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Background Maternal Toxoplasma gondii (T. gondii) infection during pregnancy has been associated with various mental illnesses in the offspring. Ginsenoside Rh2 (GRh2) is a major bioactive compound obtained from ginseng that has an anti-T. gondii effect and attenuates microglial activation through toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway. GRh2 also alleviated tumor-associated or lipopolysaccharide-induced depression. However, the effects and potential mechanisms of GRh2 on depression-like behavior in mouse offspring caused by maternal T. gondii infection during pregnancy have not been investigated. Methods We examined GRh2 effects on the depression-like behavior in mouse offspring, caused by maternal T. gondii infection during pregnancy, by measuring depression-like behaviors and assaying parameters at the neuronal and molecular level. Results We showed that GRh2 significantly improved behavioral measures: sucrose consumption, forced swim time and tail suspended immobility time of their offspring. These corresponded with increased tissue concentrations of 5-hydroxytryptamine and dopamine, and attenuated indoleamine 2,3-dioxygenase or enhanced tyrosine hydroxylase expression in the prefrontal cortex. GRh2 ameliorated neuronal damage in the prefrontal cortex. Molecular docking results revealed that GRh2 binds strongly to both TLR4 and high mobility group box 1 (HMGB1). Conclusion This study demonstrated that GRh2 ameliorated the depression-like behavior in mouse offspring of maternal T. gondii infection during pregnancy by attenuating the excessive activation of microglia and neuroinflammation through the HMGB1/TLR4/NF-κB signaling pathway. It suggests that GRh2 could be considered a potential therapy in preventing and treating psychiatric disorders in the offspring mice of mothers with prenatal exposure to T. gondii infection., Graphical abstract Image 1

Purpose: In advanced or high-grade prostate cancer (PCa), prostate-specific antigen (PSA) is usually elevated, however, some patients may present with low initial PSA (iPSA) levels. The objective of this study was to evaluate whether different iPSA levels were associated with dissimilar clinical outcomes among men with high-grade PCa and advanced disease after robot-assisted laparoscopic radical prostatectomy (RaLRP). Methods: This study enrolled 69 PCa patients with initial Gleason score ≥8 and pathologic T-stage ≥3a from April 2012 to December 2018. Patients were stratified into 3 groups based on iPSA levels at diagnosis

The authors would like to thank Jia-Wern Chen, Dr. Cheng-Hung Chu, Tomoki Watanabe, and Prof. Masanobu Haraguchi for useful discussions. We also acknowledge use of an optical measurement setup supported by Prof. Min-Hsiung Shih. We acknowledge financial support from the Ministry of Science and Technology, Taiwan (Grant No. MOST-109-2112-M-001-043-MY3 (Y.J.L.); MOST-110-2124-M-001-008-MY3 (Y.J.L.); MOST-110-2636-E-007-020 (H.H.C.); MOST-110-2622-8-007-015 (H.H.C.)) and Academia Sinica (Grant No. AS-CDA-108-M08 (Y.J.L.)). H.W.L. acknowledges the financial support from the AFOSR-AOARD (Award Number: FA2386-18-1-4099). V.T. is indebted to the support from the King Abdullah University of Science and Technology (KAUST) Office of Sponsored Research (OSR) under Award No. OSR-2018-CARF/CCF-3079.

Objective Diabetes increases the risk for cancers. However, whether it is associated with hematologic malignancies is not clear. The present study investigated the association between diabetes and acute lymphocytic leukemia (ALL), acute myeloid leukemia (ML), non-Hopkin lymphoma (NHL), and multiple myeloma (MM). Methods Newly diagnosed adult cancer patients were recruited consecutively from our clinical database. Peoples from a local enterprise were recruited to create a small-scale population-based dataset. We compared the diabetes prevalence between the cancer patients and the local people; an increase in diabetes prevalence in the cancer patients suggests an association between diabetes and the cancer(s). Results We found that the prevalence of diabetes was 19.7%, 21.3%, 12.5%, and 12.0% in ALL, AML, NHL, and MM, respectively, which was higher than that (9.1%) in the local people. Despite that there were more male than female cancer patients, there were more female than male diabetic patients. The increase in diabetes prevalence occurred in ALL and NHL patients aged 18 to 39 years old as well as in AML patients over 40. In MM patients, the increase in diabetes prevalence (18.6%) occurred only in females. Approximately 70% of the diabetic patients were undiagnosed before the diagnosis of the blood cancer. Approximately half of the pre-existing diabetic patients had anti-diabetic treatment, with over 70% of them still had poor glycemic control. Conclusions Our results suggest that diabetes is associated with ALL, AML, NHL, and MM, at least in adult patients.

“San Huang Powder,” a nonsterile milled herb powder, is frequently used to treat burn wounds in traditional Chinese herbal medicine. However, treating a wound with a nonsterile dressing or reagent is not compatible with the current guidelines in modern medicine. Therefore, we investigated the bactericidal and anti-inflammatory activities of four herb extracts used in “San Huang Powder” in vitro. Meanwhile, an in vivo porcine model with superficial second-degree burns was used for the experiments since the size and skin composition of pigs are the closest to that of the human body. The minimal bactericidal concentration (MBC) of the herb extracts was determined. The in vitro assay indicated that Rhubarb and Phellodendron bark extracts decreased the levels of inflammatory cytokines, IL-8, and GM-CSF on LPS-induced HMEC-1 cells. In accordance with this result, the histopathological evaluation results showed that the efficacy of “San Huang Powder” containing both herb materials was much better than the group without Rhubarb. Our results not only provide a basis to understand why “San Huang Powder” has been used to clinically treat wounds without sterilization directly since ancient times but also show the advantages of using multiple herb materials simultaneously on wound sites to prevent infection during treatment. Rhubarb is the recommended ingredient involved in the preparation of “San Huang Powder” to ensure the healing efficacy of burn wounds.

Purpose To investigate the potential safety and efficacy of drug-eluting bead-transcatheter arterial chemoembolization (DEB-TACE) in treating TACE-refractory hepatocellular carcinoma (HCC). Methods We retrospectively evaluated the treatment outcomes of DEB-TACE for 41 HCC nodules in 30 patients who were refractory to conventional TACE (c-TACE) according to tumor response. The antitumor response was evaluated according to mRECIST criteria, and changes in alpha-fetoprotein (AFP), albumin-bilirubin score, the incidence of adverse events, and the time to disease progression were observed. Results The objective response rate and disease control rates were 60.98% and 95.12% at 4 weeks after DEB-TACE, 63.41% and 92.68% at 8 weeks, respectively. The median time of disease progression was 4.60 ± 0.23 months. The AFP of patients decreased continuously at 2–6 weeks after operation, and the AFP at 4 weeks was significantly lower than that at 2 weeks (P = 0.038). Adverse reactions were well tolerated, and no grade 4 adverse reactions were reported. The albumin-bilirubin score did not deteriorate within 6 weeks. Conclusion DEB-TACE has potential efficacy and safety after failure of c-TACE in patients with advanced liver cancer. Further studies are needed to confirm the efficacy of DEB-TACE treatment after failure of c-TACE.

