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Purpose: To examine the efficacy of extracorporeal shock wave therapy (ESWT) and injection therapies by synthesizing direct and indirect evidence for all pairs of competing therapies for lateral epicondylitis.Methods: PubMed, EMBASE, and Web of Science databases were searched for all appropriate randomized controlled trials (RCTs), assessing the effect of ESWT or injection therapies. The primary outcome was short-term (≤3 months) and medium-term (>3 months but ≤12 months) pain, while the secondary outcomes were grip strength and patient-reported outcome measures. All outcomes were assessed using standardized mean differences (SMDs) with 95% confidence intervals (CIs) and were ranked using surface under the cumulative ranking curve (SUCRA) probabilities to determine a hierarchy of treatments. Sensitivity analysis was performed to eliminate potential therapeutic effects of normal saline (NS) and exclude trials that included patients with acute lateral epicondylitis (LE).Results: 40 RCTs were included to evaluate ESWT and five different injection therapies, including corticosteroids (CSs), autologous whole blood, platelet-rich plasma (PRP), botulinum toxin A (BoNT-A), and dextrose prolotherapy (DPT). DPT (-.78 [-1.34 to -.21]), ESWT (.57 [-.89 to -.25]), PRP (-.48 [-.85 to -.11]), and BoNT-A (-.43 [-.84 to -.02]) outperformed placebo for short-term pain relief; ESWT (-.44 [-.85 to -.04]) outperformed placebo for medium-term pain relief. DPT was ranked as the most optimal short-term and medium-term pain reliever (SUCRA, 87.3% and 98.6%, respectively). ESWT was ranked as the most optimal short-term and medium-term grip strength recovery (SUCRA; 79.4% and 86.4%, respectively).Conclusions: DPT and ESWT were the best two treatment options for pain control and ESWT was the best treatment option for grip strength recovery. CSs were not recommended for the treatment of LE. More evidence is required to confirm the superiority in pain control of DPT among all these treatment options on LE.Level Of Evidence: Level I, meta-analysis of Level I randomized controlled trials. [ABSTRACT FROM AUTHOR]

In this article, porous poly( D, L-lactide- co-glycolide) (PLGA) microsphere scaffolds with a size of ∼ 400 μm and pores of ∼ 20 μm were prepared for constructing injectable three-dimensional hepatocyte spheroids. The porous sites of PLGA microspheres provided a spatial space for hepatocyte distribution. Hepatocytes spheroids were cocultured with human umbilical vein endothelial cell, bone marrow mesenchymal stem cell, or NIH/3T3 cells by combining the porous PLGA microspheres with the relatively hydrophobic culture strategy. The combination of open porous microspheres, hepatocytes, and nonparenchymal cells was demonstrated for application in functional hepatic tissue reconstruction. Hepatocellular-specific functions can sustained up to 2 weeks in the support of coculturing with nonparenchymal cells. The spheroidal hepatocyte coculture system had the advantages of an injectable delivery, higher cell seeding density, protection from exerted shear stress, better exchange of nutrients, oxygen and metabolites, and heterotypic cell-cell contact within and between microspheres. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 101A: 2862-2869, 2013. [ABSTRACT FROM AUTHOR]

Abstract: Voiding dysfunction is an uncommon condition in young men. With increased understanding of the etiology of chronic lower urinary tract dysfunction, there has been significant improvement in the management of the condition. We have reviewed the current literature and make suggestions about diagnosis, treatment, and further research on this topic. We searched the PubMed database for the management of voiding dysfunction in young men using the following terms: voiding dysfunction, lower urinary tract symptoms, young men, risk factor, urodynamics study, uroflowmetry, magnetic resonance imaging, primary bladder neck obstruction/bladder neck dysfunction, dysfunctional voiding/pseudodyssynergia, impaired detrusor contractility/detrusor underactivity, adrenergic antagonist, transurethral incision, urotherapy, baclofen, and botulinum toxin. Uroflowmetry is an important noninvasive examination for screening young men for possible voiding dysfunction. A videourodynamic study is recommended for patients with low urine flow. Primary bladder neck obstruction and dysfunctional voiding are the two most common diagnoses. α-Adrenergic antagonists and urotherapy are widely used for treating bladder neck obstruction and dysfunctional voiding, respectively. Botulinum toxin A may become a potential therapeutic option in the future. Although the published reports usually included a small number of patients and lacked randomization and a placebo-controlled group, these clinical studies still provide great advances in managing voiding dysfunction in young men. Further well-designed studies are warranted to support optimal management of these conditions. [Copyright &y& Elsevier]

