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Han-Yu Chen,1 Shyi-Kuen Wu,1 Chuan-Chin Lu,1,2 Jia-Yuan You,3 Chung-Liang Lai4 1Department of Physical Therapy, Hungkuang University, Taichung, Taiwan; 2Department of Rheumatology, Taichung Hospital, Department of Health, Taiwan; 3Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan; 4Department of Physical Medicine and Rehabilitation, Taichung Hospital, Department of Health, Taiwan Purpose: Traditionally, the measurement of the maximal mouth opening was regarded as the mobility of the temporomandibular joint. The information, however, was not reliable. Sonography was often used to diagnose disc displacement in the temporomandibular joint and its validity was well established. The tool was also appropriate for measuring the outcome of temporomandibular disorders management. Therefore, the purpose of the study was to examine completely the reliability and error for evaluating the mobility of the mandibular condyle by sonography. In addition, the existing methods were modified to improve the repeatability.Patients and methods: The reliability examinations included between-image and within-image explorations to represent the reliabilities of the image capturing and the mobility measuring, respectively. Sixty-two subjects were recruited to receive ultrasonic examination for condylar mobility. The images of the condyle in mouth closing and opening were captured and the horizontal displacement of the condyles was measured as the anterior translation of the condyle. To confirm that the probe did not move during mouth opening, a marker was placed between the skin and the ultrasonic probe as the landmark.Results: The results demonstrated that the intrarater and interrater reliabilities in the within-image test were 0.986 and 0.970 and the reliabilities in the between-image test were 0.904 and 0.857, respectively. The standard errors of measurement in the within-image and between-image tests were 0.04 cm and 0.09 cm, respectively.Conclusion: Sonography is a reliable tool to assess condylar mobility and can be used to measure the treatment outcome for temporomandibular disorders. Keywords: temporomandibular disorders, sonography, mandibular condyle, reliability

Sheng-Kai Wu,1 Chi-Feng Chiang,1 Yu-Hone Hsu,1,4 Tzu-Hung Lin,2 Houng-Chi Liou,2 Wen-Mei Fu,2 Win-Li Lin1,3 1Institute of Biomedical Engineering, College of Medicine and College of Engineering, 2Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan; 3Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan; 4Department of Neurosurgery, Cheng-Hsin General Hospital, Taipei, Taiwan Abstract: The blood–brain/tumor barrier inhibits the uptake and accumulation of chemotherapeutic drugs. Hyperthermia can enhance the delivery of chemotherapeutic agent into tumors. In this study, we investigated the effects of short-time focused ultrasound (FUS) hyperthermia on the delivery and therapeutic efficacy of pegylated liposomal doxorubicin (PLD) for brain metastasis of breast cancer. Murine breast cancer 4T1-luc2 cells expressing firefly luciferase were injected into female BALB/c mice striatum tissues and used as a brain metastasis model. The mice were intravenously injected with PLD (5 mg/kg) with/without 10-minute transcranial FUS hyperthermia on day 6 after tumor implantation. The amounts of doxorubicin accumulated in the normal brain tissues and tumor tissues with/without FUS hyperthermia were measured using fluorometry. The tumor growth for the control, hyperthermia, PLD, and PLD + hyperthermia groups was measured using an IVIS spectrum system every other day from day 3 to day 11. Cell apoptosis and tumor characteristics were assessed using immunohistochemistry. Short-time FUS hyperthermia was able to significantly enhance the PLD delivery into brain tumors. The tumor growth was effectively inhibited by a single treatment of PLD + hyperthermia compared with both PLD alone and short-time FUS hyperthermia alone. Immunohistochemical examination further demonstrated the therapeutic efficacy of PLD plus short-time FUS hyperthermia for brain metastasis of breast cancer. The application of short-time FUS hyperthermia after nanodrug injection may be an effective approach to enhance nanodrug delivery and improve the treatment of metastatic cancers. Keywords: hyperthermia, focused ultrasound (FUS), pegylated liposomal doxorubicin (PLD), brain metastasis of breast cancer

The purpose was to examine classifiers as agents of social control in disability swimming. The examination centered on three themes: (a) resources used by classifiers to maintain the authority of Sports Assembly Executive Committee-Swimming (SAEC-SW) of the International Paralympic Committee (IPC), (b) socialization to become classifiers, and (c) influence of dominant groups. Data were collected using participant observation methodology at national and international swimming championships and a survey of the 18 SAEC-SW authorized classifiers. The results identified six essential features of SAEC-SW classifiers. SAEC-SW classifiers use their medical and swimming knowledge and experience to control the classification process and to maintain fairness of competition. Socialization of SAEC-SW classifiers enables them to play their role appropriately in disability swimming classification. [ABSTRACT FROM AUTHOR]

The aim was to analyze the relationship between performance and classes of swimmers and between types of physical impairments and medal winners. Participants were 374 swimmers at the 1996 Paralympic Games with six types of impairments: poliomyelitis, cerebral palsy, spinal cord injury, amputation, dysmelia, and les autres. Data included performance times, gender, classification, swimming stroke and distance, and type of impairment. ANOVA and Spearman rank correlation treatment of data revealed significant differences in swimmers' mean speeds across classes and positive correlations in swimmers' classes and swimming speeds in all male and female events; no type of impairment dominated the opportunity to participate, win medals, or advance to the finals. It was concluded that the current swimming classification system is effective with respect to generating fair competition for most swimmers. [ABSTRACT FROM AUTHOR]

