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The use of the metaverse in education has gained increasing attention as a potential supplement to traditional teaching methods. This study aimed to investigate the impact of experiential learning on students' intent to use metaverse learning platforms and to explore how the metaverse can support these approaches. The study included participants from three countries and used metaverse scenes, such as a restaurant or Hong Kong scene, to complete learning tasks and interact with Non-Player Characters (NPCs) to complete assessments over a semester. The results of a correlational analysis showed that pedagogical factors had a greater impact on students' intent to use the metaverse for educational purposes than technical factors, which was unexpected. However, the study also identified challenges in adapting content to match the needs and skills of students who may not be familiar with games, as well as using the metaverse for more advanced pedagogical approaches, due to limitations in integrating content. Based on the findings, recommendations for educators, designers, and researchers are provided to enhance the effectiveness of metaverse-based education. Overall, the results of this study suggest that the metaverse can be a valuable addition to traditional teaching methods. [Note: The publication year (2023) shown in the citation on the PDF is incorrect. The correct publication year is 2024.]

Ollier's disease is a rare sporadic nonhereditary condition associated with mutations in the IDH1 and IDH2 genes, that manifests in early age of life. It is characterized by widespread enchondromas, predominantly affecting one side of the body. Diagnosis is based on clinical and radiological evaluations, and interval assessment for Ollier's disease is important as enchondromas are at risk of malignant transformation into chondrosarcomas. This case report aims to discuss the role of bone scan and plain X-ray in managing multiple enchondromas of a 25-year-old male patient with swellings over the left chest wall and left acromial regions.

Abstract Background In the Intensive Care Unit (ICU), recommended end‐of‐life (EOL) care practice encompasses do‐not‐attempt cardiopulmonary resuscitation (DNACPR), withholding (WH), and withdrawing (WD) life‐sustaining treatment (LST). Objectives Our study aims to evaluate the adequacy of physicians' documentation of EOL care practices. Methods We conducted a retrospective observational study, which evaluated the documentation of 18 pre‐identified critical components related to decision‐making, implementation, and communication of WD and WH of LST in a general medical‐surgical ICU of a tertiary hospital in the Hong Kong Special Administrative Region (HKSAR) of the People's Republic of China. One hundred twenty‐nine patients with EOL care before death were enrolled from 1 January 2013 to 31 March 2015. For documentation to be considered clear, the responsible ICU physician had to record notes in written form on the medical record. Results In documenting the decision‐making process, the indication of patients' decision‐making capacity was present in 6.2% of the reviewed records. DNACPR orders were documented substantially poorer (51.6%) than WH/WD other LSTs (71.4%–96.9%) in documenting the implementation process. Reviewing the communication documentation showed that 15.5% detailed the process of determining the patient's previously expressed wishes, 16.3% included explanations of shared decisions and 5.4% covered substituted decisions. None of the patient records met the complete documentation criteria while 17% met the minimal compliance level, defined as records missing 30% or fewer items. Conclusions Despite following international standards for EOL care, documentation by ICU physicians for key aspects of decision‐making, implementation, and communication for LST limitations was inadequate. Strategies to improve documentation should be encouraged.

Introduction: Clinical practice education is an important curriculum in developing physiotherapy students to professionals. This curriculum is largely dependent on clinical educators. Although traits of effective clinical educators had been studied in Western population, it was unclear if the Asian population would yield similar traits. Hence, we studied perspectives of students and academic educators to identify top five core traits of an effective clinical educator. The findings will then help guide policy development for clinical educator training and development. Methods: A survey was circulated to physiotherapy students and academic educators through convenience sampling. We studied 16 traits – enthusiasm, availability, clarity, clinical competence / knowledge, feedback skills, organisational skills, professionalism, well prepared, scholarly activity, non-judgemental, respect students’ autonomy / independence, sincerity, listening skills, evidence-based practice, role model, and awareness of students’ learning needs. Results: The top five traits identified by students and academic educators were similar in four traits – clinical competency / knowledge, clarity, feedback skills, and enthusiasm, and differed in the choice of “non-judgemental” by students and “awareness of students’ learning needs” by academic educators. Interestingly, when the top six traits were considered instead of five, students and academic educators identified the same traits but in different ranked orders. Conclusion: The study found six common core traits of an effective clinical educator from the perspectives of students and academic educators. Continuing education development for clinical educators should focus on these six traits prior to other 10 sub-traits.

Supporting a transition in Macao's senior secondary schools from individualized, informal music curricula to a government-led music curriculum, this qualitative and exploratory needs-analysis study reports the voices of three stakeholders - the government, teachers and their students. The findings a provide an understanding of Macao's music education context, from which emerges five contributions to the current Literature: 1) Wiggins and McTighe Understanding by Design supports differing approaches to curriculum development, 2) a "needs-analysis" approach mediates education change, 3) curriculum cohesion can retain music teachers' individual autonomy, 4) students' music learning and assessment expectations exceed those of their teachers' and 5) diversity in teacher training both empowers and dis-empowers these music-teachers' autonomy.

Emotion dysregulation is common among individuals with autism spectrum disorder (ASD). This study examined the relationship between emotion dysregulation and resting heart rate variability (HRV), a marker of the autonomic nervous system, in ASD adolescents. Resting HRV data were collected from ASD (n = 23) and typically developing (TD) adolescents (n = 32) via short-term electrocardiogram. Parents/caregivers reported participants' level of emotion dysregulation with the Emotion Dysregulation Inventory (EDI). Controlling for the effects of age and gender, regression analyses revealed moderating effects of group, suggesting that lower resting HRV was more strongly associated with greater emotion dysregulation in ASD than TD adolescents. The results support the view that disruptions in autonomic functioning may contribute to emotion dysregulation in ASD.

Na+/K+-ATPase (NKA) is essential for maintaining the Na+ and K+ gradients, and supporting the secondary active transport of certain ions/molecules, across the plasma membrane of animal cells. This study aimed to clone the NKA α-subunit (NKAα) from the inner mantle adjacent to the extrapallial fluid of Tridacna squamosa, to determine its subcellular localization, and to examine the effects of light exposure on its transcript level and protein abundance. The cDNA coding sequence of NKAα from T. squamosa comprised 3105 bp, encoding 1034 amino acids with an estimated molecular mass of 114 kDa. NKAα had a basolateral localization along the shell-facing epithelium of the inner mantle. Exposure to 12 h of light led to a significantly stronger basolateral NKAα-immunofluorescence at the shell-facing epithelium, indicating that NKA might play a role in light-enhanced calcification in T. squamosa. After 3 h of light exposure, the transcript level of NKAα decreased transiently in the inner mantle, but returned to the control level thereafter. In comparison, the protein abundance of NKAα remained unchanged at hour 3, but became significantly higher than the control after 12 h of light exposure. Hence, the expression of NKAα in the inner mantle of T. squamosa was light-dependent. It is probable that a higher expression level of NKA was needed in the shell-facing epithelial cells of the inner mantle to cope with a rise in Na+ influx, possibly caused by increases in activities of some Na+-dependent ion transporters/channels involved in light-enhanced calcification.