In this study, we present a simple heating approach for preparation of gold nanoclusters (Au NCs) using bovine serum albumin (BSA) as a template. At 70 °C, the reaction for the preparation of BSA-Au NCs is completed within 20 min. By conducting matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS), we have found that the main product is BSA-Au NCs that emit at 660 nm when excited at 330 nm due to 'molecular-like' behavior. The X-ray photoelectron spectroscopy data reveal that there are Au ions and Au atoms coexisting in the BSA-Au NCs. The as-prepared Au NCs show excellent stability over a wide pH range (2.0-10.0). The fluorescence and MALDI-MS data reveal that the changes in their fluorescence properties are due to the formation of various sizes of BSA-Au NCs for different periods of reaction time. The as-prepared BSA-Au NCs are selective and sensitive (limit of detection of 4 nM at a signal-to noise ratio 3) for the detection of Hg ions through the d-d metallophilic interaction of Au and Hg that leads to a decrease in fluorescence. The present assay has been validated for the detection of Hg ions in real water samples, with a result being in good agreement with that from inductively coupled plasma mass spectrometry. [ABSTRACT FROM AUTHOR]

Amino-terminated and carboxylic acid containing aqueous-based polyurethane (PU) dispersion was prepared by a conventional NCO-terminated PU prepolymer process by using isophorone diisocyanate (IPDI), polypropylene glycol-2000 (PPG-2000) and 2,2′-dimethylolpropanoic acid (DMPA) as the key raw materials. A new curing agent, tri-glycidyl phosphate (POG) was prepared from a substitution reaction of phosphorus oxychloride and glycidol. A single-component self-curable aqueous-based PU system is obtained from an addition of POG into aqueous-base PU dispersion and its curing reaction occurred among POG oxiranes and PU amino groups immediately after hydrophobic POG diffused into PU particles (as polymeric micelles). The cross-linked PU resins were resulted on drying at ambient temperature. Original PU dissolved into THF and ethanol. And its gel content increased to 90.1% and sample loss in ethanol decreased to 9.2% of this self-cured PU system with 5.0 phr POG. The limiting oxygen index (LOI) value is 20 of original PU and its LOI reached to 27 of this same self-cured PU system. The improved mechanical and thermal properties of those self-cured PU resins were evaluated, respectively in this report. [ABSTRACT FROM AUTHOR]

Hydrophilic UV-curable PU oligomers (UV-PU) were prepared by mixing either the toluene diisocyanates (TDI) with polyethylene glycol-1000, or the isophorone diisocyanate (IPDI) with polypropylene glycol-1000 and dimethylol propanic acid (DMPA), to produce the desired carboxylic acid bearing or non-ionic PU oligmer (NCO-PU), separately. The 2-hydroxyethyl methacrylate (HEMA) was then added into the NCO-PU oligomer to form acrylate-terminated (UV-curable) PU oligomer (UV-PU). The reactive diluents, such as 1,6-hexanediol diacrylate (HDDA), trimethylolpropane tricarylate (TMPTA) and others were used to adjust the viscosity of UV-PU and to control the concentration of acrylic group. The hydrophilic UV-curable PU system was formulated and applied on PET micro-fiber and then cured by an UV-radiation at ambient temperature. The physical, thermal, and mechanical properties, in particular, the hydrophilic properties of UV-curable PU treated PET micro-fibers will be discussed. [ABSTRACT FROM AUTHOR]

The three-spot swimming crab (Portunus sanguinolentus) is mainly distributed in South East Asia. An analysis of mitochondrial control region partial sequences allows us to determine the population genetic structure, phylogeography and historical demography of this species in East Asia. The seven populations, which included 110 individuals, were collected from mainland China (Shanghai, SH, Xiamen, XM and Hong Kong, HK), Taiwan (Yilan, YL, Taichung, TC, Donggang, DG) and Singapore (Singapore, SGP). The nucleotide diversity (π) of all individuals was 0.01149, with values ranging from 0.00372 (SGP) to 0.01345 (YL). In total, 90 haplotypes have been identified, which can be divided into two major lineages: lineage A consists of specimens from SH, YL, XM, TC and DG, and lineage B corresponds to specimen from SGP. From the second to the most recent interglacial period, population expansion was observed in each lineage. However, a low level of genetic differentiation was also observed in the three-spotted swimming crab, P. sanguinolentus, according to FST values. Our results suggest that several past and present habitat configurations have shaped the genetic patterns of P. sanguinolentus until now. During Pleistocene glaciations, when sea levels were low, this species may have moved along the coast from Southeast Asia to China. It first colonized the Hong Kong area during this era. After sea levels rose and shorelines receded, it subsequently spread to the coast of mainland China. [ABSTRACT FROM AUTHOR]

