Search

The quantification of global turbulence statistical moments generated by grid turbulators is crucial for the enhancement of conjugate heat transfer in industrial thermo-fluid systems. As such, there is a need for precise, low-cost alternatives to numerically model three-dimensional flow dynamics of fractal-generated turbulence (FGT) behind multilength-scale square fractal grids (SFGs), in contrast to previously-reported direct numerical simulations. In this study, a numerical framework consisting of multiple applications of the Reynolds stress model (RSM), each employing its own distinct set of optimized coefficient values, is developed by segregating an FGT flow domain into its production and decay regions with Nelder-Mead optimization on key coefficients then performed independently for each region. The flow fields predicted by such RSM framework achieved overall disparities below 3% and 13% w.r.t. reported experimental measurements of mean velocity and turbulence intensity, respectively, considering the evolution in the flow domain along the streamwise, vertical, and spanwise directions. This is therefore the first documentation of any RANS-turbulence model being validated for mean velocity and turbulence intensity predictions of FGT in all three-dimensions. Thereafter, this proposed RSM framework is generalized to predict industry-relevant turbulence statistical moments of four additional FGT flows. The predicted centerline-statistics are verified against reported experiments, and the findings potentially enable realizations of FGT induced by arbitrary SFGs without relying on a posteriori validation while eliminating further reliance on the Nelder-Mead optimization algorithm on a case-by-case basis. The findings indicate a potential to apply the model coefficients as continuous functions of space to simulate the entire FGT domain. Overall, the accurate and numerically sustainable realizations of FGT in 3D provide valuable insights to engineer potent fluid-solid heat transfer via passive turbulence management within HVAC systems. • RSM framework employing coefficients-optimization at multiple discrete flow regions. • RSM framework presents a 12.4% disparity on fractal-generated turbulence. • Generalized current RSM framework in predicting any SFG-induced turbulence. • Turbulence statistics predicted by generalized RSM validated for 4 distinct SFGs. • First reported RANS-simulation of fractal-generated turbulence validated in 3D. [ABSTRACT FROM AUTHOR]

There is a deterioration in the quality of life (QoL) of survivor victims of warlike conflicts. Because there is a need to guarantee the effectiveness of assessment tools for these populations, we studied the adequacy of the World Health Organization Quality of Life Questionnaire (WHOQoL-BREF) to assess the QoL of 1,136 surviving victims of the armed conflict in Colombia. Although this questionnaire has yielded promising results, questions remain about its psychometric suitability for specific populations. We used model modification at the item level, comparisons of models with different factor structures, and dimensionality analysis to address the psychometric problems encountered. Dimensionality analysis using a bifactor model suggests that WHOQoL-BREF total scores might be a more appropriate way of reporting results when model fit adequacy is not reached. Conclusions are offered on the psychometric properties of the WHOQoL-BREF, the evaluation of special populations, and possible strategies to address future questionnaire modifications. [ABSTRACT FROM AUTHOR]

Introduction: Various techniques and reinforcements have been proposed over the years in order to prevent leaks and bleeding after sleeve gastrectomy (LSG). The aim of this study was to retrospectively compare the staple line complication (SLC) rate in patients who underwent LSG with the use of bioabsorbable membrane (GORE® SEAMGUARD®, GoR) for staple line versus those who received no reinforcement. Methods: Data on all consecutive patients undergoing LSG between 1 January 2014 and 31 December 2018 were retrospectively reviewed. Patients were divided into two groups: the GoR+ group if the SeamGuard (GoR) was used and the GoR− group if no reinforcement was applied on the staple line. Preoperative demographics and rate of SLC were compared between groups. All cases of SLC coming from other centers were also reviewed. Results: A total number of 626 LSGs were performed at our institution during the study period. GoR was applied in 450 (71.9%) cases (GoR+ group), while NR was used in 176 (28.1%) patients (GoR− group). Two (1.13%) cases of leaking and two (1.13%) cases of bleeding occurred in the GoR− group, while no SLC was recorded in patients who received GoR (p < 0.05). Thirteen cases of SLC coming from other institutions were treated at our hospital; all these cases were performed without any SLR. Conclusion: In our case series, the use of GoR reduced the rate of SLC after LSG. In all cases of SLC coming from other institutions, no reinforcement had been applied on the staple line during LSG. [ABSTRACT FROM AUTHOR]

Understanding selectivity trends is a crucial hurdle in the developing innovative catalysts for generating hydrogen peroxide through the two‐electron oxygen reduction reaction (2e‐ORR). The identification of selectivity patterns has been made more accessible through the introduction of a newly developed selectivity descriptor derived from thermodynamics, denoted as ΔΔG introduced in Chem Catal. 2023, 3(3), 100568. To validate the suitability of this parameter as a descriptor for 2e‐ORR selectivity, we utilize an extensive library of 155 binary alloys. We validate that ΔΔG reliably depicts the selectivity trends in binary alloys reported for their high activity in the 2e‐ORR. This analysis also enables the identification of nine selective 2e‐ORR catalysts underscoring the efficacy of ΔΔG as 2e‐ORR selectivity descriptor. This work highlights the significance of concurrently considering both selectivity and activity trends. This holistic approach is crucial for obtaining a comprehensive understanding in the identification of high‐performance catalyst materials for optimal efficiency in various applications. [ABSTRACT FROM AUTHOR]

Understanding selectivity trends is a crucial hurdle in the developing innovative catalysts for generating hydrogen peroxide through the two‐electron oxygen reduction reaction (2e‐ORR). The identification of selectivity patterns has been made more accessible through the introduction of a newly developed selectivity descriptor derived from thermodynamics, denoted as ΔΔG introduced in Chem Catal. 2023, 3(3), 100568. To validate the suitability of this parameter as a descriptor for 2e‐ORR selectivity, we utilize an extensive library of 155 binary alloys. We validate that ΔΔG reliably depicts the selectivity trends in binary alloys reported for their high activity in the 2e‐ORR. This analysis also enables the identification of nine selective 2e‐ORR catalysts underscoring the efficacy of ΔΔG as 2e‐ORR selectivity descriptor. This work highlights the significance of concurrently considering both selectivity and activity trends. This holistic approach is crucial for obtaining a comprehensive understanding in the identification of high‐performance catalyst materials for optimal efficiency in various applications. [ABSTRACT FROM AUTHOR]

Singapore presents a unique case study for multiculturalists in that the state leans heavily in its promotion of racial demarcations whilst simultaneously propagating a narrative of the state "regardless of race, language or religion". This paper argues that this apparent contradiction is a deliberate calculation to use multiculturalism to desecuritise an otherwise disparate multiracial society. Extending He's (2018) sequencing of multicultural progress as an a priori development to desecuritisation, this paper moves past traditionally democratic assumptions to demonstrate how the Singaporean state has in effect desecuritised national minorities through semi-to-autocratic management of multiculturalism. Referring to 'securitised multiculturalism' that has become increasingly evident since the 2000s, the paper progresses to consider how terrorism has affected Singapore's multicultural formulation and examines the state's top-down responses to desecuritise the security element in 'securitised multiculturalism' to the extent that such is possible. [ABSTRACT FROM AUTHOR]

To study the effect of Grade 700 MPa longitudinal rebars and hoops on the deformation capacity of RC and composite columns, eight rectangular columns were tested under cyclic lateral loading and uniform axial compression. The test parameters were the hoop type (rectangular or spiral hoops), hoop spacing, the use of composite steel section, and the shape of cross section (square column or rectangular wall-column section). All columns exhibited ductile behavior after flexural yielding. Compared to rectangular hoops and crossties, spiral hoops significantly enhanced the deformation capacity of RC and composite columns by providing lateral confinement and by restraining local buckling and tensile fractures of longitudinal rebars. On the other hand, the use of embedded steel section had limited effect on the deformation capacity because of the relatively low yield strength of the steel section. In the case of wall-column section, as the section depth increased, the deformation capacity decreased due to the increased shear demand. Existing nonlinear analysis modeling methods were applied to the test specimens. The prediction results underestimated the tested deformation capacity, particularly for columns with spiral hoops. [ABSTRACT FROM AUTHOR]