The insufficient investigations on the changes of spinal structures during traction prevent further exploring the possible therapeutic mechanism of cervical traction. A blind randomized crossover-design study was conducted to quantitatively compare the intervertebral disc spaces between axial and anterior lean cervical traction in sitting position. A total of 96 radiographic images from the baseline measurements, axial and anterior lean tractions in 32 asymptomatic subjects were digitized for further analysis. The intra- and inter-examiner reliabilities for measuring the intervertebral disc spaces were in good ranges (ICCs = 0.928-0.942). With the application of anterior lean traction, the statistical increases were detected both in anterior and in posterior disc spaces compared to the baseline (0.29 mm and 0.24 mm; both P < 0.01) and axial traction (0.16 mm and 0.35 mm; both P < 0.01). The greater intervertebral disc spaces obtained during anterior lean traction might be associated with the more even distribution of traction forces over the anterior and posterior neck structures. The neck extension moment through mandible that generally occurred in the axial traction could be counteracted by the downward force of head weight during anterior lean traction. This study quantitatively demonstrated that anterior lean traction in sitting position provided more intervertebral disc space enlargements in both anterior and posterior aspects than axial traction did. These findings may serve as a therapeutic reference when cervical traction is suggested. [ABSTRACT FROM AUTHOR]

Objective: To explore the electrophysiological properties of differentiation of rat bone marrow-derived stromal stem cells (rBMSCs) to neuron-like cells in vitro by edaravone, a new type of free radical scavenger.Methods: Stromal stem cells were separated from rat bone marrow with Ficoll-Paque reagent and expanded in different culture medium in vitro. rBMSCs were induced by edaravone containing serum-free L-DMEM. Morphologic observation and Western blot analysis including the expression of Nav1.6, Kv1.2, Kv1.3, Cav1.2 were performed, and whole patch-clamp technique was used.Results: Cyton contraction and long processes were shown in differentiated stromal stem cells. Nav1.6, Kv1.2, Kv1.3 and Cav1.2 were expressed in both differentiated and undifferentiated cells. However, the expression of channel proteins in differentiated cells was up-regulated. Consistently, their resting potential and outward currents were also enhanced in the differentiated cells, which was especially significant in the outward rectifier potassium current.Conclusion: In vitro, neuron-like cells derived from rBMSCs, induced by edaravone, possess electrophysiological properties of neurons. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have assessed surgical resection as a standard treatment option for patients with colorectal cancer (CRC) and resectable pulmonary metastases (PM). However, the role of perioperative chemotherapy after complete resection of isolated PM from patients with CRC patients remains controversial. We hypothesize that perioperative chemotherapy does not provide significant survival benefits for patients undergoing resection of PM from CRC., Aim: To determine whether perioperative chemotherapy affects survival after radical resection of isolated PM from CRC., Methods: We retrospectively collected demographic, clinical, and pathologic data on patients who underwent radical surgery for isolated PM from CRC. Cancer-specific survival (CSS) and disease-free survival were calculated using Kaplan-Meier analysis. Inter-group differences were compared using the log-rank test. For multivariate analysis, Cox regression was utilized when indicated., Results: This study included 120 patients with a median age of 61.6 years. The 5-year CSS rate was 78.2%, with 36.7% experiencing recurrence. Surgical resection for isolated PM resulted in a 5-year CSS rate of 50.0% for second metastases. Perioperative chemotherapy ( P = 0.079) did not enhance survival post-resection. Factors associated with improved survival included fewer metastatic lesions [hazard ratio (HR): 2.51, P = 0.045], longer disease-free intervals (HR: 0.35, P = 0.016), and wedge lung resections (HR: 0.42, P = 0.035). Multiple PM predicted higher recurrence risk (HR: 2.22, P = 0.022). The log-rank test showed no significant difference in CSS between single and repeated metastasectomy ( P = 0.92)., Conclusion: Perioperative chemotherapy shows no survival benefit post-PM resection in CRC. Disease-free intervals and fewer metastatic lesions predict better survival. Repeated metastasectomy is warranted for eligible patients., Competing Interests: Conflict-of-interest statement: The authors have no relevant financial or non-financial interests to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

This study aims to assess the motivational factors influencing the participation of older adults in various exercise interventions during depressive episodes and to identify which types of exercise are most effective in alleviating depressive symptoms in this population. Therefore, randomized controlled trials (RCTs) focusing on exercise interventions and their impact on depression in older adult patients, identified by the terms "exercise" AND "depression" AND "elderly" OR "geriatric", were selected from primary electronic databases to conduct this network meta-analysis (NMA). The primary outcome was the effect on depressive symptoms, while the secondary outcome was the comparison of dropout rates between the intervention groups and the usual care control groups, as a measure of sustained motivation and engagement. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed for effect evaluation. This study protocol has been registered in IPLASY (INPLASY 202460035). The results of 31 RCTs with 3238 participants indicated that qigong (SMD -1.17, -2.28 to -0.06), Otago Exercise (SMD -1.15, -2.29 to -0.01), and yoga (SMD -0.88, -1.55 to -0.21) significantly alleviate depressive symptoms in older adults. Walking (SMD -0.82, -1.34 to -0.31) and strength training (SMD -0.67, -1.05 to -0.30) also showed significant effects. Aerobic, physical training, and tai chi had moderate effects, while multisport showed a weaker impact with no significant improvement. In summary, our research findings demonstrate that exercise can effectively alleviate depressive symptoms in older adults, with low dropout rates likely due to interconnected physiological, psychological, and social mechanisms. This is crucial for enhancing treatment strategies for older adults' depression.