Abstract: Anionic aqueous-based polyurethane (PU) dispersion consists of carboxyl group that served as an internal emulsifier stabilizing aqueous PU dispersion and also a reactive site toward curing agent. A model reaction of a mono-azetidine-containing compound and trimethylacetic acid (TMAA) demonstrated that an amino ester bond formation between azetidine and carboxylic acid. A di-azetidine containing compound (HDDA–AZT) was prepared and served as a curing agent, which was synthesized by a Michael addition reaction of azetidine (AZT) to hexanediol diacrylate (HDDA). Anionic aqueous PU dispersion was treated with HDDA–AZT as a latent curing agent and becoming a self-curable aqueous PU system. A cross-linked PU resin was obtained from this self-curing PU system on drying at ambient temperature. The performance properties of these self-cured PU resins proved that cross-linking behaviors with this new curing agent, HDDA–AZT. [Copyright &y& Elsevier]

Breast cancer-related lymphedema (BCRL) is common among patients who have completed their cancer treatment. Although low-level laser therapy (LLLT) has been explored as a treatment option for BCRL, we could not find a regimen that is more effective than others. This meta-analysis aimed to organize existing research and determine the optimal combination of LLLT parameters for BCRL treatment. Studies were collected from four online databases: Embase, Ovid Medline, Cochrane, and Cinahl. The collected studies were reviewed by two of the authors. We focused on the aspects of the treatment area, treatment regimen, and total treatment sessions across the included studies. The comparisons between LLLT and non-LLLT were performed through a meta-analysis. Post-treatment QOL was significantly better in the axillary group. The group treated "three times/week with a laser density of 1.5–2 J/cm2" had significantly better outcomes in terms of swelling reduction, both immediately post-treatment and at 1–3 months follow-ups. The group with > 15 treatment sessions had significantly better post-treatment outcomes regarding reduced swelling and improved grip strength. According to these results, LLLT can relieve the symptoms of BCRL by reducing limb swelling and improving QOL. Further exploration found that a treatment approach targeting the axilla, combined with an increased treatment frequency, appropriate laser density, and extended treatment course, yielded better outcomes. However, further rigorous, large-scale studies, including long-term follow-up, are needed to substantiate this regimen. [ABSTRACT FROM AUTHOR]

Background: Patellar tendinopathy, also known as jumper's knee, can significantly impact the quality of daily life for patients due to the associated pain. A randomized controlled trial was investigated the clinical, sonographic, and serum cytokine markers in patellar tendinopathy of athletes following platelet-rich plasma (PRP) or PRP with extracorporeal shockwave therapy (ESWT) treatments. Our aims to investigate and compare therapeutic effects of PRP versus a combination of PRP with ESWT for treating patellar tendinopathy. Methods: A total of 33 athletes with patellar tendinopathy were randomized into two groups. PRP + Sham (PS) group received intraarticular injection of autologous PRP (5 mL) once and sham ESWT. PRP + ESWT (PE) group received intraarticular injection of autologous PRP once and after 1 week ESWT (0.2 mJ/mm2 energy flux density, 1350 impulses, 4 Hz) once. All patients were followed up for 1 year. Results: Autologous PRP injection and its combination with ESWT are both effective treatments for chronic patellar tendinopathy in athletes. PRP combined with ESWT resulted in faster reduction of knee pain than PRP alone at the 1-month follow-up. Serum IL-33 showed no significant difference at the 12-month follow-up. Levels of interleukin (IL)-6, IL-15, and IL-17 increased at the 12-month follow-up, potentially due to the additional training. However, the athletes did not report any discomfort or injuries, and no abnormalities were detected by ultrasonography after study. We demonstrated improvements in pain and functional scores, as well as knee injury protection in athletes, following 12 months of PRP and PRP with ESWT treatments. Conclusions: The study analyzed the therapeutic effect of PRP injection alone and combining PRP injection with ESWT for chronic patellar tendinopathy. Our results showed that combined treatment can facilitate the pain relief early than PRP alone and is a safety treatment modality. No adverse effect was noted in our study. Trial registration Research registry and the registration number is researchregistry9518. Registered 14 September 2023. https://www.researchregistry.com/browse-the-registry#home/registrationdetails/650263e4f549fd00282a338c/. The level of evidence is level II. [ABSTRACT FROM AUTHOR]