Formulating goals in therapy may facilitate young people and parents/carers' engagement in mental health support settings. A number of goal taxonomies have been developed, which involve organising goals set at the outset of therapy into themes. Goal taxonomies are considered useful for service planning and outcome purposes. In order to build on the knowledge about what young people choose as goals, and to best support good practice, it is important to explore the links and differences between the existing goal taxonomies. A systematic review was conducted to identify goal taxonomies based on goals set using the goal‐based outcome (GBO) tool. Framework analysis was conducted to investigate the extracted goal taxonomies. Overall, four core concepts were identified: "Goals targeting specific issues, symptoms, emotions, and behaviours," "Return and engage in activities," "Personal growth goals" and "Interpersonal goals." Goals regarding specific issues, personal growth and interpersonal relationships were present in most studies. Using these overarching core concepts could be useful for practitioner‐level, or service‐level organisation of goal data, for activities such as service planning and delivery. [ABSTRACT FROM AUTHOR]

Various substances within the aqueous humor (AH) can directly or indirectly impact intraocular tissues associated with intraocular pressure (IOP), a critical factor in glaucoma development. This study aims to investigate individual changes in these AH substances and the interactions among altered components through a multi‐omics approach. LC/MS analysis was conducted on AH samples from patients with exfoliation syndrome (XFS, n = 5), exfoliation glaucoma (XFG, n = 4), primary open‐angle glaucoma (POAG, n = 11), and cataracts (control group, n = 7). Subsequently, differentially expressed proteins and metabolites among groups, alterations in their network interactions, and their biological functions were examined. Both data‐independent acquisition and data‐dependent acquisition methods were employed to analyze the AH proteome and metabolome, and the results were integrated for a comprehensive analysis. In the proteomics analysis, proteins upregulated in both the XFG and POAG groups were associated with lipid metabolism, complement activation, and extracellular matrix regulation. Metabolomic analysis highlighted significant changes in amino acids related to antioxidant processes in the glaucoma groups. Notably, VTN, APOA1, C6, and L‐phenylalanine exhibited significant alterations in the glaucoma groups. Integration of individual omics analyses demonstrated that substances associated with inflammation and lipid metabolism, altered in the glaucoma groups, showed robust interactions within a complex network involving PLG, APOA1, and L‐phenylalanine or C3, APOD, and L‐valine. These findings offer valuable insights into the molecular mechanisms governing IOP regulation and may contribute to the development of new biomarkers for managing glaucoma. [ABSTRACT FROM AUTHOR]

A growing body of literature has found that sexual orientation and gender impact labor market outcomes, including earnings. This literature generally finds that gay and bisexual men earn less than heterosexual men. Despite being the highest earners among women, lesbians earn less than heterosexual men, and bisexual women earn the least. Far less research has explored intersectional disadvantages/advantages of being a lesbian, gay, or bisexual (LGB) individual and belonging to other minority groups. Using data from the 2013 to 2018 US National Health Interview Survey, this paper explores whether being an LGB racial minority or LGB immigrant results in cumulative earning disadvantages/advantages. This study finds that regardless of race or immigrant status, gay men’s earnings did not statistically differ from white/US-born heterosexual men’s earnings. For white and US-born women, their earnings followed the same pattern, with lesbians earning the most, followed by heterosexual women, then bisexuals; however, for nonwhite women, bisexuals earned the most and lesbians earned the least. The results for immigrant sexual minorities were not statistically significant. These findings suggest that disadvantage/advantage is multilayered—sexual minorities who occupy multiple minority positions may experience different levels of disadvantage/advantage. [ABSTRACT FROM AUTHOR]

Gastric cancer is the fifth most common cancer diagnosis and fourth leading cause of cancer-related death globally. The incidence of gastric cancer in the USA shows significant racial and ethnic disparities with gastric cancer incidence in Korean Americans being over five times higher than in non-Hispanic whites. Since gastric cancer is not common in the USA, there are no current screening guidelines. In countries with higher incidences of gastric cancer, screening guidelines have been implemented for early detection and intervention and this has been associated with a reduction in mortality. Immigrants from high incidence countries develop gastric cancer at lower rates once outside of their country of origin, but continue to be at higher risk for developing gastric cancer. This risk does seem to decrease with subsequent generations. With increasing availability of endoscopy, initiating gastric cancer screening guidelines for high-risk groups can have the potential to improve survival by diagnosing and treating gastric cancer at an earlier stage. This article aims to provide context to gastric cancer epidemiology globally, review risk factors for developing gastric cancer, highlight racial and ethnic disparities in gastric cancer burden in the USA, examine current guidelines that exist in high incidence countries, and suggest future studies examining the efficacy of additional screening in high-risk populations to reduce gastric cancer mortality and disparate burden on ethnic minorities in the USA. [ABSTRACT FROM AUTHOR]

Cancer‐targeting diagnostics should have a sensitive and specific binding affinity. To achieve this, biomarker development is critical. This study aimed to develop and validate a 7‐mer cyclic peptide probe that can target gastric cancer. We developed this probe based on LGR5 (leucine‐rich repeat‐containing G‐protein coupled receptor 5)‐specific targeting, which is a marker for gastric cancer stem cells. An LGR5 targeting peptide sequence that was developed using phage display technology resulted in a cyclic peptide, C‐YLASRVH‐C (named YLA). We conjugated this peptide with fluorescent probes to validate its specific targeting ability for gastric cancer. The fluorescence‐labeled YLA peptide exhibited 3.0‐fold higher fluorescence intensity in a gastric cancer cell line (MKN45) than it did in a normal cell line (CCD841 cells). In contrast, pancreatic and colorectal cancer cells did not show significant fluorescence intensity with the YLA peptide. To verify its tumor‐targeting affinity, we developed a control peptide, C‐YLASAVH‐C (named YLASA) using an ALA scanning experiment. Whole‐body imaging of a gastric cancer xenograft model showed higher fluorescence intensity of tumors in the YLA peptide group than in the control peptide group. Moreover, ex vivo imaging of tumor tissues exhibited 6.8‐fold higher fluorescence intensity in the YLA peptide group compared to that in the YLASA control peptide group. In conclusion, we confirmed that the YLA peptide probe functions as a specific diagnostic probe for gastric cancer. We anticipate that it will play a theranostic role through further development. [ABSTRACT FROM AUTHOR]

Background: The complexity of communication presents challenges for clinical assessment, outcome measurement and intervention for people with acquired brain injury. For the purposes of assessment or treatment, this complexity is usually managed by isolating specific linguistic functions or speech acts from the interactional context. Separating linguistic functions from their interactional context can lead to discourse being viewed as a static entity comprised of discrete features, rather than as a dynamic process of co‐constructing meaning. The ecological validity of discourse assessments which rely on the deconstruction of linguistic functions is unclear. Previous studies have reported assessment tasks that preserve some of the dialogic features of communication, but as yet, these tasks have not been identified as a distinct genre of assessment. We suggest the term 'co‐constructed communication' to describe tasks which are specifically designed to capture the dynamic, jointly produced nature of communication within a replicable assessment task. Aims: To identify and summarize how co‐constructed communication has been assessed with individuals with non‐progressive acquired communication disability regarding task design, measures and psychometric robustness. Methods: A scoping review methodology was used to identity relevant studies. Systematic database searches were conducted on studies published before July 2021. Studies in the yield were assessed against eligibility criteria, with 37 studies identified as eligible for inclusion. Main contribution: This is the first time that co‐constructed communication has been defined as a genre of discourse assessment for stroke and traumatic brain injury populations. Co‐constructed communication has been assessed for 144 individuals with aphasia and 111 with cognitive–communication disability. Five categories of co‐constructed communication tasks were identified, ranging in complexity. Variability exists in how these assessment tasks are labelled and measured. Assessment measures require further psychometric profiling, specifically regarding test–retest reliability and validity. Conclusions: Co‐constructed communication is a discourse genre which offers researchers and clinicians a replicable method to assess language and communication in an experimentally rigorous way, within an ecologically valid context, bridging the gap between experimental and ecological assessment approaches. What this paper adds: What is already known on this subject: Standardized assessments of language skills and monologue offer reliable, replicable ways to measure language. However, isolating language from an interactional context fundamentally changes the behaviour under study. This raises questions about the ecological validity of the measures we routinely use to determine diagnoses, guide treatment planning and measure the success of treatment. What this study adds to the existing knowledge: This review highlights studies that conceptualize, and often quantify, interaction by combining experimental rigour and aspects of everyday dialogue. This is the first time this genre of discourse assessment has been identified. We propose the term 'co‐constructed communication' to describe this genre and provide an operational definition for the term. What are the practical and clinical implications of this study?: Co‐constructed communication assessment tasks require refinement, particularly regarding aspects of psychometric robustness. In the future, these tasks offer pragmatic, meaningful ways to capture the effect and impact of aphasia and cognitive–communication disability within interaction. [ABSTRACT FROM AUTHOR]

