Search

To improve our understanding of the perception of odors, researchers are often required to undertake experimental procedures with users exposed to multiple odors in a variety of settings, including to diagnose smell loss in clinics and care homes. Existing smell tests are typically administered using multiple sniffing pens, manually presented to patients by a highly specialized nurse using a time-consuming and complex testing paradigm. Automated odor delivery devices, such as olfactometer systems, exist but are expensive, bulky and typically lab based, making them difficult to use for on the ground odor delivery. Here we have developed a portable, affordable, odor delivery device that can deliver 24 odors through individual channels with high temporal precision and without cross-contamination. The device allows for the rapid, flexible sequencing of odors via digital control using a mobile application and has been experimentally validated in the lab, as well as tested on patients. The design provides several advantages for investigating olfactory perception and offers the possibility that users can one day self-administer smell tests in a range of settings, including at home, allowing smell healthcare services to evolve and become part of a routine practice and self-care culture., (© 2024. The Author(s).)

Purpose: To determine whether odontogenic maxillary sinusitis, either alone (OMSw/oFB) or in combination with fungus ball (OMSwFB), is associated with specific clinical characteristics and treatment outcomes compared to non-odontogenic maxillary sinusitis., Materials and Methods: A retrospective cohort study was performed on patients who underwent surgical treatment for chronic maxillary sinusitis between 2013 and 2021. OMSw/oFB and OMSwFB patients, were selected as the study group, while patients diagnosed with non-odontogenic maxillary sinusitis (non-OMS) were enrolled as the control group. Predictor variables were OMSw/oFB and OMSwFB. Outcomes were clinical presentation, postoperative complications, and treatment outcome. Descriptive, bivariate, and multiple logistic regression statistics were calculated, and the significance level was set at P ≤ 0.05., Results: The sample included 200 patients with a mean age of 49.6 ± 20.1 years and 57.5 % were men. Of the 200 patients, 123 (61.5 %) had non-OMS, 55 (27.5 %) had OMSw/oFB, and 22 (11 %) had OMSwFB. Multivariate analysis showed that OMSw/oFB was associated with more successful treatment rates (OR = 8.19, p < 0.01), whereas OMSwFB was associated with a less favorable outcome (OR = 0.27, p = 0.03). Age was associated with an unfavorable outcome in both OMS groups (OR: 0.98, p = 0.03 and p = 0.03, respectively), but no significant associations with other outcomes were found., Conclusion: This study suggests that OMSwFB is a recalcitrant form of OMS associated with a higher risk of persistent symptoms and less favorable outcome. These patients should be informed about the challenging nature of the disease and closely monitored., 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. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for [Journal of Stomatology, Oral and Maxillofacial Surgery] and was not involved in the editorial review or the decision to publish this article., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Background: Although most patients with post-traumatic olfactory dysfunction (PTOD) undergo MRI, there is no consensus about its diagnostic or prognostic value. The aims were: 1) to classify the extent of post-traumatic neurodegeneration; 2) to determine its relationship with chemosensory dysfunction (smell, taste, trigeminal); and 3) to establish whether MRI can predict olfactory improvement., Methodology: We conducted a retrospective cohort study based on a series of 56 patients with PTOD. All patients underwent validated psychophysical tests of their smell, taste, and trigeminal functions, otorhinolaryngologic evaluation, and MRI. An experienced radiologist blinded to patient data evaluated 40 chemosensory-relevant brain regions according to a four-point scale (0=no lesion to 3=large lesion). Follow up data after 4 years (on average) were available in 46 patients., Results: The cluster analysis showed 4 brain lesion patterns that differed in lesion localization and severity. They are associated with diagnostic categories: anosmia, hyposmia and normosmia. Two clusters were highly specific for anosmia (100% specificity)and could accurately predict this condition (100% positive predictive value). No clusters were associated with trigeminal or taste dysfunction. Regarding improvement, 72.7% of patients in the cluster with mild lesions experienced subjective and measurable olfactory improvement whereas this was only the case in 21.7-37.5% of patients with larger lesions. The odds of subjective smell improvement were 5.9 times higher in patients within the milder cluster compared to larger ones., Conclusions: The analysis of brain lesions in PTOD allows corroboration of smell test results and prediction of subjective and measurable improvement.

Background: Chemosensory dysfunction (olfaction, taste, and trigeminal) affects quality of life, potentially impacting eating behaviors. We investigated which factors are associated with weight loss in patients with smell and taste disorders., Methods: Retrospective study of consecutive adult patients seen in the smell and taste clinic during a 10-year period. Patients were asked about smell, flavor and taste impairment. Psychophysically, smell was assessed with Sniffin' Sticks, flavor with a retronasal test, and taste with Taste Strips., Results: A total of 554 patients (313 females) were included with a median age of 51 years (IQR 23). Seventy-six (13.7%) reported involuntary weight loss (median 6 kg, IQR 6) due to chemosensory disorders. The odds of losing weight were 2.1 times higher when patients reported subjective changes in flavor perception. Parosmia was a significant predictor of weight loss. Patients with symptoms lasting longer than two years were less likely to present with weight loss. Post-traumatic chemosensory dysfunction was a significant predictor of losing weight. On psychophysical testing, the probability of a patient losing weight increased by 8% for every 1-unit reduction in Taste Strips score., Conclusion: Factors associated with weight loss were self-reported changes in flavor perception, parosmia, duration of symptoms for less than two years, head injury, and psychophysically measured low Taste Strips score. These data help to identify patients at risk of weight loss from smell or taste impairment.

