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Background Hepatitis B virus (HBV) causes chronic hepatitis B (CHB), liver cirrhosis, and hepatocellular carcinoma. The evolution of human gut microbiota during the progression of HBV-related liver diseases remains unclear. Therefore, we prospectively enrolled patients with HBV-related liver diseases and healthy individuals. Through 16S ribosomal RNA amplicon sequencing, we characterized the gut microbiota of the participants and predicted the functions of microbial communities. Results We analyzed the gut microbiota of 56 healthy controls and 106 patients with HBV-related liver disease [14 with resolved HBV infection, 58 with CHB, and 34 with advanced liver disease (15 with liver cirrhosis and 19 with hepatocellular carcinoma)]. Patients with HBV-related liver disease exhibited a higher degree of bacterial richness (all P P P Conclusions The diversity and composition of gut microbiota appear to vary significantly between healthy controls and patients at different stages of HBV-related liver disease. The understanding of gut microbiota may provide novel therapeutic options in these patients.

Objectives This study investigated the progression of pubofemoral distance (PFD) with age and assessed the correlation between PFD and late acetabular index (AI) measurements. Methods This prospective observational study was conducted between January 2017 and December 2021. We enrolled 223 newborns who underwent the first, second, and third hip ultrasounds, and pelvis radiograph at a mean age of 18.6 days, 3.1 months, 5.2 months, and 6.8 months, respectively. The difference between PFD measured at serial ultrasounds and the correlation with AI were analyzed. Results The PFD increased significantly (p p Conclusion The PFD naturally progresses with age and is positively correlated with AI. The PFD has potential for predicting residual dysplasia. However, the cutoff for abnormal PFD values may require adjustment according to the patient’s age. Key Points • The pubofemoral distance measured in hip ultrasonography naturally increases as the infant’s hips mature. • The early pubofemoral distance demonstrates a positive correlation with late acetabular index measurements. • The pubofemoral distance may help physicians predict abnormal acetabular index. However, the cutoff for abnormal pubofemoral distance values may require adjustment according to patient’s age.

The 2,3,7,8-tetrachlorodibenzodioxin (TCDD), a contaminant in Agent Orange released during the US-Vietnam War, led to a severe environmental crisis. Approximately, 50 years have passed since the end of this war, and vegetation has gradually recovered from the pollution. Soil bacterial communities were investigated by 16S metagenomics in habitats with different vegetation physiognomies in Central Vietnam, namely, forests (S0), barren land (S1), grassland (S2), and developing woods (S3). Vegetation complexity was negatively associated with TCDD concentrations, revealing the reasoning behind the utilization of vegetation physiognomy as an indicator for ecological succession along the gradient of pollutants. Stark changes in bacterial composition were detected between S0 and S1, with an increase in Firmicutes and a decrease in Acidobacteria and Bacteroidetes. Notably, dioxin digesters Arthrobacter, Rhodococcus, Comamonadaceae, and Bacialles were detected in highly contaminated soil (S1). Along the TCDD gradients, following the dioxin decay from S1 to S2, the abundance of Firmicutes and Actinobacteria decreased, while that of Acidobacteria increased; slight changes occurred at the phylum level from S2 to S3. Although metagenomics analyses disclosed a trend toward bacterial communities before contamination with vegetation recovery, non-metric multidimensional scaling analysis unveiled a new trajectory deviating from the native state. Recovery of the bacterial community may have been hindered, as indicated by lower bacterial diversity in S3 compared to S0 due to a significant loss of bacterial taxa and recruitment of fewer colonizers. The results indicate that dioxins significantly altered the soil microbiomes into a state of disorder with a deviating trajectory in restoration.

Background Several cross-sectional studies have reported risk factors for metabolic syndrome (MetS). However, these studies did not focus on sex differences in middle-aged and senior populations or employ a longitudinal design. These study design differences are important, as there are sex differences in lifestyle habits associated with MetS, and middle-aged and senior individuals have increased MetS susceptibility. Therefore, the purpose of this study was to examine whether sex differences influenced MetS risk over a ten-year follow-up period among middle-aged and senior hospital employees. Methods This population-based and prospective cohort study enrolled 565 participants who did not have MetS in 2012 for a ten-year repeated-measurement analysis. Data were retrieved from the hospital’s Health Management Information System. Analyses included Student’s t tests, χ2 tests and Cox regression. P Results Male middle-aged and senior hospital employees had an elevated MetS risk (hazard ratio (HR) = 1.936, p Conclusions The longitudinal design of our study improves the understanding of sex differences in MetS risk factors in middle-aged and senior adults. A significantly elevated risk of MetS over the ten-year follow-up period was associated with male sex, shift work, the number of chronic diseases, the number of family history risk factors, and betel nut chewing. Women who chewed betel nuts had an especially increased risk of MetS. Our study indicates that population-specific studies are important for the identification of subgroups susceptible to MetS and for the implementation of hospital-based strategies.