Professional sport is one of the essential core industries for the development of the sports industry, divided into two categories: team and individual sports. The main development feature of professional basketball is to compete through the home-and-away system’s operation and establish a good emotional foundation with the residents through the home operation, which in turn creates recognition and support for the team and enhances the profits of the basketball organization. In recent years, Southeast Asia has developed a multinational professional basketball league, which covers nine countries. The “Formosa Dreamers” professional basketball team, a joint venture of Chinese entrepreneurs and has become the first professional basketball team in Taiwan, has chosen Changhua County as the home court. This report’s objective was to explore the localization and home business strategies of professional basketball games and to summarize further and analyze the characteristics of the home business strategy of Formosa Dreamers to establish the foundation for the future development of home business sports events in Taiwan.

The purpose of this study was to explore the correlations between patients’ opioid-taking self-efficacy, social support, and their pain management satisfaction, and to evaluate the effect of social support and opioid-taking self-efficacy in explaining the variance in pain management satisfaction. We used a cross-sectional and correlational research design and recruited 123 cancer patients via convenience sampling. We used the following instruments: the Opioid-Taking Self-Efficacy Scale, the Inventory of Socially Supportive Behavior, and the Chinese version of the Pain Treatment Satisfaction Scale. There were significant and negative correlations between opioid-taking self-efficacy and pain management satisfaction (r = − .43, p

Idiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia. It is unknown why fibrosis in IPF distributes in the peripheral or named sub-pleural area. Migration of pleural mesothelial cells (PMC) should contribute to sub-pleural fibrosis. Calpain is known to be involved in cell migration, but the role of calpain in PMC migration has not been investigated. In this study, we found that PMCs migrated into lung parenchyma in patients with IPF. Then using Wt1tm1(EGFP/Cre)Wtp /J knock-in mice, we observed PMC migration into lung parenchyma in bleomycin-induced pleural fibrosis models, and calpain inhibitor attenuated pulmonary fibrosis with prevention of PMC migration. In vitro studies revealed that bleomycin and transforming growth factor-β1 increased calpain activity in PMCs, and activated calpain-mediated focal adhesion (FA) turnover as well as cell migration, cell proliferation, and collagen-I synthesis. Furthermore, we determined that calpain cleaved FA kinase in both C-terminal and N-terminal regions, which mediated FA turnover. Lastly, the data revealed that activated calpain was also involved in phosphorylation of cofilin-1, and p-cofilin-1 induced PMC migration. Taken together, this study provides evidence that calpain mediates PMC migration into lung parenchyma to promote sub-pleural fibrosis in IPF.

Purpose The U.S. Department of Veterans Affairs (VA) health care system monitors time from referral to specialist visit. We compared wait times for carpal tunnel release (CTR) at a VA hospital and its academic affiliate. Methods We selected patients who underwent CTR at a VA hospital and its academic affiliate (AA) (2010–2015). We analyzed time from primary care physician (PCP) referral to CTR, which was subdivided into PCP referral to surgical consultation and surgical consultation to CTR. Electrodiagnostic testing (EDS) was categorized in relation to surgical consultation (prereferral vs postreferral). Multivariable Cox proportional hazard models were used to examine associations between clinical variables and surgical location. Results Between 2010 and 2015, VA patients had a shorter median time from PCP referral to CTR (VA: 168 days; AA: 410 days), shorter time from PCP referral to surgical consultation (VA: 43 days; AA: 191 days), but longer time from surgical consultation to CTR (VA: 98 days; AA: 55 days). Using multivariable models, the VA was associated with a 35% shorter time to CTR (AA hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.52–0.82) and 75% shorter time to surgical consultation (AA HR, 0.25; 95% CI, 0.20–0.03). Receiving both prereferral and postreferral EDS was associated with almost a 2-fold prolonged time to CTR (AA HR, 0.49; 95% CI, 0.36–0.67). Conclusions The VA was associated with shorter overall time to CTR compared with its AA. However, the VA policy of prioritizing time from referral to surgical consultation may not optimally incentivize time to surgery. Repeat EDS was associated with longer wait times in both systems. Clinical Relevance Given differences in where delays occur in each health care system, initiatives to improve efficiency will require targeting the appropriate sources of preoperative delay. Judicious use of EDS may be one avenue to decrease wait times in both systems.

This study aimed to assess health concerns after hysterectomy from different perspectives among Taiwanese women with uterine fibroids. A mixed-methods was used in this study. In a cross-sectional study, 95 patients completed a structured questionnaire (Health Concern Questionnaire-HCQ). Face-to-face interviews with 5 patients were implemented for the qualitative component from OBS-GYN outpatient departments at two hospitals in Northern Taiwan. Participants who met the following criteria, 20 years of age or older, conscious alert without mental disturbances were recruited to this study. Descriptive statistics were calculated for social demographic variables and HCQ. A content analysis was used to analyze the qualitative data. The mean age was 46.28 of 95 patients. Findings of the present study showed that the most health concerns among patients with UFs after hysterectomy are hysterectomy-related complications, follow by impacts on daily life, body image and female identity, and intimacy and sexual relations. The findings of qualitative interviews supported the above findings. In addition, the information needs of post-operative self-care were identify in this qualitative interviews. The results of this research study could help healthcare professionals to address women's health concerns and provide adequate care for Taiwanese women with uterine fibroids after hysterectomy.

Room-temperature photoluminescence enhancement of molybdenum disulfide (MoS2) monolayers on epitaxial titanium nitride (TiN) thin films grown by molecular-beam-epitaxy as well as magnetron-sputtered TiN films is observed by a confocal laser scanning microscope with excitation wavelengths covering the transition of TiN's macroscopic optical properties from dielectric to plasmonic. The photoluminescence enhancement increases as TiN becomes more metallic, and strong enhancement is obtained at the excitation wavelengths equal to or longer than the epsilon-near-zero (ENZ) wavelength of TiN films. A good agreement is observed between measured and calculated enhancements. The enhancement is attributed to the increased excitation field in MoS2 at TiN's ENZ wavelength and interference effects for thick spacers that separate the MoS2 flakes from TiN films in the metallic regime. This study enriches the fundamental understanding of emission properties on ENZ substrates that could be important for the development of advanced nanoscale lasers/light sources, optical/biosensors, and nano-optoelectronic devices.

Exceptional points (EPs) are the singularities of a non-Hermitian system where the eigenenergies and eigenstates simultaneously coalesce, a topological property that gives rise to a plethora of exotic phenomena. Probing the EPs and associated effects requires the system to go through the EPs. However, the ultrahigh sensitivity of an isolated EP to the external disturbances makes accessing the EPs difficult. To overcome this limit, many approaches have been presented to form the exceptional line/ring and surface. Here, we demonstrate that a quantum exceptional chamber, which is a three-dimensional collection of the EPs, can be constructed in the coupled plasmon-quantum dot (QD) systems by the nondipole effect of the QD. For an asymmetric QD adjacent to a plasmonic nanoparticle, it is found that the contributions of multipole transitions to the coupling strength can be larger than that of dipole transition. The orientation-dependent quantum interference between the dipole and multipole transitions can lead to controllable switch between the weak and strong coupling, and provides an extra degree of freedom to form a high-dimension EP space. Our approach provides a robust platform for accessing the quantum EPs and related applications.