Objectives: Olfactory dysfunction (OD) is common and carries significant personal and societal burden. Accurate assessment is necessary for good clinical and research practice but is highly dependent on the assessment technique used. Current practice with regards to UK/international clinical assessment is unknown. We aimed to capture current clinical practice, with reference to contemporaneously available guidelines. We further aimed to compare UK to international practice., Design: Anonymous online questionnaire with cross-sectional non-probability sampling. Subgroup analysis according to subspeciality training in rhinology ('rhinologists' and 'non-rhinologists') was performed, with geographical comparisons only made according to subgroup., Participants: ENT surgeons who assess olfaction., Results: Responses were received from 465 clinicians (217 from UK and 17 countries total). Country-specific response rate varied, with the lowest rate being obtained from Japan (1.4%) and highest from Greece (72.5%). Most UK clinicians do not perform psychophysical smell testing during any of the presented clinical scenarios-though rhinologists did so more often than non-rhinologists. The most frequent barriers to testing related to service provision (e.g., time/funding limitations). Whilst there was variability in practice, in general, international respondents performed psychophysical testing more frequently than those from the UK. Approximately 3/4 of all respondents said they would like to receive training in psychophysical smell testing. Patient reported outcome measures were infrequently used in the UK/internationally. More UK respondents performed diagnostic MRI scanning than international respondents., Conclusions: To our knowledge, this is the most comprehensive UK-based, and only international survey of clinical practice in the assessment of OD. We present recommendations to improve practice, including increased education and funding for psychophysical smell testing. We hope this will promote accurate and reliable olfactory assessment, as is the accepted standard in other sensory systems., (© 2023 The Authors. Clinical Otolaryngology published by John Wiley & Sons Ltd.)

Background: In chronic rhinosinusitis (CRS), nasal obstruction can often be explained by anatomical deformities, polyps, or congested nasal mucosa. However, in cases with little deformity or inflammation, perceived nasal obstruction may result from reduced airflow perception caused by an alteration of the intranasal trigeminal system. The aim of this study was to assess this association., Methodology: We performed a prospective case-control study of 15 CRS patients, 18 patients with a deviated nasal septum (DNS) and 16 healthy controls. We assessed olfactory function using the Sniffin' Sticks test and Visual Analog Scales (VAS). We used the Trigeminal Lateralization Task (TLT) with eucalyptol and cinnamaldehyde to examine intranasal trigeminal function. Further, we assessed nasal patency with Peak Nasal Inspiratory Flow and VAS. Finally, we measured protein levels of trigeminal receptors (TRPM8, TRPA1 and TRPV1) and inflammatory markers (IL-13, INF-y and eosinophils) in CRS and DNS patients' mucosal biopsies using Western Blots., Results: CRS patients had significantly lower olfactory function than DNS and healthy controls. They also had significantly lower TLT scores for eucalyptol than both other groups. CRS patients had significantly lower nasal patency than controls; for DNS patients this was limited to subjective measures of nasal patency. In line with this, CRS patients exhibited significantly higher levels of sTRPM8-18 than DNS patients., Conclusions: Intranasal trigeminal function is decreased in CRS patients, possibly due to the overexpression of short isoforms of TRPM8 receptors.

Background: Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process., Conclusions: We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.

One of the most prevalent causes of olfactory loss includes traumatic brain injury with subsequent shearing of olfactory axons at the level of the cribriform plate (anterior skull base). Scar tissue at this level may prevent axonal regrowth toward the olfactory bulb. Currently, there is no cure for this debilitating and often permanent condition. One promising therapeutic concept is to implant a synthetic scaffold with growth factors through the cribriform plate/scar tissue to induce neuroregeneration. The first step toward this goal is to investigate the optimum conditions (growth factors, extracellular matrix proteins) to boost this regeneration. However, the lack of a specifically tailored in vitro model and an automated procedure for quantifying axonal length limits our ability to address this issue. The aim of this study is to create an automated quantification tool to measure axonal length and to determine the ideal growth factors and extracellular proteins to enhance axonal regrowth of olfactory sensory neurons in a mouse organotypic 2D model. We harvested olfactory epithelium (OE) of C57BL/6 mice and cultured them during 15 days on coverslips coated with various extracellular matrix proteins (Fibronectin, Collagen IV, Laminin, none) and different growth factors: fibroblast growth factor 2 (FGF2), brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor (GDNF), nerve growth factor (NGF), retinoic acid (RA), transforming growth factor β (TGFβ), and none. We measured the attachment rate on coverslips, the presence of cellular and axonal outgrowth, and finally, the total axonal length with a newly developed automated high-throughput quantification tool. Whereas the coatings did not influence attachment and neuronal outgrowth rates, the total axonal length was enhanced on fibronectin and collagen IV ( p = 0.001). The optimum growth factor supplementation media to culture OE compared to the control condition were as follows: FGF2 alone and FGF2 from day 0 to 7 followed by FGF2 in combination with NGF from day 7 to 15 ( p < 0.0001). The automated quantification tool to measure axonal length outperformed the standard Neuron J application by reducing the average analysis time from 22 to 3 min per specimen. In conclusion, robust regeneration of murine olfactory neurons in vitro can be induced, controlled, and efficiently measured using an automated quantification tool. These results will help advance the therapeutic concept closer toward preclinical studies.

The primary aim of this study was to examine the relationships between smoking status and health-related physical fitness and balance ability in older males residing in Taiwan. This investigation adopted a cross-sectional design, utilizing data from 7688 older males who took part in the 2014-2015 wave of the National Physical Fitness Survey of Taiwan. Various data sources, including a standardized structured questionnaire, anthropometric measurements, health-related physical fitness assessments, and balance ability tests, were analyzed. The participants were divided into three categories based on their smoking habits: never smokers, former smokers, and current smokers. Multiple regression analyses were performed to evaluate the linear association between cigarette smoking status and health-related physical fitness and balance ability performance. Health-related physical fitness and balance performance were significantly greater ( p < 0.05) in the never smoker group than in the current smoker group. Current smoking status was significantly negatively ( p < 0.05) associated with cardiopulmonary function, muscular endurance, flexibility, and balance performance. A history of smoking (former smoker) was significantly negatively ( p < 0.05) associated with the 2-min step test, 30-s arm curl and chair stand, as well as the 8-foot up-and-go test; however, the association was not significant for the back scratch, chair sit-and-reach, and one-leg stance with eyes open performance. These results suggest that current cigarette smoking is detrimental to health-related physical fitness and balance performance in older males. Quitting smoking may reverse the effects of smoking on overall body flexibility and static balance performance in Taiwanese older adults, thereby reducing the risk of falls and incapacity.

