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Cerebral air embolism after removal of central venous catheter (CVC) is a rare complication but can lead to fatal outcomes. We report a rare case of both cerebral venous and arterial embolism occurring in a patient with underlying scleroderma-related interstitial lung disease (SSc-ILD) and pulmonary hypertension following removal of percutaneous introducer sheath for pulmonary artery catheterization. We discuss the mechanisms, pathophysiology, management and prevention of cerebral air embolism.

Abstract Background Seasonal influenza vaccine (SIV) greatly reduces disease burden among school-aged children, yet parental vaccine hesitancy remains a persistent challenge. Two types of SIV are available for children in Hong Kong and other locations: inactivated influenza vaccine (IIV), administered through intramuscular injection, and live attenuated influenza vaccine (LAIV), administered via nasal spray. We aimed to understand how vaccine hesitancy shaped parental preference for LAIV versus IIV, particularly amidst important public health events, such as the COVID-19 pandemic and the massive rollout of COVID-19 vaccination campaigns. Methods We employed a concurrent mixed-methods design. The quantitative part involves longitudinal surveys spanning three years, from pre-pandemic to post-pandemic periods, tracking parental vaccine hesitancy and preference for SIV types. The qualitative part involves 48 in-depth interviews, providing insights into parental preference for SIV types, underlying reasons, and related values. Results Our quantitative analyses show an overall increase in parental vaccine hesitancy and preference for LAIV over IIV after the onset of the COVID-19 pandemic and especially after the rollout of the COVID-19 vaccination campaign. Further logistic regression modelling based on the cohort data shows that higher vaccine hesitancy, coupled with the COVID-19 vaccination campaign rollout, predicts a greater preference for LAIV over IIV. The qualitative analysis complements these results, highlighting that LAIV’s non-invasive nature aligns with parental values of prioritizing natural immunity and concerns about overmedication, leading to a more acceptable attitude towards LAIV. Conclusions Leveraging the higher acceptability of LAIV compared to IIV among parents with high vaccine hesitancy could promote childhood vaccination uptake.

Mesotheliomas are malignancies which involve mesothelial cells, and are commonly found in the pleura, peritoneum, pericardium, and (rarely) the testis. We present a case of paratesticular mesothelioma that was excised without the testis. An elderly gentleman presented with a painless right scrotal mass, which appeared clinically benign and separable from the underlying testis. An ultrasound showed an extratesticular lesion adhered to the scrotal wall with a complex hydrocele. An excisional biopsy was conducted, and the Jaboulay procedure was performed on the right testis. Pathological examination revealed mesothelioma, showing focal invasion into the underlying stroma. A post-operative computed tomography (CT) scan evaluation manifested no local or distant metastasis. No further surgery was performed, and no chemotherapy or radiotherapy was offered to the patient. Subsequent clinical examinations and radiological scans carried out during each clinic follow-up for two years showed no new lesion or recurrence.

Serological classification of influenza infection has classically been based on a four-fold or higher increase in antibody levels, but this approach may not be optimal. Here, the authors develop a Bayesian model to improve identification of infections in serological samples by accounting for individual antibody dynamics.

The performance of gargling for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase (RT)-PCR testing has not been previously reviewed. This review systematically assessed the performance of saline and water gargling for SARS-CoV-2 RT-PCR testing in the settings of diagnosing and monitoring viral shedding. We included original studies comparing the performance of gargling and (oropharyngeal–)nasopharyngeal swabs for SARS-CoV-2 RT-PCR testing. Studies conducted in either suspected individuals or confirmed cases were included and analysed separately. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were examined using random-effects models. Gargles achieved a high overall sensitivity (91%), specificity (97%), PPV (95%) and NPV (91%) for SARS-CoV-2 RT-PCR testing. Studies using saline gargle and water gargle have an overall sensitivity of 97% and 86%, respectively. The sensitivity values were largely maintained for saline and water gargling on stratified analysis, for both diagnosis (96% and 92%) and viral shedding monitoring (98% and 78%). A higher sensitivity was also reported by studies using sterile saline (100%), a smaller amount of gargling solution (92% versus 87%) and a longer gargling duration (95% versus 86%). Our results supported the use of gargling as a sampling approach for SARS-CoV-2 RT-PCR testing, which achieved a high sensitivity for both diagnosis and viral shedding monitoring purposes. Further investigation on the comparative performance of different gargling mediums is needed to draw a definitive conclusion.

Background: Virtual reality laparoscopic simulators were introduced to provide an optimal and safe learning environment for surgical trainees. The simulators had been validated and proven to be beneficial. Materials and Methods: The aim of this study is to assess the performance of the local surgical trainees using a validated simulator and help in the development of a training program using the simulator. Prospective repeated measures study in a single center using a validated virtual reality simulator was performed. Years 1 and 2 local postgraduate surgical trainees with limited laparoscopic cholecystectomy experience were included in the study. The trainees underwent a proposed training module, and the simulator evaluated each performance. Comparison was made between the performance before and after the training module. Results: Nine surgical trainees (eight males, median age: 33 years old) with a median of 5 years of surgical experience after graduation were included in the study. The time to complete each basic laparoscopic skill improved between 26.5% and 64.3% (P < 0.05) while the time taken to complete each of the cholecystectomy procedural task improved between 43.2% and 73.8% (P < 0.05). The time taken to complete a full cholecystectomy procedure improved from 873s to 512s (P = 0.008), and the efficiency of cauterization improved by 15.3% (P = 0.008). Analysis of the various learning curve showed the improvement plateaued between the third and tenth sessions. Conclusion: Virtual reality laparoscopic training should be implemented as part of training as it improves certain skill sets.

Influenza vaccination is an important intervention to prevent influenza virus infection. Our previous analysis suggested that indirect protection is limited in an influenza B epidemic in Hong Kong. We further analyzed six influenza A epidemics to determine such potential. We applied a statistical model to estimate household transmission dynamics in the 3 influenza A(H3N2) and 3 pandemic influenza A(H1N1) epidemics. Then, we estimated the reduction in infection risk among unvaccinated household members when all children in households are vaccinated, with different assumptions on vaccine efficacy (VE). In the optimal scenario that VE was 70%, the reduction to the total probability of infection was only marginal, with relative probabilities ranged from 0.91–0.94 when all children in households were vaccinated because community was by far the main source of infection during the six epidemics in our study. The proportion of cases attributed to household transmission was 10% (95% CrI: 7%, 13%). Individual influenza vaccination is important even when other household members are vaccinated, given the degree of indirect protection is small.

