Search

The present study examined whether and how early cognitive flexibility, metalinguistic awareness, including phonological awareness (PA) and morphological awareness (MA), Chinese word reading (CWR), and listening comprehension (LC) influenced Chinese children's later reading comprehension. In total, 153 Chinese children were recruited. Path analysis showed that cognitive flexibility measured when the children were in Grade 1 (M[subscript age] = 85.92 months, SD = 4.36) significantly explained the variance of later reading comprehension at Grade 3 (M[subscript age] = 103.03 months, SD = 3.80) and all concurrent domain-specific precursors of reading comprehension, except LC. Multiple mediation analyses further demonstrated that MA and CWR partially mediated the effect of cognitive flexibility on reading comprehension. Also, the effect of cognitive flexibility on reading comprehension was mediated partially by two two-mediator paths, PA-LC and MA-CWR. These findings demonstrated that cognitive flexibility could be related to reading comprehension directly and indirectly through multiple pathways involving metalinguistic awareness, word reading, and language comprehension. These findings particularly highlighted the roles of MA and word reading in the association between Chinese readers' cognitive flexibility and their reading comprehension.

Given that inhibition interacts with visual temporal processing (VTP), the past evidence regarding the influence of VTP on the Chinese character reading of children with dyslexia may not disclose the whole picture without considering inhibition. Thus, the present study is among the first to investigate VTP and cognitive inhibition as well as their relationships to Chinese character reading. We compared the performances of 62 Chinese-speaking children with dyslexia in primary school (n = 62, M[subscript age] = 11.36 years) on VTP and inhibition tasks to those in a chronological-age-matched group (CA; n = 62, M[subscript age] = 11.57 years) and reading-level-matched group (RL; n = 62, M[subscript age] = 8.98 years). The results revealed that children with dyslexia performed worse than both the CA-matched and RL-matched groups in VTP and inhibition after controlling for age, nonverbal intelligence, and attention. Moreover, the relationship between VTP and Chinese character reading was moderated by inhibition in children with dyslexia. VTP is positively related to Chinese character reading, but this relationship is observed only at higher levels of inhibition. Our results suggest that inhibition plays a potential role in VTP and Chinese character reading, especially for those with dyslexia whose proficiency in inhibition is not as intact as that of typically developing children.

One of the most well-known instructional methods used to enhance Chinese character reading (CCR) is Chinese stem-deriving instruction (CSDI). In this method, CCR is taught via a group of characters (e.g., [foreign character omitted], [foreign character omitted], and [foreign character omitted]) that share the same stem (e.g., [foreign character omitted]). However, the effectiveness of CSDI on the CCR of Chinese children with dyslexia remains inconsistent, and the reason may be the diverse designs of this method across studies. Thus, this study aimed to use a quasiexperiment-design study to compare the effects of various forms of CSDI based on the (in)consistency of the extending characters' sounds, their appearances, and their amount (i.e., how many of them). In total, 122 Chinese third to sixth graders with dyslexia were recruited from primary schools, and they were randomly assigned to one of three groups: (a) visuospatially controlled CSDI (n = 37; all taught characters shared the same pronunciation), (b) verbally controlled CSDI (n = 45; all taught characters shared the same structure), and (c) noncontrolled CSDI (n = 40; all taught characters selected only on the basis of their frequencies). They were tested by CCR and dictation before and after the instruction. We found that CCR was significantly improved in all three CSDI groups, whereas only the verbally controlled CSDI group showed significant improvements in dictation. Furthermore, verbally and visuospatially controlled CSDI earned the greatest benefits in decreasing the visual errors and phonetic errors in CCR and decreasing the radical errors and homophone errors in dictation. Our findings shed light on the effectiveness of CSDI in terms of diverse designs, and frontline practitioners should take our findings into consideration when using CSDI.

Abstract Background Arthrodesis serves as the traditional therapeutic approach for advanced distal interphalangeal joint (DIPJ) arthritis. However, the conventional technique may prove insufficient when the excision of pronounced volar and lateral spurs is required. To address this, we innovated the 'smile incision with reverse shotgun approach'. This method enhances joint exposure and yields superior cosmetic results by extending the transverse skin incision over the DIPJ and cleaving the accessory collateral ligament, thereby improving access to the volar and lateral joint margins. This article meticulously elucidates the surgical procedure and presents preliminary results of its implementation. Method The clinical data of 22 consecutive patients (36 fingers) who received DIPJ arthrodesis by this procedure during March 2018 to October 2022, with a mean follow-up period of 9.8 months, were reviewed. Patients’ demographics, union rate, complications, radiographic findings, as well as visual analogue scale (VAS) for pain and satisfaction, were collected and analyzed. Results Thirty-five of 36 fingers achieved uneventful bony union (97.2%). The average VAS for pain and satisfaction as well as he coronal plane deviation of DIPJ significantly improved after the operation (all, P

