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Objective: To evaluate the efficacy of the Crane reduction technique in midline lumbar fusion (MIDLF) with cortical bone trajectory screws for treating degenerative spondylolisthesis, and to identify factors affecting the reduction rate., Methods: A retrospective analysis was conducted on 87 patients (64 females and 23 males) with L4-5 degenerative spondylolisthesis who underwent MIDLF and the Crane technique. Patients were categorizing using the spondylolisthesis Meyerding classification system into Grade I (59 patients) and Grade II (28 patients) groups and compared for demographics, radiographic parameters, and the spondylolisthesis reduction rate. Data were analyzed to identify factors influencing the reduction rate., Results: Grade II patients showed higher preoperative spondylolisthesis slip ratio (29.8 ± 3.7% vs. 19.9 ± 3.2%, P < 0.01) and a lower segmental lordosis than Grade I patients. Postoperatively, Grade II patients achieved higher reduction rates (92.6% [90.8-93.8] vs. 89.9% [86.8-91.4] in Grade I, P < 0.01) and a greater segmental lordosis increase (+2.4° [0.2-5.5] vs. -1.2° [-3.5 to 1.6], P < 0.01). Multivariable analysis revealed vacuum disc phenomenon had a negative impact (β = -0.070, P < 0.01) and spondylolisthesis slip ratio had a positive impact (β = 0.612, P < 0.01) on the slip reduction rate. Complications occurred in 4.6% of cases, including 3 intraoperative durotomy and 1 nut loosening requiring revision surgery., Conclusions: The Crane technique combined with MIDLF is an effective and safe surgical approach for treating L4-5 degenerative spondylolisthesis, demonstrating high reduction rates with consistent minimal residual slip, particularly in Grade II cases., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Asymmetric multicomponent reactions that aim to control multiple chiral centers with high selectivity in a single step remain an on-gonging challenge. The realm of enantioselective radical-polar crossover transformation achieved through C-H Functionalization has yet to be fully explored. Herein, we present a successful description of a photoredox/Cr-catalyzed enantioselective three-component (hetero)arylalkylation of 1,3-dienes through C-H functionalization. A diverse array of chiral homoallylic alcohols could be obtained in good to excellent yields, accompanied by outstanding enantioselectivity. The asymmetric radical-polar crossover transformation could build two chiral centers simultaneously and demonstrates broad substrate tolerance, accommodating various drug-derived aldehydes, (hetero)aromatics, and 1,3-diene derivatives. Preliminary mechanistic studies indicate the involvement of a radical intermediate, with the chiral allylic chromium species reacting with various aliphatic and aromatic aldehydes through Zimmerman-Traxler transition states enabled by dual photoredox and chiral chromium catalysis., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: To explore clinical and genetic features of persistent asymptomatic microscopic hematuria in children. Methods: A retrospective case analysis of 135 individuals admitted to Xi 'an Children's Hospital with persistent asymptomatic microscopic haematuria between January 2016 to December 2023 was conducted. The demographic characteristics, kidney pathology and gene results of 135 individuals were analyzed. One hundred and thirty-five individuals were divided into 2 groups (positive group and negative group) according to family history of glomerulogenic hematuria in first-degree relatives. The differences of hematuria remission, proteinuria and gene variation were compared between the 2 groups. Two independent sample t test, Wilcoxon rank sum test, Pearson Chi-square, Yates' corrected Chi-squared test or Fisher exact test were used for comparison between groups. Results: All 135 children, with 48 males and 87 females, were 8.5 (6.5, 9.5) years old at first presentation. Kidney biopsy was performed in 73 cases (54.1%). Kidney pathology showed mild lesions in 41 cases (56.2%), thin basement membrane disease (TBMD) in 24 cases (32.9%), typical pathological features of Alport syndrome in 5 cases (6.8%), and other manifestations in 3 cases (4.1%). The positive group comprised 52 individuals, whereas the negative group consisted of 83 individuals. The positive group demonstrated a higher susceptibility in proteinuria and gene variation, while the negative group exhibited a greater rate of hematuria remission ( χ 2 =5.00, 5.27, 8.52, all P <0.05). Whole exome sequencing was performed in 80 individuals and 18 individuals (22.5%) had a pathogenic or likely pathogenic variant in COL4A3-5. COL4A5 was the most common gene afected, accounting for 11 cases. The 135 individuals were followed up for 4.2 (2.9, 5.1) years, of which 31 cases (22.9%) had complete hematuria remission at 2.1 (1.4, 2.7) years. Up to March 2024, there were also 7 individuals (5.2%) with varying degrees of proteinuria, and 3 individuals (2.2%) with proteinuria progressed to chronic kidney insufficiency. Conclusions: The most common kidney pathological types in children with persistent asymptomatic microscopic hematuria are minor lesions and TBMD. Children with microscopic hematuria whose first-degree relatives have a family history of hematuria are more likely to have proteinuria and gene variants. COL4A3-5 genetic screening could be considered a priority in these children.

The deep-time development of the Southern Ocean's deep-sea ecosystem remains poorly understood, despite being a key region in global ecological, climatological, and oceanographic systems, where deep water forms and biodiversity is unexpectedly high. 1 , 2 Here, we present an ∼500,000-year fossil record of the deep-sea Southern Ocean ecosystem in the subantarctic zone. The results indicate that changes in surface productivity and the resulting food supply to the deep sea, driven by eolian dust input and iron fertilization, along with changes in bottom-water temperature influenced by deep-water circulation, have controlled the deep-sea ecosystem in the Southern Ocean on orbital (10 4 -10 5 years) timescales following the Mid-Brunhes event (MBE), a major climatic transition ∼430,000 years ago. 3 However, before the MBE, the deep-sea Southern Ocean ecosystem was distinct from the present-day, post-MBE one. The present-day form of the deep-sea Southern Ocean ecosystem was established following the MBE, likely because of a stronger incursion of the warm North Atlantic deep water into the Southern Ocean after the MBE. Before that, the deep-sea Southern Ocean ecosystem lacked typical deep-sea faunal components and resembled deep, marginal sea fauna, likely because of the stronger thermal isolation of the Southern Ocean from the Atlantic Ocean. This result suggests that if future human-induced climatic warming weakens global deep-water circulation from the Atlantic through the Southern Ocean to the Pacific, 4 a deep-sea biodiversity hotspot in the Southern Ocean may diminish or even vanish., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This study descried the experiences of fathers who had lost a child to cancer. The participants were eight fathers whose children died following cancer treatment. Semi-structured interviews were conducted, and content analysis identified six major themes: (1) accompanying their child on the final journey home, (2) stabilizing family life, (3) coping with unbearable grief, 4) maintaining the memory and continuing the bond, (5) reflecting on the regrets and contradictions of the treatment process, (6) finding new meaning, and cherishing the present. The findings illustrated that these fathers, despite facing the death of their children, still prioritized family stability and used restoration-oriented strategies for their own emotions. However, these fathers also need outlets to express their feelings, making continuous psychological support from healthcare professionals essential throughout the grieving process.

Functional group translocation is undoubtedly a pivotal synthetic transformation in organic chemistry. Numerous types of reactions involving radical 1,2-aryl or 1,4-aryl migration via electron transfer mechanism have been extensively investigated. Nevertheless, energy-transfer enabled 1,4-arylation remains unknown. Herein we disclose that an unprecedented di-π-ethane rearrangement featuring 1,4-aryl migration facilitated by energy transfer catalysis under visible light conditions. The newly developed mild protocol exhibits tolerance towards diverse functional groups and enables the migration of a multitude of aromatic rings, encompassing both electron-withdrawing and electron-rich functional groups. The open-shell strategy has also found successful application in the modification of several drugs. Large-scale experiments, continuous-flow experiment, and versatile manipulation of products have demonstrated the robustness and potential utility of this synthetic method. Preliminary mechanistic studies have supported the involvement of radical species in this di-π-ethane rearrangement and have also provided evidence for the energy transfer mechanism., (© 2024 Wiley-VCH GmbH.)

Background/purpose: Osseointegration potential is greatly depended on the interaction between bone cells and dental implant surface. Since zirconia ceramic has a bioinert surface, functionalization of the surface with an organic compound allylamine was conducted to overcome its drawback of minimal interaction with the surrounding bone., Materials and Methods: The zirconia surface was initially treated with argon glow discharge plasma (GDP), then combined with amine plasma at three different conditions of 50-W, 75-W and 85-W, to prepare the final samples. The surface characteristics and cell biocompatibility were then evaluated., Results: Surface morphology analysis revealed a bulbous pattern on allylamine-treated sample groups. The aromatic C-H, C-O, N-H, C ˆ C, and C-H stretching and functional groups have been identified. Surface roughness increased, and hydrophilicity improved after surface modification. Cell viability analysis showed the highest result for the allylamine 50-W (A50) group. Alkaline phosphatase (ALP) assay indicated the A50 group had the highest activity, subsequently promoting late-stage mineralization at day 21. The reverse transcription-quantitative polymerase chain reaction (RT-qPCR) data demonstrated a significant upregulation of osteogenic gene expressions from day 1 to day 21., Conclusion: The allylamine-treated surface demonstrates immense enhancement in the surface hydrophilicity as well as in the viability, differentiation, and osteogenic properties of osteoblast-like cells. This makes it a promising candidate for future dental implant applications., Competing Interests: The authors have declared that there are no competing interests., (© 2024 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.Vé.)

