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Understanding the internal magnetization structure of an individual ferromagnetic nanoparticle (MNP) is crucial for deciphering its magnetic characteristics. Unfortunately, while certain techniques can measure the magnetic properties of an individual MNP, they fall short of accurately detecting the internal magnetization structure. In this work, micromagnetic simulations were employed to construct the internal magnetization structure of an individual CoFe2O4 (CFO) nanopyramid, and the energy jump behavior during the magnetization process was successfully explained, with simulation results aligning with dynamic cantilever magnetometry (DCM) experimental outcomes. Subsequently, the external stray field of the nanopyramid was simulated, and the stray field gradient map revealed distinct bright and dark regions corresponding to the reverse and forward saturation magnetizations of the CFO nanopyramid. This result is possible to be verified by magnetic force microscopy (MFM) measurements of individual CFO nanopyramids. The confidence in the accuracy of the simulated internal magnetization structure was significantly enhanced by independently verifying the micromagnetic simulation results through DCM and MFM experiments. Our work proposes a convenient and cost-effective method for studying the internal magnetization structure of individual MNPs. [ABSTRACT FROM AUTHOR]

The water absorption characteristics of thermoplastic starch (TPS) reveal its ability to interact with and absorb water, influencing its overall performance in various applications. The introduction of aloe vera (AV) gel into the TPS polymeric matrix film has proven beneficial in enhancing tensile strength but a notable deficiency is observed in lowering water absorption percentage. Therefore, this paper aims to reduce the water absorption of the TPS30AV polymer matrix film by utilizing polyethylene (PE) without reducing the tensile strength performance of the TPS30AV film. The TPS30AV film was produced using melt-blending and hot-press techniques. Six samples were presented consisting of a control film (TPS30AV) and TPS30AV film with different concentrations of PE resins (5%, 10%, 20%, 30%, and 40%). The film's performance was assessed by examining its mechanical properties, water absorption, and water solubility. The finding shows that TPS30AV with 40% PE has the highest improvement in water absorption percentage which reduces from 309.86% to 34.16% but a tremendous decrement in tensile strength performance. However, TPS30AV with 10% PE has the highest tensile strength, 9.65 MPa with a 20.99% improvement in water absorption reduction. The properties obtained for TPS30AV10PE were also good in Young's modulus and water solubility percentage. It shows that the film formulated is comparable with previous studies, and improvement has been achieved. As a conclusion, adding PE improved the polymeric structure of TPS30AV and can be used as a biodegradable food-packaging film. [ABSTRACT FROM AUTHOR]

Filler components play a crucial role as thermo‐mechanical reinforcement to the epoxy‐based solder mask, ensuring effective insulation and passivation. This study investigates the impact of different inorganic filler types (talc, silica (SiO2), boron nitride (BN) and barium sulfate (BaSO4)) and loadings (5 and 15 wt%) on the tensile and thermal properties of the epoxy composites. The composites were blended, cast and thermally cured. Of these composites, only 15 wt% SiO2/epoxy composite exhibits notable increments in both tensile strength and modulus, surpassing unfilled epoxy by 11.65% and 31.9%, respectively. It also displays the highest elongation at break, supported by small particle size, high specific surface area and minimal void volume fraction. For thermal tests, the addition of all fillers increases the storage modulus in both glassy and rubbery regions, especially 15 wt% talc/epoxy composite with 30.09% increment at 25 °C. Additionally, all fillers raise the glass transition temperature (Tg), notably improving it by 9 °C in the 15 wt% BN/epoxy composite. Moreover, their inclusion generally enhances the onset decomposition temperature (Tonset) and reduces weight loss during decomposition. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Soil classification is essential for understanding soil properties and their suitability for conveying the characteristics of soil types. In this study, we present a prediction of soil classification using fewer soil variables by employing the random forest (RF) technique in machine learning. This study compiled the parameters outlined in the unified soil classification system (USCS), a widely used method for categorizing soils based on their properties and behavior. These parameters, encompassing grain size distribution, Atterberg limits, the coefficient of uniformity, and the coefficient of curvature, were defined within specific ranges to create a synthetic database for training the RF model. The importance of input factors in soil classification was assessed using the out-of-bag samples in RF. Through rigorous validation techniques, including cross-validation, the performance of the RF model is thoroughly assessed, demonstrating its capability to accurately evaluate soil classification. The findings indicate that the RF model presented in this study exhibits a promising alternative, providing automated and accurate classification based on soil data. Notably, the model indicates that the coefficients of uniformity and gradation are insignificant for soil classification and can predict soil types even when these factors are missing, a feat that traditional methods struggle to achieve. [ABSTRACT FROM AUTHOR]

This study investigates the development of polylactic acid (PLA) by incorporating thermochromic black pigments (TCB) at varying concentrations of 0, 0.5, 1, 2 and 3 wt% through the process of melt blending. The color transition and reversion behaviors of the resulting specimens were examined at different temperatures (−10, 10, 30, 35 and 50 °C) using colorimetric analysis. Additionally, mechanical properties, thermal characteristic and thermal stability were assessed through tensile testing, differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA), respectively. The study revealed that an increase in TCB concentrations led to a reduction in lightness (L*). Higher pigment content enhanced thermochromic properties, resulting in more pronounced color changes. The total color difference (ΔE) remained reproducible over five cycles of heating and freezing, and this reproducibility persisted after thermal aging. Tensile strength and elongation at break exhibited improvement with increasing pigment content. Glass transition temperature (Tg) and melting temperature (Tm) of the thermochromic samples showed minimal reduction compared to that of neat PLA, which is 64.2 °C. Crystallinity degree (Xc) increased slightly by 0.2–0.92 %. The thermal stability of the PLA matrix was only marginally affected by the presence of thermochromic pigments. [ABSTRACT FROM AUTHOR]