Background Autophagy is a catabolic process that recycles damaged organelles and acts as a pro-survival mechanism, but little is known about autophagy dysfunction and epigenetic regulation in patients with obstructive sleep apnea (OSA). Methods Protein/gene expressions and DNA methylation levels of the autophagy-related genes (ATG) were examined in blood leukocytes from 64 patients with treatment-naïve OSA and 24 subjects with primary snoring (PS). Results LC3B protein expression of blood monocytes, and ATG5 protein expression of blood neutrophils were decreased in OSA patients versus PS subjects, while p62 protein expression of cytotoxic T cell was increased, particularly in those with nocturia. ATG5, ULK1, and BECN1 gene expressions of peripheral blood mononuclear cells were decreased in OSA patients versus PS subjects. LC3B gene promoter regions were hypermethylated in OSA patients, particularly in those with excessive daytime sleepiness, while ATG5 gene promoter regions were hypermethylated in those with morning headache or memory impairment. LC3B protein expression of blood monocytes and DNA methylation levels of the LC3B gene promoter region were negatively and positively correlated with apnea hyponea index, respectively. In vitro intermittent hypoxia with re-oxygenation exposure to human THP-1/HUVEC cell lines resulted in LC3B/ATG5/ULK1/BECN1 down-regulations and p62 up-regulation along with increased apoptosis and oxidative stress, while rapamycin and umbilical cord-mesenchymal stem cell treatment reversed these abnormalities through de-methylation of the ATG5 gene promoter. Conclusions Impaired autophagy activity in OSA patients was regulated by aberrant DNA methylation, correlated with clinical phenotypes, and contributed to increased cell apoptosis and oxidative stress. Autophagy enhancers may be novel therapeutics for OSA-related neurocognitive dysfunction.

Background Enterobius vermicularis (pinworm) is a common intestinal parasitic infection in children. A gradual decrease in the prevalence of pinworm infection has been noted in resource-rich settings, such as Taiwan. However, the influence of sociodemographic factors on the temporal trend in pinworm infection rates in children under the current pinworm infection prevention policy in Taiwan is not well characterized. This study aimed to evaluate the trend of pinworm infection prevalence and the associated factors among children in Hualien County, Taiwan. Methodology In this retrospective cross-sectional study, we included a total of 56,197 students (aged 6–10 years) in grades 1 and 4 in Hualien in 2009–2018. Children were screened for pinworm infection using adhesive cellophane perianal swabs in the routine student health examination. Logistic regression was conducted to evaluate the factors associated with pinworm infection. Associations between dependent and independent variables were measured by odds ratios. The Cochran–Armitage test was used to assess whether there were significant trends in different stratifications. Variables with P-values Results A total of 56,197 school-age children from grades 1 and 4 during 2009–2018 were included. Young age and male sex were risk factors for pinworm infection (P enterobiasis was observed, and decreased pinworm infection was noted during the study reference period. Children living in suburban and rural areas had higher odds of having a pinworm infection than those living in urban areas (P P P = 0.953), and it was higher than that in urban and suburban areas. Conclusions The overall prevalence of pinworm infection gradually decreased from 2009 to 2018 among school-age children in Hualien. However, there was no declining trend in pinworm infection in rural areas. Young age, male sex, and rural residence were significantly associated with pinworm infection. Pinworm infection remains a major public health concern among children in rural areas of Hualien.

Precision nitrogen fertilizer application depends on accurate estimation of plant nitrogen content. However, the assessment of plant nitrogen content at early growth stages of paddy rice through remote sensed images is complicated by the compound effects of backgrounds (e.g. flood water, bare soil, algae, etc.) on the band reflectance. The rapid changing of plant nitrogen content during the vegetative phase makes the development of an operational prediction model very difficult. In this study, aerial images acquired by a quadcopter unmanned aerial vehicle (UAV) equipped with a multispectral sensor were used to estimate plant nitrogen content at vegetative phase of rice crops. The experiments were conducted at the experimental farm of Taiwan Agricultural Research Institute (TARI) from 2018 to 2020. A variable, N-index (ratio between N content of plants to be evaluated and plants not receiving N fertilizers), was introduced to resolve the issues related to rapid changing of plant N content during the vegetative phase. After removing the interference on band reflectance by background from the aerial images, the most appropriate vegetation indices and period that can capture the variations of N-index of rice plants were identified. It was found that a normalized difference red edge index (NDRI) and red edge chlorophyll index (RECI) based model correlated well with the N-index values from c.a. 30 days after transplanting (DAT) to 55 DAT (i.e., the most crucial period for rice yield and grain quality). The developed model was then used to display the spatial and temporal heterogeneity in plant nitrogen status within an experimental field as an example to illustrate how to use the model. In the example, soil plant analysis development (SPAD) meter values at locations of various levels of estimated N-index were collected as surrogates of plant nitrogen content at various DATs to build relationships for converting N-index maps to SPAD maps for potential variable rate fertilizer application management.

We sought to investigate whether preoperative dual-phase 2-[18F]FDG PET-CT identify predictors for poor survival in patients with ampullary carcinoma receiving pancreaticoduodenectomy. The preoperative PET-CT images of patients with resected ampullary carcinoma from June 2007 to July 2017 were analyzed. Survival curves were analyzed using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazard model was used to identify potential prognostic factors associated with disease-free survival (DFS) and overall survival (OS). Fifty-four subjects (26 men, 28 women) were enrolled with a median tumor size of 20 mm. All patients were followed for a median period of 36.9 months with 3- and 5-year DFS of 50.3% and 44.2%, and OS of 77.0% and 68.2%, respectively. Parameters associated with DFS in multivariate analysis were lymphovascular invasion (hazard ratio [HR]: 9.45, p < 0.001), involved margin in pathology (HR: 7.67, p < 0.001), and tumor retention index (RI) from the dual-phase PET (HR: 2.41, p = 0.03), whereas involved margin (HR: 13.14, p < 0.001), post-recurrence chemotherapy (HR: 0.10, p < 0.001), and metabolic tumor volume (MTV) (HR: 4.62, p = 0.009) emerged as independent prognostic factors for OS. Preoperative 2-[18F]FDG PET-CT offered independent prognostic biomarkers in patients with ampullary carcinoma receiving standard surgical resection. • 2-[ 18 F]FDG PET-CT offers good survival prediction before operation in primary malignant neoplasms at ampulla of Vater. • Dual-phase PET scan with bowel distention can better delineate Ampulla of Vater and characterize tumor physiology. • Preoperative risk stratification might aid in better treatment planning.