Abstract Background Prior research has found that children with attention-deficit hyperactivity disorder (ADHD) and reading difficulties (RD) are at an elevated risk of developing further cognitive deficits and developmental challenges [1]. ADHD and RD are characterized by a deficit in working memory, which negatively affects learning and behavior. The main aims of this study were to design a working memory training app and examine its effectiveness through a 5-week training program in Chinese children with ADHD and/or RD. Methods There were three experimental groups, with 26 participants in the ADHD group, 38 participants in the RD group, and 24 participants in the ADHD + RD group. The typically developing (TD) control group had 32 participants. All participants completed the pretest and posttest assessments on executive function and reading performance. Results The findings indicate that the experimental groups improved performance in verbal and visual-spatial working memory as well as Chinese word reading. There was an overall reduction in functional impairment following the training, in contrast to the TD group. Conclusion This study showed that working memory can be improved through computerized training in children with ADHD and/or RD. The implications of future research in working memory are discussed. Trial registration Clinical Trials Identifier: NCT06567444 (retrospectively registered) on 20 August 2024.

This study investigated the cross-sectional relationships between reading-related affective and cognitive factors and reading skills among adolescents with and without dyslexia. Participants were 120 Chinese-speaking eighth graders, including 60 adolescents with dyslexia and 60 typically developing adolescents from Hong Kong, China. Adolescents completed questionnaires on general anxiety, reading anxiety, and reading self-concept. They were also assessed on measures of rapid digit naming, verbal working memory, word reading, reading fluency, and reading comprehension. The results showed that readers with dyslexia reported higher levels of general anxiety and reading anxiety and lower levels of reading self-concept than typical readers. They also showed difficulties in rapid digit naming and verbal working memory. Importantly, controlling for rapid digit naming and verbal working memory, reading self-concept was uniquely associated with word reading and reading fluency for readers with and without dyslexia. Furthermore, reading anxiety and reading self-concept were uniquely associated with reading comprehension for the two groups of readers. The findings point to the importance of considering affective factors when examining the reading skills of Chinese readers and the utility of targeting these factors when supporting the learning of adolescents with and without dyslexia.

This study aims to bridge the research gap in the humour comprehension problems of individuals with dyslexia in Chinese culture. We conducted a nonexperimental study to examine the differences between Chinese adolescents with and without dyslexia in visual humour comprehension as well as the group differences in the correlation of visual humour comprehension with other abilities. In total, 48 Chinese adolescents (16 individuals with dyslexia and 32 individuals without dyslexia) were recruited in Hong Kong. They were all administered several tasks: tests of nonverbal IQ, Chinese character reading, visual-spatial attention, orthographic knowledge, and visual humour comprehension. Our results indicated that visual humour comprehension is correlated with other abilities. Additionally, the group with dyslexia performed significantly less accurately on most tasks except humour comprehension accuracy. However, only visual spatial attention, orthographic knowledge, and humour comprehension speed significantly predicted membership in the two groups. Finally, approximately half of the participants with dyslexia had significantly slower humour comprehension than those with typical development. Our findings shed light on problems with humour comprehension exhibited by Chinese individuals with dyslexia.

Abstract Background To assess the clinical outcomes and identify the ideal indication for implementing dorsal distal radioulnar joint (DRUJ) capsular imbrication after triangular fibrocartilage complex (TFCC) repair in cases of DRUJ instability. Methods We conducted a retrospective study on patients who underwent arthroscopic TFCC repair between 2016 and 2021. Inclusion criteria comprised a symptomatic ulna fovea sign for over 6 months and dorsal DRUJ subluxation on magnetic resonance imaging. A total of 225 patients were divided into two groups: Group 1 (135 cases) with a negative ballottement test after “Cross-form TFCC repair” (CR) and Group 2 (90 cases) with a positive ballottement test after “Cross-form TFCC repair” and augmented DRUJ stability through dorsal DRUJ capsular imbrication (CR + DCI). Pain visual analog scale score (VAS), grip strength, modified Mayo Wrist Score (MMWS), wrist range of motion (ROM), and patient-reported outcomes (PROMs) were assessed for a minimum of 3 years postoperatively. Results Both groups showed significant improvements in pain VAS score, grip strength, wrist ROM, MMWS, and PROMs between the preoperative and postoperative periods (all P

To ensure sufficient reaction between concrete and carbon dioxide, carbon dioxide was added during the concrete mixing process. The study involved varying water-to-cement ratios (W/C), carbon dioxide pressure, and carbon dioxide concentration to create different cement mortar samples. The research aimed to observe the effects of carbon dioxide sequestration under these parameters. Subsequently, mortar concrete properties were tested at different curing times. The findings indicated that this method enhanced the efficiency of cement mortar in absorbing carbon dioxide. The results revealed that mixing mortar with carbon dioxide led to a rapid reaction, reducing the initial setting time of cement mortar. However, it was observed that this method significantly decreased the workability of cement mortar after carbon dioxide mixing, and this effect could potentially be mitigated by adjusting the W/C or using a superplasticizer. The bond of cement was also found to decrease after reacting with carbon dioxide, consequently impairing the compressive strength of the concrete. Nevertheless, the compressive strength remained within acceptable limits. It is essential to note that the carbonation of the concrete and its ability to protect reinforcement from rusting were compromised due to the reduced pH value of the concrete. Further assessment of the durability is necessary, particularly if this method is applied to reinforced concrete structures.