Purpose: The aim of the study was to investigate whether olfactory fluctuations (OF) are pronounced in patients with sinonasal olfactory dysfunction (OD)., Methods: The retrospective investigation included patients aged 18 years or older, who consulted a tertiary referral center for olfactory loss. Patients with normal smell function were excluded. Patients answered a structured questionnaire about their olfactory symptoms, with specific questions related to the presence of OF and its average frequency, amplitude, duration, time since most recent OF, and associated symptoms of self-reported OF. Patients also underwent clinical evaluation including a structured medical history and physical examination including nasal endoscopy. In addition, we assessed orthonasal olfactory function using Sniffin' Sticks, and gustatory function using "taste sprays"., Results: Participants included 131 men and 205 women (n = 336), aged 18 to 86 years (mean 50, SD 16). Patient-reported fluctuations occurred most frequently in sinonasal (38%), idiopathic (29%), and postviral (29%) OD. Amplitude of OF was highest in postviral OD (p = 0.009). Average frequency, duration, and the time since the most recent fluctuation were not significantly different between groups (all p's > 0.42). Odor discrimination (p = 0.002) and identification (p = 0.017) scores were higher among those individuals with OF., Conclusion: Amplitude of OF may help distinguish postviral from other causes of OD, especially in patients presenting with equivocal symptoms of sinonasal disease., (© 2022. The Author(s).)

Background and Objectives : Health-related physical fitness reduces the risk of chronic disease, promotes quality of life, and has enormous economic benefits considering the global health care costs resulting from obesity. However, relatively limited information is available regarding the dose-response relationship between scientific physical fitness and obesity risk. This study aimed to determine the associations of scientific physical fitness with body mass index (BMI) distribution and overweight/obesity risk among adults aged 23-64 years in Taiwan. Materials and Methods : We conducted a cross-sectional study and reviewed data derived from the Scientific Physical Fitness Testing Program, Sports Administration, Ministry of Education, Taiwan. Responses from 16,939 participants from the database (7761 men and 9178 women, aged 23-64 years) were collected in this study. Each participant completed a series of scientific physical fitness measurements, including cardiorespiratory fitness (3 min progressive knee-up and step [3MPKS] test), muscular fitness (hand grip strength), and flexibility (sit-and-reach test). Anthropometric measurements included body height, weight, and BMI. The quartiles of scientific physical fitness results were identified as the dependent variable in the multiple linear and multiple logistic regression analysis to determine the associations of the scientific physical fitness measurements with BMI distribution and overweight/obesity risk, as well as the dose-response relationship. Results : The 3MPKS test was significantly associated with BMI (quartile 1 (Q1): β = 1.900; quartile 2 (Q2): β = 1.594; quartile 3 (Q3): β = 1.079 for men, and Q1: β = 1.454; Q2: β = 0.882; Q3: β = 0.555 for women), overweight (Q1: odds ratio (OR) = 2.117; Q2: OR = 2.056; Q3: OR = 2.063 for men, and Q1: OR = 3.036; Q2: OR = 2.542; Q3: OR = 1.959 for women), and obesity (Q1: OR = 6.530; Q2: OR = 5.747; Q3: OR = 3.557 for men, and Q1: OR = 3.238; Q2: OR = 1.431 for women) risk compared with quartile 4 (Q4) as the reference group with a dose-response relationship. In addition, relative hand grip strength was significantly associated with BMI (Q2: β = -0.922; Q3: β = -1.865; Q4: β = -3.108 for men, and Q2: β = -1.309; Q3: β = -2.161; Q4: β = -2.759 for women), overweight (Q2: OR = 0.806; Q3: OR = 0.697; Q4: OR = 0.278 for men, and Q2: OR = 0.667; Q3: OR = 0.398; Q4: OR = 0.228 for women), and obesity (Q1: OR = 0.528; Q2: OR = 0.206; Q3: OR = 0.049 for men, and Q1: OR = 0.351; Q2: OR = 0.129; Q3: OR = 0.051 for women) risk compared with Q1 as the reference group with a dose-response relationship. Conclusions : Higher levels of performance of the 3MPKS and relative grip strength tests were associated with lower BMI and overweight/obesity risk in both sexes. However, the sit-and-reach test was only partially related to BMI and overweight/obesity risk in both sexes. Cardiorespiratory fitness and muscular fitness were effective predictors of BMI distribution and overweight/obesity risk in Taiwanese adults.

In the recent past, inclusion criteria for cochlear implant surgery expanded to patients with ever more residual acoustic hearing in the low frequencies. By applying the meticulous hearing preservation surgical strategy and specifically designed atraumatic electrode arrays, residual hearing can be preserved to a meaningful extent in a large majority of patients. In this paper, we describe two female patients suffering from mechanically evoked tinnitus after hearing preservation cochlear implantation surgery with MEDEL flex electrodes. The occurrence of audible perceptions through mechanical stimulation in the region of the external ear is believed to be due to the direct transmission of movements via the electrode array to the basilar membrane of the inner ear. In both cases, the mechanically evoked tinnitus led to revision surgery with immobilization of the array in the mastoid cavity. Despite eliminating the tinnitus, the revision surgery led to a loss of residual hearing in one patient, whereas the relatively poor residual hearing in the other revision case remained unchanged. The presence of mechanically evoked tinnitus seems to be associated with increased fragility of inner ear structures and hearing function, possibly due to direct mechanical contact of the electrode array with the basilar membrane. Consequently, the electrode array needs to be carefully immobilized in the mastoid cavity at a distance from soft tissue to prevent mechanical damage of inner ear structures, particularly in female patients with fine muscular tissue.