After completing treatment, hematologic malignancy survivors face a critical phase of reintegrating into society. This study explored how survivors and their parents gradually returned to daily life, using grounded theory and in-depth interviews with 13 survivors and 16 parents. Data were analyzed revealed that hematologic malignancy survivors and their parents needed time to gradually return to daily life after a life-altering disruption after completing treatment. This process includes three categories: (1) adjusting to achievable learning goals, (2) incrementally expanding social relationships, and (3) strengthening daily life skills. As they return to daily life, both hematologic malignancy survivors and their parents need to adjust their mindset and pace to gradually adapt to the challenges they encounter. In the future, school nurses and oncology nurses can collaborate to design appropriate return-to-school plans to assist these children in their adaptation.

Caffeic acid phenethyl ester (CAPE) is one of the main active components of the natural medicine propolis, which has antioxidant, anti-tumor, and immunomodulatory activities. This study aimed to analyze the effects and underlying mechanisms of CAPE added to the medium of in vitro cultures on the developmental competence, mitochondria, and endoplasmic reticulum of porcine embryos. The results demonstrated that 1 nM of CAPE significantly improved the quality of porcine embryos, increased the rate of blastocyst formation, and enhanced the proliferation ability. It also enhanced mitochondrial function by increasing the level of mitochondrial membrane potential and expression of the mitochondrial biogenesis-related protein PPARgamma coactivator 1 alpha and beta (PGC1 alpha and beta), regulating mitochondrial biogenesis, and increasing adenosine triphosphate (ATP) content. In addition, CAPE alleviated oxidative and endoplasmic reticulum (ER) stress in embryos by decreasing ROS accumulation and increasing glutathione content, as well as elevating Nrf2 and reducing GRP78 (ER stress marker) expression levels. Moreover, CAPE reduced the levels of apoptosis and autophagy in the cultivated embryos. These results indicate that CAPE improves the quality and enhances the mitochondrial function of in vitro-produced porcine embryos by alleviating oxidative and ER stress.

Dynamic computed tomography (CT)-based brain perfusion imaging is a non-invasive technique that can provide quantitative measurements of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). However, due to high radiation dose, dynamic CT scan with a low tube voltage and current protocol is commonly used. Because of this reason, the increased noise degrades the quality and reliability of perfusion maps. In this study, we aim to propose and investigate the feasibility of utilizing a convolutional neural network and a bi-directional long short-term memory model with an attention mechanism to self-supervisedly yield the impulse residue function (IRF) from dynamic CT images. Then, the predicted IRF can be used to compute the perfusion parameters. We evaluated the performance of the proposed method using both simulated and real brain perfusion data and compared the results with those obtained from two existing methods: singular value decomposition and tensor total-variation. The simulation results showed that the overall performance of parameter estimation obtained from the proposed method was superior to that obtained from the other two methods. The experimental results showed that the perfusion maps calculated from the three studied methods were visually similar, but small and significant differences in perfusion parameters between the proposed method and the other two methods were found. We also observed that there were several low-CBF and low-CBV lesions (i.e., suspected infarct core) found by all comparing methods, but only the proposed method revealed longer MTT. The proposed method has the potential to self-supervisedly yield reliable perfusion maps from dynamic CT images., Competing Interests: Declarations. Ethics Approval: No institutional review board is required. Consent to Participate: Written informed consent was not required for this study because this is a retrospective study. Consent for Publication: Not applicable. Competing Interests: The authors declare no competing interests., (© 2024. The Author(s) under exclusive licence to Society for Imaging Informatics in Medicine.)

Promoting osteogenesis is crucial to improve successful bone regeneration in bone tissue engineering. Several studies on osteogenesis have reported positive effects of ω-9 monounsaturated fatty acids (MUFA) on bone regeneration. This study examined the potential of ω-9 monounsaturated fatty acid abundant seed oil mechanically extracted from Sapindus mukorossi (S. mukorossi) fruit to improve osteogeneses. After showing the presence of ω-9 MUFA in S. mukorossi seed oil (SM oil) through GC-MS spectrum analysis, the proliferation and differentiation of human umbilical cord Wharton's jelly mesenchymal stem cells (WJMSCs) under SM treatment was evaluated. Our results indicate that WJMSC differentiation was induced by adding an osteogenesis-induced medium combined with SM oil. A high level of calcium deposition expression in WJMSCs induced by SM oil appears to be due to the effect of oleic acid and eicosenoic acid, both of which are ω-9 monounsaturated fatty acids. In addition, we found major contributors of SM oil-promoted WJMSC osteogenesis to be extracellular signal-regulated kinase (ERKs), c-Jun N-terminal kinase (JNKs), and the p38 MAPK pathway. The enhancement of WJMSC osteogenesis via ERK/MAPK pathways as demonstrated by qPCR analysis indicates the promise of SM oil for stem cell-based bone tissue engineering applications., 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 Ltd. All rights reserved.)

Background: Although optical coherence tomography (OCT) is useful in determining outer retinal architecture, it may be suboptimal when monitoring subtle changes in retinitis pigmentosa (RP) patients. The aim of this study is to investigate precise microperimetric parameters for disease severity identification in RP patients. Methods: A cross-sectional and retrospective study. Thirty-nine eyes of 39 RP patients were included. Associations between logMAR visual acuity (VA), spectral-domain OCT, fundus autofluorescence imaging (FAF), and various microperimetric measures were evaluated. Microperimetric test locations were grouped into "foveal", parafoveal "inner ring", and perifoveal "outer ring". Independent variables were analyzed based on logistic regression, then assessed using area under the receiver operating characteristic curve (AUROC). Results: Among all microperimetric measures, linear regression analysis indicated that mean retinal sensitivity and deep scotoma count at the parafoveal inner ring were the principal parameters associated with decreased VA. The AUROC was highest for deep scotoma count at the inner ring at a value of 0.829, with the cut-off point at 3.5. A visual function index was then established according to the number of parafoveal deep scotoma points, in order of mild (0 points), moderate (1-3 points), and severe (4 or more points). Our microperimetric visual function index also correlated significantly to logMAR VA and previously established FAF patterns. Conclusions: Our study discovered deep scotoma count at the parafoveal inner ring to be a key microperimetric parameter in evaluating vision loss in RP patients. Those with four or more deep scotoma points at the parafoveal inner ring are more likely to have functional low vision.

Aim: To investigate the efficacy of nanodiamond irrigation solution with sonic agitation for removing of hard-tissue debris (HTD) within the isthmus-containing mesial roots of human mandibular molars using micro-CT analysis., Methodology: Forty mesial roots of extracted human mandibular molars were selected based on micro-computed tomography scans (9-μm resolution). The mesial canals were mechanically prepared using ProTaper® Gold nickel-titanium rotary instruments and divided into four groups (n = 10 each) according to the final irrigation protocol: sonic agitation with nanodiamond irrigation solution for three 20-s cycles, sonic agitation with 17% EDTA for three 20-s cycles, sonic agitation with 3% NaOCl for three 20-s cycles and manual syringe irrigation with NaOCl using a 30-G needle syringe for 60 s. The samples were scanned again after canal preparation and the use of the final irrigation protocols. Data were collected to evaluate the percentage of HTD removed. Statistical comparisons were made using the anova post hoc Tukey test (p < .05)., Results: None of the irrigation protocols was able to completely eliminate HTD from the isthmus-containing mesial canals of mandibular molars. However, sonic agitation with the nanodiamond irrigant and sonic agitation with 17% EDTA irrigation solutions showed higher mean reductions of HTD (68.0% and 68.9%, respectively) compared to sonic agitation with 3% NaOCl and manual syringe irrigation with 3% NaOCl (43.4% and 13.7%, respectively) (p < .05)., Conclusions: The effectiveness of sonic agitation in removing HTD from the entire root canal was superior to that of manual syringe irrigation. When employing sonic agitation, the addition of nanodiamonds to NaOCl demonstrated enhanced HTD removal capabilities compared to using NaOCl alone and was comparable to that of EDTA. These results suggest that sonic agitation with a nanodiamond irrigation solution may serve as an effective alternative approach for HTD removal in root canal treatment., (© 2024 British Endodontic Society. Published by John Wiley & Sons Ltd.)