Background As the burden and distribution of calcification within chronic total occlusion (CTO) lesions can be diverse, its effect on CTO recanalization using multiple devices and techniques is debatable. This study investigated the role of calcification in wiring-based intraplaque tracking techniques for CTO recanalization.Methods A modified J-CTO score without counting calcification was used to analyze the procedures of 458 consecutive patients who underwent CTO interventions. Failed guidewire crossing and intraplaque tracking were considered procedural failures. Recanalization time details were analyzed for successful procedures.Results In patients with calcified CTO, the rate of procedural success only significantly declined to be lower than that of noncalcified CTO when the modified J-CTO score was ≥3 (77% vs. 94%, p = 0.008). In 422 patients with successful procedures, the presence of calcification was irrelevant to guidewire crossing time, but was accompanied with longer time from guidewire cross to final angiogram when the modified J-CTO score was 1–2 (53 ± 35 vs. 35 ± 17 [noncalcified] min, p 60 min (OR = 4.8, 95% CI = 2.2–10.2) in successfully recanalized lesions with modified J-CTO score 1–2.Conclusions Using intraplaque guidewire tracking, calcification was unfavorable for very difficult CTO lesions, and caused prolongation of angioplasty time for lesions with moderate complexity. This suggested that the role of calcification in the J-CTO score could be altered when different recanalization techniques were applied for CTO interventions.

Abstract Background Canine mammary tumors (CMTs) in intact female dogs provide a natural model for investigating metastatic human cancers. Our prior research identified elevated expression of Anterior Gradient 2 (AGR2), a protein disulfide isomerase (PDI) primarily found in the endoplasmic reticulum (ER), in CMT tissues, highly associated with CMT progression. We further demonstrated that increased AGR2 expression actively influences the extracellular microenvironment, promoting chemotaxis in CMT cells. Unraveling the underlying mechanisms is crucial for assessing the potential of therapeutically targeting AGR2 as a strategy to inhibit a pro-metastatic microenvironment and impede tumor metastasis. Methods To identify the AGR2-modulated secretome, we employed proteomics analysis of the conditioned media (CM) from two CMT cell lines ectopically expressing AGR2, compared with corresponding vector-expressing controls. AGR2-regulated release of 14-3-3ε (gene: YWHAE) and α-actinin 4 (gene: ACTN4) was validated through ectopic expression, knockdown, and knockout of the AGR2 gene in CMT cells. Extracellular vesicles derived from CMT cells were isolated using either differential ultracentrifugation or size exclusion chromatography. The roles of 14-3-3ε and α-actinin 4 in the chemotaxis driven by the AGR2-modulated CM were investigated through gene knockdown, antibody-mediated interference, and recombinant protein supplement. Furthermore, the clinical relevance of the release of 14-3-3ε and α-actinin 4 was assessed using CMT tissue-immersed saline and sera from CMT-afflicted dogs. Results Proteomics analysis of the AGR2-modulated secretome revealed increased abundance in 14-3-3ε and α-actinin 4. Ectopic expression of AGR2 significantly increased the release of 14-3-3ε and α-actinin 4 in the CM. Conversely, knockdown or knockout of AGR2 expression remarkably reduced their release. Silencing 14-3-3ε or α-actinin 4 expression diminished the chemotaxis driven by AGR2-modulated CM. Furthermore, AGR2 controls the release of 14-3-3ε and α-actinin 4 primarily via non-vesicular routes, responding to the endoplasmic reticulum (ER) stress and autophagy activation. Knockout of AGR2 resulted in increased α-actinin 4 accumulation and impaired 14-3-3ε translocation in autophagosomes. Depletion of extracellular 14-3-3ε or α-actinin 4 reduced the chemotaxis driven by AGR2-modulated CM, whereas supplement with recombinant 14-3-3ε in the CM enhanced the CM-driven chemotaxis. Notably, elevated levels of 14-3-3ε or α-actinin 4 were observed in CMT tissue-immersed saline compared with paired non-tumor samples and in the sera of CMT dogs compared with healthy dogs. Conclusion This study elucidates AGR2’s pivotal role in orchestrating unconventional secretion of 14-3-3ε and α-actinin 4 from CMT cells, thereby contributing to paracrine-mediated chemotaxis. The insight into the intricate interplay between AGR2-involved ER stress, autophagy, and unconventional secretion provides a foundation for refining strategies aimed at impeding metastasis in both canine mammary tumors and potentially human cancers.