[Development of the National Languages Act [of Taiwan]. (2019, January 9). Ministry of Culture. ] incorporating Taiwanese Sign Language (TSL) evolved from Taiwan's historical linguistic ecology and intertwined with the linguistic ecology of Taiwan's Deaf community. Utilising a qualitative document analysis incorporating a language planning and policy framework [Cooper, R. L. (1989). Language planning and social change. Cambridge University Press; Reagan, T. (2022). Language planning and language policies for sign languages: an emerging civil rights movement. Sociolinguistica, 36(1-2), 169–182], we analyze how this law fits into Taiwan's multicultural milieu. Specifically, we analyze the transmission, revival, and development of TSL by legislating status, acquisition, corpus, and prestige planning for teaching TSL to hearing learners. Secondly, gaps are identified, such as establishing early TSL access to the birth to age five deaf learners and their caregivers, promoting Chinese literacy with TSL strategies, and hiring native Deaf signing teachers. Limitations and future directions for research and practice are then outlined. [ABSTRACT FROM AUTHOR]

This paper introduces a novel approach to enhancing multi-level security using steganography, a method of concealing information within non-secret data. This paper introduces an innovative approach to multi-level security enhancement using steganography, the art of concealing information within non-obvious data. Our proposed method uniquely combines Dynamic Least Significant Bit (DLSB) steganography with Wavelet Obtained Weights (WOW) steganographic algorithms, forging a sophisticated and adaptable system for secret data embedding. In our enhanced approach, we start by embedding text into an image using an optimized version of DLSB steganography. This refined technique adapts intelligently to the image's local contrast, thereby preserving its visual quality and ensuring the integrity of the embedded information. Subsequently, the payload image is merged with a cover image through the WOW algorithm. This step optimally selects pixels for data embedding, creating a steganographic image that is virtually indistinguishable from the original. The novelty of our work lies in the seamless integration of these two advanced steganographic techniques, which significantly elevates the security and invisibility aspects beyond the current state-of-the-art methods in digital steganography. For validation, we utilized a pretrained MobileNet model to differentiate between original and stego images. This model plays a crucial role in demonstrating the indetectability of our method, achieving an impressive accuracy of 85% in distinguishing stego images from their originals. Our rigorous testing across various metrics — including Peak Signal-to-Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM), Bit Error Rate (BER), and Mean Squared Error (MSE) — showcases the effectiveness of our approach. The results indicate a robust performance, marking a significant advancement in secure digital communication. In this paper, we focus primarily on the detailed presentation of our results and the significant contributions of our current research, setting a strong foundation for future exploration in increasing robustness against steganalysis and improving the statistical invisibility of the steganography process. [ABSTRACT FROM AUTHOR]

Stylistics, a sub-discipline of applied linguistics, examines the aesthetic aspects of language style within texts, particularly literary ones. While it is often used to explore the linguistic beauty of the Quran, it is less frequently applied to Prophetic Hadith texts. This study aims to analyse Hadiths that contain conversations between the Prophet and his companions, known as the Qauli Hiwari-type, related to exemplary practices (Afdhal al-‘amal), in Sahih Bukhari. Textual analysis was applied using phonosemantic analysis to examine letter combinations in words and ascertain their meanings related to these practices. The findings reveal five exemplary practices in the Prophet's Hadiths as narrated in Sahih Bukhari, hierarchically arranged to reflect their significance: belief in Allah SWT and His Messenger, and performing prayers punctually, which are fundamental to Islam, followed by kindness to parents, Jihad fi Sabillillah, and performing Hajj Mabrur, subject to individual limitations and capacities. This study demonstrates that phonosemantic stylistics can effectively analyze the linguistic style of religious texts, particularly in discerning meanings embedded in letter combinations, and shows that Hadith texts can be examined through stylistics with appropriate guidelines. These findings contribute to a deeper understanding of the linguistic nuances and religious teachings within the Hadiths of Sahih Bukhari. [ABSTRACT FROM AUTHOR]

Summary: This study aimed to investigate the association between the steroid use patterns and the risk of AEs in patients with primary immune thrombocytopenia (ITP). A total of 2691 newly diagnosed adults with ITP between 2011 and 2018 were identified from the National Health Insurance Research Database in Taiwan, and the date of first steroid use was defined as the index date. Post‐index steroid use was calculated on a 90‐day basis as a time‐dependent variable and categorized by the average prednisolone‐equivalent daily dose (<10 mg vs. ≥10 mg) and intensity (medication possession ratio <80% vs. ≥80%). Patients were followed up for 1 year from the index date for acute AE events, while chronic AEs were assessed until death, or end of 2019. Compared to patients with low‐dose+low‐intensity steroid use, those with high‐dose+high‐intensity steroid use were associated with a higher risk of acute AE (adjusted incident rate ratio [aIRR]: 1.57, 95% confidence interval [CI]: 1.38–1.78, p < 0.01) and chronic AE (aIRR: 1.26, 95% CI: 1.08–1.47, p < 0.01). Metabolic/endocrine and ophthalmologic disorders demonstrated the strongest correlation with a high dose and intensity. The joint effect of steroid dose and intensity was observed in patients with ITP, and the findings suggest that steroids should be used carefully. [ABSTRACT FROM AUTHOR]