African lungfishes are ammonotelic in water. They can aestivate for long periods on land during drought. During aestivation, the gills are covered with dried mucus and ammonia excretion ceases. In fishes, ammonia excretion through the gills involves Rhesus glycoproteins (RhGP/Rhgp). This study aimed to obtain the complete cDNA coding sequences of rhgp from the gills of Protopterus annectens, and to determine their branchial mRNA and protein expression levels during the induction, maintenance and arousal phases of aestivation. Three isoforms of rhgp (rhag, rhbg and rhcg) were obtained in the gills of P. annectens. Their complete cDNA coding sequences ranged between 1311 and 1398 bp, coding for 436 to 465 amino acids with estimated molecular masses between 46.8 and 50.9 kDa. Dendrogramic analyses indicated that Rhag was grouped closer to fishes, while Rhbg and Rhcg were grouped closer to tetrapods. During the induction phase, the protein abundance of Rhag, but not its transcript level, was down-regulated in the gills, suggesting that there could be a decrease in the release of ammonia from the erythrocytes to the plasma. Furthermore, the branchial transcript levels of rhbg and rhcg decreased significantly, in preparation for the subsequent shutdown of gill functions. During the maintenance phase, the branchial expression levels of rhag/Rhag, rhbg/Rhbg and rhcg/Rhcg decreased significantly, indicating that their transcription and translation were down-regulated. This could be part of an overall mechanism to shut down branchial functions and save metabolic energy used for transcription and translation. It could also be regarded as an adaptive response to stop ammonia excretion. During the arousal phase, it is essential for the lungfish to regain the ability to excrete ammonia. Indeed, the protein abundance of Rhag, Rhbg and Rhcg recovered to the corresponding control levels after 1 day or 3 days of recovery from 6 months of aestivation.

An 18-year-old male with multiple endocrine neoplasm type 1 (MEN1) syndrome presented with hyperparathyroidism. Parathyroidectomy was performed. Patient complained of bone pain afterwards, multiple imaging modalities revealed features of osteitis fibrosa cystica and biochemical profile showed features of hungry bone syndrome. Incidental suspicious pancreatic lesion was initially revealed by 18F-FDG PET/CT scan while MRI further characterized the possibility of insulinoma. Ultimately, the patient was diagnosed of MEN1 syndrome by genetic test. This case report demonstrates the utilization of various imaging modalities such as ultrasound, Tc99m-sestamibi parathyroid scintigraphy, bone scintigraphy, CT, PET/CT and MRI, which leads to ultimately the diagnosis of MEN1 syndrome.

Microglia exhibit both maladaptive and adaptive roles in the pathogenesis of neurodegenerative diseases and have emerged as a cellular target for central nervous system (CNS) disorders, including those affecting the retina. Replacing maladaptive microglia, such as those impacted by aging or over-activation, with exogenous microglia that can enable adaptive functions has been proposed as a potential therapeutic strategy for neurodegenerative diseases. To investigate microglia replacement as an approach for retinal diseases, we first employed a protocol to efficiently generate human-induced pluripotent stem cell (hiPSC)-derived microglia in quantities sufficient for in vivo transplantation. These cells demonstrated expression of microglia-enriched genes and showed typical microglial functions such as LPS-induced responses and phagocytosis. We then performed xenotransplantation of these hiPSC-derived microglia into the subretinal space of adult mice whose endogenous retinal microglia have been pharmacologically depleted. Long-term analysis post-transplantation demonstrated that transplanted hiPSC-derived microglia successfully integrated into the neuroretina as ramified cells, occupying positions previously filled by the endogenous microglia and expressed microglia homeostatic markers such as P2ry12 and Tmem119. Furthermore, these cells were found juxtaposed alongside residual endogenous murine microglia for up to 8 months in the retina, indicating their ability to establish a stable homeostatic state in vivo. Following retinal pigment epithelial cell injury, transplanted microglia demonstrated responses typical of endogenous microglia, including migration, proliferation, and phagocytosis. Our findings indicate the feasibility of microglial transplantation and integration in the retina and suggest that modulating microglia through replacement may be a therapeutic strategy for treating neurodegenerative retinal diseases.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most prevalent cause of chronic liver disease worldwide affecting over one-third of the adult population. Despite the recent evolution of new nomenclature and diagnostic criteria for MASLD, progress in drug development for this condition remains limited. This review highlights the potential of drug-target Mendelian randomisation (MR), a study design that leverages human genetics and genomics, for the discovery, repositioning and safety assessment of drug targets in MASLD. We summarised key aspects of designing and appraising a drug-target MR study, discussing its inherent assumptions and considerations for instrument selection. Furthermore, we presented real-world examples from studies in MASLD which focused on opportunities and challenges in identifying novel drug targets, repositing existing drug targets, informing adjunctive treatments and addressing issues in paediatric MASLD.

A case report of a severely dyspnoeic kyphoscoliotic patient intended for an elective major thoracic surgery for suspected lung malignancy. With baseline near maximal breathing frequency and shallow breaths and poor lung mechanics, the first encountered anaesthetist considered this patient too high risk for lobectomy. This case illustrated the application of cardiopulmonary exercise testing to provide an objective assessment of the patient’s functional capacity, ventilatory efficiency and delineation of modifiable respiratory components that guide the formulation of individualized prehabilitation programme. It also depicted the perioperative role of an off-label use of incentive spirometry in providing visual feedbacks and led to subsequent assessment breathing pattern alternation. Patient underwent the lung resection uneventfully and returned to normal lifestyle on postoperative day 4.

This study aimed to obtain the coding cDNA sequences of voltage-gated Na+ channel (scn) α-subunit (scna) and β-subunit (scnb) isoforms from, and to quantify their transcript levels in, the main electric organ (EO), Hunter's EO, Sach's EO and the skeletal muscle (SM) of the electric eel, Electrophorus electricus, which can generate both high and low voltage electric organ discharges (EODs). The full coding sequences of two scna (scn4aa and scn4ab) and three scnb (scn1b, scn2b and scn4b) were identified for the first time (except scn4aa) in E. electricus. In adult fish, the scn4aa transcript level was the highest in the main EO and the lowest in the Sach's EO, indicating that it might play an important role in generating high voltage EODs. For scn4ab/Scn4ab, the transcript and protein levels were unexpectedly high in the EOs, with expression levels in the main EO and the Hunter's EO comparable to those of scn4aa. As the key domains affecting the properties of the channel were mostly conserved between Scn4aa and Scn4ab, Scn4ab might play a role in electrogenesis. Concerning scnb, the transcript level of scn4b was much higher than those of scn1b and scn2b in the EOs and the SM. While the transcript level of scn4b was the highest in the main EO, protein abundance of Scn4b was the highest in the SM. Taken together, it is unlikely that Scna could function independently to generate EODs in the EOs as previously suggested. It is probable that different combinations of Scn4aa/Scn4ab and various Scnb isoforms in the three EOs account for the differences in EODs produced in E. electricus. In general, the transcript levels of various scn isoforms in the EOs and the SM were much higher in adult than in juvenile, and the three EOs of the juvenile fish could be functionally indistinct.

