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This study explored the views of 63 Taiwanese pre-service teachers who had participated in a workshop about the value of integrating drama-based approaches in their practical science learning. It was primarily designed to investigate the pedagogical approach of Heathcote and other founders of process drama. In addition, it examined specific claims that it immerses learners in an enjoyable and social learning environment (Poston-Anderson, 2008; Lin, 2017) and that learners can practice core scientific skills such as making predictions, observing, and then validating their predictions (Weisberg et al., 2016). Following the workshop, participants completed an anonymized online questionnaire. Descriptive data analysis indicated that most participants (75%) strongly agreed that integrating drama-based approaches into practical science teaching was satisfying. Of the remainder, 20.7% agreed, 2.1% neither agreed nor disagreed, 2.2% disagreed, and none strongly disagreed with this statement. Moreover, 34.9% of the participants lacked opportunities to experience improvisation and integration of drama-based teaching in practical science. The study indicated that a drama-based approach can be a highly effective strategy for enhancing practical science teaching among pre-service teachers. Furthermore, the findings provide valuable insights into the factors influencing drama-based teaching in practical science. They suggest it could be an excellent strategy to stimulate learners' interest in science and interdisciplinary science-related subjects and improve their science skills. Teachers could thus provide young children with similar drama-based teaching in practical science activities to promote their learning of science. Finally, the study offers a set of important recommendations for future pedagogical policymaking and further research by drama-based practitioners.

The Expert-based Collective Advising Mechanism (ECAM) was embedded in the open online tutoring project to provide free tutoring for rural students and to help them improve their academic performance, and thus, to solve education inequity. Taking urban and rural students in Tongzhou District of Beijing as the objects, this study gathered data on the tutoring frequency, the durations students received tutoring, the number of teachers who tutored the same student, and the students' academic performance. The tutoring behavior and academic performance of rural and urban students were compared. The results showed that the ECAM could improve students' academic performance. Rural and urban students who received tutoring got the same degree of performance appreciation. Finally, gender, school type, and tutoring duration predicted academic performance positively.

Previous studies suggest that child behavior problems were associated with higher levels of parenting stress and depressive symptoms in parents of children with autism spectrum disorder (ASD). Parents' coping strategies have been found to provide potential buffering effects. Thus, this study investigated the mediation effect of coping strategies on the relationships between child behavior problems, parenting stress and depressive symptoms in Taiwanese mothers of children with ASD. Participants were 128 children with ASD (mean age = 32.32 months, SD = 10.43) and their mothers. All mothers completed a battery of questionnaires on parenting stress, depressive symptoms, coping strategies and child behavior problems. Principal components factor analysis identified three coping categories: Problem-focused coping, avoidance coping, and distraction coping. Problem-focused coping was correlated with decreased parenting stress and depressive symptoms, whereas avoidance coping was associated with increased parenting stress and depressive symptoms. In addition, problem-focused coping mediated the relationship between child externalizing behavior problems and parenting stress. In conclusion, problem-focused coping could be an effective strategy to deal with the stress issues on mothers of preschool-age children with ASD, and potentially may decrease the possibilities of negative outcomes.

Objective(s): Ulcerative colitis (UC) is a commonly recurrent inflammatory bowel disease. T helper 17 (Th17)/regulatory T (Treg) cell balance plays an essential role in UC progression. However, it is unknown whether curcumin chitosan microspheres (CCM) regulate the Th17/Treg cell balance.Materials and Methods: The UC mouse model was established by administering 3% dextran sodium sulfate and treated with CCM. The influence of CCM on the Th17/Treg balance was detected using flow cytometry. Cell experiments were conducted to investigate the role and mechanism of IGF2BP1 in Th17/Treg balance.Results: We revealed that CCM demonstrated a significant therapeutic effect on UC. CCM obviously decreased the Th17 cell percentage but boosted the Treg cell percentage in UC mice. CCM remarkably increased the mRNA expression of Foxp3 but suppressed RORγt and interleukin-10 mRNA expression. PCR array of RNA modification-related genes revealed that the m6A binding protein IGF2BP1 was a key molecule in CCM regulation of Th17/Treg balance. IGF2BP1 overexpression dramatically repressed the CCM-induced balance of Th17/Treg cell differentiation. Mechanically, IGF2BP1 targeted LRP5 and regulated LRP5 through m6A modification. Furthermore, the silencing of LRP5 canceled the suppressive effect of IGF2BP1 on Th17/Treg cell percentage.Conclusion: CCM modulated the Th17/Treg balance through IGF2BP1-mediated m6A modification, thereby alleviating UC, and providing new ideas for the treatment of UC.

