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In higher education, it is challenging to cultivate non-computer science majors' programming concepts. This study used the GAME model (gamification, assessment, modeling, and enquiry) in a programming education course to enhance undergraduates' self-efficacy and performance of basic programming concepts. There were 83 undergraduates taking part in this study, which adopted a quasi-experimental research design. Students in the experimental group (n = 43) experienced a course in which the GAME model was used to design the block-based programming course. The control group (n = 40) was given a general information education course covering similar learning concepts without the game-based learning strategy. The analysis of covariance (ANCOVA) was adopted to investigate the effect of the GAME model on students' learning outcomes for the quantitative data. In the qualitative analysis, students' responses to the course perception questionnaire were coded and analyzed. The results showed that students in the experimental group outperformed their counterparts regarding self-efficacy and basic programming concepts. The experimental treatment resulted in a small to medium effect size difference between the two groups. The results showed that incorporating the GAME model into block-based programming teaching helped improve undergraduates' self-efficacy and performance of basic programming concepts. In addition, these experimental group undergraduates also perceived the pedagogic GAME model positively. Several research suggestions are proposed based on the findings of the present study.

Abstract This cross-sectional survey aims to determine whether cotinine exposure would enhance the relationship between blood manganese (Mn) and non-alcoholic fatty liver disease (NAFLD) in children using the NHANES database. Restricted cubic spline (RCS) and logistic regression analyses were adopted to determine the potential relationship. Besides, we tested the robustness of the results by performing trend tests and subgroup analyses. The study finally enrolled 866 children aged 18 years and below. Blood Mn was linearly linked to NAFLD and the risk of NAFLD was increased with the blood Mn elevation (P

Abstract Cryo-electron microscopy (cryo-EM) technique is widely used for protein structure determination. Current automatic cryo-EM protein complex modeling methods mostly rely on prior chain separation. However, chain separation without sequence guidance often suffers from errors caused by cross-chain interaction or noise densities, which would accumulate and mislead the subsequent steps. Here, we present EModelX, a fully automated cryo-EM protein complex structure modeling method, which achieves sequence-guiding modeling through cross-modal alignments between cryo-EM maps and protein sequences. EModelX first employs multi-task deep learning to predict Cα atoms, backbone atoms, and amino acid types from cryo-EM maps, which is subsequently used to sample Cα traces with amino acid profiles. The profiles are then aligned with protein sequences to obtain initial structural models, which yielded an average RMSD of 1.17 Å in our test set, approaching atomic-level precision in recovering PDB-deposited structures. After filling unmodeled gaps through sequence-guiding Cα threading, the final models achieved an average TM-score of 0.808, outperforming the state-of-the-art method. The further combination with AlphaFold can improve the average TM-score to 0.911. Analyzes conducted by comparing some EModelX-built models and PDB structures highlight its potential to improve PDB structures. EModelX is accessible at https://bio-web1.nscc-gz.cn/app/EModelX .

Abstract Background In recent years, the addition of cetuximab to chemotherapy has improved treatment outcomes for patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). In this study, we present the real-world survival data of R/M HNSCC patients who received cetuximab-containing regimens from thirteen medical centers in Taiwan, as well as a three-level risk stratification model for this patient population. Methods This study enrolled R/M HNSCC patients from thirteen medical centers in Taiwan who received cetuximab-containing regimens from January 1, 2017 to June 6, 2022. The cases were divided into a training cohort and a validation cohort based on the start of treatment. Overall survival (OS) was evaluated in both cohorts and exploratory analysis was performed to identify associated adverse clinical and laboratory factors. The results of the exploratory analysis were used to construct a three-level risk stratification prediction model for OS. Results A total of 1434 patients with R/M HNSCC were enrolled in this study and received cetuximab-containing regimens. The overall population had a median OS of 8.57 months (95% CI: 8.07 – 9.08). Multivariate analysis of the training cohort identified poor ECOG performance status, heavy alcohol consumption, and prior adjuvant CCRT or lack of prior RT as adverse prognostic factors. Comparison of laboratory data between patients with OS≦6 and OS > 6 also revealed unfavorable factors, including increased white blood cell count, decreased hemoglobin level, increased platelet count, increased absolute neutrophil count, decreased absolute lymphocyte count, and increased neutrophil-to-lymphocyte ratio. Using forward prediction, a three-level risk stratification prediction model was constructed using the variables of ECOG performance status, alcohol consumption, skin metastasis, modality of radiation therapy, hemoglobin level, and neutrophil-to-lymphocyte ratio. The median OS in the low-risk, intermediate-risk, and high-risk groups were 12.02 months (95% CI 10.44–13.61), 7.5 months (95% CI 7.33–8.17), and 4.01 months (95% CI 3.94–4.08), respectively, with a log-rank test p-value