Introduction: Preconception is a critical period to optimise gamete function and early placental development, essential for successful conception and long-term maternal-child health. However, there is a lack of preconception services and consequently, global fertility rates continue to fall and mothers embark on their pregnancy journey in poor health. There is an urgent need to implement a holistic community-level preconception care programme to optimise risk factors for poor fecundability and improve long-term maternal-child health. Method: We reviewed current evidence on fecundability lifestyle risk factors, the efficacy of existing preconception interventions and the use of digital platforms for health optimisation, to create a new digital-based preconception intervention model that will be implemented via an app. We present the theory, content and mode of delivery of this holistic model targeting couples planning for pregnancy. Results: We propose a new model featuring a user-friendly mobile app, which enables couples to self-assess fecundability risks through a personalised risk score that drives a tailored management plan. This tiered management provides anticipatory guidance supported by evidence-based recommendations, and promotes ongoing engagement for behavioural optimisation and specialist referrals as required. Based on the health belief model, this new model delivered with a mobile app seeks to shift couples’ perceptions about their susceptibility and severity of subfertility, benefits of making a change and barriers to change. Conclusion: Our proposed digital-based intervention model via a mobile app stands to enhance preconception care by providing personalised risk assessments, real-time feedback and tiered management to optimise preconception reproductive health of couples. This model forms a reference content framework for future preconception care intervention delivery. [ABSTRACT FROM AUTHOR]

This study examines the highlights of spiritual approach intervention studies in depression. Depression experienced by students can affect human functioning, behavior, emotions and thinking. Students need to be given the knowledge to treat depression through the intervention of a spiritual approach to obtain peace and achieve happiness in life. Accordingly, this article has conducted a systematic literature review of spiritual approach interventions for student depression that are used among researchers. A systematic review of the literature was conducted to obtain information related to the topic to be studied by using online databases such as Web Of Science (WOS) and Scopus from 2018 to 2023. Several keywords used are spirit* OR religious* OR believe *, student OR teenager OR youth and depressed* OR sad* OR hopeless* to find related studies with online search engines. Following a review of abstracts and the elimination of similar titles, 29 studies that met the research criteria were selected for analysis. The research sought only related to mental health issues that include depression. The PRISMA model is used as a guide in the literature search. Findings through the results of the research in this article show that the use of spiritual approach interventions is more focused on two subtheme categorizations, namely institutional use and during the Covid 19 Pandemic. Meanwhile, from the perspective of spiritual approach interventions for student depression, it was found that spiritual approaches can be discussed in the role of spiritual approaches in treating depression. The findings of the study show that spiritual and spiritual approaches are used as alternative interventions when students are faced with the challenge of depression. [ABSTRACT FROM AUTHOR]

The exothermic nature of acrylate photopolymerizations enables room temperature 3D printing of a quaternary formulation that incorporates an acrylate monomer, and an epoxy/thiol‐ene system (ETES). The latter comprises an epoxy monomer, a multifunctional thiol and a tetraallyl functionalized ditertiary amine curing agent. Pristine ETES necessitates temperatures of 85–95 °C for curing. Several mechanisms operate simultaneously during this process: homopolymerization of acrylates, thiol‐acrylate photopolymerization, thiol‐ene photopolymerization between the double bonds of curing agent and the multifunctional thiol, the Michael addition between thiolates derived from ETES and the double bonds of acrylates, and the anionic polymerization of the epoxy resin via the tertiary amine groups. To optimize the quaternary formulations for printing, parameters, such as reactivity, exothermicity, and viscosity, was explored. Subsequently, the thermal and viscoelastic properties of the printed cross‐linked polymers derived from these formulations were analyzed using Differential Scanning Calorimetry (DSC), Dynamic Mechanical Analysis (DMA) and Thermogravimetric Analysis (TGA). The polymers derived from quaternary formulations exhibited lower crosslinked density compared to those obtained from the pristine acrylates. This reduction in crosslink density contributes to the improved toughness of the hybrid polymers. [ABSTRACT FROM AUTHOR]

Students often struggle to apply their knowledge of bioscience to their care practice. Such knowledge is generally learned through remembering and understanding, but retention quickly fades. They also experience difficulty progressing to higher-order cognitive skills such as applying, analyzing, evaluating, and even creating, which are necessary to develop soft skills, such as critical thinking, in the care profession. In order to improve existing programs, there is a need to better understand students' prior learning experiences and processes. The proposed study will explore the previous learning experiences of nurses enrolled in a two-year nursing program at a Taiwan university and identify the challenges they face in integrating multidisciplinary knowledge and developing critical thinking competency. The study will adopt a constructivist grounded theory methodology to collect interview data. The findings are expected to improve higher cognitive learning performance and inform the revision of the two-year nursing curriculum. [ABSTRACT FROM AUTHOR]

Background: Drug-induced adverse symptoms affect patients' quality of life (QoL) during treatment. Understanding the underlying mechanisms of drug-induced adverse effects could help prevent them. As current drugs have limited effects in halting the progress of Alzheimer's disease (AD), patients are required to take these drugs over a long period. The main obstacles to long-term compliance are drug-elicited side effects that deteriorate patient QoL. Objective: Donepezil, the most popular acetylcholinesterase inhibitor (AChEI) drug for AD, induces various side effects, especially at high doses. This study aimed to identify a drug that can attenuate the side effects of donepezil and investigate the underlying mechanisms. Methods: Five-week-old Sprague-Dawley rats received daily oral donepezil and N-acetylcysteine (NAC) for four weeks. General symptoms following administration were monitored daily to address drug-related adverse effects. Cytosolic calcium influx and generation of reactive oxygen species (ROS) after drug treatment were measured in vitro using C2C12 myotubes. Results: High-dose donepezil induced numerous adverse symptoms in male and female rats, which were markedly attenuated by co-treatment with NAC. NAC significantly reduced both acute and chronic muscle-related symptoms caused by donepezil. Additionally, in vitro studies showed that high-dose donepezil increased ROS and intracellular calcium ([Ca2+]i) levels in muscle cells, contributing to these adverse effects. NAC co-treatment dramatically reduced ROS and [Ca2+]i levels in muscle cells. Conclusions: Combined treatment with NAC effectively diminishes the adverse effects elicited by donepezil by regulating ROS and [Ca2+]i levels in the skeletal muscle, which could contribute to improving donepezil treatment in patients. [ABSTRACT FROM AUTHOR]

