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Kunping Cui, Chang-Hai Liu, Xiangnan Teng, Fang Chen, Yan Xu, Shaoqun Zhou, Qi Yang, Lingyao Du, YuanJi Ma, Lang Bai Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, People’s Republic of ChinaCorrespondence: YuanJi Ma; Lang Bai, Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, People’s Republic of China, Tel +86-02885422650 ; +86-18980602254, Email maxe.doc@163.com; pangbailang@163.comObjective: The artificial liver support system (ALSS) has been recruited as an available method for patients with acute-on-chronic liver failure (ACLF), but its impact on the outcome of ACLF remains controversial. This study aimed to investigate the association between ALSS treatment and short-term prognosis of hepatitis B-related ACLF (HBV-ACLF).Methods: This was a retrospective observational cohort study, and data were obtained from the Center of Infectious Diseases, West China Hospital of Sichuan University, between Mar 2015 and December 2021. The primary outcome was 28-day transplant-free mortality and the secondary outcomes were 60- and 90-day transplant-free mortality. Patients were divided into standard medical therapy (SMT) and ALSS groups. Kaplan-Meier survival analysis curves show the 28-day, 60-day and 90-day transplant-free mortality. Based on the feature selection result of univariate logistic, univariate Cox and Boruta algorithm, the univariate and multivariate logistic and COX regression models were used to investigate the association of ALSS with 28-day, 60-day and 90-day outcomes in patients with HBV-ACLF. Subgroup analyses were conducted to test the robustness of the results.Results: A total of 589 hBV-ACLF patients were enrolled in this study (median age, 48.00 years [IQR,44.00– 55.00 years]; 70 [11.9%] female). The 28-day, 60-day and 90-day transplant-free mortality rates were 25.6%, 35.8% and 38.9%, respectively. In the univariate and Kaplan-Meier survival analysis, ALSS could significantly reduce 28-day, 60-day and 90-day transplant-free mortality compared to SMT. Furthermore, an in-depth analysis of our study revealed that the therapeutic benefits of the ALSS were observed exclusively within the end-stage (PT-INR ≥ 2.5) subgroup of HBV-ACLF patients.Conclusion: Compared to SMT, ALSS demonstrated efficacy primarily in enhancing the short- term prognosis of end-stage HBV-ACLF patients, rather than across the entire spectrum of HBV-ACLF patients.Keywords: artificial liver support systems, hepatitis B-related acute-on-chronic liver failure, prognosis

Lekha Rethi,1,2,* Lekshmi Rethi,2,* Chia-Hung Liu,3,* Tin Van Hyun,4,5 Chih-Hwa Chen,1,2,6 Er-Yuan Chuang1,2,7 1Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan; 2International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan; 3Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan; 4International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan; 5Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, 700000, Vietnam; 6Department of Orthopedics, Taipei Medical University – Shuang Ho Hospital, New Taipei City, Taiwan; 7Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan*These authors contributed equally to this workCorrespondence: Er-Yuan Chuang, Email eychuang@tmu.edu.twAbstract: Due to their non-toxic function in biological systems, Iron oxide NPs (IO-NPs) are very attractive in biomedical applications. The magnetic properties of IO-NPs enable a variety of biomedical applications. We evaluated the usage of IO-NPs for anticancer effects. This paper lists the applications of IO-NPs in general and the clinical targeting of IO-NPs. The application of IONPs along with photothermal therapy (PTT), photodynamic therapy (PDT), and magnetic hyperthermia therapy (MHT) is highlighted in this review’s explanation for cancer treatment strategies. The review’s study shows that IO-NPs play a beneficial role in biological activity because of their biocompatibility, biodegradability, simplicity of production, and hybrid NPs forms with IO-NPs. In this review, we have briefly discussed cancer therapy and hyperthermia and NPs used in PTT, PDT, and MHT. IO-NPs have a particular effect on cancer therapy when combined with PTT, PDT, and MHT were the key topics of the review and were covered in depth. The IO-NPs formulations may be uniquely specialized in cancer treatments with PTT, PDT, and MHT, according to this review investigation.Keywords: cancer, hyperthermia, iron oxide, magnetic hyperthermia, photodynamic therapy, photothermal therapy, near-infrared

Chung-Chen Yeh,1– 3,* Yu-Tung Lee,4,* Cheng-Yu Chien,5,6 Po-Cheng Chen,3,7 Jian-Hong Chen,3,8,9 Chun-Hao Liu3,10 1Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; 2Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan; 3College of Medicine, Chang Gung University, Taoyuan City, Taiwan; 4Department of Psychiatry, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan; 5Graduate Institute of Management, Chang Gung University, Taoyuan City, Taiwan; 6Department of Emergency Medicine, Ton-Yen General Hospital, Hsinchu County, Taiwan; 7Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan; 8Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung City, Taiwan; 9National Taiwan Sport University, Taoyuan City, Taiwan; 10Department of Child & Adolescent Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan*These authors contributed equally to this workCorrespondence: Chun-Hao Liu, Department of Child & Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Hsin St., Gueishan District, Taoyuan City, 333, Taiwan, Tel +886-3-3281200 ext 2439, Fax +886-3-3280267, Email abucastor@hotmail.comPurpose: People’s health-care-seeking behaviors considerably changed during the COVID-19 pandemic. This study evaluated the changes in self-harm- and violence-related urgent psychiatric consultation (UPC) in the emergency department (ED) during different stages of the pandemic and at different levels of hospitals.Patients and Methods: We recruited patients who received UPC during the baseline (2019), peak (2020), and slack (2021) periods of the same time window (calendar weeks 4– 18) during the COVID-19 pandemic. Demographic data such as age, sex, and referral type (by the police/emergency medical system) were also recorded.Results: We found female gender and younger age associated with higher risk of self-harm-related UPCs, whereas patients visiting regional hospitals, male patients, and patients referred by the policy/emergency medical system, had a higher risk of violence-related UPCs. After adjustment, the different pandemic stages were not significantly associated with self-harm- or violence-related UPCs.Conclusion: Patient’s demographic data, but not the pandemic itself, may be responsible for the changes in self-harm- and violence-related UPCs during the pandemic.Keywords: COVID-19, emergency department, psychiatric consultation, self-harm, violence

Dong Wang,* Shi-Jun Wang,* Ying-Jie Li, Chun-Hui Liu, Yong-Qiang Li, Yin-Sheng Zhang, Su Yan Department of Urology, Peking Union Medical College Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Su Yan, Department of Urology, Peking Union Medical College Hospital, No. 1 of Shuaifuyuan, Dongcheng District, Beijing, 100730, People’s Republic of China, Tel +86 13801326306, Fax +86 10 69152520, Email yansudrob@outlook.comBackground: Phosphodiesterase 5 inhibitors (PDE5Is) and other more invasive options merely provide symptomatic relief rather than a permanent improvement in erectile dysfunction (ED), whereas the long-term improvement in ED via low-intensity extracorporeal shockwave therapy (Li-ESWT) has been confirmed. So far, no comparative study of sildenafil versus Li-ESWT has been conducted with respect to treatment satisfaction.Objective: In this study, we aim to compare erectile function status and satisfaction rates in patients who received sildenafil or Li-ESWT for ED.Methods: Patients complaining of ED were considered candidates. Participants chose to enter one of two active treatment groups according to their treatment intention—either a 9-week Li-ESWT regimen or 100 mg on-demand sildenafil. The erectile function was evaluated using the erectile function domain of the International Index of Erectile Function questionnaires (IIEF-EF), while the treatment satisfaction was evaluated using the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaires (EDITS).Results: We enrolled 72 participants in the study (42 in the Li-ESWT group and 30 in the sildenafil group). Patients in both groups were young men. Four weeks after the last session, the IIEF-EF score for Li-ESWT and sildenafil was 16.3± 5.5 and 18.3± 6.5 (P > 0.05), respectively. The total EDITS index of the patient version and the partner version were similar in the two groups. Among EDITS questions measuring overall satisfaction and efficacy duration, the score was higher in the Li-ESWT group.Conclusion: We found that Li-ESWT may have better satisfaction than on-demand sildenafil for young ED patients. However, further studies are needed to determine the factors influencing satisfaction.Keywords: erectile dysfunction, Erectile Dysfunction Inventory of Treatment Satisfaction, low-intensity extracorporeal shock wave therapy, sildenafil