Abstract Background The Patient Right to Autonomy Act (PRAA), implemented in Taiwan in 2019, enables the creation of advance decisions (AD) through advance care planning (ACP). This legal framework allows for the withholding and withdrawal of life-sustaining treatment (LST) or artificial nutrition and hydration (ANH) in situations like irreversible coma, vegetative state, severe dementia, or unbearable pain. This study aims to investigate preferences for LST or ANH across various clinical conditions, variations in participant preferences, and factors influencing these preferences among urban residents. Methods Employing a survey of legally structured AD documents and convenience sampling for data collection, individuals were enlisted from Taipei City Hospital, serving as the primary trial and demonstration facility for ACP in Taiwan since the commencement of the PRAA in its inaugural year. The study examined ADs and ACP consultation records, documenting gender, age, welfare entitlement, disease conditions, family caregiving experience, location of ACP consultation, participation of second-degree relatives, and the intention to participate in ACP. Results Data from 2337 participants were extracted from electronic records. There was high consistency in the willingness to refuse LST and ANH, with significant differences noted between terminal diseases and extremely severe dementia. Additionally, ANH was widely accepted as a time-limited treatment, and there was a prevalent trend of authorizing a health care agent (HCA) to make decisions on behalf of participants. Gender differences were observed, with females more inclined to decline LST and ANH, while males tended towards accepting full or time-limited treatment. Age also played a role, with younger participants more open to treatment and authorizing HCA, and older participants more prone to refusal. Conclusion Diverse preferences in LST and ANH were shaped by the public’s current understanding of different clinical states, gender, age, and cultural factors. Our study reveals nuanced end-of-life preferences, evolving ADs, and socio-demographic influences. Further research could explore evolving preferences over time and healthcare professionals’ perspectives on LST and ANH decisions for neurological patients..

Objective: This study aims to predict new-onset secondary adrenal insufficiency (NOSAI) after transsphenoidal pituitary tumor resection surgery using perioperative growth hormone (GH) and prolactin (PRL) levels, among other factors. Methods: A cohort of 124 adult patients who underwent transsphenoidal resection for non-functioning pituitary adenoma, with routine perioperative glucocorticoid use, was used to develop the predictive regression model. An additional 46 patients served as the validation cohort. Generalized additive models were used to identify optimal cut-off points for the variables. Results: The GH level on postoperative day one (POD1) can be a simple predictor by implementing a cut-off point of 0.41 ng/ml. A value ≤ 0.41 ng/mL predicted NOSAI with 0.6316 sensitivity and 0.7810 specificity for the original cohort and 1.0000 sensitivity and 0.7143 specificity for the validation cohort. The multiple logistic regression model included perioperative PRL level difference, perioperative GH level difference, intraoperative cerebrospinal fluid (CSF) leakage, tumor size, and the combined effect of diabetes insipidus (DI) and relative perioperative GH level difference. The areas under the receiver operating characteristic curves were 0.9410 (original cohort) and 0.9494 (validation cohort) for the regression model. Conclusion: Early morning GH level on POD1 can predict NOSAI with fair accuracy when perioperative stress dose glucocorticoid is administered. Prediction accuracy can be improved by considering CSF leakage, DI, and perioperative changes in GH and PRL in the final regression model.

This study investigates the effectiveness of using ultra-high-performance concrete (UHPC) to strengthen concrete members subjected to high temperature and freeze-thaw conditions. Initially, the physical and mechanical properties of UHPC were examined. Subsequently, the durability of UHPC was evaluated through high temperature and freeze-thaw tests, assessing compressive strength, flexural strength, and splitting tensile strength. The study examined the reinforcing effects of different repair materials and thicknesses, including plain concrete and UHPC with varying fibre content. Results indicate that UHPC demonstrates high strength, ductility, and durability. However, under high temperature conditions exceeding 400°C for 2 hours, UHPC experienced bursting. Nonetheless, its strength remained relatively stable after 1000 freeze-thaw cycles, demonstrating excellent durability and resistance. Additionally, applying a 2-cm thickness of UHPC to strengthen concrete members resulted in significant retrofitting effects, enhancing the structural integrity of damaged buildings.

Abstract This study unveils a groundbreaking technique leveraging the superposition of electric field vectors to manipulate liquid crystals (LCs). Demonstrated through a simple configuration of four independent electrodes at the corners of a rectangular enclosure, notably, this configuration can be further simplified or modified as needed, showcasing the versatility of the approach. Significantly, the design showcased in the paper eliminates the need for an alignment layer, highlighting the versatility of the method. Through nuanced adjustments in waveforms, amplitudes, frequencies, and phases in AC or DC from these electrodes, precise control over LC shape deformation and dynamic phase transformation is achieved in both temporal and spatial dimensions. In contrast to traditional methods, the approach presented here abolishes alignment layers and intricate electrode-array systems, opting for a streamlined configuration with varying AC frequencies and DC electric signals. This innovative methodology, founded on simplified governing equations from Q-tensor hydrodynamics theory, demonstrates true 3D control over LCs, displaying efficiency in electrode usage beyond current arrays. The study's contributions extend to temporal control emphasis, superposition techniques, and the elimination of fixed electrodes, promising unprecedented possibilities for programming LC materials and advancing the field of programmable LC devices.

