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Biliary Atresia (BA) is a severe liver disease that affects newborns. This disease may cause cholestasis and progressive hepatic failure or even death if not treated immediately. ELISA blood tests for metabolic screening are the current method of diagnosing BA. However, Newborns need rapid BA detection for treatment in the future. Level increase of intrahepatic matrix metalloproteinase-7 (MMP7) is a factor known to cause BA-related liver fibrosis. We brought out a platform to detect BA using an electric-double-layer (EDL)-gated field-effect transistor (FET). MMP7 concentration differences affect gate voltages then consequent in the sensitivity of this platform. EDL-gated FETs are planned to display in hospitals for medical personnel to accurately detect BA in infants.

Objectives: In the past, an inherent dilemma in the education field was the difficulty in stimulating self-regulated learning. Flipped education, i.e., flipped teaching and learning, changed the teaching model, with a strategy of increasing students’ active learning during class time through a transformation of teaching and learning methods that enable students to build learning and knowledge on their own. This study investigates the impact of field-based flipped courses on college students taking up self-regulated learning and their learning performance. Methods: This study considers a national university in central Taiwan that adopts 34 field flipped teaching courses and 796 non-degree students from four colleges across all grades as the research objects, and conducts statistical analysis using descriptive statistics, t-test, ANOVA, Pearson’s correlation, and regression analysis on questionnaires to evaluate the association among variables. Findings: 1. With respect to the understanding of the uniqueness of field-based flipped teaching before and after the courses, there were differences among students in the Colleges of Education, Humanities, and Management. 2. In terms of students’ learning performance in the course pertaining to mastery over core literacy, there were differences between students of the Colleges of Education and Humanities at the beginning of the flipped-learning course. 3. There were differences among the students of Colleges of Education, Humanities, and Science and Technology in the later stage of the flipped-learning course. 4. Differences were found in the pre-test of learning performance at the grade level. 5. Self-regulated learning correlated with learning performance. 6. Field-based flipped teaching correlated with learning performance. 7. Self-regulated learning had a mediating effect on field-based flipped teaching and learning performance. Innovations: There is a little systematic discussion on the emergence and impact of flipped teaching in higher education currently in Taiwan. The authors found correlations among flipped teaching, self-regulated learning, and learning performance from the data, as well as discovered that self-regulated learning had a mediating effect on learning performance in field-based flipped teaching. Value: Making the university, when the curriculum arrangement and the development of the unique curriculum map of higher education in the future, possible to be linked with the local revitalization thinking in addition to the general curriculum, as well as being closely integrated with the local people and matters through field-flipped courses, and sustainably interacting therewith to practice university social responsibility.

BackgroundLimited studies have assessed the association of motor vehicle crashes (MVCs) during pregnancy with adverse maternal outcomes using a population-based nationwide dataset that covers all MVCs.MethodsA total of 20 844 births from women who had been involved in MVCs during pregnancy were obtained from the National Birth Notification (BN) Database in Taiwan. We randomly selected 83 274 control births from women in the BN matched on age, gestational age and crash date. All study subjects were linked to medical claims and the Death Registry to identify the maternal outcomes after crashes. Conditional logistic regression models were used to estimate the adjusted odds ratio (aOR) and 95% CI of adverse outcomes associated with MVCs during pregnancy.ResultsPregnant women involved in MVCs had significantly higher risks of placental abruption (aOR=1.51, 95% CI 1.30 to 1.74), prolonged uterine contractions (aOR=1.31, 95% CI 1.11 to 1.53), antepartum haemorrhage (aOR=1.19, 95% CI 1.12 to 1.26) and caesarean delivery (aOR=1.05, 95% CI 1.02 to 1.09) than the controls. Such elevated risks tended to be higher in the MVCs with greater severity. Scooter riders had higher ORs of various adverse maternal outcomes than car drivers.ConclusionsWomen involved in MVCs during pregnancy were at increased risk of various adverse maternal outcomes, especially in those with severe MVCs and riding scooters at MVCs. These findings suggest that clinicians should be aware of these effects, and educational materials that include the above information should be provided as part of prenatal care.