Purpose: Nano-engineering techniques have significantly enhanced the various aspects of dentistry, with notable advancements, especially in dental implant surface modification. Dental implants are among the most significant and highly successful developments in contemporary dentistry. The use of nanotechnology for surface modification of zirconia ceramic implant increases interaction with surrounding bone cells, and ultimately leading to increase osseointegration., Materials and Methods: Glow discharge plasma was utilized to graft allylamine and fibronectin nanoproteins onto the surface of zirconia implants. A total of 18 implants were placed in right and left femurs of nine New Zealand rabbits. Implant stability test (IST), 3D bone reconstruction and micro-CT (µCT) analysis, bone-implant contact (BIC) from histomorphometry analysis, and osteogenic gene expression were analyzed after scarification at 4, 8, and 12 weeks., Results: IST results demonstrated a significant secondary stability gain at the end of 12 weeks. The surface-treated group obtained a gradual increase in marginal bone level. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis revealed increased expression of osteogenic genes of alkaline phosphatase (ALP) and transcription factor SP7 (SP7) biomarkers at 4 weeks. Osteoprotegerin (OPG) expression increased at 8 weeks, while runt-related transcription factor 2 (RUNX2), collagen 1A1 (COL1), bone sialoprotein (BSP), and receptor activator of nuclear factor κ B (RANK) exhibited the highest expression at 12 weeks. Importantly, histomorphometric analysis of BIC indicated that new bone formation was significantly higher in the A50F10 group compared to the control group at 12 weeks ( P < 0.001)., Conclusion: Based on the above findings, we conclude that the nanorough zirconia implant surface grafted with fibronectin nanoproteins prominently stimulated cellular activity and improved osseointegration properties. These results evidence its potential for future applications in dental implant surface modifications., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Aung et al.)

A general and flexible platform for catalytic aldehyde-alkyne couplings triggered by ketyl radicals is described. This open-shell strategy necessitates only a catalytic quantity of a photoredox catalyst, along with Hünig's base (DIPEA) as a halogen atom transfer reagent. The reaction proceeds through sequential steps involving activation, halogen atom transfer, and radical addition. This carbonyl-alkyne coupling exhibits a wide substrate scope and functional group compatibility and has been successfully applied to the late-stage modification of complex architectures.

Fibromyalgia is a chronic illness usually accompanied by long-lasting, general pain throughout the body, often accompanied by anxiety, depression, fatigue, and sleep disruption. Meanwhile, doctors and scientists have not entirely discovered detailed mechanisms; patients always have an exaggerated sensation to pervasive pain without satisfied medical service. Given the lack of knowledge on its underlying mechanism, current treatments aim to provide pain and/or symptom relief. The present study aimed to clarify the role of cannabinoid receptor 1 (CB1) signaling in a mouse fibromyalgia pain model. To develop the mouse fibromyalgia model, mice were subjected to intermittent cold stress (ICS). Our results indicated that mechanical (2.09 ± 0.09 g) and thermal hyperalgesia (4.77 ± 0.29 s), which were evaluated by von Frey and Hargraves' tests, were induced by ICS, suggesting successful modeling. The hurting replies were then provoked by electroacupuncture (EA) but not for sham EA mice. Further, in a Western blot analysis, we found significantly decreased CB1 protein levels in the thalamus, somatosensory cortex, and anterior cingulate cortex. In addition, the levels of pain-related protein kinases and transcription factor were increased. Treatment with EA reliably increased CB1 expression in various brain regions sequentially alleviated by nociceptive mediators. Furthermore, the administration of a CB1 agonist significantly attenuated fibromyalgia pain, reversed EA analgesia by the CB1 antagonist, and further reversed the chemogenetic inhibition of SSC. Our innovative findings evidence the role of CB1 signaling in the interaction of EA and fibromyalgia, suggesting its potential for clinical trials and as a treatment target.

Objectives: To investigate the nutritional status of children with Crohn's Disease (CD) at diagnosis and its association with clinical characteristics., Methods: A retrospective analysis was performed for the clinical data and nutritional status of 118 children with CD who were admitted to Beijing Children's Hospital, Capital Medical University, from January 2016 to January 2024. A multivariate logistic regression analysis was used to investigate the risk factors for malnutrition., Results: A total of 118 children with CD were included, among whom there were 68 boys (57.6%) and 50 girls (42.4%), with a mean age of (11±4) years. Clinical symptoms mainly included recurrent abdominal pain (73.7%, 87/118), diarrhea (37.3%, 44/118), and hematochezia (32.2%, 38/118), and 63.6% (75/118) of the children had weight loss at diagnosis. The incidence rate of malnutrition was 63.6% (75/118), and the children with moderate or severe malnutrition accounted for 67% (50/75). There were 50 children (42.4%) with emaciation, 8 (6.8%) with growth retardation, and 9 (7.6%) with overweight or obesity. Measurement of nutritional indices showed a reduction in serum albumin in 83 children (70.3%), anemia in 74 children (62.7%), and a reduction in 25 hydroxyvitamin D in 15 children (60%, 15/25). The children with malnutrition had significantly higher disease activity, proportion of children with intestinal stenosis, and erythrocyte sedimentation rate and a significant reduction in serum albumin ( P <0.05). The multivariate logistic regression analysis showed that intestinal stenosis was an independent risk factor for malnutrition in children with CD ( OR =4.416, P <0.05)., Conclusions: There is a high incidence rate of malnutrition in children with CD at diagnosis, which is associated with disease activity and disease behavior. The nutritional status of children with CD should be closely monitored.

Aim: To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure., Methods: Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator (CAM) training. The add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training. A control group received only the standard treatment. Treatment success was defined as best-corrected visual acuity (BCVA) ≥20/25. The age, sex, initial BCVA, refractive errors, sessions and duration of training, and final BCVA were recorded., Results: A total of 209 children (129 children in add-on CAM group and 80 children in control group) were enrolled. Seventy-six percent of unilateral and 87% of bilateral amblyopic children achieved treatment success. In children with unilateral or bilateral moderate amblyopia, the duration to reach BCVA ≥20/25 was significantly shorter in add-on CAM group than in control group. Poor initial BCVA ( P <0.001) and high astigmatism ( P =0.007) were risk factors for treatment failure after add-on CAM training. Age, sex, and types of refractive error were not associated with treatment success., Conclusion: Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children., Competing Interests: Conflicts of Interest: Huang HC, None; Cho WH, None; Fang PC, None; Lin PW, None; Chen YH, None; Huang HM, None., (International Journal of Ophthalmology Press.)

Scope: Maternal high fructose diet (HFD) during pregnancy and lactation can initiate retinal dysfunction. However, the underlying mechanism remains largely unknown., Methods and Results: By using the rodent model of maternal HFD in this study, the results from electroretinography (ERG) indicate that b-wave amplitude, an index of inner retinal function, is significantly reduced as early as 3 months old and the deteriorated effect can be detected at 15 months old. Further, the protein expressions of CD11b (a marker of active microglia), p40 phox subunit of NADPH oxidase, GFAP (a marker of active astrocytes), and NLPR3 examined by western blot and immunofluorescence are significantly increased in the retina of the male HFD offspring at 3 months old. Treatment with omega-3 polyunsaturated fatty acids (ω-3 PUFAs) for 2 weeks (from 2.5 to 3 months old) effectively reverses the aforementioned changes., Conclusion: Together, these results indicate that the early onset and extensive retinal dysfunction may be a result of glial activation which is induced by maternal HFD to initiate an inflammatory microenvironment leading to a long-term progression of retinopathy. Short-term administration of ω-3 PUFA at a young age may be a feasible strategy to intervene in the maternal HFD-programmed retinal impairment in male offspring., (© 2024 Wiley‐VCH GmbH.)

Quantitative analysis of diffusion-weighted magnetic resonance imaging (DW-MRI) has been explored for many clinical applications since its development. In particular, the intravoxel incoherent motion (IVIM) model for DW-MRI has been commonly utilized in various organs. However, because of the presence of excessive noise, the IVIM parameter maps obtained from pixel-wise fitting are often unreliable. In this study, we propose a kernelized total difference-based curve-fitting method to estimate the IVIM parameters. Simulated DW-MRI data at five signal-to-noise ratios (i.e., 10, 20, 30, 50, and 100) and real abdominal DW-MRI data acquired on a 1.5-T MRI scanner with nine b-values (i.e., 0, 10, 25, 50, 100, 200, 300, 400, and 500 s/mm 2 ) and six diffusion-encoding gradient directions were used to evaluate the performance of the proposed method. The results were compared with those obtained by three existing methods: trust-region reflective (TRR) algorithm, Bayesian probability (BP), and deep neural network (DNN). Our simulation results showed that the proposed method outperformed the other three comparing methods in terms of root-mean-square error. Moreover, the proposed method could preserve small details in the estimated IVIM parameter maps. The experimental results showed that, compared with the TRR method, the proposed method as well as the BP (and DNN) method could reduce the overestimation of the pseudodiffusion coefficient and improve the quality of IVIM parameter maps. For all studied abdominal organs except the pancreas, both the proposed method and the BP method could provide IVIM parameter estimates close to the reference values; the former had higher precision. The kernelized total difference-based curve-fitting method has the potential to improve the reliability of IVIM parametric imaging., (© 2024 John Wiley & Sons Ltd.)