Acute kidney injury (AKI) is a critical complication known for their extremely high mortality rate and lack of effective clinical therapy. Disorders in mitochondrial dynamics possess a pivotal role in the occurrence and progression of contrast-induced nephropathy (CIN) by activating NLRP3 inflammasome. The activation of dynamin-related protein-1 (Drp1) can trigger mitochondrial dynamic disorders by regulating excessive mitochondrial fission. However, the precise role of Drp1 during CIN has not been clarified. In vivo experiments revealed that inhibiting Drp1 through Mdivi-1 (one selective inhibitor of Drp1) can significantly decrease the expression of p-Drp1 (Ser616), mitochondrial p-Drp1 (Ser616), mitochondrial Bax, mitochondrial reactive oxygen species (mROS), NLRP3, caspase-1, ASC, TNF-α, IL-1β, interleukin (IL)-18, IL-6, creatinine (Cr), malondialdehyde (MDA), blood urea nitrogen (BUN), and KIM-1. Moreover, Mdivi-1 reduced kidney pathological injury and downregulated the interaction between NLRP3 and thioredoxin-interacting protein (TXNIP), which was accompanied by decreased interactions between TRX and TXNIP. This resulted in increasing superoxide dismutase (SOD) and CAT activity, TRX expression, up-regulating mitochondrial membrane potential, and augmenting ATP contents and p-Drp1 (Ser616) levels in the cytoplasm. However, it did not bring impact on the expression of p-Drp1 (Ser637) and TXNIP. Activating Drp-1though Acetaldehyde abrogated the effects of Mdivi-1. In addition, the results of in vitro studies employing siRNA-Drp1 and plasmid-Drp1 intervention in HK-2 cells treated with iohexol were consistent with the in vivo experiments. Our findings revealed inhibiting Drp1 phosphorylation at Ser616 could ameliorate iohexol -induced acute kidney injury though alleviating the activation of the TXNIP-NLRP3 inflammasome pathway., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Integrating two-dimensional (2D) layered materials with wide bandgap β-Ga 2 O 3 has unveiled impressive opportunities for exploring novel physics and device concepts. This study presents the epitaxial growth of 2D β-In 2 Se 3 /3D β-Ga 2 O 3 heterostructures on c-Sapphire substrates by plasma-assisted molecular beam epitaxy. Firstly, we employed a temperature-dependent two-step growth process to deposit Ga 2 O 3 and obtained a phase-pure ( 2 ¯ 01 ) β-Ga 2 O 3 film on c-Sapphire. Interestingly, the in-situ reflective high-energy electron diffraction (RHEED) patterns observed from this heterostructure revealed the in-plane 'b' lattice constant of β-Ga 2 O 3  ~ 3.038Å. In the next stage, for the first time, 2D In 2 Se 3 layers were epitaxially realized on 3D β-Ga 2 O 3 under varying substrate temperatures (T sub ) and Se/In flux ratios (R VI/III ). The deposited layers exhibited (00l) oriented β-In 2 Se 3 on ( 2 ¯ 01 ) β-Ga 2 O 3 /c-Sapphire with the epitaxial relationship of [ 11 2 ¯ 0 ] β-In 2 Se 3 || [010] β-Ga 2 O 3 and [ 10 1 ¯ 0 ] β-In 2 Se 3 || [102] β-Ga 2 O 3 as observed from the RHEED patterns. Also, the in-plane 'a' lattice constant of β-In 2 Se 3 was determined to be ~ 4.027Å. The single-phase β-In 2 Se 3 layers with improved structural and surface quality were achieved at a T sub  ~ 280 °C and R VI/III  ~ 18. The microstructural and detailed elemental analysis further confirmed the epitaxy of 2D layered β-In 2 Se 3 on 3D β-Ga 2 O 3 , a consequence of the quasi-van der Waals epitaxy. Furthermore, the β-Ga 2 O 3 with an optical bandgap (E g ) of ~ 5.04 eV (deep ultraviolet) when integrated with 2D β-In 2 Se 3 , E g  ~ 1.43eV (near infra-red) can reveal potential applications in the optoelectronic field., (© 2024. The Author(s).)

This study investigated the efficacy and safety of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in relapse prevention of bipolar disorder (BD), addressing the shortcomings of current medications. Thirty-one stable BD patients were randomized to receive n-3 PUFAs or placebo for 6 months and intergroup differences in the incidence of the recurrence of bipolar depression were assessed. Differences in depression severity, manic symptoms, and routine biochemical parameters were also assessed. Interestingly, n-3 PUFAs demonstrated a favorable preventive effect on bipolar depression recurrence (p=0.005; Log-Rank) and reduced depression severity compared to placebo, and were well-tolerated, suggesting their potential as a safe prophylactic therapy for BD., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Understanding of psychosocial factors of physical activity (PA) in children is crucial in encouraging sustained PA, which in turn is associated with important health outcomes. This study aimed to examine how children's attraction to physical activity (CAPA) is associated with PA., Methods: This cross-sectional study was conducted among 219 primary school children (105 boys; 114 girls) aged 7 years old-10 years old in Kuala Lumpur, Malaysia in 2016-2017. Children from three main ethnicities, namely Malay, Chinese and Indian, were recruited. Weight, height and waist circumference were measured; body composition was assessed by deuterium dilution technique. CAPA and level of PA were obtained through self-administered questionnaires and reported as CAPA and PA scores., Results: Median CAPA and PA scores were 3.40 (Q 1 = 3.00, Q 3 = 3.80) and 2.31 (Q 1 = 1.95, Q 3 = 2.74), respectively. Significant gender differences were found in CAPA and PA scores, with boys being more attracted to PA (3.16 [Q 1 = 2.90, Q 3 = 3.44]; P = 0.001) and more physically active compared with girls (2.47 [Q 1 = 2.07, Q 3 = 3.07]; P = 0.001). CAPA and PA scores correlated positively in both sexes. Boys scored higher than girls in 'liking of games and sports' (ρ = 0.301, P = 0.002) and 'liking of vigorous PA' (ρ = 0.227, P = 0.02) CAPA subscales, which also correlated positively with PA scores. Girls' PA scores correlated with 'peer acceptance in games and sports' (ρ = 0.329, P < 0.001)., Conclusion: Boys are more physically active and have higher attraction to PA compared with girls. Differences in PA scores between the sexes were related to gender differences in CAPA scores. Thus, attention should be given to gender differences in CAPA related psychosocial factors when planning interventions to promote PA among children., Competing Interests: Conflict of Interests: None., (© Penerbit Universiti Sains Malaysia, 2023.)