Hepatitis B surface antigen (HBsAg) seroclearance is considered the functional cure and the optimal treatment endpoint for chronic hepatitis B (CHB). Patients with CHB who cleared HBsAg generally have a favorable clinical course with minimal risk of developing hepatocellular carcinoma (HCC) or cirrhotic complications. Nevertheless, a minority of patients still develop HCC despite HBsAg seroclearance. While patients with liver cirrhosis are still recommended for HCC surveillance, whether other non-cirrhotic patients who achieved HBsAg seroclearance should remain on HCC surveillance remains unclear. This review provides an overview of the incidence of HBsAg seroclearance, the factors associated with the occurrence of HBsAg seroclearance, the durability of HBsAg seroclearance, the risk of developing HCC after HBsAg seroclearance, the risk factors associated with HCC development after HBsAg seroclearance, the role of HCC risk scores, and the implications on HCC surveillance. Existing HCC risk scores have a reasonably good performance in patients after HBsAg seroclearance. In the era of artificial intelligence, future HCC risk prediction models based on artificial intelligence and longitudinal clinical data may further improve the prediction accuracy to establish a foundation of a risk score-based HCC surveillance strategy. As different novel hepatitis B virus (HBV) antiviral agents aiming at HBsAg seroclearance are under active development, new knowledge is anticipated on the natural history and HCC risk prediction of patients treated with new HBV drugs.

Abstract Adiponectin (APN) is an adipokine which predominantly expresses in adipocytes with neuroprotective and anti-inflammatory effects. We have recently indicated that circulatory trimeric APN can enter the brain by crossing the blood–brain barrier (BBB) and modulate microglia-mediated neuroinflammation. Here, we found that the microglial NLR family pyrin domain containing 3 (NLRP3)-inflammasome activation was exacerbated in APN −/− 5xFAD mice in age-dependent manner. The focus of this study was to develop a new and tractable therapeutic approach for treating Alzheimer’s disease (AD)-related pathology in 5xFAD mice using peripheral APN gene therapy. We have generated and transduced adeno-associated virus (AAV2/8) expressing the mouse mutated APN gene (APNC39S) into the liver of 5xFAD mice that generated only low-molecular-weight trimeric APN (APNTri). Single dose of AAV2/8-APNC39S in the liver increased circulatory and cerebral APN levels indicating the overexpressed APNTri was able to cross the BBB. Overexpression of APNTri decreased both the soluble and fibrillar Aβ in the brains of 5xFAD mice. AAV2/8-APNTri treatment reduced Aβ-induced IL-1β and IL-18 secretion by suppressing microglial NLRP3-inflammasome activation. The memory functions improved significantly in AAV-APNTri-treated 5xFAD mice with reduction of dystrophic neurites. These findings demonstrate that peripheral gene delivery to overexpress trimeric APN can be a potential therapy for AD. Graphical Abstract

To identify fake Malaysian banknotes, this research suggested a revolutionary fuzzy logic weighted specific (FLWS) approach in image processing techniques. The FLWS Algorithm has the benefit of a more accurate model because it is a human guidance learning algorithm that demands training to obtain the precise weights for each security feature. The trial outcomes also demonstrated that, for the purpose of detecting counterfeit Malaysian banknotes, the FLWS model outperformed the parallel fuzzy logic weighted averaging (FLWA) algorithm, MobileNet model, and VGG16 model. Its adoption of well-known watermark features, with specific weights assigned, and well-known machine learning techniques to distinguish between genuine Malaysian banknotes and counterfeit Malaysian banknotes gives it a clear advantage over earlier or current banknote counterfeit detection techniques.

This study aimed to obtain the coding cDNA sequences of Na+/K+-ATPase α (nkaα) isoforms from, and to quantify their mRNA expression in, the skeletal muscle (SM), the main electric organ (EO), the Hunter's EO and the Sach's EO of the electric eel, Electrophorus electricus. Four nkaα isoforms (nkaα1c1, nkaα1c2, nkaα2 and nkaα3) were obtained from the SM and the EOs of E. electricus. Based on mRNA expression levels, the major nkaα expressed in the SM and the three EOs of juvenile and adult E. electricus were nkaα1c1 and nkaα2, respectively. Molecular characterization of the deduced Nkaα1c1 and Nkaα2 sequences indicates that they probably have different affinities to Na+ and K+. Western blotting demonstrated that the protein abundance of Nkaα was barely detectable in the SM, but strongly detected in the main and Hunter's EOs and weakly in the Sach's EO of juvenile and adult E. electricus. These results corroborate the fact that the main EO and Hunter's EO have high densities of Na+ channels and produce high voltage discharges while the Sach's EO produces low voltage discharges. More importantly, there were significant differences in kinetic properties of Nka among the three EOs of juvenile E. electricus. The highest and lowest Vmax of Nka were detected in the main EO and the Sach's EO, respectively, with the Hunter's EO having a Vmax value intermediate between the two, indicating that the metabolic costs of EO discharge could be the highest in the main EO. Furthermore, the Nka from the main EO had the lowest Km (or highest affinity) for Na+ and K+ among the three EOs, suggesting that the Nka of the main EO was more effective than those of the other two EOs in maintaining intracellular Na+ and K+ homeostasis and in clearing extracellular K+ after EO discharge.