Abstract: Guidelines on antiplatelet recommendation for CYP2C19 intermediate metabolizer (IM) have not come to an agreement. This study aimed to evaluate the clinical benefit of ticagrelor when compared with high-dose clopidogrel in CYP2C19 IM after percutaneous coronary intervention for acute coronary syndromes. Patients were enrolled according to CYP2C19 genotype and individual antiplatelet therapy. Patient characteristics and clinical outcomes were collected through electronic medical record system. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE), namely a composite of death from cardiovascular causes, myocardial infarction, stroke, and stent thrombosis within 12 months. The secondary outcome was Bleeding Academic Research Consortium scale bleeding events within 12 months. The Cox proportional hazards regression model was performed, with inverse probability treatment weighting (IPTW) adjusting for potential confounders. A total of 532 CYP2C19 IM were enrolled in this retrospective single-center study. No statistically significant difference in incidence rate of MACCE was found between patients receiving ticagrelor versus clopidogrel (7.01 vs. 9.52 per 100 patient-years; IPTW-adjusted hazard ratio 0.71; 95% confidence interval: 0.32-1.58; adjusted log-rank P = 0.396), but the incidence rate of Bleeding Academic Research Consortium type 2, 3, or 5 bleeding events was statistically higher in the loss of function-ticagrelor group than in the loss of function-clopidogrel group (13.53 vs. 6.16 per 100 patient-years; IPTW-adjusted hazard ratio: 2.29; 95% confidence interval: 1.10-4.78; adjusted log-rank P = 0.027). Ticagrelor treatment in CYP2C19 IM resulted in a statistically higher risk of bleeding compared with high-dose clopidogrel, whereas a clear association between treatments and MACCE warrants further investigations., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: To evaluate whether the application of Dynamic tape to the pitching shoulder could result in reduced shoulder fatigue, reduced delayed onset muscle soreness, or improved performance., Methods: This is a randomized crossover study, in which participants and investigators were blinded, included 20 amateur adult baseball players without shoulder pain. Sham taping and Dynamic taping were randomized, using an internal rotation support taping method in both groups. Bilateral shoulder strength and range of motion were measured with a handheld dynamometer and clinical goniometer before and after each test. The percentage of strength decrease, range of motion, pitch velocity, spin rate, and shoulder pain were recorded. The post-pitching decrease in strength and percentage of strength decrease were calculated by paired t-test and the pitching speed and spin rates in the innings for both the sham and Dynamic taping groups were analyzed using two-way ANOVA., Results: Compared with the sham group, the Dynamic tape group showed a significant loss in the percentage of strength decrease in internal rotation compared to the sham group (-1.4% vs. 7.0%, p = 0.03). However, no significant differences were observed in other strength declines, shoulder range of motion, pain, pitching velocity, or spin rate., Conclusions: Dynamic tape reduced direction-specific shoulder fatigue but did not significantly enhance pitching performance or prevent delayed onset muscle soreness., Trial Registration: ClinicalTrials: N201912094., (© 2024. The Author(s).)

Food allergy are triggered by an abnormal immune response to specific food components, with milk and eggs being the most common food allergens, especially in children. Food allergy can cause various symptoms such as rashes, difficulty breathing, and digestive issues. Allergen component diagnostics is a technique used to identify specific allergenic proteins, aiding doctors in providing more precise treatment and management recommendations for patients. This article analyzes the latest research developments and clinical significance of milk and egg allergen components based on the " Molecular Allergology User's Guide 2.0 (MAUG 2.0)" issued by the European Academy of Allergy and Clinical Immunology (EAACI), including their applications in clinical diagnosis, treatment, and management. This article aims to enhance healthcare professionals' understanding of milk and egg allergies, offering new perspectives and practical guidelines for research and clinical practice to promote accurate diagnosis and personalized treatment strategies.

The region with the highest marine biodiversity on our planet is known as the Coral Triangle or Indo-Australian Archipelago (IAA) 1,2 . Its enormous biodiversity has long attracted the interest of biologists; however, the detailed evolutionary history of the IAA biodiversity hotspot remains poorly understood 3 . Here we present a high-resolution reconstruction of the Cenozoic diversity history of the IAA by inferring speciation-extinction dynamics using a comprehensive fossil dataset. We found that the IAA has exhibited a unidirectional diversification trend since about 25 million years ago, following a roughly logistic increase until a diversity plateau beginning about 2.6 million years ago. The growth of diversity was primarily controlled by diversity dependency and habitat size, and also facilitated by the alleviation of thermal stress after 13.9 million years ago. Distinct net diversification peaks were recorded at about 25, 20, 16, 12 and 5 million years ago, which were probably related to major tectonic events in addition to climate transitions. Key biogeographic processes had far-reaching effects on the IAA diversity as shown by the long-term waning of the Tethyan descendants versus the waxing of cosmopolitan and IAA taxa. Finally, it seems that the absence of major extinctions and the Cenozoic cooling have been essential in making the IAA the richest marine biodiversity hotspot on Earth., (© 2024. The Author(s).)

Two important factors affecting the progress of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are the S-protein binding function of ACE2 receptors and the membrane fluidity of host cells. This study aimed to evaluate the effect of static magnetic field (SMF) on S-protein/ACE2 binding and cellular membrane fluidity of lung cells, and was performed in vitro using a Calu-3 cell model and in vivo using an animal model. The ability of ACE2 receptors to bind to SARS-CoV-2 spike protein on host cell surfaces under SMF stimulation was evaluated using fluorescence images. Host lung cell membrane fluidity was tested using fluorescence polarization to determine the effects of SMF. Our results indicate that 0.4 T SMF can affect binding between S-protein and ACE2 receptors and increase Calu-3 cell membrane fluidity, and that SMF exposure attenuates LPS-induced alveolar wall thickening in mice. These results may be of value for developing future non-contact, non-invasive, and low side-effect treatments to reduce disease severity in COVID-19-invaded lungs., (© 2024. The Author(s).)

Molecular rearrangement occupies a pivotal position among fundamental transformations in synthetic chemistry. Radical translocation has emerged as a prevalent synthetic tool, efficiently facilitating the migration of diverse functional groups. In contrast, the development of di-π-methane rearrangement remains limited, particularly in terms of the translocation of cyano functional groups. This is primarily attributed to the energetically unfavorable three-membered-ring transition state. Herein, we introduce an unprecedented di-π-ethane rearrangement enabled by energy-transfer catalysis under visible light conditions. This innovative open-shell rearrangement boasts broad tolerance toward a range of functional groups, encompassing even complex drug and natural product derivatives. Overall, the reported di-π-ethane rearrangement represents a complementary strategy to the development of radical translocation enabled by energy-transfer catalysis.

Competing Interests: The authors report no conflicts of interest.

Progesterone (P 4 ) plays a pivotal role in regulating the cancer progression of various types, including breast cancer, primarily through its interaction with the P 4 receptor (PR). In PR-negative breast cancer cells, P 4 appears to function in mediating cancer progression, such as cell growth. However, the mechanisms underlying the roles of P 4 in PR-negative breast cancer cells remain incompletely understood. This study aimed to investigate the effects of P 4 on cell proliferation, gene expression, and signal transduction in PR-negative MDA-MB-231 breast cancer cells. P 4 -activated genes, associated with proliferation in breast cancer cells, exhibit a stimulating effect on cell growth in PR-negative MDA-MB-231 cells, while demonstrating an inhibitory impact in PR-positive MCF-7 cells. The use of arginine-glycine-aspartate (RGD) peptide successfully blocked P 4 -induced extracellular signal-regulated kinase 1/2 (ERK1/2) activation, aligning with computational models of P 4 binding to integrin αvβ3. Disrupting integrin αvβ3 binding with RGD peptide or anti-integrin αvβ3 antibody altered P 4 -induced expression of proliferative genes and modified P 4 -induced cell growth in breast cancer cells. In conclusion, integrin αvβ3 appears to mediate P 4 -induced ERK1/2 signal pathway to regulate proliferation via alteration of proliferation-related gene expression in PR-negative breast cancer cells., Competing Interests: 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., (© 2024 The Authors. Published by Elsevier Ltd.)

