromuscular control (i.e. control based on human efferent neural signals from the central nervous system to peripheral muscles for movement production). Neuromuscular control signals can be recorded from muscles, called electromyographic (EMG) or myoelectric signals. In fact, using EMG signals for robotic lower limb prostheses control has been an emerging research topic in the field for the past decade to address novel prosthesis functionality and adaptability to different environments and task contexts. The objective of this paper is to review robotic lower limb Prosthesis control via EMG signals recorded from residual muscles in individuals with lower limb amputations. Approach. We performed a literature review on surgical techniques for enhanced EMG interfaces, EMG sensors, decoding algorithms, and control paradigms for robotic lower limb prostheses. Main results. This review highlights the promise of EMG control for enabling new functionalities in robotic lower limb prostheses, as well as the existing challenges, knowledge gaps, and opportunities on this research topic from human motor control and clinical practice perspectives. Significance. This review may guide the future collaborations among researchers in neuromechanics, neural engineering, assistive technologies, and amputee clinics in order to build and translate true bionic lower limbs to individuals with lower limb amputations for improved motor function., (Creative Commons Attribution license.)

Objective: To carry out a systematic review of the effect of cardiac rehabilitation (CR) and its components on cardiovascular outcomes in patients with stable angina., Methods: We searched the databases including Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL from their inception up to November 1, 2017. The search was not restricted to time or publication status but was limited to the English language. Two independent investigators screened the identified studies and extracted the data in duplicate. We reviewed the included studies and, where possible, pooled their results and conducted meta-analyses. Risk of bias was assessed using Cochrane Collaboration tools., Results: The search identified 7508 studies. Ten randomized trials including 4005 participants with the mean (SD) age of 59.6 (5.7) years were considered eligible for inclusion in our analyses. The results of meta-analyses of exercise-based CR for patients with stable angina revealed that CR improved exercise capacity (the difference between baseline and follow-up was 0.76 watt [0.49 to 1.02] higher in the CR group vs the non-CR group) and decreased angina frequency (standard mean difference, -0.27 [CI, -0.43 to 0.11]). No significant differences were noted in other outcomes, including quality of life. Mortality could not be adequately assessed because it was analyzed in only 1 exercise-based CR study., Conclusion: Our systematic review, involving a relatively small number of studies with low to moderate risk of bias and with considerable heterogeneity, found a significant decrease in angina frequency and increase in exercise capacity in patients with stable angina who participated in an exercise-based CR program. Studies involving the impact of components of CR are limited and generally report beneficial outcomes. Additional studies are needed to clarify the possible role of CR in the management of patients with stable angina., (© 2021 Published by Elsevier Inc on behalf of Mayo Foundation for Medical Education and Research.)

Background: Perianchor cyst formation (PCF) can occur after arthroscopic rotator cuff repair with poly-L-lactic acid (PLLA) anchors; however, little is known about PCF after all-suture anchor (ASA) use., Methods: We reviewed patients who underwent double-row arthroscopic rotator cuff repair from 2012 to 2017 with ASAs implanted in the medial row and PLLA anchors in the lateral row. We evaluated PCF (graded on magnetic resonance imaging) and compared physical examination and functional surveys between patients with PCF (WC) and without PCF (WoC) at long-term follow-up., Results: Among twenty-two patients (23 shoulders), 93% of PLLA anchors (vs. 79% ASA) displayed a grade 0 PCF, P  = .100. No PLLA anchors had a grade 3 or 4 PCF, compared to 11% of ASAs, P  = .158. At a mean postoperative follow-up time of 113 weeks, there was no significant difference between WC and WoC cohorts with regard to range of motion, rotator cuff strength, American Shoulder and Elbow Surgeons survey scores, or retear rates. However, the WoC cohort had a significantly higher University of California at Los Angeles shoulder survey score at final follow-up (34.3 WoC vs. 30.9 WC, P  = .024)., Conclusion: No difference was found in PCF between ASAs and PLLA anchors. At long-term follow-up, WoC patients had significantly improved functional outcome scores, based on the University of California at Los Angeles survey, but equivalent range of motion and rotator cuff strength examinations compared with WC patients., (© 2021 The Authors.)