The African lungfish, Protopterus annectens, can undergo aestivation during drought. Aestivation has three phases: induction, maintenance and arousal. The objective of this study was to examine the differential gene expression in the liver of P. annectens after 6 months (the maintenance phase) of aestivation as compared with the freshwater control, or after 1 day of arousal from 6 months aestivation as compared with 6 months of aestivation using suppression subtractive hybridization. During the maintenance phase of aestivation, the mRNA expression of argininosuccinate synthetase 1 and carbamoyl phosphate synthetase III were up-regulated, indicating an increase in the ornithine-urea cycle capacity to detoxify ammonia to urea. There was also an increase in the expression of betaine homocysteine-S-transferase 1 which could reduce and prevent the accumulation of hepatic homocysteine. On the other hand, the down-regulation of superoxide dismutase 1 expression could signify a decrease in ROS production during the maintenance phase of aestivation. In addition, the maintenance phase was marked by decreases in expressions of genes related to blood coagulation, complement fixation and iron and copper metabolism, which could be strategies used to prevent thrombosis and to conserve energy. Unlike the maintenance phase of aestivation, there were increases in expressions of genes related to nitrogen, carbohydrate and lipid metabolism and fatty acid transport after 1 day of arousal from 6 months aestivation. There were also up-regulation in expressions of genes that were involved in the electron transport system and ATP synthesis, indicating a greater demand for metabolic energy during arousal. Overall, our results signify the importance of sustaining a low rate of waste production and conservation of energy store during the maintenance phase, and the dependence on internal energy store for repair and structural modification during the arousal phase, of aestivation in the liver of P. annectens.

The scarcity of high-quality annotated data poses a significant challenge to the application of deep learning in fabric defect tasks, limiting the generalization and segmentation performance of existing models and impeding their capability to address the complexity of various fabric types and defects. To overcome these obstacles, this study introduces an innovative method to infuse specialized knowledge of fabric defects into the Segment Anything Model (SAM), a large-scale visual model. By introducing and training a unique set of fabric defect-related parameters, this approach seamlessly integrates domain-specific knowledge into SAM without the need for extensive modifications to the preexisting model parameters. The revamped SAM model leverages generalized image understanding learned from large-scale natural image datasets while incorporating fabric defect-specific knowledge, ensuring its proficiency in fabric defect segmentation tasks. The experimental results reveal a significant improvement in the model’s segmentation performance, attributable to this novel amalgamation of generic and fabric-specific knowledge. When benchmarking against popular existing segmentation models across three datasets, our proposed model demonstrates a substantial leap in performance. Its impressive results in cross-dataset comparisons and few-shot learning experiments further demonstrate its potential for practical applications in textile quality control.

BackgroundDepression and anxiety are common mental health problems among adolescents worldwide. Extant research has found that intelligence, emotion, and failure-is-debilitating beliefs (fixed mindsets) are closely related to more depression and anxiety symptoms, hopelessness, and suicidality. Recent research also points to the importance of parental mindset, which can strongly influence children’s affect, behavior, and mental health. However, the effects of parent-child mindset interventions on a child’s internalizing problems have not yet been empirically examined. As recent evidence has shown the promise of single-session interventions in reducing and preventing youth internalizing problems, this study develops and examines a parent and child single-session intervention on mindsets of intelligence, failure, and emotion (PC-SMILE) to tackle depression and anxiety in young people. ObjectiveUsing a 3-arm randomized controlled trial, this study will examine the effectiveness of PC-SMILE in reducing depression and anxiety symptoms among children. We hypothesize that compared to the waitlist control group, the PC-SMILE group and child single-session intervention on mindsets of intelligence, failure, and emotion (C-SMILE) group will significantly improve child depression and anxiety (primary outcome) and significantly improve secondary outcomes, including children’s academic self-efficacy, hopelessness, psychological well-being, and parent-child interactions and relationships, and the PC-SMILE is more effective than the C-SMILE. MethodsA total of 549 parent-child dyads will be recruited from 8 secondary schools and randomly assigned to either the PC-SMILE intervention group, the C-SMILE intervention group, or the no-intervention waitlist control group. The 45-minute interventions include parent-version and child-version. Both parents and students in the PC-SMILE group receive the intervention. Students in C-SMILE group receive intervention and their parents will receive intervention after all follow-up ends. Students in 3 groups will be assessed at 3 time points, baseline before intervention, 2 weeks post intervention, and 3 months post intervention, and parents will be assessed in baseline and 3-month follow-up. The intention-to-treat principle and linear-regression-based maximum likelihood multilevel models will be used for data analysis. ResultsRecruitment started in September 2023. The first cohort of data collection is expected to begin in May 2024 and the second cohort will begin in September 2024. The final wave of data is expected to be collected by the end of the first quarter of 2025. The results are expected to demonstrate improved anxiety and depression among students assigned to the intervention condition, as well as the secondary outcomes compared to those in the control group. The efficacy and effectiveness of the intervention will be discussed. ConclusionsThis study is the first attempt to develop a web-based single-session intervention for students and their parents to enhance their well-being in Hong Kong and beyond, which potentially contributes to providing evidence-based recommendations for the implementation of brief digital parent-child interventions. International Registered Report Identifier (IRRID)PRR1-10.2196/63220

Utilizing renewable electricity for the electrocatalytic conversion of CO2 into alcohols represents a promising avenue for generating value‐added fuels and achieving carbon neutrality. Recently, there has been growing scientific interest in achieving high‐efficiency conversion of CO2 to alcohols, with significant advancements made in mechanism understanding, reactor design, catalyst development, and more. Herein, a thorough examination of the latest advances in electrocatalytic CO2 reduction reaction (CO2RR) to alcohols is provided. General mechanisms and pathways of electrocatalytic conversion of CO2‐to‐alcohols are systematically illustrated. Subsequently, electrolyzer configurations, electrolytes, and electrocatalysts employed in CO2RR are summarized. After that, critical operating parameters (e.g., reaction pressure, temperature, and pH) that would significantly influence the CO2RR process are also analyzed. Finally, the review addresses challenges and offers perspectives in this field to guide future studies aimed at advancing CO2‐to‐alcohols conversion technologies.

Abstract In order to cope with the increasingly serious problem of energy shortage, supercapacitors have been developed as a clean and renewable energy source, and the supercapacitors with excellent energy density and long cycle life are imperative. Here, by employing a facile liquid–liquid (L‐L) interfacial method at room temperature (RT), a set of two‐dimensional (2D) metal complex nanosheets N1‐N3 have been synthesized by the facile coordination between Co2+ ion and 2,3,6,7,10,11‐hexaiminotriphenylene (HITP). Given the layered superstructure with well‐ordered nanopores, the N1‐N3 electrodes displayed excellent capacities of 4751.9, 5770.9 and 6075.2 F g−1 at 1 A g−1, and a good cyclic stability with 92.1% capacity retention after 1000 cycles for the N3 electrode. The asymmetric supercapacitor device with N3 as the positive electrode delivers a maximum energy density of 238.2 Wh kg−1 at a power density of 1610.1 W kg−1 and an excellent cycling stability with a capacitance retention of 109.1% after 5000 cycles. This is the best electroactive bottom‐up metal complex nanosheet reported so far for use in supercapacitor, which greatly expands the applicability of this 2D nanomaterial in energy device applications.