Incense is an indispensable material with religion and life in Asia. It is also a bridge of cultural expression and inheritance. Because the operating environment concentration of dust generated during the production process is considerable, most of the research pertaining to the hazard of incense factories has investigated air pollution, such as PM2.5, PM10, and VOCs. However, the production of incense causes dust dispersion, high temperature from ovens, and static electricity generated by friction. It can all possibly lead a dust explosion. To prevent and alleviate hazard from re-occurring, we used sandalwood dust at an incense factory in Taiwan, measured the effect of moisture content on the explosion parameters under normal conditions by 20-L apparatus, and used the oven to diminish its moisture content to 0%, 10.0%, and 15.0% as a control group to analyze the explosion characteristics at the different moisture contents, such as maximum explosion pressure and explosion limit. The results showed that the minimum ignition energy of dry dust was 30 mJ. Beyond doubt, incense factories face potential explosion hazards. The above results could be evaluated by the most dangerous range to avoid incense dust in this range at the workplace, lessening hazards caused by a dust explosion. The effect of moisture content on the suppression of the dust explosion was explored.

When a survey study is related to sensitive issues such as political orientation, sexual orientation, and income, respondents may not be willing to reply truthfully, which leads to bias results. To protect the respondents’ privacy and improve their willingness to provide true answers, Warner (J Am Stat Assoc 60:63–69, 1965) proposed the randomized response (RR) technique in which respondents select a question by means of a random device in order to ensure that they maintain privacy. Huang (Stat Neerl 58:75–82, 2004) extended the RR design of Warner (1965) to propose a two-stage RR design. Not only can this method be used to estimate the population proportion of persons with a sensitive characteristic, but also estimate the honest answer rate in the first stage. This work develops a covariate extension of the two-stage RR design of Huang (2004) by applying logistic regression to investigate the effects of covariates on a sensitive characteristic and an honest response. Simulation experiments are conducted to study the finite-sample performance of the maximum likelihood estimators of the logistic regression parameters. The proposed methodology is applied to analyze the survey data of sexuality of freshmen at Feng Chia University in Taiwan in 2016.

Background This study investigated the association between early Graf classification and femoral head coverage (FHC) with the acetabular index (AI) at the age of 6 months. Methods A prospective observational study was conducted between 2017–2018. Patients requiring Pavlik harness treatment and patients with syndromic dislocation or neurogenic dislocation were excluded. In total, 169 newborns with the first ultrasound performed at the mean age of 12.3 (0–15) days, the second ultrasound performed at the mean age of 3.2 (2.5–4.1) months, and the AI measured at the age of 6.6 (4.3–7.1) months were enrolled. The correlation between the AI and first and second alpha angles and FHC measurements, and the correlation of dysplasia in early ultrasound with dysplasia in the AI were analyzed. Results At the first ultrasound, only the FHC (P = .02) demonstrated a significant negative correlation with the AI. At the second ultrasound, both the alpha angle (P P Conclusions FHC and alpha angle exhibited significant negative correlations with the AI at six months, both ultrasound parameters may have the potential to predict AI in DDH screening. Compared to the ultrasound measurements taken at 2 weeks, Graf and FHC at 3 months demonstrated superior sensitivity, specificity, PPV, and NPV to detect abnormal AI. The best timing to perform ultrasound examination may need further research.

Acute upper gastrointestinal bleeding (UGIB) in acute coronary syndrome (ACS) patients are not uncommon, particularly under dual antiplatelet therapy (DAPT). The efficiency and safety of early endoscopy (EE) for UGIB in these patients needs to be elucidated. This multicenter randomized controlled trial randomized recent ACS patients presenting acute UGIB to non-EE and EE groups. All eligible patients received intravenous proton pump inhibitor therapy. Those in EE group underwent therapeutic endoscopy within 24 h after bleeding. The data regarding efficacy and safety of EE were analyzed. It was early terminated because the UGIB rate was lower than expected and interim analysis was done. In total, 43 patients were randomized to non-EE (21 patients) and EE (22 patients) groups. The failure rate of control hemorrhage (intention-to-treat [ITT] 4.55% vs. 23.81%, p

In this study, energy harvesting devices using Wiegand-effect transducer is investigated through integration with linear positioning measurement system. With the device, energy can be harvested due to the changes of magnetic polarities from linear position measurement system. Using numerical finite element method, the energy harvesting module is parametrically investigated to offer the optimal design in the magnetic guide that directs the dynamic magnetic field into the Wiegand transducer. From experiments, the influence of parameters such as geometry, speed and gap size has been validated to offer optimal design composition to provide the highest energy output from the system.

Despite evidence that breast cancer screening effectively diagnoses and treats cancer through early detection, mammography use remains low in Taiwan. We applied the health belief model (HBM) and the knowledge-attitude-behavior (KAB) model as theoretical frameworks to examine factors associated with mammography uptake among women aged 45-69 years in Taiwan. A cross-sectional survey January-July 2018 was conducted of women aged 45-69 years in five southern Taiwan health institutions. Survey questionnaires included demographics, HBM constructs, and health knowledge regarding breast cancer and screening. Multivariable logistic regression models explored the mediation effects of HBM constructs between health knowledge and mammography use. The final analytical sample included 621 women; 67 did not receive mammography and 554 received mammography. When the regression model was adjusted only for demographic factors, women with adequate health knowledge were more likely to undergo mammography (AOR = 2.321, 95%CI = 1.141-3.809); in regression models including health knowledge and HBM constructs, the likelihood effect of health knowledge declined and became insignificant (AOR = 1.711, 95%CI = 0.985-2.972), indicating potential mediation effects between health knowledge and up-to-date mammography use. Overall, based on the HBM and the KAB theoretical framework, our data support that health belief played a substantial mediating role in the association between health knowledge and mammography uptake, in particular perceived barriers and cues to action in the HBM, which were modifying factors of health beliefs. Therefore, to improve mammography uptake, it may be helpful to design educational model-based interventions through tackling those modifiable perceived barriers and enhancing the intensity of external cues to action.