For machining parts with complex shapes, consisting of computer numerical control (CNC) machine tools, different CNC machine tools will be used according to the machining method. If the workpiece is removed for off-machine measurement after machining, when the size is incorrect, it will need to be returned to the CNC machine tool for secondary machining. In this case, the workpiece surface quality and machining accuracy will be affected, which is very time-consuming. On-machine measurement and complex machine center is a key to solve this problem. In the recent researches that the touch probe was integrated on three or five axis machine for error compensation and shape construction based on on-machine measurement, but turning-milling machine was rare. In addition, the most types of parts were thin-walled parts or thin web parts. In this study, a contact measurement system is integrated into a CNC combined turning-milling machine for on-machine measuring. Macro-programming is used to design the machining path of A6061-T6 aluminum alloy hexagonal punch, and the action of probe measurement is added to the machining path. As the measured data exceed the tolerance range, the calculated data are fed back to the controller for machining improvement by compensation. The finished hexagonal punch is measured in a 3D coordinate measuring machine and the error is compared. The experimental results show that the contact probe needs to be corrected before machining, and the size of the corrected workpiece can reach the tolerance range of ±0.01 mm. The size error of rough machining is larger than that of fined machining, and the size error of rough machining will increase with the length of the workpiece. [ABSTRACT FROM AUTHOR]

Presents a least mean square (LMS) nonlinear prediction error filter for adaptive autoregressive (AR) modeling in a white Gaussian noise. LMS prediction error filter in white noise; Gamma-least mean square filter; Rho-LMS filter; Convergence analysis of each LMS filters; Computer simulation of two LMS filters; Conclusions.

Objectives. This study is aimed at exploring the feasibility of sonoelastography on muscle stiffness of spastic forearm and evaluating the improvement of functional performance in patients with poststroke spasticity (PSS) after receiving kinesiotaping (KT) and rehabilitation. Methods. According to the spastic levels (using modified Ashworth scale (MAS)) of the affected upper extremity, 59 patients with stroke were allocated into two groups, group A (MAS 0–1): 31 patients (14 men and 17 women; mean age: 60 years) and group B (MAS 1+–2): 28 patients (22 men and 6 women; mean age: 51 years). The Brunnstrom motor recovery stage at the wrist/distal parts in groups A and B was stage 3/3.5 and stage 2.75/3. We evaluated the Brunnstrom stage, spastic levels by MAS and modified Tardieu scale (MTS), and Fugl-Meyer Assessment for upper extremity (FMA-UE). We also evaluated the muscle spasticity of flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), and flexor digitorum superficialis (FDS) muscles using sonoelastography with shear wave velocity (SWV). We applied KT for 20 patients in group B, comparing the changes in sonoelastography and functional outcomes between KT and without KT interventions. Results. Both the MAS and MTS scales were moderately correlated with the SWV in forearm muscles on hemiplegic side (r = 0.336 – 0.554) After KT intervention, the SWV in FCR decreased (p = 0.028). Muscle spasticity was reduced (p < 0.01), and distal part of the Brunnstrom stage and FMA-UE were increased (p = 0.045 and p = 0.001). In patients without KT intervention, only the MTS degree reduced (p = 0.026). Conclusions. The SWV of sonoelastography could objectively assess the reduction of muscle stiffness of the affected forearms in patients with PSS after KT intervention. Advances in Knowledge. Sonoelastography could be a quantitative method to follow up for therapeutic effect of the spastic forearm. [ABSTRACT FROM AUTHOR]