Circadian rhythms are daily cycles in physiology that can affect medical interventions. This review considers how these rhythms may relate to solid organ transplantation. It begins by summarizing the mechanism for circadian rhythm generation known as the molecular clock, and basic research connecting the clock to biological activities germane to organ acceptance. Next follows a review of clinical evidence relating time of day to adverse transplantation outcomes. The concluding section discusses knowledge gaps and practical areas where applying circadian biology might improve transplantation success. [ABSTRACT FROM AUTHOR]

Background: Coronavirus Disease 2019 (COVID-19) continues to cause significant hospitalizations and deaths in the United States. Its continued burden and the impact of annually reformulated vaccines remain unclear. Here, we present projections of COVID-19 hospitalizations and deaths in the United States for the next 2 years under 2 plausible assumptions about immune escape (20% per year and 50% per year) and 3 possible CDC recommendations for the use of annually reformulated vaccines (no recommendation, vaccination for those aged 65 years and over, vaccination for all eligible age groups based on FDA approval). Methods and findings: The COVID-19 Scenario Modeling Hub solicited projections of COVID-19 hospitalization and deaths between April 15, 2023 and April 15, 2025 under 6 scenarios representing the intersection of considered levels of immune escape and vaccination. Annually reformulated vaccines are assumed to be 65% effective against symptomatic infection with strains circulating on June 15 of each year and to become available on September 1. Age- and state-specific coverage in recommended groups was assumed to match that seen for the first (fall 2021) COVID-19 booster. State and national projections from 8 modeling teams were ensembled to produce projections for each scenario and expected reductions in disease outcomes due to vaccination over the projection period. From April 15, 2023 to April 15, 2025, COVID-19 is projected to cause annual epidemics peaking November to January. In the most pessimistic scenario (high immune escape, no vaccination recommendation), we project 2.1 million (90% projection interval (PI) [1,438,000, 4,270,000]) hospitalizations and 209,000 (90% PI [139,000, 461,000]) deaths, exceeding pre-pandemic mortality of influenza and pneumonia. In high immune escape scenarios, vaccination of those aged 65+ results in 230,000 (95% confidence interval (CI) [104,000, 355,000]) fewer hospitalizations and 33,000 (95% CI [12,000, 54,000]) fewer deaths, while vaccination of all eligible individuals results in 431,000 (95% CI: 264,000–598,000) fewer hospitalizations and 49,000 (95% CI [29,000, 69,000]) fewer deaths. Conclusions: COVID-19 is projected to be a significant public health threat over the coming 2 years. Broad vaccination has the potential to substantially reduce the burden of this disease, saving tens of thousands of lives each year. Using the Scenario Modeling Hub approach, Jung and colleagues project the potential impact of COVID-19 and assess the extent to which vaccinations may reduce hospitalizations and deaths. Author summary: Why was this study done?: While Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is likely to pose a persistent threat to public health for the foreseeable future, regular revaccination with reformulated vaccines is considered a prominent mitigation tool. Questions exist regarding the effectiveness of annual vaccination campaigns and the optimal target age ranges, given the concentration of severe Coronavirus Disease 2019 (COVID-19) outcomes in older populations. The US COVID-19 Scenario Modeling Hub (SMH) has provided projections on the unfolding of the COVID-19 epidemic under various conditions, summarizing the results of multiple teams working on the same set of scenarios. Informed decisions on future vaccination policy need to be made with well-grounded projections of the likely course of COVID-19 epidemics and its impact under different vaccination scenarios. What did the researchers do and find?: Applying the SMH approach, we projected the potential impact of COVID-19 from April 2023 to April 2025 and assessed the extent to which vaccination can reduce hospitalizations and deaths. Under plausible assumptions about viral evolution and waning immunity, COVID-19 will likely cause annual epidemics peaking in November to January over the two-year projection period. Though significant, hospitalizations and deaths are unlikely to reach levels seen in previous winters. The projected health impacts of COVID-19 are reduced by 10% to 20% through moderate use of reformulated vaccines. What do these findings mean?: COVID-19 is projected to remain a significant public health threat in the coming years, exceeding the pre-pandemic mortality of influenza and pneumonia. Annual vaccination can reduce morbidity, mortality, and strain on health systems. While the projected impact of annual vaccination is significant, it is conditional on scenario assumptions including vaccine coverage and effectiveness. [ABSTRACT FROM AUTHOR]

AbstractBackgroundAimMethodsResultsConclusionProblem-based learning is used widely in pharmacy and medical programmes, incorporating realistic patient scenarios into regular teaching as a way of linking theory to practice. Routine case-based learning lessons ranges from real patient involvement, scripted patient scenarios, digital simulations (avatars) as well as through media such as Zoom. The existing literature has explored the extensive benefits of using patients in clinical education, but fewer studies have directly compared the efficacy of each model as learning tools.To compare student perceptions of patient-based learning models to elicit student empathy, increase engagement, improve knowledge, and enrich learning experience.A questionnaire was distributed to second-year pharmacy students in Swansea University to gather their perceptions on the nine different patient-based learning models in their routine teaching (SUMS RESC 2023-0011). Students were asked to rank their experience of the models explicitly against each other, based on the four pillars of (1) eliciting student empathy, (2) increasing engagement, (3) improving knowledge and (4) enriching the learning experience. Students were also asked to rate the significance of realism (i.e. knowing the patient demographics/having a visual representation of the patient) to their experience.Altogether, 31 student rankings of the nine learning models were weighted (9 = highest rank; 1 = lowest ranked). The data showed clear preferences for real-patient involvement over fictional cases, especially for eliciting empathy. Interestingly, scripted scenarios were rated highly for both engagement and learning experience only when avatars were involved, which suggests a role of animated visual representation of the patient in facilitating these outcomes.Whilst it is useful to have multiple patient-based learning models, this study serves as a guide for educators in preparing case-based learning sessions for achieving the desired outcomes of any of the four pillars above. [ABSTRACT FROM AUTHOR]

Since the emergence of SARS-CoV-2, different variants and subvariants successively emerged to dominate global virus circulation as a result of immune evasion, replication fitness or both. COVID-19 vaccines continue to be updated in response to the emergence of antigenically divergent viruses, the first being the bivalent RNA vaccines that encodes for both the Wuhan-like and Omicron BA.5 subvariant spike proteins. Repeated infections and vaccine breakthrough infections have led to complex immune landscapes in populations making it increasingly difficult to assess the intrinsic neutralizing antibody responses elicited by the vaccines. Hong Kong's intensive COVID-19 containment policy through 2020–2021 permitted us to identify sera from a small number of infection-naïve individuals who received 3 doses of the RNA BNT162b2 vaccine encoding the Wuhan-like spike (WT) and were boosted with a fourth dose of the WT vaccine or the bivalent WT and BA.4/5 spike (WT + BA.4/5). While neutralizing antibody to wild-type virus was comparable in both vaccine groups, BNT162b2 (WT + BA.4/BA.5) bivalent vaccine elicited significantly higher plaque neutralizing antibodies to Omicron subvariants BA.5, XBB.1.5, XBB.1.16, XBB.1.9.1, XBB.2.3.2, EG.5.1, HK.3, BA.2.86 and JN.1, compared to BNT162b2 monovalent vaccine. The single amino acid substitution that differentiates the spike of JN.1 from BA.2.86 resulted in a profound antigenic change. [ABSTRACT FROM AUTHOR]