The nanotribological properties of aluminum gallium nitride (Al x Ga 1-x N) epitaxial films grown on low-temperature-grown GaN/AlN/Si substrates were investigated using a nanoscratch system. It was confirmed that the Al compositions played an important role, which was directly influencing the strength of the bonding forces and the shear resistance. It was verified that the measured friction coefficient (μ) values of the Al x Ga 1-x N films from the Al compositions (where x = 0.065, 0.085, and 0.137) were in the range of 0.8, 0.5, and 0.3, respectively, for Fn = 2000 μN and 0.12, 0.9, and 0.7, respectively, for Fn = 4000 μN. The values of μ were found to decrease with the increases in the Al compositions. We concluded that the Al composition played an important role in the reconstruction of the crystallites, which induced the transition phenomenon of brittleness to ductility in the Al x Ga 1-x N system.

The menopausal transition is often accompanied with distressing manifestations, such as vasomotor symptoms, sleep disruptions, and depressive syndrome. Omega-3 polyunsaturated fatty acids ( n -3 PUFAs) have emerged as a potential intervention to alleviate these symptoms. This review aimed to comprehensively assess the impact of n -3 PUFAs supplementation on vasomotor symptoms, sleep quality, and depression among postmenopausal women. We conducted a systematic literature search of randomized controlled trials across the Cochrane Library, Web of Science, PubMed, CINAHL, EMBASE, and SCOPUS databases from inception to August 2023. Among the initial pool of 163 identified studies, nine studies met the inclusion criteria and were incorporated into this systematic review. Notably, four studies detected potential benefits of n -3 PUFAs in improving hot flashes and night sweats. On the contrary, sleep quality outcomes displayed heterogeneity across the studies. Incorporating diverse scales, such as the Hamilton Depression Rating Scale-21, the Patient Health Questionnaire depression scale, and Generalized Anxiety Disorder-7 for depression outcomes, we found inconclusive evidence of n -3 PUFA's impact on depression. Overall, the combined analysis of these studies did not provide substantial evidence to support the efficacy of n -3 PUFAs in improving vasomotor symptoms, sleep quality, and depression. Further well-designed randomized clinical trials with larger participant groups are crucial to validate and generalize these results. Review Registration: PROSPERO registration no: CRD42023421922.

This study aimed to provide up-to-date information regarding the estimated prevalence of developmental coordination disorder (DCD) in Taiwanese children. Their unhealthy weight status was also examined, as well as the roles of sex and age. This cross-sectional study recruited 825 children aged between 4 and 12 years and categorized them into either typically developing children (TD, >16th percentile) or children at risk for DCD (rDCD, ≤16th percentile) based on the result of the Movement Assessment Battery for Children-2nd edition. Body mass index was calculated to determine weight status (i.e., normal weight, underweight, overweight, and obesity). The estimated prevalence of rDCD was 9.7%. There were significantly more boys in the rDCD groups ( p < 0.001). Additionally, preschool children with rDCD were at greater risk for being underweight. However, there was no significant group difference which was found for overweight/obesity. A lower prevalence of rDCD was found in this study. Nevertheless, children with rDCD may be more likely to be underweight in early childhood. Early intervention should be provided to target this population.

The co-occurrence of depression and obesity has become a significant public health concern worldwide. Recent studies have shown that metabolic dysfunction, which is commonly observed in obese individuals and is characterized by inflammation, insulin resistance, leptin resistance, and hypertension, is a critical risk factor for depression. This dysfunction may induce structural and functional changes in the brain, ultimately contributing to depression's development. Given that obesity and depression mutually increase each other's risk of development by 50-60%, there is a need for effective interventions that address both conditions. The comorbidity of depression with obesity and metabolic dysregulation is thought to be related to chronic low-grade inflammation, characterized by increased circulating levels of pro-inflammatory cytokines and C-reactive protein (CRP). As pharmacotherapy fails in at least 30-40% of cases to adequately treat major depressive disorder, a nutritional approach is emerging as a promising alternative. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are a promising dietary intervention that can reduce inflammatory biomarkers, particularly in patients with high levels of inflammation, including pregnant women with gestational diabetes, patients with type 2 diabetes mellitus, and overweight individuals with major depressive disorder. Further efforts directed at implementing these strategies in clinical practice could contribute to improved outcomes in patients with depression, comorbid obesity, and/or metabolic dysregulation.

Objective: To grasp the epidemiological characteristics of influenza outbreaks in Guangdong Province by analyzing the outbreaks of influenza-like cases reported in Guangdong Province from January 2015 to the end of August 2022. Methods: In response to the outbreak of epidemics in Guangdong Province from 2015 to 2022, information on on-site epidemic control was collected, and epidemiological analysis was conducted to describe the characteristics of the epidemics. The factors that influence the intensity and duration of the outbreak were determined through a logistic regression model. Results: A total of 1 901 influenza outbreaks were reported in Guangdong Province, with an overall incidence of 2.05%. Most outbreak reports occurred from November to January of the following year (50.24%, 955/1 901) and from April to June (29.88%, 568/1 901). A total of 59.23% (1 126/1 901) of the outbreaks were reported in the Pearl River Delta region, and primary and secondary schools were the main places where outbreaks occurred (88.01%, 1 673/1 901). Outbreaks with 10-29 cases were the most common (66.18%, 1 258/1 901), and most outbreaks lasted less than seven days (50.93%,906/1 779). The size of the outbreak was related to the nursery school (a OR =0.38, 95% CI :0.15-0.93), the Pearl River Delta region (a OR =0.60, 95% CI :0.44-0.83), the time interval between the onset of the first case and the time of report (>7 days compared with ≤3 days: a OR =3.01, 95% CI :1.84-4.90), the influenza A(H1N1) (a OR =2.02, 95% CI :1.15-3.55) and the influenza B (Yamagata) (a OR =2.94, 95% CI : 1.50-5.76). The duration of outbreaks was related to school closures (a OR =0.65, 95% CI : 0.47-0.89), the Pearl River Delta region (a OR =0.65, 95% CI : 0.50-0.83) and the time interval between the onset of the first case and the time of report (>7 days compared with ≤3 days: a OR =13.33, 95% CI : 8.80-20.19; 4-7 days compared with ≤3 days: a OR =2.56, 95% CI : 1.81-3.61). Conclusions: An influenza outbreak in Guangdong Province exhibits two peaks, one in the winter and spring seasons and the other in the summer. Primary and secondary schools are high-risk areas, and early reporting of outbreaks is critical for controlling influenza outbreaks in schools. Furthermore, comprehensive measures should be taken to prevent the spread of the epidemic.