Background Resuscitation guidance has advanced; however, the predictive performance of the termination of resuscitation (TOR) rule has not been validated for different resuscitation protocols published by the American Heart Association (AHA). Methods A retrospective study validating the basic life support (BLS) and advanced life support (ALS) TOR rules was conducted using an Utstein-style database in Tainan city, Taiwan. Adult patients with nontraumatic out-of-hospital cardiac arrests from January 1, 2015, to December 31, 2015, (using the AHA 2010 resuscitation protocol) and from January 1, 2020, to December 31, 2020, (using the AHA 2015 resuscitation protocol) were included. The characteristics of rule performance were calculated, including sensitivity, specificity, positive predictive value (PPV) and negative predictive value. Results Among 1260 eligible OHCA patients in 2015, 757 met the BLS TOR rule and 124 met the ALS TOR rule. The specificity and PPV for predicting unfavorable neurological outcomes were 61.1% and 99.0%, respectively, for the BLS TOR rule and 93.8% and 99.2%, respectively, for the ALS TOR rule. A total of 970 OHCA patients were enrolled in 2020, of whom 438 met the BLS TOR rule and 104 met the ALS TOR rule. The specificity and PPV for predicting unfavorable neurological outcomes were 85.7% and 100%, respectively, for the BLS TOR rule and 99.5% and 100%, respectively, for the ALS TOR rule. Conclusions Both the BLS and ALS TOR rules performed better when using the 2015 AHA resuscitation protocols compared to the 2010 protocols, with increased PPVs and decreased false-positive rates in predicting survival to discharge and good neurological outcomes at discharge. The BLS and ALS TOR rules can perform differently while the resuscitation protocols are updated. As the concepts and practices of resuscitation progress, the BLS and ALS TOR rules should be evaluated and validated accordingly.

Background Limited treatment options exist for relapsed advanced lung squamous cell carcinoma (SCC), leading to poor outcomes compared with adenocarcinoma. This study aimed to investigate the efficacy of second-line afatinib versus chemotherapy in patients with advanced lung SCC who progressed after first-line chemotherapy. Methods In this retrospective, multisite cohort study, we recruited patients with initial locally advanced or metastatic lung SCC from four institutes in Taiwan between June 2014 and October 2020. The primary endpoint of this study was progression-free survival (PFS), and the secondary endpoints were the objective response rate (ORR), disease control rate (DCR), and overall survival (OS). Results The present study enrolled 108 patients: 19 received second-line afatinib, and 89 received second-line chemotherapy. The median ages were 71 and 67 years, respectively. PFS was significantly longer among patients who received afatinib than among those who received chemotherapy (median 4.7 months [95% confidence interval (CI), 0.1–7.5] vs. 2.6 months [95% CI, 0.9–6.7]; hazard ratio (HR) 0.53 [95% CI 0.32–0.88], p = 0.013). Compared with the chemotherapy group, OS was longer in the afatinib group but did not reach significance (median 16.0 months [95% CI, 6.1–22.0] vs. 12.3 months [6.2–33.9]; HR 0.65 [95% CI 0.38–1.11], p = 0.112). Conclusions Afatinib offered a longer PFS and comparable OS to chemotherapy in advanced lung SCC patients in a real-world setting, it may be considered as a 2nd line alternative treatment choice for immunotherapy unfit advanced lung SCC patients.

Concurrent chemoradiotherapy (CCRT) is one of the standard treatments for patients with advanced head and neck squamous cell carcinoma (HNSCC). However, CCRT may lead to decreased quality of life (QoL) and treatment compliance. This study aimed to determine the effects of PG2 (Astragalus polysaccharides) injection on CCRT-associated adverse events (AEs) and patients’ compliance with the CCRT course. In this phase II double-blind randomized placebo-controlled trial, PG2 injection (sterile powder form) or placebo was administrated three times per week in parallel with CCRT to patients with HNSCC. The chemotherapy regimen included 50 mg/m2 cisplatin every 2 weeks with daily tegafur–uracil (300 mg/m2) and leucovorin (60 mg/day). The study was terminated prematurely due to the successful launch of a newly formulated PG2 injection (lyophilized form). A total of 17 patients were enrolled. The baseline demographics and therapeutic compliance were comparable between the CCRT/PG2 and CCRT/placebo groups. During CCRT, severe treatment-associated AEs were less frequent in the CCRT/PG2 group than in the CCRT/placebo group. Furthermore, less QoL fluctuations from the baseline during CCRT were noted in the CCRT/PG2 group than in the CCRT/placebo group, with a significant difference in the pain, appetite loss, and social eating behavior. The tumor response, disease-specific survival and overall survival did not differ between the two groups. This preliminary study demonstrated PG2 injection exhibited an excellent safety profile, and has potential in ameliorating the deterioration in QoL and the AEs associated with active anticancer treatment among patients with advanced pharyngeal or laryngeal HNSCC under CCRT. Further research in patients with other cancer types or treatment modalities may widen PG2’s application in clinical settings.