Abstract Controversy still exists regarding how much the inflow arterial percutaneous transluminal angioplasty (PTA) contributed to maintaining fistula function for hemodialysis. We aimed to analyze patency and risk factors after inflow arterial PTA. Hemodialysis patients with inflow arterial primary stenosis who were admitted to our institution from January 2017 to December 2022 were examined. One group had arterial-venous fistula with inflow artery stenosis alone (AVF + iAS) and another group had AVF with inflow artery stenosis and any vein stenosis (AVF + iAS + VS). The characteristics of patients, stenotic lesions, and PTA procedures were recorded. Kaplan–Meier analysis was used to compare primary patency, assisted primary patency, and secondary patency in the two groups. Cox proportional hazard analysis was used to identify risk factors associated with patency. We examined 213 patients, 53 in the AVF + iAS group (51 radial arterial stenosis and 2 ulnar arterial stenosis) and 160 in the AVF + iAS + VS group (159 radial arterial stenosis and 1 ulnar arterial stenosis). Kaplan–Meier analysis indicated the AVF + iAS group had better primary patency and assisted primary patency (both P

Abstract Background Premature ovarian insufficiency (POI) is a condition characterized by a substantial decline or loss of ovarian function in women before the age of 40. However, the pathogenesis of POI remains to be further elucidated, and specific targeted drugs which could delay or reverse ovarian reserve decline are urgently needed. Abnormal DNA damage repair (DDR) and cell senescence in granulosa cells are pathogenic mechanisms of POI. Ubiquitin-specific protease 14 (USP14) is a key enzyme that regulates the deubiquitylation of DDR-related proteins, but whether USP14 participates in the pathogenesis of POI remains unclear. Methods We measured USP14 mRNA expression in granulosa cells from biochemical POI (bPOI) patients. In KGN cells, we used IU1 and siRNA-USP14 to specifically inhibit USP14 and constructed a cell line stably overexpressing USP14 to examine its effects on DDR function and cellular senescence in granulosa cells. Next, we explored the therapeutic potential of IU1 in POI mouse models induced by D-galactose. Results USP14 expression in the granulosa cells of bPOI patients was significantly upregulated. In KGN cells, IU1 treatment and siUSP14 transfection decreased etoposide-induced DNA damage levels, promoted DDR function, and inhibited cell senescence. USP14 overexpression increased DNA damage, impaired DDR function, and promoted cell senescence. Moreover, IU1 treatment and siUSP14 transfection increased nonhomologous end joining (NHEJ), upregulated RNF168, Ku70, and DDB1, and increased ubiquitinated DDB1 levels in KGN cells. Conversely, USP14 overexpression had the opposite effects. Intraperitoneal IU1 injection alleviated etoposide-induced DNA damage in granulosa cells, ameliorated the D-galactose-induced POI phenotype, promoted DDR, and inhibited cell senescence in ovarian granulosa cells in vivo. Conclusions Upregulated USP14 in ovarian granulosa cells may play a role in POI pathogenesis, and targeting USP14 may be a potential POI treatment strategy. Our study provides new insights into the pathogenesis of POI and a novel POI treatment strategy.