The association between the gut mycobiome and its potential influence on host metabolism in the Thai Cohort was assessed. Two distinct predominant enterotypes, Saccharomyces (Sa) and Aspergillus/Penicillium (Ap/Pe) showed differences in gut mycobiota diversity and composition. Notably, the Sa enterotype exhibited lower evenness and richness, likely due to the prevalence of Saccharomyces, while both enterotypes displayed unique metabolic behaviors related to nutrient metabolism and body composition. Fiber consumption was positively correlated with adverse body composition and fasting glucose levels in individuals with the Sa enterotype, whereas in the Ap/Pe enterotype it was positively correlated with fat and protein intake. The metabolic functional analysis revealed the Sa enterotype associated with carbohydrate metabolism, while the Ap/Pe enterotype involved in lipid metabolism. Very interestingly, the genes involved in the pentose and glucuronate interconversion pathway, such as polygalacturonase and l-arabinose-isomerase, were enriched in the Sa enterotype signifying a metabolic capacity for complex carbohydrate degradation and utilization of less common sugars as energy sources. These findings highlight the interplay between gut mycobiome composition, dietary habits, and metabolic outcomes within the Thai cohort studies. [ABSTRACT FROM AUTHOR]

Anonymous web-based experiments are increasingly used in many domains of behavioral research. However, online studies of auditory perception, especially of psychoacoustic phenomena pertaining to low-level sensory processing, are challenging because of limited available control of the acoustics, and the inability to perform audiometry to confirm normal-hearing status of participants. Here, we outline our approach to mitigate these challenges and validate our procedures by comparing web-based measurements to lab-based data on a range of classic psychoacoustic tasks. Individual tasks were created using jsPsych, an open-source JavaScript front-end library. Dynamic sequences of psychoacoustic tasks were implemented using Django, an open-source library for web applications, and combined with consent pages, questionnaires, and debriefing pages. Subjects were recruited via Prolific, a subject recruitment platform for web-based studies. Guided by a meta-analysis of lab-based data, we developed and validated a screening procedure to select participants for (putative) normal-hearing status based on their responses in a suprathreshold task and a survey. Headphone use was standardized by supplementing procedures from prior literature with a binaural hearing task. Individuals meeting all criteria were re-invited to complete a range of classic psychoacoustic tasks. For the re-invited participants, absolute thresholds were in excellent agreement with lab-based data for fundamental frequency discrimination, gap detection, and sensitivity to interaural time delay and level difference. Furthermore, word identification scores, consonant confusion patterns, and co-modulation masking release effect also matched lab-based studies. Our results suggest that web-based psychoacoustics is a viable complement to lab-based research. Source code for our infrastructure is provided. [ABSTRACT FROM AUTHOR]

Managed aquifer recharge has become a standard water resources management practice to promote the development of locally sustainable water supplies and combat water scarcity. However, installation of injection wells for replenishment purposes in urban areas with complex hydrogeology faces many challenges, such as limited land availability, potential impacts on municipal production wells and known subsurface contamination plumes, and complex spatially variable hydraulic connections between aquifer units. To assess the feasibility and cost‐effectiveness of injecting advanced treated water (ATW) into a complex urban aquifer system, a Simulation‐Optimization (SO) model was developed to automate a systematic search for the most cost‐effective locations to install new wells for injecting various quantities of ATW, if feasible. The generalized workflow presented here uses an existing MODFLOW groundwater model—along with advanced optimization routines that are publicly available—to flexibly accommodate a multiobjective function, complex constraints, and specific project requirements. The model successfully placed wells for injection of 1 to 4 MGD of ATW in aquifers underlying the study area. The injection well placement was primarily constrained by avoiding excessive impact on environmental sites with underlying groundwater plumes. The largest costs were for well installation and piping to the wells from the existing ATW pipes. This workflow is readily adaptable to other sites with different complexities, decision variables, or constraints. [ABSTRACT FROM AUTHOR]

Optimal management of placenta accreta spectrum (PAS) requires antenatal diagnosis. We sought to evaluate the sensitivity of ultrasound findings suggestive of PAS in detecting posterior PAS. Cohort study of patients with posterior placentation and pathology-confirmed PAS from 2011 to 2020 at a tertiary center. Patients were excluded if ultrasound images were unavailable. Ultrasounds were reviewed for presence of lacunae, hypervascularity, myometrial thinning, loss of the hypoechoic zone, bridging vessels, abnormal uterine serosa–bladder interface, placental bulge, placental extension into/beyond the myometrium, and an exophytic mass. Risk factors, postpartum outcomes, and ultrasound findings were compared by antepartum suspicion for PAS. Sensitivity was calculated for each ultrasound finding. Thirty-three patients were included. PAS was not suspected antenatally in 70 % (23/33). Patients with unsuspected PAS were more likely to be non-Hispanic, have in vitro fertilization, no prior Cesarean deliveries, no placenta previa, and delivered later in gestation. Depth of invasion and estimated blood loss were less for unsuspected PAS, but there was no difference in hysterectomy between groups. Ultrasound findings were less frequently seen in those who were not suspected antenatally: lacunae 17.4 vs. 100 % (p<0.001), hypervascularity 8.7 vs. 80 % (p<0.001), myometrial thinning 4.4 vs. 70 % (p<0.001), and placental bridging vessels 0 vs. 60 % (p<0.001). There was poor sensitivity (0–42.4 %) for all findings. Posterior PAS is less likely to be detected antenatally due to a lower sensitivity of typical ultrasound findings in the setting of a posterior placenta. Further studies are needed to better identify reliable markers of posterior PAS. [ABSTRACT FROM AUTHOR]

In the last few years, international student mobility has been disrupted not only by the global health crisis resulting from the outbreak of the COVID‐19 pandemic but also adversely affected by the rise of geopolitics. The worsening relationship between China and its western counterparts led by the United States and its allies has significantly influenced students' motivation and plan for overseas education. Based upon interviews with 75 students from leading universities in mainland China, this article examines how Chinese elite students evaluate the impact of the new geopolitics on their overseas study plans and opportunities. The study found that, due to the influence of scientific internationalism ideas and institutional habitus, interviewees underestimated the impact of geopolitical factors. Furthermore, unpleasant environmental factors (such as racial discrimination) caused by geopolitical changes are tolerable because most of the interviewees plan to return China after studying abroad. On the other hand, deterioration of Sino‐US relations has substantially affected Chinese students' international mobility. Many interviewees, especially those majoring in science and engineering, were unable to obtain visas. Some of them gave up their study abroad plans, while others transferred to other study abroad destination countries such as the United Kingdom and Singapore. We also find that the perception of the power shift in the field of higher education shapes the students' decision making. This article critically reflects upon the international student mobility from the broader political economy perspective, discussing policy implications for future international education. [ABSTRACT FROM AUTHOR]

A synbiotic is a combination of live microorganisms and specific substrates that are selectively utilized by host microorganisms, resulting in health benefits for the host. Previous studies have demonstrated the protective effects of L. reuteri KUB-AC5 against Salmonella infection in chicken and mouse models. The probiotic activity of L. reuteri KUB-AC5 in these hosts was influenced by nutritional supplements. Water-based plants contain significant amounts of carbohydrates, particularly dietary fiber and proteins, making them potential prebiotic substrates. In this study, four water-based plants (Ulva rigida, Caulerpa lentillifera, Wolffia globosa, and Gracillaria fisheri) were screened for their ability to support the growth of L. reuteri KUB-AC5. Under monoculture testing, U. rigida exhibited the highest capacity to support the growth of L. reuteri KUB-AC5 and the production of organic acids, including acetic acid, lactic acid, and propionic acid (p ≤ 0.05). In co-culture experiments, the synbiotic combination of U. rigida and L. reuteri KUB-AC5 demonstrated the potential to eliminate Salmonella Typhimurium DMST 48437 when inoculated at 104 CFU/mL within 9 h. The synbiotic activities of U. rigida and L. reuteri KUB-AC5 were further investigated using an in vitro human gut model. Compared to the probiotic treatment, the synbiotic combination of L. reuteri KUB-AC5 and U. rigida showed significantly higher levels of L. reuteri KUB-AC5 (5.1 log copies/mL) and a reduction of S. Typhimurium by 0.8 log (CFU/ml) after 24 h (p ≤ 0.05). Synbiotic treatment also significantly promoted the production of short-chain fatty acids (SCFAs), including butyric acid, propionic acid, and acetic acid, compared to prebiotic and probiotic treatments alone (p ≤ 0.05). Furthermore, the synbiotic formulation modulated the in vitro simulated gut microbiome, enhancing putatively beneficial gut microbes, including lactobacilli, Faecalibacterium, and Blautia. Our findings demonstrated that L. reuteri KUB-AC5, in combination with U. rigida, exhibited synergistic activity, as indicated by increased viability, higher anti-pathogenicity toward Salmonella, and the ability to modulate the gut microbiome. [ABSTRACT FROM AUTHOR]