The study applies machine learning (ML) algorithms to investigate the association between the length of a test item written in Chinese (through word count), item difficulty, and students' item perceptions (IPs) in science term examinations. For Research Question 1, items for grade 7 students aged 12–13 in a Taiwanese secondary school from 2014 to 2019 were analyzed. For Research Question 2, the study included 4,916 students from the said population. For RQ3, perceptions were gathered from 48 students of the same school in 2020. The study's results showed that first, the average word count of the 611 items was 88.81, with an average stem word count of 41.16, average options word count of 47.66, and stem-to-options word count ratio (S-O ratio) of 1.27. Second, given that the ML M5P categorization algorithm affirms the items' predictive power, the length of an item is a key factor in determining its difficulty. As a result of this algorithm, 3 categories of the length of science term examination items were classified ( 91.5 words), and 3 linear prediction models of item difficulty (LM1, LM2, and LM3) were generated. From these models, it was found that as the length of an item increases, so does its difficulty. In the prediction analysis of students' IPs, the J48 prediction result was better and convertible into understandable rules. IP was the root node of the decision rule, indicating the importance of this variable. Therefore, students would more likely answer an item correctly when 1) it was perceived to be easy or normal, 2) the students had high or ordinary learning achievements in science, and 3) it contained below 71 words. The study's results can be used as a reference for educators, examiners, and researchers in practical science term examination design. Moreover, it can guide the further research method and direction of applying machine learning in analyzing the difficulty of items in scientific assessments.

We presented and demonstrated a new type of vertical nanowire (NW) and nanosheet (NS) field-effect transistors (FETs), named vertical sandwich gate-all-around FETs or VSAFETs, which were formed with the process compatible in the main stream industry. The VSAFETs with self-aligned high- ${k}$ metal gates (HKMGs) were fabricated with epitaxy of Si/SiGe/Si sandwich structure, an isotropic quasi-atomic-layer-etch (qALE) process, and gate replacement process. The gate-length of VSAFETs is mainly determined by the thickness of SiGe film grown by epitaxy. The NW diameter and NS thickness could be obtained by the isotropic qALE method, which can be used to the Si-selective etching of SiGe. As a result, p-type NS and NW VSAFETs with good device characteristics were fabricated. Device performance and the influence of silicide, Ge fraction, Si cap, and high thermal process were investigated; threshold voltage tuning and reliability were also discussed.

The distribution of fibrosis in idiopathic pulmonary fibrosis (IPF) is subpleural with basal predominance. Alveolar epithelial cell was considered as the key cell in the initial phase of IPF. However, the idea of activation and damage of alveolar epithelial cells is very difficult to explain why fibrosis distributes in the subpleural area. In this study, human pleural mesothelial cell (PMC) line and primary rat PMC was used as in vitro model. Intraperitoneal injection of bleomycin was used for making a pulmonary fibrosis model. The integrity of cultured monolayer PMCs was determined by transepithelial electric resistance (TEER). Pleural permeability was estimated by measuring paracellular transport of fluorescein isothiocyanate (FITC)-conjugated dextran. Changes in lung tissue of patients with IPF were analyzed by Masson’s and immunofluorescence staining. We found bleomycin induced PMCs damage and increased PMCs permeability; increased PMCs permeability aggravated bleomycin-induced subpleural inflammation and pulmonary fibrosis. Moreover, bleomycin was found to activate VEGF/Src signaling which increased PMCs permeability. In vivo, inhibition of VEGF/Src signaling prevented bleomycin-induced subpleural pulmonary fibrosis. At last, activation of VEGF/Src signaling was confirmed in subpleural area in patients with IPF. Taken together, our findings indicate that VEGF/Src signaling mediated pleural barrier damage and increased permeability which contributes to subpleural pulmonary fibrosis.

Introduction To explore the influence of intestinal flora on the occurrence, development and antiviral therapy of chronic hepatitis B (CHB), 16S rDNA amplification sequencing was performed to investigate the intestinal flora in CHB patients treated with entecavir (ETV) and Clostridium butyricum (CB). Methods CHB patients were divided into the ETV group (treatment with ETV alone) and ETV + CB group (treatment with ETV and CB). After 8-week treatment, feces samples were collected and processed for 16S rDNA amplicon sequencing; blood samples were collected for the biochemical, immunologic and virologic evaluations, which were compared between groups. Results ETV treatment for 8 weeks significantly decreased the serum levels of alanine aminotransferase (ALT), interleukin-6 (IL-6), IL-8, tumor necrosis factor-α (TNF-α) and HBV DNA compared to those before treatment, but there were no marked differences between the ETV group and ETV + CB group. The intestinal flora changed significantly in the CHB patients after ETV + CB treatment: there were marked differences in 13 unique species before treatment and 4 unique species after ETV + CB treatment; at the phylum level, the top five bacteria with significant difference between patients before treatment and ETV + CB patients were Firmicutes, Actinobacteria, Cyanobacteria, Euryarchaeota and Synergistetes. There were significant differences in 25 unique species in the ETV group and 4 unique species in the ETV + CB group; at the phylum level, the top five bacteria with significant difference between ETV patients and ETV + CB patients were Actinobacteria, Fusobacteria, Proteobacteria, Saccharibacteria and Synergistetes. Conclusion ETV treatment improves the serum biochemical, immunologic and virologic variables, but additional CB fails to further improve these variables. Of note, additional CB affects the intestinal flora in the CHB patients treated with ETV.

Flexible electronics has recently captured extensive attention due to its intriguing functionalities and great potential for influencing our daily life. In addition, with the increasing demand for green energy, photoelectrochemical (PEC) water splitting is a clean process that directly converts solar energy to chemical energy in the form of hydrogen. Thus the development of flexible green energy electronics represents a new domain in the research field of energy harvesting. In this work, we demonstrate the BiVO4 (BVO)/WO3/ITO/muscovite heterostructure photoelectrode for water splitting with flexible characteristics. The performance of BVO was modified by specific crystal facets, and the BVO/WO3 bilayer exhibited superior performance of 33% enhanced PEC activity at 1 V vs Ag/AgCl compared with pure BVO due to the proper staggered band alignment. Moreover, excellent mechanical stability was verified by a series of bending modes. This study demonstrates a pathway to a flexible photoelectrode for developing innovative devices for solar fuel generation.

BACKGROUND N-Methyl-d-aspartate receptor (NMDAR) in the hypothalamic paraventricular nucleus (PVN) plays critical roles in regulating sympathetic outflow. Studies showed that acute application of the antagonists of NMDAR or its subunits would reduce sympathetic nerve discharges. However, little is known about the effect of long-term management of NMDAR in hypertensive animals. METHODS PEAQX, the specific antagonist of NMDAR subunit 2A (GluN2A) was injected into both sides of the PVN of two-kidney, one-clip (2K1C) renal hypertensive rats and control (normotensive rats) for 3 weeks. RESULTS Three weeks of PEAQX infusion significantly reduced the blood pressure of the 2K1C rats. It managed to resume the balance between excitatory and inhibitory neural transmitters, reduce the level of proinflammatory cytokines and reactive oxygen species in the PVN, and reduce the level of norepinephrine in plasma of the 2K1C rats. PEAQX administration also largely reduced the transcription and translation levels of GluN2A and changed the expression levels of NMDAR subunits 1 and 2B (GluN1 and GluN2B). In addition, NMDAR was known to function through activating the extracellular regulated protein kinases (ERK) or phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) pathways. In our study, we found that in the PVN of 2K1C rats treated with PEAQX, the phosphorylation levels of mitogen-activated protein kinase kinase (MEK), ERK1/2, and cAMP-response element-binding protein (CREB) significantly reduced, while the phosphorylation level of PI3K did not change significantly. CONCLUSIONS Chronic blockade of GluN2A alleviates hypertension through suppression of MEK/ERK/CREB pathway.