Background: Acne vulgaris (AV) results from increased sebum production and Cutibacterium acnes (C. acnes) overgrowth, leading to pilosebaceous unit inflammation. The androgen-androgen receptor (AR) pathway significantly contributes to acne development, with minoxidil showing promise in suppressing AR-related activities. Objectives: This study aims to examine the mechanism and effectiveness of minoxidil in treating AV. Methods: The effects of minoxidil on lipid metabolism and bacterial infection/inflammation were tested. A clinical trial was performed to evaluate the effect of topical minoxidil on AV. Results: Minoxidil suppressed fatty acid synthase activity and lipid formation in an androgen-sensitive prostate cancer cell line in vitro and sebum formation in hamster flank organs in vivo. For C. acnes, minoxidil had a half-maximum inhibitory concentration of 5 mM. Both 2% and 5% minoxidil suppressed C. acnes-induced infection/inflammation in an animal model. A phase I/II clinical trial of topical minoxidil in treating AV using a split-face model demonstrated a good response and well-tolerated side effects. Compared to the untreated side, the numbers of all types of lesions decreased significantly on the treated side on day 3 (mean: −2.238, 95% confidence interval [CI]: −3.821 to −0.655, P = 0.008), day 8, and reached the maximum effect on day 15 (mean: −1.286, 95% CI: −2.151 to −0.420, P = 0.006). Responders to topical minoxidil may experience rapid regression of acne as early as 3 days of treatment. Conclusion: Our collective data indicate that minoxidil could inhibit AR-related functions and C. acnes growth in treating AV.

Abstract Background Capsule endoscopy (CE) is useful for managing patients with suspected small bowel diseases. However, the effect of prolonged CE examination time on CE performance is unknown. Aim To evaluate the completeness and diagnostic yield of prolonged CE imaging in patients with suspected small bowel bleeding. Methods We reviewed consecutive records of adult CE examinations via an overnight protocol from Jan 2016 to Dec 2020 at a tertiary center in Taiwan. We subcategorized the CE records by recording length into within 8 h, within 12 h and throughout the whole procedure and compared the completion rate and diagnostic yield between the groups. Cochran’s Q test was used for statistical analysis. Results A total of 88 patients were enrolled with 78.4% inpatients (median age 72 years). The small bowel evaluation completion rate was 93.2%, which was significantly greater than the 79.5% rate within 12 h (p = 0.025) and the 58% rate within 8 h (p

This study aimed to develop a maker spirit problem-based learning (PBL) innovation and entrepreneurship course and explore its impact on students' learning effectiveness. A mixed research method was adopted for this study, in which qualitative and quantitative data were collected for inductive analysis. The research subjects comprised 49 students who took the 'Innovation and Entrepreneurship Course' at a university of science and technology. Further, an 18-week experimental teaching activity was implemented, in which the 'Maker Spirit -- PBL Innovation and Entrepreneurship Course' was innovatively developed. Results revealed that most students showed significant positive learning effectiveness in two levels, namely 'innovation and entrepreneurship', and 'maker practice', after the experimental teaching. Therefore, five major implementation points of the 'Maker Spirit -- PBL Innovation and Entrepreneurship Course' were proposed to provide references for future implementations and applications in the teaching field.