Olfactory disorders became known by large parts of the population since the Covid-19 pandemic. The causes of olfactory dysfunctions are manifold. Similar to other sensory impairments the disruption can be qualitative or quantitative. Quantitative olfactory disorders such as anosmia or hyposmia are well explored, whereas the knowledge on qualitative disorders such as parosmia or phantosmia is still limited. This article gives an update on the current clinical knowledge and workup of parosmia and phantosmia., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Wearing a safety helmet is important in construction and manufacturing industrial activities to avoid unpleasant situations. This safety compliance can be ensured by developing an automatic helmet detection system using various computer vision and deep learning approaches. Developing a deep-learning-based helmet detection model usually requires an enormous amount of training data. However, there are very few public safety helmet datasets available in the literature, in which most of them are not entirely labeled, and the labeled one contains fewer classes. This paper presents the Safety HELmet dataset with 5K images (SHEL5K) dataset, an enhanced version of the SHD dataset. The proposed dataset consists of six completely labeled classes ( helmet , head , head with helmet , person with helmet , person without helmet , and face ). The proposed dataset was tested on multiple state-of-the-art object detection models, i.e., YOLOv3 (YOLOv3, YOLOv3-tiny, and YOLOv3-SPP), YOLOv4 (YOLOv4 and YOLOv4 pacsp-x-mish ), YOLOv5-P5 (YOLOv5s, YOLOv5m, and YOLOv5x), the Faster Region-based Convolutional Neural Network (Faster-RCNN) with the Inception V2 architecture, and YOLOR. The experimental results from the various models on the proposed dataset were compared and showed improvement in the mean Average Precision (mAP). The SHEL5K dataset had an advantage over other safety helmet datasets as it contains fewer images with better labels and more classes, making helmet detection more accurate.

Purpose of the Review: This study aims to summarize the current state of the art of how taste disorders are clinically best managed., Recent Findings: Taste disorders are distressing for the concerned patients since eating and drinking become bothersome or impossible. Apart from nutritional problems, quality of life is impaired. Still, diagnosis and treatment of taste disorders are elusive, and general knowledge about taste and its affection is little within the population and the medical community. This review stresses the importance of accurate workup and diagnosis of taste disorders in order to offer an effective treatment. Yet unclear aspects of taste disorders are discussed, and interesting findings regarding the treatment of taste disorders are reviewed. A special focus is given to current pharmacological options on how to treat taste disorders., Summary: Despite impressive insights into the gustatory function and molecular logic of taste receptor cells, there is currently poor clinical knowledge on the pathophysiology of taste disorders in humans. Diagnosing, measuring, and treating gustatory disorders remain restricted to a handful of specialized smell and taste centers worldwide. Despite interesting work on potential drugs treating taste disorders, many of the reported medications lack controlled and randomized trials confirming their efficacy in taste dysfunction. Future efforts need to be focused on the treatment of taste disorders., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) 2022.)

The recent growth of the elderly population has led to the requirement for constant home monitoring as solitary living becomes popular. This protects older people who live alone from unwanted instances such as falling or deterioration caused by some diseases. However, although wearable devices and camera-based systems can provide relatively precise information about human motion, they invade the privacy of the elderly. One way to detect the abnormal behavior of elderly residents under the condition of maintaining privacy is to equip the resident's house with an Internet of Things system based on a non-invasive binary motion sensor array. We propose to concatenate external features ( previous activity and begin time-stamp ) along with extracted features with a bi-directional long short-term memory (Bi-LSTM) neural network to recognize the activities of daily living with a higher accuracy. The concatenated features are classified by a fully connected neural network (FCNN). The proposed model was evaluated on open dataset from the Center for Advanced Studies in Adaptive Systems (CASAS) at Washington State University. The experimental results show that the proposed method outperformed state-of-the-art models with a margin of more than 6.25% of the F 1 score on the same dataset.

The frequent association between coronavirus disease 2019 (COVID-19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID-19-related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID-19-related olfactory dysfunction is high; and (3) corticosteroids have well-known potential adverse effects. We encourage randomized placebo-controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects., (© 2021 ARS-AAOA, LLC.)

Background: Respiratory tract viruses are the second most common cause of olfactory dysfunction. As we learn more about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction (PIOD)., Objective: Our aim was to provide an evidence-based practical guide to the management of PIOD (including post-coronavirus 2019 cases) for both primary care practitioners and hospital specialists., Methods: A systematic review of the treatment options available for the management of PIOD was performed. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group for their perusal before roundtable expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regard to treatment of PIOD., Results: The search resulted in 467 citations, of which 107 articles were fully reviewed and analyzed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomized controlled trials. In total, 15 of the articles specifically looked at PIOD whereas the other 25 included other etiologies for olfactory dysfunction., Conclusions: The Clinical Olfactory Working Group members made an overwhelming recommendation for olfactory training; none recommended monocycline antibiotics. The diagnostic role of oral steroids was discussed; some group members were in favor of vitamin A drops. Further research is needed to confirm the place of other therapeutic options., (Copyright © 2021 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

This paper proposes the Parallel Residual Bi-Fusion Feature Pyramid Network (PRB-FPN) for fast and accurate single-shot object detection. Feature Pyramid (FP) is widely used in recent visual detection, however the top-down pathway of FP cannot preserve accurate localization due to pooling shifting. The advantage of FP is weakened as deeper backbones with more layers are used. In addition, it cannot keep up accurate detection of both small and large objects at the same time. To address these issues, we propose a new parallel FP structure with bi-directional (top-down and bottom-up) fusion and associated improvements to retain high-quality features for accurate localization. We provide the following design improvements: 1) parallel bifusion FP structure with a bottom-up fusion module (BFM) to detect both small and large objects at once with high accuracy; 2) concatenation and re-organization (CORE) module provides a bottom-up pathway for feature fusion, which leads to the bi-directional fusion FP that can recover lost information from lower-layer feature maps; 3) CORE feature is further purified to retain richer contextual information. Such CORE purification in both top-down and bottom-up pathways can be finished in only a few iterations; 4) adding of a residual design to CORE leads to a new Re-CORE module that enables easy training and integration with a wide range of deeper or lighter backbones. The proposed network achieves state-of-the-art performance on the UAVDT17 and MS COCO datasets.