Yu-Ching Lin,1,2,&ast; Chung-Ying Lin,3– 6,&ast; Chia-Wei Fan,7 Chieh-Hsiu Liu,8 Daniel Kwasi Ahorsu,9 Duan-Rung Chen,10 Hui-Ching Weng,3,11 Mark D Griffiths12 1Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 2Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 4Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 5Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 6Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 7Department of Occupational Therapy, AdventHealth University, Orlando, FL, USA; 8Department of Geriatrics and Gerontology, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 9Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong; 10Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan; 11Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 12International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK&ast;These authors contributed equally to this workCorrespondence: Hui-Ching Weng, Institute of Allied Health Sciences and Institute of Gerontology, College of Medicine, National Cheng Kung University, 1 University Road, East District, Tainan City, 70101, Taiwan, Tel +886-6-2353535 ext. 5986, Fax +886-6-3028175, Email hc6127@mail.ncku.edu.twPurpose: The present study compared two nationally representative cohort datasets concerning Taiwan residents’ healthy behaviors, subjective health outcomes, generalized trust, and accessibility to health promotion resources.Patients and Methods: The Taiwan Social Change Survey (TSCS) was conducted in two waves ten years apart: 2011 cohort (n = 1021; 48.4% males) and 2021 cohort (n = 1425; 47.4%) cohorts. Descriptive statistics were calculated to compare the two TSCS datasets. Then, multiple regression models were constructed with health outcome as the dependent variable, and demographics and other key components as independent variables.Results: The 2011 TSCS cohort showed higher prevalence for cigarette smoking (30.8% vs 25.2%; p=0.002), alcohol drinking (52.5% vs 24.3%; p< 0.001), exercise habits (52.7% vs 48.0%; p=0.02), and better fruit and vegetable accessibility (Mean=3.91 vs 3.82; p=0.04). The 2021 TSCS cohort reported higher body mass index (Mean=24.20 vs 23.63; p< 0.001), less residency in urban areas (22.4% vs 31.1%; p< 0.001), better jogging accessibility (4.14 vs 4.05; p=0.006), higher generalized trust (2.26 vs 2.17; p=0.001), and greater internet usage (3.43 vs 2.89; p< 0.001). The regression model showed that exercise habits (standardized coefficient=0.20 and 0.10; p< 0.001) and generalized trust (standardized coefficient=0.11 and 0.11; p=0.004 and < 0.001) were consistently associated with health outcomes in both cohorts. Additionally, internet use (standardized coefficient=− 0.07; p=0.026) and alcohol drinking behaviors (standardized coefficient=− 0.07; p=0.0022) were negatively associated with health outcomes in the 2021 cohort.Conclusion: The present study demonstrated the trends and changes over 10 years regarding multiple health-related components among Taiwan residents. The study’s findings provide insight into education promotion programs to reduce unhealthy behaviors as well as enhancing generalized trust building and developing healthy behaviors for Taiwan residents.Keywords: health behavior, health promotion, COVID-19, Taiwan, trust

Chung-Cheng Yeh,1– 3 Cheng-Yu Chien,2,4,5 Ting-Yu Lee,3 Chun-Hao Liu3,6 1Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; 2Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 3College of Medicine, Chang Gung University, Taoyuan, Taiwan; 4Department of Emergency Medicine, Ton-Yen General Hospital, Hsinchu, Taiwan; 5Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan; 6Department of Child & Adolescent Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCorrespondence: Chun-Hao Liu, Department of Child & Adolescent Psychiatry, Chang Gung Memorial Hospital at Linkou, No. 5, Fu-Hsin St., Gueshan District, Taoyuan City, 333, Taiwan, Tel +886-3-3281200 #2479, Email abucastor@hotmail.comPurpose: During the coronavirus disease 2019 (COVID-19) pandemic, visits to emergency department (ED) have significantly declined worldwide. The purpose of this study was to identify the trend of visits to ED for different diseases at the peak and slack stages of the epidemic.Patients and Methods: This was a retrospective observational study conducted in a tertiary referral medical center in northern Taiwan. We recorded weekly ED visits for myocardial infarction with or without ST-elevation (STEMI or NSTEMI), out-of-hospital cardiac arrest (OHCA), acute stroke, and congestive heart failure from 2016 to 2021. We compared the local epidemic peak periods (calendar weeks 4– 18, 2020 and calendar weeks 21– 31, 2021) and its corresponding slack periods (calendar weeks 4– 18, 2021 and calendar weeks 21– 31, 2020) with the baseline period (2016– 2019) using Mann–Whitney test to identify the difference.Results: We observed a significant decline in ED visits (median [Q1, Q3]) during the epidemic for OHCA (6 [5, 7] and 5 [4, 6], p = 0.046, for baseline and peak period, respectively, in week 4– 18), acute stroke (41.5 [38, 47] and 35 [28, 39], p < 0.001, in week 4– 18, 40 [35, 45] and 35 [28, 40], p = 0.039, in week 21– 31) and CHF (28 [24.25, 33] and 19 [12, 23], p < 0.001, in week 4– 18, 18 [16, 23] and 13 [11, 16], p = 0.001, in week 21– 31). Significant difference was not observed in patients with NSTEMI and STEMI in both week 4– 18 and 21– 31, and cardiac arrest in week 21– 31. There was a rebound in ED visits in the slack period.Conclusion: This study revealed that ED visits significantly declined during the COVID-19 epidemic and rebounded in the slack period. The trend was significant for acute stroke and heart failure but was relatively less prominent effect for emergent events such as cardiac arrest or myocardial infarction.Keywords: cardiac arrest, congestive heart failure, emergency department, health seeking behavior, myocardial infarction, stroke

Chang-He Liu,1 Na Hua,2 Huai-Yu Yang1 1Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, People’s Republic of China; 2Department of Otolaryngology, Affiliated Zhongshan Hospital of Dalian University, Dalian, People’s Republic of ChinaCorrespondence: Chang-He LiuDepartment of Cardiology, Affiliated Zhong Shan Hospital of Dalian University, 6 Jiefang Street, Zhongshan District, Dalian, People’s Republic of ChinaTel +86-13478661433Fax +86-041162893555Email liuchanghe159951@163.comBackground: Accumulating evidence has shown the important role of the inflammatory process in the pathophysiology of mental disorders. However, the relative levels of inflammatory markers in patients with panic disorder (PD) have rarely been evaluated. The aim of the present study was to conduct a systematic review to determine the correlation of peripheral C-reactive protein (CRP) and inflammatory cytokine profiles with PD.Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched for quantitative research studies published up to July 31, 2021 that measured peripheral levels of CRP and inflammatory cytokines in people with PD compared with controls. Meta-analysis using a random-effects model was performed for the levels of CRP and inflammatory cytokines with data from three or more studies.Results: Fourteen identified studies met the inclusion criteria. In total, 18 cytokines were evaluated. Markers that were reported in more than 3 studies were included in this meta-analysis. The results showed that peripheral levels of CRP, IL-6, IL-2 and TNF-α were significantly higher in PD patients than in healthy controls, while there was no significant difference in peripheral levels of IL-1β, IL-10 and IFN-γ between groups. Notably, the relevant studies involving IL-6, IL-1β, IL-10 and IFN-γ in PD patients were highly heterogeneous. Similar to meta-analyses of other inflammatory factors in mental disorders, our meta-analysis also reflected differences in participant medication use, comorbid anxiety or depression, sampling methods and detection methods. Eight inflammatory cytokines were reported in only one study, and their expression levels were higher, lower, or unchanged compared with those in healthy controls.Conclusion: There is preliminary evidence to suggest a significant inflammatory response in PD patients, but the role of inflammatory markers in PD remains unclear. Studying inflammatory markers in PD will help to clarify the etiology and pathophysiological mechanisms of the disorder.Keywords: CRP, interleukin, TNF-α, IFN-γ, panic disorder