Background & Aims: Patients with nonalcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) face a multifaceted disease burden which includes impaired health-related quality of life (HRQL) and potential stigmatization. We aimed to assess the burden of liver disease in patients with NAFLD and the relationship between experience of stigma and HRQL. Methods: Members of the Global NASH Council created a survey about disease burden in NAFLD. Participants completed a 35-item questionnaire to assess liver disease burden (LDB) (seven domains), the 36-item CLDQ-NASH (six domains) survey to assess HRQL and reported their experience with stigmatization and discrimination. Results: A total of 2,117 patients with NAFLD from 24 countries completed the LDB survey (48% Middle East and North Africa, 18% Europe, 16% USA, 18% Asia) and 778 competed CLDQ-NASH. Of the study group, 9% reported stigma due to NAFLD and 26% due to obesity. Participants who reported stigmatization due to NAFLD had substantially lower CLDQ-NASH scores (all p

Abstract Background Mastication is important for breaking down food, aiding swallowing and nutrients absorption, and is therefore fundamental to a child’s development. Studies have shown poor masticatory function to be associated with younger age and presence of caries. However, studies of the association between masticatory function and malocclusion yielded contradictory results. The aim of this study is therefore to investigate the association between three-dimensional occlusal features with masticatory function, among preschool children in Hong Kong. Methods Self-administered questionnaires on masticatory function in three domains, namely general chewing difficulty, requiring help when eating different food types and increased preference for soft food were completed by parents. Information on non-nutritive sucking habits and basic demographics were also collected in the questionnaire. Clinical examinations were conducted to record three-dimensional occlusal features and presence of caries. Baseline investigations and one-year follow-ups were undertaken for 1,566 and 996 preschool children. Association of poor masticatory function with occlusal features, sucking habits and caries was investigated using chi-squared tests. Binomial logistic regressions were then carried out incorporating any significant factors identified. Longitudinal analysis of the one-year follow-up data was carried out to investigate whether improved occlusal features, sucking habits and caries resulted in better masticatory function. Results In the cross-sectional study, the first domain of general chewing difficulty was associated with caries and thumb/digit sucking. The second domain of requiring help when eating different food types was associated with the male sex, younger age, caries and pacifier use. The last domain of increased preference for soft foods was associated with caries and thumb/digit sucking. Occlusal features, including abnormal overjet and unilateral permanent molars not in contact, were significantly associated with poor masticatory function in the bivariate analyses, but were not significant in the logistic regressions. In the longitudinal analysis, general chewing difficulty was found to improve in those of older age and those with resolved anterior crossbite. Less help was required to eat meat in those with fewer caries. Similarly, less help was required to eat food containing bones in those with reduced pacifier use. Preferences for eating soft foods was reduced in those who developed a normal overjet. Conclusions The study identified significant relationships between masticatory difficulties and factors associated with age, gender, active caries, and non-nutritive oral habits such as thumb/digit sucking and pacifier use. Younger children and males required more assistance with certain food types. Active caries and thumb/digit sucking habits contributed to general masticatory difficulties and preference for soft foods. The one-year follow-up indicated that improvement in masticatory function varies across age cohorts and were associated with improved occlusal features, such as resolution of anterior crossbite and normalized overjet, reduced pacifier use, and a decrease in the number of decayed teeth.

Deep learning models have demonstrated promising results in the early and accurate diagnosis of osteonecrosis of the femoral head (ONFH), enabling early detection and informed surgical decision-making. The objective of this review is to summarize the applications of deep learning models on the medical images of ONFH. English papers were searched from CINAHL via EBSCOhost, Embase, IEEE Xplore® Digital Library, PubMed, Scopus, and Web of Science. Sixteen studies (n =16) were eligible for data synthesis. Among these, five studies (n =5) focusing on radiographs, ten studies (n =10) focusing on magnetic resonance imaging, and one study (n =1) focusing on computed tomographic images. The applications of these studies included identifying ONFH from normal or other hip pathologies, classifying severity, segmenting, and detecting femoral head and necrotic regions, predicting signs and symptoms of ONFH, and predicting potential ONFH after fracture fixation. Generally, the models demonstrated good to excellent classification performance and excellent discriminatory power; and generally comparable to that of experienced physicians and superior to that of less experienced physicians. However, the external validity of these studies demonstrated only moderate, as evidenced by the performance on the external testing set and might be attributed to the relatively small data size used during model training. we observed a shift from CNN-based models to U-Net-based models (i.e., with encoder-decoder architecture). In addition to streamlining the segmentation, detection, and classification procedures, future studies will explore multimodal attention, self-supervised learning, explainable models, and data augmentation through generative models.

Location-based services find a number of applications in vehicular environments such as navigation, parking, infortainment etc. However, the disclosure of vehicles' location information raises multiple privacy issues. To balance the tradeoff between privacy and utility, this paper proposes a framework to preserve users' location privacy while delivering the desired quality of experience (QoE). The proposed framework allows users to quantify the data utility while accessing location-based services under different privacy levels through the QoE metric. The privacy analysis of the proposed framework is provided under two adversary models. Finally, the effectiveness of the proposed framework is demonstrate using the real-world “Dianping” review dataset.

This study aimed to test the hypothesis that branchial osmoregulatory acclimation involved increased apoptosis and replacement of mitochdonrion-rich cells (MRCs) in the climbing perch, Anabas testudineus, during a progressive acclimation from freshwater to seawater. A significant increase in branchial caspase-3/-7 activity was observed on day 4 (salinity 20), and an extensive TUNEL-positive apoptosis was detected on day 5 (salinity 25), indicating salinity-induced apoptosis had occurred. This was further supported by an up-regulation of branchial mRNA expression of p53, a key regulator of cell cycle arrest and apoptosis, between day 2 (salinity 10) and day 6 (seawater), and an increase in branchial p53 protein abundance on day 6. Seawater acclimation apparently activated both the extrinsic and intrinsic pathways, as reflected by significant increases in branchial caspase-8 and caspase-9 activities. The involvement of the intrinsic pathway was confirmed by the significant increase in branchial mRNA expression of bax between day 4 (salinity 20) and day 6 (seawater). Western blotting results revealed the presence of a freshwater Na+/K+-ATPase (Nka) α-isoform, Nka α1a, and a seawater isoform, Nka α1b, the protein abundance of which decreased and increased, respectively, during seawater acclimation. Immunofluorescence microscopy revealed the presence of two types of MRCs distinctly different in sizes, and confirmed that the reduction in Nka α1a expression, and the prominent increases in expression of Nka α1b, Na+:K+:2Cl- cotransporter 1, and cystic fibrosis transmembrane conductance regulator Cl- channel coincided with the salinity-induced apoptotic event. Since modulation of existing MRCs alone could not have led to extensive salinity-induced apoptosis, it is probable that some, if not all, freshwater-type MRCs could have been removed through increased apoptosis and subsequently replaced by seawater-type MRCs in the gills of A. testudineus during seawater acclimation.