In a preregistered, cross-sectional study, we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19-; n = 546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean ± SD, C19+: -82.5 ± 27.2 points; C19-: -59.8 ± 37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC = 0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4 < OR < 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Frontotemporal dementia (FTD) is a progressive neurodegenerative disease. Diagnosis of FTD, especially the behavioural variant, is challenging because of symptomatic overlap with psychiatric disorders (depression, schizophrenia, bipolar disorder). Olfactory dysfunction is common in both FTD and psychiatric disorders, and often appears years before symptom onset. This systematic review analysed 74 studies on olfactory function in FTD, depression, schizophrenia and bipolar disorder to identify differences in olfactory dysfunction profiles, focusing on the most common smell measures: odour identification and discrimination. Results revealed that FTD patients were severely impaired in odour identification but not discrimination; in contrast, patients diagnosed with schizophrenia showed impairments in both measures, while those diagnosed with depression showed no olfactory impairments. Findings in bipolar disorder were mixed. Therefore, testing odour identification and discrimination differentiates FTD from depression and schizophrenia, but not from bipolar disorder. Given the high prevalence of odour identification impairments in FTD, and that smell dysfunction predicts neurodegeneration in other diseases, olfactory testing seems a promising avenue towards improving diagnosis between FTD and psychiatric disorders., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments, such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation, and initial results of a multilingual, international questionnaire to assess self-reported quantity and quality of perception in 3 distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, and 8 others, aged 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste, and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (-79.7 ± 28.7, mean ± standard deviation), taste (-69.0 ± 32.6), and chemesthetic (-37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell but also affects taste and chemesthesis. The multimodal impact of COVID-19 and the lack of perceived nasal obstruction suggest that severe acute respiratory syndrome coronavirus strain 2 (SARS-CoV-2) infection may disrupt sensory-neural mechanisms., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: Many patients complain about olfactory fluctuation (OF), which is a symptom commonly attributed to sinonasal disease. Data-based evidence for its association with sinonasal disease is scarce. The aim of the study is to identify explanatory variables associated with OF and to analyze its predictive value regarding sinonasal disease., Study Design: We performed a retrospective study based on patients with olfactory dysfunction., Methods: We analyzed data from 482 patients attending the smell and taste outpatient clinic with full psychophysical workup and structured questions regarding their symptoms. The questionnaire included items on OF and chronic nasal symptoms. Clinical investigators filled out the second part of this questionnaire that included information about nasal endoscopy, psychophysical tests of orthonasal olfaction (Sniffin' Sticks), retronasal olfaction, and putative etiology of olfactory dysfunction., Results: OF was more prevalent in sinonasal disease (42.4%) compared to other putative etiologies of olfactory dysfunction such as postinfectious (28%) or posttraumatic (11.7%) (X2 [5, n = 440] = 24.98; P < .0001). OF was strongly associated with Sniffin' Sticks score categories (anosmia, hyposmia, normosmia) (X2 [2, n = 424] = 39.21; P < .0001; Cramer's V = 0.30; P < .0001) and presence of "chronic nasal symptoms" (X2 [1, n = 437] = 22.71; P < .0001; Cramer's V = 0.23; P < .0001). The accuracy in predicting putative sinonasal disease etiology when OF was present depended strongly on the clinical context., Conclusion: Olfactory fluctuation is a symptom mostly but not exclusively associated with sinonasal disease, elevated Sniffin' Sticks test scores, and is frequently accompanied by other nasal complaints. Its presence is valuable information for clinicians to be integrated into the clinical context when doing patients' workup., Level of Evidence: 4 Laryngoscope, 130:2442-2447, 2020., (© 2020 The American Laryngological, Rhinological and Otological Society, Inc.)

The aim of this study is to investigate the effect of olfactory dysfunction (OD) on the two other chemical senses, namely gustation and the intranasal trigeminal system. Taste and trigeminal function were analyzed in a retrospective cross-sectional study of 178 participants with OD (n = 78 posttraumatic, n = 42 idiopathic, n = 27 post-infectious and n = 31 chronic rhinosinusitis (CRS) OD). All patients had been investigated for OD at our smell and taste outpatient clinic. Evaluation of olfaction was performed by means of the Sniffin' Sticks test (odor threshold, odor discrimination and odor identification), whereas gustatory function was assessed with the Taste Strips test and the intranasal trigeminal sensitivity by means of the lateralization task. The degree of olfactory impairment was found to depend on the cause of OD, but not on patients' age. Patients with posttraumatic OD showed lower olfactory function than patients with idiopathic, post-infectious and CRS OD (p = 0.01). Gustatory and trigeminal sensitivity in turn depended on age rather than the cause of olfactory dysfunction. Partial correlations between olfactory, gustatory, and trigeminal scores, with age as covariate, were significant, showing a decrease of taste and trigeminal function proportional to the OD (p < 0.05). The present data suggest that the three chemical senses are closely connected for humans underlining that in case of OD the remaining chemical senses (taste, trigeminal function) tend to decrease rather than compensate as this is seen for sensory loss in other modalities. This finding has direct clinical implications and importance when dealing with smell and taste disorders.

PRéCIS:: Disc tilt is a characteristic of high myopia and related to lower wedge-shaped retinal nerve fiber layer (RNFL) defects in normal-tension glaucoma (NTG). In primary open-angle glaucoma (POAG), the direction of disc torsion corresponds to the location of wedge-shaped RNFL defects., Purpose: To evaluate the disc characteristics in high myopia and the relationships between disc tilt and torsion and the location of wedge-shaped RNFL defects in primary POAG and NTG., Materials and Methods: The differences in disc properties and clinical characteristics between POAG (n=53) and NTG (n=82), and between high myopic (<-6 D, n=77) and non-high myopic (≥-6 D, n=58) glaucoma, were investigated. The association between disc tilt and torsion and the location of wedge-shaped RNFL defects in POAG and NTG were assessed by univariate and multivariate logistic regression analyses., Results: In NTG, but not in POAG, high myopia eyes had significantly smaller discs, a lower tilt ratio (0.73±0.09), and more disc tilt (56.5%) than did non-high myopia eyes (0.80±0.09, 33.3%). In POAG, eyes with lower wedge-shaped RNFL defects had a significantly smaller torsion angle (-5.44±19.62 degrees, inferior disc torsion) than did eyes with upper defects (9.70±23.62 degrees, superior disc torsion; P=0.014). In NTG, a significantly decreased tilt ratio (0.74±0.93; P=0.001) and more disc tilt (55.9%, P=0.005) were found in eyes with lower wedge-shaped RNFL defects than in eyes with upper defects (0.81±0.09; 21.7%). The torsion degree and tilt ratio were the only factors associated with the location of wedge-shaped RNFL defects in POAG and NTG, respectively., Conclusions: In NTG, smaller and tilted discs were the characteristics of high myopia. Disc tilt was associated with lower wedge-shaped RNFL defects. In POAG, the direction of disc torsion corresponded to the location of the wedge-shaped RNFL defects.