Hai-Hua Chuang,1– 3 Chi-Hung Liu,4 Chao-Yung Wang,5 Yu-Lun Lo,6 Guo-She Lee,7,8 Yi-Ping Chao,4,9 Hsueh-Yu Li,10 Terry BJ Kuo,11 Cheryl CH Yang,11 Liang-Yu Shyu,12 Li-Ang Lee10,11 1Department of Family Medicine, Chang Gung Memorial Hospital, Taipei Branch and Linkou Main Branch, Chang Gung University, Taoyuan, Taiwan; 2Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan; 3Genomic Medicine Institute & Obesity Institute, Geisinger Medical, Danville, PA, USA; 4Department of Neurology, Chang Gung Memorial Hospital, Linkou Main Branch, Chang Gung University, Taoyuan, Taiwan; 5Department of Cardiology, Chang Gung Memorial Hospital, Linkou Main Branch, Chang Gung University, Taoyuan, Taiwan; 6Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Linkou Main Branch, Chang Gung University, Taoyuan, Taiwan; 7Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; 8Department of Otolaryngology, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan; 9Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan; 10Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Chang Gung University, Taoyuan, Taiwan; 11Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; 12Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, TaiwanCorrespondence: Li-Ang LeeDepartments of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital, Linkou Main Branch, No. 5, Fu-Hsing Street, Guishan District, Taoyuan, 33305, TaiwanTel +886 33281200 ext. 3972Fax +886 33979361Email 5738@cgmh.org.twBackground: Obstructive sleep apnea (OSA) and snoring have been reported to be modifiable risk factors for thick carotid intima-media thickness (CIMT) and carotid atherosclerosis, which are closely linked to cardiovascular disease.Methods: This cross-sectional study prospectively recruited 70 participants with OSA and without a history of carotid artery disorder, who primarily sought surgical Intervention. OSA and snoring were assessed with the Epworth Sleepiness Scale, Snore Outcomes Survey, polysomnography, and snoring sound recording. The carotid arteries were evaluated with ultrasonography and divided into three types of carotid artery profiles (normal carotid artery, thick CIMT, or significant carotid atherosclerosis). Multivariate linear/logistic/categorical regressions were performed with the forward selection approaches/logistic least absolute shrinkage and selection operator, as appropriate.Results: Normalized snoring sound energy (301– 850 Hz) was independently associated with the carotid intima-media thickness (regression coefficient [β] = 0.01, standard error [SE] = 0.004, P = 0.03; R2 = 0.067) and type of carotid profile (β = 0.40, SE = 0.09, P < 0.001; R2 = 0.156). Normalized snoring sound energy (4– 300 Hz) (β = − 0.10, SE = 0.04, P = 0.01) and female sex (β = 1.90, SE = 0.94, P = 0.04) were independently related to the presence of carotid stenosis (R2 = 0.159). The optimal regression model of the type of carotid artery profile included normalized snoring sound energy (301– 850 Hz) (β = 0.33, SE = 0.14, P = 0.03), snoring time (β = 0.26, SE = 0.13, P = 0.047), female sex (β = 0.26, SE = 0.13, P = 0.047), and increased age (β = 0.20, SE = 0.10, P = 0.04) under the control of the Snore Outcomes Survey score, 3% oxygen desaturation index, snoring sound energy (4– 1500 Hz), normalized snoring sound energy (851– 1500 Hz), cigarette smoking, and hyperlipidemia (R2 = 0.427).Conclusion: Our findings suggested that snoring sound characteristics are associated with carotid artery profiles among early OSA patients who cannot be noticed by ultrasound because organic changes of the carotid artery have not yet started. Future studies are warranted to verify the clinical significance of the results.Keywords: atherosclerosis, common carotid artery, categorical regression, obstructive sleep apnea, snoring, ultrasound

Ching-Hsiung Liu,1,2 Yen-Ying Kung,2–4 Chun-Liang Lin,1 Jen-Lin Yang,2–4 Ta-Peng Wu,3 Hong-Chun Lin,3 Yang-Kai Chang,3 Ching-Mao Chang,2–4 Fang-Pey Chen2,3 1Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan, Republic of China; 2Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; 3Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; 4Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of ChinaCorrespondence: Fang-Pey ChenInstitute of Traditional Medicine, School of Medicine, National Yang-Ming University, and Director, Center for Traditional Medicine, Taipei Veterans General Hospital, Number 155, Section 2, Linong Street, Taipei 112, Taiwan, Republic of ChinaTel +8862-2875-7454Fax +8862-2875-7452Email fpchen@vghtpe.gov.twPurpose: To investigate the required sample size for and feasibility of a full-scale randomized controlled trial examining the impact of the “dose” effect of acupuncture in treating sciatica.Patients and methods: Fifty-seven patients with sciatica, aged 35–70 years, were recruited and screened. Thirty-one participants were randomly assigned to receive “low-dose” manual acupuncture (MAL) (n= 15) or “high-dose” manual acupuncture (MAH) (n=16). The acupuncture treatment was administered twice weekly for 4 weeks. The primary outcome was the visual analog scale (VAS) score at baseline and after 4 weeks of acupuncture treatment. Secondary outcomes included the Roland Disability Questionnaire for Sciatica (RDQS), the Sciatica Bothersomeness Index (SBI), and the World Health Organization Quality of Life in the Brief Edition (WHOQOL-BREF) scores at baseline and after 4 weeks of acupuncture treatment.Results: Thirty patients completed the study. For all patients, acupuncture achieved significant improvement in the VAS (5.48±2.0, p

Lin-Ling Chiu,1,* Chun-Hao Liu,2,3,* Chun-Lin Chu,4 Huang-Li Lin,2 Shu-Chung Lii5,*1School of Medicine, Collage of Medicine, Chang Gung University, Taoyuan, Taiwan; 2Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 3Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 4Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan; 5Humanistic & Social Medicine Division, College of Medicine, Chang Gung University, Taoyuan, Taiwan*These authors contributed equally to this workBackground: In this study, we applied a qualitative approach to explore patients’ subjective experiences of long-acting injectable antipsychotics (LAIs).Methods: Patients undergoing psychiatric treatment from the chronic ward or outpatient department of a medical center in northern Taiwan who had experience with LAI treatment were enrolled. Information was obtained through semi-structured in-depth interviews. The interviews were audio-recorded and then translated verbatim, and the data were collected and analyzed concurrently to develop major themes and categories.Result: In total, 14 participants (8 female) were interviewed. In a bio-psycho-social model, the participants used LAIs as a method to become “normal,” in order to achieve a balance between the “effects” and “side effects” that may influence their daily lives. Their past experiences constructed their concepts about and expectations regarding LAIs, and their relationships with their family members and co-workers also modeled their experiences.Conclusion: In our study, we sought to understand the experience of LAI in the daily life context of the patients. We attempted to use a bio-psycho-social model to evaluate the subjective experience of the patients; an improved understanding can help mental health specialists gain a closer insight into patient experience.Keywords: antipsychotics, experience, long-acting injectable, LAI, qualitative research

Chun-Hao Liu,1,2,* Tsai-Sheng Fu,2,3,* Chin-Pang Lee,1,2 Ching-I Hung1,2 1Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; 2Chang Gung University, Taoyuan, Taiwan; 3Department of Orthopedics, Chang Gung Memorial Hospital, Keelung, Taiwan *These authors contributed equally to this work Background: The Depression and Somatic Symptoms Scale (DSSS), which is a free scale that includes a depression subscale (DS) and a somatic subscale (SS), was developed to evaluate depression and somatic symptoms simultaneously. This study aimed to examine the reliability and validity of the DSSS among patients with chronic low back pain (CLBP). Methods: Two-hundred and twenty-five patients with CLBP were enrolled. Psychiatric diagnoses were made based on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision. The DSSS, Oswestry Disability Index, Hospital Anxiety and Depression Scale (HADS), and Short Form 36 (SF-36) were administered. Cronbach’s alpha was used to test internal consistency. Receiver operating characteristic (ROC) analysis was used to identify cutoff scores for a major depressive episode (MDE). Results: Subjects with an MDE (N=21) had greater severities of depression, anxiety, somatic symptoms, and disability as compared with those without an MDE. The Cronbach’s alpha values of the DS and SS were 0.90 and 0.83, respectively. The DS and SS were significantly correlated with the Oswestry Disability Index, the HADS, and the SF-36 subscales. The DS had the greatest area under the receiver operating characteristic curve (0.96) as compared with the SS and the HADS subscales. The cutoff score for an MDE was a DS score ≥15 (sensitivity and specificity: 100% and 88.7%, respectively). Conclusion: The DSSS subscales were of acceptable reliability and validity. The DS can be used as a tool for evaluating the severity of depression and detecting an MDE in patients with CLBP. Keywords: back pain, cutoff point, depression, psychometrics, somatization

Parasitic helminthes can suppress and/or regulate the host immune response to allow long-term survival and chronic infection where toll-like receptors (TLRs) expressed on macrophages play essential roles in response to parasitic infection. Semi-quantitative PCR and flow cytometry studies about the modulation of TLRs and cytokine profiles in macrophages following T. spiralis infection were performed. TLRs, MyD88 and NF-κB were up-regulated by T. spiralis infection and essential to the parasite life cycles. Cytokines profiles (IL-6, IL-10, IL-12, TNF-α) were modulated during T. spiralis infection. Results suggest that T. spiralis infection may regulate the expression of TLR4 on macrophages and TLR4/MyD88/NF-κB signaling pathways. This study provides further insights into the mechanisms of TLR-mediated post-inflammatory response during T. spiralis infection.