Background: Uteroglobin is a multifunctional protein with anti-inflammatory properties. Studies have revealed the importance of inflammation in type 2 diabetes mellitus (T2D) pathogenesis. Here, we investigated the relationship between uteroglobin and T2D. Methods: We performed diagnostic tests for diabetes in subjects who had not been diagnosed with or treated for T2D. We established three groups, containing those with normal glucose tolerance (NGT), prediabetes and T2D, consisting of 80 people each, and compared their uteroglobin levels. In addition, 28 patients newly diagnosed with T2D were treated with metformin for 12 weeks, and 63 patients newly diagnosed with dyslipidaemia during the treatment for T2D were treated with statin for 12 weeks. Results: This study showed that uteroglobin levels were significantly lower in prediabetes and T2D groups than in the NGT group. Uteroglobin levels were not significantly correlated with other metabolic parameters, except BMI, HOMA-b and eGFR. In the group treated with metformin or statin, uteroglobin levels increased after treatment compared to before treatment. Conclusions: Uteroglobin is a sensitive factor that was decreased even in prediabetes and increased upon treatment with drugs with anti-inflammatory effects. Uteroglobin is a potential early biomarker that reflects a chronic inflammatory condition in T2D. [ABSTRACT FROM AUTHOR]

Noble metal catalysts are excellent oxygen evolution reaction (OER) catalysts, but the expensive price and scarce reserves constrain the development of water splitting. CuCoO2 is known as a promising catalytic material due to its abundant raw materials and unique structure. However, its OER performance requires further enhancement. In this research, S-doped CuCoO2 nanocrystals were synthesized through a one-step solvothermal method. The electrochemical test results revealed that 0.33 mmol S doped CuCoO2 (CCOS-3) exhibits superior catalytic activity (η10 = 375.5 mV, Tafel slope = 83.4 mV dec−1) in 1.0 M KOH electrolyte. Furthermore, after an 18 hours OER stability test, the CCOS-3 exhibited a minimal overpotential degradation of 27 mV. Brunauer–Emmett–Teller (BET) tests showed that the surface area of CCOS-3 is 12.51 m2 g−1. X-ray photoelectron spectroscopy (XPS) and ultraviolet-visible-near infrared (UV-Vis-NIR) absorption spectra results revealed that S doping boosts the quantity of oxygen defect sites and narrows the band gap of CuCoO2. Therefore, the charge transfer within the material is accelerated and the catalytic activity is optimized. This work may offer a novel insight into enhancing the OER performance of CuCoO2 catalysts through nonmetallic doping. [ABSTRACT FROM AUTHOR]

Introduction: Polydrug use in the context of chemsex is commonplace among gay, bisexual, and other men-who-have-sex-with-men (GBMSM). This study aimed to examine the differences in experiences of physical, social, and psychological harms, as well as mental ill-health among GBMSM who use different combinations of methamphetamine and gamma-hydroxybutyric acid/gamma-butyrolactone (GHB/GBL) during chemsex. Method: Adult GBMSM participants who had experience of chemsex in the past 12 months participated in a cross-sectional online survey in Taiwan and self-reported their sociodemographic background, sexual behaviours, mental health, and experiences of harm following a chemsex session. We used univariable and multivariable logistic regression to assess the different experiences of harm and mental ill-health among GBMSM who engaged in chemsex without using methamphetamine, used methamphetamine but not GHB/GBL, and who used both drugs. Results: Out of 510 participants who completed all items included in the analysis, 24.1% engaged in chemsex without using methamphetamine, 36.9% used methamphetamine but not GHB/GBL, and 39.0% used both drugs. Eighty five percent of men who used both methamphetamine and GHB/GBL reported at least one kind of social harm after a chemsex session, such as missing dates or appointments, or appearing "high" at work, followed by used methamphetamine but not GHB/GBL (69.7%) and those without using methamphetamine (37.4%). After controlling for polydrug and frequency of drug use in the multivariable logistic regression, those who used methamphetamine but not GHB/GBL and those who used both drugs were more likely to report experiencing physical and psychological harms compared to those who did not use methamphetamine (p < 0.003). Conclusion: GBMSM who used both methamphetamine and GHB/GBL in a chemsex context were more likely to report experience of harms than those who only used a single chemsex drug or engaged in chemsex without methamphetamine or GHB/GBL. Harm reduction should focus on both preventing HIV and STI transmission and on minimising psychosocial harm to GBMSM, with varying impacts depending on drug use. [ABSTRACT FROM AUTHOR]

Background: To mitigate the growing burden of non-communicable diseases, doctors training to become paediatricians should be equipped with concepts and knowledge regarding Developmental Origins of Health and Disease (DOHaD). Methods: We assessed the knowledge, attitudes, and practices (KAP) of medical officers, resident physicians, as well as junior and senior residents practising in the paediatric department of a tertiary women's and children's hospital. This was done through a cross-sectional online survey, with questions developed after focused group discussions with domain experts, and responses based on a 5-point Likert scale. Results: A total of 95 physicians met the inclusion criteria, grouped into Medical Officers (MOs) and Registrars (REGs), and we received a 100% response rate. Results showed that few physicians (n = 22, 23.2%) knew the term DOHaD, and majority rated their colleagues to be inadequately informed (n = 84, 88.4%). Among the physicians, one third (n = 32, 33.7%) were not confident in their ability to counsel patients about initiating healthy feeding practices to prevent future metabolic diseases in their children. However, there was a readiness to be better equipped with DOHaD principles and knowledge, and 95.8% (n = 91) strongly acknowledged the physician's responsibility to optimise early life determinants of cardiometabolic health. Conclusion: In conclusion, the findings suggest a poor translation of DOHaD concepts, indicating that bridging the gap between DOHaD research knowledge and clinical application represents an unmet need. These principles should be inculcated early in the professional training of all healthcare providers. [ABSTRACT FROM AUTHOR]