In this prospective study, we sought to compare the clinical utility of fluorodeoxyglucose PET/MRI, MRI, and PET/CT in the detection of synchronous cancers and distant metastases in patients with oropharyngeal and hypopharyngeal squamous cell carcinoma (OHSCC). We examined 198 consecutive patients with biopsy-proven OHSCC who agreed to receive chemoradiation. All patients underwent pretreatment PET/MRI and PET/CT on the same day. Patients were followed-up for a minimum of 12 months or until death. The McNemar’s test and receiver-operating characteristic (ROC) curves were used to compare sensitivity/specificity and the diagnostic capabilities of PET/MRI, MRI, and PET/CT, respectively. We identified 55 patients (27.7%) who had synchronous cancers and/or distant metastases (number of involved sites: 83). The results of site-based analysis revealed that the sensitivity of PET/MRI was 15.7% higher than that of MRI (73.5% versus 57.8%, p

In this paper, a novel interval possibilistic fuzzy c-means (IPFCM) clustering method is proposed for clustering symbolic interval data. Clustering algorithms are important methods that required in pattern recognition, data mining and text mining, etc. Most of cluster algorithms focus on single-valued data. The interval fuzzy c-means (IFCM) clustering method is first proposed for symbolic interval data. However, the IFCM may not have good performance when facing noisy date or data with outliers. Hence, the advantages of the proposed IPFCM clustering algorithm in this study mainly overcome the noisy date or data with outliers in symbolic interval data. In the proposed approach, two different distances; namely, Euclidean and Hausdorff distance measures are all individually considered. That is, based on Lagrange multipliers nonlinear programming method, the proposed IPFCM clustering algorithm under Euclidean and Hausdorff distance measure was individually derived for symbolic interval data. From our experimental results, the proposed IPFCM clustering algorithm indeed has better performance than the IFCM and the interval fuzzy possibilistic c-means (IFPCM) clustering algorithm under different distance measures for the noisy date or data with outlier problem. Besides, the proposed IPFCM clustering algorithm is also implemented on windows smart phone platform and shown better performance as expected. Finally, a real data set is added for testing.

This study aimed to develop wearable devices of textile-based triboelectric nanogenerators (TENGs) integrated with plastic metal electrodes. The plastic metal electrodes were developed using Ga-In liquid alloy with glaze powders as the contact electrodes of the textile-based TENGs. Moreover, nylon and polyester textiles with different microstructures/nanostructures were selected as frictional electrodes in TENGs to achieve high flexibility, stability, and electric conductivity. The experimental results indicated that the maximum output voltage and current of the textile-based TENGs were 30.96 V and 3.07 μA, respectively, when the TENG comprised a nylon layer with embroidered square array patterns and a polyester layer with polyvinylidene fluoride nanofibers. Furthermore, these TENGs could generate a maximum output power of 13.97 μW when the external load resistance was 10 MΩ. After a continuous 7200 cycle operation with a reciprocating linear motion platform having a pneumatic cylinder, the textile-based TENG exhibited excellent stability and durability. The fabricated TENGs integrated in a commercial coat, shoe, kneecap, and wristband achieved biomechanical energy conversion functions with high electrical performance for practical applications of self-powered devices.

Background Goji (Lycium) is a popular traditional health food, and its fruit and root extracts have been found to possess antioxidant, anti-inflammatory, and hypocholesterolemia-inducing abilities. Goji leaves also contain high amounts of phenolic compounds, similar to its fruit, and their extracts also exhibit several pharmaceutical effects. The induction of galls on Goji leaves reduces their photosynthetic ability and fruit yield, which raise their farming costs, thereby leading to economic loss. However, the defense mechanisms induced by infection may elevate the secondary metabolite content of the leaves, which might provide more nutritive compounds. Method Content of chlorophyll, carotenoids, polyphenols, and flavonoids in the extracts of normal and infected Goji leaves (L. chinense) were analyzed. The relative content of chlorogenic acid and rutin, two major phenolic compounds in Goji leaves, were determined by LC-MS/MS. Antioxidant activity was presented by demonstrating the DPPH scavenging percentage. The extract of Goji fruit (L. barbarum) was also analyzed to show a comparative result. Results In this study, we found that in infected Goji leaves, the polyphenol content was significantly increased. The level of chlorogenic acid was increased by 36% in galled leaves. The content of rutin in galled leaves was also elevated. Testing the antioxidant activities also showed that the extracts of galled leaves have higher DPPH scavenging abilities. Conclusions Our results demonstrated that galled Goji leaves have higher functional value, and may have potential as being consumed as health food.

Background Both medical education and radiation oncology have progressed significantly in the past decade, but a generalized overview of educational research for radiation oncology residents has not been produced. This study examines recent research trends in medical education for residents in radiation oncology through a scoping review. Methods We conducted a scoping review of medical education research for residents in radiation oncology to survey the research trends. We used publications available on MEDLINE, PubMed, and Scopus to conduct this scoping review. Results We screened 221 full-text articles, 146 of which met our inclusion criteria. These publications showed increased activity in medical education research for residents, most involving affiliations in the United States. We identified persistent interest in training-, contouring-, and technology-related issues. An increase in research related to career, treatment quality, and multidisciplinary training was also observed. However, no research about teacher training was identified. Conclusions This scoping review presents the trends in study interests among stakeholders of medical education research in radiation oncology. With an investigation of existing studies, this research identifies areas of high priority and a lack of studies about teacher training. This study provides potential future directions for medical education research for residents in radiation oncology.

The aim of this study was to establish a control system with multi-axis motors for a lower limb robotic exoskeleton (LLRE). This LLRE structure was built by using an aluminum alloy designed with an adjustable mechanism. A four-motor control system with four Maxon brushless direct current motors was developed and installed in the hips and knees of the LLRE, respectively. In addition, four harmonic reducers were connected to the motors to increase the torque. A master controller which commands the four-axis motors was developed by using Texas Instruments (TI) embedded chip (TMS320F28069). The walking gait parameters were established to support the LLRE movement. The controller local area network protocol was used to communicate between the master and slave motor controllers. The slave motor controllers were developed by using TI embedded chip (DRV8301/TMS320F28069) for each joint by a high bandwidth control strategy. A high dynamic response system was obtained by considering the LLRE inertia, external variable load induced by the LLRE and delay in a digital control system. The result showed that this high bandwidth control with the experimental ones, the trajectory of each joint demonstrated a high response bandwidth and the tracking gait errors were significantly eliminated. This study indicated that the development of this LLRE with a master controller/the slave motor controllers strategy through controller local area network protocol was feasible for healthcare applications.