We explored clinicopathological features and treatment strategies for thoracic SMARCA4 -deficient undifferentiated tumor ( SMARCA4 -UT). Thoracic SMARCA4 -UT is a new entity recently acknowledged in the 2021 edition of World Health Organization Classification of Thoracic Tumors, and doctors are relatively unfamiliar with its diagnosis, treatment, and prognosis. Taking a case of SMARCA4 -UT treated in Peking University First Hospital as an example, this multi-disciplinary discussion covered several hot issues on diagnosing and treating thoracic SMARCA4 -UT, including histological features, immu- nohistochemical and molecular phenotype, immune checkpoint inhibitor (ICI) therapy, and pathological assessment of neoadjuvant therapy response. The patient was an older man with a long history of smoking and was admitted due to a rapidly progressing solid tumor in the lower lobe of the right lung. Histologically, tumor cells were epithelioid, undifferentiated, diffusely positive for CD34, and partially positive for SALL4.The expression of BRG1 protein encoded by SMARCA4 gene was lost in all of tumor cells, and next-generation sequencing(NGS)confirmed SMARCA4 gene mutation (c.2196T>G, p.Y732Ter). The pathological diagnosis reached as thoracic SMARCA4 -UT, and the preoperative TNM stage was T1N2M0 (ⅢA). Tumor proportion score (TPS) detected by immunohistochemistry of programmed cell death 1-ligand 1 (PD-L1, clone SP263) was 2%. Tumor mutation burden (TMB) detected by NGS of 1 021 genes was 16. 3/Mb. Microsatellite detection showed the tumor was microsatellite stable (MSS). Neo-adjuvant therapy was implemented with the combined regimen of chemotherapy and ICI. Right lower lobectomy was performed through thoracoscopy after the two weeks' neoadjuvant. The pathologic assessment of lung tumor specimens after neoadjuvant therapy revealed a complete pathological response (CPR). The post-neoadjuvant tumor TNM stage was ypT0N0M0. Then, five cycles of adjuvant therapy were completed. Until October 2022, neither tumor recurrence nor metastasis was detected, and minimal residual disease (MRD) detection was negative. At present, it is believed that if BRG1 immunohistochemical staining is negative, regardless of whether SMARCA4 gene mutation is detected, it should be classified as SMARCA4 -deficient tumors. SMARCA4 -deficient tumors include a variety of carcinomas and sarcomas. The essential criteria for diagnosing SMARCA4 -UT includes loss of BRG1 expression, speci-fic histological morphology, and exclude other common thoracic malignant tumors with SMARCA4 -deficiency, such as squamous cell carcinoma, adenocarcinoma and large cell carcinoma. SMARCA4 -UT is a very aggressive malignant tumor with a poor prognosis. It has almost no targeted therapy mutations, and little response to chemotherapy, but ICI is currently the only effective drug. The successful diagnosis and treatment for this case of SMARCA4 -UT should enlighten significance for various kinds of SMARCA4 -deficient tumors.

Objective: This study investigated whether parental SES moderates the effect of birth health on Developmental Coordination Disorder (DCD) in preschool children., Methods: One hundred and twenty-two children aged 4 to 6 years were enrolled in the study. The Movement Assessment Battery for Children --2nd Edition (MABC-2) test was used to assess the motor coordination of children. They were preliminarily categorized into either the DCD (<=16th percentile, n = 23) or typically developing (TD) group (>16th percentile, n = 99) based on the testing results. All children in the DCD group were further confirmed to meet other diagnostic criteria of the DSM-V using the intellectual test and parental questionnaires. Moderation analysis was conducted using the PROCESS macro for SPSS, and 95% confidence intervals with a bootstrap procedure were calculated to identify the significant moderating effect., Results: Maternal education (unstandardized coefficient = 0.6805, SE = 0.3371, p < 0.05) and maternal employment status (unstandardized coefficient = 0.6100, SE = 0.3059, p < 0.05) were found to moderate the relationship between birth length and the probability of having DCD. Moreover, the relationship between birth weight and the probability of having DCD was moderated by the annual household income (unstandardized coefficient = -0.0043, SE = 0.0022, p < 0.05)., Conclusion: The lower maternal education level and maternal unemployment strengthened the negative relationship between birth length and the probability of having DCD. Additionally, the negative relationship between birth weight and the probability of having DCD was statistically significant in high annual household salaries., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Tran, Tseng, Chen, Wu and Li.)

The senescence-associated secretory phenotype (SASP) can promote paracrine invasion while suppressing tumour growth, thus generating complex phenotypic outcomes. Likewise, centrosome amplification can induce proliferation arrest yet also facilitate tumour invasion. However, the eventual fate of cells with centrosome amplification remains elusive. Here, we report that centrosome amplification induces a variant of SASP, which constitutes a pathway activating paracrine invasion. The centrosome amplification-induced SASP is non-canonical as it lacks the archetypal detectable DNA damage and prominent NF-κB activation, but involves Rac activation and production of reactive oxygen species. Consequently, it induces hypoxia-inducible factor 1α and associated genes, including pro-migratory factors such as ANGPTL4. Of note, cellular senescence can either induce tumourigenesis through paracrine signalling or conversely suppress tumourigenesis through p53 induction. By analogy, centrosome amplification-induced SASP may therefore be one reason why extra centrosomes promote malignancy in some experimental models but are neutral in others., (© 2023 The Authors. Aging Cell published by Anatomical Society and John Wiley & Sons Ltd.)