Control of oxidation/antioxidation homeostasis is important for cellular protective functions, and disruption of the antioxidation balance by exogenous and endogenous ligands can lead to profound pathological consequences of cancerous commitment within cells. Although cancers are sensitive to antioxidation drugs, these drugs are sometimes associated with problems including tumor resistance or dose-limiting toxicity in host animals and patients. These problems are often caused by the imbalance between the levels of oxidative stress-induced reactive oxygen species (ROS) and the redox efficacy of antioxidants. Increased ROS levels, because of abnormal function, including metabolic abnormality and signaling aberrations, can promote tumorigenesis and the progression of malignancy, which are generated by genome mutations and activation of proto-oncogene signaling. This hypothesis is supported by various experiments showing that the balance of oxidative stress and redox control is important for cancer therapy. Although many antioxidant drugs exhibit therapeutic potential, there is a heterogeneity of antioxidation functions, including cell growth, cell survival, invasion abilities, and tumor formation, as well as the expression of marker genes including tumor suppressor proteins, cell cycle regulators, nuclear factor erythroid 2-related factor 2, and Jun dimerization protein 2; their effectiveness in cancer remains unproven. Here, we summarize the rationale for the use of antioxidative drugs in preclinical and clinical antioxidant therapy of cancer, and recent advances in this area using cancer cells and their organoids, including the targeting of ROS homeostasis. [ABSTRACT FROM AUTHOR]

In this study, an Integrated Electronics Piezoelectric (IEPE)-type accelerometer based on an environmentally friendly lead-free piezoceramic was fabricated, and its field applicability was verified using a cooling pump owned by the Korea Atomic Energy Research Institute (KAERI). As an environmentally friendly piezoelectric material, 0.96(K,Na)NbO3-0.03(Bi,Na,K,Li)ZrO3-0.01BiScO3 (0.96KNN-0.03BNKLZ-0.01BS) piezoceramic with an optimized piezoelectric charge constant (d33) was introduced. It was manufactured in a ring shape using a solid-state reaction method for application to a compression mode accelerometer. The fabricated ceramic ring has a high piezoelectric constant d33 of ~373 pC/N and a Curie temperature TC of ~330 °C. It was found that the electrical and physical characteristics of the 0.96KNN-0.03BNKLZ-0.01BS piezoceramic were comparable to those of a Pb(Zr,Ti)O3 (PZT) ring ceramic. As a result of a vibration test of the IEPE accelerometer fabricated using the lead-free piezoelectric ceramic, the resonant frequency fr = 20.0 kHz and voltage sensitivity Sv = 101.1 mV/g were confirmed. The fabricated IEPE accelerometer sensor showed an excellent performance equivalent to or superior to that of a commercial IEPE accelerometer sensor based on PZT for general industrial use. A field test was carried out to verify the applicability of the fabricated sensor in an actual industrial environment. The test was conducted by simultaneously installing the developed sensor and a commercial PZT-based sensor in the ball bearing housing location of a centrifugal pump. The centrifugal pump was operated at 1180 RPM, and the generated vibration signals were collected and analyzed. The test results confirmed that the developed eco-friendly lead-free sensor has comparable vibration measurement capability to that of commercial PZT-based sensors. [ABSTRACT FROM AUTHOR]

Background: The treatment-free interval is a significant predictor of worse prognosis and poor response rates of the second-line treatment in patients with carboplatin and paclitaxel (PT)-pretreated, advanced, or recurrent endometrial cancer (EC). Whether lenvatinib plus pembrolizumab still confers a survival benefit compared with doxorubicin in patients with platinum-free intervals of <6 months remains unclear. Methods: This multi-institutional retrospective analysis was performed using de-identified electronic health records from the TriNetX Research Network. Patients with advanced or recurrent ECs who received lenvatinib plus pembrolizumab or doxorubicin within six months of first-line PT were identified. A 1:1 propensity score matching (PSM) was conducted to control for potential confounding variables. Overall survival (OS) and adverse event profile were the primary and secondary outcomes. Results: Between January 2018 and February 2024, 130 patients with PT-treated, advanced, or recurrent ECs who received lenvatinib plus pembrolizumab and 122 patients who received doxorubicin at a platinum-free interval of <6 months were identified across 31 healthcare organizations. In the balanced cohort following PSM with 117 patients in each group, treatment with lenvatinib plus pembrolizumab was associated with improved OS compared with treatment with doxorubicin (12.8 vs. 8.2 months, p = 0.012, hazard ratio: 0.65, 95% confidence interval: 0.46–0.91). Regarding adverse event analysis, a higher incidence of hypothyroidism and proteinuria was observed with lenvatinib plus pembrolizumab, and more hematological toxicities were observed with doxorubicin. Conclusions: in patients with treatment-free intervals of <6 months, lenvatinib plus pembrolizumab still confers improved survival compared with doxorubicin in PT-treated, advanced, or recurrent ECs. [ABSTRACT FROM AUTHOR]

Given the importance of innovation, artificial intelligence (AI) education, and online learning during the COVID-19 pandemic, we explored the effects of science, technology, engineering, art, and mathematics (STEAM) hands-on learning on online AI learning and creativity. We also analyzed the effects of creative emotions on AI learning using facial expressions. We recruited 25 preservice teachers at a public university as participants. A pretest – post-test nonequivalent comparison group design was adopted. AI learning was applied to experimental teaching. The experimental and control groups received online STEAM hands-on learning and standard teaching, respectively. The findings were as follows: STEAM hands-on learning had a significant positive effect on the conjunction item, example item, and total AI concept scores, and an even greater positive effect on AI attitude scores, particularly for AI processing and output; the effect size of STEAM hands-on learning on AI creativity was large, and the effect was positive in terms of design novelty, elaboration, and usability; and participants had higher anger levels in the designing and drawing AI learning stages, implying a high degree of focus and engagement. Finally, recommendations for instruction include the use of more online resources and engaging practical software to improve professional learning and enjoyment. [ABSTRACT FROM AUTHOR]