To determine the value of early evaluation of response to concurrent chemoradiotherapy (CCRT) using 18F-FDG PET-derived parameters and the Epstein-Barr virus (EBV) DNA titre in outcome prediction in patients with primary nasopharyngeal carcinoma (NPC). Sixty patients with primary NPC were prospectively enrolled. All patients underwent 18F-FDG PET/CT before and during CCRT. The plasma EBV DNA titre was measured along with the PET/CT-derived parameters. Changes in EBV DNA titre and PET/CT-derived parameters during CCRT were analysed in relation to response to treatment, recurrence-free survival (RFS) and overall survival (OS). A total lesion glycolysis (TLG) reduction ratio of ≤0.6 and a detectable EBV DNA titre during CCRT were predictors of an unfavourable response to treatment, RFS and OS. In multivariate analysis, a TLG reduction ratio of ≤0.6 predicted incomplete remission (p = 0.002) and decreased RFS (p = 0.003). The proportion of patients with a TLG reduction ratio of >0.6 who achieved a complete response was more than twice that of patients with a TLG reduction ratio of ≤0.6. A detectable EBV DNA titre, a TLG reduction ratio of ≤0.6 and older age were independently associated with a poorer OS (p = 0.037, 0.009 and 0.016, respectively). A scoring system was developed based on these independent predictors of OS. Patients with a score of 1 and 2/3 had poorer survival outcomes than those with a score of 0 (hazard ratio 4.756, p = 0.074, and hazard ratio 18.973, p = 0.001, respectively). This scoring system appeared to be superior to the traditional TNM staging system (p

A low operating temperature CO (carbon monoxide) sensor was fabricated from a nanometer-scale SnO2 (tin oxide) powder. The SnO2 nanoparticles in a size range 10–20 nm were synthesized as a function of surfactant (tri-n-octylamine, TOA) addition (0–1.5 mol%) via a simple thermal decomposition method. The resulting SnO2 nanoparticles were first screen-printed onto an electrode patterned substrate to be a thick film. Subsequently, the composite film was heat-treated to be a device for sensing CO gas. The thermal decomposed powders were characterized by field-emission scanning electron microscopy (FESEM), X-ray diffractometry (XRD), and surface area measurements (BET). The CO-sensing performance of all the sensors was investigated. The experimental results showed that the TOA addition significantly decreased the particle size of the resulting SnO2 nanoparticle. However, the structure of the powder coating was crucial to their sensing performance. After heat-treatment, the smaller particle tended to cause the formation of agglomeration, resulting in the decline of surface area and reducing the reaction site during sensing. However, the paths for the sensed gas entering between the agglomerated structure may influence the sensing performance. As a CO sensing material, the SnO2 nanoparticle (~12 nm in diameter) prepared with 1.25 mol% TOA addition exhibited most stable electrical performance. The SnO2 coating with TOA addition >0.75 mol% exhibited sensor response at a relatively low temperature of

Both head and neck magnetic resonance imaging (MRI) and 18F–fluorodeoxyglucose (18F–FDG) positron emission tomography (PET)/computed tomography (CT) play a crucial role in the staging of primary nasopharyngeal carcinoma (NPC). In this study, we sought to prospectively investigate the clinical utility of simultaneous whole-body 18F–FDG PET/MRI for primary staging of NPC patients. We examined 113 patients with histologically confirmed NPC who underwent pretreatment, simultaneous whole-body PET/MRI and PET/CT for primary tumor staging. The images obtained with the different imaging modalities were interpreted independently and compared with each other. PET/MRI increased the accuracy of head and neck MRI for assessment of primary tumor extent in four patients via addition of FDG uptake information to increase the conspicuity of morphologically subtle lesions. PET/MR images were more discernible than PET/CT images for mapping tumor extension, especially intracranial invasion. Regarding the N staging assessment, the sensitivity of PET/MRI (99.5%) was higher than that of head and neck MRI (94.2%) and PET/CT (90.9%). PET/MRI was particularly useful for distinguishing retropharyngeal nodal metastasis from adjacent nasopharyngeal tumors. For distant metastasis evaluation, PET/MRI exhibited a similar sensitivity (90% vs. 86.7% vs. 83.3%), but higher positive predictive value (93.1% vs. 78.8% vs. 83.3%) than whole-body MRI and PET/CT, respectively. For tumor staging of NPC, simultaneous whole-body PET/MRI was more accurate than head and neck MRI and PET/CT, and may serve as a single-step staging modality.

Previous flux measurements in the perhumid cloud forest of northeastern Taiwan have shown efficient photosynthesis of the endemic tree species Chamaecyparis obtusa var. formosana even under foggy conditions in which leaf surface moisture would be expected. We hypothesized this to be the result of ‘xeromorphic’ traits of the Chamaecyparis leaves (hydrophobicity, stomatal crypts, stomatal clustering), which could prevent coverage of stomata by precipitation, fog, and condensation, thereby maintaining CO2 uptake. Here we studied the amount, distribution, and composition of moisture accumulated on Chamaecyparis leaf surfaces in situ in the cloud forest. We studied the effect of surface tension on gas penetration to stomata using optical O2 microelectrodes in the laboratory. We captured the dynamics of condensation to the leaf surfaces with an environmental scanning electron microscope (ESEM). In spite of substantial surface hydrophobicity, the mean water film thickness on branchlets under foggy conditions was 80 µm (upper surface) and 40 µm (lower surface). This amount of water could cover stomata and prevent CO2 uptake. This is avoided by the clustered arrangement of stomata within narrow clefts and the presence of Florin rings. These features keep stomatal pores free from water due to surface tension and provide efficient separation of plant and atmosphere in this perhumid environment. Air pollutants, particularly hygroscopic aerosol, may disturb this functionality by enhancing condensation and reducing the surface tension of leaf surface water.