Abstract Background Longitudinal integrated clerkships (LICs) and traditional block rotations (TBRs) employ different designs that provide various learning experiences for students. In this study, we explored students’ clinical participation and interpersonal interactions in LICs and TBRs at 2 metropolitan hospitals in Taiwan. Methods In April 2018, we enrolled 15 LIC and 29 TBR students. We conducted a cross-sectional survey which required the students to outline a typical daily schedule during their internal medicine rotations and draw an ecomap of the clinical team members. With the patient in the center as a reference, the size of each circle in an ecomap indicated the importance of the member; the distances and number of connecting lines between two circles represented the relationship and frequency of interaction, respectively, between the corresponding members. We analyzed the results and compared the responses of the LIC and TBR students. Results The LIC students spent more time on direct patient care and in the outpatient clinic/operation room, whereas the TBR students participated more in educational activities and in observation behind their seniors. In the ecomap analysis, the LIC students had a closer relationship with attending physicians and had better interactions with patients and preceptors than did the TBR students. Conversely, the TBR students felt closer to and interacted more frequently with interns and residents. Conclusions The LIC students had more opportunities to care for patients directly and engaged in interactions with patients and attending physicians more frequently than did the TBR students. Trial registration Ethical approval for the study was obtained from the Institutional Review Board of Tri-Service General Hospital (TSGHIRB 2–106–05–018).

Abstract This study introduces a novel image capture and lighting techniques using a cutting-edge hybrid MEMS scanner system designed for compact microscopic imaging. The scanner comprises a tapered optical fiber waveguide and innovative aerosol-jet printed PZT (lead zirconate titanate) bimorph push-pull actuators on a stainless-steel substrate, effectively addressing issues that are commonly associated with PZT on silicon substrates such as fracture and layer separation. By leveraging nonlinear vibration, the scanner achieves a spiral scan pattern from a single signal input, in addition to the expected two-dimensional scanning and target illumination from two phase-shifted inputs. This capability is further enhanced by a novel process to taper the optical fiber, which reduces illumination scattering and tunes the fiber to the resonant frequencies of the scanner. The precisely tapered tip enables large fields of view while maintaining independent 2-axis scanning through one-degree-of-freedom actuation. Experimental validation showcases the successful generation of a spiral scan pattern with a 60 μm diameter scan area and a 10 Hz frame rate, effectively reconstructing scanned images of 5 μm lines, cross patterns (15 μm in length with a 5 μm gap), and structures of a Psychodidae wing.

Objective: In patients with atrial fibrillation (AF) and end-stage renal disease (ESRD), oral anticoagulants are contraindicated, and left atrial appendage occlusion (LAAO) is an alternative treatment. However, the efficacy of thromboembolic prevention using LAAO in these patients has rarely been reported in Asian populations. To our knowledge, this is the first long-term LAAO study in patients with AF undergoing dialysis in Asia. Methods: In this study, 310 patients (179 men) with a mean age of 71.3 ± 9.6 years and mean CHA2DS2-VASc 4.2 ± 1.8 were consecutively enrolled at multiple centers in Taiwan. The outcomes of 29 patients with AF and ESRD undergoing dialysis who underwent LAAO were compared to those without ESRD. The primary composite outcomes were stroke, systemic embolization, or death. Results: No difference in mean CHADS-VASc score was noted between patients with versus without ESRD (4.1 ± 1.8 vs. 4.6 ± 1.9, p = 0.453). After a mean follow-up of 38 ± 16 months, the composite endpoint was significantly higher in patients with ESRD (hazard ratio, 5.12 [1.4–18.6]; p = 0.013) than in those without ESRD after LAAO therapy. Mortality was also higher in patients with ESRD (hazard ratio, 6.6 [1.1–39.7]; p = 0.038). The stroke rate was numerically higher in patients with versus without ESRD, but the difference was not statistically significant (hazard ratio, 3.2 [0.6–17.7]; p = 0.183). Additionally, ESRD was associated with device-related thrombosis (odds ratio, 6.15; p = 0.047). Conclusion: Long-term outcomes of LAAO therapy may be less favorable in patients with AF undergoing dialysis, possibly because of the poor condition of patients with ESRD.

Frozen shoulder (FS) is a common shoulder condition accompanied by shoulder pain and a loss of shoulder range of motion (ROM). The typical clinical assessment tools such as questionnaires and ROM measurement are susceptible to subjectivity and individual bias. To provide an objective evaluation for clinical assessment, this study proposes an inertial measurement unit (IMU)-based identification system to automatically identify shoulder tasks whether performed by healthy subjects or FS patients. Two groups of features (time-domain statistical features and kinematic features), seven machine learning (ML) techniques, and two deep learning (DL) models are applied in the proposed identification system. For the experiments, 24 FS patients and 20 healthy subjects were recruited to perform five daily shoulder tasks with two IMUs attached to the arm and the wrist. The results demonstrate that the proposed system using deep learning presented the best identification performance using all features. The convolutional neural network achieved the best identification accuracy of 88.26%, and the multilayer perceptron obtained the best F1 score of 89.23%. Further analysis revealed that the identification performance based on wrist features had a higher accuracy compared to that based on arm features. The system’s performance using time-domain statistical features has better discriminability in terms of identifying FS compared to using kinematic features. We demonstrate that the implementation of the IMU-based identification system using ML is feasible for FS assessment in clinical practice.