Relevance of indirect protection of household members of vaccinees is unclear. Here, Tsang et al. quantify the direct and indirect protection of vaccination in a randomized controlled trial and show that benefits of individual vaccination remain important even when other household members are vaccinated.

Abstract Endobronchial one‐way valves (EBV) have been proposed as a treatment option for persistent air leak (PAL) complicating spontaneous pneumothorax when surgical intervention is considered not feasible. Published case series showed this form of treatment to be generally safe. We report two such cases in which both achieved immediate cessation of air leak and post‐procedural chest radiograph showed significant collapse of the treated lobe, but developed sudden onset of shortness of breath within 24 h after EBV insertion. Chest radiograph showed continued collapse of the treated lobes with enlarged ipsilateral pneumothorax in one patient and new contralateral pneumothorax in the other. Pulmonologists and thoracic surgeons inserting EBV for treatment of PAL should be aware of this possible and important complication.

Acute respiratory distress syndrome secondary to severe acute respiratory syndrome coronavirus-2 pneumonia or coronavirus disease 2019-related acute respiratory distress syndrome is the primary cause of mortality in coronavirus disease 2019. Some studies have described the concept of “high and low” elastance coronavirus disease 2019-related acute respiratory distress syndrome and proposed individualized management for the acute respiratory distress syndrome, deviating from low tidal volume ventilation. We report simultaneously measured respiratory parameters (static lung compliance, alveolar dead space ventilation, and shunt fraction) in 14 patients with advanced coronavirus disease 2019-related acute respiratory distress syndrome. The results were consistent with typical acute respiratory distress syndrome and did not support the concept of high-type coronavirus disease 2019-related acute respiratory distress syndrome and low-type coronavirus disease 2019-related acute respiratory distress syndrome.

This was a mixed-methods study comprising a questionnaire-based survey, a qualitative study, and analysis of school newsletters to evaluate elementary school staff’s acceptability, delivery challenges and communication about school-located influenza vaccination program (SIVP) in Hong Kong. We found that school staff with lower intention to implement SIVP perceived greater logistical difficulties in arranging SIVP. Challenges regarding program delivery included schools’ limited infrastructure, the burden of paperwork, the fear of being overwhelmed by multiple school-based vaccination schedules, lacking confidence in communicating with parents about influenza vaccines, and the difficulties in managing vaccination-related anxiety among children with intellectual disability. School staff were generally passive in communicating with parents and students about influenza vaccines. We also found that schools may use the school newsletters as a substitute of the formal informed consent forms. Good partnerships among government, service providers and schools should be established to minimize the burden of paperwork for school staff, facilitate early planning of SIVP, and support schools with limited infrastructure and the vaccination of children with intellectual disabilities. Training is needed to enhance school staff’s confidence in communicating with parents and students about influenza vaccines and improve information delivery to support parents’ informed decisions for children’s vaccination.

There are randomized controlled study data showing that endobronchial one‐way valves (EBV) are useful for bronchoscopic lung volume reduction (BLVR). There is also case series data showing EBV to be effective in stopping persistent air leaks complicating pneumothoraces. We describe a 66‐year‐old man with severe chronic obstructive pulmonary disease (COPD) who failed assessments for BLVR because of the inability to perform the carbon monoxide diffusion test but subsequently had EBV deployed to his right upper lobe bronchi for persistent air leak complicating a spontaneous pneumothorax. Afterwards, there was subjective improvement in breathlessness, exercise capacity, and reduced frequency of exacerbations requiring hospitalization. Lung function parameters showed marked improvement. This case suggests that patients with compatible spirometric lung volume and computed tomography findings should proceed with BLVR. In addition, one should be aware of the possibility of improved lung function in patients with pulmonary emphysema following implantation of EBV for persistent air leak.

Rationale: Little is known about effects of paternal tobacco smoke (PTS) on the offspring’s asthma and its prenatal epigenetic programming.Objective: To investigate whether PTS exposure was associated with the offspring’s asthma and correlated to epigenetic CG methylation of potential tobacco-related immune genes: LMO2, GSTM1 or/and IL-10 genes.Measurements and Main Results: In a birth cohort of 1,629 newborns, we measured exposure rates of PTS (23%) and maternal tobacco smoke (MTS, 0.2%), cord blood DNA methylation, infant respiratory tract infection, childhood DNA methylation, and childhood allergic diseases. Infants with prenatal PTS exposure had a significantly higher risk of asthma by the age of 6 than those without (p = 0.026). The PTS exposure doses at 0,

In this study, a novel nanodroplet cutting fluid (NDCF), consisting of emulsified water and oil nanodroplets, was developed to improve the surface quality of the single-point diamond-turned optical polymers. This developed NDCF was able to penetrate the chip–tool interface, contributing to both cooling and lubricating effects. The performance of NDCF was evaluated from perspectives of the surface irregularity, roughness, and cutting force of the machined groove in a series of taper cutting experiments. Meanwhile, a high-quality optical surface was obtained and the micro-level form error was reduced in the diamond turning of a Polymethylmethacrylate (PMMA) microlens array.

[This corrects the article DOI: 10.1371/journal.pone.0193899.].

This study aimed to assess predictive ability of heart rate variability (HRV) for pregnancy outcomes with in vitro fertilization (IVF) treatment.A total of 180 women with 261 cycles of IVF and 211 embryo transfers (ETs) were analyzed. HRV was measured at four times during IVF treatment: the first date of menstruation, r-HCG (Ovidrel) administration, and before and after ET. Pregnancy indicators included chemical pregnancy, ongoing pregnancy (> 10 weeks), and live birth (pregnancy > 24 weeks). Mixed effect models were applied to identify predictors for IVF pregnancy. The area under the receiver operating characteristic curve (AUC) was used to assess prediction models for pregnancy.The HRV values increased during IVF treatment and then decreased after ET. The trend of changes in HRV values during IVF treatment was significant among patients with chemical pregnancy (p < 0.01) and those with live birth (p = 0.02). Women without pregnancy had lower HRV compared to those with IVF pregnancy (p < 0.05). With a one unit increase in HRV difference before and after ET, the odds of chemical pregnancy decreased by 18% (odds ratio; OR: 0.82, 95% CI: 0.70-0.97, p < 0.02). With a one year increase in maternal age, the odds decreased by 16% (OR: 0.84, 95% CI: 0.76-0.93, p < 0.01), 25% (OR: 0.75, 95% CI: 0.58-0.93, p = 0.02), and 28% (OR: 0.72, 95% CI: 0.54-0.91, p = 0.01) for chemical pregnancy, ongoing pregnancy, and live birth, respectively. The AUCs were 0.77 (95% CI: 0.70, 0.84), 0.89 (0.79, 0.98), and 0.91(0.83, 0.99) for the prediction models for chemical pregnancy, ongoing pregnancy, and live birth, respectively.Reduced HRV may be an indicator for low chance of IVF pregnancy. The changes in HRV before and after ET and maternal age might be prognostic predictors of IVF pregnancy.