Background: Nurses and nursing students are at greater risk of tuberculosis (TB) exposure due to their higher intensity contact with patients. In Indonesia, a country with high TB incidence, it is crucial to assess undergraduate nursing students' clinical confidence during their clinical practicums., Purpose: This study aimed to explore factors associated with nursing students' clinical confidence in caring for TB patients., Methods: This cross-sectional study utilized an internet survey based on the United States National TB Curriculum Consortium (NTCC) in September and November 2020. The survey questions focused on TB knowledge, beliefs about the value of TB instruction, and clinical confidence in caring for TB patients. Descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and hierarchical regression were used for data analysis. The Indonesian version of the original NTCC survey was used., Results: The study found that nursing students' knowledge about TB increased with their year of study (r = 0.290, p < .001). However, students perceived TB instruction as less valuable as they neared graduation (r = -0.233, p < .001) and with more frequent practice in the TB unit (r = -0.162, p < .001). Students who spent more time learning about TB outside of class perceived the TB instruction in the nursing curriculum more positively (r = 0.181, p < .004). The study also found a significant difference between nursing students' belief in the value of TB education and their clinical confidence in caring for TB patients (F = 5.711, p < .001). Furthermore, experience caring for TB patients and the number of TB patients cared for predicted clinical confidence., Conclusions/implications: This study highlights the need for improved curriculum content and teaching methods regarding TB for nursing students. It also suggests that experience caring for TB patients and the number of TB patients cared for can improve clinical confidence in nursing students. Given the high incidence of TB in Indonesia, this study's findings could have important implications for the country's healthcare system., (Copyright © 2023 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Natural products have attracted great interest in the development of tissue engineering. Recent studies have demonstrated that unsaturated fatty acids found in natural plant seed oil may exhibit positive osteogenic effects; however, few in vivo studies have focused on the use of plant seed oil for bone regeneration. The aim of this study is to investigate the effects of seed oil found in Sapindus mukorossi ( S. mukorossi ) on the osteogenic differentiation of mesenchymal stem cells and bone growth in artificial bone defects in vivo. In this study, Wharton-jelly-derived mesenchymal stem cells (WJMSCs) were co-cultured with S. mukorossi seed oil. Cellular osteogenic capacity was assessed using Alizarin Red S staining. Real-time PCR was carried out to evaluate ALP and OCN gene expression. The potential of S. mukorossi seed oil to enhance bone growth was assessed using an animal model. Four 6 mm circular defects were prepared at the parietal bone of New Zealand white rabbits. The defects were filled with hydrogel and hydrogel- S. mukorossi seed oil, respectively. Quantitative analysis of micro-computed tomography (Micro-CT) and histological images was conducted to compare differences in osteogenesis between oil-treated and untreated samples. Although our results showed no significant differences in viability between WJMSCs treated with and without S. mukorossi seed oil, under osteogenic conditions, S. mukorossi seed oil facilitated an increase in mineralized nodule secretion and upregulated the expression of ALP and OCN genes in the cells ( p < 0.05). In the animal study, both micro-CT and histological evaluations revealed that new bone formation in artificial bone defects treated with S. mukorossi seed oil were nearly doubled compared to control defects ( p < 0.05) after 4 weeks of healing. Based on these findings, it is reasonable to suggest that S. mukorossi seed oil holds promise as a potential candidate for enhancing bone healing efficiency in bone tissue engineering.

The electrical manipulation of the magnetic transition and spin-polarized states has attracted extensive attention in the field of spintronics. In this work, we perform a detailed study on the electronic and magnetic properties of the carrier-doped monolayer CrCTe 3 by using first-principles calculation. It is found that, the magnetic transition from Néel-antiferomagnetic (nAFM) to ferromagnetic (FM) is observed in the case of the electron doping, while for hole doping a magnetic transition sequence of nAFM→zigzag-AFM→FM is observed in the monolayer CrCTe 3 . Interestingly, the carrier doping induced FM ground state always exhibits half-metallicity with full spin polarization. Moreover, the spin polarity of the half-metallic electronic states is opposite for electron and hole doping, meaning that the spin polarization direction can be tuned by manipulating a gate voltage. The Monte Carlo calculations show that the magnetic transition temperature of the doped FM CrCTe 3 is rapidly increased with the increasing doping concentration and is extremely expected to achieve room temperature at a suitable doping concentration. These findings demonstrate that the monolayer AFM system possesses a potential application in spintronic devices with electrically tunable spin polarization., (© 2024 IOP Publishing Ltd.)

Objective: To investigate the effects of subcutaneous immunotherapy (SCIT) on patients' immune markers and metabolic levels in the early stage of allergen treatment, and to gain insight into the role of SCIT in regulating immune responses and metabolic levels, so as to provide reference data for the further discovery of potential biomarkers. Methods: A longitudinal study was used to include 40 subjects who underwent SCIT with dust mite allergens in the Department of Pediatrics of the First Affiliated Hospital of Guangzhou Medical University between November 2017 and February 2022, including 20 subjects each of single mite subcutaneous immunotherapy (SM-SCIT) and double mite subcutaneous immunotherapy (DM-SCIT). In this study, levels of dust mite allergen-specific antibodies and polyunsaturated fatty acid metabolism were measured before and 12 months after treatment, while pulmonary function tests were performed. The therapeutic effects of the patients were followed up by visual analogue scale (VAS), asthma control test (ACT) and total medication scores (TMS). The results were statistically analyzed using t -test and Mann-Whitney U -test. Results: After 12 months of treatment with SCIT, both groups showed a significant decrease in total VAS score (SM-SCIT: Z =-2.298, P <0.05; DM-SCIT: Z =-3.411, P <0.001); total ACT score (SM-SCIT: Z =-2.054, P <0.05; DM-SCIT: Z =-2.014, P <0.05) and total medication scores (SM-SCIT: Z =-3.799, P <0.000 1; DM-SCIT: Z =-3.474, P <0.001) were significantly higher, in addition to significantly higher MMEF75/25 values in the DM-SCIT group ( t =-2.253, P <0.05). There was no significant change in sIgE in the SM-SCIT group ( P >0.05), and the sIgG4 levels of the Der p, Der f, p 1, p 2, f 2, and p 21 fractions were significantly elevated ( Z= -2.651, -3.771, -2.949, -2.912, -2.725, -2.128, and -3.285, respectively, all P <0.05); The sIgE of Der p 2, f 2, p 7 and p 23 fractions( Z =-2.651, -3.771, -2.949, -2.912, -2.725, -2.128, -3.285, all P <0.05) and the sIgG4 levels of the Der p, Der f, p 1, p 2, f 1, f 2, p 10, p 21 and p 23 fractions ( Z =-3.808, -3.845, -3.061, -2.688, -2.464, -3.211, -2.371, -2.091, -2.427, all P <0.05) of the DM-SCIT group were significantly elevated. Metabolomics analysis showed that arachidonic acid, docosahexaenoic acid, docosapentaenoic acid, eicosapentaenoic acid, 5, 9, 12-octadecatrienoic acid, 5(S)-hydroxylated eicosatetraenoic acid, and dihomo-gamma-linolenic acid were significantly elevated at the beginning of the treatment period after SM-SCIT treatment ( Z of -2.191, -2.497, -1.988, -2.090, -2.19, -2.803, -2.073, all P <0.05); 5(S)-hydroxylated eicosatetraenoic acid showed elevated and alpha-linolenic acid, eicosadienoic acid, and eicosapentaenoic acid were significantly decreased in the DM-SCIT group after treatment ( Z =-1.988, -2.090, -2.497, -1.988, respectively, all P <0.05). Correlation analysis showed that arachidonic acid was significantly negatively correlated with changes in dust mite-specific IgG4 ( r= -0.499, P <0.05), and that alpha-linolenic acid, 5, 9, 12-octadecatrienoic acid, and eicosapentaenoic acid were positively correlated with the ΔsIgG4 of the dust mite der p 2 ( r =0.451, 0.420, 0.474, respectively; all P <0.05). Conclusion: Significant changes in allergen-specific antibody levels and polyunsaturated fatty acid metabolism levels occur during SCIT, and the two may interact and influence each other.