This study aims to expand our understanding of the relations of oral reading fluency at word, sentence, and passage levels to reading comprehension in Chinese-speaking secondary school-aged students. In total, 80 participants (46 males and 34 females) ranging from 13 to 15 years old joined this study and were tested on tasks of oral reading fluency at three levels, reading comprehension, and nonverbal IQ. Our results showed a clear relationship from fluency at the level of the word to the sentence and then the passage in oral reading fluency as well as both the direct and indirect importance of word-level oral reading fluency in reading comprehension. Only the indirect effect from word-level oral reading fluency to reading comprehension through passage-level oral reading fluency was significant. Our findings suggest that sentence-level oral reading fluency is the crucial component to reading comprehension in Chinese. Additionally, recognition of the potential value of unique features, such as syntactic awareness and word segment accuracy, that happen at the sentence level should be integrated into instructional activities for reading.

Neurorehabilitation devices and technologies are crucial for enhancing stroke recovery. These include noninvasive brain stimulation devices that provide repetitive transcranial magnetic stimulation or transcranial direct current stimulation, which can remodulate an injured brain. Technologies such as robotics, virtual reality, and telerehabilitation are suitable add-ons or complements to physical therapy. However, the appropriate application of these devices and technologies, which target specific deficits and stages, for stroke therapy must be clarified. Accordingly, a literature review was conducted to evaluate the theoretical and practical evidence on the use of neurorehabilitation devices and technologies for stroke therapy. This narrative review provides a practical guide for the use of neurorehabilitation devices and describes the implications of use and potential integration of these devices into healthcare.

Aims: Several artificial bone grafts have been developed but fail to achieve anticipated osteogenesis due to their insufficient neovascularization capacity and periosteum support. This study aimed to develop a vascularized bone-periosteum construct (VBPC) to provide better angiogenesis and osteogenesis for bone regeneration. Methods: A total of 24 male New Zealand white rabbits were divided into four groups according to the experimental materials. Allogenic adipose-derived mesenchymal stem cells (AMSCs) were cultured and seeded evenly in the collagen/chitosan sheet to form cell sheet as periosteum. Simultaneously, allogenic AMSCs were seeded onto alginate beads and were cultured to differentiate to endothelial-like cells to form vascularized bone construct (VBC). The cell sheet was wrapped onto VBC to create a vascularized bone-periosteum construct (VBPC). Four different experimental materials – acellular construct, VBC, non-vascularized bone-periosteum construct, and VBPC – were then implanted in bilateral L4-L5 intertransverse space. At 12 weeks post-surgery, the bone-forming capacities were determined by CT, biomechanical testing, histology, and immunohistochemistry staining analyses. Results: At 12 weeks, the VBPC group significantly increased new bone formation volume compared with the other groups. Biomechanical testing demonstrated higher torque strength in the VBPC group. Notably, the haematoxylin and eosin, Masson’s trichrome, and immunohistochemistry-stained histological results revealed that VBPC promoted neovascularization and new bone formation in the spine fusion areas. Conclusion: The tissue-engineered VBPC showed great capability in promoting angiogenesis and osteogenesis in vivo. It may provide a novel approach to create a superior blood supply and nutritional environment to overcome the deficits of current artificial bone graft substitutes. Cite this article: Bone Joint Res 2023;12(12):722–733.

Abstract Background A variety of surgical techniques had been developed over the past few decades for treating thumb carpometacarpal joint (CMCJ) osteoarthritis (OA). However, there are currently no accepted consensus on the ideal treatment for thumb CMCJ OA. Arthrodesis was one of the widely popular treatment methods; however, studies have showed that non-union rates were as high as 50%, with higher complications such as osteoarthritis of neighbouring joints and higher revision surgeries required as compared to other surgical methods. Patients with arthrodesis were also reported to have decreased thumb range of motion and loss of opponens function. Currently, there are numerous intraoperative positioning techniques for arthrodesis which could be confusing for young surgeons. With recent developments of fixation plates and better understanding of the wrist anatomy, this retrospective review aimed to evaluate the efficacy of our intraoperative hand-grip positioning method for arthrodesis of thumb CMCJ OA. What are the postoperative functional outcomes of (1) T-hook plates and (2) our intraoperative hand-grip positioning method for Eaton III thumb CMCJ OA arthrodesis by evaluating pain visual analogue scale (VAS) score, Disabilities of the Arm, Shoulder and Hand questionnaires (DASH), Mayo Wrist scores, capability of thumb opposition (Kapandji score), and comparing pre- and postoperative grip and pinch strength? Methods Twenty patients with CMCJ OA underwent arthrodesis using our intraoperative hand-grip positioning method and T-hook plates and screws (Acumed, USA). Patients were evaluated preoperatively and at 1, 3, 6 and 12 months postoperatively. Radiologic assessment including fusion evaluation, evaluation of radial and palmar abduction angles was done on hand X-rays. Results Twenty patients with a minimum follow-up duration of 12 months were included in this study. 100% fusion rate was achieved with only 1 case of complication involving radial sensory nerve neuropathy which was resolved after removal of implant and neurolysis. Significant improvement in pain and Mayo Wrist scores were noted 3 months postoperatively, whilst DASH score exhibited significant improvements after 6 months of follow-up (p