Purpose: Early dissemination of primary pancreatic ductal adenocarcinoma (PDAC) is the main cause of dismal prognosis as it highly limits possible treatment options. A number of PDAC patients experience distant metastasis even after treatment due to the metastatic clones. We aimed to demonstrate the molecular architecture of borderline resectable PDAC manifests cancer dissemination of PDAC. Methods: Here, 36 organoids isolated from primary tumor masses of PDAC patients with diverse metastatic statues are presented. Whole-exome sequencing and RNA sequencing were performed and drug responses to clinically relevant 18 compounds were assessed. Results: Our results revealed that borderline resectable PDAC organoids exhibited distinct patterns according to their metastatic potency highlighted by multiple genetic and transcriptional factors and strong variances in drug responses. Conclusions: These data suggest that the presence of metastatic PDAC can be identified by integrating molecular compositions and drug responses of borderline resectable PDAC. [ABSTRACT FROM AUTHOR]

Biofilms are complex bacterial colonies embedded in an extracellular matrix. These pose a major obstacle to wound healing and are noticeable in chronic wounds. It protects the bacteria from the host's immune system and conventional antibiotic treatments. The biofilm's protective matrix prevents essential nutrients and oxygen from diffusing into the surrounding healthy tissue. In addition, microbes living in biofilms naturally have increased resistance to antibiotics, which reduces the effectiveness of traditional therapies. As such, biofilms serve as persistent reservoirs of infection, which further disrupts the normal course of wound healing. In this review, the current formulation strategies such as hydrogels, polymeric nanoparticles, and nanofibers that are used in wound healing to counteract biofilms have been comprehensively discussed. The formulations have been meticulously designed and developed to disturb the biofilm matrix, prevent the growth of microorganisms, and increase the potency of antimicrobials and antibiotics. The mechanism of action, advantages and limitations associated with the existing formulation strategies have been reviewed. The formulation strategies that have been translated into clinical applications and patented are also discussed in this paper. [ABSTRACT FROM AUTHOR]

Background: Postoperative hypoparathyroidism is a major complication of thyroidectomy, occurring when the parathyroid glands are inadvertently damaged during surgery. Although intraoperative images are rarely used to train artificial intelligence (AI) because of its complex nature, AI may be trained to intraoperatively detect parathyroid glands using various augmentation methods. The purpose of this study was to train an effective AI model to detect parathyroid glands during thyroidectomy. Methods: Video clips of the parathyroid gland were collected during thyroid lobectomy procedures. Confirmed parathyroid images were used to train three types of datasets according to augmentation status: baseline, geometric transformation, and generative adversarial network-based image inpainting. The primary outcome was the average precision of the performance of AI in detecting parathyroid glands. Results: 152 Fine-needle aspiration-confirmed parathyroid gland images were acquired from 150 patients who underwent unilateral lobectomy. The average precision of the AI model in detecting parathyroid glands based on baseline data was 77%. This performance was enhanced by applying both geometric transformation and image inpainting augmentation methods, with the geometric transformation data augmentation dataset showing a higher average precision (79%) than the image inpainting model (78.6%). When this model was subjected to external validation using a completely different thyroidectomy approach, the image inpainting method was more effective (46%) than both the geometric transformation (37%) and baseline (33%) methods. Conclusion: This AI model was found to be an effective and generalizable tool in the intraoperative identification of parathyroid glands during thyroidectomy, especially when aided by appropriate augmentation methods. Additional studies comparing model performance and surgeon identification, however, are needed to assess the true clinical relevance of this AI model. [ABSTRACT FROM AUTHOR]

Background and aim: The COVID-19 pandemic has led to a significant adverse effect on the mental health of healthcare professionals. This study aims to assess the effects of the prolonged pandemic on burnout and mood disorders and to evaluate the influence of positive vaccination beliefs on these factors at a medical center during the extended COVID-19 pandemic. Methods: This retrospective study analyzed the results of an online questionnaire survey including burnout status and mood disorders from 2020 to 2022. The factors related to mood moderate/severe disorders and the impact of the positive vaccine belief were also explored. Results: The initial analysis revealed that healthcare professionals continued to experience significant levels of personal and work-related burnout, along with mood disorders. However, the scores and the percentage of moderate to severe burnout gradually decreased. Notably, the percentage of individuals with moderate to severe mood disorders also gradually declined (2020: 13.4%, 2021: 12.3%, 2022: 11.1%). The number of participants who need professional interventions decreased from 56.2% in 2020 to 45.9% in 2021, and 46% in 2022. Multivariate analysis revealed a positive vaccine belief was associated with a lower risk of moderate/severe mood disorders, with odd ratios (OR) and 95% confidence intervals (95% CI) of 0.38 (0.28 -- 0.52) and 0.41 (0.30 -- 0.52) in the 2021 and 2022 cohorts, respectively. Further investigation revealed that age over 50 was linked to a positive vaccine belief in 2021 and 2022. Within the 2022 cohort, working as nurses was identified as the independent factor associated with a less positive belief, with the OR and 95% CI of 0.49 (0.27 -- 0.90). Conclusion: The findings of the present study suggest burnout and mood disorders are still significant during the pandemic. A positive vaccine belief may mitigate pandemic-related mental distress. Further interventions to enhance the belief combined with other supporting measures are important in a long fight against the pandemic. [ABSTRACT FROM AUTHOR]

