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This study aimed to investigate the correlation between rotator cuff stump classification and postoperative outcomes after superior capsular reconstruction (SCR). A total of 75 patients who underwent SCR between June 2013 and May 2021 were included in this study. Based on stump classification using the signal intensity ratio of the tendon rupture site to the deltoid muscle in the coronal view of preoperative T2-weighted, fat-suppressed magnetic resonance imaging scans, the patients were classified into types 1, 2, and 3 with ratios of <0.8, 0.8–1.3, and >1.3 (44, 17, and 14 patients, respectively). The American Shoulder and Elbow Surgeons (ASES), Constant, and visual analog scale (VAS) scores for pain and range of motion were evaluated at a minimum of 1 year of follow-up postoperatively. The acromiohumeral distance and rotator cuff arthropathy according to the Hamada classification were assessed on plain radiography. The graft integrity was evaluated by magnetic resonance imaging at 3 and 12 months postoperatively and annually thereafter. Clinical and radiological outcomes were significantly improved after SCR. In comparison with type 2 and 3 patients, type 1 patients had significantly higher ASES scores (type 1, 2, and 3 = 84 ± 10, 75 ± 15, and 76 ± 14; all P =.014), Constant scores (type 1, 2, and 3 = 65 ± 5, 61 ± 9, and 56 ± 13; all P =.005), and forward flexion (type 1, 2, and 3 = 155 ± 10, 154 ± 15, and 145 ± 13; all P =.013). However, these statistical differences between groups were below the established minimum clinically important difference values for the ASES and Constant scores after rotator cuff repair. The graft failure rate after surgery was lower in the type 1 group than that in the other 2 groups; however, the difference was not statistically significant (P =.749). Patients with stump classification type 1 showed significantly better functional scores (ASES and VAS scores) and forward flexion; however, the clinical importance of these differences may be limited. Stump classification may be useful for predicting postoperative clinical outcomes. [ABSTRACT FROM AUTHOR]

Hand hygiene reminders for healthcare workers (HCWs) are commonly used to empower patients. However, this approach overlooks the role of family carers in delivering direct contact care in Asian countries. Limited knowledge exists regarding empowerment strategies for patients and their family carers in infection prevention and control (IPC) recommendations. This study aimed to provide a comprehensive exploration of IPC empowerment within the context of family involvement in care provision across Bangladesh, Indonesia, and South Korea. In-depth interviews were conducted in 5 tertiary-level hospitals in Bangladesh, Indonesia, and South Korea. A total of 64 participants were interviewed through 57 interviews, including 6 group interviews, comprising 2 groups: (1) patients and their family and private carers; and (2) HCWs. The study identified barriers to engaging patients and family carers in IPC measures. These included concerns about the patient-HCW hierarchical relationship, lack of knowledge about healthcare-associated infection, IPC, and patient zone, perceptions of IPC as a barrier to family connections, and disempowerment of patients in IPC due to family bonds. This study provides diverse perspectives on IPC empowerment, revealing challenges faced by patients, family carers, and HCWs. The interlaced relationship established by social norms of family carer provision hinders the empowerment of family carers. Acknowledging the cultural influence on health care arrangements and its implication for IPC empowerment is crucial in mitigating these barriers. • Social norms of family care provision hinder infection prevention and control (IPC) empowerment. • Cultural impact on healthcare must be recognized to promote IPC. • Tailoring interventions to cultural contexts enhance IPC practices. [ABSTRACT FROM AUTHOR]