Abstract Background Feline mammary carcinoma (FMC) is one of the most prevalent malignancies of female cats. FMC is highly metastatic and thus leads to poor disease outcomes. Among all metastases, liver metastasis occurs in about 25% of FMC patients. However, the mechanism underlying hepatic metastasis of FMC remains largely uncharacterized. Results Herein, we demonstrate that FMC-derived extracellular vesicles (FMC-EVs) promotes the liver metastasis of FMC by activating hepatic stellate cells (HSCs) to prime a hepatic premetastatic niche (PMN). Moreover, we provide evidence that sphingosine kinase 1 (SK1) delivered by FMC-EV was pivotal for the activation of HSC and the formation of hepatic PMN. Depletion of SK1 impaired cargo sorting in FMC-EV and the EV-potentiated HSC activation, and abolished hepatic colonization of FMC cells. Conclusions Taken together, our findings uncover a previously uncharacterized mechanism underlying liver-metastasis of FMC and provide new insights into prognosis and treatment of this feline malignancy.

Abstract Human preimplantation development involves extensive remodeling of RNA expression and splicing. However, its transcriptome has been compiled using short-read sequencing data, which fails to capture most full-length mRNAs. Here, we generate an isoform-resolved transcriptome of early human development by performing long- and short-read RNA sequencing on 73 embryos spanning the zygote to blastocyst stages. We identify 110,212 unannotated isoforms transcribed from known genes, including highly conserved protein-coding loci and key developmental regulators. We further identify 17,964 isoforms from 5,239 unannotated genes, which are largely non-coding, primate-specific, and highly associated with transposable elements. These isoforms are widely supported by the integration of published multi-omics datasets, including single-cell 8CLC and blastoid studies. Alternative splicing and gene co-expression network analyses further reveal that embryonic genome activation is associated with splicing disruption and transient upregulation of gene modules. Together, these findings show that the human embryo transcriptome is far more complex than currently known, and will act as a valuable resource to empower future studies exploring development.

Customized production has greatly diversified product categories, which has altered product life cycles and added complexity to business management. This paper introduces a matrix-clustering technique that integrates k-means clustering with the BCG Matrix, enhanced by time modeling, to offer a comprehensive framework for multi-item product sales forecasting. The approach builds upon existing BCG Matrix outcomes, re-clustering high-selling products more precisely and redefining their relationship with other product lines more objectively. This method addresses the challenge of forecasting situations with limited historical data, providing more accurate sales predictions. Using Taiwan’s sales data, an empirical study on integrated circuit tray products demonstrated the effectiveness of the matrix clustering technique. The results showed improved data utilization, increasing from 35.93% with the original BCG analysis to 52.43% with the combined matrix-clustering and time modeling methods. This study contributes to academic research by presenting a portfolio analysis approach rooted in matrix clustering, which systematically enhances traditional BCG Matrix methods. The proposed framework is adaptable to the unique traits of different portfolios, offering businesses workflows that are efficient, reliable, sustainable, and scalable.

A Z-scheme heterojunction photo(electro)catalyst was fabricated by coupling sulfonic acid-modified graphitic carbon nitride (SA-g-CN) with bismuth oxyiodide (BiOI). The SA-g-CN component was prepared via wet-impregnation, while BiOI was synthesized through a hydrothermal method. Comprehensive characterization elucidated the structural and morphological properties of the resulting composite. The SA-g-CN/BiOI exhibited exceptional performance in both photocatalytic degradation of tartrazine (TTZ) and photoelectrochemical oxygen evolution reaction (OER). Notably, 98.26% TTZ removal was achieved within 60 min of irradiation, while an OER onset potential of 0.94 V (vs. Ag/AgCl) and a high photocurrent density of 6.04 mA were recorded under AM 1.5G illumination. Band energy calculations based on Mott–Schottky measurements confirmed the formation of a Z-scheme heterojunction, which facilitated efficient charge separation and transfer, thereby enhancing catalytic activity. These findings establish the SA-g-CN/BiOI composite as a promising candidate for sustainable energy generation and environmental remediation applications.

In the chemical industry, stable reactor operation is essential for consistent production. Motor failures can disrupt operations, resulting in economic losses and safety risks. Traditional monitoring methods, based on human experience and simple current monitoring, often need to be faster and more accurate. The rapid development of artificial intelligence provides powerful tools for early fault detection and maintenance. In this study, the Hotelling T2 index is used to calculate the root mean square values of the normal motor’s x, y, and z axes. A long short-term memory (LSTM) model creates a trend model for the Hotelling T2 index, determining an early warning threshold. Current anomaly detection follows the ISO 10816-1 standard, while future anomaly prediction uses the T2-LSTM trend model. Validated at a chemical plant in Southern Taiwan, the method shows 98% agreement between the predicted and actual anomalies over three months, demonstrating its effectiveness. The T2-LSTM model significantly improves the accuracy of motor fault detection, potentially reducing economic losses and improving safety in the chemical industry. Future research will focus on reducing false alarms and integrating more sensor data.