Monolayer transition metal dichalcogenides (TMDs), direct bandgap materials with an atomically thin nature, are promising materials for electronics and photonics, especially at highly scaled lateral dimensions. However, the characteristically low total absorption of photons in the monolayer TMD has become a challenge in the access to and realization of monolayer TMD-based high-performance optoelectronic functionalities and devices. Here, we demonstrate gate-tunable plasmonic phototransistors (photoFETs) that consist of monolayer molybdenum disulfide (MoS2) photoFETs integrated with the two-dimensional plasmonic crystals. The plasmonic photoFET has an ultrahigh photoresponsivity of 2.7 × 104 AW-1, achieving a 7.2-fold enhancement in the photocurrent compared to pristine photoFETs. This benefits predominately from the combination of the enhancement of the photon-absorption-rate via the strongly localized-electromagnetic-field and the gate-tunable plasmon-induced photocarrier-generation-rate in the monolayer MoS2. These results demonstrate a systematic methodology for designing ultrathin plasmon-enhanced photodetectors based on monolayer TMDs for next-generation ultracompact optoelectronic devices in the trans-Moore era.

Growth arrest‐specific 5 (GAS5) is a kind of long non‐coding RNAs (lncRNAs). Previous studies showed that down‐regulation of LncRNA‐GAS5 was involved in the development of systemic lupus erythematosus (SLE). However, the regulatory mechanism of down‐expressed LncRNA‐GAS5 in SLE remains obscure. In this study, we aimed to investigate the association of LncRNA‐GAS5 polymorphism with SLE risk. And further explore how LncRNA‐GAS5 is involved in the occurrence of SLE. Here, we evaluated the relationship between the risk for the development of SLE and the 5‐base pair (AGGCA/‐) insertion/deletion (I/D) polymorphism (rs145204276) in the LncRNA‐GAS5 promoter region. A custom 36‐Plex SNPscan kit was used for genotyping the LncRNA‐GAS5 polymorphisms. The LncRNA‐GAS5 and miR‐21 target prediction was performed using bioinformatics software. Enzyme‐linked immunosorbent assay (ELISA) and quantitative real‐time PCR (qRT‐PCR) were performed to assess GAS5 and miR‐21 mRNA expression and PTEN protein expression. The results revealed that rs145204276 resulted in a decreased risk of SLE (DD genotypes vs II genotypes: adjusted OR = 0.538, 95% CI, 0.30‐0.97, P = .039; ID genotypes vs II genotypes: adjusted OR = 0.641, 95% CI, 0.46‐0.89, P = .007; ID/DD genotypes vs II genotypes: adjusted OR = 0.621, 95% CI, 0.46‐0.84, P = .002; D alleles vs I alleles: adjusted OR = 0.680, 95% CI, 0.53‐0.87, P = .002). A reduced incidence of renal disorders in SLE was found to be related to ID/DD genotypes and D alleles (ID/DD genotypes vs II genotypes: OR = 0.57, 95% CI, 0.36‐0.92, P = .020; D alleles vs I alleles: OR = 0.63, 95% CI, 0.43‐0.93, P = .019). However, no significant association of rs2235095, rs6790, rs2067079 and rs1951625 polymorphisms with SLE risk was observed (P > .05). Additionally, haplotype analysis showed that a decreased SLE risk resulted from the A‐A‐C‐G‐D haplotype (OR = 0.67, 95% CI, 0.49‐0.91, P = .010). Also, patients in the SLE group showed a down‐regulated expression of LncRNA‐GAS5 and PTEN than the healthy volunteers; however, patients with rs145204276 ID/DD genotypes showed up‐regulated expression of LncRNA‐GAS5 and PTEN compared with patients carrying the II genotype. Furthermore, the miR‐21 levels were considerably up‐regulated in the SLE group than the healthy volunteers, and patients with rs145204276 ID/DD genotype had lower miR‐21 levels than the ones with the II genotype. Thus, we found that the LncRNA‐GAS5/miR‐21/PTEN signalling pathway was involved in the development of SLE, where LncRNA‐GAS5 acted as an miR‐21 target, and miR‐21 regulated the expression of PTEN. These findings indicated that the rs145204276 ID/DD genotypes in the LncRNA‐GAS5 gene promoter region may be protected against SLE by up‐regulating the expression of LncRNA‐GAS5, which consecutively regulated miR‐21 and PTEN levels.

The outstanding properties of perovskites have attracted huge attention in optoelectronic applications. However, the current study mainly focuses on small-area single-layer perovskite films. Surfac...

Background A proportion of lung cancers show sodium/iodide symporter (NIS) expression. Lung cancers with NIS expression may uptake radioiodine (RAI) and show RAI-avid lesions on RAI scan for differentiated thyroid cancer (DTC) surveillance. Aim To investigate the possibility of RAI uptake by lung cancer in a cohort with thyroid cancer. Methods RAI-avid lung cancers were analyzed using a prospectively maintained database of patients with thyroid cancer who were registered at a medical center between December 1, 1976 and May 28, 2018. NIS expression in lung cancer was assessed using immunohistochemical staining. Results Of the 5000 patients with thyroid cancer from the studied dataset, 4602 had DTC. During follow-up, 33 patients developed primary lung cancer. Of these patients, nine received an iodine-131 (131I) scan within 1 year before the diagnosis of lung cancer. One of these nine lung cancers was RAI-avid. NIS expression was evaluated, and three of the eight available lung cancers revealed NIS expression. The proportions of lung cancer cells with NIS expression were 60%, 15%, and 10%. The RAI-avid lung cancer had the highest level of expression (60%). The RAI-avid lung cancer had a spiculated border upon single-photon emission computed tomography/computed tomography, which led to an accurate diagnosis. Conclusion A proportion of lung cancer demonstrates NIS expression and is RAI-avid. Clinicians should be aware of this possibility in the interpretation of RAI scintigraphy.