The bio-tar transformation was conducted utilizing Ni-based catalysts supported on mesoporous SBA-15 within a supercritical ethanol environment. This approach aimed to facilitate the synthesis of biofuels and/or value-added chemical compounds, including alkyl phenols and aromatics. The characterization of the catalysts was accomplished by X-ray diffraction (XRD), N 2 -sorption, temperature programmed reduction (TPR), Transmission electron microscope (TEM), and Fourier Transform Infrared (FT-IR) techniques. Among the examined catalysts, namely SBA-15, Ni/SBA-15, Ni–Mo/SBA-15, and Mg–Ni–Mo/SBA-15, Mg–Ni–Mo/SBA-15 emerged as the catalyst demonstrating the most pronounced activity for the hydrodeoxygenation (HDO) of bio-tar to produce high-quality liquid products (Total Acid Number (TAN): 3.4 mgKOHg−1, oxygen content: 11.0 wt%, Higher heating value (HHV): 36.7 MJkg−1). The effect of reaction temperature (275–350 °C) and time (0–120 min) on the upgrading of bio-tar over Mg–Ni–Mo/SBA-15 was investigated in a one-pot process. The acids, aldehydes, and oxygenated phenols underwent complete conversion into chemically more stable compounds such as aromatics and alkyl phenols at 325 °C for a 120 min holding time. In particular, the oxygenated phenols found in the bio-tar underwent a complete transformation into alkyl phenols within the liquid products. [Display omitted] • Alkyl phenols were produced through the upgrading of bio-tar over Ni-based catalysts. • Mg–Ni–Mo/SBA-15 displayed superior hydrodeoxygenation and ring-alkylation activity. • High-quality biofuel with TAN 3.4 mgKOH/g, oxygen 11.0 wt%, HHV 36.7 MJ/kg was obtained. • A complete conversion of oxygenated phenolics was achieved at 325 °C for 120 min. [ABSTRACT FROM AUTHOR]

Arginine methylation is a posttranslational modification mediated by protein arginine methyltransferases (PRMTs). Although previous studies have shown that PRMT1 contributes to the severity of allergic airway inflammation or asthma, the underlying mechanism is poorly understood. This study aimed to explore the role of PRMT1 and its relevant mechanism in the development of allergic rhinitis (AR). The expression levels of PRMTs and cytokines were determined by RT-PCR, and the localization of PRMT1 was determined by immunohistochemistry and confocal microscopy. The levels of house dust mite (HDM)-specific immunoglobulins in serum and of cytokines in nasal lavage fluids were determined by ELISA. PRMT1 inhibition was achieved by siRNA and treatment with the pan PRMT inhibitor arginine N -methyltransferase inhibitor-1. PRMT1 expression was significantly increased in the nasal mucosa of patients and mice with AR. The degree of eosinophilic infiltration in the nasal mucosa was reduced in PRMT1 +/− AR mice compared with wild-type mice. PRMT1 haploinsufficiency reduced the levels of HDM-specific immunoglobulins in serum and those of T H 2 (IL-4, IL-5, and IL-13) and epithelial (thymic stromal lymphopoietin [TSLP], IL-25, and IL-33) cytokines in the nasal lavage fluids of AR mice. In nasal epithelial cells, HDM and IL-4 cooperate to enhance PRMT1 expression through a mitogen-activated protein kinase–dependent pathway. In addition, PRMT1 was essential for the production of TSLP, IL-25, and IL-33 in response to HDM and IL-4. Arginine N -methyltransferase inhibitor-1 treatment alleviated AR in the mouse model. PRMT1 plays an important role in AR development by regulating epithelial-derived cytokine production and might be a new therapeutic target for AR. [Display omitted] [ABSTRACT FROM AUTHOR]

[Display omitted] • Orange peels was liquefied in sub/supercritical environments without N 2 supply. • The synergetic effects of process parameters promote biocrude's quality and yield. • Biocrude HHV of 38.1 MJ/kg was obtained at 50% ethanol, 430 °C and 35 min. • Biocrude' volatility and molecular weight depends on process variables. • Orange peels is an excellent bioresource material for biocrude production. The efficient valorization of biomass for energy-derived biocrudes is essential for effective waste management. However, the production of biocrudes with high energy and reduced oxygen contents during the liquefaction process requires further insight. Therefore, the impact of reaction temperature, residence time, and ethanol: acetone on the energy compositions and bioproduct's yield enhancement were investigated. The biocrudes obtained were characterized using elemental analysis, GC–MS, FTIR, GPC and TGA to understand the effects of process parameters on the biocrudes' compositions. An improved HHV (38.18 MJ/kg) and lower O/C ratio (0.11) were obtained at 430 °C, 35 min and 50% ethanol with a significant improvement in the enhancement factor, deoxygenation, and percentage hydrogenation of 2.63, 36.88%, and 77.87%, respectively. The presence of ketones, hydrocarbons, phenolics and aromatics of 23.74, 4.28, 37.20 and 17.81% respectively indicate the potential of the obtained biocrude as renewable energy sources upon further upgrading. [ABSTRACT FROM AUTHOR]