Objective: To investigate the relative expression level and clinical significance of LINC00475 in serum of patients with multiple myeloma (MM)., Methods: The expression of LINC00475 in serum of 108 MM patients and five MM cell lines including RPMI 8226, NCI-H929, U266, OPM2 and CAG were detected by real-time fluorescence quantitative PCR. The diagnostic value of LINC00475 in MM was evaluated by receiver operating characteristic (ROC) curve analysis. The correlation of LINC00475 with patients' characteristics was analyzed., Results: Compared with control groups, the expression of LINC00475 was up-regulated in serum of MM patients and MM cell lines (all P < 0.05). ROC curve analysis showed that the optimal cut-off value of LINC00475 was 262.4, the area under curve (AUC) was 0.924(95% CI : 0.884-0.964), and sensitivity and specificity was 83.3% and 91.7%, respectively, which indicated that LINC00475 had good evaluation value in MM patients. Compared with low- LINC00475 expression group, patients in high- LINC00475 expression group had higher levels of β 2 microglobulin (β 2 -MG) and Cystatin C (Cys-C) but lower albumin (ALB) (all P < 0.05). Compared with MM patients with International Staging System (ISS) stage I, the expression level of LINC00475 was significantly higher in patients with stage II and III (both P < 0.05)., Conclusion: LINC00475 is helpful to distinguish MM patients from healthy adults, which is correlated with the prognostic indicators such as β 2 -MG, ALB, and ISS stage.

This study examines the impact of Notoginsenoside R1 (NGR1), a compound from Panax notoginseng, on the maturation of porcine oocytes and their embryonic development, focusing on its effects on antioxidant levels and mitochondrial function. This study demonstrates that supplementing in vitro maturation (IVM) medium with NGR1 significantly enhances several biochemical parameters. These include elevated levels of glutathione (GSH), nuclear factor erythrocyte 2-related factor 2 (NRF2) and mRNA expression of catalase (CAT) and GPX. Concurrently, we observed a decrease in reactive oxygen species (ROS) levels and an increase in JC-1 immunofluorescence, mitochondrial distribution, peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α) and nuclear NRF2 mRNA levels. Additionally, there was an increase in ATP production and lipid droplets (LDs) immunofluorescence. These biochemical improvements correlate with enhanced embryonic outcomes, including a higher blastocyst rate, increased total cell count, enhanced proliferative capacity and elevated octamer-binding transcription factor 4 (Oct4) and superoxide dismutase 2 (Sod2) gene expression. Furthermore, NGR1 supplementation resulted in decreased apoptosis, reduced caspase 3 (Cas3) and BCL2-Associated X (Bax) mRNA levels and decreased glucose-regulated protein 78 kD (GRP78) immunofluorescence in porcine oocytes undergoing in vitro maturation. These findings suggest that NGR1 plays a crucial role in promoting porcine oocyte maturation and subsequent embryonic development by providing antioxidant levels and mitochondrial protection., (© 2024 Wiley‐VCH GmbH. Published by John Wiley & Sons Ltd.)

Background: Surgical scheduling is pivotal in managing daily surgical sequences, impacting patient experience and hospital resources significantly. With operating rooms costing approximately US $36 per minute, efficient scheduling is vital. However, global practices in surgical scheduling vary, largely due to challenges in predicting individual surgeon times for diverse patient conditions. Inspired by the Toyota Production System's efficiency in addressing similar logistical challenges, we applied its principles as detailed in the book "Lean Thinking" by Womack and Jones, which identifies processes that do not meet customer needs as wasteful. This insight is critical in health care, where waste can compromise patient safety and medical quality., Objective: This study aims to use lean thinking and Toyota methods to develop a more efficient surgical scheduling system that better aligns with user needs without additional financial burdens., Methods: We implemented the 5 principles of the Toyota system: specifying value, identifying the value stream, enabling flow, establishing pull, and pursuing perfection. Value was defined in terms of meeting the customer's needs, which in this context involved developing a responsive and efficient scheduling system. Our approach included 2 subsystems: one handling presurgery patient data and another for intraoperative and postoperative data. We identified inefficiencies in the presurgery data subsystem and responded by creating a comprehensive value stream map of the surgical process. We developed 2 Excel (Microsoft Corporation) macros using Visual Basic for Applications. The first calculated average surgery times from intra- or postoperative historic data, while the second estimated surgery durations and generated concise, visually engaging scheduling reports from presurgery data. We assessed the effectiveness of the new system by comparing task completion times and user satisfaction between the old and new systems., Results: The implementation of the revised scheduling system significantly reduced the overall scheduling time from 301 seconds to 261 seconds (P=.02), with significant time reductions in the revised process from 99 seconds to 62 seconds (P<.001). Despite these improvements, approximately 21% of nurses preferred the older system for its familiarity. The new system protects patient data privacy and streamlines schedule dissemination through a secure LINE group (LY Corp), ensuring seamless flow. The design of the system allows for real-time updates and has been effectively monitoring surgical durations daily for over 3 years. The "pull" principle was demonstrated when an unplanned software issue prompted immediate, user-led troubleshooting, enhancing system reliability. Continuous improvement efforts are ongoing, except for the preoperative patient confirmation step, which requires further enhancement to ensure optimal patient safety., Conclusions: Lean principles and Toyota's methods, combined with computer programming, can revitalize surgical scheduling processes. They offer effective solutions for surgical scheduling challenges and enable the creation of a novel surgical scheduling system without incurring additional costs., (©Chien-Chung Lin, Jian-Hong Shen, Shu-Fang Chen, Hung-Ming Chen, Hung-Meng Huang. Originally published in JMIR Formative Research (https://formative.jmir.org), 24.05.2024.)

The rapid assembly of valuable cyclic amine architectures in a single step from simple precursors has been recognized as an ideal platform in term of efficiency and sustainability. Although a vast number of studies regarding cyclic amine synthesis has been reported, new synthetic disconnection approaches are still high in demand. Herein, we report a catalytic radical-polar crossover cycloaddition to cyclic amine synthesis triggered from primary sulfonamide under photoredox condition. This newly developed disconnection, comparable to established synthetic approaches, will allow to construct β, β-disubstituted cyclic amine and β-monosubstituted cyclic amine derivatives efficiently. This study highlights the unique utility of primary sulfonamide as a bifunctional reagent, which acts as a radical precursor and a nucleophile. The open-shell methodology demonstrates broad tolerance to various functional groups, drug derivatives and natural products in an economically and sustainable fashion., (© 2024 Wiley‐VCH GmbH.)

Monoamine oxidase B (MAOB), a neurotransmitter-degrading enzyme, was reported to reveal conflicting roles in various cancers. However, the functional role of MAOB and impacts of its genetic variants on prostate cancer (PCa) is unknown. Herein, we genotyped four loci of MAOB single-nucleotide polymorphisms (SNPs), including rs1799836 (A/G), rs3027452 (G/A), rs6651806 (A/C) and rs6324 (G/A) in 702 PCa Taiwanese patients. We discovered that PCa patients carrying the MAOB rs6324 A-allele exhibited an increased risk of having a high initial prostate-specific antigen (iPSA) level (>10 ng/mL). Additionally, patients with the rs3027452 A-allele had a higher risk of developing distal metastasis, particularly in the subpopulation with high iPSA levels. In a subpopulation without postoperative biochemical recurrence, patients carrying the rs1799836 G-allele had a higher risk of developing lymph node metastasis and recurrence compared to those carrying the A-allele. Furthermore, genotype screening in PCa cell lines revealed that cells carrying the rs1799836 G-allele expressed lower MAOB levels than those carrying the A-allele. Functionally, overexpression and knockdown of MAOB in PCa cells respectively suppressed and enhanced cell motility and proliferation. In clinical observations, correlations of lower MAOB expression levels with higher Gleason scores, advanced clinical T stages, tumour metastasis, and poorer prognosis in PCa patients were noted. Our findings suggest that MAOB may act as a suppressor of PCa progression, and the rs3027452 and rs1799836 genetic variants of MAOB are linked to PCa metastasis within the Taiwanese population., (© 2024 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)

