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The white-rot fungus Phellinus noxius is known to cause brown root rot disease (BRRD) in woody trees and shrubs. To understand the pathogenicity of P. noxius in herbaceous plants, we investigated 23 herbaceous weed and turfgrass species in 32 BRRD-infested sites in Taiwan and/or tested them by artificial inoculation. In the field survey, P. noxius was isolated from seven symptomless herbaceous species (i.e., Typhonium blumei, Paspalum conjugatum, Paspalum distichum, Oplismenus compositus, Bidens pilosa, Digitaria ciliaris, and Zoysia matrella). Potted plant inoculation assays suggested that P. noxius is able to infect Artemisia princeps, O. compositus, and Z. matrella but not Axonopus compressus, Eremochloa ophiuroides, Ophiopogon japonicus, or Cynodon dactylon. A. princeps plants wilted within 2 weeks postinoculation, but inoculated O. compositus and Z. matrella were asymptomatic, and P. noxius could be isolated from only inoculated sites. The colonization of P. noxius in the cortex and vascular cylinder of roots was visualized by paraffin sectioning and trypan blue staining of juvenile seedlings grown on water agar. To evaluate the effect of replantation for the remediation of BRRD-infested sites, P. noxius-inoculated wood strips were buried in soil with or without vegetation. After 4 weeks, P. noxius could be detected only in the bare soil group. For the control of BRRD, the herbaceous hosts should be removed around the diseased trees/stumps and non-host turfgrasses (e.g., A. compressus, E. ophiuroides, O. japonicus, or C. dactylon) planted to accelerate the degradation of P. noxius.

本文著重在職場暴力對居家醫療與長期照護從業人員的健康威脅。職場暴力可分為四種類型：第一型為具犯罪意圖之暴力，第二型是「客戶對員工」施加之暴力，第三型是「員工間」發生的暴力，第四型是親密伴侶間的暴力。其中，醫療保健與社會服務業之勞工被認為是職場暴力之高風險族群，其所受到的暴力通常來自患者或患者親屬（第二型職場暴力）。而對於居家醫療與長期照護工作者而言，由於其工作環境與工作性質，於各類型之職場暴力皆有很高的暴露風險。研究顯示，相當比例的居家醫療與長期照護從業人員經歷過第二型職場暴力，其中，居家醫療從業人員的發生率普遍高於長期照護從業人員。然而，由於通報率偏低，學者們認為醫療場域之職場暴力盛行率有被低估的可能性。本文提出對居家醫療與長期照護從業人員有所裨益的職場暴力預防策略，囊括四種面向。首先，健康與安全之教育訓練可以有效促進居家訪視的安全性，包含成立安全及諮詢委員會、提供教育訓練、加強溝通技巧、強化事件通報流程，以及重視事件之後續追蹤等。其次，對於居家訪視進行風險評估有助於改善居家之環境安全，目前已有數種評量工具。其三，防身物品、緊急電話及合宜之應對態度是面對暴力事件時的重要應對技巧。其四，為預防醫療職場暴力，《職業安全衛生法》與《醫療法》也逐年修訂。綜上所述，本文蒐集醫療場域之職場暴力現況，並提供預防及因應策略，以期居家醫療與長期照護從業人員能擁有更友善健康的工作環境。 Workplace violence (WPV) is a serious occupational threat for healthcare workers (HCWs). WPV can be divided into the following four types: Type I concerning criminal intent, Type II client-on-worker violence, Type III worker-on-worker violence, and Type IV personal relationship (or intimate partner violence). A high level of exposure to WPV has been identified in the healthcare and social work settings where patients form a common source of WPV (more specifically Type II WPV). Of all healthcare professionals, home healthcare workers (HHCWs) and long-term care workers (LTCWs) are particularly vulnerable to WPV due to the unique characteristics and requirements of their services, and home healthcare workers appear to be at a greater risk of experiencing WPV than their long-term care counterparts. Moreover, most scholars are of the opinion that the prevalence of WPV is very likely to be underestimated due to underreporting. Accordingly, the paper proposed four major WPV coping strategies for the two groups of healthcare workers. First, training courses should be planned and implemented to improve communication skills of workers and safeguard their safety during home and long-term care visits. Relevant committees or advisory boards should be established to streamline incident reporting SOP, provide counseling, develop safety manual, and monitor follow-ups of reported incidents. Second, home environment safety should be assessed using one of the several tools that have already been developed. Third, HHCWs and LTCWs should equip themselves with personal defense and protection gadgets and memorize emergency phone numbers for every visit. Fourth, related laws and regulations, notably Occupational Safety and Health Act and Medical Care Act, should be reviewed and amended on a regular basis to better prevent WPV in the home and long-term care settings. In the paper, we comprehensively report the prevalence of medical workplace violence, prevention and intervention strategies for HHCWs and LTCWs to stay safe while working. &nbsp

A biologic is a therapeutic agent with biological activity that is administered to achieve an enhanced regenerative or reparative effect. The use of biologics has progressively become a core component of contemporary periodontal practice. However, some questions remain about their safety, indications, and effectiveness in specific clinical scenarios. Given their availability for routine clinical use and the existing amount of related evidence, the goal of this American Academy of Periodontology (AAP) best evidence consensus (BEC) was to provide a state-of-the-art, evidence-based perspective on the therapeutic application of autologous blood-derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet-derived growth factor BB (rhPDGF-BB), and recombinant human bone morphogenetic protein 2 (rhBMP-2). A panel of experts with extensive knowledge on the science and clinical application of biologics was convened. Three systematic reviews covering the areas of periodontal plastic surgery, treatment of infrabony defects, and alveolar ridge preservation/reconstruction and implant site development were conducted a priori and provided the foundation for the deliberations. The expert panel debated the merits of published data and exchanged experiential information to formulate evidence-based consensus statements and recommendations for clinical practice and future research. Based on an analysis of the current evidence and expert opinion, the panel concluded that the appropriate use of biologics in periodontal practice is generally safe and provides added benefits to conventional treatment approaches. However, therapeutic benefits and risks range based on the specific biologics used as well as patient-related local and systemic factors. Given the limited evidence available for some indications (e.g., gingival augmentation therapy, alveolar ridge preservation/reconstruction, and implant site development), future clinical studies that can expand the knowledge base on the clinical use of biologics in periodontal practice are warranted.