The feasibility of potassium hydroxide for simultaneous removal of chlorophyll during solvent extraction from wet microalgae (200 g/L) was evaluated. Extracted oil was converted to biodiesel by ZSM-5-based heterogeneous catalysts. The total oil (fatty acid-based) content of Nannochlorposis oceanica cultivated in open raceway ponds was 19.5%. The oil recovery yields from dry and wet microalgae using hexane were 44.4 and 11.8%, respectively, whereas using a hexane-methanol mixture were increased to 79.3 and 74.8%, respectively. For the heterogeneous transesterification of microalgal oil extracted by the hexane-methanol mixture from wet microalgae, the fatty acid methyl ester (FAME) contents were 2.3, 48.3, and 4.7% of product recovered after reaction for ZSM-5, Na/ZSM-5, and SO 4 2−/ZSM-5, respectively; by the potassium hydroxide-assisted process, the corresponding FAME contents were increased to 21.9, 86.2, and 86.0%, respectively, due to improvement of the oil properties by the decrease of the chlorophyll content. Through the addition of potassium hydroxide, chlorophyll was effectively removed from oil, and eventually, the biodiesel conversion was sharply increased with heterogeneous Na/ZSM-5 and SO 4 2−/ZSM-5 catalysts. Image 1 • Enhancement of extraction efficiency from wet microalgae by hexane-methanol mixture. • Removal of chlorophyll from N. oceanica by KOH-assisted hexane-methanol extraction. • Conversion of microalgal oil to biodiesel by Na/ZSM-5 and SO 4 2−/ZSM-5 catalysts. • Enhancement of heterogeneous transesterification by chlorophyll removal from oil. • Successful application of heterogeneous catalysts for microalgal biodiesel production. [ABSTRACT FROM AUTHOR]

The continuous delivery of volumetric modulated arc therapy (VMAT) plans is usually approximated by discrete apertures at evenly-spaced gantry angles for dose calculation purposes. This approximation can potentially lead to large dose calculation errors if the gantry angle spacings are large and/or there are large changes in the MLC apertures from one control point (CP) to the next. In this work, we developed a sliding-window (SW) method to improve VMAT dose calculation accuracy. For any 2 adjacent VMAT CPs ni and ni + 1, the dose distribution was approximated by a 2-CP SW IMRT beam with the starting MLC positions at CP ni and ending MLC positions at CP ni + 1, with the gantry angle fixed in the middle of the 2 VMAT CPs. Therefore, a VMAT beam with N CPs was approximated by a SW plan with N-1 SW beams. To validate the method, VMAT plans were generated for 10 patients in Pinnacle using 4° gantry spacing. Each plan was converted to a SW plan and dose was recalculated. Another VMAT plan, with 1° gantry spacing, was created by interpolating the original VMAT beam. The original plans were delivered on an Elekta Versa HD and measured with ArcCHECK. For both the isodose distribution and DVH, there were significant differences between the original VMAT plan and either the SW or the interpolated plan. However, they were indistinguishable between the SW and the interpolated plans. When compared with measurement, the average passing rates of the original VMAT plans were 87.3 ± 2.8% and 93.1 ± 1.0% for the 5 HN and 5 spine SBRT cases, respectively. On the other hand, the passing rates for both the VMAT1 and SW plans were above 95% for all the 10 cases studied. The dose calculation times of the original VMAT plans and the SW plans were very similar. We conclude that the proposed SW approach improves VMAT dose calculation accuracy without increase in dose calculation time. [ABSTRACT FROM AUTHOR]