There are many studies on the application of raw diatomite. Still, there are few studies on using waste diatomite to partially replace cement in concrete, especially in the literature regarding mechanical properties and heat insulation. As such, many waste diatomaceous earths are buried yearly. This study used recycled diatomite to replace part of the cement (10%, 15%, 20%, 30%, 40%) to make mixed cement mortar. Various tests were performed to determine its properties and thermal insulation benefits. According to the results of multiple tests, the amount of replacement diatomite increases the amount of mixing water and setting time. The weight loss and shrinkage rates of the freeze-thaw cycles also increased. However, its water absorption and thermal conductivity decreased. Regarding compressive strength, 10% diatomite substitution had higher strength at 28 days, but 20% diatomite substitution had higher strength at 90 days. The volume change did not exceed the 0.1% critical value specified in ASTM standards. These findings indicate that the most potential results (in terms of mechanical and thermal insulation performance) can be obtained in blends with 20% waste diatomite from the brewing industry.

Background Implantation of the left atrial appendage occluder (LAAO) has been proven to prevent stroke effectively in patients with atrial fibrillation who cannot tolerate anticoagulants. Incomplete endothelization of LAAO may cause device‐related thrombus, and currently no good image modality exists to clearly see LAAO endothelialization. We aimed to use coronary optic coherence tomography (OCT) to visualize LAAO endothelialization. Methods and Results We enrolled 14 patients (72.8±9.4 years old) undergoing pulmonary vein isolation with a preexisting LAAO implanted more than 1 year ago (5 Watchman and 9 Amulet). After pulmonary vein isolation, we did OCT via steerable sheath and coronary guiding catheter to adjust OCT probe location and injected contrast medium to visualize the LAAO surface. In vitro testing was also performed to see the bare occluder. In vitro OCT showed the surface of the bare device as an interrupted granule pattern, which included the Watchman surface polytetrafluoroethylene membrane string, Amulet disc metal strut, and inner polytetrafluoroethylene membrane string. In the implanted Watchman, OCT showed endothelialization as a smooth surface layer with noninterrupted coarser granules. In the implanted Amulet, OCT showed endothelialization as thin (early) or thick (late) endothelialization layer covering struts with OCT shadows. Among patients with Watchman, 2 showed no, 2 early, and 1 complete endothelialization. Among patients with Amulet, 2 showed no, 3 early, and 4 late endothelialization. Conclusions We demonstrated the feasibility of OCT to visualize LAAO endothelization with high resolution. Further studies are needed to determine antithrombotic regimens if incomplete endothelization is detected. A new OCT catheter may be designed specifically for LAAO.

Abstract Background Hematoxylin and Eosin (H&E)-based frozen section (FS) pathology is presently the global standard for intraoperative tumor assessment (ITA). Preparation of frozen section is labor intensive, which might consume up-to 30 minutes, and is susceptible to freezing artifacts. An FS-alternative technique is thus necessary, which is sectioning-free, artifact-free, fast, accurate, and reliably deployable without machine learning and/or additional interpretation training. Methods We develop a training-free true-H&E Rapid Fresh digital-Pathology (the-RFP) technique which is 4 times faster than the conventional preparation of frozen sections. The-RFP is assisted by a mesoscale Nonlinear Optical Gigascope (mNLOG) platform with a streamlined rapid artifact-compensated 2D large-field mosaic-stitching (rac2D-LMS) approach. A sub-6-minute True-H&E Rapid whole-mount-Soft-Tissue Staining (the-RSTS) protocol is introduced for soft/frangible fresh brain specimens. The mNLOG platform utilizes third harmonic generation (THG) and two-photon excitation fluorescence (TPEF) signals from H and E dyes, respectively, to yield the-RFP images. Results We demonstrate the-RFP technique on fresh excised human brain specimens. The-RFP enables optically-sectioned high-resolution 2D scanning and digital display of a 1 cm2 area in 700 M bits/sec, with zero post-acquisition data/image processing. Training-free blind tests considering 50 normal and tumor-specific brain specimens obtained from 8 participants reveal 100% match to the respective formalin-fixed paraffin-embedded (FFPE)-biopsy outcomes. Conclusions We provide a digital ITA solution: the-RFP, which is potentially a fast and reliable alternative to FS-pathology. With H&E-compatibility, the-RFP eliminates color- and morphology-specific additional interpretation training for a pathologist, and the-RFP-assessed specimen can reliably undergo FFPE-biopsy confirmation.

Wood is a natural, organic, renewable, sustainable, and versatile building material. The mechanical reinforcement and durability of carbon fiber-reinforced polymer (CFRP) composites to wood are issues of concern. This study focuses on the durability aspects of CFRP-strengthened wood members. To ensure durability, we tested carbon fiber sheets wrapped by wooden member specimens, subjected to two different environments, including seawater dry-wet cycling and freeze-thaw cycling, on surface hardness. The samples also underwent SEM observation, pull-off strength, compressive shear strength, compressive strength, and flexural strength tests. After the above-mentioned environmental conditions and tests, the effect and durability of the CFRP-strengthened wood members were evaluated. The results indicate that wood members wrapped with CFRP can increase their strength, mainly when applying two resin layers. After two environmental durability tests, the wood components bonded well with CFRP. Our findings indicate that as the number of reinforcement layers increased, the compressive strength, flexural strength, and compression-shear strength of CFRP-reinforced wood specimens increased, but the pull-off strength remained unchanged.