Purpose: To report two cases of ciliochoroidal effusion after the usage of topiramate., Cases: Two middle-aged women experienced sudden onset of acute glaucoma and acquired myopia after taking topiramate. Ultrasound biomicroscopy demonstrated bilateral ciliochoroidal effusion and angle closure. The A-scan ultrasonography revealed shallow anterior chamber and thick lens. After the treatment and drug withdrawal, intraocular pressure, refractive status and angle anatomy returned to normal and there was resolution of ciliochoroidal effusion. During the clinical course, the anterior chamber depth (ACD) increased from 2.02 to 3.30 mm (1.28 mm of changes) OD and from 1.94 to 3.36 mm (1.42 mm of changes) OS. The lens thickness (LT) became thinner from 4.53 to 4.31 mm (0.22 mm of changes) OD and from 4.59 to 4.30 mm (0.29 mm of changes) OS in the first case. In the second case, the ACD increased from 2.33 to 3.07 mm (0.74 mm of changes) OD and from 2.30 to 3.05 mm (0.75 mm of changes) OS. The LT became thinner from 4.42 to 4.27 mm (0.15 mm of changes) OD and from 4.38 to 4.26 mm (0.12 mm of changes) OS. The forward displacement of the lens-iris diaphragm contributed more to the shallowness of the anterior chamber than the thickening of the lens itself (only accounting for 20%)., Conclusion: Topiramate-induced bilateral acute angle closure glaucoma and myopic shift was due to ciliochoroidal effusion which resulted in thicker lens and shallow anterior chamber. The later was mainly due to anterior displacement of the lens-iris diaphragm.

Olfactory disorders are common and may lead to severe consequences on quality of life. Medical management including treatment options can be proposed to the patients. For this reason, a correct diagnosis is important. Olfactory testing is one of the cornerstones for the diagnosis of smell impairment which helps to quantify the deficit. Despite good and widespread psychophysical olfactory tests, there are still many challenges in testing olfaction. Most of the current available test may not fully account for some cultural and genetic biases. Therefore it is difficult to develop olfactory tests and standardize them across different populations. In this paper we discuss an alternative method based on « white smells » which may help to overcome these issues.

The use of fluorescent tags to monitor protein expression and to lineage-trace cells has become a standard complement to standard histological techniques in the fields of embryology, pathology and regenerative medicine. Unfortunately, traditional paraffin embedding protocols can substantially diminish or abolish the native emission signal of the fluorophore of interest. To preserve the fluorescent signal, an alternative is to use cryosectioning; however, this can often result in undesirable artefacts such as tearing or shattering - particularly for mineralized tissues such as bone and cartilage. Here we present a method of using a commercially available tape to stabilize murine femur tissue, thus allowing for cryosectioning of cartilage and bone tissues carrying fluorescent tags without the need for demineralization.

Differences in the timing of vegetative-to-reproductive phase transition have evolved independently and repeatedly in different plant species. Due to their specific biological functions and positions in pathways, some genes are important targets of repeated evolution - independent mutations on these genes caused the evolution of similar phenotypes in distantly related organisms. While many studies have investigated these genes, it remains unclear how gene duplications influence repeated phenotypic evolution. Here we characterized the genetic architecture underlying a novel rapid-flowering phenotype in Boechera stricta and investigated the candidate genes BsFLC1 and BsFLC2 . The expression patterns of BsFLC1 suggested its function in flowering time suppression, and the deletion of BsFLC1 is associated with rapid flowering and loss of vernalization requirement. In contrast, BsFLC2 did not appear to be associated with flowering and had accumulated multiple amino acid substitutions in the relatively short evolutionary timeframe after gene duplication. These non-synonymous substitutions greatly changed the physicochemical properties of the original amino acids, concentrated non-randomly near a protein-interacting domain, and had greater substitution rate than synonymous changes. Here we suggested that, after recent gene duplication of the FLC gene, the evolution of rapid phenology was made possible by the change of BsFLC2 expression pattern or protein sequences and the deletion of BsFLC1 .

We report the case of a 27-year-old female who presented with a peculiar story of anosmia fluctuating in a circadian manner. Olfactory function appeared an hour after breakfast, was normal during daytime, and disappeared in the early evening. Imaging confirmed chronic rhinosinusitis (CRS). Initial systemic, followed by topical steroid treatment, rapidly and sustainably reversed this condition. The olfactory fluctuation paralleled the endogenous steroid production. This suggests that slight congestion changes in a chronically inflamed nasal mucosa may have been sufficient to induce this circadian anosmia. The importance of identifying fluctuation of olfactory function as a sign of CRS is emphasized and discussed. Laryngoscope, 128:1537-1539, 2018., (© 2018 The American Laryngological, Rhinological and Otological Society, Inc.)

Smell dysfunction is a common and underdiagnosed medical condition that can have serious consequences. It is also an early biomarker of neurodegenerative diseases, including Alzheimer's disease, where olfactory deficits precede detectable memory loss. Clinical tests that evaluate the sense of smell face two major challenges. First, human sensitivity to individual odorants varies significantly, so test results may be unreliable in people with low sensitivity to a test odorant but an otherwise normal sense of smell. Second, prior familiarity with odor stimuli can bias smell test performance. We have developed nonsemantic tests for olfactory sensitivity (SMELL-S) and olfactory resolution (SMELL-R) that use mixtures of odorants that have unfamiliar smells. The tests can be self-administered by healthy individuals with minimal training and show high test-retest reliability. Because SMELL-S uses odor mixtures rather than a single molecule, odor-specific insensitivity is averaged out, and the test accurately distinguished people with normal and dysfunctional smell. SMELL-R is a discrimination test in which the difference between two stimulus mixtures can be altered stepwise. This is an advance over current discrimination tests, which ask subjects to discriminate monomolecular odorants whose difference in odor cannot be quantified. SMELL-R showed significantly less bias in scores between North American and Taiwanese subjects than conventional semantically based smell tests that need to be adapted to different languages and cultures. Based on these proof-of-principle results in healthy individuals, we predict that SMELL-S and SMELL-R will be broadly effective in diagnosing smell dysfunction., Competing Interests: Conflict of interest statement: J.W.H., A.K., and L.B.V. are inventors on US provisional patent application 62/528,420, filed July 3, 2017, by The Rockefeller University, relating to the smell test methods in this manuscript., (Published under the PNAS license.)