Purpose: Parents must manage their own stress and help their child with cancer during the treatment process, both physically and emotionally. With the increased involvement of fathers in caring for the family, how fathers adjust to the stress and play a role in care responsibilities is unknown. This study aimed to explore the fathers' experiences of caring for their ill child during the cancer diagnosis and treatment process., Method: This study adopted a qualitative descriptive design and conducted in-depth interviews with 21 fathers with a diagnosed child recruited from a northern Taiwan medical center. Data were managed and analysed using content analysis., Results: Two main categories in the Taiwanese fathers' experiences of caring for their ill child during the cancer diagnosis and treatment process emerged: 1) the maintainer of family stability, and 2) thoughts and value adjustment. Each main category consists of 3-4 generic categories. They make the necessary adjustments between work and family, actively participate in caring for the entire family, and redefine family values. They convey information about the illness to their children, pay attention to the physical and psychological development of the child with cancer, and cherish the time spent together as a family., Conclusions: During the cancer treatment process, fathers play the roles of the protector and maintainer of family stability and adjust their attitudes and thoughts toward the family members and family life. Healthcare professionals can offer the fathers comprehensive support and improve the family's overall well-being during this demanding period., Competing Interests: Declaration of competing interest The authors do not have any conflict of interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study is to assess the association between atrial fibrillation (AF) and sudden sensorineural hearing loss (SSNHL)., Methods: This study was conducted by searching the longitudinal health insurance database of the Taiwan National Health Insurance Program for relevant information from January 1, 2000, to December 31, 2011. Patients with AF were matched with non-AF controls with a 1:1 strategy according to propensity scores. Multiple logistic regression analyses were performed to determine the risk of SSNHL., Results: In total, 14 698 patients with AF were matched with the same number of non-AF patients as controls. After propensity score matching, the use of antiplatelet or anticoagulation medications and the occurrence of SSNHL were found to have a significant difference between AF and non-AF patients. The occurrence of SSNHL was found to be higher in men, those of 45 to 74 years old, and patients with hypertension in both AF and non-AF groups. Multiple logistic regression analyses revealed that male gender, age between 45 and 74 years, hyperlipidemia, and hypertension are risk factors for SSNHL. The use of aspirin was found to reduce the rate of SSNHL (odds ratio [OR]: 0.67, 95% CI: 0.49-0.94, P = .019), but AF was not found to be a risk factor for SSNHL (OR: 0.89, 95% CI: 0.64-1.23, P = .467)., Conclusion: The association between AF and SSNHL is not significant., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Maternal nutrient intake influences the health of the offspring via microenvironmental systems in digestion and absorption. Maternal high fructose diet (HFD) impairs hippocampus-dependent memory in adult female rat offspring. However, the underlying mechanisms remain largely unclear. Maternal HFD causes microbiota dysbiosis. In this study, we find that the plasma level of butyrate, a major metabolite of microbiota, is significantly decreased in the adult female maternal HFD offspring. In these rats, GPR43, a butyrate receptor was downregulated in the hippocampus. Moreover, the expressions of mitochondrial transcription factor A (TFAM), and peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) were downregulated in the hippocampus. The decreases of these functional proteins were reversed by fructooligosaccharides (FOS, a probiotic) treatment in adulthood. Astrocytes are critical for energy metabolism in the brain. Primary astrocyte culture from female maternal HFD offspring indicated that GPR43 and the mitochondrial biogenesis were significantly suppressed, which was reversed by supplemental butyrate incubation. The oxygen consumption rate (OCR) was reduced in the HFD group and rescued by butyrate. Intriguingly, the nuclear histone deacetylase 4 (HDAC4) was enhanced in the HFD group, suggesting an inhibitory role of butyrate on histone deacetylase activity. Inhibition of HDAC4 effectively restored the OCR, bioenergetics, and biogenesis of mitochondria. Together, these results suggested that the impaired butyrate signaling by maternal HFD could underlie the reduced mitochondrial functions in the hippocampus via HDAC4-mediated epigenetic changes., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: Biportal endoscopic spinal surgery (BESS) is recommended as a safer and less destructive option for lumbar disc herniations. However, limited data exist on clinical outcomes for extraforaminal lumbar disc herniation (ELDH) surgery. This retrospective study presents our preliminary experience with transforaminal unilateral BESS for ELDH., Methods: Patients with lumbar radiculopathy refractory to conservative treatment, diagnosed with ELDH by magnetic resonance imaging, and treated with transforaminal unilateral BESS in 2021-2023 in 2 institutions in Taiwan were eligible for inclusion. Those with lumbar spondylolisthesis grade 2 or more with segmental instability, history of drug abuse or psychiatric diseases, or with a follow-up duration <1 year were excluded. Primary outcomes included visual analog scale for pain, assessed at 1 week, 1 month, 6 months, and 1 year using generalized estimating equations analysis; success and satisfaction of BESS graded by the Macnab criteria; and perioperative complications. Secondary outcomes were operative time and hospital length of stay., Results: Seventeen patients were included in the analysis, with a mean age of 65.8 years; 11 (64.7%) were males and 15 (88.2%) had no prior lumbar spine surgery. mean operative time was 107.9 minutes, and length of stay was 3.5 days. Graded by Macnab criteria, 16 (94.1%) of patients had good to excellent outcomes. Only 1 patient experienced complications. No recurrence/reoperation was observed. Generalized estimating equations analysis showed that postoperative visual analog scale scores decreased significantly at 1 week (adjusted Beta [aBeta] = -5.47, standard error: 0.29, P < 0.001), 1 month (aBeta = -5.82), 6 months (aBeta = -5.88), and 1 year (aBeta = -6.29)., Conclusions: Transforaminal unilateral BESS is an alternative and feasible method for treating ELDH, producing good surgical outcomes with few complications and sustaining pain improvement. Future studies with larger patient numbers and comparisons between BESS and other minimally invasive techniques for ELDH are warranted., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Alopecia is a common and distressing medical condition that has been related to psychiatric disorders. Stem cell-derived conditioned medium (CM), a novel therapy for hair regeneration, has shown effectiveness in several trials., Methods: This meta-analysis aims to explore the effectiveness of stem cell-derived CM in improving hair growth for patients of alopecia. We prospectively registered this systematic review and meta-analysis in PROSPERO (CRD42023410249). Clinical trials that the enrolled participants suffering from alopecia applied stem cell-derived CM were included. We calculated the mean and standard deviation for the hair density and thickness., Results: Ten clinical trials were included in our analysis. On the basis of eight clinical trials (n = 221), our pooled results indicate that stem cell-derived CM is effective in increasing hair density (mean difference [MD]: 14.93, confidence interval [95% CI]: 10.20-19.67, p < 0.0001) and thickness (MD: 18.67, 95% CI: 2.75-34.59, p < 0.0001) (μm) in patients with alopecia. Moreover, our findings suggest that longer treatment duration is associated with significantly greater improvement than shorter treatment duration (p = 0.02). Three of the included studies were randomized controlled trials (RCTs), and when we specifically analyzed these RCTs; statistical significance could also be observed in terms of hair density (MD: 9.23, 95% CI: 1.79-16.68, p < 0.00001)., Key Messages: Stem cell-derived conditioned medium can effectively increase hair density and thickness for alopecia, and there is no difference between each method (topical application, microneedling, or injection)., Competing Interests: Declaration of Competing Interest Wei-Ying Chien, Hui-Min Huang, Yi-No Kang, Kee-Hsin Chen, and Chiehfeng Chen declare that they have no financial and non-financial conflict of interests to this study., (Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate the changes in liver and kidney function, red blood cell (RBC) count and hemoglobin (HGB) levels in patients undergoing ultrasound-guided percutaneous microwave ablation (UPMWA) for uterine fibroids on postoperative day 1., Methods: The changes in liver and kidney function, RBC count and HGB levels in 181 patients who underwent selective UPMWA in the Second Affiliated Hospital of Shantou University Medical College, China, between August 2017 and January 2023 were retrospectively analyzed., Results: All patients underwent UPMWA for uterine fibroids; 179 patients had multiple uterine fibroids and 2 patients had single uterine fibroids. The maximum fibroid diameter ranged from 18 to 140 mm, with an average of 68.3 mm. Ultrasound imaging was used to confirm that the blood flow signal within the mass had disappeared in all patients, indicating that the ablation was effective. Within 24 h, compared with before UPMWA, levels of total bilirubin, direct bilirubin, indirect bilirubin and aspartate aminotransferase had significantly increased ( p  < 0.01), whereas levels of total protein, albumin, globulin, alanine aminotransferase, creatinine and urea had significantly decreased ( p  < 0.01). Acute kidney injury (AKI) occurred in 1 of the 181 patients. The RBC count and HGB levels decreased significantly after UPMWA ( p  < 0.01)., Conclusion: Ultrasound-guided percutaneous microwave ablation for uterine fibroids can impose a higher detoxification load on the liver and cause thermal damage to and the destruction of RBCs within local circulation, potentially leading to AKI. Protein levels significantly decreased after UPMWA. Therefore, perioperative organ function protection measures and treatment should be actively integrated into clinical practice to improve prognosis and enhance recovery.