Background Increasing evidence suggests that chronic stress increases pain sensitivity and exacerbates existing pain. However, whether and how chronic unpredictable stress (CUS) affects surgical pain is unclear. Methods A postsurgical pain model was performed by longitudinal incision from 0.3 cm of the proximal edge of the heel toward the toes. The skin was sutured, and the wound site was covered. Sham surgery groups underwent the same procedure without an incision. The short-term CUS procedure was conducted by exposure of mice to 2 different stressors each day for 7 days. The behavior tests were conducted between 9:00 am and 4:00 pm. Mice were killed on day 19, and the mouse bilateral L4/5 dorsal root ganglia, spinal cord, anterior cingulate and insular cortex, and amygdala were collected for immunoblot analyses. Results Presurgical exposure of mice to CUS every day for 1–7 days showed significant depression-like behavior as evidenced by reduced sucrose preference in the sucrose consumption test and prolonged immobility time in the forced swimming task. This short-term CUS procedure did not affect the basal nociceptive response to mechanical and cold stimuli in the Von Frey and acetone-induced allodynia tests, but it delayed pain recovery after surgery, as indicated by the prolonged hypersensitivity in mechanical and cold stimuli by 12 days. The subsequent studies demonstrated that this CUS caused an increase in adrenal gland index. The abnormalities in pain recovery and adrenal gland index after surgery were reversed by a glucocorticoid receptor (GR) antagonist RU38486. Moreover, the prolonged pain recovery after surgery induced by CUS seemed to involve an increase in GR expression and decreases in cyclic adenosine monophosphate, phosphorylated cAMP response element binding protein, and brain-derived neurotrophic factor levels in emotion-related brain regions, such as anterior cingulate and insular cortex, amygdala, dorsal horn, and dorsal root ganglion. Conclusions This finding indicates that stress-induced GR change may result in dysfunction of GR-related neuroprotective pathway.

Accurate and efficient computation of traveltimes and their spatial derivatives for 3D heterogeneous media is essential in many areas of seismology, such as traveltime/slope tomography and quantitative migration. A popular method of obtaining this information is to solve the eikonal equation using a finite-difference (FD) scheme. However, the complex surface of the earth causes numerical complications when applying FD methods based on rectangular grids. To overcome the challenge of taking into account topographic effects, we make use of the 3D topography-dependent eikonal equation (TDEE) which is a 3D surface-flattening scheme that uses curvilinear grids to transform irregular surfaces in the physical domain into regular surfaces in the computational domain. Unfortunately, solving the TDEE in three dimensions starting from the initial point-source condition needs to get around the point-source singularity. Therefore, we formulate the 3D factored TDEE (FTDEE) according to a factorization principle. Furthermore, to numerically solve the 3D original TDEE, as well as the FTDEE, we apply a lock sweeping method, which avoids the problem of repetitive computation when using the fast sweeping method. Several numerical examples demonstrate the efficiency of the new lock scheme in terms of computation time and accuracy of the 3D FTDEE solver for the calculation of traveltimes and their derivatives. This scheme provides a good choice for the calculation of traveltimes and their spatial derivatives using models with irregular surfaces, which means greater potential for seismic data processing under conditions of complex topography.