The swamp eel, Monopterus albus, can survive in high concentrations of ammonia (>75 mmol l(-1)) and accumulate ammonia to high concentrations in its brain (4.5 µmol g(-1)). Na(+)/K(+)-ATPase (Nka) is an essential transporter in brain cells, and since NH4(+) can substitute for K(+) to activate Nka, we hypothesized that the brain of M. albus expressed multiple forms of Nka α-subunits, some of which might have high K(+) specificity. Thus, this study aimed to clone and sequence the nka α-subunits from the brain of M. albus, and to determine the effects of ammonia exposure on their mRNA expression and overall protein abundance. The effectiveness of NH4(+) to activate brain Nka from M. albus and Mus musculus was also examined by comparing their Na(+)/K(+)-ATPase and Na(+)/NH4(+)-ATPase activities over a range of K(+)/NH4(+) concentrations. The full length cDNA coding sequences of three nkaα (nkaα1, nkaα3a and nkaα3b) were identified in the brain of M. albus, but nkaα2 expression was undetectable. Exposure to 50 mmol l(-1) NH4Cl for 1 day or 6 days resulted in significant decreases in the mRNA expression of nkaα1, nkaα3a and nkaα3b. The overall Nka protein abundance also decreased significantly after 6 days of ammonia exposure. For M. albus, brain Na(+)/NH4(+)-ATPase activities were significantly lower than the Na(+)/K(+)-ATPase activities assayed at various NH4(+)/K(+) concentrations. Furthermore, the effectiveness of NH4(+) to activate Nka from the brain of M. albus was significantly lower than that from the brain of M. musculus, which is ammonia-sensitive. Hence, the (1) lack of nkaα2 expression, (2) high K(+) specificity of K(+) binding sites of Nkaα1, Nkaα3a and Nkaα3b, and (3) down-regulation of mRNA expression of all three nkaα isoforms and the overall Nka protein abundance in response to ammonia exposure might be some of the contributing factors to the high brain ammonia tolerance in M. albus.

The African lungfish, Protopterus annectens, can undergo aestivation during drought. Aestivation has three phases: induction, maintenance and arousal. The objective of this study was to examine the differential gene expression in the brain of P. annectens during the induction (6 days) and maintenance (6 months) phases of aestivation as compared with the freshwater control using suppression subtractive hybridization. During the induction phase of aestivation, the mRNA expression of prolactin (prl) and growth hormone were up-regulated in the brain of P. annectens, which indicate for the first time the possible induction role of these two hormones in aestivation. Also, the up-regulation of mRNA expression of tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein γ polypeptide and the down-regulation of phosphatidylethanolamine binding protein, suggest that there could be a reduction in biological and neuronal activities in the brain. The mRNA expression of cold inducible RNA-binding protein and glucose regulated protein 58 were also up-regulated in the brain, probably to enhance their cytoprotective effects. Furthermore, the down-regulation of prothymosin α expression suggests that there could be a suppression of transcription and cell proliferation in preparation for the maintenance phase. In general, the induction phase appeared to be characterized by reduction in glycolytic capacity and metabolic activity, suppression of protein synthesis and degradation, and an increase in defense against ammonia toxicity. In contrast, there was a down-regulation in the mRNA expression of prl in the brain of P. annectens during the maintenance phase of aestivation. In addition, there could be an increase in oxidative defense capacity, and up-regulation of transcription, translation, and glycolytic capacities in preparation for arousal. Overall, our results signify the importance of reconstruction of protein structures and regulation of energy expenditure during the induction phase, and the needs to suppress protein degradation and conserve metabolic fuel stores during the maintenance phase of aestivation.

L-gulono-γ-lactone oxidase (Gulo) catalyzes the last step of ascorbic acid biosynthesis, which occurs in the kidney of elasmobranchs. This study aimed to clone and sequence gulonolactone oxidase (gulo) from the kidney of the euryhaline freshwater stingray, Himantura signifer, and to determine the effects of acclimation from freshwater to brackish water (salinity 20) on its renal gulo mRNA expression and Gulo activity. We also examined the effects of brackish water acclimation on concentrations of ascorbate, dehydroascorbate and ascorbate + dehydroascorbate in the kidney, brain and gill. The complete cDNA coding sequence of gulo from the kidney of H. signifer contained 1323 bp coding for 440 amino acids. The expression of gulo was kidney-specific, and renal gulo expression decreased significantly by 67% and 50% in fish acclimated to brackish water for 1 day and 6 days, respectively. There was also a significant decrease in renal Gulo activity after 6 days of acclimation to brackish water. Hence, brackish water acclimation led to a decrease in the ascorbic acid synthetic capacity in the kidney of H. signifer. However, there were significant increases in concentrations of ascorbate and ascorbate + dehydroascorbate in the gills (after 1 or 6 days), and a significant increase in the concentration of ascorbate and a significant decrease in the concentration of dehydroascorbate in the brain (after 1 day) of fish acclimated to brackish water. Taken together, our results indicate that H. signifer might experience greater salinity-induced oxidative stress in freshwater than in brackish water, possibly related to its short history of freshwater invasion. These results also suggest for the first time a possible relationship between the successful invasion of the freshwater environment by some euryhaline marine elasmobranchs and the ability of these elasmobranchs to increase the capacity of ascorbic acid synthesis in response to hyposalinity stress.

We obtained a full cDNA coding sequence of aquaporin 1aa (aqp1aa) from the gills of the freshwater climbing perch, Anabas testudineus, which had the highest expression in the gills and skin, suggesting an important role of Aqp1aa in these organs. Since seawater acclimation had no significant effects on the branchial and intestinal aqp1aa mRNA expression, and since the mRNA expression of aqp1aa in the gut was extremely low, it can be deduced that Aqp1aa, despite being a water channel, did not play a significant osmoregulatory role in A. testudineus. However, terrestrial exposure led to significant increases in the mRNA expression of aqp1aa in the gills and skin of A. testudineus. Since terrestrial exposure would lead to evaporative water loss, these results further support the proposition that Aqp1aa did not function predominantly for the permeation of water through the gills and skin. Rather, increased aqp1aa mRNA expression might be necessary to facilitate increased ammonia excretion during emersion, because A. testudineus is known to utilize amino acids as energy sources for locomotor activity with increased ammonia production on land. Furthermore, ammonia exposure resulted in significant decreases in mRNA expression of aqp1aa in the gills and skin of A. testudineus, presumably to reduce ammonia influx during ammonia loading. This corroborates previous reports on AQP1 being able to facilitate ammonia permeation. However, a molecular characterization of Aqp1aa from A. testudineus revealed that its intrinsic aquapore might not facilitate NH3 transport. Hence, ammonia probably permeated the central fifth pore of the Aqp1aa tetramer as suggested previously. Taken together, our results indicate that Aqp1aa might have a greater physiological role in ammonia excretion than in osmoregulation in A. testudineus.