Quantum cryptography is a major ingredient of the future quantum internet that promises various secure communication tasks. Quantum conference key agreement (CKA) is an important cryptographic primitive of quantum cryptography, which provides the conference key among multiple users simultaneously. However, quantum CKA is currently far from practical application due to the low conference key rate. Here, we propose a quantum CKA protocol of three users with information-theoretic security. Our protocol only requires phase-randomized weak coherent sources and threshold single-photon detectors, and is anticipated to be experimentally demonstrated over 600 km under current technology. Our scheme can be widely implemented in the approaching large-scale quantum network., Comment: 6 pages, 3 figures, accepted by IEEE Access

Background This study aimed to identify potential stemness-related targets in gastric cancer (GC) in order to support the development of new treatment strategies and improve patient survival. Methods Using the edgeR package, we identified stemness-related differentially expressed genes (DEGs) using GSE112631 and the stemness-related signaling pathways in the Gene Set Enrichment Analysis (GSEA) database. Lasso-penalized Cox regression analysis and multivariate Cox regression analysis tested by Akaike Information Criterion (AIC) were used to screen out survival genes in order to construct a prognostic model. We verified the accuracy of our prognostic model using a nomogram and receiver operating characteristic (ROC) curve analysis. Patients were divided into two groups based on the median risk score, and functional enrichment analysis was used to explore the differences between the two groups. Results Eight genes were selected to establish a prognostic model of The Cancer Genome Atlas (TCGA) and a validation model of the GSE84437 dataset from the Genome Expression Omnibus (GEO). In both models, we found that the low risk score group had better overall survival (OS) than the high-risk score group. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways between the two risk groups were totally different. Conclusions We used eight stemness-related genes to build a prognostic model. The high-risk score group had a worse prognosis compared to the low-risk score group.

Neurosurgical procedures often cause damage to the brain tissue at the periphery from surgical manipulations. Especially during retraction, a large amount of pressure could be applied on the brain surface, which can damage it, leading to brain herniation, which can be fatal for patients. To resolve this issue, we have developed a pressure sensor that can be used to monitor the applied pressure during surgery for intraoperative care. This device was tested on a rodent model to create a superficial surgically induced damage profile for three different applied pressures (30, 50, and 70 mmHg) and compared to a standard intracranial pressure monitoring system. Magnetic resonance imaging has been performed after surgical procedures to detect the herniation caused by applied pressure. To evaluate the damage to brain cells and tissue rupture, histological analysis was performed using hematoxylin and eosin staining. A scoring system was developed to understand the severity of the surgically induced brain injury, which will help neurosurgeons to limit the pressure to an optimum point without causing damage.

Selenium (Se) is an essential micronutrient with antioxidative properties, but previous studies have shown that extremely high circulating Se concentrations are associated with a higher prevalence of cardiovascular diseases (CVDs). To date, it remains unknown whether this association has connections with arterial calcification. A total of 982 participants with both serum Se concentration and abdominal aortic calcification (AAC) score data were enrolled from the 2013-2014 National Health and Nutrition Examination Survey (NHANES), a cross-sectional study of a noninstitutionalized population in the USA. Serum Se levels were determined by inductively coupled plasma-dynamic reaction cell-mass spectrometry. AAC was obtained from dual-energy X-ray absorptiometry and quantified by the Kauppila score system. Severe AAC was defined as Kauppila score ≥ 5. Among all participants, the mean serum Se level was 132.89 μg/L. The average AAC score was 1.51, and 11.7% had severe AAC. Compared with those in the lowest quartile of Se ( 121.1 μg/L), the highest quartile subgroup ( 143.1 μg/L) was associated with a higher mean AAC score (β-coefficient 0.88; 95% CI 0.28, 1.47; p = 0.004) and greater odds of having severe AAC (odds ratio 2.19; 95% CI 1.10, 4.36; p = 0.026) after adjusting for demographic, biochemical, and clinical characteristics. The concentrations of other circulating trace elements showed no statistically significant association with the AAC score. High serum Se levels were independently associated with an increased mean AAC score and aggravated AAC severity among noninstitutionalized US adults. Serum Se might adversely affect the cardiovascular system when the serum Se concentration exceeds 143 μg/L.

The operation characteristics of polycrystalline Si (poly-Si) gate-all-around (GAA) junctionless (JL) charge-trapping (CT) flash memory devices with the Zr-based stacked trapping layer were studied in this work. Devices with the Si3N4/ZrO2 stacked trapping layer show enhanced erasing speeds and comparable retention characteristics in comparison to Si3N4/HfO2 due to many shallow energy traps and smaller valance band offset in the ZrO2 layer. By inserting Al2O3 between Si3N4 and ZrO2 trapping layer, the retention and endurance characteristics are improved. The erasing speed can be further improved by a Zr-rich oxide layer near the tunneling oxide since the energy barrier can confine more injected electrons near the tunneling oxide. The retention characteristic can be improved without sacrificing the erasing speed because some of the shallow traps can be passivated by NH3 plasma treatment on ZrO2. Hence, the ZrO-based stacked trapping layer is very promising for the poly-Si GAA JL CT flash devices for nonvolatile memory applications.

Hydrothermal methods are widely used in chemical synthesis of target products with specific morphology and nanostructure. Those methods are very efficient for the preparation of well-controlled structures but the reaction time is usually long. The assistance of microwave makes the reaction system heat up faster, more uniformly and reactions are accelerated, it also can be utilized to change the morphology or structure of materials, which improves the physic-chemical properties of synthesized products and influences its gas-sensing performance. Copper oxide (CuO) is widely applied in semiconductor gas sensors because of its good reactivity and stability. This review article briefly introduces the principle, mechanism and recent development of CuO nanostructures obtained by microwave-assisted hydrothermal synthesis (MWHS) process. It also discussed the relation between endopathic factors of material and its gas-sensitive performance. The technical challenges and prospective solutions for high-performance CuO-based gas-sensitive materials with unique nanostructure are proposed. It is pointed out that the hierarchical CuO-based nanostructures and their composite materials prepared by MWHS process are efficacious methods to improve the gas-sensitive performance of the materials. On the basis of the morphology, the materials are divided into nanorods, nanoflowers, nanosheets, nanospheres and other nanostructures. The influence of microwave parameters on the properties of synthetic products is analyzed. The influence followed by metal element loading on the structure and properties of CuO-based materials by MWHS process is further discussed. Then this review summarizes the research progress of graphene-CuO and metal oxide-CuO composites prepared by MWHS process in recent years.

Herein, core-twisted tetrachloroperylenediimides (ClPDIs) were introduced as new efficient electron-transporting materials (ETMs) to replace the commonly used fullerene acceptor PC61 BM in inverted planar perovskite solar cells (PSCs). ClPDI showed a low-lying lowest unoccupied molecular orbital (LUMO) energy level of -3.95 eV, which was compatible with the conduction band of CH3 NH3 PbI3-x Clx (-3.90 eV). In addition, the role of the length of the alkyl side chain at the imide position of ClPDI in modulating the molecular solubility, aggregation capacity for charge-transport properties, surface hydrophobicity, and PSC performance was investigated. The device based on ClPDI-C4 (ClPDI with n-butyl side chains) as ETM achieved a maximum power conversion efficiency (PCE) of 17.3 % under standard AM 1.5G illumination, which iwas very competitive with that of the reference device employing PC61 BM/C60 (PCE=17.2 %) as ETM. Moreover, the devices with ClPDIs as ETMs exhibited better device stability than that with PC61 BM/C60 . This work highlights the great potential of ClPDI derivatives as low-cost (≈2.0 USD g-1 ) and effective ETMs to obtain efficient solution-processed inverted PSCs. This class of ClPDI derivatives is expected further promote the performance and stability of PSCs after extended investigation.