Shuai Zhang,1,* Xu Wang,2,* Chao-Qun Yan,1 Shang-Qing Hu,3 Jian-Wei Huo,4 Zhong-Yan Wang,4 Ping Zhou,1 Chun-Hong Liu,1 Cun-Zhi Liu3 1Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Dongcheng District, Beijing, 2School of Life Sciences, Beijing University of Chinese Medicine, Chaoyang District, Beijing, 3Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Fengtai District, Beijing, 4Department of Medical Imaging, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Dongcheng District, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Chronic shoulder pain (CSP) is a common disease causing pain and functional limitation, which is highly prevalent and has substantial negative effects on the quality of life. Acupuncture has gained popularity and has been accepted gradually by many countries because it can successfully treat patients with chronic pain, but the specific brain mechanisms under acupuncture treatment for CSP remain unclear. Therefore, in this study, we aimed to 1) compare the clinical effects between acupuncture at the contralateral and ipsilateral Tiaokou (ST 38) point in patients with unilateral shoulder pain and 2) explore how contralateral- and ipsilateral-acupuncture modulates the regional homogeneity (ReHo) of patients with CSP.Patients and methods: This was a pilot functional magnetic resonance imaging (fMRI) trial. Twenty-four patients with CSP were recruited and randomized to the contralateral acupuncture group (contra-group) and the ipsilateral acupuncture group (ipsi-group). All patients completed resting-state functional magnetic resonance imaging (fMRI) scans before and after acupuncture treatment. Shoulder pain intensity (visual analog scale [VAS]) and shoulder joint function (Constant–Murley score [CMS]) were used to evaluate clinical efficiency of treatment. ReHo was used to assess resting-state brain activity.Results: We found clinical improvement in decreasing pain intensity and increasing shoulder function in both groups, and the mean objective shoulder functional improvement in contra-group was better than that in ipsi-group (p = 0.010). Interestingly, the brain mechanism of contra-acupuncture at ST 38 was distinguishable from ipsi-acupuncture regarding ReHo values.Conclusion: Anterior cingulate cortex (ACC) may play a direct role in the regulation of brain by the contralateral acupuncture at ST 38 in patients with shoulder pain. On the contrary, the pathway of brainstem-thalamus-cortex may be likely to work in mechanism of acupuncture at ipsilateral ST 38.Significance: Our results indicate that the clinical effects and brain mechanisms are different between the stimulation given at contralateral and ipsilateral acupoints in patients with CSP and imply that the selection of either contralateral or ipsilateral acupuncture therapy to treat some chronic pain conditions is necessary. Keywords: region homogeneity, anterior cingulate cortex, brainstem, resting-state fMRI, ST 38

Chun-Hao Liu,1,2 Po-Hsin Tsai,2,3 Ching-Yen Chen2,3 1Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, 2College of Medicine, Chang Gung University, Taoyuan, 3Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan Background: Although many studies have discussed psychiatrists’ attitudes toward long-acting injectable antipsychotics (LAIs), no previous study has focused on differences in preference based on the facilities in which the psychiatrists practiced.Materials and methods: A pilot survey was conducted in a medical center in northern Taiwan, and a questionnaire was then distributed at the annual conference of the Taiwanese Society of Psychiatry in 2013. The questionnaire included general demographic data and preferences for the use of LAIs in different situations.Results: A total of 142 psychiatrists were included in our study. Among them, 114 were male (80.3%), and most practiced in general hospitals (n=110, 77.5%). We found that general hospital psychiatrists were more likely to prescribe LAIs for patients in the acute stage and with positive symptoms than were psychiatric hospital psychiatrists. General hospital psychiatrists also tended to prescribe LAIs at every time point of the disease.Conclusion: General hospital psychiatrists were more likely to prescribe LAIs than those in psychiatric hospitals. Knowing the factors affecting psychiatrists’ preferences may help us to develop a further study to explore “why” psychiatrists consider or do not consider LAIs in different facilities. Keywords: antipsychotic agents, general hospital, injections, psychiatric hospital

Shih-Hsiang Liao,1 Chia-Hung Liu,2 Bishnu Prasad Bastakoti,3 Norihiro Suzuki,7 Yung Chang,4 Yusuke Yamauchi,3 Feng-Huei Lin,5,6 Kevin C-W Wu1,6 1Department of Chemical Engineering, National Taiwan University No 1, Taipei, 2Department of Urology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan; 3National Institute for Materials Science, Ibaraki, Japan; 4R&D Center for Membrane Technology and Department of Chemical Engineering, Chung Yuan Christian University, Taoyua, 5Institute of Biomedical Engineering, National Taiwan University No 1, Taipei City, 6Division of Medical Engineering Research, National Health Research Institutes, Miaoli County, Taiwan, 7International Center for Young Scientists (ICYS), National Institute for Materials Science (NIMS), Tsukuba, Ibaraki, Japan Abstract: Hyperthermia is one of the promising treatments for cancer therapy. However, the development of a magnetic fluid agent that can selectively target a tumor and efficiently elevate temperature while exhibiting excellent biocompatibility still remains challenging. Here a new core-shell nanostructure consisting of inorganic iron oxide (Fe3O4) nanoparticles as the core, organic alginate as the shell, and cell-targeting ligands (ie, D-galactosamine) decorated on the outer surface (denoted as Fe3O4@Alg-GA nanoparticles) was prepared using a combination of a pre-gel method and coprecipitation in aqueous solution. After treatment with an AC magnetic field, the results indicate that Fe3O4@Alg-GA nanoparticles had excellent hyperthermic efficacy in a human hepatocellular carcinoma cell line (HepG2) owing to enhanced cellular uptake, and show great potential as therapeutic agents for future in vivo drug delivery systems. Keywords: hyperthermia, iron oxide, alginate, pre-gel, targeting

Nianhong Lu, Caihong Liu, Jiangyuan Wang, Ying Ding, Qing Ai Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, People’s Republic of China Abstract: Toxoplasmosis complicating lung cancer has been described only rarely. Here, we report a case of acute Toxoplasma gondii infection in a patient with squamous lung cancer. A 64-year-old woman was admitted to our hospital with a history of cough of 6 months' duration and chest pain of 1 week’s duration. Further examination revealed multiple swollen lymph nodes, palpable on the top of the right collarbone and without tenderness. The chest X-ray, bronchoscopy, and computed tomography scan confirmed squamous carcinoma of the right lung. The Wright-stained bronchoalveolar-lavage fluid cytology diagnosis was positive for T. gondii and tachyzoites were detected. All of them were of free type (ectocytic), without intracellular parasites. Serological examination revealed that the anti-T. gondii immunoglobulin (Ig) M and IgG antibodies were positive. Unfortunately the patient did not continue treatment and was lost to follow-up. Toxoplasmosis is a life-threatening opportunistic infection in patients with lung cancer. Prompt recognition of T. gondii infection among cancer patients with subsequent targeted treatment of toxoplasmosis could help alleviate symptoms and improve survival. Keywords: lung cancer, Toxoplasma gondii, bronchoalveolar-lavage fluid, tachyzoite