Summary We introduce LongDat, an R package that analyzes longitudinal multivariable (cohort) data while simultaneously accounting for a potentially large number of covariates. The primary use case is to differentiate direct from indirect effects of an intervention (or treatment) and to identify covariates (potential mechanistic intermediates) in longitudinal data. LongDat focuses on analyzing longitudinal microbiome data, but its usage can be expanded to other data types, such as binary, categorical, and continuous data. We tested and compared LongDat with other tools (i.e., MaAsLin2, ANCOM, lgpr, and ZIBR) on both simulated and real data. We showed that LongDat outperformed these tools in accuracy, runtime, and memory cost, especially when there were multiple covariates. The results indicate that the LongDat R package is a computationally efficient and low-memory-cost tool for longitudinal data with multiple covariates and facilitates robust biomarker searches in high-dimensional datasets. Availability and Implementation The R package LongDat is available on CRAN (https://cran.r-project.org/web/packages/LongDat/) and GitHub (https://github.com/CCY-dev/LongDat). Supplementary information Supplementary data are available at Bioinformatics Advances online.

The ability to employ a wide range of native substrates is essential for the broad application of transition-metal-catalyzed C–H activation. Recent advances have made native carboxylic acids, ketones, and amines amenable to C(sp3)–H activation, but alcohols, perhaps the most common functionality in organic chemistry, have remained intractable due to their low affinity for late-transition-metal catalysts. Herein we describe the rational development of ligands to overcome this challenge and enable alcohol-directed -C(sp3)–H arylation reactions. Our ligand design strategy employs charge balance and a secondary-coordination-sphere H-bonding interaction—evidenced by SAR studies, computational modelling, and crystallographic data—to stabilize L-type hydroxyl coordination to palladium, thereby facilitating the assembly of the key C–H cleavage transition state. In contrast to prior studies in C–H activation, where secondary interactions were used to control selectivity in the context of established reactivity, this report demonstrates the feasibility of employing secondary interactions to enable challenging novel reactivity by enhancing substrate-catalyst affinity.

This study aimed to assess the accuracy of a method of predicting post-movement root position during orthodontic treatment using a 3D digital crown/root model (3DCRM) created with pre-movement records of both cone-beam computed tomography (CBCT) and dental arch digital scans. Pre- and post-movement CBCT scans and dental arch digital scans of five patients who had completed orthodontic treatments were used in this study. The 3DCRM was superimposed onto the post-movement scanned dental arch to identify the post-movement root position (test method). Post-movement CBCT (referenced as the current method) served as the control to identify the actual post-movement root position. 3D-coordinate analysis revealed no significant differences between the test and current methods along the X and Y axes. However, the discrepancy on the Z axis (especially in cases of intrusion) was greater than that in all other directions for all three tooth types examined (p < 0.05). A strong positive correlation between the degree of discrepancy and the distance of tooth movement was observed on the Z axis (r = 0.71). The 3DCRM method showed promising potential to accurately predict root position during orthodontic treatments without the need for a second CBCT. However, root resorption, which affected the Z axis prediction, needs to be closely monitored using periapical radiographs to complement this method.

The wood-based furniture manufacturing industries prioritize quality of production to meet higher market demands. Identifying various types of edge-glued wooden panel defects are a challenge for a human worker or a camera. Several studies have shown that the detection of edge-glued defects with low, high, normal, overlong, short is identified but detection of residue and bluntness is highly challenging. Thus, the present model identifies defects of low, high, normal, overlong, short by computer vision and/or deep learning, whereas defects of residue and bluntness by deep learning based decide by pass for having better performance. The goal of this paper is to provide an improved defect detection solution for wood-based furniture manufacturing industries by process automation. Therefore, a system was designed that takes defect input images from a camera as raw image and laser-aligned image for defect detection of the edge-glued wooden panel. The process automation then performs computer vision-based image features extraction with deep learning for defect detection. The aim of this paper is to solve edge-glued defect detection problems by using design and implementation of edge-glued wooden defect detection, that can be stated as edge-glued wooden panel defect detection using deep learning (WDD-DL) for process automation by artificial intelligence and Automated Optical Inspection (AOI) consolidation. Possibly there exist several types of defects on the edges while edge-banding on the wooden panel in furniture manufacturing. Therefore, the scope is to achieve higher accuracy by raw image and laser-aligned image feature extraction using deep learning algorithms for final result defect classification in WDD-DL by AOI. The WDD-DL system uses Gabor, Harris corner, morphology, structured light detection and curvature calculation for pre-processing and InceptionResnetV2 Convolutional Neural Network algorithm to attain the best results. The applications of this work can be found in quality control of the furniture manufacturing industry for an edge, corner, joint defect detection of the wooden panels. The WDD-DL achieves best results as the precision, recall and F1 score are 0.97, 0.90 and 0.92, respectively. The experiments demonstrate higher accuracy achievement as compared to other methods with overkill and escape rate analysis. Ultimately, the discussion section provides an interesting experience sharing about the necessary factors for implementing the WDD-DL in real-time industrial operations.