The dissolution of chitosan is a tedious and time-consuming process. Herein, we select the best Ionic Liquids (ILs) for chitosan dissolution through the application of Conductor-like Screening Model for Real Solvents (COSMO-RS), which allowed the screening of 640 ILs based on 32 cations based on amino acids, imidazolium, pyridinium, and pyrrolidinium, and 20 selected anions such as [C2H3O2], [Cl], [NO3], [BF4], and others. Thermodynamic properties such as logarithmic activity coefficient at infinite dilution (ln γ) and excess enthalpy (HE) were used to evaluate the dissolution potential of ILs towards chitosan, whereby low values of ln γ and HE indicated better engagement between the solute and the solvent, thus resulting in a higher solute being dissolved. A preliminary screening of chitosan dissolution was carried out in all 5 synthesized ILs to validate the results obtained by COSMO-RS. It was observed that ILs with [BF4−] as the anion and cations such as [Ser], [Gly], [Phe], [Cys], and [Asn] have the lowest ln γ values, hence better interaction with chitosan. The values of HE indicated that the molecular interactions between chitosan and ILs were governed by hydrogen bonding (ranging from 37 to 50%), followed by misfit interactions (ranging from 21 to 31%) and van der Waals forces (ranging from 22 to 32%) due to the abundance of hydroxyl (–OH) groups present in the intermolecular and intramolecular chitosan structures. These proved the great ability of COSMO-RS to accurately predict the dissolution of chitosan in ILs. [ABSTRACT FROM AUTHOR]

American College of Cardiology/American Heart Association guidelines recommend distinct risk classification systems for primary and secondary cardiovascular disease prevention. However, both systems rely on similar predictors (eg, age and diabetes), indicating the possibility of a universal risk prediction approach for major adverse cardiovascular events (MACEs). The authors examined the performance of predictors in persons with and without atherosclerotic cardiovascular disease (ASCVD) and developed and validated a universal risk prediction model. Among 9,138 ARIC (Atherosclerosis Risk In Communities) participants with (n = 609) and without (n = 8,529) ASCVD at baseline (1996-1998), we examined established predictors in the risk classification systems and other predictors, such as body mass index and cardiac biomarkers (troponin and natriuretic peptide), using Cox models with MACEs (myocardial infarction, stroke, and heart failure). We also evaluated model performance. Over a follow-up of approximately 20 years, there were 3,209 MACEs (2,797 for no prior ASCVD). Most predictors showed similar associations with MACE regardless of baseline ASCVD status. A universal risk prediction model with the predictors (eg, established predictors, cardiac biomarkers) identified by least absolute shrinkage and selection operator regression and bootstrapping showed good discrimination for both groups (c-statistics of 0.747 and 0.691, respectively), and risk classification and showed excellent calibration, irrespective of ASCVD status. This universal prediction approach identified individuals without ASCVD who had a higher risk than some individuals with ASCVD and was validated externally in 5,322 participants in the MESA (Multi-Ethnic Study of Atherosclerosis). A universal risk prediction approach performed well in persons with and without ASCVD. This approach could facilitate the transition from primary to secondary prevention by streamlining risk classification and discussion between clinicians and patients. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives To compare the incidence of major adverse cardiovascular events (MACEs), cancer and infective complications in RA patients using Janus kinase (JAKis) and TNF (TNFis) inhibitors. Method A retrospective analysis of data from the Hong Kong Biologics Registry 2008–2021 was performed. RA patients who had ever used JAKis or TNFis were included. The incidence of MACEs, cancer and infections were compared between the two groups, with adjustment for confounding factors. Results A total of 2471 courses of JAKis (n  = 551) and TNFis (n  = 1920) were used in 1732 RA patients (83.7% women, age 53.8 [12.5] years; follow-up 6431 patient-years). JAKi users had significantly older age, more atherosclerotic risk factors and higher frequency of past malignancies. A total of 15 and 40 MACEs developed in the JAKi and TNFi users, respectively (incidence 1.34 vs 0.75 per 100 patient-years; P  = 0.22). There was no significant difference in the incidence of cancers between the two groups (0.81 [JAKi] vs 0.85 [TNFi] per 100 patient-years; P  = 0.25). The adjusted hazard ratios of MACE and cancer in the JAKi users were 1.36 (95% CI: 0.62, 2.96) (P  = 0.44) and 0.87 (95% CI: 0.39, 1.95) (P  = 0.74), respectively. Rates of infections were significantly higher in the JAKi than TNFi users (16.3 vs 9.9 per 100 patient-years; P  = 0.02), particularly herpes zoster (3.49 vs 0.94 per 100 patient-years; P  < 0.001). Conclusions In a real-life setting, there is no increase in MACEs or cancers in users of JAKis compared with TNFis. However, the incidence of non-serious infections, including herpes zoster, was increased in users of JAKis. [ABSTRACT FROM AUTHOR]

This article proposes an identification method of continuous-time fractional-order Hammerstein model using smoothed functional algorithm with a norm-limited update vector (NL-SFA). In particular, the standard smoothed functional algorithm (SFA) based method is modified by implementing a limit function in the update vector of the standard SFA based method to solve the issue of high tendency of divergence during the identification process. As a result of this, the proposed NL-SFA based method is applied to identify the variables of the linear and non-linear subsystems in the Hammerstein model. While most of the actual linear subsystems can be naturally expressed in a continuous-time domain, the implementation of the fractional-order could also reduce the computational complexity in finding a more accurate reduced-order model. Moreover, three experiments of the Hammerstein model identification based on a numerical example, an actual twin-rotor system, and an actual flexible manipulator system were carried out in this study to verify the effectiveness of the proposed NL-SFA-based method. The numerical and experimental results were analyzed to correspond to the measurement of the objective function and variable identification error and time-domain and frequency-domain responses. Conclusively, the proposed NL-SFA-based method can provide stable convergence and significantly better accuracy of the Hammerstein model in the numerical example, the actual twin-rotor system, and the flexible manipulator system compared to the standard SFA. Moreover, the proposed NL-SFA also provides slightly competitive identification accuracy with the existing norm-limited simultaneous perturbation stochastic approximation (NL-SPSA) and the average multi-verse optimizer sine cosine algorithm (AMVO-SCA) based methods. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the impact of pharmacist's intervention on annual comprehensive medication review (Annual CMR) for Medicare Part D beneficiaries. Background: To develop a new approach to assess Medicare Part D Annual CMR using a technological tool. Methods: One hundred sixty-three (163) eligible Medicare Part D beneficiaries were enrolled. By using an Electronic Health Record (EHR) Program, the pharmacist was able to assess laboratory, pharmacy, diagnosis, and patient information. A post-medication review summary was provided to the medical providers and patients which included a medication action plan. At the end of 3 months, 6 months and 12 months after the medication review, data were collected, assessed and compared. Results: The study showed that pharmacist's interventions were recommended to seventy-four (74) enrollees which comprised of 45% of the total enrollees. It showed that at 3-month, 6-month, and 12-month intervals after the medication review, the recommended interventions acknowledged and implemented by the medical providers were 20%, 51% and 64% respectively, which showed a significant difference over a 12-month period (P -value <.05). Different types of pharmacist's interventions that were recommended may include to initiate, to adjust and to discontinue medication. The most common disease states that required interventions were psychiatric disorder, cardiovascular disease, pulmonary disease, gastrointestinal disease, diabetes, dyslipidemia and pain. Conclusion: The finding of this study revealed that such a web-based EHR system was a very meaningful and effective tool in assisting pharmacists to assess the proper and safe use of medication in elderly patients. [ABSTRACT FROM AUTHOR]