Let G(V, E) be a connected and undirected graph with n-vertex-set V and m-edge-set E. For each v ∈ V, let N(v) = {u|v ∈ V and(u, v) ∈ E}. For a positive integer k, a k-rainbow dominating function of a graph G is a function f from V(G) to a k-bit Boolean string f(v) = f k (v)f k − 1(v) … f 1(v), i.e., f i (v) ∈ {0, 1}, 1 ≤ i ≤ k, such that for any vertex v with f(v) = 0(k) we have ⋈ u ∈ N(v) f(u) = 1(k), for all v ∈ V, where ⋈ u ∈ S f(u) denotes the result of taking bitwise OR operation on f(u), for all u ∈ S. The weight of f is defined as $w(f) = {\sum }_{v\in V}{\sum }^{k}_{i=1} f_{i}(v)$ . The k-rainbow domination number γ k r (G) is the minimum weight of a k-rainbow dominating function over all k-rainbow dominating functions of G. The 1-rainbow domination is the same as the ordinary domination. The k-rainbow domination problem is to determine the k-rainbow domination number of a graph G. In this paper, we determine γ 2r (S(n, m)), γ 2r (S +(n, m)), and γ 2r (S ++(n, m)), where S(n, m), S +(n, m), and S ++(n, m) are Sierpinski graphs and extended Sierpinski graphs.

Breast cancer is the most common cancer in women, and some patients develop recurrence after standard therapy. Effective predictors are urgently needed to detect recurrence earlier. The activation of Hedgehog signaling in breast cancer is correlated with poor prognosis. PTCH1 is an essential membrane receptor of Hedgehog. However, there are few reports about mutations in Hedgehog genes in breast cancer. We conducted a comprehensive study via an experimental and bioinformatics approach to detect mutated genes in breast cancer. Twenty-two breast cancer patients who developed recurrence within 24 months postoperatively were enrolled with 22 control cancer patients. Targeted deep sequencing was performed to assess the mutations among individuals with breast cancer using a panel of 143 cancer-associated genes. Bioinformatics and public databases were used to predict the protein functions of the mutated genes. Mutations were identified in 44 breast cancer specimens, and the most frequently mutated genes were BRCA2, APC, ATM, BRCA1, NF1, TET2, TSC1, TSC2, NOTCH1, MSH2, PTCH1, TP53, PIK3CA, FBXW7, and RB1. Mutation of these genes was correlated with protein phosphorylation and autophosphorylation, such as peptidyl-tyrosine and protein kinase C phosphorylation. Among these highly mutated genes, mutations of PTCH1 were associated with poor prognosis and increased recurrence of breast cancer, especially mutations in exons 22 and 23. The public sequencing data from the COSMIC database were exploited to predict the functions of the mutations. Our findings suggest that mutation of PTCH1 is correlated with early recurrence of breast cancer patients and will become a powerful predictor for recurrence of breast cancer.

In the archetypal lithium-rich cathode compound Li1.2Ni0.13Co0.13Mn0.54O2, a major part of the capacity is contributed from the anionic (O2−/−) reversible redox couple and is accompanied by the transition metal ions migration with a detrimental voltage fade. A better understanding of these mutual interactions demands for a new model that helps to unfold the occurrences of voltage fade in lithium-rich system. Here we present an alternative approach, a cationic reaction dominated lithium-rich material Li1.083Ni0.333Co0.083Mn0.5O2, with reduced lithium content to modify the initial band structure, hence ~80% and ~20% of capacity are contributed by cationic and anionic redox couples, individually. A 400 cycle test with 85% capacity retention depicts the capacity loss mainly arises from the metal ions dissolution. The voltage fade usually from Mn4+/Mn3+ and/or On−/O2− reduction at around 2.5/3.0 V seen in the typical lithium-rich materials is completely eliminated in the cationic dominated cathode material.

The issue of electronic heat dissipation has received much attention in recent times and has become one of the key factors in electronic components such as circuit boards. Therefore, designing of materials with good thermal conductivity is vital. In this work, a thermally conductive SBP/PU composite was prepared wherein the spherical h-BN@PMMA (SBP) composite powders were dispersed in the polyurethane (PU) matrix. The thermal conductivity of SBP was found to be significantly higher than that of the pure h-BN/PU composite at the same h-BN filler loading. The SBP/PU composite can reach a high thermal conductivity of 7.3 Wm−1 K−1 which is twice as high as that of pure h-BN/PU composite without surface treatment in the same condition. This enhancement in the property can be attributed to the uniform dispersion of SBP in the PU polymer matrix that leads to a three-dimensional continuous heat conduction thereby improving the heat diffusion of the entire composite. Hence, we provide a valuable method for preparing a 3-dimensional heat flow path in polyurethane composite, leading to a high thermal conductivity with a small amount of filler.