Pomegranate juice (PJ) has total antioxidant capacity which is reportedly higher compared to other common beverages. This short study aimed to assess the total antioxidant capacity of commercial PJ and pomegranate fruit using a newly described method for iron (III) reducing antioxidant capacity (iRAC) and to compare with the ABTS (2,2′-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid)) and Folin–Ciocalteu assays. Commercial PJ, freeze-dried pomegranate, and oven-dried pomegranate were analyzed. The calibration results for iRAC were comparable to ABTS and Folin–Ciocalteu methods in terms of linearity (R2 > 0.99), sensitivity and precision. The total antioxidant capacity for PJ expressed as trolox equivalent antioxidant capacity (TEAC) was 33.4 ± 0.5 mM with the iRAC method and 36.3 ± 2.1 mM using the ABTS method. For dried pomegranates, total antioxidant capacity on a dry weight basis (DB) was 89–110 mmol/100 g DB or 76.0 ± 4.3 mmol/100 g DB using iRAC and ABTS methods, respectively. Freeze-dried pomegranate had 15% higher total antioxidant capacity compared with oven-dried pomegranate. In conclusion, pomegranate has high total antioxidant capacity as evaluated by the iRAC and ABTS methods, though variations occur due to the type of cultivar, geographic origin, processing and other factors. The study is relevant for attempts to refine food composition data for pomegranate and other functional foods.

We propose interdependent defense (IDD) games, a computational game-theoretic framework to study aspects of the interdependence of risk and security in multi-agent systems under deliberate external attacks. Our model builds upon interdependent security (IDS) games, a model by Heal and Kunreuther that considers the source of the risk to be the result of a fixed randomized-strategy. We adapt IDS games to model the attacker’s deliberate behavior. We define the attacker’s pure-strategy space and utility function and derive appropriate cost functions for the defenders. We provide a complete characterization of mixed-strategy Nash equilibria (MSNE), and design a simple polynomial-time algorithm for computing all of them for an important subclass of IDD games. We also show that an efficient algorithm to determine whether some attacker’s strategy can be a part of an MSNE in an instance of IDD games is unlikely to exist. Yet, we provide a dynamic programming (DP) algorithm to compute an approximate MSNE when the graph/network structure of the game is a directed tree with a single source. We also show that the DP algorithm is a fully polynomial-time approximation scheme. In addition, we propose a generator of random instances of IDD games based on the real-world Internet-derived graph at the level of autonomous systems (≈27 K nodes and ≈100 K edges as measured in March 2010 by the DIMES project). We call such games Internet games. We introduce and empirically evaluate two heuristics from the literature on learning-in-games, best-response gradient dynamics (BRGD) and smooth best-response dynamics (SBRD), to compute an approximate MSNE in IDD games with arbitrary graph structures, such as randomly-generated instances of Internet games. In general, preliminary experiments applying our proposed heuristics are promising. Our experiments show that, while BRGD is a useful technique for the case of Internet games up to certain approximation level, SBRD is more efficient and provides better approximations than BRGD. Finally, we discuss several extensions, future work, and open problems.

Elevation of serum IgE levels has long been associated with allergic diseases. Many genes have been linked to IgE production, but few have been linked to the developmental aspects of genetic association with IgE production. To clarify developmental genetic association, we investigated what genes and gene-gene interactions affect IgE levels among fetus, infancy and childhood in Taiwan individuals. A birth cohort of 571 children with completion of IgE measurements from newborn to 1.5, 3, and 6 years of age was subject to genetic association analysis on the 384-customized SNPs of 159 allergy candidate genes. Fifty-three SNPs in 37 genes on innate and adaptive immunity, and stress and response were associated with IgE production. Polymorphisms of the IL13, and the HLA-DPA1 and HLA-DQA1 were, respectively, the most significantly associated with the IgE production at newborn and 6 years of age. Analyses of gene-gene interactions indentified that the combination of NPSR1, rs324981 TT with FGF1, rs2282797 CC had the highest risk (85.7%) of IgE elevation at 1.5 years of age (P=1.46 × 10(-4)). The combination of IL13, CYFIP2 and PDE2A was significantly associated with IgE elevation at 3 years of age (P=5.98 × 10(-7)), and the combination of CLEC2D, COLEC11 and CCL2 was significantly associated with IgE elevation at 6 years of age (P=6.65 × 10(-7)). Our study showed that the genetic association profiles of the IgE production among fetus, infancy and childhood are different. Genetic markers for early prediction and prevention of allergic sensitization may rely on age-based genetic association profiles.