Background: The risk of skeletal events is rising in parallel with the burden of chronic kidney disease and mineral bone disorder (CKD-MBD), whilst the role of the fat-bone axis in CKD-MBD remains elusive. Adiponectin derived from adipocytes has emerged as a valid biomarker of low bone mineral density and increased marrow adiposity. We aimed to explore the association between adiponectin and bone fracture (BF) risks in patients with maintenance hemodialysis (MHD). Methods: Serum concentrations of adiponectin and bio-clinical data were determined at study entry. The Cox proportional hazard regression analyses were used to assess unadjusted and adjusted hazard ratios (aHRs) of adiponectin and various clinical predictors for BF risks. The predictive accuracy of adiponectin for BF events was evaluated by receiver operating characteristic (ROC) curve analysis. Results: Age and serum concentrations of adiponectin, phosphate, and intact parathyroid hormone were significantly associated with higher risks of BF. With respect to the risk of BF events, the cumulative event-free survival curves differed significantly between the high and low concentration groups of adiponectin (p = 0.02). In multivariable analysis, higher adiponectin levels were associated with an incremental risk of BF (adjusted hazard ratios (aHRs): 1.08 (95% confidence interval (CI): 1.01–1.15, p < 0.05). The ROC analysis of adiponectin cutoff point concentration (18.15 ug/mL) for prediction of BF showed 0.66 (95% CI = 0.49 to 0.84). Conclusion: Adiponectin was associated with an incremental risk of BF that could serve as a potential predictor of BF in MHD patients. In the high-risk population with hyperphosphatemia, an elevated adiponectin level could alert clinicians to the urgent need to correct mineral dysregulation and undertake further bone survey. [ABSTRACT FROM AUTHOR]

Background: The risk of cardiovascular (CV) and fatal events remains extremely high in patients with maintenance hemodialysis (MHD), and the growth differentiation factor 15 (GDF15) has emerged as a valid risk stratification biomarker. We aimed to develop a GDF15-based risk score as a death prediction model for MHD patients. Methods: Age, biomarker levels, and clinical parameters were evaluated at study entry. One hundred and seventy patients with complete information were finally included for data analysis. We performed the Cox regression analysis of various prognostic factors for mortality. Then, age, GDF15, and robust clinical predictors were included as a risk score model to assess the predictive accuracy for all-cause and CV death in the receiver operating characteristic (ROC) curve analysis. Results: Age, GDF15, and albumin were significantly associated with higher all-cause and CV mortality risk that were combined as a risk score model. The highest tertile of GDF-15 (>1707.1 pg/mL) was associated with all-cause mortality (adjusted hazard ratios (aHRs): 3.06 (95% confidence interval (CI): 1.20–7.82), p < 0.05) and CV mortality (aHRs: 3.11 (95% CI: 1.02–9.50), p < 0.05). The ROC analysis of GDF-15 tertiles for all-cause and CV mortality showed 0.68 (95% CI = 0.59 to 0.77) and 0.68 (95% CI = 0.58 to 0.79), respectively. By contrast, the GDF15-based prediction model for all-cause and CV mortality showed 0.75 (95% CI: 0.67–0.82) and 0.72 (95% CI: 0.63–0.81), respectively. Conclusion: Age, GDF15, and hypoalbuminemia predict all-cause and CV death in MHD patients, yet a combination scoring system provides more robust predictive powers. An elevated GDF15-based risk score warns clinicians to determine an appropriate intervention in advance. In light of this, the GDF15-based death prediction model could be developed in the artificial intelligence-based precision medicine. [ABSTRACT FROM AUTHOR]