Reduced precision computation is a key enabling factor for energy-efficient acceleration of deep learning (DL) applications. This article presents a 7-nm four-core mixed-precision artificial intelligence (AI) chip that supports four compute precisions--FP16, Hybrid-FP8 (HFP8), INT4, and INT2--to support diverse application demands for training and inference. The chip leverages cutting-edge algorithmic advances to demonstrate leading-edge power efficiency for 8-bit floating-point (FP8) training and INT4 inference without model accuracy degradation. A new HFP8 format combined with separation of the floating- and fixed-point pipelines and aggressive circuit/architecture optimization enables performance improvements while maintaining high compute utilization. A high-bandwidth ring protocol enables efficient data communication, while power management using workload-aware clock throttling maximizes performance within a given power budget. The AI chip demonstrates 3.58-TFLOPS/W peak energy efficiency and 26.2-TFLOPS peak performance for HFP8 iso-accuracy training, and 16.9-TOPS/W peak energy efficiency and 104.9-TOPS peak performance for INT4 iso-accuracy inference.

In most landscape evolution models, extreme rainfall enhances river incision. In steep landscapes, however, these events trigger landslides that can buffer incision via increased sediment delivery and aggradation. We quantify landslide sediment aggradation and erosional buffering with a natural experiment in southern Taiwan where a northward gradient in tectonic activity drives increasing landscape steepness. We find that landscape response to extreme rainfall during the 2009 typhoon Morakot varied along this gradient, where steep areas experienced widespread channel sediment aggradation of >10 m and less steep areas did not noticeably aggrade. We model sediment export to estimate a sediment removal timeline and find that steep, tectonically active areas with the most aggradation may take centuries to resume bedrock incision. Expected sediment cover duration reflects tectonic uplift. We find that despite high stream power, sediment cover may keep steep channels from eroding bedrock for up to half of a given time period. This work highlights the importance of dynamic sediment cover in landscape evolution and suggests a mechanism by which erosional efficiency in tectonically active landscapes may decrease as landscape steepness increases.

Because of the cancer incidence increase and population aging in Taiwan, we aimed to assess the cancer prevalence, to summarize the comorbidities of older patients with the five most common cancers (i.e., breast, colorectal, liver, lung, and oral), and to develop a Taiwan cancer comorbidity index (TCCI) for studying their actual prognosis. The linkage of the Taiwan Cancer Registry, Cause of Death Database, and National Health Insurance Research Database was used. We followed the standard statistical learning steps to obtain a survival model with good discriminatory accuracy in predicting death due to noncancer causes, from which we obtained the TCCI and defined comorbidity levels. We reported the actual prognosis by age, stage, and comorbidity level. In Taiwan, cancer prevalence nearly doubled in 2004–2014, and comorbidities were common among older patients. Stage was the major predictor of patients' actual prognoses. For localized and regional breast, colorectal, and oral cancers, comorbidities correlated with noncancer-related deaths. Compared with the US, the chances of dying from comorbidities in Taiwan were lower and the chances of dying from cancer were higher for breast, colorectal, and male lung cancers. These actual prognoses could help clinicians and patients in treatment decision-making and help policymakers in resource planning.

The white-rot fungus

Introduction: Metformin (Met) is used as a first-line treatment in type II diabetes, reduces the cardiovascular (CV) risk in diabetes and may lead to decreased CV mortality independent of diabetes status. Met treatment has been shown to induce gut microbiome changes leading to enhanced production of protective short-chain fatty acids and potentially harmful metabolites (LPS). Our study aims to examine the effects of Met in a model of RAAS-mediated hypertension with cardio-renal damage. Methods: Four-week-old double transgenic rats (dTGR, transgenic for human renin and angiotensinogen) received oral Metformin (Met) or Vehicle (Veh) for 3 weeks. SD rats served as healthy controls. Flow cytometry (n=10 per group), echocardiography (n=14), radiotelemetric blood pressure (BP) measurements (n=5), clinical chemistry and gene expression analyses (n=14) were used to assess damage to kidney and heart. Results: Met treatment did not influence survival nor lead to lactate acidosis. Met treatment lowered BP significantly (systolic BP: Met: 218±5 mmHg, Veh: 237±3 mmHg). Interestingly, the decreased BP was accompanied by increased cardiac hypertrophy (heart weight to tibia length, SD: 34±1 g/m, Met: 40±1 g/m, Veh: 37±1 g/m). Echocardiographic systolic and diastolic function was deteriorated (EF: Met: 64±2 %, Veh: 68±4 %; E/A: Met: 0.75±0.1, Veh: 0.93±0.1). Plasma BNP and cardiac ß-to-α MHC ratio were higher in Met-treated dTGR. Intestines, spleens, kidneys and hearts of dTGR showed a strong pro-inflammatory phenotype with increased adaptive (e.g. cardiac T cells % of leucocytes: (SD: 10±0.003 %, Met: 15±0.01 %, Veh: 13±0.01 %) and innate (e.g. cardiac monocytes % of leucocytes: (SD: 2±0.001 %, Met: 3±0.004 %, Veh: 5±0.02 %) immune cell subsets in comparison to SD rats; with almost no differences between Met- and Veh-treated dTGR. Fecal metagenomic shotgun sequencing showed no large-scale taxonomic shifts between Veh- and Met-treated dTGR. Conclusion: dTGR display a pronounced pro-inflammatory immunophenotype across several organs. Met did not ameliorate hypertensive target organ damage in dTGR despite the BP lowering effect. These findings could help to understand the effects of Met on the microbiome, immunome and organ damage in the context of hypertension.