Yu-Te Liao,1 Chia-Hung Liu,2 Jiashing Yu,1 Kevin C-W Wu1,3 1Department of Chemical Engineering, National Taiwan University, Taipei, Taiwan; 2Department of Urology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan; 3Division of Medical Engineering Research, National Health Research Institutes, Zhunan Township, Miaoli County, Taiwan Abstract: A new microsphere consisting of inorganic mesoporous silica nanoparticles (MSNs) and organic alginate (denoted as MSN@Alg) was successfully synthesized by air-dynamic atomization and applied to the intracellular drug delivery systems (DDS) of liver cancer cells with sustained release and specific targeting properties. MSN@Alg microspheres have the advantages of MSN and alginate, where MSN provides a large surface area for high drug loading and alginate provides excellent biocompatibility and COOH functionality for specific targeting. Rhodamine 6G was used as a model drug, and the sustained release behavior of the rhodamine 6G-loaded MSN@Alg microspheres can be prolonged up to 20 days. For targeting therapy, the anticancer drug doxorubicin was loaded into MSN@Alg microspheres, and the (lysine)4-tyrosine-arginine-glycine-aspartic acid (K4YRGD) peptide was functionalized onto the surface of MSN@Alg for targeting liver cancer cells, hepatocellular carcinoma (HepG2). The results of the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay and confocal laser scanning microscopy indicate that the MSN@Alg microspheres were successfully uptaken by HepG2 without apparent cytotoxicity. In addition, the intracellular drug delivery efficiency was greatly enhanced (ie, 3.5-fold) for the arginine-glycine-aspartic acid (RGD)-labeled, doxorubicin-loaded MSN@Alg drug delivery system compared with the non-RGD case. The synthesized MSN@Alg microspheres show great potential as drug vehicles with high biocompatibility, sustained release, and targeting features for future intracellular DDS. Keywords: alginate, mesoporous silica nanoparticles, atomization, sustained release, targeting therapy

Chen-Hua Liu,1–3 Jia-Horng Kao1–3 1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 2Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan; 3Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan Abstract: Asia is endemic for hepatitis C virus (HCV) infection, which is the leading cause of cirrhosis, hepatic decompensation, hepatocellular carcinoma , and liver transplantation worldwide. HCV has six major genotypes and each HCV genotype has its specific geographic distribution. HCV genotypes 1, 2, 3, and 6 are common in Asia. The aim of HCV treatment is to eradicate the virus by effective therapeutic agents; viral clearance is durable after long-term post-treatment follow-up. In most Asian countries, peginterferon alfa (PEG-IFN α) in combination with ribavirin remains the standard of care, and the overall sustained viral response (SVR) rate in Asian HCV patients is higher than that in Western patients. The differences are most significant in patients with HCV genotype 1 (HCV-1) infection, which is attributed to the higher frequency of IFN-responsive or favorable interleukin-28B (IL-28B) genotype in Asian populations than in other ethnic populations. In addition, the introduction of response-guided therapy, where the optimized treatment duration is based on the early viral kinetics during the first 12 weeks of treatment, increases the SVR rate. Recently, telaprevir or boceprevir-based triple therapy was found to further improve the SVR rate in treated and untreated HCV-1 patients and has become the new standard of care in Western and some Asian countries. Many novel direct-acting antiviral agents, either in combination with PEG-IFN α plus ribavirin or used as IFN-free regimens are under active investigation. At the time of this writing, simeprevir and sofosbuvir have been approved in the US. Because the SVR rates in Asian HCV patients receiving PEG-IFN α plus ribavirin therapy are high, health care providers should judiciously determine the clinical usefulness of these novel agents on the basis of treatment duration, anticipated viral responses, patient tolerance, financial burdens, and drug accessibility. Keywords: PEG-IFN α, HCV, SVR, RGT, IL28B

AIM:To analyze the influencing factors of visual outcome after vitrectomy for polypoidal choroidal vasculopathy(PCV)combined with vitreous hemorrhage and establish a predictive model.METHODS: A retrospective analysis was conducted on the clinical data of 129 cases(129 eyes)of patients who underwent vitrectomy for PCV combined with vitreous hemorrhage from June 2021 to January 2024 in our hospital. They were divided into elevated group(71 eyes)and non-elevated group(58 eyes)according to visual outcome at early posoperative stage(within 24 mo). Another 30 cases(30 eyes)of PCV with vitreous hemorrhage undergoing vitrectomy were selected as external validation data. The predictive value of the model for the postoperative visual outcomes of both internal and external populations was evaluated.RESULTS: The non-elevated group had a higher proportion of patients aged ≥60 years, diabetes, continuous abnormalities of the ellipsoid zone(EZ)during surgery, bleeding involving the macular fovea, and postoperative retinal scar formation than the elevated group were independent factors affecting postoperative visual acuity(all P

[Purposes] Carbon nitrides in graphite phase (g-C3N4, GCN) have been widely used in photocatalytic degradation of organic pollutants in water. However, traditional GCN is limited in practical application because of its low specific surface area and few active sites. [Methods] In this study, photocatalyst (PCN) was prepared by thermal polymerization method by using urea as precursor. PCN was characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, and Fourier transform infrared spectroscopy. Diclofenac (DCF) was selected as target pollutant to study photocatalytic degradation. [Findings] The results show that the specific surface area of PCN (133.963 m2/g) is significantly higher than that of GCN (2.605 m2/g), about 67 times that of GCN. PCN (0.20 g/L) can achieve 100% catalytic degradation of DCF (10 mg/L) within 10 min at pH of 5. Free radical quenching experiments confirm that superoxide radical (•O2−) and hydroxyl radical (•OH) are the primary reactive oxygen species. The degradation pathway of DCF is determined by the Fukui index-based density functional theory and the determination of intermediates. The experimental results show that PCN has high stability and has promising applications in the field of photocatalytic degradation of emerging pollutants in water.

Post⁃stroke functional impairments place a significant psychological and economic burden on patients' families and society. Neuromodulation technique involves invasive or non⁃invasive methods to regulate neural system activity for the treatment or improvement of various neurological disorders or diseases. This article aims to review the mechanisms of different types of neuromodulation technique and their application in combination with rehabilitation therapies to improve stroke patient function, providing theoretical guidance for the application of neuromodulation technique in rehabilitation of stroke.

To effectively assess food safety risks associated with potential plant toxin residues present in honey, this study aimed to establish and validate a method for the detection of 39 plant toxins in honey using solid-phase extraction combined with ultra-high performance liquid chromatography-tandem mass spectrometry (SPE-UPLC-MS/MS). The developed method involved sample extraction with 0.1% formic acid, purification using a hydrophilic-lipophilic balanced (HLB) cartridge, detection in the multiple reaction monitoring (MRM) mode, and quantification using the matrix-matched external standard method. The calibration curves exhibited good linearity for all the analytes. Average recoveries ranged from 78.7% to 112.8% with relative standard deviation (RSD) between 1.6% and 15.2% (n = 6). This method was characterized by ease of operation, high throughput and high sensitivity, and could be used for the monitoring these toxins in honey. Varying levels of pyrrolizidine alkaloids (PAs) and rhodojaponin III were detected in some of the 36 tested batches of honey, confirming the presence of phytotoxin residue risks in honey.

The Anaesthetist Rostering Problem (ARP) presents significant challenges in healthcare management due to complex constraints and regulations. Existing models for the ARP often fail to address the complexities of real-world hospital environments, particularly in integrating monthly and weekly schedules across multiple locations. This study addresses the key question: How can we develop anaesthetist rosters that improve both staff fairness and operational efficiency while meeting complex hospital requirements? To address this challenge, we propose a novel mixed-integer linear programming model with updated constraints, parameters, and an enhanced evaluation function. We implemented the model at Hospital Canselor Tuanku Muhriz (HCTM), Malaysia, to handle various shift types across multiple locations for both monthly and weekly rosters. The proposed model optimises the roster by satisfying mandatory constraints first (such as legal requirements), and then minimising soft constraint violations, such as employee preferences, through iterative refinement. The evaluation function assesses roster quality by minimising penalties for soft constraint violations. We modified the evaluation function and constraints to accommodate HCTM’s specific shift patterns and rest requirements, enhancing fairness, flexibility, and workload distribution. The model reduced penalties by 69.57% for monthly rosters and 64.37% for weekly rosters compared to manual scheduling. Statistical analysis proved significant enhancement in monthly rosters and weekly rosters. The model improves workload fairness and scheduling efficiency, bridging theoretical models and practical applications. It contributes to healthcare workforce management by offering better resource allocation and increased staff satisfaction.