• Only 6 acknowledged the provision of care to hospitalised patients by family members. • Only 1 advised the same level of IPC training as HCW for family members who provide inpatient care. • No IPC policies and guidelines from target countries note the involvement of family members. Although familial involvement during inpatient care is not uncommon in western countries, the types of caring activities that family members in Asian countries provide are significantly different. These activities may place the family member at risk from a health care–associated infection. This study aimed to examine whether the role of patients' families has been accounted for in the infection prevention and control (IPC) guidelines and policy, using examples from Bangladesh (low-income country), Indonesia (middle-income country), and South Korea (high-income country). The World Health Organization website and Institutional Repository for Information Sharing, Centers for Disease Control and Prevention website, Australian Government Web Archive, Open Grey, Grey Matters, World Bank, and advanced Google search, as well as the Health Department/Ministry of Health websites for each target country and 4 western countries (Australia, Canada, England, and the United States) were searched. Other databases, such as Embase, Medline, CINAHL, Global Health, ProQuest databases, Google scholar, Web of Science, and Scopus were also searched. This was to review the reflection of the cultural influence in IPC policies/guidelines by reviewing those from the global organizations, which are often used as a blueprint for policy development, as well as those from western countries, which hold different cultures in care arrangement. Search was conducted with attention to the key areas: definition and role of carer in the acute health care facility, involvement of patients/family members in IPC activities, patient and family member hand hygiene, and IPC education. Ninety-two articles were identified based on the criteria for the study. Only 6 acknowledged that care is provided to hospitalized patients by their family members, and only 1 recommended that family members receive the same level of training as health care workers on IPC precautions. Other guides recommended the provision of information on IPC measures as means of patient involvement in the IPC program. Recognition of family caregivers or inclusion of them in the IPC strategies was not included in the target countries' guidelines. Although health care workers are the primary actors when it comes to providing care in acute health care settings, it is important to expand the IPC guides by considering the role of other caregivers. Policies and guidelines should reflect the cultural influence over healthcare. This is especially true when cultural values strongly influence over healthcare arrangements and the healthcare accommodates these cultural influences in the practice. Further work needs to be undertaken on the level of training/education provided to family members in Bangladesh, Indonesia, and South Korea. [ABSTRACT FROM AUTHOR]

Abstract Three homoisoflavonoids and one dimethoxychalcone from Portulaca oleracea L. were isolated using bioassay-guided fractionation and HPLC. Among the compounds 1 – 4 , (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone (compound 3) had the most effect on glucose uptake in the adipocytes. We investigated how (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone contributed to increase glucose uptake in 3T3-L1 adipocytes. Levels of the glucose transporters GLUT-4, as well as glucose uptake, and key proteins of the insulin pathway, namely PI3K/AKT and AMPK pathway are analyzed using glucose uptake assay and western blot analysis. Our results show that (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone significantly increased glucose uptake by stimulating translocation of GLUT4 to the plasma membrane in 3T3-L1 adipocytes. High levels of expression of GLUT4 in the plasma membrane resulted from IRS-1 phosphorylation, PI3K activation, Akt phosphorylation and phosphorylation of AMPK, resulting in increased glucose uptake by the cells. The increase in glucose uptake due to (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone was significantly inhibited by the PI3K inhibitor and the AMPK inhibitor in 3T3-L1 adipocytes. These findings suggest that (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone may increase glucose uptake by stimulating GLUT4 translocation to the plasma membrane via activating the PI3K/Akt and AMPK pathways in 3T3-L1 adipocytes. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to evaluate the surgical outcomes of laparoscopic proximal gastrectomy (LPG) reconstructed by the double-tract method in comparison to those of laparoscopic total gastrectomy (LTG). Methods A retrospective review of the prospectively established database identified early gastric cancer patients who underwent LPG (n = 34) or LTG (n = 46) between January 2011 and December 2015. Baseline characteristics and surgical outcomes including postoperative complications, changes in body composition, nutritional status, and quality of life (QOL) after surgery were compared between the LPG and LTG patients. Results Operating time was significantly longer in the LTG group (240.7 ± 43.9 vs. 211.7 ± 32.8 min, p = 0.007). The incidence of grade II or more complications and the hospital stay were comparable between the groups. There was no significant difference between the groups in terms of body composition using a bioelectrical impedance method in 1 year postoperatively. Nutritional status assessed by serum hemoglobin, iron, vitamin B12, albumin, total protein, and total cholesterol levels and postoperative changes in quality of life up to 2 years after surgery were also similar between the groups. Vitamin B12 supplementation was required in 75.4% of the patients in the LTG group and 46.5% in the LPG group within 2 years after surgery (p = 0.005). Conclusion LPG with double-tract reconstruction appears superior in preventing vitamin B12 deficiency compared to LTG, particularly after 1 year after the surgery, although it offered little benefit in terms of postoperative body composition changes and QOL. [ABSTRACT FROM AUTHOR]