Background: This study aims to determine whether end-stage renal disease (ESRD) is a true contraindication for extracorporeal membrane oxygenation in adult patients. Materials and methods: Adult patients who received VA-ECMO at National Taiwan University Hospital between January 2010 and December 2021 were included. Patients who received regular dialysis before the index admission were included in the ESRD group. The primary outcome was in-hospital mortality. Results: 1341 patients were included in the analysis, 121 of whom had ESRD before index admission. The ESRD group was older (62.3 versus 56.8 years; P

Abstract Type 2 diabetes mellitus (T2DM) is a prevalent health challenge faced by countries worldwide. In this study, we propose a novel large language multimodal models (LLMMs) framework incorporating multimodal data from clinical notes and laboratory results for diabetes risk prediction. We collected five years of electronic health records (EHRs) dating from 2017 to 2021 from a Taiwan hospital database. This dataset included 1,420,596 clinical notes, 387,392 laboratory results, and more than 1505 laboratory test items. Our method combined a text embedding encoder and multi-head attention layer to learn laboratory values, and utilized a deep neural network (DNN) module to merge blood features with chronic disease semantics into a latent space. In our experiments, we observed that integrating clinical notes with predictions based on textual laboratory values significantly enhanced the predictive capability of the unimodal model in the early detection of T2DM. Moreover, we achieved an area greater than 0.70 under the receiver operating characteristic curve (AUC) for new-onset T2DM prediction, demonstrating the effectiveness of leveraging textual laboratory data for training and inference in LLMs and improving the accuracy of new-onset diabetes prediction.

Deep storage tunnels (DSTs) are used in densely urbanized areas to relieve stormwater collection systems, thereby reducing urban floods and runoff pollution, due to their substantial storage capacity. The computation of the hydraulic characteristics and flow trajectories of DSTs under rapid filling scenarios can help to predict sediment deposition and pollutant accumulation associated with the stored runoff, as well as the likelihood of operational problems, such as excessive surging. However, such assessments are complicated by various inflow scenarios encountered in tunnel systems during their operation. In this study, the Suzhou River DST in China is selected as a study case. Particles were tracked, and hydraulic analysis was conducted with scaled model experiments and numerical models. The flow field, particle movement, air‒water phase, and pressure patterns in the DST were simulated under various one- and two-sided inflow scenarios. The results showed that with regards to the design conditions involving two-sided inflows, flow reversals occurred with stepwise increases in the water surface and pressure. In contrast, this phenomenon was not observed under the one-sided inflow scenario. Under the asymmetric two-sided inflow scenarios, water inflows led to particle accumulation near the shaft, reducing the received inflows. However, under the symmetric inflow conditions, particles were concentrated near the middle of the tunnel. Compared to those under the symmetric inflow scenario, asymmetric inflow caused surface wave and entrapped air reductions. This study could provide support for regulation of the inflow of the Suzhou River DST and for prediction of sediment and pollutant accumulation.

Abstract Background Laser acupuncture is a proven non-invasive treatment with effects comparable to traditional acupuncture in different types of headaches, but there is still insufficient evidence for chronic migraine (CM) in adults. We aim to investigate the efficacy and safety of laser acupuncture (LA) as an add-on preventive therapy on CM. Methods A single-blind randomized controlled trial was conducted from January 2022 to November 2023. CM patients with unsatisfactory pharmacological effects were randomly assigned in a 1:1 ratio to receive either LA or sham treatment over a course of 8 sessions spanning 4 weeks. The co-primary outcomes were changes in monthly migraine days (MMD) and acute headache medications usage days per month from baseline. Evaluations were taken at baseline (12 weeks before randomization), at 4th week (treatment completed), 8th week and 12th week from baseline. Results A total of 60 patients (30 in each group) were included in the intention-to-treat analyses. Baseline headache characteristics between trial groups were similar. Compared with the sham group, the LA group had a significant reduction in MMD (5.2 vs. 1.5 days at 8th week, p = 0.015; 7.3 vs. 1.8 days at 12th week, p = 0.001), and acute headache medications usage days per month (3.1 vs. 0.4 days at 4th week, p = 0.007; 3.2 vs. 0.0 days at 8th week, p = 0.005; 3.9 vs. 0.0 days at 12th week, p