BACKGROUND The aim of this study was to examine osseous changes following lateral bone augmentation using a novel Ossix Volumax (OV) scaffold alone and compare it to combination therapy using freeze-dried bone allograft (FDBA) and resorbable collagen membrane (FDBA/CM). METHODS Thirty patients completed this 9-months prospective two-center cohort clinical trial. Before surgery and 9-months re-entry, linear measurements were performed, and impressions taken. Cone-beam computed tomography (CBCT) were done at baseline and 9 months. DICOM slice data were converted into volumetric images using 3D Slicer. Following 3D volumetric image construction, pre- and post-op Standard Triangle Language files were superimposed and volumetric data were extracted for a 10-mm region of interest. Linear measurements were compared similarly. RESULTS Baseline clinical parameters were similar in both groups (4.22 and 4.53 mm for OV and FDBA/CM at -2 mm, respectively). Following treatment, vertical distance from the stent had changed minimally (-0.36 and -0.12 mm, respectively). Similarly, lateral bone gain ranged from 0 to 0.4 mm, for both groups. To the contrary, the CBCT measurements showed a significantly greater increase in horizontal width in the control at -2 mm (0.95 ± 0.2 mm) compared with -0.62 mm for the OV (P = 0.000). Similar changes were observed at -5 mm (0.63 and -0.41 mm, respectively, P = 0.01). Sites volume had increased from 266 ± 149 mm3 to 360 ± 138 mm3 (P = 0.001) for FDBA/CM with negligible changes for OV (from 334 to 335 mm3 , P = 0.952). these between-group changes being statistically significant (P = 0.023). CONCLUSION FDBA/CM yielded better albeit moderate increase in the volume of the edentulous ridge, while OV scaffolds failed to produce similar results.

Balancing selection is frequently invoked as a mechanism that maintains variation within and across populations. However, there are few examples of balancing selection operating on loci underpinning complex traits, which frequently display high levels of variation. We investigated mechanisms that may maintain variation in a focal polymorphism—leaf chemical profiles of a perennial wildflower (Boechera stricta, Brassicaceae)—explicitly interrogating multiple ecological and genetic processes including spatial variation in selection, antagonistic pleiotropy, and frequency-dependent selection. A suite of common garden and greenhouse experiments showed that the alleles underlying variation in chemical profile have contrasting fitness effects across environments, implicating two ecological drivers of selection on chemical profile: herbivory and drought. Phenotype-environment associations and molecular genetic analyses revealed additional evidence of past selection by these drivers. Together, these data are consistent with balancing selection on chemical profile, likely caused by pleiotropic effects of secondary chemical biosynthesis genes on herbivore defense and drought response., Editor’s Summary: Evidence for balancing selection acting on loci that control complex traits is limited. Here, the authors show evidence for past selection on chemical profile in a perennial wildflower by two ecological drivers, herbivory and drought, consistent with balancing selection on this trait.

Junctional adhesion molecule 3 (JAM3) is involved in epithelial cell junction, cell polarity, and motility. The molecular mechanisms underlying the role of JAM3 in placental dysfunction remain unclear. We hypothesized that JAM3 expression regulates trophoblast fusion, differentiation, proliferation, and apoptosis. Our results revealed that JAM3 was expressed in the cytotrophoblasts and syncytiotrophoblasts of first-trimester and term placental villi. JAM3 expression in cell–cell junctions decreased with the formation of syncytiotrophoblasts. Using trophoblasts as an in vitro model, we observed that forskolin and JAM3 knockdown significantly reduced JAM3 expression and increased syncytium formation. JAM3 knockdown additionally inhibited trophoblast proliferation and increased the number of trophoblasts in the sub-G1 and G2/M phases, indicating cell-cycle disturbance and apoptosis. Cell-cycle arrest was associated with the engagement of checkpoint kinase 2-cell division cycle 25C-cyclin-dependent kinase 1/cyclin B1 signaling. Increased expression of BIM, NOXA, XAF1, cytochrome c, and cleaved caspase-3 further indicated trophoblast apoptosis. Overexpression of JAM3 or recombinant JAM3 protein enhanced trophoblast adhesion and migration, which were inhibited by JAM3 knockdown. JAM3 knockdown induced reactive oxygen species and syncytin 2 expression in trophoblasts. Furthermore, H2O2-induced oxidative stress reduced JAM3 expression in trophoblasts and cell culture supernatants. H2O2 simultaneously induced trophoblast apoptosis. JAM3 expression was significantly decreased in the plasmas and placentas of patients with early-onset severe preeclampsia. Thus, our results show that JAM3 may not only be a structural component of trophoblast cell junctions but also regulates trophoblast fusion, differentiation, proliferation, apoptosis, and motility. Dysregulated trophoblast JAM3 expression is crucial in preeclampsia development.

Evaluating several vital signs and chest X-ray (CXR) reports regularly to determine the recovery of the pneumonia patients at general wards is a challenge for doctors. A recent study shows the identification of pneumonia by the history of symptoms and signs including vital signs, CXR, and other clinical parameters, but they lack predicting the recovery status after starting treatment. The goal of this paper is to provide a pneumonia status prediction system for the early affected patient’s discharge from the hospital within 7 days or late discharge more than 7 days. This paper aims to design a multimodal data analysis for pneumonia status prediction using deep learning classification (MDA-PSP). We have developed a system that takes an input of vital signs and CXR images of the affected patient with pneumonia from admission day 1 to day 3. The deep learning then classifies the health status improvement or deterioration for predicting the possible discharge state. Therefore, the scope is to provide a highly accurate prediction of the pneumonia recovery on the 7th day after 3-day treatment by the SHAP (SHapley Additive exPlanation), imputation, adaptive imputation-based preprocessing of the vital signs, and CXR image feature extraction using deep learning based on dense layers-batch normalization (BN) with class weights for the first 7 days’ general ward patient in MDA-PSP. A total of 3972 patients with pneumonia were enrolled by de-identification with an adult age of 71 mean ± 17 sd and 64% of them were male. After analyzing the data behavior, appropriate improvement measures are taken by data preprocessing and feature vectorization algorithm. The deep learning method of Dense-BN with SHAP features has an accuracy of 0.77 for vital signs, 0.92 for CXR, and 0.75 for the combined model with class weights. The MDA-PSP hybrid method-based experiments are proven to demonstrate higher prediction accuracy of 0.75 for pneumonia patient status. Henceforth, the hybrid methods of machine and deep learning for pneumonia patient discharge are concluded to be a better approach.