Global university rankings have reshaped the landscape of higher education (HE) across various parts of the globe. The intensified competition stirred by these rankings has significantly affected academic lifestyles. The quest for global university rankings has also inevitably increased the degree of homogenisation amongst universities. Given the negative impact of global university rankings on university development, these rankings have been criticised as game playing, whilst some countries and institutions are beginning to withdraw themselves from the competition. This article sets out against the above context to review Chinese government's response to the challenges and its policy changes. Findings suggest policy responses occur very differently in different areas. Instead of simply following the rules and criteria set by global university rankings, China is trying to set its own criteria. This article contributes to the theoretical and practical understanding of China's responses to the global rankings. [ABSTRACT FROM AUTHOR]

The immune system is built to counteract unpredictable threats, yet it relies on predictable cycles of activity to function properly. Daily rhythms in immune function are an expanding area of study, and many originate from a genetically based timekeeping mechanism known as the circadian clock. The challenge is how to harness these biological rhythms to improve medical interventions. Here, we review recent literature documenting how circadian clocks organize fundamental innate and adaptive immune activities, the immunologic consequences of circadian rhythm and sleep disruption, and persisting knowledge gaps in the field. We then consider the evidence linking circadian rhythms to vaccination, an important clinical realization of immune function. Finally, we discuss practical steps to translate circadian immunity to the patient's bedside. [ABSTRACT FROM AUTHOR]

Human parsing is very important in a diverse range of industrial applications. Despite the considerable progress that has been achieved, the performance of existing methods is still less than satisfactory, since these methods learn the shared features of various parsing labels at the image level. This limits the representativeness of the learnt features, especially when the distribution of parsing labels is imbalanced or the scale of different labels is substantially different. To address this limitation, a Region‐level Parsing Refiner (RPR) is proposed to enhance parsing performance by the introduction of region‐level parsing learning. Region‐level parsing focuses specifically on small regions of the body, for example, the head. The proposed RPR is an adaptive module that can be integrated with different existing human parsing models to improve their performance. Extensive experiments are conducted on two benchmark datasets, and the results demonstrated the effectiveness of our RPR model in terms of improving the overall parsing performance as well as parsing rare labels. This method was successfully applied to a commercial application for the extraction of human body measurements and has been used in various online shopping platforms for clothing size recommendations. The code and dataset are released at this link https://github.com/applezhouyp/PRP. [ABSTRACT FROM AUTHOR]

We tested seroprevalence of open reading frame 8 antigens to infer the number of unrecognized SARS-CoV-2 Omicron infections in Hong Kong during 2022. We estimate 33.6% of the population was infected, 72.1% asymptomatically. Surveillance and control activities during large-scale outbreaks should account for potentially substantial undercounts. [ABSTRACT FROM AUTHOR]

Sarcoscypha (Sarcoscyphaceae, Pezizales) is a saprobic fungus characterized by the cup or disc-shaped blight red apothecium and oblong to ellipsoid ascospores. The 18 species of Sarcoscypha were known to occur in Europe, North America, and tropical Asia. However, up to date, only two Sarcoscypha species have been reported in Korea. In this study, novel Sarcoscypha specimens were collected from Juwangsan, Odaesan, and Taebaeksan National Parks from September to October in Korea. This species is well distinguished from other Sarcoscypha species according to the molecular and phylogenetic analysis based on internal transcribed spacer (ITS) region. Here, we provided detailed descriptions with illustrations and a phylogenetic tree to report our specimens as novel Sarcoscypha species. [ABSTRACT FROM AUTHOR]

This article discusses the use of hydroxychloroquine (HCQ) in the treatment of systemic lupus erythematosus (SLE). HCQ has been shown to have multiple benefits in reducing SLE activity, preventing flares, and reducing the severity of lupus nephritis. However, non-adherence to HCQ is a major concern for patients, with up to 83% of SLE patients reporting intermittent or persistent non-adherence. Studies have shown that low HCQ levels are associated with higher disease activity and increased risk of flares. On the other hand, higher HCQ levels have been associated with toxicities such as skin hyperpigmentation and retinopathy. The article suggests that routine measurement of HCQ levels may help identify non-adherence and stratify patients at risk of toxicities. Better communication, patient education, reminders, and regular surveillance of drug adherence may help improve adherence and treatment outcomes. [Extracted from the article]

Background: The rate of geriatric hip fracture in Hong Kong is increasing steadily and associated mortality in fragility fracture is high. Moreover, fragility fracture patients increase the pressure on hospital bed demand. Hence, this study aims to develop a predictive model on the length of hospital stay (LOS) of geriatric fragility fracture patients using machine learning (ML) techniques. Methods: In this study, we use the basic information, such as gender, age, residence type, etc., and medical parameters of patients, such as the modified functional ambulation classification score (MFAC), elderly mobility scale (EMS), modified Barthel index (MBI) etc, to predict whether the length of stay would exceed 21 days or not. Results: Our results are promising despite the relatively small sample size of 8000 data. We develop various models with three approaches, namely (1) regularizing gradient boosting frameworks, (2) custom-built artificial neural network and (3) Google's Wide & Deep Learning technique. Our best results resulted from our Wide & Deep model with an accuracy of 0.79, with a precision of 0.73, with an area under the receiver operating characteristic curve (AUC-ROC) of 0.84. Feature importance analysis indicates (1) the type of hospital the patient is admitted to, (2) the mental state of the patient and (3) the length of stay at the acute hospital all have a relatively strong impact on the length of stay at palliative care. Conclusions: Applying ML techniques to improve the quality and efficiency in the healthcare sector is becoming popular in Hong Kong and around the globe, but there has not yet been research related to fragility fracture. The integration of machine learning may be useful for health-care professionals to better identify fragility fracture patients at risk of prolonged hospital stays. These findings underline the usefulness of machine learning techniques in optimizing resource allocation by identifying high risk individuals and providing appropriate management to improve treatment outcome. [ABSTRACT FROM AUTHOR]

Metabolic disorders are characterized by an imbalance in muscle fiber composition, and a potential therapeutic approach involves increasing the proportion of oxidative muscle fibers. Prokineticin receptor 1 (PROKR1) is a G protein-coupled receptor that plays a role in various metabolic functions, but its specific involvement in oxidative fiber specification is not fully understood. Here, we investigated the functions of PROKR1 in muscle development to address metabolic disorders and muscular diseases. A meta-analysis revealed that the activation of PROKR1 upregulated exercise-responsive genes, particularly nuclear receptor subfamily 4 group A member 2 (NR4A2). Further investigations using ChIP-PCR, luciferase assays, and pharmacological interventions demonstrated that PROKR1 signaling enhanced NR4A2 expression by Gs-mediated phosphorylation of cyclic adenosine monophosphate (cAMP) response element-binding protein (CREB) in both mouse and human myotubes. Genetic and pharmacological interventions showed that the PROKR1-NR4A2 axis promotes the specification of oxidative muscle fibers in both myocytes by promoting mitochondrial biogenesis and metabolic function. Prokr1-deficient mice displayed unfavorable metabolic phenotypes, such as lower lean mass, enlarged muscle fibers, impaired glucose, and insulin tolerance. These mice also exhibited reduced energy expenditure and exercise performance. The deletion of Prokr1 resulted in decreased oxidative muscle fiber composition and reduced activity in the Prokr1-CREB-Nr4a2 pathway, which were restored by AAV-mediated Prokr1 rescue. In summary, our findings highlight the activation of the PROKR1- CREB-NR4A2 axis as a mechanism for increasing the oxidative muscle fiber composition, which positively impacts overall metabolic function. This study lays an important scientific foundation for the development of effective muscular-metabolic therapeutics with unique mechanisms of action. [ABSTRACT FROM AUTHOR]