Highlights • Anthracosilicosis can mimic extensive node metastasis from gastric cancer. • The PET-CT scan is not specific enough to detect metastatic lymph nodes precisely. • Surgical exploration should be considered when the result of imaging studies is doubtful. Abstract Introduction Lymph node metastasis is one of the most important prognostic factors in gastric cancer and precise assessment of nodal status facilitates optimal therapeutic decisions. Many diagnostic modalities including endoscopic ultrasound (EUS), computed tomography (CT), and sometimes, positron emission tomography (PET) have been utilized to improve diagnostic accuracy in detecting metastatic lymph nodes; however, their accuracy remains unsatisfactory. Presentation of case We report a case of a 73-year old male patient who was erroneously diagnosed with stage IV gastric cancer due to the distant nodal metastasis from early gastric cancer lesion during the initial staging process. However, surgical exploration revealed an anthracosilicosis-associated lymphadenopathy that mimicked extensive distant nodal metastasis in the preoperative CT and PET-CT scans. The patient was finally diagnosed with stage I gastric cancer confined to the mucosa without nodal metastasis. Discussion We report a rare case of gastric cancer concurrent extensive nodal involvement of anthracosilicosis mimicking metastatic nodal disease in the imaging studies. This case implies that PET-CT scan for clinical staging is not specific enough to clearly delineate malignant lesions, causing a diagnostic dilemma. Conclusion When the characteristics of the primary tumor is poorly correlated to the findings of imaging studies, surgical exploration can be a viable option for a definitive diagnosis before making a hasty decision based only upon the diagnostic imaging results. [ABSTRACT FROM AUTHOR]

Abstract Purpose To investigate the factors affecting detectability of invasive breast cancers on BSGI. Material and methods We evaluated BSGI, mammography and pathologic reports of 89 patients with invasive breast cancers. Results 87.6% were visible on BSGI. Cancer in old or postmenopausal women were more visible on BSGI (p = 0.003, 0.046). Cancers ≥ 1.0 cm in size were significantly more visible on BSGI than those <1 cm in size (p = 0.002). Cancers in fatty breasts were more visible than those in dense breasts (p = 0.042). Conclusion Invasive cancers in older, postmenopausal patients, cancers with size ≥1.0 cm, and those with fatty breast are better visualized by BSGI, than those in younger, premenopausal patients, with size <1.0 cm and dense breast. Highlights • BSGI has a high sensitivity for detecting breast cancer. • BSGI of breast cancer can be affected by several clinical or pathologic factors. • Invasive cancers in older or postmenopausal patients are better visualized by BSGI. • Cancers with size ≥1.0 cm and with fatty breast density are more visible on BSGI. [ABSTRACT FROM AUTHOR]

Most ingested foreign bodies do not cause serious complications. In rare cases, elderly people with cognitive decline may unintentionally swallow a blister pack while trying to take medicine. When a blister pack is separated into individual parts, the separated parts have sharp edges that can cause serious damage if ingested. We report a case of an elderly patient who unintentionally ingested a blister pack, which led to esophageal perforation and ultimately his death. [ABSTRACT FROM AUTHOR]