Despite the global decline in the standardized mortality rate of multiple sclerosis (MS), recent research on MS patient survival, especially in Taiwan, remains limited. This study aimed to investigate survival, mortality causes, and associated factors among MS patients in Taiwan. The Taiwan National Health Insurance Research Database was used as the primary data source, and a Cox proportional hazard model was employed to estimate and analyze factors related to survival. We analyzed data from 1444 MS patients diagnosed between 2000 and 2018. Age at diagnosis was positively correlated with the risk of death. Among the 190 patients who died, the leading causes of disease-related deaths were nervous system diseases (n = 83, 43.68%), followed by respiratory system diseases and certain infectious and parasitic diseases. The 8-, 13-, and 18-year survival rates for MS patients were 0.97, 0.91, and 0.81, respectively. This study highlights that the MS patient’s socioeconomic status, environmental factors, comorbidity severity, and related medical variables were not significantly associated with survival.

Objective: Cervical cancer is the fourth most prevalent cancer in women worldwide. It is vital to achieve a high cervical cancer screening rate among women. We compared the Pap smear test (PST) used between individuals with disabilities and those without disabilities in Taiwan. Methods: Individuals registered in the Taiwan Disability Registration File and the National Health Insurance Research Database (NHIRD) were screened for this nationally representative retrospective cohort study. Women aged 30 and above in 2016 and who were still alive in 2016 were matched in a 1:1 ratio via propensity score matching (PSM); 186,717 individuals with disabilities and 186,717 individuals without disabilities were included. Controlling for relevant variables, the odds of receiving PST were compared using conditional logistic regression analysis. Results: A lower percentage of individuals with disabilities (16.93%) received PST than those without disabilities (21.82%). The odds of individuals with disabilities receiving PST were 0.74 times that of individuals without disabilities (OR = 0.74, 95% CI = 0.73–0.76). Compared to individuals without disabilities, individuals with intellectual and developmental disabilities had the lower odds of receiving PST (OR = 0.38, 95% CI = 0.36–0.40), followed by individuals with dementia (OR = 0.40, 95% CI = 0.33–0.48) or multiple disabilities (OR = 0.52, 95% CI = 0.49–0.54). Conclusions: We highly recommend that healthcare practitioners recognize the unique needs of individuals with different types of disabilities, especially those with cognitive impairments.

The use of zirconia for implants and abutments has become more prevalent in implant dentistry as an alternative to the commonly used titanium implants, and peri-implant disease can still affect them. The erbium, chromium-doped:yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser has emerged as a promising treatment modality. The purposes of this in vitro study were to (1) determine the effects of the laser on the surface roughness of zirconia discs; (2) determine the extent of removal of a single species biofilm, E. coli, on the zirconia discs after applying the laser; (3) determine the amount of cell adhesion and proliferation utilizing fibroblasts on zirconia discs after treatment with the laser. All treatments will be compared with the commonly used ultrasonic instrumentation and hand scalers. For the first aim, gross examination revealed noticeable surface damage on the discs when using ultrasonic and scalers but not for the laser group. For surface roughness, the mean roughness was Pa= 0.623±0.185 μm, 0.762±0.421 μm, 0.740±0.214 μm, and 0.724±0.168 μm for control discs, and discs treated with either the Er,Cr:YSGG laser, ultrasonic instrumentation, and hand scalers respectively. There was no statistical significance among the groups (p=0.628). For bacteria decontamination, there was a statistical significance among the groups (p< 0.0001). Statistical significance was seen between the control group and each of the three treatment groups, favoring the treatment groups (p< 0.0001). Statistical significance was seen when comparing ultrasonic instrumentation and hand scalers (p= 0.000) as well as when comparing the Er,Cr:YSGG laser to hand scalers (p= 0.007), favoring both the ultrasonic instrumentation and Er,Cr:YSGG laser. No significance between the Er,Cr:YSGG laser group and the ultrasonic instrumentation group was noted (p =0.374). When comparing the cell attachment following treatment in each of the three groups and also without treatment (control), there was a statistical significance among the groups (p

Soft tissue sealing around zirconia (ZrO2) abutment is critical for the long-term stability of dental implants. The goal of the study is to develop a strong basal lamina (BL)-mediated epithelial attachment to ZrO2 via a novel physicochemical immobilization method. An electrophoretic fusion (EPF) method was applied to fuse a phosphonic acid (PA) linker to ZrO2 discs. Bindings of the PA linker and the following protease activated receptor 4 (PAR4) were verified by Fourier-transform infrared spectroscopy (FITR). Then, ZrO2 discs were doped in platelet-rich plasma (PRP). Platelet-derived growth factor (PDGF) was measured to assess platelet activation. PRP-doped discs were subsequently co-cultured with human gingival epithelial cells (OBA9) to evaluate establishment of basal lamina-mediated epithelial attachment. The EPF method achieved robust immobilization of the PA linker and PAR4 onto the ZrO2 surface. The resultant PAR4-coupled ZrO2 successfully induced platelet aggregation and activation. Furthermore, a BL-mediated epithelial attachment was established. The results are significant for clinical application to minimize the risk of developing peri-implant diseases.

This systematic review aimed to assess the clinical efficacy of antibiotics when used as an adjunct in treating peri-implant diseases.A systematic search of papers published between January 1980 and March 2020 was conducted. Randomized clinical trials with at least 10 patients who had peri-implant diseases, treated with or without adjunctive antibiotics in combination with surgical or nonsurgical therapies, and with a minimum of at least 3 months of follow-up were included. Meta-analyses were conducted to analyze weighted mean differences in probing depth reduction, radiographic bone level gain, and odds ratio of treatment success.From the 856 articles identified, 10 articles met the inclusion criteria and were selected. Of these, 7 articles were used for the meta-analysis. The adjunctive use of antibiotics in the treatment of peri-implant diseases yielded significantly greater probing depth reduction (weighted mean differences = 0.56 mm at 3 months, P = .001; 0.77 mm at 6 months, P.00001; 0.92 mm at 12 months, P.00001), radiographic bone level gain (weighted mean differences = 0.64 mm, P = .03), and treatment success (odds ratio = 1.74, P = .04) compared to the same treatment without antibiotics.Based on the existing evidence, the use of adjunctive antibiotics to treat peri-implant diseases, especially peri-implantitis, provided potential benefits in clinical outcomes for up to 12 months posttherapy.