Botulinum toxin A (BTX-A) is a powerful neurotoxin with long-lasting activity that blocks muscle contractions. In addition to effects on neuromuscular junctions, BTX-A also plays a role in sensory feedback loops, suggesting the potentiality for pain relief. Although the only approved indications for BTX-A in the bladder are neurogenic detrusor overactivity and refractory overactive bladder, BTX-A injections to treat bladder pain refractory to conventional therapies are also recommended. The mechanism of BTX-A activity in bladder pain is complex, with several hypotheses proposed in recent studies. Here we comprehensively reviewed properties of BTX-A in peripheral afferent and efferent nerves, the inhibition of nociceptive neurotransmitter release, the reduction of stretch-related visceral pain, and its anti-inflammatory effects on the bladder urothelium. Studies have also revealed possible effects of BTX-A in the human brain. However, further basic and clinical studies are warranted to provide solid evidence-based support in using BTX-A to treat bladder pain. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the functional improvement and pain reduction of different nonsurgical treatments for patellar tendinopathy (PT), a systematic review with network meta-analysis was performed.Methods: Studies were comprehensively searched for without language restrictions in the CENTRAL, MEDLINE, EMBASE, Web of Science, Physiotherapy Evidence Database, and SPORTDiscus databases from inception to May 2018. Randomized controlled trials about nonsurgical treatments for PT were included. The outcome measurements were the Victorian Institute of Sports Assessment (VISA) scale and pain scores (such as the visual analog scale or Numerical Rating Scale). Study quality was evaluated using the Physiotherapy Evidence Database score. Direct comparisons were performed using pairwise meta-analysis, whereas network meta-analysis was performed using a frequentist method in a multivariate random-effects model.Results: Eleven studies with 430 affected patellar tendons were included in the systematic review. The summary mean difference of improvement in the VISA scale versus the control group for corticosteroid injection was -23.00 (95% confidence interval [CI] -36.73 to -9.27), for leukocyte-rich platelet-rich plasma (LR-PRP) was 13.22 (95% CI 2.37-24.07), for focused extracorporeal shockwave therapy (ESWT) was -1.28 (95% CI -6.25 to 3.68), for radial ESWT was -6.68 (95% CI -20.20 to 6.84), for ultrasound was -0.70 (95% CI -11.23 to 9.83), for autologous blood injection was -0.60 (95% CI -9.30 to 8.10), for dry needling was 17.51 (95% CI -2.57 to 37.60), for topical glyceryl trinitrate was -0.90 (95% CI -13.07 to 11.27), and for skin-derived tendon-like cells was 10.40 (95% CI -1.59 to 22.39). LR-PRP (Surface Under the Cumulative Ranking curve [SUCRA] = 87.5%) or dry needling (SUCRA = 90.5%) was most likely to be ranked the best in terms of improvement on the VISA scale. Compared with the control group, the summary mean difference of the change in pain score for corticosteroid injection was 0.80 (95% CI -3.48 to 5.08), for LR-PRP was -1.87 (95% CI -3.28 to -0.46), for focused ESWT was 0.13 (95% CI -0.68 to 0.93), for radial ESWT was 0.03 (95% CI -1.92 to 1.98), for ultrasound was -0.20 (95% CI -1.49 to 1.09), for autologous blood injection was 0.60 (95% CI -0.73 to 1.93), for dry needling was -0.37 (95% CI -2.71 to 1.97), and for topical glyceryl trinitrate was -0.50 (95% CI -2.55 to 1.55). The treatment most likely to be ranked the best in terms of change in pain score was LR-PRP (SUCRA = 94.9%).Conclusions: The network meta-analysis demonstrated that LR-PRP has the greatest functional improvement and pain reduction for PT compared with other treatment options. However, the treatment effect estimates can be biased by the possible intransitivity and should not be overestimated.Level Of Evidence: Level I, meta-analysis of Level I studies. [ABSTRACT FROM AUTHOR]

Purpose: People's health-care-seeking behaviors considerably changed during the COVID-19 pandemic. This study evaluated the changes in self-harm- and violence-related urgent psychiatric consultation (UPC) in the emergency department (ED) during different stages of the pandemic and at different levels of hospitals. Patients and Methods: We recruited patients who received UPC during the baseline (2019), peak (2020), and slack (2021) periods of the same time window (calendar weeks 4– 18) during the COVID-19 pandemic. Demographic data such as age, sex, and referral type (by the police/emergency medical system) were also recorded. Results: We found female gender and younger age associated with higher risk of self-harm-related UPCs, whereas patients visiting regional hospitals, male patients, and patients referred by the policy/emergency medical system, had a higher risk of violence-related UPCs. After adjustment, the different pandemic stages were not significantly associated with self-harm- or violence-related UPCs. Conclusion: Patient's demographic data, but not the pandemic itself, may be responsible for the changes in self-harm- and violence-related UPCs during the pandemic. [ABSTRACT FROM AUTHOR]