Perceptual learning (PL) can significantly improve human performance in perceptual tasks primarily through template reweighting. Previous studies have documented how PL changes perceptual template in stimulus feature space. We investigated how PL reweights visual information in time. With a dynamic external noise paradigm and the elaborated perceptual template model (ePTM) analysis, we found that training with an orientation identification task in the zero external noise condition reduced contrast thresholds in both zero and high external noise conditions, whereas training in the high external noise condition only reduced contrast thresholds in high external noise conditions. The ePTM analysis showed that training in both zero and high external noise changed the overall amplitude, but not the shape of the temporal window of the perceptual template to exclude external noise across time, and training in zero external noise additionally reduced additive internal noise. Our results provided additional constraints for models of PL.

This study aimed to analyze second-semester organic chemistry students' problem-solving strategies, specifically focusing on the resources activated while solving problems on E2, E1, and E1cB elimination reactions. Using the theoretical framework by Elby and Hammer, we defined a resource as a unit of information used in the problem-solving process. The resources activated to solve elimination reaction problems were probed using a mixed-methods approach using survey assessments and think-aloud interviews. The data were analyzed quantitatively and qualitatively following a validated set of scoring criteria. The results align with existing findings that students focus on surface-level structural information and use resources that have been repetitively emphasized over multiple semesters. Resources related to acid-base chemistry were activated more often than reaction-specific resources, such as conformational analyses or carbocation rearrangements. Although acid-base resources aid students in successfully analyzing reaction mechanisms, additional resources must be activated to rationalize specific mechanisms and to explain the products formed. This calls for instructors to provide formative and summative assessments that evaluate the many resources required to elucidate elimination reaction mechanisms and product stereochemistry.

Abstract Background Maternal diabetes mellitus can influence the development of offspring. Gestational diabetes mellitus (GDM) creates a short-term intrauterine hyperglycaemic environment in offspring, leading to glucose intolerance in later life, but the long-term effects and specific mechanism involved in skeletal muscle dysfunction in offspring remain to be clarified. Methods Pregnant mice were divided into two groups: The GDM group was intraperitoneally injected with 100 mg/kg streptozotocin on gestational days (GDs) 6.5 and 12.5, while the control (CTR) group was treated with vehicle buffer. Only pregnant mice whose random blood glucose level was higher than 16.8 mmol/L beginning on GD13.5 were regarded as the GDM group. The growth of the offspring was monitored, and the glucose tolerance test was performed at different time points. Body composition analysis and immunohistochemical methods were used to evaluate the development of lean mass at 8 weeks. The exercise capacity and grip strength of the male mouse offspring were assessed at the same period. Transmission electron microscopy was used to observe the morphology inside skeletal muscle at 8 weeks and as a foetus. The genes and proteins associated with mitochondrial biogenesis and oxidative metabolism were investigated. We also coanalyzed RNA sequencing and proteomics data to explore the underlying mechanism. Chromatin immunoprecipitation and bisulfite-converted DNA methylation detection were performed to evaluate this phenomenon. Results Short-term intrauterine hyperglycaemia inhibited the growth and reduced the lean mass of male offspring, leading to decreased endurance exercise capacity. The myofiber composition of the tibialis anterior muscle of GDM male offspring became more glycolytic and less oxidative. The morphology and function of mitochondria in the skeletal muscle of GDM male offspring were destroyed, and coanalysis of RNA sequencing and proteomics of foetal skeletal muscle showed that mitochondrial elements and lipid oxidation were consistently impaired. In vivo and in vitro myoblast experiments also demonstrated that high glucose concentrations impeded mitochondrial organisation and function. Importantly, the transcription of genes associated with mitochondrial biogenesis and oxidative metabolism decreased at 8 weeks and during the foetal period. We predicted Ppargc1α as a key upstream regulator with the help of IPA software. The proteins and mRNA levels of Ppargc1α in the skeletal muscle of GDM male offspring were decreased as a foetus (CTR vs. GDM, 1.004 vs. 0.665, p = 0.002), at 6 weeks (1.018 vs. 0.511, p = 0.023) and 8 weeks (1.006 vs. 0.596, p = 0.018). In addition, CREB phosphorylation was inhibited in GDM group, with fewer activated pCREB proteins binding to the CRE element of Ppargc1α (1.042 vs. 0.681, p = 0.037), Pck1 (1.091 vs. 0.432, p = 0.014) and G6pc (1.118 vs. 0.472, p = 0.027), resulting in their decreased transcription. Interestingly, we found that sarcopenia and mitochondrial dysfunction could even be inherited by the next generation. Conclusions Short-term intrauterine hyperglycaemia significantly reduced lean mass in male offspring at 8 weeks, resulting in decreased exercise endurance and metabolic disorders. Disrupted organisation and function of the mitochondria in skeletal muscle were also observed among them. Foetal exposure to hyperglycaemia decreased the ratio of phosphorylated CREB and reduced the transcription of Ppargc1α, which inhibited the transcription of downstream genes involving in mitochondrial biogenesis and oxidative metabolism. Abnormal mitochondria, which might be transmitted through aberrant gametes, were also observed in the F2 generation.