Aims: Evidence is lacking on whether diabetes duration is associated with type 1 diabetes (T1D) self‐management during late adolescence before transfer from paediatric to adult care. We examined associations of diabetes duration with dimensions of perceived comfort with diabetes self‐management (self‐efficacy, transition readiness, diabetes distress) and glycaemic control in late adolescence. Methods: Using a cross‐sectional design, we conducted a secondary analysis of baseline data of adolescents (ages 16–17 years) with T1D followed at paediatric diabetes academic hospitals in Montreal and enrolled in the Group Education Trial to Improve Transition (GET‐IT‐T1D). Participants completed validated questionnaires on self‐efficacy (Self‐Efficacy for Diabetes Self‐Management Measure [SEDM], score 1 to 10), diabetes distress and transition readiness, as well as a haemoglobin (HbA1c) capillary blood test. Our primary outcome was self‐efficacy. We examined associations of diabetes duration with self‐efficacy, diabetes distress, transition readiness and HbA1c using linear and logistic regression models adjusted for sex, socioeconomic status, insulin pump use, glucose sensor use and psychiatric comorbidity. Results: Of 203 adolescents with T1D, mean diabetes duration (SD) was 7.57 (4.44) years. Mean SEDM score was 6.83 (SD 1.62). Diabetes duration was not associated with self‐efficacy, diabetes distress or transition readiness. Each additional year of diabetes duration was associated with 0.11% (95% CI, 0.05 to 0.16) higher HbA1c. Conclusions: Although diabetes duration is not associated with dimensions of perceived comfort with diabetes self‐management, adolescents with longer diabetes duration are at risk for higher HbA1c and may need additional support to improve glycaemic control before transition to adult care. [ABSTRACT FROM AUTHOR]

Aims: In type 1 diabetes (T1D), psychosocial factors may impact quality of life (QOL) and clinical outcomes, but remain understudied, particularly during late adolescence. Our aim was to determine whether stigma, diabetes distress and self‐efficacy are associated with QOL in adolescents with T1D as they are preparing to transition to adult care. Methods: We conducted a cross‐sectional study of adolescents (ages 16–17 years) with T1D participating in the Group Education Trial to Improve Transition (GET‐IT) in Montreal, Canada. Participants completed validated questionnaires on stigma using the Barriers to Diabetes Adherence (BDA) stigma subscale, self‐efficacy (Self‐Efficacy for Diabetes Self‐Management Measure [SEDM], score 1–10), diabetes distress (Diabetes Distress Scale for Adults with type 1 diabetes) and QOL (Pediatric Quality of Life Inventory [PedsQL] 4.0 Generic Core Scale and PedsQL 3.2 Diabetes Module). We examined associations of stigma, diabetes distress and self‐efficacy with QOL using multivariate linear regression models adjusted for sex, diabetes duration, socioeconomic status and HbA1c. Results: Of 128 adolescents with T1D, 76 (59%) self‐reported having the diabetes‐related stigma and 29 (22.7%) reported experiencing diabetes distress. Those with stigma had lower diabetes‐specific and general QOL scores compared with those without stigma, and stigma and diabetes distress were both associated with lower diabetes‐specific QOL and lower general QOL. Self‐efficacy was associated with higher diabetes‐specific and general QOL. Conclusions: Stigma and diabetes distress are associated with lower QOL, whereas self‐efficacy is associated with higher QOL in adolescents with T1D preparing to transfer to adult care. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a prevalent inflammatory skin disease characterized by epidermal barrier dysfunction and Th2-skewed inflammation. Campanula takesimana (C. takesimana), a Korean endemic plant grown on Ulleng Island, has long been associated with a traditional alternative medicine for asthma, tonsillitis, and sore throat. In this study, we reported the effect of C. takesimana callus extract on upregulating epidermal barrier-related proteins dysregulated by Th2 cytokines. C. takesimana callus extract induced the expression of skin barrier proteins, such as filaggrin, claudin-1, and zonula occludens-1, in both human primary keratinocytes and Th2-induced AD-like skin-equivalent models. Additionally, RNA sequencing analysis demonstrated that C. takesimana callus extract partially restored Th2 cytokine-induced dysregulation of the epidermal development and lipid metabolic pathways. Considering the advantages of callus as a sustainable eco-friendly source of bioactive substances, and its effect on skin barrier proteins and lipid metabolic pathways, C. takesimana callus extracts can possibly be utilized to improve the integrity of the skin barrier. [ABSTRACT FROM AUTHOR]

This study aimed to gather a homogeneous sample of adolescent patients to analyze the differences in functional connectivity and brain network parameters between suicidal and non-suicidal major depressive disorder (MDD) patients using a data-driven whole-brain approach. Patients recruited at the psychiatry department of Korea University Guro Hospital from November 2014 to March 2020 were diagnosed with MDD, were 13–18 years old, had IQ scores >80, had no family history of psychotic or personality disorders, had no smoking or alcohol consumption history, and were drug-naïve to psychotropic medication. Depressive symptoms were assessed using the Hamilton Depression Rating Scale and the Children's Depression Inventory. Structural and functional MRI scans were conducted and analyzed using the CONN toolbox. Of 74 enrolled patients, 62 were analyzed. Regions of interest (ROIs) showing higher betweenness centrality in non-suicidal patients were the left superior temporal gyrus and left supramarginal gyrus. ROIs showing higher betweenness centrality in suicidal patients were the right hippocampus, left intracalcarine cortex, right inferior temporal gyrus, and the lateral visual network. Suicidal patients also showed different resting state functional connectivity profiles from non-suicidal patients. Small sample size. Suicidal patients may overthink and overvalue future risks while having a more negatively biased autobiographical memory. Social cognition and the ability to overcome egocentricity bias seem to weaken. Such features can disrupt cognitive recovery and resilience, leading to more suicidal behaviors. Therefore, increased suicidality is not acquired, but is an innate trait. • Adolescent drug-naïve major depressive disorder patients with/without suicidal behavior were analyzed. • Patients with suicidal behavior showed different network properties compared to non-suicidal patients. • Suicidal patients are associated with certain cognitive weaknesses that could be more innate than acquired. [ABSTRACT FROM AUTHOR]

With advancements in technology, digital humans are becoming increasingly sophisticated, with their application scope widening to include interactions with real people. However, research on expressions that facilitate natural engagement in interactions between real people and digital humans is scarce. With this study, we aimed to examine the differences in user engagement as measured by subjective evaluations, eye tracking, and electroencephalogram (EEG) responses relative to different gaze expressions in various conversational contexts. Conversational situations were categorized as face-to-face, face-to-video, and digital human interactions, with gaze expressions segmented into eye contact and gaze avoidance. Story stimuli incorporating twelve sentences verified to elicit positive and negative emotional responses were employed in the experiments after validation. A total of 45 participants (31 females and 14 males) underwent stimulation through positive and negative stories while exhibiting eye contact or gaze avoidance under each of the three conversational conditions. Engagement was assessed using subjective evaluation metrics in conjunction with measures of the subjects' gaze and brainwave activity. The findings revealed engagement disparities between the face-to-face and digital-human conversation conditions. Notably, only positive stimuli elicited variations in engagement based on gaze expression across different conversation conditions. Gaze analysis corroborated the engagement differences, aligning with prior research on social sensitivity, but only in response to positive stimuli. This research departs from traditional studies of un-natural interactions with digital humans, focusing instead on interactions with digital humans designed to mimic the appearance of real humans. This study demonstrates the potential for gaze expression to induce engagement, regardless of the human or digital nature of the conversational dyads. [ABSTRACT FROM AUTHOR]

The electro-hydraulic actuator (EHA) system applied in rear axle steering (RAS) is used to steer the rear auxiliary wheels of large commercial vehicles and prevent oversteering. For safety reasons, commercial vehicles reduce the steering angle as the load applied to the rear wheels increases or the speed of the vehicle increases. In this study, we present a well-composed model based design (MBD) of an RAS system employing EHA used in large commercial vehicles. In order to apply loads to the rear of the vehicle to validate the legitimacy of the modeling and to replace the actual model's experiments with the simulations, the rotational speed of the motor obtained in the experiment was input to the motor of the simulation model. The organized formulas of the steering angle based on the structural form were defined to compare the steering angle against both the cylinder displacement of the actual model and the simulated model. We also applied load working on the steering wheel to check the angle difference according to the weight. The organized formulas were applied in the MBD system to compare the results of simulation modeling with the actual experimental values to confirm the modeling's validity. [ABSTRACT FROM AUTHOR]