Purpose: This study explored the unmet care needs of gynecological cancer patients, including overall and subdomain needs (i.e., physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and information needs), and related factors., Methods: In this cross-sectional study, gynecological cancer patients treated at a medical center in northern Taiwan were recruited. Data on demographics, symptoms, distress, finances, social support, resource utilization, and care needs were collected. Spearman's correlation and the Mann-Whitney U test were used for analysis., Results: This study of 118 cancer patients found that 73% had unmet psychological and emotional needs, followed by 54% with unmet health system and information needs. The most common physical symptoms were insomnia, fatigue, and pain, with 51.7% experiencing moderate or high levels of distress. Overall, the patients received considerable social support, both instrumental and emotional, primarily through medical information booklets (39.0%), cancer information websites (28.8%), and rehabilitative resources (20.3%). Factors associated with unmet care needs included younger age, non-ovarian cancer, symptoms (pain, fatigue, appetite loss, insomnia, dyspnea, nausea, and vomiting), distress, finances, social support, and the use of cancer information websites., Conclusion: Psychological and emotional unmet needs is prevalent among patients with gynecological cancer; psychological support is crucial. Younger patients and those with non-ovarian cancer had more unmet care needs. These needs are linked to severe symptoms, distress, financial difficulties, limited social support, and low use of cancer information websites. Enhancing support for this population through targeted interventions is necessary., Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest related to this study., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This study investigated antioxidant and anti-inflammatory peptides from Edible Bird's Nest (EBN). The prepared EBN peptides were sequentially separated, purified, and successively identified by ultrafiltration, gel filtration and mass spectrometry techniques. Four potential antioxidant and anti-inflammatory peptides were identified as Peptide 1 (LFWSPSVYLK), Peptide 2 (GWPHLEDNYLDW), Peptide 3 (NPPADLHK) and Peptide 4 (GDLAYLDQGHR). Molecular docking analysis revealed that Peptide 1 and Peptide 2 can competitively interrupt the formation of Keap1-Nrf2 due to the presence of hydrophobic and antioxidant amino acids in their peptide sequences. Peptide 3 and Peptide 4 have a strong effect on interacting with the binding site of IKK-β due to the interaction of anti-inflammatory amino acids and C-terminal arginine/lysine. The four peptides were synthesised and validated for their antioxidant and anti-inflammatory activities. The results suggest that the four peptides may serve as promising bioactive peptides for preventing oxidative stress and inflammation-related diseases., Competing Interests: Declaration of competing interest 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., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Proteinuria is a common adverse event arising from treatment with bevacizumab, requiring diagnostic testing via 24-h urine collection. However, this method is cumbersome. We assessed urine screenings in gynecologic cancer patients from February 2021 to May 2022. Along with a simple urine dipstick (UD), the urine microalbumin, total protein, and creatinine were measured and calculated as the urine albumin to creatinine ratio (UACR) and the urine protein to creatinine ratio (UPCR), which were further adjusted through the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations to be estimated and correlated with 24-h urine total protein content. The incremental cost-effectiveness ratio was used for cost analysis. There were 129 urine samples from 36 patients. The sensitivity and specificity for the UACR were 0.56 and 0.97, and for the UPCR, 0.71 and 0.88, respectively. The 24-h TP correlated strongly with the UACR (r = 0.75; p < 0.001) and UPCR (r = 0.79; p < 0.001) and fair for the simple UD (r = 0.35; p < 0.001). The UPCR saves one unnecessary 24-h urine test for less than a dollar compared to a simple UD. The results indicate that using the UPCR could enhance diagnostic accuracy, lower costs, and reduce unnecessary 24-h urine sampling.

Endometrial cancer in Lynch syndrome is characterized by a higher incidence, younger age at onset, and increased recurrence rates compared to sporadic cases, while the safety and efficacy of fertility-sparing treatments remain uncertain. This case report presents the oncology outcome of fertility-preserving treatment in a 39-year-old woman diagnosed with Lynch syndrome and atypical endometrial hyperplasia. Initially, she responded favorably to fertility-preserving treatment but subsequently experienced disease relapse and rapid progression during retreatment. Final pathology revealed endometrial cancer with metastasis to the right ovary, categorized as FIGO 2023 stage IIIA1. This population's unique molecular mechanisms and genetic mutations warrant special consideration when opting for fertility-sparing treatment. We have reviewed and summarized the oncology and pregnancy outcomes among Lynch syndrome and MMR-deficient patients through previous literature. However, no studies have investigated retreatment after recurrence in Lynch syndrome. Our case highlights the potential risks associated with retreatment following relapse. Vigilant monitoring and prompt consideration of surgical intervention are recommended upon disease relapse., 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 © 2024 Hsu and Chen.)

Precis: This study reports 12-month outcomes of combined phacoemulsification and Hydrus Microstent implantation in Asian eyes with moderate-to-severe normal tension glaucoma, demonstrating a significant reduction in glaucoma medications with an excellent intra- and post-operative safety profile., Purpose: To evaluate the 12-month safety and efficacy outcomes of combined phacoemulsification and Hydrus Microstent (Ivantis Inc., Irvine, CA) implantation in Asian eyes with moderate to severe normal tension glaucoma (NTG)., Methods: Retrospective study of consecutive surgeries performed from August 2019 to August 2021 in a single tertiary eye centre in Singapore. Outcome measures included reduction in intraocular pressure (IOP), number of glaucoma medications, and intra- and post-operative complications., Results: Data from 21 eyes of 21 subjects was analysed. All subjects were ethnic Chinese and majority were male (14, 66.7%). At baseline, mean IOP was 13.3 (2.3) mmHg, all eyes had a Humphrey Visual Field (HVF) mean deviation (MD) of ≥-6 dB [mean -13.9 (4.3) dB] and all eyes were on at least one glaucoma medication. There was no statistically significant reduction in IOP at all timepoints compared to baseline (all P>0.05). However, median number of medications was reduced from 2 to 0 at all timepoints, up to POM12 (all P<0.001). There were no intraoperative complications. No eyes underwent secondary glaucoma procedures nor lost any Snellen's line of visual acuity by POM12. One (4.8%) eye experienced numerical hypotony at POD1, which resolved conservatively. Two (9.5%) eyes underwent laser iridoplasty for stent occlusion by iris. There was no deterioration in HVF MD at POM12 compared to baseline (n=20, P>0.05)., Conclusion: Combined phacoemulsification and Hydrus Microstent implantation was effective in reducing medication burden in Asian eyes with moderate to severe NTG, up to 12 months post-operatively., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Major depressive disorder (MDD) patients commonly encounter multiple types of functional disabilities, such as social, physical, and role functioning. MDD is related to an accreted risk of brain atrophy, aging-associated brain diseases, and mortality. Based on recently available studies, there are correlations between notable biological brain aging and MDD in adulthood. Despite several clinical and epidemiological studies that associate MDD with aging phenotypes, the underlying mechanisms in the brain remain unknown. The key areas in the study of biological brain aging in MDD are structural brain aging, impairment in functional connectivity, and the impact on cognitive function and age-related disorders. Various measurements have been used to determine the severity of brain aging, such as the brain age gap estimate (BrainAGE) or brain-predicted age difference (BrainPAD). This review summarized the current results of brain imaging data on the similarities between the manifestation of brain structural changes and the age-associated processes in MDD. This review also provided recent evidence of BrainPAD or BrainAGE scores in MDD, brain structural abnormalities, and functional connectivity, which are commonly observed between MDD and age-associated processes. It serves as a basis of current reference for future research on the potential areas of investigation for diagnostic, preventive, and potentially therapeutic purposes for brain aging in MDD., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Objective: This study aims to describe the dome-type manual morcellation technique, a modified form of C-type incision, its comparative advantages over existing morcellation methods, the perioperative outcomes of trainees with varying experience levels, and the variables influencing morcellation speed based on our two years of experience., Methods: This retrospective cohort study included women who underwent laparoscopic myomectomy or hysterectomy using dome-type morcellation for tissue extraction at a tertiary teaching hospital between May 2020 and September 2022. Morcellation was performed by either a single surgeon or a trainee (resident). Basic patient characteristics, perioperative outcomes, and morcellation time and speed were compared between the surgeon and trainee group. Regression models were employed to analyze variables influencing morcellation speed., Results: A total of 41 women were enrolled. Among them, 20 procedures were performed by a surgeon alone, while the remaining 21 procedures were completed by trainees under the surgeon's supervision. The median weight of the specimens was 378 g (range 91-1345 g), and the median time for morcellation was 10 min (range 1-55 min). The median morcellation speed of surgeon and trainees was 70.25 and 31.7 g/min, respectively. Trainees' level of experience was found to be associated with morcellation speed, particularly for soft specimens. Additionally, both incision size and specimen stiffness were significantly associated with morcellation speed. No morcellation-related complications or bag ruptures were observed., Conclusion: Dome-type manual morcellation is an intuitive, efficient and safe method for specimen removal and is easy to learn for beginners., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