Abstract Background In recent years, with benefits from the continuous improvement of clinical technology and the advantage of fertility preservation, the application of embryo cryopreservation has been growing rapidly worldwide. However, amidst this growth, concerns about its safety persist. Numerous studies have highlighted the elevated risk of perinatal complications linked to frozen embryo transfer (FET), such as large for gestational age (LGA) and hypertensive disorders during pregnancy. Thus, it is imperative to explore the potential risk of embryo cryopreservation and its related mechanisms. Methods Given the strict ethical constraints on clinical samples, we employed mouse models in this study. Three experimental groups were established: the naturally conceived (NC) group, the fresh embryo transfer (Fresh-ET) group, and the FET group. Blastocyst formation rates and implantation rates were calculated post-embryo cryopreservation. The impact of FET on fetal growth was evaluated upon fetal and placental weight. Placental RNA-seq was conducted, encompassing comprehensive analyses of various comparisons (Fresh-ET vs. NC, FET vs. NC, and FET vs. Fresh-ET). Results Reduced rates of blastocyst formation and implantation were observed post-embryo cryopreservation. Fresh-ET resulted in a significant decrease in fetal weight compared to NC group, whereas FET reversed this decline. RNA-seq analysis indicated that the majority of the expression changes in FET were inherited from Fresh-ET, and alterations solely attributed to embryo cryopreservation were moderate. Unexpectedly, certain genes that showed alterations in Fresh-ET tended to be restored in FET. Further analysis suggested that this regression may underlie the improvement of fetal growth restriction in FET. The expression of imprinted genes was disrupted in both FET and Fresh-ET groups. Conclusion Based on our experimental data on mouse models, the impact of embryo cryopreservation is less pronounced than other in vitro manipulations in Fresh-ET. However, the impairment of the embryonic developmental potential and the gene alterations in placenta still suggested it to be a risky operation.

Background: Cytomegalovirus (CMV) can cause infection and critical diseases in hematopoietic stem cell transplantation (HSCT) recipients. This study aimed to explore the cumulative incidence and risk factors for CMV infection and disease among HSCT recipients in Taiwan. Methods: This retrospective cohort study using the Taiwan Blood and Marrow Transplantation Registry (TBMTR) included HSCT recipients between 2009 and 2018 in Taiwan. The primary outcome was cumulative incidence of CMV infection or disease at day 100 after HSCT. Secondary outcomes included day 180 cumulative incidence of CMV infection or disease, infection sites, risk factors for CMV infection or disease, survival analysis, and overall survival after CMV infection and disease. Results: There were 4394 HSCT recipients included in the study (2044 auto-HSCT and 2350 allo-HSCT). The cumulative incidence of CMV infection and disease was significantly higher in allo-HSCT than in auto-HSCT patients at day 100 (53.7% vs. 6.0%, P

BackgroundCognitive impairment (CI) is common in Parkinson’s disease (PD). Multiple brain regions and their interactions are involved in PD associated CI. Magnetic resonance imaging (MRI) technology is a non-invasive method in investigating brain structure and inter-regional connections. In this study, by comparing cortical thickness, subcortical volume, and brain network topology properties in PD patients with and without CI, we aimed to understand the changes of brain structure and structural covariance network properties in PD associated CI.MethodsA total of 18 PD patients with CI and 33 PD patients without CI were recruited. Movement Disorder Society Unified Parkinson’s Disease Rating Scale, Hoehn and Yahr stage, Mini Mental State Examination Scale, Non-motor Symptom Rating Scale, Hamilton Anxiety Scale, and Hamilton Depression Scale were assessed. All participants underwent structural 3T MRI. Cortical thickness, subcortical volume, global and nodal network topology properties were measured.ResultsCompared with PD patients without CI, the volumes of white matter, thalamus and hippocampus were lower in PD patients with CI. And decreased whole-brain local efficiency is associated with CI in PD patients. While the cortical thickness and nodal network topology properties were comparable between PD patients with and without CI.ConclusionOur findings support the alterations of brain structure and disruption of structural covariance network are involved in PD associated CI, providing a new insight into the association between graph properties and PD associated CI.