Background Radiotherapy is an indispensable treatment modality in head and neck cancer (HNC), while radioresistance is the major cause of treatment failure. The aim of this study is to identify a prognostic molecular signature associated with radio-resistance in HNC for further clinical applications. Methods Affymetrix cDNA microarrays were used to globally survey different transcriptomes between HNC cell lines and isogenic radioresistant sublines. The KEGG and Partek bioinformatic analytical methods were used to assess functional pathways associated with radioresistance. The SurvExpress web tool was applied to study the clinical association between gene expression profiles and patient survival using The Cancer Genome Atlas (TCGA)-head and neck squamous cell carcinoma (HNSCC) dataset (n = 283). The Kaplan-Meier survival analyses were further validated after retrieving clinical data from the TCGA-HNSCC dataset (n = 502) via the Genomic Data Commons (GDC)-Data-Portal of National Cancer Institute. A panel maker molecule was generated to assess the efficacy of prognostic prediction for radiotherapy in HNC patients. Results In total, the expression of 255 molecules was found to be significantly altered in the radioresistant cell sublines, with 155 molecules up-regulated 100 down-regulated. Four core functional pathways were identified to enrich the up-regulated genes and were significantly associated with a worse prognosis in HNC patients, as the modulation of cellular focal adhesion, the PI3K-Akt signaling pathway, the HIF-1 signaling pathway, and the regulation of stem cell pluripotency. Total of 16 up-regulated genes in the 4 core pathways were defined, and 11 over-expressed molecules showed correlated with poor survival (TCGA-HNSCC dataset, n = 283). Among these, 4 molecules were independently validated as key molecules associated with poor survival in HNC patients receiving radiotherapy (TCGA-HNSCC dataset, n = 502), as IGF1R (p = 0.0454, HR = 1.43), LAMC2 (p = 0.0235, HR = 1.50), ITGB1 (p = 0.0336, HR = 1.46), and IL-6 (p = 0.0033, HR = 1.68). Furthermore, the combined use of these 4 markers product an excellent result to predict worse radiotherapeutic outcome in HNC (p

We prospectively investigated the roles of pretreatment dynamic contrast-enhanced MR imaging (DCE-MRI), diffusion-weighted MR imaging (DWI) and 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG PET)/CT for predicting survival of oropharyngeal or hypopharyngeal squamous cell carcinoma (OHSCC) patients treated with chemoradiation. Patients with histologically proven OHSCC and neck nodal metastases scheduled for chemoradiation were eligible. Clinical variables as well as DCE-MRI-, DWI- and 18F-FDG PET/CT-derived parameters of the primary tumours and metastatic neck nodes were analysed in relation to 3-year progression-free survival (PFS) and overall survival (OS) rates. Eighty-six patients were available for analysis. Multivariate analysis identified the efflux rate constant (K ep)-tumour

Two important biological events happen coincidently soon after nerve injury in the peripheral nervous system in C. elegans: removal of axon debris and initiation of axon regeneration. But, it is not known how these two events are co-regulated. Mutants of ced-1, a homolog of Draper and MEGF10, display defects in both events. One model is that those events could be related. But our data suggest that they are actually separable. CED-1 functions in the muscle-type engulfing cells in both events and is enriched in muscle protrusions in close contact with axon debris and regenerating axons. Its two functions occur through distinct biochemical mechanisms; extracellular domain-mediated adhesion for regeneration and extracellular domain binding-induced intracellular domain signaling for debris removal. These studies identify CED-1 in engulfing cells as a receptor in debris removal but as an adhesion molecule in neuronal regeneration, and have important implications for understanding neural circuit repair after injury., It is unclear how removal of axon debris and initiation of axon regeneration following nerve injury is co-regulated. In this study, the authors show that the extracellular domain (ECD) of the engulfment receptor, CED-1, functions as an adhesion molecule to promote axonal regeneration after injury, independent of its function in phagocytosis

Plastic metal (PM) is a highly advanced material with numerous advantages, such as the convenience associated with its shaping and coating, precise pattern definitions, and convenience for recycling, thereby making it an excellent material for soft electronics. PM material has the ability to be plastically molded into arbitrary deformation by external forces, but it can remain intact even under large deformations as long as PM is encapsulated in polydimethylsiloxane (PDMS). This study aims to verify the feasibility of its application to wearable soft sensors, including flexible and pressure sensors. The experimental results show that with the use of synthetic conditions at a 4:1 mass ratio of liquid metal (LM) to quartz powder, PM yields the best characteristics. Apart from the good electrical conductivity (with a resistivity of 3.29 × 10− 5 Ω-cm), it also has better coating ability, plasticity, and film formability. The developed flexible sensor can sense bending angle changes in the range of 0°–180° with stable performance and with an average gauge factor $${\text{G}}{{\text{F}}_{{\text{avg}}}}$$ of 2.616. With regard to the pressure sensor, when the pressure range is from 0 to 40 psi (≈ 275.79 kPa), the resistance change rate shows a slightly concave-down quadratic curve, while the pressure is greater than 40 psi, the characteristic is a linear relationship with an average slope of 0.022. Furthermore, real-life verification of the two sensors based on experiments shows that their performances are stable and repeatable. Therefore, this study has confirmed that the sensors made of PM can be practically applied to the development of wearable sensors and has emphasized the potential for their use in dynamic sensing applications in humans or robots.

Cell surface glucose regulated protein 78 (GRP78), an endoplasmic reticulum (ER) chaperone, was suggested to be a cancer stem cell marker, but the influence of this molecule on cancer stemness is poorly characterized. In this study, we developed a mass spectrometry platform to detect the endogenous interactome of GRP78 and investigated its role in cancer stemness. The interactome results showed that cell surface GRP78 associates with multiple molecules. The influence of cell population heterogeneity of head and neck cancer cell lines (OECM1, FaDu, and BM2) according to the cell surface expression levels of GRP78 and the GRP78 interactome protein, Progranulin, was investigated. The four sorted cell groups exhibited distinct cell cycle distributions, asymmetric/symmetric cell divisions, and different relative expression levels of stemness markers. Our results demonstrate that cell surface GRP78 promotes cancer stemness, whereas drives cells toward a non-stemlike phenotype when it chaperones Progranulin. We conclude that cell surface GRP78 is a chaperone exerting a deterministic influence on cancer stemness.