To investigate the changes of blood pressure (BP) on patients with obstructive sleep apnea/hypopnea syndrome (OSA) before and after upper airway surgery.Case series with chart review.Tertiary academic medical center.Patients with OSA who underwent upper airway surgery were enrolled. We retrospectively investigated the nighttime and daytime BP before and at least 3 months after OSA surgery. PairedIn total, 176 patients with OSA (149 men, 27 women; mean age, 42.9 years; mean apnea/hypopnea index, 43.1/h) were enrolled in this study. The overall nighttime and daytime BP decreased significantly before and after OSA surgery (daytime systolic BP was reduced from 137.3 ± 14.0 mm Hg to 132.7 ± 17.0 mm Hg,Surgical modifications of the upper airways for patients with OSA could benefit blood pressure.

Background This report presents the third case of trochlear schwannoma arising from the pineal region and the first case to be resected using a paramedian infratentorial supracerebellar approach. Schwannomas of cranial nerves have traditionally been thought to arise from the transitional point where the axonal envelopment switches from glial cells to Schwann cells; however, recent temporal bone histopathologic evidence from vestibular schwannomas challenges this view. Of the 38 cases of pathology-confirmed trochlear schwannoma in the literature, there are only 2 cases arising from the pineal region, where the nerve sheath transition zone is located. Here, we discuss an unusual case of trochlear schwannoma arising from this transition zone. Case Description A 65-year-old man was admitted to our institute after a traffic accident. He complained of headache and dizziness, and a computed tomography scan revealed an isodense mass in the pineal region with obstructive hydrocephalus. Magnetic resonance imaging with contrast showed an enhancing mass in the pineal region. The tumor was subtotally resected using a paramedian infratentorial supracerebellar approach, and pathology confirmed the diagnosis of trochlear schwannoma. Conclusions Trochlear schwannoma should be considered when a mass is identified in the pineal region. This diagnosis should still be entertained for mass lesions along the free tentorial edge because the tumor may arise distant from the glial-Schwann transition zone located by the dorsal midbrain. We propose a treatment algorithm for this rare tumor that seeks to maximize functional outcome.

Urothelial carcinomas (UCs) are highly prevalent in patients with end-stage renal disease. Chronic kidney disease (CKD) is the predecessor of end-stage renal disease, and it is also associated with UC. However, the interplay between CKD and UC lacks solid evidence. Acrolein is produced by polyamines and has been suggested to be the uremic "toxin." The level of acrolein correlates well with chronic renal failure. We recently found that acrolein-induced DNA damage and inhibited DNA repair in urothelial cells, which contribute to bladder cancer. Therefore, we hypothesize that acrolein is involved in the formation of UC in patients with CKD.A total of 62 UC patients and 43 healthy control subjects were recruited. Acrolein-DNA (Acr-dG) adducts and p53 gene mutations in UC tissues, plasma acrolein-protein conjugates (Acr-PC) and S-(3-hydroxypropyl)-N-acetylcysteine levels, and urinary Acr metabolites were analyzed in these patients.Acr-dG levels were statistically correlated with CKD stages in UC patients (P0.01). Most p53 mutations were G to A and G to T mutations in these patients, and 50% of mutations at G:C pairs occurred in CpG sites, which is similar to the mutational spectra induced by Acr-dG adducts. Acr-PC levels in the plasma of UC patients with CKD were significantly higher than those of control subjects (P0.001). Altered urinary S-(3-hydroxypropyl)-N-acetylcysteine was also found in UC patients with CKD compared to control subjects (P0.005).These results indicate that acrolein acts as an endogenous uremic toxin and contributes to UC formation in patients with CKD.

Liver resection for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) offers a chance of cure, although survival is often limited. The actual 3-year survival and its associated prognostic factors have not been reported. A nationwide database of HCC patients with PVTT who underwent liver resection with ‘curative’ intent was analyzed. The clinicopathologic characteristics, the perioperative, and survival outcomes for the actual long-term survivors were compared with the non-long-term survivors (patients who died within 3 years of surgery). Univariable and multivariable regression analyses were performed to identify predictive factors associated with long-term survival outcomes. The study included 1590 patients with an actuarial 3-year survival of 16.6%, while the actual 3-year survival rate was 11.7%. There were 171 patients who survived for at least 3 years after surgery and 1290 who died within 3 years of surgery. Multivariable regression analysis revealed that total bilirubin > 17.1 μmol/l, AFP > 400 ng/ml, types of hepatectomy, extent of PVTT, intraoperative blood loss > 400 ml, tumor diameter > 5 cm, tumor encapsulation, R0 resection, liver cirrhosis, adjuvant TACE, postoperative early recurrence (

Aim: To establish and validate a nomogram for the estimation of overall survival of patients with uterine leiomyosarcoma (uLMS). Methods: Information on patients diagnosed as uLMS was retrospectively retrieved from the Surveillance, Epidemiology, and End Results database. The patients were randomly assigned into the training and the validation cohorts. Univariate and multivariate analyses were used to determine the independent prognostic factors for building a nomogram for predicting overall survival. The predictive accuracy was evaluated based on the concordance indices and the calibration plots. Results: A nomogram that combined age, marital status, tumor size, Surveillance, Epidemiology, and End Result stage, surgery and radiation was established. The internal and external concordance indices were 0.748 and 0.745, respectively. The calibration plots approached 45 degrees. Conclusion: The nomogram might be an effective tool for predicting the survival of patients with uLMS.

Optical gyroscopes are among the most accurate rotation measuring devices and are widely used for navigation and accurate pointing. Since the advent of photonic integrated components for communications, and with their increasing complexity, there has been interest in the possibility of chip-scale optical gyroscopes1. Besides the potential benefits of integration, such solid-state systems would be robust and resistant to shock. Here, we report a gyroscope using Brillouin ring lasers on a silicon chip. Its stability and sensitivity enable measurement of Earth’s rotation, representing a major milestone for this new class of gyroscope. A Sagnac gyroscope based on Brillouin ring lasers on a silicon chip is presented. The stability and sensitivity of this on-chip planar gyroscope allow measurement of the Earth’s rotation, with an amplitude sensitivity as small as 5 deg h−1 for a sinusoidal rotation, an angle random walk of 0.068 deg h−1/2 and bias instability of 3.6 deg h−1.

Aims and objectives The primary aim of this study is to explore the influence of obesity, healthy lifestyle and sleep quality of endometrial cancer survivors on their fatigue level. Background As many as 30% of endometrial cancer survivors still suffer from fatigue 5 years after completing therapy. Fatigue may hinder cancer survivors from participating in daily activities or returning to their original roles and functions, thus affecting their health-related quality of life. Design This study adopted a cross-sectional correlational research design. The STROBE checklist for cross-sectional studies was used as a reference for reporting the study. Methods A consecutive sample of 134 endometrial cancer survivors was recruited from the outpatient clinics of a medical centre in Taipei, Taiwan. Data were collected using structured questionnaires. Results Study subjects scored 44 points (SD = 7.09) on average for the fatigue levels. Results of linear regression showed that sleep quality (s = -0.38), comorbidity index (s = -0.024) and age (s = 0.20) were important predictors of fatigue. However, differences in obesity, vegetable and fruit intake, physical activity did not lead to significant differences in fatigue level. Conclusions Survivors who had poorer sleep quality, higher comorbidity index and younger age reported higher fatigue. Relevance to clinical practice The study findings are relevant for assessing and preventing fatigue in endometrial cancer survivors. Those with poorer sleep quality, higher comorbidity index and younger age are at a greater risk for fatigue and deserve further attention. Although the study results failed to support the link between obesity, vegetable and fruit intake, physical activity and fatigue, the ratio of survivors who comply with recommended healthy lifestyles was low. Hence, it is of urgent necessity that this population receives the help to maintain a healthy lifestyle.