Bovine serum albumin (BSA) and glutathione (GSH) have been used to prepare gold nanoclusters (BSA/GSH-Au NCs) with excitation/emission wavelengths of 330/650 nm from Au 3+ at 70 °C for 30 min. In the preparation of BSA/GSH-Au NCs, BSA and GSH act mainly as capping and reducing agents, respectively. With the assistance of GSH, only 30 μM BSA is required to prepare stable and bright BSA/GSH-Au NCs. In addition to BSA, small amounts of lysozyme, ovalbumin, and transferrin have also been used separately to prepare protein/GSH-Au NCs. The decreased order of the photoluminescence (PL) intensity of protein/GSH-Au NCs agrees with the decreased orders of size and number of tyrosine/cysteine of the four proteins. The PL of BSA/GSH-Au NCs is quenched by nitrite (NO 2 − ) at pH 3.0, mainly due to the oxidation of BSA/GSH-Au NCs with nitrosyl ions (NO + ). This approach allows detection of NO 2 − down to 0.3 μM, with great selectivity and stability against salt (up to 500 mM NaCl). Practicality of this simple and sensitive approach has been validated by the analysis of pond water samples. [ABSTRACT FROM AUTHOR]

Erectile dysfunction (ED) is mostly due to the lack of blood flow into the penis. In the past 20 years, near-infrared spectroscopy (NIRS) was used in measuring the concentrations and temporal dynamics of different hemoglobin types. However, the dynamics of the light absorption (photoplethysmography; PPG) have not been applied to survey penile hemodynamics and erection quality. This paper compared the use of photoplethysmography (PPG) to study vascular ED with standard penile Doppler ultrasonography. Men diagnosed with vascular ED for at least 6 months and nominated for penile ultrasonography were included. PPG signals were collected during the ultrasound examination. All beat-to-beat PPG waveforms were aligned with the peak and averaged to one representative template waveform for feature analysis, including amplitude differences (APD) index, reflection time index (RTI), augmentation index (AI), and perfusion index (PI). An inverse correlation was found between end-erection amplitude and both erection hardness score (EHS) and resistive index (RI). APD index and EHS as well as the international index of erectile function-5 (IIEF) and RI were positively correlated. RTI and AI were inversely correlated to IIEF and RI. PI was positively correlated to RI. PPG may therefore be useful as a noninvasive, convenient, technique for sexual function evaluation. [ABSTRACT FROM AUTHOR]

Objective. To investigate the association between poststroke depression (PSD) and psychological crisis in patients who have experienced a stroke within 6 months. Methods. This was a retrospective cross-sectional study that enrolled patients within 6 months after stroke onset. The investigators reviewed medical charts to obtain patients' baseline characteristics, and a psychologist evaluated each patient for depression using the Taiwanese Depression Questionnaire (TDQ) and for psychological crisis using the Triage Assessment System (TAS). A generalized linear model (GLM) was used to analyze the association between the results of the TDQ and TAS. Results. Ninety-seven patients with stroke were included. Age (p = 0.003), time since onset of stroke (p = 0.041), diabetes mellitus (p = 0.004), hypertension (p = 0.016), heart disease (p = 0.005), and TDQ score were significantly different between the hemorrhagic stroke group and the ischemic stroke group. The TDQ score was significantly lower in the hemorrhagic stroke group (p = 0.012). The TDQ score was associated with the TAS total score and each domain score, and the presence of heart disease was associated with poorer TAS score in the behavioral domain (p = 0.016). Conclusion. PSD is likely an important component of psychological crisis in stroke patients. For clinicians, a comprehensive psychologic evaluation is necessary to optimize treatment. [ABSTRACT FROM AUTHOR]

Background: Stimulant poisoning frequently causes altered mental status (AMS) and can result in severe cerebral vascular complications. The role of noncontrast brain computed tomography (CT) in acute stimulant-poisoned patients presenting with AMS remains unclear.Objectives: We examined the results and impacts of brain CT in acute stimulant-poisoned patients with AMS.Methods: We performed a retrospective single-center study that included all adult patients who presented to the emergency department with stimulant poisoning and AMS (Glasgow coma scale [GCS] score <15) between January 1, 2010 and December 31, 2017. Patients who had concomitant head trauma or who presented with focal neurologic symptoms were excluded. The primary outcome was the rate of acute abnormalities on brain CT. The secondary outcomes were to identify factors that affected the decision to perform brain CT in stimulant-poisoned patients with AMS and whether obtaining the brain CT scan itself affected the patients' prognoses.Results: The analysis included 66 patients, of whom 6 died from the poisoning. Noncontrast brain CT was performed in 31 patients and none had acute abnormalities. Patients who underwent brain CT were found to have worse GCS scores, higher body temperatures, higher intubation rates, higher admission rates, longer admission periods and intensive care unit stays, and a higher mortality rate. After adjusting for the propensity score, performing brain CT itself did not independently affect the patients' clinical outcomes.Conclusions: Nontrauma stimulant-poisoned patients presenting with AMS and without focal neurologic symptoms were unlikely to have acute abnormalities on brain CT. Patients who underwent brain CT scans had worse consciousness and greater disease severity. [ABSTRACT FROM AUTHOR]