Sarcomas, malignant tumors from mesenchymal tissues, exhibit poor prognosis despite advancements in treatment modalities such as surgery, radiotherapy, and chemotherapy, with doxorubicin being a cornerstone treatment. Resistance to doxorubicin remains a significant hurdle in therapy optimization. This study aims to dissect the molecular bases of doxorubicin resistance in sarcoma cell lines, which could guide the development of tailored therapeutic strategies. Eighteen sarcoma cell lines from 14 patients were established under ethical approvals and classified into seven subtypes. Molecular, genomic, and transcriptomic analyses included whole-exome sequencing, RNA sequencing, drug sensitivity assays, and pathway enrichment studies to elucidate the resistance mechanisms. Variability in doxorubicin sensitivity was linked to specific genetic alterations, including mutations in TP53 and variations in the copy number of genomic loci like 11q24.2. Transcriptomic profiling divided cell lines into clusters by karyotype complexity, influencing drug responses. Additionally, pathway analyses highlighted the role of signaling pathways like WNT/BETA-CATENIN and HEDGEHOG in doxorubicin-resistant lines. Comprehensive molecular profiling of sarcoma cell lines has revealed complex interplays of genetic and transcriptomic factors dictating doxorubicin resistance, underscoring the need for personalized medicine approaches in sarcoma treatment. Further investigations into these resistance mechanisms could facilitate the development of more effective, customized therapy regimens. [ABSTRACT FROM AUTHOR]

Self‐classification technology has remarkable potential for autonomously discerning various stimuli without any circuit or software assistance, enabling it to realize electronic skin. In conventional self‐classification systems that rely on complex circuitry for operation, integrating the sensing and algorithm processing units inevitably leads to bulkiness in devices and bottlenecks in signal processing. In this study, the novel double‐sided structure inspired by the human nervous system is newly designed for a self‐classifying sensor (SCS) without the need for additional circuits. The sensor is layered with Ag nanocomposites that have been mechanically enhanced via interface engineering and surface treatment techniques. This structure enables the resistance‐capacitance hybrid operation, facilitating the detection and distinguishment of changes in strain, pressure, and temperature within a single device, which mimics the human sensing recognition process. Moreover, the intensity of the applied stimuli is determined by analyzing the detected signal, and precise localization of the stimuli is achieved by arraying the sensors. With its self‐classification capabilities, SCS opens promising avenues for applications in soft robotics and advanced multifunctional sensor platforms, providing a sensing system characterized by simplicity and efficiency. [ABSTRACT FROM AUTHOR]

More recently, the trend of miniaturization in microelectronic devices has led to a continual reduction in bump dimensions, the volume fraction of intermetallic compounds (IMCs) is increasing, significantly highlighting the impact of IMCs on the reliability of microbumps. Ni3Sn4 is the most common IMC formed in Ni/Sn/Ni bumps. However, its formation leads to a significant volume shrinkage up to 11.3% due to phase transformation. This volume shrinkage effect is particularly pronounced in microbumps, which may raise significant concerns regarding their reliability. To resolve these issues, the addition of Ag into the solder has been investigated as a method to modify the microstructure and improve the overall performance of microbumps. This study focused on investigating the microstructure and mechanical properties of microbumps with sub-10 micron bump thickness in two systems: Cu/Ni/Sn/Ni/Cu and Cu/Ni/Sn-3.5Ag/Ni/Cu. Various reflow heat treatment processes were employed to achieve different fractions of Ni3Sn4 IMC, allowing for a detailed comparison of the volume shrinkage effect between these two systems. The results of shear testing demonstrated that the Cu/Ni/Sn-3.5Ag/Ni/Cu bumps exhibited a significant improvement in shear strength and toughness, with shear strength increasing by approximately 37% compared to the Cu/Ni/Sn/Ni/Cu samples. Microstructure and fracture path analyses were also used to elucidate the strengthening mechanisms in Cu/Ni/Sn-3.5Ag/Ni/Cu bumps, highlighting the effectiveness of Ag addition in improving the reliability of microbumps. [ABSTRACT FROM AUTHOR]

What is Known on the Subject?: People living with schizophrenia have reduced physical function and are more likely to experience loneliness than those without condition.Low physical function is associated with greater loneliness in people with psychosis. However, it is unclear whether social isolation and loneliness contribute to impaired physical function in this population.Loneliness is linked to an increased risk of physical function impairment among older individuals, but research on patients living with schizophrenia is limited. What This Paper Adds to Existing Knowledge?: This study is the first to evaluate the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia.It showed that more than one third of the participants experienced a decline in physical function over a 2‐year period.Loneliness, rather than social isolation, was associated with an increase in physical function impairment over 2 years among inpatients living with schizophrenia. What are the Implications for Practice?: Healthcare professionals should recognize loneliness as a potential risk factor for impaired physical function among inpatients diagnosed with schizophrenia.It is recommended that people living with schizophrenia are assessed for loneliness and that interventions are offered to alleviate their feelings of loneliness.Implementing interventions to reduce loneliness may help improve physical function and overall quality of life for individuals living with schizophrenia. Introduction: Patients living with schizophrenia often experience low physical function, which is associated with negative health outcomes. Therefore, investigating the risk factors for physical function is crucial in this population. Aim: This study examined the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia. Methods: Physical function was assessed using measures of activities daily living (ADL), instrumental activities daily living (IADL) and the combination scores of ADL/IADL. Social isolation was indexed with five types of social connection and loneliness was measured using UCLA Loneliness Scale. Results: Social isolation was not associated with the measures of physical function over 2 years. Loneliness exhibited an association with IADL and ADL/IADL at follow‐up, after adjustment for baseline levels of the outcomes. These associations remained when both social isolation and loneliness were simultaneously entered into the model. Discussion: Loneliness, rather than social isolation, was associated with increased physical function impairment over 2 years among inpatients living with schizophrenia. Implications for Practice: Healthcare professionals should consider loneliness as a potential risk factor for impaired physical function. It would be beneficial to assess patients for loneliness and implement interventions to reduce feelings of loneliness. [ABSTRACT FROM AUTHOR]