Purpose: The purpose of this study was to assess the amount of variance in the coping strategies of patients with brain tumors that could be accounted for by resilience. Methods: This cross-sectional survey involved 95 patients who had experienced surgical, chemotherapy, or radiotherapy therapies for their brain tumors at least 1 month before data collection. The investigator collected data using the scales of the Ways of Coping Checklist-Revised and Resilience Scale. Data were analyzed using descriptive statistics, t tests, analysis of variance, Pearson product–moment correlation, and hierarchical multiple regression. Results: The results revealed that resilience was significantly positively associated with patients' problem-focused coping (r = .65, p

The coherent light source is one of the most important foundations in both optical physics studies and applied photonic devices. However, the whispering gallery microcavity, as a prime platform for novel light sources, has the intrinsically chiral symmetry and severely rules out access to directional light output, all-optical flip-flops, efficient light extraction, etc. Here, we demonstrate a reconfigurable symmetry-broken microlaser in an ultrahigh-Q whispering gallery microcavity with the symmetric structure, in which a chirality of lasing field is empowered spontaneously by the optical nonlinear effect. Experimentally, the ratio of counter-propagating lasing intensities is found to exceed 160:1, and the chirality can be controlled dynamically and all-optically by the bias in the pump direction. This work not only presents a distinct recipe for coherent light sources with robust and reconfigurable performance, but also opens up an unexplored avenue to symmetry-broken physics in optical micro-structures., The directional lasing emission in whispering gallery microcavities typically resorts to breaking the structure symmetry. Here the authors demonstrate a reconfigurable symmetry-broken microlaser in a symmetric ultrahigh-Q whispering gallery microcavity, in which a chirality of lasing fields is empowered spontaneously by nonlinear effects.

To evaluate the predictive accuracy of the %p2PSA and prostate health index (PHI) in predicting aggressive pathological outcomes in patients with prostate cancer (PCa) undergoing radical prostatectomy (RP), we enrolled 91 patients with organ-confined PCa who were treated with robot-assisted RP. p2PSA levels and the PHI were investigated for their ability to predict pathological results. The %p2PSA and PHI were both significantly higher in patients with ≥pT3 disease, high-risk disease, positive surgical margin, or seminal vesical invasion (SVI). In univariable analysis, p2PSA derivatives were significant predictors of the presence of ≥pT3 disease, high-risk disease, positive surgical margin, and SVI. To predict adverse pathological outcomes at a sensitivity of 90%, p2PSA derivatives had higher specificity than standard PSA derivatives. In multivariable analysis, additional increases in the area under the receiver operating characteristic curve (AUC) were observed with the %p2PSA and PHI for ≥pT3 disease, high-risk disease, and positive surgical margin (8.2% and 2.7%, 6.2% and 4.1%, and 8.6% and 5.4%, respectively). A PHI ≥61.26 enhanced the predictive accuracy of the model for SVI by increasing the AUC from 0.624 to 0.819 (p = 0.009). The preoperative %p2PSA and PHI accurately predict adverse pathological results and are useful for decision-making.

Oleanolic acid is an analogue of pentacyclic triterpenoids. It has been used as a hepatic drug for over 20 years in China. Currently, there are only five approved drugs derived from pentacyclic triterpenoids, including oleanolic acid (liver diseases), asiaticoside (wound healing), glycyrrhizinate (liver diseases), isoglycyrrhizinate (liver disease) and sodium aescinate (hydrocephalus). To understand more about the bioactivity and functional mechanisms of oleanolic acid, it can be developed as a potent therapeutic agent, in particular, for the prevention and treatment of heart diseases that are the leading cause of death for people worldwide. The primary aim of this mini-review is to summarize the new applications of oleanolic acid and its derivatives as cardioprotective agents reported in recent years and to highlight their therapeutic perspectives in cardiovascular diseases.

BACKGROUND Intraperitoneal (IP) chemotherapy is often a preferred treatment for ovarian cancer because of its clinical benefits, but research on the experiences of patients receiving IP chemotherapy is limited. OBJECTIVES The purpose of this article is to explore the lived experiences of Taiwanese patients diagnosed with ovarian cancer who have received at least one cycle of IP chemotherapy. METHODS A semistructured interview guide was used to collect data. Interviews were analyzed using a qualitative content analysis. FINDINGS The following themes emerged from the data.

Head trauma is one of the most common etiologies of olfactory dysfunction. It is difficult to use either the olfactory function test or magnetic resonance imaging to directly assess the course of damage to olfactory nerves. Thallium-201 (201Tl) olfacto-scintigraphy has been shown to be an able means for objectively assessing the olfactory nerve transport function. It is expected to be used to evaluate olfactory nerve regeneration after damage to the olfactory nerves. However, no such result has been reported. We present a patient who lost his olfactory function after experiencing head trauma. When his olfactory function remained anosmic, a 201Tl olfacto-scintigraphy showed no migration of 201Tl from the nasal mucosa to the olfactory bulb. After treatment with medicines and olfactory training, his olfactory function improved. A second 201Tl olfacto-scintigraphy showed an increased migration of 201Tl from the nasal mucosa to the olfactory bulb.

Background The microRNA-17-92 (miR-17-92) cluster is one of the most extensively studied miRNA clusters. Abnormal expression of the cluster has been found to play important role in different kinds of human diseases, including ischemic stroke (IS). The aim of our study was to investigate the association between three polymorphisms (rs1491034, rs9301654 and rs982873) in the promoter of the miR-17-92 cluster and risk of IS. Methods Three hundred and ninety-eight patients with IS and 397 control subjects were included. The genotypes of the three polymorphisms were determined by Snapshot SNP genotyping assay. Relative expression of the cluster in peripheral blood mononuclear cells (PBMCs) of cases and controls were examined by quantitative real-time PCR. Results Significant association between rs9301654 polymorphism and risk of IS were observed basing on genotype, model and allele analyses (GA vs. AA: adjusted OR = 0.63, 95% CI: 0.41~0.97, P = 0.037; GG vs. AA: adjusted OR = 0.23, 95% CI: 0.07~0.78, P = 0.018; GA + GG vs. AA: adjusted OR = 0.57, 95% CI: 0.38~0.87, P = 0.009; GA + AA vs. GG: adjusted OR = 0.27, 95% CI: 0.08~0.89, P = 0.032; G vs. A: adjusted OR = 0.58, 95% CI: 0.40~0.83). Haplotype analysis showed that TGC and TGT haplotypes were associated with decreased risk of IS (OR = 0.59, 95% CI: 0.40~0.87, P = 0.007 for TGC haplotype; OR = 0.21, 95% CI: 0.06~0.75, P = 0.009 for TGT haplotype). Importantly, we found the expression of miR-17-5p was significant higher while miR-19a-3p was significant lower in patient with IS compared with the control group (P P Conclusions Our findings indicated that rs9301654 polymorphism in the promoter of miR-17-92 cluster may be associated with susceptibility of IS in the Chinese population. However, we found that rs9301654 polymorphism and its respective gene expression did not demonstrate consistent association with IS in the Chinese population. Further studies such as gene-gene interaction are warranted to reveal the role of miR-19a and its regulatory genes in the etiology of IS.