Continuous steering movement (CSM) is an essential component of the upper extremity (UE) task during vehicle driving, and could be a suitable candidate for multi-joint rehabilitation programs for patients with UE disabilities. This study aims to evaluate the UE muscle activation during CSM and how the rotating speed and direction affect CSM's kinematic and kinetic performance. Surface electromyography (EMG), hand contact information, and steering torque were measured under fast (180°/s) and slow (60°/s) constant-velocity CSM to reveal the activation of shoulder and elbow muscles, temporal characteristics, and force exertion during the stance and swing phases of a CSM cycle. Data from 24 normal young adults showed that shorter contact duration but higher force exertion occurred in the hand moving in an outward steering direction during only fast CSM in either the clockwise (CW) or counterclockwise (CCW) direction. During a steering cycle (either fast or slow speed), the triceps brachii, sternal part of the pectoralis major (PS), and posterior deltoid play major roles in generating steering torque in the CW direction of the CSM. In contrast, the PS, clavicular part of the pectoralis major (PC), and anterior deltoid (AD) largely contribute to torque generation during the CCW CSM. During the swing phase of CSM, AD, PC, and PS are the major muscles that move the hand for the next grasping of the steering wheel in all four conditions. Using the mean activation profiles of the major contributing muscles, the functional roles of these elbow and shoulder muscles were analyzed and are discussed herein. These findings help us to further understand the activation patterns of UE muscles and the kinematic and kinetic changes during two rotating directions and two speeds of CSM, and suggest important implications for future practice in clinical training., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: To better understand biomechanical factors that affect intervertebral alignment throughout active therapeutic exercise, it is necessary to determine spinal kinematics when subjects perform spinal exercises. This study aims to investigate the outcomes of active cervical therapeutic exercise on intervertebral foramen changes in neck pain patients with disc herniation., Methods: Thirty diagnosed C4/5 and/or C5/6 disc-herniated patients receiving an 8-week cervical therapeutic exercise program were followed up with videofluoroscopic images. The dynamic changes in the foramen were computed at different timepoints, including the neutral position, end-range positions in cervical flexion-extension, protrusion-retraction, and lateral flexion movements., Results: The results showed that the active cervical flexion, retraction, and lateral flexion away from the affected side movements increased the area of the patients' intervertebral foramen; while the active extension, protrusion, and lateral flexion toward the affected side reduced the areas of intervertebral foramen before treatment. After the treatment, the active cervical flexion significantly increased the C2/3, C3/4, and C6/7 foramen area by 5.02-8.67% (p = 0.001 ~ 0.029), and the extension exercise significantly reduced the C2/3 and C4/5 area by 5.12-9.18% (p = 0.001 ~ 0.006) compared to the baseline. Active retraction movement significantly increased the foramen area from C2/3 to C6/7 by 3.82-8.66% (p = 0.002 ~ 0.036 with exception of C5/6). Active lateral flexion away from the affected side significantly increased the foramen by 3.71-6.78% (p = 0.007 ~ 0.046 with exception of C6/7)., Conclusions: The 8-week therapeutic exercises including repeated cervical retraction, extension, and lateral flexion movements to the lesion led to significant changes and improvements in intervertebral foramen areas of the patients with disc herniation., Trial Registration: ISRCTN61539024., (© 2022. The Author(s).)

Single-phase two-dimensional (2D) indium monoselenide (γ-InSe) film is successfully grown via solid phase epitaxy in the molecular beam epitaxy (MBE) system. Having high electron mobility and high photoresponsivity, ultrathin 2D γ-InSe semiconductors are attractive for future field-effect transistor and optoelectronic devices. However, growing single-phase γ-InSe film is a challenge due to the polymorphic nature of indium selenide (γ-InSe, α-In 2 Se 3 , β-In 2 Se 3 , γ-In 2 Se 3 , etc.). In this work, the 2D α-In 2 Se 3 film was first grown on a sapphire substrate by MBE. Then, the high In/Se ratio sources were deposited on the α-In 2 Se 3 surface, and an γ-InSe crystal emerged via solid-phase epitaxy. After 50 min of deposition, the initially 2D α-In 2 Se 3 phase was also transformed into a 2D γ-InSe crystal. The phase transition from 2D α-In 2 Se 3 to γ-InSe was confirmed by Raman, XRD, and TEM analysis. The structural ordering of 2D γ-InSe film was characterized by synchrotron-based grazing-incidence wide-angle X-ray scattering (GIWAXS).

In sonodynamic therapy, cellular toxicity from sonosensitizer drugs, such as 5-aminolevulinic acid hydrochloride (5-ALA), may be triggered with focused ultrasound through the production of reactive oxygen species (ROS). Here we show that by increasing local oxygen during treatment, using oxygen-loaded perfluorocarbon nanodroplets (250 +/- 8 nm), we can increase the damage induced by 5-ALA, and monitor the severity by recording acoustic emissions in the brain. To achieve this, we sonicated the right striatum of 16 healthy rats after an intravenous dose of 5-ALA (200 mg/kg), followed by saline, nanodroplets, or oxygen-loaded nanodroplets. We assessed haemorrhage, edema and cell apoptosis immediately following, 24 hr, and 48 hr after focused ultrasound treatment. The localized volume of damaged tissue was significantly enhanced by the presence of oxygen-loaded nanodroplets, compared to ultrasound with unloaded nanodroplets (3-fold increase), and ultrasound alone (40-fold increase). Sonicating 1 hr following 5-ALA injection was found to be more potent than 2 hr following 5-ALA injection (2-fold increase), and the severity of tissue damage corresponded to the acoustic emissions from droplet vaporization. Enhancing the local damage from 5-ALA with monitored cavitation activity and additional oxygen could have significant implications in the treatment of atherosclerosis and non-invasive ablative surgeries., Competing Interests: Competing Interests: K.H. is a co-founder of FUS Instruments, a company that is commercializing the preclinical FUS system used in this work., (© The author(s).)