Background: The aim of present study was to compare the effects of different aerobic exercise intensities and energy expenditures on the body composition of sedentary obese college students in Taiwan., Methods: Forty-eight obese participants [body mass index (BMI) ≥ 27 kg/m 2 , age 18-26 years] were randomized into four equal groups (n = 12): light-intensity training group (LITG), 40%-50% heart rate reserve (HRR); middle-intensity training group (MITG), 50%-70% HRR; high-intensity training group (HITG), 70%-80% HRR; and control group (CG). The aerobic exercise training program was conducted for 60 min per day on a treadmill 3 days per week for 12 weeks. All participant anthropometric data, blood biochemical parameters, and health-related physical fitness components were measured at baseline and after 12 weeks., Results: At baseline, the anthropometric indices did not differ significantly among the four groups (p > 0.05). After 12-week exercise intervention, the HITG and MITG had significantly more changes in body weight, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) than the LITG. The changes in BMI and body fat percentage differed among all four groups (p < 0.05)., Conclusions: A 12-week high-intensity exercise intervention with high energy expenditure can considerably reduce body weight, body fat, WC, WHR, and WHtR, whereas a light-intensity exercise intervention can significantly reduce body weight and body fat., Trial Registration: Current Controlled Trials TPECTR09831410900 , registered on 24 th Dec 2009.

Two triazine-based dendrimers were successfully prepared in 60-75% yields. These newly prepared dendrimers 2a and 2b containing the -NMe(CH2)2NMe- and the -NMe(CH2)4NMe- linkers between two G3 dendrons, respectively, exhibit columnar phases during the thermal process. However, the corresponding dendrimers 1a and 1b containing the -NH(CH2)2NH- and the -NH(CH2)4NH- linkers between two G3 dendrons, respectively, do not show any LC phases on thermal treatment. Computational investigations on molecular conformations reveal that N-methylation of the dendritic central linker leads dendrimers to possess more isomeric conformations and thus successfully converts non-LC dendrimers (1a and 1b) into LC dendrimers (2a and 2b).

Purpose: To evaluate the morphologic characteristics of optic neuropathy and its association with visual field (VF) defects in primary open-angle glaucoma (POAG) eyes with high myopia., Methods: In this cross-sectional study, we reviewed data from 375 Taiwanese patients (375 eyes) of POAG, ages 20 to 60 years. Optic disc photographs were used for planimetric measurements of morphologic variables. The myopic refraction was divided into high myopia (<-6.0 D) and nonhigh myopia (moderate myopia to hyperopia). The optic disc area was classified as moderate (1.59 to 2.85 mm(2)), large, and small. Differences in characteristics between groups, correlations with the disc area, and factors associated with VF defects were determined., Results: Of the 142 highly myopic eyes, 33 (23%) had a large disc, 26 (18%) had a small disc, and 55 (39%) had a tilted disc. Large discs had a higher cup-to-disc (C/D) area ratio and a higher tilt ratio; small discs had a smaller rim area and a lower tilt ratio (all P<0.05). Characteristics associated with high myopia included a smaller rim area, a higher C/D area ratio, and a lower tilt ratio (all P<0.001). In logistic regression, the refraction, the C/D area ratio, the rim area, and the tilt ratio (all P<0.05) were associated with VF defects., Conclusions: In Taiwanese individuals with POAG, our study found that tilted, large, or small discs were prevalent in highly myopic eyes. Of these characteristics, only the disc tilt and high myopia by itself were associated with the severity of glaucomatous optic neuropathy.

Purpose: To demonstrate that a 44-amino acid peptide from pigment epithelial-derived factor (PEDF) induces the regeneration of limbal excision wound, and the regenerated limbus can act as the regeneration source for new limbal excisional injuries in rabbit model of limbal deficiency., Methods: Half circumference partial limbal excision was followed by PEDF peptide treatment to achieve limbal wound regeneration. Three months later, a second stage half circumference partial limbal excision removed the remaining native limbal tissue followed by PEDF peptide treatment. The structure and function of the regenerated limbus were analyzed at 3 and 6 months. Conjunctivalization was analyzed by impression cytology. Immunohistochemical analysis was performed with antibodies to corneal epithelium-associated keratin 3 (K3), conjunctival epithelium-associated keratin 13 (K13), ΔNp63α, ABCG2, and BrdU. Extensive limbal excision was performed to examine the regeneration potential of the PEDF peptide., Results: Total limbal stem cell deficiency occurred with severe inflammation and conjunctivalization of the limbal wound and adjacent cornea in vehicle control eyes. In PEDF peptide treated eyes, the regenerated limbus prevented fibrovascular invasion and goblet cell migration into the corneal surface. Immunohistochemical staining of the regenerated limbus showed a wide distribution of cells expressing ΔNp63α and ABCG2 as in the native limbus. BrdU labeling assay revealed the presence of slow-cycling cells in the basal layer of the regenerated limbus. The PEDF peptide can heal extensive limbal excisional wounds and sustain ocular surface integrity., Conclusions: The addition of PEDF peptide has the potential to repair limbal excisional wounds with the recovery of normal limbus-like anatomy and function. The PEDF peptide is a potential remedy for extensive limbal injury.