BackgroundPatients with respiratory or cardiovascular diseases often experience higher rates of hospital readmission due to compromised heart-lung function and significant clinical symptoms. Effective measures such as discharge planning, case management, home telemonitoring follow-up, and patient education can significantly mitigate hospital readmissions. ObjectiveThis study aimed to determine the efficacy of home telemonitoring follow-up in reducing hospital readmissions, emergency department (ED) visits, and total hospital days for high-risk postdischarge patients. MethodsThis prospective cohort study was conducted between July and October 2021. High-risk patients were screened for eligibility and enrolled in the study. The intervention involved implementing home digital monitoring to track patient health metrics after discharge, with the aim of reducing hospital readmissions and ED visits. High-risk patients or their primary caregivers received education on using communication measurement tools and recording and uploading data. Before discharge, patients were familiarized with these tools, which they continued to use for 4 weeks after discharge. A project manager monitored the daily uploaded health data, while a weekly video appointment with the program coordinator monitored the heart and breathing sounds of the patients, tracked health status changes, and gathered relevant data. Care guidance and medical advice were provided based on symptoms and physiological signals. The primary outcomes of this study were the number of hospital readmissions and ED visits within 3 and 6 months after intervention. The secondary outcomes included the total number of hospital days and patient adherence to the home monitoring protocol. ResultsAmong 41 eligible patients, 93% (n=38) were male, and 46% (n=19) were aged 41-60 years, while 46% (n=19) were aged 60 years or older. The study revealed that home digital monitoring significantly reduced hospitalizations, ED visits, and total hospital stay days at 3 and 6 months after intervention. At 3 months after intervention, average hospitalizations decreased from 0.45 (SD 0.09) to 0.19 (SD 0.09; P=.03), and average ED visits decreased from 0.48 (SD 0.09) to 0.06 (SD 0.04; P

Abstract Background The role of circRNAs in hepatocellular carcinoma (HCC) progression remains unclear. CircPIAS1 (circBase ID: hsa_circ_0007088) was identified as overexpressed in HCC cases through bioinformatics analysis. This study aimed to investigate the oncogenic properties and mechanisms of circPIAS1 in HCC development. Methods Functional analyses were conducted to assess circPIAS1’s impact on HCC cell proliferation, migration, and ferroptosis. Xenograft mouse models were employed to evaluate circPIAS1’s effects on tumor growth and pulmonary metastasis in vivo. Bioinformatics analysis, RNA immunoprecipitation, and luciferase reporter assays were utilized to elucidate the molecular pathways influenced by circPIAS1. Additional techniques, including RNA pulldown, fluorescence in situ hybridization (FISH), chromatin immunoprecipitation (ChIP), qPCR, and western blotting, were used to further explore the underlying mechanisms. Results CircPIAS1 expression was elevated in HCC tissues and cells. Silencing circPIAS1 suppressed HCC cell proliferation and migration both in vitro and in vivo. Mechanically, circPIAS1 overexpression inhibited ferroptosis by competitively binding to miR-455-3p, leading to upregulation of Nuclear Protein 1 (NUPR1). Furthermore, NUPR1 promoted FTH1 transcription, enhancing iron storage in HCC cells and conferring resistance to ferroptosis. Treatment with ZZW-115, an NUPR1 inhibitor, reversed the tumor-promoting effects of circPIAS1 and sensitized HCC cells to lenvatinib. Conclusion This study highlights the critical role of circPIAS1 in HCC progression through modulation of ferroptosis. Targeting the circPIAS1/miR-455-3p/NUPR1/FTH1 regulatory axis may represent a promising therapeutic strategy for HCC.