ABSTRACT A novel composite catalyst with readily preparation and good catalytic performance was designed and synthesized using sulfonation‐modified zeolite socony mobil‐5 (ZSM‐5) as the carrier and nano‐CoO/NiO as the active components. Compared with traditional in situ conversion, the composite catalyst could effectively reduce the activation energy of catalytic reactions, improve the efficiency of oil and gas conversion, and ameliorate the quality of oil products. When the loading amount of nano‐CoO/NiO was 20 wt% and the silicon/aluminum ratio of ZSM‐5 was 40–50, the required activation energy for oil shale cracking was as low as 43.64 kJ/mol, the yield of oil products was as high as 15.46 wt%, and the content of organic compounds in medium‐/low‐carbon hydrocarbon was as high as 71.50%. The prepared composite catalysts had low preparation cost, environmental friendliness, and significant catalytic effects, providing a feasible approach for the effective exploitation and utilization of oil shale.

Abstract To investigate the failure mechanism and establish stability control methods for surrounding rock in high geo-stress roadways, this study incorporated the brittle failure characteristics of the surrounding rock mass into a unified strength criterion, developing an elastic-plastic theoretical model to represent rock damage and fracture. Using this model, analytical expressions for the damage rupture radius and stress field distribution are derived, leading to the proposal of a grading control method. The analysis of calculation examples reveals that an increase in stress, damage degree, and the brittleness coefficient of the rock mass results in the expansion of both the plastic damage and damage residual zones. Conversely, an increase in the intermediate principal stress coefficient and support resistance reduces the extent of these zones. The proposed grading control strategy includes three levels: Level I focus on preventing cracks through initial support, Level II involves reinforcing anchor injections to reduce cracks, and Level III applies local borehole pressure relief. Implementing this strategy can significantly reduce stress concentration and deformation in the surrounding rock, providing valuable insights for roadway support control.

ObjectiveTo explore the feasibility of the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) in evaluating the overall functional level, rehabilitation treatment effects, and the relationship between rehabilitation efficacy and cost-effectiveness of patients with knee osteoarthritis (KOA) in the northwest Gobi region.MethodsA total of 50 patients with KOA who were hospitalized in the Acupuncture and Moxibustion Department of Jimsar County Hospital of Traditional Chinese Medicine from March 2022 to March 2023 were selected. A total of eight cases discontinued or dropped out due to comprehension deviation and low assessment compliance, and finally 42 cases were included. Personalized rehabilitation programs were formulated according to the severity of functional disorders referring to the "Clinical Practice Guidelines of Traditional Chinese Medicine Rehabilitation for Knee Osteoarthritis". The treatment was conducted once a day, six days a week for two weeks. The ICF-RS was used to evaluate the overall functional level, rehabilitation efficacy and rehabilitation treatment costs.ResultsThe main body functional impairments of patients with KOA were b280 pain sensation, b455 exercise tolerance, b130 energy and drive function, and b134 sleep function in sequence; the main activity limitations were d410 changing basic body postures, d455 moving around, and d415 maintaining a body posture; the main participation dysfunctions were d850 remunerative employment and d920 recreation and leisure. There was no statistically significant difference in the composition ratio of the frequency of the limit values in all categories of ICF-RS (except d240 handling stress and other psychological needs) between Han and ethnic minority patients with KOA (P>0.05). The ICF-RS assessment results showed that, all categories of the body function, activities and participation in patients with KOA increased significantly after treatment (P

ObjectiveThis study explores the use of the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) to evaluate the physical, activities, and social participation levels of patients with chronic neck, shoulder, waist, and leg pain, and to explore its influencing factors.MethodsA total 162 patients with chronic neck, shoulder, hip and leg pain from the outpatient departments of the Central Hospital of Xiangyang City from July to December 2023, who had meet the diagnostic criteria and inclusion and exclusion criteria for chronic pain. A trained assessor used a questionnaire to collect detailed information on the patients' basic demographic data (sex, age, education level, medical expenses, body mass index), lifestyle habits (smoking, drinking), medical history (hypertension, hyperlipidemia, diabetes), and use of pain medication. The patients were assessed for their functional levels (physical function, activity function, social participation) using the ICF-RS. A multivariate ordered Logistic regression analysis was used to identify independent risk factors for the patients' body function, activity function, and social participation function (mild, moderate, and severe impairment).ResultsAmong the three dimensions of physical function, daily activities, and social participation of patients with chronic pain in outpatient clinics, about 1/3 of them with mild functional impairments being the main type. There were 10 ICF-RS categories (33.33%) with a functional impairment proportion > 50%, involving 4 categories in the physical function dimension, 2 categories in the daily activity function dimension, and 4 categories in the social participation dimension. The differences in exercise tolerance and mobility function among patients with chronic pain of different age groups were statistically significant (P=0.040, P=0.030); the differences in the ability to help others among patients with chronic pain of different age groups and whether they drank alcohol were statistically significant (P=0.008, P=0.021); the differences in entertainment and leisure ability among patients with chronic pain of different age groups and whether they had hyperlipidemia were statistically significant (P=0.028, P=0.004).ConclusionPatients with chronic pain have varying degrees of functional impairments in their body function, daily activities function, and social participation function, with mild functional impairments being the predominant; Age, alcohol consumption, and hyperlipidemia are independent influencing factors for functional impairment in body function, daily activity function, and social participation function.

During the Omni-media era, the in-depth advancement of intelligent process endowed public opinion information (referred to as public opinion) with unique spreading characteristics, and put forward new and higher requirements for its governance. Against this background, we proposed an improved public opinion propagation model coupling the possible factors to grasp its spreading rules. Then, the spreading characteristics of public opinion and its governance timing-intensity-effect in online social networks (OSN) were discussed through numerical simulations. Our results showed that the propagation of public opinion shows faster speed and is more dependent on netizens' attributes in open OSN with a wider scope and depends more on information content in closed OSN. During the governance process of public opinion propagation, the regulators' strategies should have priority: Governance timing $ \succ $ governance proportion $ \succ $ punishment intensity. Based on research findings, targeted countermeasures and decision-making references were provided for the regulators to reasonably guide the evolution trend of public opinion.

In this article, using the least action principle and minimax methods in critical point theory, some existence and multiplicity results for periodic solutions of second-order Hamiltonian systems are obtained.

Abstract Stable or metastable crystal structures of assembled atoms can be predicted by finding the global or local minima of the energy surface within a broad space of atomic configurations. Generally, this requires repeated first-principles energy calculations, which is often impractical for large crystalline systems. Here, we present significant progress toward solving the crystal structure prediction problem: we performed noniterative, single-shot screening using a large library of virtually created crystal structures with a machine-learning energy predictor. This shotgun method (ShotgunCSP) has two key technical components: transfer learning for accurate energy prediction of pre-relaxed crystalline states, and two generative models based on element substitution and symmetry-restricted structure generation to produce promising and diverse crystal structures. First-principles calculations were performed only to generate the training samples and to refine a few selected pre-relaxed crystal structures. The ShotunCSP method is less computationally intensive than conventional methods and exhibits exceptional prediction accuracy, reaching 93.3% in benchmark tests with 90 different crystal structures.

To investigate the relationship between the expression levels of serum forkhead box protein M1(FOXM1) and insulin-like growth factor 2 (IGF2) mRNA in patients with acute respiratory distress syndrome (ARDS) condition and prognosis.