Purpose: To examine the clinical outcomes in chronic or recurrent anterior uveitis in the presence or absence of cytomegalovirus (CMV) and investigate the predictive factors for uveitic activity and recurrence. Methods: Polymerase chain reaction (PCR) was performed in a prospective cohort of immunocompetent adults with recurrent or chronic anterior uveitis to detect CMV in aqueous humor. The clinical outcomes were compared between eyes with and without CMV DNA. Logistic regression was performed to evaluate associations between iris depigmentation, CMV-PCR status, uveitic activity, and recurrence. Results: Thirty-eight eyes of 38 subjects with a mean age of 61.1 ± 11.2 years old were analyzed. Fifteen eyes were positive for CMV. More eyes with CMV developed recurrences and remained actively inflamed at 6, 12, and 24 weeks though the differences were insignificant. The presence of iris depigmentation was predictive of a greater odd of uveitic recurrences by 12 and 24 weeks (Odds ratio (OR) = 9.17 and 5.72, P = 0.007 and 0.034 respectively), whereas positive CMV-PCR predicts a greater odd of uveitic activity at postoperative 12 and 24 weeks (OR = 13.08, 34.30; P = 0.027, 0.007). Conclusion: Eye with and without detectable CMV behaved similarly in their clinical course. Our findings suggested that iris depigmentation was predictive of more frequent uveitic recurrence, regardless of the PCR status, whereas the presence of CMV in aqueous humor was associated with persistent uveitic activity. Iris changes may be present during the earlier phase of the disease and precede the detection of virus from the aqueous humor at a later stage of CMV infection. [ABSTRACT FROM AUTHOR]

Drug-resistant Plasmodium falciparum parasites have swept across Southeast Asia and now threaten Africa. By implementing a P. falciparum genetic cross using humanized mice, we report the identification of key determinants of resistance to artemisinin (ART) and piperaquine (PPQ) in the dominant Asian KEL1/PLA1 lineage. We mapped k13 as the central mediator of ART resistance in vitro and identified secondary markers. Applying bulk segregant analysis, quantitative trait loci mapping using 34 recombinant haplotypes, and gene editing, our data reveal an epistatic interaction between mutant PfCRT and multicopy plasmepsins 2/3 in mediating high-grade PPQ resistance. Susceptibility and parasite fitness assays implicate PPQ as a driver of selection for KEL1/PLA1 parasites. Mutant PfCRT enhanced susceptibility to lumefantrine, the first-line partner drug in Africa, highlighting a potential benefit of opposing selective pressures with this drug and PPQ. We also identified that the ABCI3 transporter can operate in concert with PfCRT and plasmepsins 2/3 in mediating multigenic resistance to antimalarial agents. [ABSTRACT FROM AUTHOR]

Using declassified colonial and British records in Hong Kong and London, as well as memoirs of former leftists and newspapers, this article explores the strategies the Hong Kong colonial government employed in a propaganda campaign to garner political support of the rural population in the New Territories, a porous land frontier during the Cold War. It also analyses the varying political orientations of migrant farmers, who often had received economic benefits from both the colonial government and the leftist organizations. This article reveals that the colonial government established the Vegetable Marketing Organization (VMO), a state-owned enterprise, to first nationalize the vegetable wholesale market in the immediate post-war period, and subsequently used it to combat increasing political influence and anti-government activities of the communist-controlled Society of Plantations. Despite the improvement of the livelihood of immigrant farmers, the VMO Scheme failed to out-compete the Society economically, which was ultimately eliminated by draconian measures. Through studying the agrarian politics and economic contestations in Hong Kong's rural area, this article provides a lens on how the Cold War was played out at a village level in East Asia. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to compare the diagnostic performance of cardiac CT and transthoracic echocardiogram (TTE) depending on the degree of valvular calcification and bicuspid aortic valve (BAV) subtype. Materials and Methods This retrospective study included 266 consecutive patients (106 with BAV and 160 with tricuspid aortic valve) who underwent cardiac CT and TTE before aortic valve replacement. Cardiac CT was used to evaluate the morphology of the aortic valve, and a calcium scoring scan was used to quantify valve calcium. The aortic valves were classified into fused and two-sinus types. The diagnostic accuracy of cardiac CT and TTE was calculated using a reference standard for intraoperative inspection. Results CT demonstrated significantly higher sensitivity, negative predictive value, and accuracy than TTE in detecting BAV (p < 0.001, p < 0.001, and p = 0.003, respectively). The TTE sensitivity tended to decrease as valvular calcification increased. The error rate of TTE for CT was 10.9% for the twosinus type of BAV and 28.3% for the fused type (p = 0.044). Conclusion Cardiac CT had a higher diagnostic performance in detecting BAV than TTE and may help diagnose BAV, particularly in patients with severe valvular calcification. [ABSTRACT FROM AUTHOR]

Our understanding of interstitial cystitis/bladder pain syndrome (IC/BPS) has evolved over time. The diagnosis of IC/BPS is primarily based on symptoms such as urgency, frequency, and bladder or pelvic pain. While the exact causes of IC/BPS remain unclear, it is thought to involve several factors, including abnormalities in the bladder's urothelium, mast cell degranulation within the bladder, inflammation of the bladder, and altered innervation of the bladder. Treatment options include patient education, dietary and lifestyle modifications, medications, intravesical therapy, and surgical interventions. This review article provides insights into IC/BPS, including aspects of treatment, prognosis prediction, and emerging therapeutic options. Additionally, it explores the application of deep learning for diagnosing major diseases associated with IC/BPS. [ABSTRACT FROM AUTHOR]

Background WGS has the potential to detect resistance-associated mutations and guide treatment of MDR TB. However, the knowledge base to confidently interpret mutations associated with the new and repurposed drugs is sparse, and phenotypic drug susceptibility testing is required to detect resistance. Methods We screened 900 Mycobacterium tuberculosis complex genomes from Ireland, a low TB incidence country, for mutations in 13 candidate genes and assessed their association with phenotypic resistance to bedaquiline, clofazimine, linezolid, delamanid and pretomanid. Results We identified a large diversity of mutations in the candidate genes of 195 clinical isolates, with very few isolates associated with phenotypic resistance to bedaquiline (n  = 4), delamanid (n  = 4) and pretomanid (n  = 2). We identified bedaquiline resistance among two drug-susceptible TB isolates that harboured mutations in Rv0678. Bedaquiline resistance was also identified in two MDR-TB isolates harbouring Met146Thr in Rv0678 , which dated back to 2007, prior to the introduction of bedaquiline. High-level delamanid resistance was observed in two isolates with deletions in ddn , which were also resistant to pretomanid. Delamanid resistance was detected in two further isolates that harboured mutations in fbiA , but did not show cross-resistance to pretomanid. All isolates were susceptible to linezolid and clofazimine, and no mutations found were associated with resistance. Conclusions More studies that correlate genotypic and phenotypic drug susceptibility data are needed to increase the knowledge base of mutations associated with resistance, in particular for pretomanid. Overall, this study contributes to the development of future mutation catalogues for M. tuberculosis complex isolates [ABSTRACT FROM AUTHOR]

This article discusses the use of jakinibs, small molecules that selectively block the actions of Janus kinase (JAK) proteins, in the treatment of systemic lupus erythematosus (SLE). SLE is a complex autoimmune disease characterized by abnormal expression of certain cytokines and activation of immune cells. The article specifically focuses on the efficacy and safety of baricitinib, a JAK1/2 inhibitor, in SLE. While some studies have shown positive results, others have been inconclusive, and there are concerns about serious adverse events associated with baricitinib. The article also mentions other targeted small molecules that have shown promising results in SLE. Overall, more research is needed to determine the effectiveness of jakinibs in treating SLE. [Extracted from the article]