Purpose: This study seeks to advance the literature by examining the mediating role of brand loyalty and the moderating impact of brand awareness in the relationships between social media marketing and collectivist Chinese behavior in the hospitality service context. This exploration is grounded in brand commitment and expectancy disconfirmation theories. Methods: Empirical testing was conducted on survey data gathered from 150 collectivist Chinese customers in Hong Kong, utilizing partial least squares structural equation modeling. Results: Brand loyalty plays a partial mediating role in the relationships between social media marketing and purchase intention as well as word-of-mouth. Additionally, brand awareness exerts a negative moderating influence on social media marketing-brand loyalty link. Implications: Recommendations are provided for front-line staff tasked with addressing communication challenges by effectively managing the hotel’s social media account. They are strongly advised to steer clear of creating face-threatening situations and to demonstrate respect for the loyalty of Chinese collectivist customers. Furthermore, a negative brand awareness effect emerges when collectivist Chinese customers compare hotel brands with online travel agents.

Abstract One major issue in pharmaceutical supply chain management is the supply shortage, and determining the root causes of medicine shortages necessitates an in-depth investigation. The concept of risk management is proposed in this study to identify significant risk factors in the pharmaceutical supply chain. Fuzzy failure mode and effect analysis and data envelopment analysis were used to evaluate the risks of the pharmaceutical supply chain. Based on a case study on the Malaysian pharmaceutical supply chain, it reveals that the pharmacy node is the riskiest link. The unavailability of medicine due to unexpected demand, as well as the scarcity of specialty or substitute drugs, pose the most significant risk factors. These risks could be mitigated by digital technology. We propose an appropriate digital technology platform consisting of big data analytics and blockchain technologies to undertake these challenges of supply shortage. By addressing risk factors through the implementation of a digitalized supply chain, organizations can fortify their supply networks, fostering resilience and efficiency, and thereby playing a pivotal role in advancing the Pharma 4.0 era.

In Singapore, 10 captive lions tested positive for SARS-CoV-2 by real-time PCR. Genomic analyses of nanopore sequencing confirmed human-to-animal transmission of the SARS-CoV-2 Delta variant. Viral genomes from the lions and zookeeper shared a unique spike protein substitution, S:A1016V. Widespread SARS-CoV-2 transmission among humans can increase the likelihood of anthroponosis.

We detected African swine fever virus (ASFV) from a wild boar in Singapore. In

Salmonella remains a significant foodborne pathogen globally with S. Typhimurium presenting as a frequently occurring serovar. This study aimed to characterize 67 S. Typhimurium isolates from humans, food, farms, and slaughterhouses collected in Singapore from 2016 to 2017. Using whole-genome sequencing analysis, the isolates were found to belong to either ST19 (n = 33) or ST36 (n = 34). ST36 predominated in human intestinal and chicken isolates, while human extra-intestinal and non-chicken food isolates belonged to ST19. Plasmids were predicted in 88.1% (n = 59) of the isolates with the most common incompatibility group profiles being IncFIB(S), IncFII(S) and IncQ1. IncFIB(S) (adjusted p-value < 0.05) and IncFII(S) (adjusted p-value < 0.05) were significantly more prevalent in ST19 isolates, while Col156 (adjusted p-value < 0.05) was more significantly found in ST36 isolates. ST36 isolates exhibited higher resistance to multiple antibiotic classes such as penicillins, phenicols, folate pathway inhibitors, aminoglycosides, β-lactam/β-lactamase inhibitor combinations, tetracyclines, and fluoroquinolones. Phylogenetics analysis suggested potential shared routes of transmission among human, chicken, farm and slaughterhouse environments. Taken together, this study offers a cross-sectional epidemiological insight into the genomic epidemiology and antimicrobial landscape of S. Typhimurium isolates in Singapore, informing strategies for future public health and food safety surveillance.

This study focuses on university students' experience of peer tutoring supported by a mobile application called MENTOR (Mobile Education Networked Tutoring On Request) that was developed by the research team. The development of the mobile application was underpinned by theories related to self-directed learning, self-regulated learning, students' help-seeking behaviors, as well as Vygotsky's social-cultural learning theory. Using cultural-historical activity theory (CHAT) as the framework, this study examines the affordances of the mobile application, the student's perception of the application, the uptake of affordances, and the contradictions identified through CHAT. The participants identified tutor's factors (e.g. tutoring skills) and technological factors (e.g. annotatable canvas) that facilitated the process, and appreciated the affordances of convenience, flexibility, physical safety, and psychological safety of the mobile peer tutoring, especially during the COVID-19 situation. A few contradictions were identified through CHAT, which served as the impetus for improvement. Among these are the novelty of mobile peer tutoring and the lack of cues about turn-taking. Some participants did not understand the requirement to indicate the level of cognitive processing. This study contributes to the design and implementation of mobile technology in supporting peer tutoring, an under-researched topic.

Abstract Conversion of solar energy into H2 by photoelectrochemical (PEC) water splitting is recognized as an ideal way to address the growing energy crisis and environmental issues. In a typical PEC cell, the construction of photoanodes is crucial to guarantee the high efficiency and stability of PEC reactions, which fundamentally rely on rationally designed semiconductors (as the active materials) and substrates (as the current collectors). In this review work, we start with a brief introduction of the roles of substrates in the PEC process. Then, we provide a systematic overview of representative strategies for the controlled fabrication of photoanodes on rationally designed substrates, including conductive glass, metal, sapphire, silicon, silicon carbide, and flexible substrates. Finally, some prospects concerning the challenges and research directions in this area are proposed.

ObjectivesOnline mindfulness-based program (MBP) for parents and families especially in clinical population is limited. Engagement and significant dropout are major issues in MBP implementation. This pilot study examined the effects of an online mindfulness-based program (MBP) on parents of children with Attention Deficit/Hyperactivity Disorder (ADHD).MethodsA mixed methods study was applied to evaluate the effects of the MBP. A total of 43 parents were recruited and were randomly assigned into intervention group and waitlist control group. The online MBP lasted for 28 days, including 20 psychoeducation videos, homework audio guidance, and four instructor-led online group meetings. Purposive sampling was used to recruit parents who completed the program to share their experiences and suggestions for improving the program in semi-structured online interviews.ResultsQuantitative data showed that participants from the online MBP reported a medium to large effect on the reduction of child ADHD symptoms. In semi-structured interviews, participants reported positive experiences in their help seeking intention, and personal changes, such as emotion regulation and quality attention to their children. Participants further made suggestions for improvement.ConclusionsThe effect of online MBP is promising, and the program should be conducted. A large scale randomized controlled trial should be conducted to investigate the effects of MBP in clinical populations.Clinical trial registrationClinicalTrials.gov NCT05480423.