The pathophysiology of Primary Open Angle Glaucoma (POAG) remains poorly understood. Through proteomic analysis of aqueous humour (AH) from POAG patients, we aim to identify changes in protein composition of these samples compared to control samples. High resolution mass spectrometry-based TMT6plex quantitative proteomics analysis is performed on AH samples collected from POAG patients, and compared against a control group of patients with cataracts. Data are available via ProteomeXchange with identifier PXD033153. 1589 proteins were quantified from the aqueous samples using Proteome Discoverer version 2.2 software. Among these proteins, 210 were identified as unique master proteins. The proteins which were up or down-regulated by ±3 fold-change were considered significant. Human neuroblastoma full-length cDNA clone CS0DD006YL02 was significantly upregulated in patients with severe POAG on >2 medications, while actin, cytoplasmic 1, V2-7 protein (fragment), immunoglobulin-like polypeptide 1 and phosphatidylethanolamine-binding protein 4 were only present in these patients with severe POAG on >2 medications. Beta-crystallin B1 and B2, Gamma-crystallin C, D and S were significantly downregulated in the severe POAG ≤2 glaucoma medications group. Beta-crystallin B2, Gamma-crystallin D and GCT-A9 light chain variable region (fragment) were significantly downregulated in the non-severe POAG group. Actin, cytoplasmic 1 was significantly upregulated in subjects with severe POAG who required more than 2 glaucoma medications. Crystallins (Beta-crystallin B1 and B2, Gamma-crystallin C, D and S) were significantly downregulated in subjects with severe POAG who required less than 2 glaucoma medications., Competing Interests: Declaration of competing interest Financial disclosure: There are no financial conflicts of interest. Nonfinancial disclosure: There are no nonfinancial conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This study investigates the sound symbolic expressions of gender in Japanese names with machine learning algorithms. The main goal of this study is to explore how gender is expressed in the phonemes that make up Japanese names and whether systematic sound-meaning mappings, observed in Indo-European languages, extend to Japanese. In addition to this, this study compares the performance of machine learning algorithms. Random Forest and XGBoost algorithms are trained using the sounds of names and the typical gender of the referents as the dependent variable. Each algorithm is cross-validated using k-fold cross-validation (28 folds) and tested on samples not included in the training cycle. Both algorithms are shown to be reasonably accurate at classifying names into gender categories; however, the XGBoost model performs significantly better than the Random Forest algorithm. Feature importance scores reveal that certain sounds carry gender information. Namely, the voiced bilabial nasal /m/ and voiceless velar consonant /k/ were associated with femininity, and the high front vowel /i/ were associated with masculinity. The association observed for /i/ and /k/ stand contrary to typical patterns found in other languages, suggesting that Japanese is unique in the sound symbolic expression of gender. This study highlights the importance of considering cultural and linguistic nuances in sound symbolism research and underscores the advantage of XGBoost in capturing complex relationships within the data for improved classification accuracy. These findings contribute to the understanding of sound symbolism and gender associations in language., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ngai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Integrating two-dimensional (2D) layered materials with wide bandgap β-Ga 2 O 3 has unveiled impressive opportunities for exploring novel physics and device concepts. This study presents the epitaxial growth of 2D β-In 2 Se 3 /3D β-Ga 2 O 3 heterostructures on c-Sapphire substrates by plasma-assisted molecular beam epitaxy. Firstly, we employed a temperature-dependent two-step growth process to deposit Ga 2 O 3 and obtained a phase-pure ( 2 ¯ 01 ) β-Ga 2 O 3 film on c-Sapphire. Interestingly, the in-situ reflective high-energy electron diffraction (RHEED) patterns observed from this heterostructure revealed the in-plane 'b' lattice constant of β-Ga 2 O 3  ~ 3.038Å. In the next stage, for the first time, 2D In 2 Se 3 layers were epitaxially realized on 3D β-Ga 2 O 3 under varying substrate temperatures (T sub ) and Se/In flux ratios (R VI/III ). The deposited layers exhibited (00l) oriented β-In 2 Se 3 on ( 2 ¯ 01 ) β-Ga 2 O 3 /c-Sapphire with the epitaxial relationship of [ 11 2 ¯ 0 ] β-In 2 Se 3 || [010] β-Ga 2 O 3 and [ 10 1 ¯ 0 ] β-In 2 Se 3 || [102] β-Ga 2 O 3 as observed from the RHEED patterns. Also, the in-plane 'a' lattice constant of β-In 2 Se 3 was determined to be ~ 4.027Å. The single-phase β-In 2 Se 3 layers with improved structural and surface quality were achieved at a T sub  ~ 280 °C and R VI/III  ~ 18. The microstructural and detailed elemental analysis further confirmed the epitaxy of 2D layered β-In 2 Se 3 on 3D β-Ga 2 O 3 , a consequence of the quasi-van der Waals epitaxy. Furthermore, the β-Ga 2 O 3 with an optical bandgap (E g ) of ~ 5.04 eV (deep ultraviolet) when integrated with 2D β-In 2 Se 3 , E g  ~ 1.43eV (near infra-red) can reveal potential applications in the optoelectronic field., (© 2024. The Author(s).)