Medicinal plants are the primary sources of healthcare among the people of developing countries in villages and local towns. Documenting and reporting the traditional knowledge of medicinal plants may contribute to pharmaceutical research development. For this reason, we present our findings on ethnomedicinal plants from Lingchuan County, Shanxi, China, an unexplored area rich in medicinal plant resources. Information of ethnomedicinal plants were collected through questionnaire/semi-structured interviews from 180 informants, including traditional healers. Field surveys were conducted in 53 villages of Lingchuan County from 2017 to 2018. Informed consent was obtained from each participant before conducting the interview process. Quantitative analysis was performed for each recorded species, such as Relative Frequency Citation (RFC), Use Value (UV), and Factor of Informant Consensus (FIC). Diseases were categorized into twelve groups. A total 138 species of medicinal plants were recorded, belonging to 123 genera of 58 families. Asteraceae was the dominant plant family with 19 species, followed by Rosaceae and Fabaceae. Herbs were dominant among plant life-forms with 96 species, followed by shrubs and trees (15 species each). Roots were the most commonly used plant parts with 58 species, followed by whole plants and fruits (28 species each). Most plant species were reported non-toxic (84, 60%), followed by unknown toxicity (35, 25%), poisonous, and less toxic (19, 14%). Quantitative analysis revealed that Forsythia suspensa was with higher (0.33) RFC value, and Scutellaria baicalensis was recorded with a higher (0.91) UV. Treated diseases were categorized in 12 groups and evaluated by their FIC value, in which gynecological diseases have higher (0.93) FIC value followed by urinary system diseases. Most medicinal plants are used to clear away heat and relieve the surface. The present study revealed that local people of Lingchuan County confidently use ethnomedicinal plants for their healthcare needs. The higher indices value of a plant species resulted from quantitative analysis warrants further investigation, which may possess valuable phytochemical compounds that may result in new drugs for treating various human disorders.

Background: Human dental pulp stem cells (hDPSCs) exhibit excellent differentiation potential and are capable of differentiating into several different cellular phenotypes, including neurons. Platelet-rich plasma (PRP) contains numerous growth factors that can stimulate stem cell differentiation. In this study, we investigated the potential stimulatory effects of PRP on neurogenic differentiation and anti-apoptosis of hDPSCs in injured spinal cords., Methods: The unipotential differentiation capacity of hDPSCs was analyzed by cell surface antigen identification and cell cycle analysis. A spinal cord injury rat model composed of 40 Sprague-Dawley (SD) rats was used to facilitate an in vivo study. Rats were divided into four groups: a double-treatment group (receiving both neurogenic-induced hDPSCs and PRP), two single-treatment groups (receiving neurogenic-induced hDPSCs or PRP) and a sham group (receiving normal saline). The Basso, Beattie, Bresnahan Locomotor Rating Scale was subsequently used to evaluate the motor function of the spinal cord. Cell viability and differentiation of hDPSCs in the damaged spinal cords were analyzed and apoptosis of neural cells was evaluated using the terminal uridine nucleotide end labeling (TUNEL) assay., Results: Growth pattern, cell surface marker and cell cycle analyses revealed that hDPSCs have a high degree of multi-directional differentiation potential and can be induced into neurons in vitro . In the rat spinal cord injury model, double-treatment with hDPSC/PRP or single treatment with hDPSCs or PRP significantly improved motor function compared with the sham group (P<0.05). Apoptosis of neural cells was observed to be significantly higher in the sham group compared to any of the treatment groups. Double-treatment with hDPSCs and PRP resulted in the lowest apoptotic rate among the groups analyzed., Conclusions: hDPSCs exhibit differentiation potential and are capable of transforming into neural cells both in vitro and in vivo . Significantly increased inhibition of neuronal apoptosis and improved motor function recovery of the spinal cord were observed following double-treatment with hDPSCs and PRP compared with the single-treatment groups., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-1745/coif). The authors have no conflicts of interest to declare., (2022 Annals of Translational Medicine. All rights reserved.)

Objective: This study aimed to evaluate the relationships between the albumin/globulin ratio (AGR), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) and clinicopathological information for gastric cancer patients. In addition, the prognostic values of these hematological parameters for resectable gastric cancer patients undergoing a total gastrectomy were determined., Methods: A total of 245 patients with gastric cancer who underwent a total gastrectomy at our hospital between January 1, 2005, and December 30, 2015, were enrolled into this study. The preoperative AGR, NLR, and PLR in the serum samples of the patients were measured. The relationships between the hematological parameters and the disease-free survival (DFS) as well as overall survival (OS) were analyzed by statistical analysis., Results: The cutoff values of AGR, NLR, and PLR were 1.57, 3.5, and 193, respectively. Univariate analyses demonstrated that a low AGR, a high NLR, and a high PLR were significant risk factors for a poor prognosis. According to multivariate analysis, a high PLR was found to be independently associated with a poor survival. Additionally, when age was considered as a stratified factor, univariate analyses demonstrated that a low AGR had the tendency to be correlated with a shorter DFS in nonelderly patients (<65 years old). A low AGR was significantly correlated with a shorter DFS and OS in elderly patients (≥65 years old)., Conclusion: AGR, NLR, and PLR are independent risk factors associated with a poor gastric cancer survival by univariate analysis, and AGR is an independent risk factor for predicting DFS and OS in elderly patients (≥65 years old) with gastric cancer after total gastrectomy., (© 2022. Huazhong University of Science and Technology.)

The high electron mobility transistor (HEMT) structures on Si (111) substrates were fabricated with heavily Fe-doped GaN buffer layers by metalorganic chemical vapor deposition (MOCVD). The heavy Fe concentrations employed for the purpose of highly insulating buffer resulted in Fe segregation and 3D island growth, which played the role of a nano-mask. The in situ reflectance measurements revealed a transition from 2D to 3D growth mode during the growth of a heavily Fe-doped GaN:Fe layer. The 3D growth mode of Fe nano-mask can effectively annihilate edge-type threading dislocations and improve transfer properties in the channel layer, and consequently decrease the vertical leakage current by one order of magnitude for the applied voltage of 1000 V. Moreover, the employment of GaN:C film on GaN:Fe buffer can further reduce the buffer leakage-current and effectively suppress Fe diffusion.