Three triazine-based dendrons (1 a-c) were successfully prepared in 70-83 % yields. These newly prepared dendrons are found to be liquid crystalline (LC). Computational investigations on molecular conformations and dipoles of triazine-based dendrons reveal that the substituent on the central triazine unit interrupts strong dipole or H-bond interactions to avoid dimeric formation. The obtained dendrons, not favouring self-assembly into dimers but showing LC behaviours, provides evidence for an approach contrary to the conventional method of inducing LC behaviours of dendrons by dimer or trimer formation, mostly through H-bond interactions., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

In response injury, intrinsic repair mechanisms are activated in skeletal muscle to replace the damaged muscle fibers with new muscle fibers. The regeneration process starts with the proliferation of satellite cells to give rise to myoblasts, which subsequently differentiate terminally into myofibers. Here, we investigated the promotion effect of pigment epithelial-derived factor (PEDF) on muscle regeneration. We report that PEDF and a synthetic PEDF-derived short peptide (PSP; residues Ser(93)-Leu(112)) induce satellite cell proliferation in vitro and promote muscle regeneration in vivo. Extensively, soleus muscle necrosis was induced in rats by bupivacaine, and an injectable alginate gel was used to release the PSP in the injured muscle. PSP delivery was found to stimulate satellite cell proliferation in damaged muscle and enhance the growth of regenerating myofibers, with complete regeneration of normal muscle mass by 2 wk. In cell culture, PEDF/PSP stimulated C2C12 myoblast proliferation, together with a rise in cyclin D1 expression. PEDF induced the phosphorylation of ERK1/2, Akt, and STAT3 in C2C12 myoblasts. Blocking the activity of ERK, Akt, or STAT3 with pharmacological inhibitors attenuated the effects of PEDF/PSP on the induction of C2C12 cell proliferation and cyclin D1 expression. Moreover, 5-bromo-2'-deoxyuridine pulse-labeling demonstrated that PEDF/PSP stimulated primary rat satellite cell proliferation in myofibers in vitro. In summary, we report for the first time that PSP is capable of promoting the regeneration of skeletal muscle. The signaling mechanism involves the ERK, AKT, and STAT3 pathways. These results show the potential utility of this PEDF peptide for muscle regeneration., (Copyright © 2015 the American Physiological Society.)

Purpose: To investigate the potential of a pigment epithelial-derived factor (PEDF) peptide 44-mer to promote limbal regeneration in a rabbit partial limbal deficiency model., Methods: Limbal excision (180°) was created surgically, and topical application of 44-mer-containing ointment once a day for 2 weeks was started immediately after injury. Limbal barrier function was inspected at 2 and 6 months after treatment. Corneal neovascularization was observed under slit-lamp microscope. The presence of goblet cells on the corneal surface was examined using impression cytology. The resulting repair tissue was assessed by immunohistochemical staining with antibodies for putative limbal stem cell (LSC) markers ΔNp63α and ABCG2. Cells harvested from the regenerated tissue were analyzed for colony-forming capacity and expression of LSC markers by immunostaining assay and quantitative real-time PCR (qPCR)., Results: Eyes treated with the 44-mer blocked vascularization and goblet cell migration onto the corneal surface. By means of immunohistochemical staining and cell isolation in the repair tissue, we showed that LSCs were widely distributed at the regenerated tissue after 44-mer treatment. The repaired limbus contributed robustly to corneal wound healing as effectively as undamaged limbus., Conclusions: We demonstrated that 44-mer regenerates a functional limbus-like structure on limbal excision wounds. Our finding suggests that the PEDF peptide derivative may be an innovative strategy for tissue engineering and repair therapy in partial LSC deficiency diseases.

Because international travel is now more frequent and convenient, communicable diseases that occur in one region can be transmitted to another area within a few hours. For this reason, many efforts have been undertaken in Taiwan to establish a comprehensive border quarantine system to protect against imported diseases that may threaten the health of the population. According to the International Health Regulations (2005), decades of development strategies for border quarantine have covered not only routine practices and specific measures for handling a pandemic but also have drawn attention to the development of core capacities at designated points of entry. However, as a result of the rapidly increasing number of points of entry, changes in transportation patterns, and the emergence of diseases, current border quarantine practice is being challenged to maintain human resources and the efficacy of entry screening. It is therefore critical to reexamine border quarantine strategies that will fit future needs and national conditions. This article reviews the current border health practices in Taiwan and discusses 5 key challenges to be further considered and improved. The findings can serve as a guide for further policy reform in Taiwan and other countries.

Background: As designated points of entry (PoEs) play a critical role in preventing the transmission of international public health risks, huge efforts have been invested in Taiwan to improve the core capacities specified in the International Health Regulations 2005 (IHR 2005). This article reviews how Taiwan strengthened the core capacities at the Taoyuan International Airport (TIA) and the Port of Kaohsiung (PoK) by applying a new, practicable model., Design: An IHR PoE program was initiated for implementing the IHR core capacities at designated PoEs. The main methods of this program were 1) identifying the designated PoEs according to the pre-determined criteria, 2) identifying the competent authority for each health measure, 3) building a close collaborative relationship between stakeholders from the central and PoE level, 4) designing three stages of systematic assessment using the assessment tool published by the World Health Organization (WHO), and 5) undertaking action plans targeting the gaps identified by the assessments., Results: Results of the self-assessment, preliminary external assessment, and follow-up external assessment revealed a continuous progressive trend at the TIA (86, 91, and 100%, respectively), and at the PoK (77, 97, and 99.9%, respectively). The results of the follow-up external assessment indicated that both these designated PoEs already conformed to the IHR requirements. These achievements were highly associated with strong collaboration, continuous empowerment, efficient resource integration, and sustained commitments., Conclusions: Considering that many countries had requested for an extension on the deadline to fulfill the IHR 2005 core capacity requirements, Taiwan's experiences can be a source of learning for countries striving to fully implement these requirements. Further, in order to broaden the scope of public health protection into promoting global security, Taiwan will keep its commitments on multisectoral cooperation, human resource capacity building, and maintaining routine and emergency capacities.

Four unconventional triazine-based dendrimers have been prepared and characterized by (1) H and (13) C NMR spectroscopies, mass spectrometry, and elemental analysis. Based on DSC studies, polarizing microscopy, and powder XRD, two of these dendrimers, containing linkers with an odd number of carbon atoms, were observed to display columnar liquid-crystalline phases during thermal treatment. However, the other two dendritic analogues, containing linkers with an even number of carbon atoms, were not observed to behave correspondingly. Based on computer simulation, we reasonably assume that the dendrimers with an odd number of carbon atoms in their linkers distort their molecular shape and adopt two isomeric structures due to asymmetrical congestion. This reduces the molecular π-π face-to-face interaction, which in turn causes the dendrimers to form columnar LC phases during thermal treatment. However, the dendrimers with an even number of carbon atoms in their linkers have more symmetrical skeletons and do not display any liquid-crystalline phase upon thermal treatment. This new strategy should be applicable for eliciting the columnar liquid-crystalline properties of other types of unconventional dendrimers with rigid frameworks., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)