This paper presents the landscape of research on airborne microplastics and nanoplastics (MPs/NPs) according to the bibliometric analysis of 147 documents issued between 2015 and 2021, extracted from the Web of Science database. The publications on airborne MPs/NPs have increased rapidly from 2015 onwards, which is largely due to the existence of funding support. Science of the Total Environment is one of the prominent journals in publishing related papers. China, England, the USA, and European Countries have produced a significant output of airborne MP/NP research works, which is associated with the availability of funding agencies regionally or nationally. The research hotspot on the topic ranges from the transport of airborne MPs/NPs to their deposition in the terrestrial or aquatic environments, along with the contamination of samples by indoor MPs/NPs. Most of the publications are either research or review papers related to MPs/NPs. It is crucial to share the understanding of global plastic pollution and its unfavorable effects on humankind by promoting awareness of the existence and impact of MPs/NPs. Funding agencies are vital in boosting the research development of airborne MPs/NPs. Some countries that are lacking funding support were able to publish research findings related to the field of interest, however, with lesser research output. Without sufficient fundings, some impactful publications may not be able to carry a substantial impact in sharing the findings and discoveries with the mass public., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In response to the ICRP's amending the occupational exposure limit for the eye lens, the Institute of Nuclear Energy Research (INER) established the Hp(3) calibration system for eye dose monitoring in Taiwan to accurately assess the dose received in the eye lens. INER employed the narrow-spectrum series radiation according to the ISO 4037 as the X-ray radiation qualities, and the measured half-value layer consistent with a 5% difference. The air kerma rate standard was determined by the self-made free air chamber, and through dose conversion coefficient referring to ISO 4037 to obtain the Hp(3) on an ISO cylinder phantom. Furthermore, the calibration system was provided as the characteristics tests for DOSIRIS headset dosemeters. Finally, the Hp(3) calibration system has been established in Taiwan, and it can be used to provide calibration services for eye lens dosemeters and be applied to the proficiency testing that will be held in 2023., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Ovarian cancer is the most lethal gynecological malignancy and is characterized by peritoneal disseminated metastasis. Although O-mannosyltransferase TMTC1 is highly expressed by ovarian cancer, its pathophysiological role in ovarian cancer remains unclear. Here, immunohistochemistry showed that TMTC1 was overexpressed in ovarian cancer tissues compared with adjacent normal ovarian tissues, and high TMTC1 expression was associated with poor prognosis in patients with ovarian cancer. Silencing TMTC1 reduced ovarian cancer cell viability, migration, and invasion in vitro, as well as suppressed peritoneal tumor growth and metastasis in vivo. Moreover, TMTC1 knockdown reduced cell-laminin adhesion, which was associated with the decreased phosphorylation of FAK at pY397. Conversely, TMTC1 overexpression promoted these malignant properties in ovarian cancer cells. Glycoproteomic analysis and Concanavalin A (ConA) pull-down assays showed that integrins β1 and β4 were novel O-mannosylated protein substrates of TMTC1. Furthermore, TMTC1-mediated cell migration and invasion were significantly reversed by siRNA-mediated knockdown of integrin β1 or β4. Collectively, these results suggest that TMTC1-mediated invasive behaviors are primarily through integrins β1 and β4 and that TMTC1 is a potential therapeutic target for ovarian cancer., (© 2023. The Author(s).)

Objective: To evaluate alterations in the choroidal angioarchitecture of COVID-19 patients using optical Coherence Tomography (OCT) based surrogate markers., Methods: This prospective case-control study recruited 56 COVID-19 patients (111 eyes) and 61 healthy individuals (120 eyes). Choroidal thickness (CT) and Choroidal vascularity index (CVI) were derived from OCT images using a purpose-built automated software for choroidal image segmentation. A linear mixed model with age and gender as covariates was employed to compare CVI and CT between groups., Results: COVID-19 patients had significantly higher subfoveal (81.3um vs 86.8um, p = .02), temporal (78.8um vs 84.3um, p = .005), nasal (87.5um vs 95.1um, p = .001) and average CT (82.5um vs 88.7um, p = .001). COVID-19 patients had significantly lower subfoveal (64.0 vs 63.5, p = .02) and average CVI (63.5 vs 63.1, p = .02)., Conclusion: COVID-19 results in significantly thicker choroid with reduced relative vascularity. This may be attributable to increased vascular permeability secondary to inflammation, resulting in choroidal stromal edema.

Aim: This study aims to compare the efficacy and safety of combined phacoemulsification with iStent inject (Phaco-iStent) and Hydrus microstent (Phaco-Hydrus)., Methods: This was a retrospective comparative study of patients who underwent Phaco-iStent from April 2019 to August 2020 and Phaco-Hydrus from August 2019 to December 2020 at a tertiary eye centre in Singapore. Sixty-nine Phaco-iStent eyes and 49 Phaco-Hydrus eyes were included in this study. Complete surgical success was defined as freedom from second glaucoma surgery, Intraocular pressure (IOP) of 18 mmHg or less, and discontinuation of all antiglaucoma medications., Results: At 12 months, both Phaco-iStent and Phaco-Hydrus groups had comparable surgical success rate (68.1% vs 51%, p =0.061), reduction in antiglaucoma medication use (-1.3 ± 0.1 vs -1.4 ± 0.10, p =0.880) and intraocular pressure reduction (-1.1 ± 0.5 mmHg vs -1.6 ± 0.9 mmHg, p =0.323). Overall intraoperative and postoperative complications rate were similar in both groups, though hyphema was more commonly seen in early postoperative period in the Phaco-Hydrus compared to the Phaco-iStent group (8% vs 0%, p =0.028), with majority of cases resolving without any need for surgical intervention. Device obstruction was also more common in the Phaco-Hydrus group compared to the Phaco-iStent group (14% vs 4.3%, p =0.04)., Conclusion: Phaco-iStent and Phaco-Hydrus have similar surgical efficacy and safety profiles at 12 months., Competing Interests: Dr Bryan Chin Hou Ang receives research support, speaker’s honorarium, and travel reimbursement from Glaukos Corporation and speaker’s honorarium and travel from Alcon, Inc., outside the submitted work. Dr Leonard Wei Leon Yip is a speaker for Glaukos Singapore. The authors report no other conflicts of interest in this work., (© 2023 Chee et al.)