Global vaccination against the coronavirus disease 2019 (COVID-19) is thought to be the most effective way to end or at least contain the COVID-19 pandemic. However, despite the good safety profiles and effectiveness of the available COVID-19 vaccines, rare but serious hematological complications have emerged, including thromboembolic outcomes with thrombocytopenia following the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) and Ad26.COV.2.S (JohnsonJohnson/Janssen) vaccines. Moreover, COVID-19 vaccination may be linked to the development of aplastic anemia (AA). We discuss four cases of AA that arose after COVID-19 vaccination in our hospital and two other such cases identified in our literature review.

Advances in deep neural networks (DNNs) and the availability of massive real-world data have enabled superhuman levels of accuracy on many AI tasks and ushered the explosive growth of AI workloads across the spectrum of computing devices. However, their superior accuracy comes at a high computational cost, which necessitates approaches beyond traditional computing paradigms to improve their operational efficiency. Leveraging the application-level insight of error resilience, we demonstrate how approximate computing (AxC) can significantly boost the efficiency of AI platforms and play a pivotal role in the broader adoption of AI-based applications and services. To this end, we present RaPiD, a multi-tera operations per second (TOPS) AI hardware accelerator core (fabricated at 14-nm technology) that we built from the ground-up using AxC techniques across the stack including algorithms, architecture, programmability, and hardware. We highlight the workload-guided systematic explorations of AxC techniques for AI, including custom number representations, quantization/pruning methodologies, mixed-precision architecture design, instruction sets, and compiler technologies with quality programmability, employed in the RaPiD accelerator.

There has been an increase in utilizing 3D printers in dental restorations. The purpose of the study is to compare mechanical properties of 3D-printed prostheses to those of self-cured and/or computer-aided design-computer-aided manufacturing (CAD-CAM) restorations. A metal master typodont was prepared for the mandibular left sextant with implant analogs embedded at the first premolar and first molar positions with a missing second premolar. Three-unit provisional fixed dental prosthesis (FDP) was designed utilizing the 3Shape tooth library and forty-five uniform specimens were fabricated with different materials: self-cured poly(methyl methacrylate) (PMMA) (N = 15), milled PMMA CAD-CAM blocks (N = 15) and 3D-printed resin (N = 15). All specimens were tested using an Instron machine at a crosshead speed of 0.5 mm/min by an axial load on the occlusal surface of the second premolar pontic site. Statistical analysis was completed with Shapiro-Wilk, ANOVA and Tukey post-hoc tests. Mean fracture force was 300.61 N, 294.64 N and 408.49 N for self-cured PMMA, milled PMMA and 3D-printed resin, respectively. Mean force at FDP fracture of 3D-printed resin was significantly greater than the mean fracture force of either self-cured (p = 0.016, 95% CI [17.86, 197.91]) or milled (p = 0.010, 95% CI [23.83, 203.88]) PMMA.

This investigation was designed to evaluate the reestablishment of bone-to-implant contact on infected dental implant surfaces following decontamination with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser and reconstructive therapy. Three patients presenting with at least one failing implant each were enrolled and consented to treatment with the Er,Cr:YSGG laser surface decontamination and reconstruction with a bone replacement allograft and a collagen membrane. The laser treatment was carried out at a setting of 1.5 W, air/water of 40%/50%, and pulse rate of 30 Hz. At 6 months, all three patients returned for the study. En bloc biopsy samples of four implants were obtained and analyzed. Two patients had excellent clinical outcomes, while one patient with two adjacent failing implants experienced an early implant exposure during the follow-up period. There was histologic evidence of new bone formation with two implant specimens and less bone gain with the others. Despite the small sample size, these were optimistic findings that suggested a positive role of Er,Cr:YSGG laser in debridement of a titanium implant surface to facilitate subsequent regenerative treatment. This investigation provides histologic evidence as well as encouraging clinical results that use of the Er,Cr:YSGG laser can be beneficial for treatment of peri-implantitis, but further long-term clinical studies are needed to investigate the treatment outcome obtained.

The objective of this study is to evaluate titanium decontamination after different protocols while assessing changes in surface roughness, chemical composition, and wettability.Ninety-six smooth (S) and 96 minimally rough (R) titanium microimplants were used. Pristine microimplants were reserved for negative control (S-nC/R-nC, n = 9), while the remaining microimplants were incubated in Escherichia coli culture. Non-decontaminated microimplants were used as positive control (S-pC/R-pC, n = 3). The other microimplants were divided into seven different decontamination protocols (12 S/R per group): 24% EDTA, 2% chlorhexidine (CHL), gauze soaked in 2% chlorhexidine (GCHL), gauze soaked in ultrapure water (GMQ), scaling (SC), titanium brush (TiB), and implantoplasty (IP). Contaminated areas were assessed by scanning electron microscope images, chemical composition by energy dispersive X-ray spectroscopy, wettability by meniscus technique, and roughness by an optical profiler.Higher residual bacteria were observed in R-pC compared with S-pC (P 0.0001). When comparing S and R with their respective pC groups, the best results were obtained with GCHL, SC, TiB, and IP, with no difference between these protocols (P 0.05). Changes in surface roughness were observed after all treatments, with S/R-IP presenting the smoother and a less hydrophilic surface (P 0.05). Apart from IP protocol, all the other groups presented a more hydrophilic surface in R than in S microimplants (P 0.003). All decontamination protocols resulted in a lower percentage of superficial Ti when compared with S/R-nC (P 0.002).All decontamination protocols resulted in changes in roughness, wettability, and chemical composition, but GCHL, SC, TiB, an IP presented the best decontamination outcomes.