For a chemotherapeutic agent to be effective, it must conquer the presence of blood-brain barrier (BBB), which limits the penetration of drugs into the brain. Tumours in the brain compromise the integrity of BBB and result in a highly heterogeneous vasculature, known as blood-brain tumour barrier (BBTB). In this chapter, we firstly highlight the cellular and molecular characteristics of the BBB and BBTB as well as the challenges aroused by BBB/BBTB for drug delivery. Secondly, we discuss the current strategies overcoming the challenges in invasive and non-invasive manners. Finally, we highlight the emerging strategy using focused ultrasound (FUS) with systemic microbubbles to transiently and reversibly enhance the permeability of these barriers for drug delivery., (© 2020. Springer Nature Switzerland AG.)

Vascular impairment is a crucial factor associated with chronic muscle pain, but relevant research from the microcirculatory aspect is lacking. Here, we investigated the differences in neck muscle microcirculation detected through laser-doppler flowmetry (LDF) and cervical biomechanics by a videofluoroscopic image in asymptomatic participants and patients with postural neck and shoulder pain. To understand the mechanism behind the effect of myofascial treatment, transverse friction massage (TFM) was applied and the immediate effects of muscular intervention on microcirculation were monitored. In total, 16 asymptomatic participants and 22 patients (mean age = 26.3 ± 2.4 and 25.4 ± 3.2 years, respectively) were recruited. Their neck muscle microcirculation and spinal image sequence were assessed. The differences in the baseline blood flow between the asymptomatic and patient groups were nonsignificant. However, the standard deviations in the measurements of the upper trapezius muscle in the patients were significantly larger ( p < 0.05). Regarding the TFM-induced responses of skin microcirculation, the blood flow ratio was significantly higher in the patients than in the asymptomatic participants ( p < 0.05). In conclusion, postintervention hyperemia determined through noninvasive LDF may be an indicator for the understanding of the mechanism underlying massage therapies and the design of interventions for postural pain.

Objective: To analyze the prognostic factors of breast cancer patients with isolated chest wall recurrence (ICWR) after mastectomy, and investigate the optimal treatment. Methods: A total of 201 breast cancer patients with ICWR after mastectomy who were treated in Cancer Hospital, Chinese Academy of Medical Sciences and the Fifth Medical Center Chinese PLA General Hospital from October 1998 to April 2018 were retrospectively analyzed. The median follow-up was 92.8 months and survival data were obtained. Results: Among 201 patients with ICWR, 103 patients developed subsequent locoregional recurrence (sLRR) and 5-year cumulative sLRR rate was 49.1%; 134 patients developed distant metastasis (DM) and 5-year DM rate was 64.4%; 103 patients died, the median progression-free survival (PFS) was 17.4 months and the 5-year PFS rate was 23.2%; the median overall survival (OS) was 62.5 months and the 5-year OS rate was 52.1%. Multivariate analysis showed that the recurrence interval ( HR =2.17, 95% CI: 1.26-3.73) and the locoregional treatment ( HR =1.59, 95% CI: 1.05-2.40) were the independent prognostic factors for sLRR. The initial HER2 status ( HR =1.60, 95% CI: 1.03-2.48) was the independent prognostic factor for DM. The recurrence interval ( HR =1.99, 95% CI: 1.30-3.04), the locoregional treatment ( HR =1.99, 95% CI: 1.43-2.76) and the treatment modalities after recurrence ( HR =1.70, 95% CI: 1.18-2.46) were the independent prognostic factors for PFS. The initial HER2 status ( HR =1.69, 95% CI: 1.02-2.81), the recurrence interval ( HR =1.85, 95% CI: 1.15-2.98) and the treatment modalities after recurrence ( HR =2.48, 95% CI: 1.56-3.96) were the independent prognostic factors for OS. Conclusions: Breast cancer patients after ICWR have an optimistic OS until now, but the risk of sLRR and DM is high. Comprehensive treatment modalities including surgery, radiotherapy and systemic therapy improve the outcome of breast cancer patients with ICWR after mastectomy.

Hydrostatically pressurized studies using diamond anvil cells on the structural phase transition of the free-standing screw-dislocation-driven (SDD) GaSe thin film synthesized by molecular beam epitaxy have been demonstrated via in-situ angle-dispersive synchrotron X-ray diffraction and Raman spectroscopy. The early pressure-driven hexagonal-to-rock salt transition at approximately ~ 20 GPa as well as the outstandingly structural-phase memory after depressurization in the SDD-GaSe film was recognized, attributed to the screw dislocation-assisted mechanism. Note that, the reversible pressure-induced structural transition was not evidenced from the GaSe bulk, which has a layer-by-layer stacking structure. In addition, a remarkable 1.7 times higher in bulk modulus of the SDD-GaSe film in comparison to bulk counterpart was observed, which was mainly contributed by its four times higher in the incompressibility along c-axis. This is well-correlated to the slower shifting slopes of out-of-plane phonon-vibration modes in the SDD-GaSe film, especially at low-pressure range (< 5 GPa). As a final point, we recommend that the intense density of screw dislocation cores in the SDD-GaSe lattice structure plays a crucial role in these novel phenomena., (© 2021. The Author(s).)

The effect of Mg doping on the electrical and optical properties of the p-GaN/AlGaN structures on a Si substrate grown by metal organic chemical vapor deposition was investigated. The Hall measurement showed that the activation efficiency of the sample with a 450 sccm Cp 2 Mg flow rate reached a maximum value of 2.22%. No reversion of the hole concentration was observed due to the existence of stress in the designed sample structures. This is attributed to the higher Mg-to-Ga incorporation rate resulting from the restriction of self-compensation under compressive strain. In addition, by using an AlN interlayer (IL) at the interface of p-GaN/AlGaN, the activation rate can be further improved after the doping concentration reaches saturation, and the diffusion of Mg atoms can also be effectively suppressed. A high hole concentration of about 1.3 × 10 18 cm -3 can be achieved in the p-GaN/AlN-IL/AlGaN structure.