Stress is known to have a significant impact on mental health. While gender differences can be found in stress response and mental disorders, there are limited studies on the neuronal mechanisms of gender differences in mental health. Here, we discuss gender and cortisol in depression as presented by recent clinical studies, as well as gender differences in the role of glucocorticoid receptors (GRs) and mineralocorticoid receptors (MRs) in stress-associated mental disorders. When examining clinical studies drawn from PubMed/MEDLINE (National Library of Medicine) and EMBASE, salivary cortisol generally showed no gender correlation. However, young males were reported to show heightened cortisol reactivity compared to females of similar age in depression. Pubertal hormones, age, early life stressors, and types of bio-samples for cortisol measurement affected the recorded cortisol levels. The role of GRs and MRs in the HPA axis could be different between males and females during depression, with increased HPA activity and upregulated MR expression in male mice, while the inverse happened in female mice. The functional heterogeneity and imbalance of GRs and MRs in the brain may explain gender differences in mental disorders. This knowledge and understanding will support the development of gender-specific diagnostic markers involving GRs and MRs in depression.

Introduction: The purpose of this study was to evaluate the impact of COVID-19 infection on retinal microvasculature by topographically mapping the retinal arteriole-to-venule ratio (AVR)., Methods: In a comparative cross-sectional case-control study, fundus photos were obtained in COVID-19-infected patients and healthy controls. AVT was measured over 16 points across the retina using retinal vascularity index (RVI)-a novel semi-automated computerized parameter based on retinal vasculature., Results: A total of 51 COVID-19-positive patients and 65 healthy controls were enrolled in the study. Overall, the mean RVI of all 16 points across the retina was 0.34 ± 0.02 in patients with COVID-19 and 0.33 ± 0.02 in control subjects (p = 0.64). Out of the 16 points being measured, three points had a statistically significant greater value in patients with COVID compared to normal controls., Conclusion: Localised greater RVI values were found in some of the points in COVID-19-positive patients, which likely indicates a more focal change of the vasculature., (© 2022. The Author(s).)

Background: The quality of flexion-extension motion after cervical disc arthroplasty has been a subject of interest due to the number of available devices with different designs and kinematics. Previous studies of motion quality have been limited to measuring the range of motion using two radiographs taken at the extremes of flexion and extension. This is the first study evaluating the in vivo quality of index segment motion using fluoroscopic images collected over the arc of flexion-extension after M6-C cervical disc arthroplasty surgery., Methods: Eligible participants had previously undergone a single-level cervical disc arthroplasty surgery for degenerative cervical spine disease performed by the senior author. Study participants underwent dynamic lateral fluoroscopic imaging to capture the C2-C7 motion between maximal flexion and extension. The amount of motion contribution by individual segments to the C2-C7 motion (termed segmental motion fraction) and its variation throughout the arc of flexion-extension were compared between the index and adjacent segments. The shift of centre of rotation during the arc of motion was also assessed., Results: Ten subjects with a mean age of 43.8 years old were recruited, with an average follow-up of 16.2 months at the time of fluoroscopy. The C2-C7 cervical spine had an average flexion-extension range of 66.7 degrees. The contribution of the index segment averaged over the flexion-extension arc of motion was 18.9% (peak contribution 24.4%) for the C5-C6 group; and 15.5% (peak contribution 25.5%) for the C6-C7 group. The mean cranial-caudal location of the centre of rotation progressively shifted in the cranial direction from C2-C3 to C6-C7 motion segment., Conclusions: Our results demonstrated physiologic quality of motion at the index segment and harmony among its neighbouring segments following cervical disc arthroplasty, without gearshift-like intermittent locking of the prosthesis during the arc of flexion-extension motion. This pilot study provides a basis for the design of future long-term studies with larger sample size to compare the quality of motion between different cervical disc prostheses using the concept of segmental motion fraction as a motion-quality metric., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jss.amegroups.com/article/view/10.21037/jss-22-62/coif). The authors have no conflicts of interest to declare., (2023 Journal of Spine Surgery. All rights reserved.)

The COVID-19 pandemic threatens to exacerbate the school psychology personnel crisis. There is a dearth of knowledge regarding how the pandemic has impacted school psychology trainers and course delivery. In this national study, 92 school psychology trainers completed an online questionnaire regarding technological instructional changes, job satisfaction, and their own mental health well-being during the pandemic. Findings suggest that during the portion of the pandemic assessed most trainers reported that they: (a) switched from in-person instruction to primarily online instruction, (b) were mostly satisfied with their jobs, and (c) generally experienced a positive sense of well-being. Furthermore, a sizable portion of those that switched to a mixture of hybrid and online instruction during the pandemic endorsed that they are likely to continue to use these modalities after the pandemic subsides. Unfortunately, although school psychology trainers presented as generally resilient workforce during the pandemic, almost 20% participants screened positive for possible depression., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023.)