Taiwan is an aging society, but the appropriate designs must be considered in senior care spaces. Universal design knowledge has been addressed in universities, but students cannot imagine how age affects the needs of senior citizens physically and psychologically. The teaching practice in this study adopted a dyadic teaching method whereby students observed the needs of individuals in a nursing care center for elderly people. It also used cooperative learning methods for nursing students to discuss the needs of senior citizens and to help design students understand the lifestyles of senior citizens through the use of simulation devices. Through the feedback from the learning process, statistical analysis was used to assess the learning performance of students. The design studio used these two teaching methods, and the respective work was entered into an open design competition to verify whether teaching performance was successful. Approximately 70% of the works earned design awards. This provided a preliminary validation of the success of the respective teaching practice method.

Taiwan is an aging society, but the appropriate designs must be considered in senior care spaces. Universal design knowledge has been addressed in universities, but students cannot imagine how age affects the needs of senior citizens physically and psychologically. The teaching practice in this study adopted a dyadic teaching method whereby students observed the needs of individuals in a nursing care center for elderly people. It also used cooperative learning methods for nursing students to discuss the needs of senior citizens and to help design students understand the lifestyles of senior citizens through the use of simulation devices. Through the feedback from the learning process, statistical analysis was used to assess the learning performance of students. The design studio used these two teaching methods, and the respective work was entered into an open design competition to verify whether teaching performance was successful. Approximately 70% of the works earned design awards. This provided a preliminary validation of the success of the respective teaching practice method.

AIMS: Hypertension (HTN) can lead to heart and kidney damage. The gut microbiota has been linked to HTN, although it is difficult to estimate its significance due to the variety of other features known to influence HTN. In the present study, we used germ-free (GF) and colonized (COL) littermate mice to quantify the impact of microbial colonization on organ damage in HTN. METHODS AND RESULTS: Four-week-old male GF C57BL/6J littermates were randomized to remain GF or receive microbial colonization. HTN was induced by subcutaneous infusion with angiotensin (Ang) II (1.44 mg/kg/d) and 1% NaCl in the drinking water; sham-treated mice served as control. Renal damage was exacerbated in GF mice, whereas cardiac damage was more comparable between COL and GF, suggesting that the kidney is more sensitive to microbial influence. Multivariate analysis revealed a larger effect of HTN in GF mice. Serum metabolomics demonstrated that the colonization status influences circulating metabolites relevant to HTN. Importantly, GF mice were deficient in anti-inflammatory fecal short-chain fatty acids (SCFA). Flow cytometry showed that the microbiome has an impact on the induction of anti-hypertensive myeloid-derived suppressor cells and pro-inflammatory Th17 cells in HTN. In vitro inducibility of Th17 cells was significantly higher for cells isolated from GF than conventionally raised mice. CONCLUSIONS: Microbial colonization status of mice had potent effects on their phenotypic response to a hypertensive stimulus, and the kidney is a highly microbiota-susceptible target organ in HTN. The magnitude of the pathogenic response in GF mice underscores the role of the microbiome in mediating inflammation in HTN. TRANSLATION PERSPECTIVE: To assess the potential of microbiota-targeted interventions to prevent organ damage in hypertension, an accurate quantification of microbial influence is necessary. We provide evidence that the development of hypertensive organ damage is dependent on colonization status and suggest that a healthy microbiota provides anti-hypertensive immune and metabolic signals to the host. In the absence of normal symbiotic host-microbiome interactions, hypertensive damage to the kidney in particular is exacerbated. We suggest that hypertensive patients experiencing perturbations to the microbiota, which are common in CVD, may be at a greater risk for target-organ damage than those with a healthy microbiome.

Marine lubricants’ ability of dispersing Heavy Fuel Oil (HFO) can be quantitatively observed and evaluated with an efficient and economic method: heating capillary video microscopy. Effects on HFO ...

Located in tropical and subtropical region, Taiwan is an island with high algal species diversity. In this study, a number of fungal strains were isolated from marine macroalgae collected from northeastern intertidal zone of Taiwan. Preliminary anti-inflammatory screening has shown that the methanolic extracts of solid fermented products of the red alga Mastophora rosea-derived fungal strain Acremonium sp. NTU492 exhibited significant bioactivity. In an attempt to disclose the active principles from this fungal strain, a series of separation and purification was thus undertaken, which has led to the isolation and characterization of seven compounds including four new peptides, namely acrepeptins A-D (1-4), along with previously reported destruxin B (5), guangomide A (6), and guangomide B (7). Their structures were elucidated by spectroscopic analysis and compared with literatures. Of these, acrepeptins A (1) and C (3) showed markedly inhibitory activities on nitric oxide production in lipopolysaccharide-activated microglial BV-2 cells with IC

The dissolution rate of nicotine in aqueous solutions of sodium chloride (NaCl) was investigated at room temperature and 70 °C by quantitatively visualizing the shrinkage rate of microscopic nicotine droplets. Four different salt concentrations were used: 15 wt % (3.0 M), 20 wt % (4.3 M), 25 wt % (5.7 M), and the saturation NaCl concentration of 26 wt % (6.0 M). These results, together with the Epstein-Plesset mathematical model, provided estimates of nicotine's diffusion coefficient in the NaCl solutions. At room temperature, the dissolution rate of nicotine and diffusion coefficients decreased with increasing NaCl concentration, and below 15 wt %, the dissolution kinetics were too fast to measure accurately via optical microscopy. At the higher temperature of 70 °C, nicotine's dissolution rate showed a decrease for 15 and 20% NaCl. However, at near-saturation 25% NaCl, nicotine's dissolution rate did not exhibit significant change for the two temperatures, and for 26%, dissolution was higher at 70 °C than at room temperature.