[Objective]Spraying calcium can effectively prevent the occurrence of dry burning heart disease in Chinese cabbage. Accurately targeting spraying calcium can more effectively improve the utilization rate of calcium. Since the sprayer needs to move rapidly in the field, this can lead to over-application or under-application of the pesticide. This study aims to develop a targeted spray control system based on deep learning technology, explore the relationship between the advance speed, spray volume, and coverage of the sprayer, thereby addressing the uneven application issues caused by different nebulizer speeds by studying the real scenario of calcium administration to Chinese cabbage hearts.[Methods]The targeted spraying control system incorporates advanced sensors and computing equipment that were capable of obtaining real-time data regarding the location of crops and the surrounding environmental conditions. This data allowed for dynamic adjustments to be made to the spraying system, ensuring that pesticides were delivered with high precision. To further enhance the system's real-time performance and accuracy, the YOLOv8 object detection model was improved. A Ghost-Backbone lightweight network structure was introduced, integrating remote sensing technologies along with the sprayer's forward speed and the frequency of spray responses. This innovative combination resulted in the creation of a YOLOv8-Ghost-Backbone lightweight model specifically tailored for agricultural applications. The model operated on the Jetson Xavier NX controller, which was a high-performance, low-power computing platform designed for edge computing. The system was allowed to process complex tasks in real time directly in the field. The targeted spraying system was composed of two essential components: A pressure regulation unit and a targeted control unit. The pressure regulation unit was responsible for adjusting the pressure within the spraying system to ensure that the output remains stable under various operational conditions. Meanwhile, the targeted control unit played a crucial role in precisely controlling the direction, volume, and coverage of the spray to ensure that the pesticide was applied effectively to the intended areas of the plants. To rigorously evaluate the performance of the system, a series of intermittent spray tests were conducted. During these tests, the forward speed of the sprayer was gradually increased, allowing to assess how well the system responded to changes in speed. Throughout the testing phase, the response frequency of the electromagnetic valve was measured to calculate the corresponding spray volume for each nozzle.[Results and Conclusions]The experimental results indicated that the overall performance of the targeted spraying system was outstanding, particularly under conditions of high-speed operation. By meticulously recording the response times of the three primary components of the system, the valuable data were gathered. The average time required for image processing was determined to be 29.50 ms, while the transmission of decision signals took an average of 6.40 ms. The actual spraying process itself required 88.83 ms to complete. A thorough analysis of these times revealed that the total response time of the spraying system lagged by approximately 124.73 ms when compared to the electrical signal inputs. Despite the inherent delays, the system was able to maintain a high level of spraying accuracy by compensating for the response lag of the electromagnetic valve. Specifically, when tested at a speed of 7.2 km/h, the difference between the actual spray volume delivered and the required spray volume, after accounting for compensation, was found to be a mere 0.01 L/min. This minimal difference indicates that the system met the standard operational requirements for effective pesticide application, thereby demonstrating its precision and reliability in practical settings.[Conclusions]In conclusion, this study developed and validated a deep learning-based targeted spraying control system that exhibited excellent performance regarding both spraying accuracy and response speed. The system serves as a significant technical reference for future endeavors in agricultural automation. Moreover, the research provides insights into how to maintain consistent spraying effectiveness and optimize pesticide utilization efficiency by dynamically adjusting the spraying system as the operating speed varies. The findings of this research will offer valuable experiences and guidance for the implementation of agricultural robots in the precise application of pesticides, with a particular emphasis on parameter selection and system optimization.

[Objective]Grape picking is a key link in increasing production. However, in this process, a large amount of manpower and material resources are required, which makes the picking process complex and slow. To enhance harvesting efficiency and achieve automated grape harvesting, an improved YOLOv8n object detection model named 3C-YOLOv8n was proposed, which integrates the RealSense D415 depth camera for grape recognition and localization.[Methods]The propoesed 3C-YOLOv8n incorporated a convolutional block attention module (CBAM) between the first C2f module and the third Conv module in the backbone network. Additionally, a channel attention (CA) module was added at the end of the backbone structure, resulting in a new 2C-C2f backbone network architecture. This design enabled the model to sequentially infer attention maps across two independent dimensions (channel and spatial), optimize features by considering relationships between channels and positional information. The network structure was both flexible and lightweight. Furthermore, the Content-aware ReAssembly of Features up sampling operator was implemented to support instance-specific kernels (such as deconvolution) for feature reconstruction with neighboring pixels, replacing the nearest neighbor interpolation operator in the YOLOv8n neck network. This enhancement increased the receptive field and guided the reconstruction process based on input features while maintaining low parameter and computational complexity, thereby forming the 3C-YOLOv8n model. The pyrealsense2 library was utilized to obtain pixel position information from the target area using the Intel RealSense D415 camera. During this process, the depth camera was used to capture images, and target detection algorithms were employed to pinpoint the location of grapes. The camera's depth sensor facilitated the acquisition of the three-dimensional point cloud of grapes, allowing for the calculation of the distance from the pixel point to the camera and the subsequent determination of the three-dimensional coordinates of the center of the target's bounding box in the camera coordinate system, thus achieving grape recognition and localization.[Results and Discussions]Comparative and ablation experiments were conducted. it was observed that the 3C-YOLOv8n model achieved a mean average precision (mAP) of 94.3% at an intersection ratio of 0.5 (IOU=0.5), surpassing the YOLOv8n model by 1%. The accuracy (P) and recall (R) rates were recorded at 91.6% and 86.4%, respectively, reflecting increases of 0.1% and 0.7%. The F1-Score also improved by 0.4%, demonstrating that the improved network model met the experimental accuracy and recall requirements. In terms of loss, the 3C-YOLOv8n algorithm exhibited superior performance, with a rapid decrease in loss values and minimal fluctuations, ultimately leading to a minimized loss value. This indicated that the improved algorithm quickly reached a convergence state, enhancing both model accuracy and convergence speed. The ablation experiments revealed that the original YOLOv8n model yielded a mAP of 93.3%. The integration of the CBAM and CA attention mechanisms into the YOLOv8n backbone resulted in mAP values of 93.5% each. The addition of the Content-aware ReAssembly of Features up sampling operator to the neck network of YOLOv8n produced a 0.5% increase in mAP, culminating in a value of 93.8%. The combination of the three improvement strategies yielded mAP increases of 0.3, 0.7, and 0.8%, respectively, compared to the YOLOv8n model. Overall, the 3C-YOLOv8n model demonstrated the best detection performance, achieving the highest mAP of 94.3%. The ablation results confirmed the positive impact of the proposed improvement strategies on the experimental outcomes. Compared to other mainstream YOLO series algorithms, all evaluation metrics showed enhancements, with the lowest missed detection and false detection rates among all tested algorithms, underscoring its practical advantages in detection tasks.[Conclusions]By effectively addressing the inefficiencies of manual labor, 3C-YOLOv8n network model not only enhances the precision of grape recognition and localization but also significantly optimizes overall harvesting efficiency. Its superior performance in evaluation metrics such as precision, recall, mAP, and F1-Score, alongside the lowest recorded loss values among YOLO series algorithms, indicates a remarkable advancement in model convergence and operational effectiveness. Furthermore, the model's high accuracy in grape target recognition not only lays the groundwork for automated harvesting systems but also enables the implementation of complementary intelligent operations.