Abstract Continued evolution of SARS-CoV-2 generates variants to challenge antibody immunity established by infection and vaccination. A connection between population immunity and genesis of virus variants has long been suggested but its molecular basis remains poorly understood. Here, we identify a class of SARS-CoV-2 neutralizing public antibodies defined by their shared usage of VL6-57 light chains. Although heavy chains of diverse genotypes are utilized, convergent HCDR3 rearrangements have been observed among these public antibodies to cooperate with germline VL6-57 LCDRs to target a convergent epitope defined by RBD residues S371-S373-S375. Antibody repertoire analysis identifies that this class of VL6-57 antibodies is present in SARS-CoV-2-naive individuals and is clonally expanded in most COVID-19 patients. We confirm that Omicron-specific substitutions at S371, S373 and S375 mediate escape of antibodies of the VL6-57 class. These findings support that this class of public antibodies constitutes a potential immune pressure promoting the introduction of S371L/F-S373P-S375F in Omicron variants. The results provide further molecular evidence to support that antigenic evolution of SARS-CoV-2 is driven by antibody mediated population immunity.

Abstract Most cancer cells reprogram their glucose metabolic pathway from oxidative phosphorylation to aerobic glycolysis for energy production. By reducing enzyme activity of pyruvate kinase M2 (PKM2), cancer cells attain a greater fraction of glycolytic metabolites for macromolecule synthesis needed for rapid proliferation. Here we demonstrate that hydrogen sulfide (H2S) destabilizes the PKM2 tetramer into monomer/dimer through sulfhydration at cysteines, notably at C326, leading to reduced PKM2 enzyme activity and increased PKM2-mediated transcriptional activation. Blocking PKM2 sulfhydration at C326 through amino acid mutation stabilizes the PKM2 tetramer and crystal structure further revealing the tetramer organization of PKM2-C326S. The PKM2-C326S mutant in cancer cells rewires glucose metabolism to mitochondrial respiration, significantly inhibiting tumor growth. In this work, we demonstrate that PKM2 sulfhydration by H2S inactivates PKM2 activity to promote tumorigenesis and inhibiting this process could be a potential therapeutic approach for targeting cancer metabolism.

Abstract Background Radiation-induced brain injury (RIBI) is a debilitating sequela after cranial radiotherapy. Research on the topic of RIBI has gradually entered the public eye, with more innovations and applications of evidence-based research and biological mechanism research in the field of that. This was the first bibliometric analysis on RIBI, assessing brain injury related to radiation articles that were published during 1998–2023, to provide an emerging theoretical basis for the future development of RIBI. Methods Literature were obtained from the Web of Science Core Collection (WOSCC) from its inception to December 31, 2023. The column of publications, author details, affiliated institutions and countries, publication year, and keywords were also recorded. Results A total of 2543 journal articles were selected. The annual publications on RIBI fluctuated within a certain range. Journal of Neuro-oncology was the most published journal and Radiation Oncology was the most impactful one. LIMOLI CL was the most prolific author with 37 articles and shared the highest h-index with BARNETT GH. The top one country and institutions were the USA and the University of California System, respectively. Clusters analysis of co-keywords demonstrated that the temporal research trends in this field primarily focused on imaging examination and therapy for RIBI. Conclusion This study collects, visualizes, and analyzes the literature within the field of RIBI over the last 25 years to map the development process, research frontiers and hotspots, and cutting-edge directions in clinical practice and mechanisms related to RIBI.

This study investigated the effects of different thermal sterilization conditions on the structural and functional properties of whey and caseins in goat milk. The commonly used industrial sterilization conditions including 65 ℃ for 30 min, 80 ℃ for 30 s, 95 ℃ for 5 min and 135 ℃ for 4 s were selected to treat goat milk, and whey and casein proteins were separated from the treated milk. Circular dichroism (CD) spectroscopy, Fourier transform infrared (FTIR) spectroscopy, fluorescence spectroscopy, laser confocal scanning microscopy (LCSM) and atomic force microscopy (AFM) were used to analyze the changes in protein structure and properties. The results showed that the structures of whey and casein proteins changed little after treatment at 65 ℃ for 30 min and 80 ℃ for 30 s, and the increase in protein unfolding and surface hydrophobicity resulted in better foaming and emulsifying properties of whey and casein proteins. The treatments at 95 ℃ for 5 min and 135 ℃ for 4 s resulted in a significant decrease in the relative content of α-helix, a significant increase in the relative content of random coil, severe denaturation of the proteins, and a decrease in solubility and surface hydrophobicity, which adversely affected the stability of functional properties of goat milk proteins. The above results provide a reference for optimizing the quality and stability of goat milk products, and help to develop functional goat milk products.