This research explores the optimal export policy of a domestic industry characterized by numerous multinational enterprises (MNEs) co-existing with cross-border ownership investments in foreign firms and exports to a foreign country. We demonstrate that the optimal export policy depends on whether MNEs make centralized or decentralized decisions in ownership investments. With decentralized decision-making, the optimal export policy can be either a subsidy or a tax, while with centralized decision-making, it is a tax. Furthermore, we examine how the optimal trade policy responds to the optimal strategy of centralized decision-making by MNEs. Our results show that under certain circumstances, the optimal trade policy is an export subsidy, and MNEs prefer to voluntarily relinquish centralized decision-making, even when they have the option to control the production levels of foreign partner firms. [ABSTRACT FROM AUTHOR]

Oxidative stress causes mitochondrial damage and bioenergetic dysfunction and inhibits adenosine triphosphate production, contributing to the pathogenesis of cardiac diseases. Dipeptidyl peptidase 4 (DPP4) is primarily a membrane-bound extracellular peptidase that cleaves Xaa-Pro or Xaa-Ala dipeptides from the N terminus of polypeptides. DPP4 inhibitors have been used in patients with diabetes and heart failure; however, they have led to inconsistent results. Although the enzymatic properties of DPP4 have been well studied, the substrate-independent functions of DPP4 have not. In the present study, we knocked down DPP4 in cultured cardiomyocytes to exclude the effects of differential alteration in the substrates and metabolites of DPP4 then compared the response between the knocked-down and wild-type cardiomyocytes during exposure to oxidative stress. H2O2 exposure induced DPP4 expression in both types of cardiomyocytes. However, knocking down DPP4 substantially reduced the loss of cell viability by preserving mitochondrial bioenergy, reducing intracellular reactive oxygen species production, and reducing apoptosis-associated protein expression. These findings demonstrate that inhibiting DPP4 improves the body's defense against oxidative stress by enhancing Nrf2 and PGC-1α signaling and increasing superoxide dismutase and catalase activity. Our results indicate that DPP4 mediates the body's response to oxidative stress in individuals with heart disease. [ABSTRACT FROM AUTHOR]

In standard promotion tournaments, contestants are ranked based on their output or productivity. We argue that workers' career progression may also depend on their relative rankings in dimensions a priori unrelated to their job performance, such as visibility or in-person presence. Such implicit tournaments may rationalize a variety of seemingly counterproductive practices in the workplace, including long working hours, low uptake of statutory leave, and presenteeism. We illustrate the significance of implicit tournaments using the case of paternity leave among new fathers, where we exogenously vary a focal worker's ranking within a contest, not via his own leave status but that of his competitors, exploiting a policy reform. We show that the focal worker is put on a better earnings trajectory than otherwise when a larger share of his competitors take leave because of the reform. The focal worker's own absolute leave, however, has no direct effect on his earnings path as long as his own and his competitors' leave statuses are symmetric. With effective coordination, it should thus be possible for all fathers to utilize paternity leave without incurring unwarranted career costs. This has implications for statutory leave policies, flexible work arrangements, and gender equality. [ABSTRACT FROM AUTHOR]

Background: Current guidelines recommend against the use of routine imaging tests to detect distant metastasis in asymptomatic breast cancer patients. However, recent advancements in effective therapeutics and diagnostic accuracy have raised the need to reassess the clinical efficacy of intensive metastasis surveillance. We report the results of a multicenter retrospective study to investigate the association between intensive imaging studies and survival outcomes. Patients and Methods: We retrospectively reviewed the data of 4130 patients who underwent surgery from 11 hospitals in Korea between January 2010 and December 2011. Patients were divided into two groups on the basis of the intensity of metastasis imaging studies during their disease-free period. The types and intervals of the imaging studies were based on each physician's decisions. Results: High-intensive screening showed a shorter distant metastasis-free survival [p < 0.001, hazard ratio (HR) 1.62; 95% confidence interval (CI) 1.29–2.04], especially for patients in whom bone or lung was the first site of metastasis. With a median follow-up period of 110.0 months, the 5-year breast cancer-specific survival (BCSS) rate was 96.5%. The high-intensity screening group showed significantly poorer BCSS compared with the low-intensity screening group (p < 0.001, HR 3.13; 95% CI 2.32–4.21). However, both multivariable analysis and propensity score matching analysis showed no significant association between the screening intensity and BCSS. Conclusions: Frequent imaging studies to detect distant metastasis were associated with earlier detection of distant metastasis, especially for lung and bone metastasis. However, intensive surveillance showed no apparent association with BCSS despite the use of currently available treatments. [ABSTRACT FROM AUTHOR]

Aims: Worsening heart failure (WHF) events occurring in non‐inpatient settings are becoming increasingly recognized, with implications for prognostication. We evaluate the performance of a natural language processing (NLP)‐based approach compared with traditional diagnostic coding for non‐inpatient clinical encounters and left ventricular ejection fraction (LVEF). Methods and results: We compared characteristics for encounters that did vs. did not meet WHF criteria, stratified by care setting [i.e. emergency department (ED) and observation stay]. Overall, 8407 (22%) encounters met NLP‐based criteria for WHF (3909 ED visits and 4498 observation stays). The use of an NLP‐derived definition adjudicated 3983 (12%) of non‐primary HF diagnoses as meeting consensus definitions for WHF. The most common diagnosis indicated in these encounters was dyspnoea. Results were primarily driven by observation stays, in which 2205 (23%) encounters with a secondary HF diagnosis met the WHF definition by NLP. Conclusions: The use of standard claims‐based adjudication for primary diagnosis in the non‐inpatient setting may lead to misclassification of WHF events in the ED and overestimate observation stays. Primary diagnoses alone may underestimate the burden of WHF in non‐hospitalized settings. [ABSTRACT FROM AUTHOR]