This investigation was designed to evaluate the healing response of 9.3-μm CO2 laser-assisted periodontal therapy. Five patients presenting with moderate to severe periodontitis, with an initial pocket depth (PD) ≥ 5 mm and with teeth predetermined to be surgically extracted, were enrolled and consented to treatment with full-mouth CO2 laser-assisted therapy. The laser treatment was carried out in the Ultraguide Mode at a setting of 0.25-mm spot size, with an average power of 0.65 to 1.15 watts and 20% mist. The laser tip was passed from the gingival margin and down apically to the base of the pocket with a sweeping L motion. The teeth were intensely scaled with piezoultrasonic instrumentation afterwards. A second pass of the laser tip was performed for the study teeth. At 9 months, all patients were clinically reevaluated. For sites with an initial pocket depth of ≥ 7 mm, a mean PD reduction of 3.97 ± 1.36 mm and a mean clinical attachment level gain of 3.54 ± 1.54 mm were achieved, resulting in a mean PD of 3.91 ± 0.77 mm. En bloc biopsy samples of four teeth were obtained and analyzed; two demonstrated histologic evidence of new bone formation while the other two healed with a long junctional epithelium with minimal inflammatory infiltrate. Further long-term clinical studies are needed to investigate the treatment stability obtained with a 9.3-μm CO2 laser compared to conventional surgical therapy. Nevertheless, the encouraging clinical results indicated that adjunctive use of the 9.3-μm CO2 laser-assisted periodontal therapy can be beneficial for treatment of periodontally compromised patients.

Selective inhibitors of gut bacterial β-glucuronidases (GUSs) are of particular interest in the prevention of xenobiotic-induced toxicities. This study reports the first structure-activity relationships on potency and selectivity of several iminocyclitols (2-7) for the GUSs. Complex structures of Ruminococcus gnavus GUS with 2-7 explained how charge, conformation, and substituent of iminocyclitols affect their potency and selectivity. N1 of uronic isofagomine (2) made strong electrostatic interactions with two catalytic glutamates of GUSs, resulting in the most potent inhibition (Ki ≥ 11 nM). C6-propyl analogue of 2 (6) displayed 700-fold selectivity for opportunistic bacterial GUSs (Ki = 74 nM for E. coli GUS and 51.8 μM for RgGUS). In comparison with 2, there was 200-fold enhancement in the selectivity, which was attributed to differential interactions between the propyl group and loop 5 residues of the GUSs. The results provide useful insights to develop potent and selective inhibitors for undesired GUSs.

Background/Aim: Casein kinase 1 epsilon (CK1ε) is a member of the casein kinase 1 family, which includes highly conserved and ubiquitous serine/threonine protein kinases. Recent research has revealed that CK1ε plays an important role in a variety of human cancer types; however, its role in human melanoma remains unclear. The aim of this study was to elucidate the clinical role of CK1ε in patients with melanoma. Patients and Methods: Samples from 34 patients with melanoma were analyzed by immunohistochemical staining. Formalin-fixed paraffin-embedded tissue microarrays were also examined by two histopathologists to assess CK1ε protein expression in humans. Results: Cytoplasmic CK1ε protein expression was significantly lower in tumor tissue than in normal tissue. Lack of cytoplasmic CK1ε protein was significantly correlated with distant metastasis (p=0.022) and poorer survival (p=0.030). However, Kaplan-Meier survival analysis revealed that elevated expression of cytoplasmic CK1ε protein was not significantly associated with the overall survival of patients with melanoma. Univariate and multivariate analyses demonstrated that lack of cytoplasmic CK1ε protein expression was related to distant metastasis (p

Background This study aimed to collect data regarding patient perception and knowledge of dental implants. It was conducted with the hope that the data would provide dental professionals and policymakers with a better understanding of ways to promote implant therapy. Methods An anonymous online survey with 10 questions was distributed through 12 dental offices in Tokyo and provincial cities in Japan to assess patient perception and knowledge of dental implants. Harvard Medical School’s IRB approved this study. Results We collected data from 1172 patients (59% female, 41% male). The most common perceptions of implant therapy were that it was “expensive,” “advanced,” and “scary”. Patients’ implant knowledge came primarily from magazines or books, while professional dental societies/associations were the least sought out source of information. Patients believed that the purpose of dental implants was to avoid dentures and improve chewing function. Their primary concerns about dental implants were the cost and longevity. Approximately 12% of patients with dental implants and 61% of patients without implants did not know that bone grafts may be required and that sedation during surgery was an option. For patients who experienced sedation during the procedure, 60% of them want it for future surgeries. Patients also had limited knowledge of bone-graft materials and the effects of CBCT radiation; 75% of the patients expressed concerns over the safety of graft materials and radiation exposure. For patients with a history of dental implant therapy, 80% of them would recommend dental implants to their family and friends. Conclusions Overall, patients’ experiences with dental implant therapy were positive, but there was a lack of patient education regarding dental implants and their associated procedures. Dental professionals need to take the initiative to improve patient education.

Endozoicomonas, a core bacterial group in corals, may also be a coral symbiont. Endozoicomonas communities often decrease rapidly in corals under heat stress. However, how the bacteria respond to changes in temperature and coral host during heat stress is unknown. Here, we employed the cultivable, dominant species E. montiporae as a working organism to explore how Endozoicomonas responds to heat stress. We designed two experiments to clarify the extent to which E. montiporae is influenced by temperature and coral host. We detected differentially expressed protein (DEP) profiles in this bacterium at 31°C and 33°C compared to 25°C by tandem mass tags-based quantitative proteome analysis. Fifty DEPs, including many heat shock proteins, were detected when the temperature changed. The expression of antioxidant defense proteins and key pyruvate synthase proteins decreased, suggesting that E. montiporae were in a physiology of stress at 33°C. Furthermore, some proteins were differentially expressed because of the heat-stress-treated coral lysate specifically, suggesting that not only heat but also heat-induced host factors can affect the protein expression of the bacterium. This study provides an in-depth analysis of how the molecular mechanisms of Endozoicomonas are affected by heat stress and coral host.