The neuropeptide pituitary adenylate cyclase-activating polypeptide (PACAP) has been identified to facilitate osteogenic differentiation and bone formation both in vitro and in vivo. However, whether lack of PACAP is associated with osteoporosis (OP) still remains unknown. The scope of the current study was to examine the potential relationship between serum PACAP concentrations and disease severity in female patients with postmenopausal osteoporosis (PMOP). 123 PMOP females were enrolled in our study. During the same period, BMI and age-matched 120 postmenopausal non-osteoporotic (PMNOP) patients were also recruited as control. Serum PACAP concentrations were determined by Sandwich ELISA. Bone mineral density was examined by dual-energy x-ray absorptiometry (DXA) at the total hip, lumbar 1–4 vertebrae and left femoral neck. Genant grade was utilized for evaluating the degree of vertebral fracture and receiver operating characteristic (ROC) curve was performed to examine the diagnostic value of PACAP with regard to Genant grade. The numerical rating scale (NRS) was applied for test pain and 6-min walking as well as sit-to-stand test was used for functional status. The bone turnover markers including N-terminal propeptide of type I procollagen (PINP) (marker of bone formation) and C-telopeptide of type I collagen (CTX-I) (marker of bone resorption) were also examined. The PMOP women had significantly decreased mean serum PACAP levels in comparison with the PMNOP females. Serum levels of PACAP in vertebrae fracture patients were significantly lower than that in non-fracture patients Serum PACAP concentrations were negatively and significantly related to Genant grade as well as BMD at total hip, lumbar 1–4 vertebrae and left femoral neck. Further ROC analysis indicated that PACAP may act as a decent marker for Genant grade. In addition, serum PACAP levels were negatively associated with NRS and positively related to 6-min walking as well as sit-to-stand test scores. Last, we found PACAP were negatively correlated with increased CTX-I levels and positively related to PINP levels. Attenuated PACAP concentrations were related to disease severity of PMOP, PACAP may act as a protective role during PMOP.

Background: Angiotensin receptor neprilysin inhibitor (ARNI) was recommended by major guidelines as the frontline therapy for heart failure with reduced ejection fraction (HFrEF) since its clinical benefit was proved in the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure (PARADIGM-HF) trial. However, little is known about its safety and effectiveness in real-world practice, often with sicker and more fragile patients. In addition, East Asia population is underrepresented in PARADIGM-HF trial. Methods: We performed a retrospective analysis of patients who received ARNI in 3 medical institutes located in Northern Taiwan. Patients who received a prescription of at least 30 days of ARNI were enrolled. The date of first prescription was defined as the index date, and a period of 12 months preceding the index date was defined as the baseline period. Results: A total of 452 patients were identified (age: 61.9 ± 15.0, male: 79.4%). Compared to PARADIGM-HF populations, our patients had higher values of baseline serum creatinine (mean: 1.5 vs 1.1 mg/dL) and B-type natriuretic peptide (BNP; median: 554.5 vs 255 pg/mL). After 12 months, 41.6% of the patients received less than half of the standard dose. Overall, all-cause death, cardiovascular death, and heart failure readmission rate were 3.0%, 1.1%, and 6.9% in 12 months, respectively. In those who had both baseline and 12-month data, renal function did not change (1.7-1.8 mg/dL, P = .091), left ventricular ejection fraction improved (30.8%-36.8%, P < .001), BNP decreased (777.0-655.8 pg/mL, P = .032), and uric acid decreased (7.5-7.1 mg/dL, P = .009). Conclusion: In our study, patients with HFrEF had higher BNP and serum creatinine level at baseline and had received lower dose of ARNI than the PARADIGM-HF populations. Angiotensin receptor neprilysin inhibitor appeared to be safe as regard renal function and effective in real-world practice. Left ventricular reverse remodeling was observed 1 year after heart failure medication treatment, including ARNI.

Discrete-modulated continuous-variable quantum key distribution with homodyne detection is widely recognized for its ease of implementation, efficiency with respect to error correction, and its compatibility with modern optical communication devices. However, recent studies report that the application of homodyne detection obtains poor tolerance to excess noise and insufficient transmission distance, hence seriously restricting the large-scale deployment of quantum secure communication networks. In this paper, we propose a homodyne detection protocol using the quadrature phase shift keying technique. By limiting information leakage, our proposed protocol enhances excess noise tolerance to a high level. Furthermore, we demonstrate that homodyne detection performs better than heterodyne detection in quaternary-modulated continuous-variable quantum key distribution under the untrusted detector noise scenario. The security is analyzed using the tight numerical method against collective attacks in the asymptotic regime. Our results imply that the current protocol is able to distribute keys in nearly intercity area and thus paves the way for constructing low-cost quantum secure communication networks., 14 pages, 10 figures. Accepted by PRX Quantum

BackgroundProstate-specific antigen (PSA) is considered neither sensitive nor specific for prostate cancer (PCa). We aimed to compare total PSA (tPSA), percentage of free PSA (%fPSA), the PSA density (PSAD), Prostate Health Index (PHI), and the PHI density (PHID) to see which one could best predict clinically significant prostate cancer (csPCa): a potentially lethal disease.MethodsA total of 412 men with PSA of 2–20 ng/mL were prospectively included. Serum biomarkers for PCa was collected before transrectal ultrasound guided prostate biopsy. PHI was calculated by the formula: (p2PSA/fPSA) x √tPSA. PHID was calculated as PHI divided by prostate volume measured by transrectal ultrasound.ResultsOf the 412 men, 134 (32.5%) and 94(22.8%) were diagnosed with PCa and csPCa, respectively. We used the area under the receiver operating characteristic curve (AUC) and decision curve analyses (DCA) to compare the performance of PSA related parameters, PHI and PHID in diagnosing csPCa. AUC for tPSA, %fPSA, %p2PSA, PSAD, PHI and PHID were 0.56、0.63、0.76、0.74、0.77 and 0.82 respectively for csPCa detection. In the univariate analysis, the prostate volume, tPSA, %fPSA, %p2PSA, PHI, PSAD, and PHID were all significantly associated with csPCa, and PHID was the most important predictor (OR 1.41, 95% CI 1.15–1.72). Besides, The AUC of PHID was significantly larger than PHI in csPCa diagnosis (p=0.004). At 90% sensitivity, PHID had the highest specificity (54.1%) for csPCa and could reduce the most unnecessary biopsies (43.7%) and miss the fewest csPCa (8.5%) when PHID ≥ 0.67. In addition to AUC, DCA re-confirmed the clinical benefit of PHID over all PSA-related parameters and PHI in csPCa diagnosis. The PHID cut-off value was positively correlated with the csPCa ratio in the PHID risk table, which is useful for evaluating csPCa risk in a clinical setting.ConclusionThe PHID is an excellent predictor of csPCa. The PHID risk table may be used in standard clinical practice to pre-select men at the highest risk of harboring csPCa.