Rice wine is made from rice fermented by Jiuqu. It is very popular among consumers because of its rich nutrient content and unique flavor. Microorganisms from Jiuqu or the environment play an important role in the formation of rice wine flavor. In this article, the diversity and dynamic changes of the microbial community in the brewing process of rice Jiuqu and rice wine are reviewed, the relationship between the microbial community and the formation of the flavor of rice wine is analyzed, and the current status of research on and the application value of functional microorganisms involved in the fermentation of rice wine are summarized. At last, the deficiencies of current studies on rice wine microorganisms and the metabolic mechanism of rice wine flavor are discussed, and an outlook on future research directions is given. This review will provide a theoretical reference for improving the quality of rice wine and promoting the standardized production of rice wine.

Abstract Various stress-releasing phenomena, such as episodic tremor and slip (ETS) and low-frequency earthquakes, occur at the downdip seismogenic zone in southwest Japan. However, it is unclear how much net stress and slip deficit accumulate at these depths during the interseismic phase. Here, we perform both elastic and viscoelastic earthquake-cycle forward models and reassess the locking state in Nankai from a synthesized perspective with the aid of geodetic modeling results. Our results suggest that the overestimation of the locking depth due to ignoring Earth’s viscoelasticity is much smaller (less than 5 km) in this early interseismic subduction zone compared to that (~ 10 km) of late-interseismic margins. Considering viscoelastic modeling results and other physical arguments, the preferred steady-state viscosities for the continental and oceanic mantle are 5 × 1019 Pa s and 1020 Pa s, respectively. We find a clear trade-off between the full locking depth and the width of the transition zone when explaining both horizontal and vertical geodetic data, demanding other data to further resolve this inherent ambiguity. Unlike in Cascadia, partial megathrust locking in Nankai likely penetrates into the ETS zone, leaving no intervening gap between the shallow megathrust, where hosts large earthquakes, and the ETS zone. Assuming locking extends into the downdip of the ETS zone (i.e., 40 km), we propose a preferred viscoelastic locking model with a full locking depth of 18 km and a broad transition zone spanning a 22-km depth range. In this model, the downdip half portion of the transition zone corresponds to the ETS zone, which can accumulate certain slip deficit in a largely creeping and partially locked state. However, most of the accumulated slip deficit in the ETS zone may be accommodated aseismically simultaneously by stress-releasing phenomena, leaving limited to no budget to release during future megathrust earthquakes. We suggest that precise documentation of total slip during slow slip events, along with refinement of viscoelastic locking models, will provide new insights into the net slip budget available in the ETS zone. This will help assess the potential of future coseismic and/or postseismic slip penetrating into the ETS zone in Nankai, Cascadia and other subduction zones. Graphical Abstract

Abstract This study investigated the association between serum albumin concentration and 12-weeks mortality of HIV/AIDS with late diagnosis in China. This retrospective cohort study included, 1079 inpatients diagnosis with late HIV/AIDS between January 2018 and December 2021. Disease progression was estimated based on the 12-weeks mortality rate. Cox proportional hazards regression models were used to evaluate the relationship between serum albumin levels and disease progression. The effects of serum albumin levels on mortality was estimated via Kaplan–Meier curves. The mortality risk decreased by 7% with every 1 g/L increase in serum albumin after adjustment ([HR] = 0.93, 95% CI: 0.88–0.97). Compared with that of the low (< 28 g/L) serum albumin group, the middle (28–34 g/L) group’s mortality risk decreased by 70% (HR = 0.30, 95% CI: 0.15–0.59), and that of the high (≥ 34 g/L) group decreased by 40% (HR = 0.6, 95% CI: 0.29–1.23) after adjustment. Our findings suggest a positive correlation between the increase in serum albumin levels upon admission and a decrease in mortality at 12 weeks post-discharge among patients with late AIDS/HIV diagnosis. Further research is needed to characterize the role of serum albumin in 12-weeks mortality prevention in patients with a late diagnosis.