Objective To explore the clinical efficacy and changes in hemodynamic parameters before and after incomplete stent angioplasty with percutaneous transluminal angioplasty and stenting (PTAS) for severe intracranial atherosclerotic stenosis. Methods A total of 52 patients with severe intracranial artery stenosis (> 70%) who underwent incomplete stent angioplasty with PTAS at Shijiazhuang People's Hospital in Hebei from February 2018 to February 2023 were selected. The residual stenosis rate after implantation of stent was evaluated, and neurological function was evaluated before and 6 months after surgery by modified Rankin Scale (mRS). The MeshLab software was used to analyze three⁃dimensional imaging data of arterial vessels, perform virtual repair of arterial stenosis approaching normal vessel diameter, and obtain hemodynamic parameters of each segment of the arterial wall and lumen before and after implantation of stent. Results The residual stenosis rate after stent implantation was (15.34 ± 6.12)%, which was better than the stenosis rate before stent implantation [(84.60 ± 7.20)%; t = 98.672, P =0.000]. The mRS score 6 months after surgery was (0.38 ± 0.21) points, which was lower than before surgery [(1.21 ± 0.43) points; t = 24.124, P = 0.000]. Compared with the hemodynamic parameters of each segment of the arterial wall before stent implantation, the dynamic pressure, total pressure, shear stress,shear rate, and cell Reynolds number of the proximal normal segment, stenotic and distal normal segment of the artery decreased after stent implantation (P = 0.000, for all), also the dynamic pressure (P = 0.000), total pressure (P = 0.000), shear stress (P = 0.000), shear rate (P = 0.008), and cell Reynolds number (P = 0.000) of the narrowed branch root decreased. Compared with the hemodynamic parameters related to the lumen of each segment of the artery before stent implantation, the dynamic pressure (P = 0.000), total pressure (P = 0.000), blood flow velocity (P = 0.000), vorticity (P = 0.005), turbulence kinetic energy (P = 0.000), turbulence intensity (P = 0.000), turbulence dissipation rate (P = 0.000), and turbulence Reynolds number (P = 0.000) of the proximal normal segment of the artery decreased after stent implantation, while the cell Reynolds number increased (P = 0.000). Excluding blood flow velocity (P = 0.138), the dynamic pressure, total pressure, vorticity, turbulence kinetic energy, turbulence intensity, turbulence dissipation rate, and turbulence Reynolds number of the root and segment of the artery decreased (P = 0.000, for all). The dynamic pressure, total pressure, blood flow velocity, vorticity, turbulence kinetic enery, turbulence intensity, turbulence dissipation rate, and turbulence Reynolds number of stenotic segment of the artery decreased (P = 0.000, for all). The dynamic pressure (P = 0.000), total pressure (P = 0.000), blood flow velocity (P = 0.001), vorticity (P = 0.000), turbulence kinetic energy (P = 0.000), turbulence intensity (P =0.000), turbulence dissipation rate (P = 0.000), and turbulence Reynolds number (P = 0.000) of the distal normal segment decreased, while the cell Reynolds number increased (P = 0.000). The hemodynamic parameters of the wall and lumen after virtual repair of artery stenosis were close to those after stent implantation. Conclusions The use of incomplete stent angioplasty with PTAS for severe intracranial atherosclerotic stenosis can significantly alleviate clinical symptoms, improve hemodynamic parameters in each segment of the stenosis, reduce the damage of turbulent blood flow to the arterial wall, and lower the risk of plaque fragmentation, detachment, and embolism of distal brain tissue caused by complete dilation of the stenosis.

This study deals with the existence of nodal solutions for the following gauged nonlinear Schrödinger equation with zero mass: −Δu+hu2(∣x∣)∣x∣2+∫∣x∣+∞hu(s)su2(s)dsu=∣u∣p−2u,x∈R2,-\Delta u+\left(\frac{{h}_{u}^{2}\left(| x| )}{{| x| }^{2}}+\underset{| x| }{\overset{+\infty }{\int }}\frac{{h}_{u}\left(s)}{s}{u}^{2}\left(s){\rm{d}}s\right)u={| u| }^{p-2}u,\hspace{1.0em}x\in {{\mathbb{R}}}^{2}, where p>6p\gt 6 and hu(s)=12∫0sru2(r)dr{h}_{u}\left(s)=\frac{1}{2}{\int }_{0}^{s}r{u}^{2}\left(r){\rm{d}}r. By variational methods, we prove that for any integer k≥0k\ge 0, the above equation has a nodal solution wk{w}_{k} which changes sign exactly kk times. Moreover, we also prove that wk{w}_{k} belongs to L2(R2){L}^{2}\left({{\mathbb{R}}}^{2}) provided p>10p\gt 10.

[Purposes] The dry fluidized-bed separation technology represents a significant advancement of the gas-solid two-phase theory within the domain of coal beneficiation. During coal separation in fluidized beds, the surface moisture of coal is transported and dispersed throughout the bed with gas flow and particle movement, resulting in particle agglomeration. Particle agglomeration refers to the accumulation of particles caused by fluid actions and dissipative interactions between particles, leading to an irregular mesoscale structure. Particle agglomeration can adversely affect fluidization quality, bed stability, density distribution, and product quality. [Methods] In this study, the collision and adhesion characteristics between heavy medium particles and the coal surface under wet conditions are investigated, focusing on the particle collision and adhesion processes. [Findings] The findings indicate that an increase in collision velocity corresponds to an increase in the normal restitution coefficient of the particles. Furthermore, under same humidity conditions and collision velocities, the restitution coefficient increases with larger particle sizes. The primary energy loss during particle-particle collisions in a wet fluidized bed is attributed to surface viscoelasticity loss and liquid bridge adhesion loss. As relative humidity increases, the adhesion loss caused by liquid bridge forces progressively rises, resulting in a significant decrease in the particle restitution coefficient. [Conclusions] The mechanism of particle agglomeration collision and adhesion is revealed from this work, providing a theoretical basis for controlling the agglomeration of particles in sorting fluidized beds, maintaining stable fluidization of the bed, and improving the sorting efficiency of fluidized beds.

To explore the flavor changes of Gushi goose nuggets of Henan, Xinyang during processing, GC-MS was used to analyze the volatile components of Gushi goose block samples at four different processing stages, and a comparative study was conducted by combining chemometrics methods. The results showed that a total of 24 volatile compounds were identified by GC-MS, which could be divided into aldehydes, ketones, esters, thioethers, alcohols and others. Among them, the proportion of alcohol volatile flavor substances reached 83.38% and 83.39% after stewing and sterilization, respectively, with high proportions of ethanol and acetaldehyde. The proportion of ketone volatile flavor substances increased gradually with the progression of processing stages, imparting fruity, fresh, and buttery aromas to the goose cubes. Multivariate statistical analysis showed that there were statistical differences in the characteristic flavor components of different samples. The ROAV method determined 7, 5, 4, and 4 key volatile flavor substances for each sample, respectively, among which aldehydes were the key volatile flavor components for all four processing stages, positively contributing to the flavor of Gushi goose cubes at different processing stages. Based on the results of GC-MS, the orthogonal partial least squares discriminant analysis model, principal component analysis and cluster analysis showed that the flavor of the samples after stewing and sterilization was close, indicating that the sterilization had a great influence on the flavor of Gushi goose products. This study is of great significance to improve the deep processing level and large-scale production of Xinyang Gushi goose blocks, as well as enhance the added value of Xinyang dishes.

Abstract Early Diagnosis of oral cancer is very important and can save you from some oral malignancies. However, while this approach aids in the rapid healing of patients and the preservation of their lives, there are several causes for poor and wrong diagnosis of oral cancer. In recent years, the use of computer-aided design diagnosis tools as an auxiliary tool alongside clinicians has greatly benefited in more accurate identification of this malignancy. The current study proposes a new approach for identifying oral cancer patients based on image processing and deep learning. The current study employs a recently integrated model of an improved tunicate swarm algorithm to produce an efficient tool for improving a convolutional neural network and delivering an accurate cancer diagnostic system. The approach is then implemented on the oral cancer pictures dataset. The approach is then validated by comparing it to other published papers using various measurement markers. The proposed model achieved an accuracy of 98.70% and a recall of 93.71% in detecting oral cancerous lesions from photographic images. The model also achieved an F1-score of 90.08% and a precision of 96.42%. The final results demonstrate that the offered approach can produce more exact results and can be used in conjunction with clinicians to help in diagnosing oral cancer.

Abstract The recently identified novel duck reovirus (NDRV) is a waterfowl reovirus that can seriously harm or kill various waterfowl species. However, how NDRV interacts with host cells in Muscovy ducklings beyond the typical pathogenesis resulting from a viral infection is unknown. The current study examined the global translation efficiency of the Fabricius bursa of Muscovy ducklings infected with NDRV HN10 using mass spectrometry and ribosome footprint sequencing. Protein-protein interactions were investigated using immunogold labeling, transmission electron microscopy, and immunocytochemistry. An analysis of the relationship between m6A and translation was performed using RNA immunoprecipitation and m6A methylation immunoprecipitation. We found that both in vivo and in vitro, the translation efficiency of RNA modified with m6A could be significantly reduced by σB, a structural protein component of NDRV HN10. Furthermore, σB might simultaneously interact with the stress granule complex CAPRIN1 and G3BP1 and the m6A reader protein YTHDF1/3. Significant overlap was observed between m6A-modified and G3BP1-enriched RNA, indicating that granule stress could capture m6A-methylated RNA. We discovered a new function for NDRV HN10 in translational shutoff by recruiting m6A-modified RNA into stress granules located in the Fabricius bursa of Muscovy ducklings.