Wearable technology has recently started gaining mass market attention, but the actual adoption of the technology is not up to expectations. The current study examines the effects of consumers’ domain-specific innovativeness (DSI) on the adoption of wearable technology. In this study, consumer DSI is first conceptualized to have two dimensions namely, product-possessing innovativeness (PPI) and information-possessing innovativeness (IPI). The effects of PPI and IPI on perceived attributes of wearable technology (relative advantage, social image, aesthetics, and novelty) are then examined, which influence purchase intention. Exploratory and confirmatory factor analyses were conducted on a survey data from young consumers. Structural equation modeling was employed to evaluate the proposed research model. Results demonstrate that 1) the DSI construct must be examined in the two dimensions so that it can properly measure the nature and characteristics of DSI, 2) IPI plays an important role, having a positive effect on all four perceived attributes of IT innovations, 3) PPI has a positive effect on perceived social image and perceived novelty, and finally 4) all perceived attributes of IT innovations have a positive effect on consumers’ purchase intention of wearable devices. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

A new modified Red-Al reagent prepared from commercially available 1,1,1,3,3,3-hexamethyldisilazane and sodium bis(2-methoxyethoxy)aluminumhydride (Red-Al) is reported for the selective reduction of carbonyl compounds containing representative functional groups. Moreover, this novel reagent is superior for the chemoselective reduction of aldehydes and ketones to the corresponding alcohols in excellent yields under mild reaction conditions. Moreover, aldehydes can be reduced selectively in the presence of ketones with similar reactivity. [ABSTRACT FROM AUTHOR]

Progesterone (P4), acting through its nuclear receptor (PGR), plays an essential role in ovulation by mediating the expression of genes involved in ovulation and/or luteal formation. To identify ovulatory specific PGR-regulated genes, a preliminary microarray analysis was performed using rat granulosa cells treated with hCG ± RU486 (PGR antagonist). The transcript most highly down-regulated by RU486 was an EST (expressed sequence tag) sequence (gb: BI289578.1) that matches with predicted sequence for Xlr5c-like mRNA. Since nothing is known about Xlr5c-like , we first characterized the expression pattern of Xlr5c-like mRNA in the rat ovary. The level of mRNA for Xlr5c-like is transiently up-regulated in granulosa cells of periovulatory follicles after hCG stimulation in PMSG-primed rat ovaries. The transient induction of Xlr5c-like mRNA was mimicked by hCG treatment in cultured granulosa cells from preovulatory ovaries. We further demonstrated that the LH-activated PKA, MEK, PI3K, and p38 signaling is involved in the increase in Xlr5c-like mRNA. The increase in Xlr5c-like mRNA was abolished by RU486. The inhibitory effect of RU486 was reversed by MPA (synthetic progestin), but not by dexamethasone (synthetic glucocorticoid). Furthermore, mutation of SP1/SP3 and PGR response element sites in the promoter region of Xlr5c-like decreased Xlr5c-like reporter activity. RU486 also inhibited Xlr5c-like reporter activity. ChIP assay verified the binding of PGR and SP3 to the Xlr5c-like promoter in periovulatory granulosa cells. Functionally, siRNA-mediated Xlr5c-like knockdown in granulosa cell cultures resulted in reduced levels of mRNA for Snap25 , Cxcr4 , and Adamts1 . Recombinant Xlr5c-like protein expressed using an adenoviral approach was localized predominantly to the nucleus and to a lesser extent to the cytoplasm of rat granulosa cells. In conclusion, this is the first report showing the spatiotemporally regulated expression of Xlr5c-like mRNA by hCG in rat periovulatory ovaries. P4/PGR mediates the LH-induced increase in Xlr5c-like mRNA. In turn, Xlr5c-like is involved in regulating the expression of specific ovulatory genes such as Snap25 , Cxcr4 , and Adamts1 , possibly acting in the nucleus of periovulatory granulosa cells. [ABSTRACT FROM AUTHOR]