Objective: Whether pregnancy is associated with severe injuries from motor vehicle crashes (MVCs) remains unclear. This study aimed to investigate the potential relationship between pregnancy and severity of injuries from MVCs. Methods: We identified a total of 23,559 pregnant women victims who encountered MVCs during pregnancy as well as 94,236 age- and calendar year-at MVC matched non-pregnant women victims that are also involved in MVCs. Injury severity was assessed using the Maximum Abbreviated Injury Scale (MAIS) based on the diagnosis of medical claims after MVCs. Multinomial logistic regression models were used to estimate the odds ratio and corresponding 95 % CI of injury severity levels associated with pregnancy. Results: Pregnant women had a significantly higher risk of both severe (adjusted odds ratio, aOR = 1.79, 95 % CI = 1.54–2.08) and mild injuries (aOR = 8.63, 95 % CI = 8.21–9.07) following MVCs as compared to non-pregnant women victims. Particularly, pregnant women who were riding scooters had an increased risk of severe injury (aOR = 4.25, 95 % CI = 3.58–5.04). In addition, pregnant women who experienced MVC but without any injury were more likely to visit a clinic than non-pregnant MVC victims. Conclusion: Pregnant women victims, particularly those who were riding scooters involved in MVCs suffered from a higher risk of severe injury as compared to their non-pregnant counterparts. Our findings suggest that women should consider avoiding riding a scooter and must use restrictive devices during pregnancy, which would help reduce the severity of injuries sustained following an MVC.

With the popularity of online one-to-one tutoring, there are emerging concerns about the quality and effectiveness of this kind of tutoring. Although there are some evaluation methods available, they are heavily relied on manual coding by experts, which is too costly. Therefore, using machine learning to predict instruction quality automatically is an effective way to reduce human costs. Three classification methods are analyzed in this article: (1) random forest algorithm with human-engineered descriptive features; (2) long and short-term memory algorithm with acoustic features generated by open speech and music interpretation by large space extraction toolkit; and (3) convolutional neural network algorithm with Mel spectrogram of the audio. The results show that the three approaches can complete the prediction task well, with the second approach exhibiting the best accuracy. The importance of the features in these classification models is analyzed according to eXplainable Artificial Intelligence techniques (i.e., XAI) and statistical feature analysis methods. In this way, key indicators of high-quality tutoring are identified. This study demonstrated the usefulness of XAI techniques in understanding why some tutoring sessions are of good quality and others are not. The results can be potentially used to guide the improvement of online one-to-one tutoring in the future.

One of the characteristics of individuals on the autism spectrum is the restricted, repetitive patterns of behaviors, interests, or activities which have been considered the result of a direct deficit in self-regulation skills. Peer-mediated intervention (PMI) is one of the ways to support young children on the autism spectrum for following school routines independently. PMI is an evidence-based practice based on behavioral principles to train typical peers to help with students on the autism spectrum. By using PMI, students on the autism spectrum can have more interaction opportunities with typical peers. Students on the autism spectrum can become less dependent on adult support to complete the expectations independently or with peers' support. The aim of this study is to use PMI to support students with autism and ADHD aged 7-8 in a regular classroom to complete the behavioral expectations in Taiwan. This study used a multiple probe design across three participants to determine the effects of the intervention. The researchers trained seven typically developing peers on how to prompt and reinforce the target children. This study took both peers and target children's data. The data shows a positive result for target children to follow the expectations independently and most peer models can prompt and reinforce the target children after being trained. Our study has extended the effectiveness and usage of PMI in teaching behavioral expectations in Taiwan.