Sepsis is a life-threatening illness caused by the dysregulated host response to infection. Nevertheless, our current knowledge of the microbial landscape in the blood of septic patients is still limited. Next-generation sequencing (NGS) is a sensitive method to quantitatively characterize microbiomes at various sites of the human body. In this study, we analyzed the blood microbial DNA of 22 adult patients with sepsis and 3 healthy subjects. The presence of non-human DNA was identified in both healthy and septic subjects. Septic patients had a markedly altered microbial DNA profile compared to healthy subjects over α- and β-diversity. Unexpectedly, the patients could be further divided into two subgroups (C1 and C2) based on β-diversity analysis. C1 patients showed much higher bacteria, viruses, fungi, and archaea abundance, and a higher level of α-diversity (Chao1, Observed and Shannon index) than both C2 patients and healthy subjects. The most striking difference was seen in the case of Streptomyces violaceusniger, Phenylobacterium sp. HYN0004, Caulobacter flavus, Streptomyces sp. 11-1-2, and Phenylobacterium zucineum, the abundance of which was the highest in the C1 group. Notably, C1 patients had a significantly poorer outcome than C2 patients. Moreover, by analyzing the patterns of microbe-microbe interactions in healthy and septic subjects, we revealed that C1 and C2 patients exhibited distinct co-occurrence and co-exclusion relationships. Together, our study uncovered two distinct microbial signatures in the blood of septic patients. Compositional and ecological analysis of blood microbial DNA may thus be useful in predicting mortality of septic patients.

Abstract 2D conjugated metal‐organic frameworks (c‐MOFs) have emerged as promising materials for (opto)electronic applications due to their excellent charge transport properties originating from the unique layered‐stacked structures with extended in‐plane conjugation. The further advancement of MOF‐based (opto)electronics necessitates the development of novel 2D c‐MOF thin films with high quality. Cu‐HHHATN (HHHATN: hexahydroxyl‐hexaazatrinaphthylene) is a recently reported 2D c‐MOF featuring high in‐plane conjugation, strong interlayer π–π stacking, and multiple coordination sites, while the production of its thin‐film form has not yet been reported. Herein, large‐area Cu‐HHHATN thin films with preferential orientation, high uniformity, and smooth surfaces are realized by using a convenient layer‐by‐layer growth method. Flexible photodetectors are fabricated, showing broadband photoresponse ranging from UV to short‐wave infrared (370 to 1450 nm). The relatively long relaxation time of photocurrent, which arises from the trapping of photocarriers, renders the device's synaptic plasticity similar to that of biological synapses, promising its use in neuromorphic visual systems. This work demonstrates the great potential of Cu‐HHHATN thin films in flexible optoelectronic devices for various applications.

Customer churn is defined as the tendency of customers to cease doing business with a company in a given period. ABC Multistate Bank faces the challenges to hold clients. The purpose of this study is to apply machine learning algorithms to develop the most effective model for predicting bank customer churn. In this study, six supervised machine learning methods, K-Nearest Neighbors, Support Vector Machine, Naïve Bayes, Decision Tree, Random Forest, and Extreme Gradient Boosting (XGBoost), are applied to the churn prediction model using Bank Customer Data of ABC Multistate Bank obtained from Kaggle. The results showed that XGBoost outperformed the other six classifiers, with an accuracy rate of 84.76%, an F1 score of 56.95%, and a ROC curve graph of 71.64%. The bank may use XGBoost model to accurately identify customers who are at risk of leaving, concentrate their efforts on them, and possibly make a profit. Future research should focus on various machine learning approaches for determining the most accurate models for bank customer churn datasets.

Regular physical activity (PA) contributes to maintaining health and improving the quality of life among older people. This cross-sectional study investigates the associations between motivations derived from self-determination theory (SDT) and physical activity levels, as well as health-related fitness indices, in older Chinese women. We recruited 92 retired older women (range: 60–85 years; mean age ± SD: 71.74 ± 5.39 years) from Hong Kong, China. We assessed participants' motivations (autonomous motivation, controlled motivation, and amotivation) using the Treatment Self-Regulation Questionnaire, and measured their moderate-to-vigorous intensity physical activity (MVPA) and weekly walking using the International Physical Activity Questionnaire. We also evaluated body fat (fat mass, fat percentage, and visceral fat) using the Tanita SC240MA, flexibility with the Back Scratch Test and Chair Sit-and-Reach Test, and muscle strength using the Five-Times Sit-to-Stand Test and ''Timed Up and Go'' Test. We analyzed the data using partial-least squares structural equation modeling with Warp PLS 8.0 software. The results showed that autonomous motivation was significantly and positively related to walking (β = .24, p

This paper proposed a novel fuzzy logic weighted averaging (FLWA) algorithm in image processing techniques to detect counterfeit Malaysian banknotes. Image acquisition techniques on banknote position detection and re-adjustment, image pre-processing techniques, feature extraction methods on Malaysian banknotes’ watermarks are also covered in the paper. The FLWA Algorithm has the advantage of a much simpler model since it is a human guidance learning algorithm that does not require enrolment process to get the specific weights for each security feature. Each security feature is treated with equal weight. The experimental results also shown that FLWA model also outperform the MobileNet model and VGG16 model in Malaysian banknotes’ counterfeit detection. It has a distinct advantage over earlier or current banknote counterfeit detection techniques in that it adopted the known watermarks features, with known machine learning techniques to identify real Malaysian banknotes and detect those counterfeit Malaysian banknotes.

Duchenne muscular dystrophy (DMD) is a disease with a life-threatening trajectory resulting from mutations in the dystrophin gene, leading to degeneration of skeletal muscle and fibrosis of cardiac muscle. The overwhelming majority of mutations are multiexonic deletions. We previously established a dystrophic mouse model with deletion of exons 52–54 in Dmd that develops an early-onset cardiac phenotype similar to DMD patients. Here we employed CRISPR-Cas9 delivered intravenously by adeno-associated virus (AAV) vectors to restore functional dystrophin expression via excision or skipping of exon 55. Exon skipping with a solitary guide significantly improved editing outcomes and dystrophin recovery over dual guide excision. Some improvements to genomic and transcript editing levels were observed when the guide dose was enhanced, but dystrophin restoration did not improve considerably. Editing and dystrophin recovery were restricted primarily to cardiac tissue. Remarkably, our exon skipping approach completely prevented onset of the cardiac phenotype in treated mice up to 12 weeks. Thus, our results demonstrate that intravenous delivery of a single-cut CRISPR-Cas9-mediated exon skipping therapy can prevent heart dysfunction in DMD in vivo.