Background: Obstructive sleep apnea syndrome (OSAS) is a common disorder associated with serious sequelae. The current gold standard diagnostic method, polysomnography, is costly and time consuming and requires patients to stay overnight at a facility., Aim: This study aimed to reveal the prevalence of OSAS in general adult population using a home sleep test (HST) during the coronavirus disease 2019 (COVID-19) pandemic., Methods: This prospective cohort study was conducted by the Department of Otolaryngology, Taipei City Hospital, Taipei, Taiwan, between January 2020 and December 2021. A total of 1372 patients aged 30-70 years completed an HST using a Type 3 portable sleep monitor (PM). The apnea-hypopnea index (AHI) was analyzed to assess the association of OSAS with age, body mass index (BMI), sex, Epworth Sleepiness Scale (ESS) and the Sleep Apnea Risk Assessment questionnaire (STOP-Bang questionnaire) rating., Results: The mean age of the patients (782 men, 57%; 590 women, 43%) was 49.24 ± 11.04 years. OSAS was detected in 954 (69.5%) patients with 399 (29.1%) mild OSAS; 246 (17.9%) moderate OSAS; and 309 (22.5%) severe OSAS. Among these, the prevalence of moderate-to-severe OSAS was 143 (10.4%) in women and 412 (30.0%) in men. The mean age was the highest (51.29 ± 11.29) in the mild OSAS group and lowest (47.08 ± 10.87) in the healthy group. OSAS severity was greater with increasing BMI, 23.39 ± 3.44 in the healthy group and 29.29 ± 5.01 in the severe OSAS group. A positive correlation was also noted between the ESS/STOP-Bang questionnaire rating and OSAS severity., Conclusion: The prevalence of OSAS in Taiwan was 69.5% in our study. It showed strong evidence that OSAS has important public health consequences and PMs are simple, fast, feasible, and cost-effective tools for OSAS screening in the home environment, especially during the COVID-19 pandemic., Competing Interests: The authors declare that they have no conflict of interest., (© 2023 Chou et al.)

Material decomposition (MD) is an application of dual-energy computed tomography (DECT) that decomposes DECT images into specific material images. However, the direct inversion method used in MD often amplifies noise in the decomposed material images, resulting in lower image quality. To address this issue, we propose an image-domain MD method based on the concept of deep image prior (DIP). DIP is an unsupervised learning method that can perform different tasks without using a large training dataset with known targets (i.e., basis material images). We retrospectively recruited patients who underwent non-contrast brain DECT scans and investigated the feasibility of using the proposed DIP-based method to decompose DECT images into two (i.e., bone and soft tissue) and three (i.e., bone, soft tissue, and fat) basis materials. We evaluated the decomposed material images in terms of signal-to-noise ratio (SNR) and modulation transfer function (MTF). The proposed DIP-based method showed greater improvement in SNR in the decomposed soft-tissue images compared to the direct inversion method and the iterative method. Moreover, the proposed method produced similar MTF curves in both two- and three-material decompositions. Additionally, the proposed DIP-based method demonstrated better separation ability than the other two studied methods in the case of three-material decomposition. Our results suggest that the proposed DIP-based method is capable of unsupervisedly generating high-quality basis material images from DECT images., (© 2023. Australasian College of Physical Scientists and Engineers in Medicine.)

Background: During the coronavirus disease 2019 (COVID-19) epidemic, the fever clinic is an important link for screening and diagnosing whether a patient is infected with the novel coronavirus. Blood collection from children's fingertips is a commonly used detection method; however, in children, the blood collection process may cause discomfort and resistance. To address this problem, the use of heating gloves combined with hand swinging can be considered for fingertip blood collection in children., Aim: To explore the application of fever gloves with the handshaking method for fingertip blood collection from children in fever clinics during the COVID-19 epidemic., Methods: A total of 100 children were selected for fingertip blood collection at the fever clinic of our hospital from June 2022 to June 2023 and were divided into two groups using a randomized numerical table method, with 50 cases in each group, including the control and observation groups. The patients in the control group followed the doctor's instructions to cooperate with the routine fingertip blood collection method, and the patients in the observation group followed the doctor's instructions to cooperate with the static fever gloves with the shaking hands method of children's fingertip blood collection. The level of the six blood routine and collection indexes, and the satisfaction of the examination of the patients in the peripheral blood group and the fever gloves with the shaking hands method of the children's fingertip blood collection group were compared., Results: The red and white blood cell count, hemoglobin, and red blood cell pressure volume in the observation group were higher than those in the control group ( P < 0.05); the platelet count in the control group was lower than that in the observation group ( P < 0.05); the number of times of squeezing the fingertip, the average time of blood collection, and the score of puncture pain in the observation group were significantly better than those in the control group ( P < 0.05); and satisfaction with the routine blood examination in the observation group was greater than that in the control group., Conclusion: The application value of the fever gloves with shaking hands method for children's fingertip blood collection was better, the accuracy of examination indexes was higher, and patient satisfaction with the examination was greater., Competing Interests: Conflict-of-interest statement: All authors have no conflicts of interest., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Resilience is essential for managing stress and maintaining equilibrium. During the clinical practicum, nursing students may experience tremendous physical and mental stress, and these negative experiences are considered a source of resilience for students. However, no universal definition of resilience among nursing students exists in the literature, occasioning the need to define the processes and indicators of resilience., Purpose: This study aims to explore the resilience process and indicators among nursing students in clinical practicum in Taiwan. Participants: Fifteen fifth-year junior college nursing students in Northeastern Taiwan who had completed the clinical practicum were interviewed, including 12 females and three males. All participants were aged 20.3 ± 0.61 years and all participants had clinical practicum experiences over four months., Methods: A qualitative descriptive study, using purposive and snowball sampling methods, was conducted to collect the experience of the nursing students in their internship. Data were collected using a semi-structured guide and deep interviews, and analyzed through the content analysis method by Waltz, Strickland, & Lenz (2010)., Results: Based on the participants' practical experiences during their clinical practicum, three main themes and nine indicators were identified. The resilience of nursing students is considered a process. The main themes are (1) uncontrolled clinical practical stress, (2) Maintain learning-life balance, (3) Positive attitude toward nursing., Conclusions: Resilience is a critical factor to stabilize nursing students and enable them to recover from adversity. Both positive and negative experiences significantly impacted the students' attitudes and confidence levels during the clinical practicum. The findings will provide faculty to adapt their teaching method to various situations of nursing students., Competing Interests: 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., (© 2023 The Authors.)

Palladium-based nanocatalysts play an important role in catalyzing the cathode oxygen reduction reaction (ORR) for fuel cells working under alkaline conditions, but the performance still needs to be improved to meet the requirements for large-scale applications. Herein, Au@Pd core-shell nanowires have been developed by coating Pd atomic layers on ultrafine gold nanowires and display outstanding electrocatalytic performance towards alkaline ORR. It is found that Pd overlayers with atomic thickness can be coated on 3 nm Au nanowires under CO atmosphere and completely cover the surfaces. The obtained ultrafine Au@Pd nanowires exhibit an electrochemical active area (ECSA) of 68.5 m 2 /g and a mass activity of 0.91 A/mg (at 0.9 V vs. RHE), which is around 3.1 and 15.2 times higher than that of commercial Pd/C. The activity loss of the ultrafine Au@Pd nanowire after 10,000 cycles of accelerated degradation tests is only ∼20 %, demonstrating its much better stability compared to commercial Pd/C. Further characterizations combined with density functional theory (DFT) calculations demonstrate that the electronic interactions between Pd atomic layers and underlying Au can increase the electronic density of Pd and promote the efficient activation of oxygen, thus leading to the improved ORR performance., 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 © 2023 Elsevier Inc. All rights reserved.)

Over the past few decades, recognition of early lung cancers was researched for effective treatments. In early lung cancers, the invasiveness is an important factor for expected survival rates. Hence, how to effectively identify the invasiveness by computed tomography (CT) images became a hot topic in the field of biomedical science. Although a number of previous works were shown to be effective on this topic, there remain some problems unsettled still. First, it needs a large amount of marked data for a better prediction, but the manual cost is high. Second, the accuracy is always limited in imbalance data. To alleviate these problems, in this paper, we propose an effective CT invasiveness recognizer by semi-automated segmentation. In terms of semi-automated segmentation, it is easy for doctors to mark the nodules. Just based on one clicked pixel, a nodule object in a CT image can be marked by fusing two proposed segmentation methods, including thresholding-based morphology and deep learning-based mask region-based convolutional neural network (Mask-RCNN). For thresholding-based morphology, an initial segmentation is derived by adaptive pixel connections. Then, a mathematical morphology is performed to achieve a better segmentation. For deep learning-based mask-RCNN, the anchor is fixed by the clicked pixel to reduce the computational complexity. To incorporate advantages of both, the segmentation is switched between these two sub-methods. After segmenting the nodules, a boosting ensemble classification model with feature selection is executed to identify the invasiveness by equalized down-sampling. The extensive experimental results on a real dataset reveal that the proposed segmentation method performs better than the traditional segmentation ones, which can reach an average dice improvement of 392.3%. Additionally, the proposed ensemble classification model infers better performances than the compared method, which can reach an area under curve (AUC) improvement of 5.3% and a specificity improvement of 14.3%. Moreover, in comparison with the models with imbalance data, the improvements of AUC and specificity can reach 10.4% and 33.3%, respectively.