Yu-Ling Chen,1– 3,* Yu-Dan Liang,4,* Kai-Feng Guo,2 Zhen Huang,2 Wen-Qi Feng3 1Rehabilitation Department of the Panyu Central Hospital, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 2Rehabilitation Department of the Panyu Central Hospital, Guangzhou, People’s Republic of China; 3Department of Acupuncture and Moxibustion of the YiBin Hospital of Traditional Chinese Medicine, YiBin, People’s Republic of China; 4Department of Acupuncture and Rehabilitation, the Affiliated Jiangmen Traditional Chinese Medicine Hospital of Jinan University, Jiangmen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhen Huang, Rehabilitation Department of the Panyu Central Hospital, No. 8 Fuyu Road, Qiaonan District, Guangzhou, 511400, People’s Republic of China, Tel +86 18922238059, Email Mishz@126.com Wen-Qi Feng, Department of Acupuncture and Moxibustion of the YiBin Hospital of Traditional Chinese Medicine, No. 2 Dawan Road, Nanan District, YiBin, 644000, People’s Republic of China, Tel +86 13629031868, Email Moonly1981@163.comPurpose: Acupuncture is widely used to relieve shoulder pain. A survey was conducted in order to recognize hotspots and frontiers of acupuncture for shoulder pain from the year 2000– 2022.Methods: The Web of Science Core Collection was used to collect literature related to acupuncture therapy for shoulder pain, which spanned January 2000 to August 2022. The number of publications yearly, countries/institutions, journals, and keywords was analyzed and visualized in shoulder pain with acupuncture therapy by CiteSpace v.5.7.R5.Results: We totally analyzed 214 articles that met the inclusion criteria. The overall trend of publication volume continues to increase. The most productive authors in the field were César Fernández las Peñas and José L Arias-Buría, and the most influential author was Green S. Kyung Hee University and the People’s Republic of China had the highest volume of publications, respectively. The most influential journal is Pain with high citation and impact factor. The hot keywords were “acupuncture”, “shoulder pain”, “dry needling”, “randomized trial”, and “injection”. The research frontier in acupuncture for treating chronic shoulder pain was mainly “mechanism”.Conclusion: Over the last 22 years, the findings of this bibliometric analysis have provided research trends and frontiers in clinical research on acupuncture therapy for patients with shoulder pain, which identifying hot topics and exploring new directions for the future may be helpful to researchers. Studying mechanisms underlying acupuncture therapy for shoulder pain remains a focus of future research.Keywords: acupuncture, shoulder pain, bibliometric analysis, CiteSpace

BACKGROUND: The increasing prevalence of end-stage renal disease (ESRD) imposes a substantial economic burden on public health-care systems. Hemodialysis (HD) is a pivotal treatment modality for patients with ESRD. However, prolonged use of HD vessels may result in stenosis, thrombosis, and occlusion due to repeated daily punctures. Thus, early detection and prevention of the dysfunction of dialysis routes are crucial. OBJECTIVE: In this study, we designed a wearable device for the early and accurate detection of arteriovenous access (AVA) stenosis in HD patients. METHODS: A personalized three-dimensional (3D) printed wearable device was designed by combining the phonoangiography (PAG) and photoplethysmography (PPG) techniques. The capability of this device to monitor AVA dysfunction before and after percutaneous transluminal angioplasty (PTA) was evaluated. RESULTS: After PTA, the amplitudes of both PAG and PPG signals increased in patients with arteriovenous fistulas and those with arteriovenous grafts; this might be due to increased blood flow. CONCLUSION: Our designed multi-sensor wearable medical device using PAG, PPG, and 3D printing appears suitable for early and accurate detection of AVA stenosis in HD patients.

Background Previous studies have compared the effectiveness of constraint-induced movement therapy (CIMT) by different training doses. However, whether the dosing schedule, that is, intensive or distributed, influences the effectiveness of CIMT in children with unilateral cerebral palsy (CP) is unknown. Objective To investigate the effectiveness of intensive and distributed CIMT for children with unilateral CP. Methods Fifty children with unilateral CP were assigned to intensive or distributed CIMT group with a total of 36 training hours. The intensive CIMT was delivered within 1 week, and the distributed CIMT was delivered twice a week for 8 weeks. The outcomes were the Melbourne Assessment 2, Box and Block Test, Pediatric Motor Activity Log-Revised (PMAL-R), Bruininks–Oseretsky test of motor proficiency 2, ABILHAND-Kids and Parenting Stress Index—Short Form. The intensive group was assessed at the initiation of treatment (week 0), at the end of 1 week treatment (week 1), and 8 weeks after the initiation of treatment (week 8). The distributed group was assessed at week 0 and week 8. Results The within-group analyses demonstrated significant differences on all motor outcomes. There were no significant between-group differences at post-treatment, while the intensive CIMT demonstrated larger improvements than the distributed CIMT did on quality of use of the more-affected hand, as rated by parents on the PMAL-R at week 8. Conclusions The 2 dosing schedules of CIMT had similar effectiveness for children with unilateral CP. The intensive CIMT yielded additional improvement on parent rated motor quality of the more-affected hand at 8 weeks after the initiation of treatment. Trial registration: ClinicalTrials.gov (ID: NCT03128385)