Infectious airborne diseases like the recent COVID-19 pandemic render confined spaces high-risk areas. However, in-person activities like teaching in classroom settings and government services are often expected to continue or restart quickly. It becomes important to evaluate the risk of airborne disease transmission while accounting for the physical presence of humans, furniture, and electronic equipment, as well as ventilation. Here, we present a computational framework and study based on detailed flow physics simulations that allow straightforward evaluation of various seating and operating scenarios to identify risk factors and assess the effectiveness of various mitigation strategies. These scenarios include seating arrangement changes, presence/absence of computer screens, ventilation rate changes, and presence/absence of mask-wearing. This approach democratizes risk assessment by automating a key bottleneck in simulation-based analysis-creating an adequately refined mesh around multiple complex geometries. Not surprisingly, we find that wearing masks (with at least 74% inward protection efficiency) significantly reduced transmission risk against unmasked and infected individuals. While the use of face masks is known to reduce the risk of transmission, we perform a systematic computational study of the transmission risk due to variations in room occupancy, seating layout and air change rates. In addition, our findings on the efficacy of face masks further support use of face masks. The availability of such an analysis approach will allow education administrators, government officials (courthouses, police stations), and hospital administrators to make informed decisions on seating arrangements and operating procedures., Supplementary Information: The online version contains supplementary material available at 10.1007/s00366-022-01773-9., Competing Interests: Conflict of interestThe authors have no competing interests to declare that are relevant to the content of this article., (© The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background/objectives: To evaluate the factors influencing final visual outcome after surgical repair of open globe injuries (OGIs) in a rural population using the International Globe and Adnexal Trauma Epidemiology Study (IGATES) online registry., Subjects/methods: Retrospective cohort study of patients with OGI. OGIs were identified from the IGATES database at a tertiary referral eye care centre in rural West India over a period of 12 years. Patient demographics, clinical and pre-operative factors affecting final visual outcome was evaluated., Results: A total of 791 eyes with OGIs were included in data analysis. 11 eyes that were lost to follow-up and 12 eyes with incomplete data were excluded. Most of the patients were male (559, 70.6%) and mean age of all patients was 23.9 years ± 19.4 years. Occupational hazards (including domestic housework) (307, 38.8%) and leisure play (324, 41.0%) were the leading causes of OGI. The most common mechanism of injury was being struck by a wooden stick (250, 31.6%). Univariate analysis of pre-operative variables showed initial visual acuity (VA), zone of injury, size of wound, structures involved in the injury and presence of infection were significant prognostic factors for worse final visual outcome (p < 0.001). Multivariate analysis showed VA ≤ 3/60 or worse at presentation had statistically significantly higher odds ratio of ending up with worse visual outcomes (p < 0.012)., Conclusions: Males in working age groups suffer from OGIs more frequently, usually from agricultural and pastoral activities. Initial VA, zone 3 injuries, corneoscleral wound, large wound size and presence of post-traumatic infections are significant prognostic factors., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Gynecologic cancers are the leading cause of death in women. Endometrial, ovarian, and cervical cancer are the three main types of gynecologic cancers. Poor prognoses and high mortality rates of advanced-stage cancer are still challenges of all three types. Diagnostic tools for early cancer detection could be the cornerstone for further cancer treatment and prevention. Glycosylation plays a vital role in cell proliferation, adhesion, motility, and angiogenesis, and is aberrantly expressed in cancer cells. Alterations of glycosylation may represent promising biomarkers with potential diagnostic and monitoring applications, as well as disease prognosis. Many glycosylated biomarkers, including glycoprotein, glycan, and enzyme, were discovered and well-studied for application in gynecologic cancers. Some of them have been developed as targets for cancer treatment. The use of certain biomarkers for diagnostics and monitoring of gynecologic cancers has clinical advantages, as it is quantitative, comparable, convenient, and inexpensive. However, one of the single markers have sufficient sensitivity for the screening of gynecologic cancers. In this review, we introduced the details of glycosylation and the current application of glycosylated biomarkers in these three cancers. Moreover, we also reviewed the different roles of each biomarker in other cancers and aimed to understand these glycosylated biomarkers comprehensively.

Purpose: To evaluate the changes in clinical outcome and urodynamic parameters after tailored anterior transvaginal mesh (ATVM) surgeries in a mid-term follow-up., Methods: Between November 2011 and December 2015, women with ≥stage II pelvic organ prolapse (POP) who underwent ATVM surgeries were retrospectively reviewed. The data-reviewing timeframe was until December 2021. Clinical and urodynamic diagnoses regarding urinary symptoms were evaluated before and after the operation., Results: A total of 160 women were included. Stress urinary incontinence decreased significantly after the operation (99% (159/160) vs. 43% (68/160), p < 0.01), as well as the pad weight (20.5 ± 2.7 vs. 9.4 ± 2.0, p < 0.001) and diagnosis of urodynamic stress incontinence (83% (132/160) vs. 51% (82/160), p < 0.01). Overactive bladder syndrome increased significantly after the operation (18% (29/160) vs. 28% (45/160), p = 0.03), even though the objective parameters, such as first and strong desire to void, bladder oversensitivity, and detrusor overactivity, were all improved after the operation. The pad weight was mostly improved significantly within the first postoperative 2 years. Eighteen (11%) women had global recurrent POP, and only one (0.6%) woman had true recurrence of cystocele. Twenty-four (15%) women had mesh extrusion, and two-thirds of them could be managed in an office setting., Conclusion: In women with advanced cystocele, the ATVM surgery provides a favorable anatomic reduction outcome with an acceptable mesh extrusion rate. The ATVM provides an anti-incontinence effect, both in subjective symptoms and objective parameters, but this effect might decline after postoperative 2 years., Competing Interests: Conflict of Interest The authors have no conflicts of interest relevant to this article., (Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Environmental enrichment (EE) is an environmental paradigm encompassing sensory, cognitive, and physical stimulation at a heightened level. Previous studies have reported the beneficial effects of EE in the brain, particularly in the hippocampus. EE improves cognitive function as well as ameliorates depressive and anxiety-like behaviors, making it a potentially effective neuroprotective strategy against neurodegenerative diseases such as Alzheimer's disease (AD). Here, we summarize the current evidence for EE as a neuroprotective strategy as well as the potential molecular pathways that can explain the effects of EE from a biochemical perspective using animal models. The effectiveness of EE in enhancing brain activity against neurodegeneration is explored with a view to differences present in early and late life EE exposure, with its potential application in human being discussed. We discuss EE as one of the non pharmacological approaches in preventing or delaying the onset of AD for future research., (© 2022. The Author(s).)

This study was to determine the significance of factors considered for the measurement accuracy of personal dosimeter in dosimetry services such as dosimetry service, irradiation category, years of use and readout frequency. The investigation included management information questionnaire, on-site visit and blind test. The blind test with random selected personal badge was used in inter-comparison of eight dosimetry services, and the test results followed ANSI/HPS N13.11 criteria. This study also analyzed the measurement deviations if they felt in the criteria of ICRP 75 or not. One-way ANOVA tests were used to analyze the significant difference of the measurement deviations in different dosimetry services, irradiation categories, and years of use. Simple linear-regression test was performed for the significance of the prediction model between measurement deviations and readout frequencies. All visited dosimetry services followed the proper statue of basic management and passed the performance check of the tolerance level. The average deviations corresponding to category I, category II deep dose, and category II shallow dose were 6.08%, 9.49%, and 10.41% respectively. There had significant differences of measurement deviation in different dosimetry services (p < 0.0001) and irradiation categories (p = 0.016) but no significant difference in years of use (p = 0.498). There was no significance in the linear-regression model between measurement deviation and badge readout frequencies. Based on the regular calibration of the personal dosimeter, the deviation of the measured value is mainly affected by different dosimetry services and irradiation categories; and there shows no significant influence by years of use and readout frequency., (© 2022. The Author(s).)