Purpose: Only few studies have investigated medial epicondyle (MEC) lesions, particularly in the 12-18 age group. To the best of our knowledge, no study has compared ultrasonography (US), radiography and magnetic resonance imaging (MRI) in detecting MEC lesions. The aims of this study were to examine the value of US for detecting MEC lesions and to investigate correlations among diagnostic tools.Methods: A prospective, comparative study was performed. Young baseball players from southern Taiwan were recruited, and basic characteristics, as well as passive range of motion (pROM) of the upper extremities, were recorded. Screening US was performed to identify MEC lesions, and players with MEC lesions received follow-up plain radiography and MRI.Results: A total of 299 young baseball players were screened using US, and 28 of 299 players with possible MEC lesions were identified with a positive predictive value (PPV) of 88% according to MRI findings. The MEC lesions were primarily comprised of unfused ossicles and bony fragmentation. Other diagnoses, including UCL strain and medial epicondylitis, were also found by MRI in players with abnormal US screening results. The pROM of shoulder external rotation (ER) of the throwing hand was significantly reduced in players with MEC lesions (p = 0.006).Conclusions: Bony cortical discontinuity or fragmentation over the MEC warrants further research, and US provides good PPV for types of MEC lesions. Decreased shoulder ER may relate to MEC lesions and should be taken into consideration. The use of US may facilitate early detection and intervention.Level Of Evidence: IV, Cross-sectional study. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate soft tissue disorders of affected shoulders after nerve-sparing selective neck dissection (SND) in patients with head and neck cancers (HNCs) by sonography. Eighteen HNCs patients with shoulder disability after SND were enrolled. Shoulder motions, pain, and the sonographic findings were measured and analyzed. Significantly decreased flexion, abduction, and increased pain were found on affected shoulders compared with normal shoulders. There were significant decrease in thickness of trapezius muscle (p=0.001), abnormal findings of supraspinatus tendon (p=0.022), and subdeltoid bursa (p=0.018) on surgical side. The ratio of trapezius muscle atrophy was related to shoulder pain (p=0.010). Patients with subdeltoid abnormalities had significant limitation on shoulder flexion and abduction. Abnormalities of supraspinatus tendon and subdeltoid bursa on sonography and trapezius muscle atrophy may play a key role in shoulder pain and shoulder flexion and abduction limitations. [ABSTRACT FROM AUTHOR]

Background. Extracorporeal shock wave therapy (ESWT) had been proved to be beneficial in calcific tendinosis; however, the treatment efficacy in noncalcific tendinosis of rotator cuff still remains controversial. The present study was to compare the outcomes ESWT among the noncalcific rotator cuff tendinosis and different types of calcific tendinosis on the basis of similar shoulder functional status. Methods. A retrospective, comparative study was conducted with the enrollment of 20 patients in each group through propensity score matching in a 1:1:1 ratio from 291 patients who underwent single ESWT for painful shoulder tendinosis. The patients were divided into three groups which included noncalcified tendinosis (NCTS), type I dense calcified tendinosis of shoulder (DCTS), and type II and type III translucent calcified tendinosis of shoulder (TCTS) according to Gartner and Heyer classification. The clinical evaluation included the subjective pain score with visual analog scale (VAS) and functional outcome with Constant and Murley score (CMS). Results. Twelve months after ESWT, the VAS in TCTS (1.5 ± 2.48) was statistically significant lower than NCTS (2.9 ± 2.86) and DCTS (3.8 ± 2.46) (p=.011). For the functional outcome, the overall CMS was superior in TCTS than the NCTS and DCTS (86.9 ± 19.7 versus 78.7 ± 18.3 and 71.1 ± 17.8, p=.014). Besides, the subscales of pain score, strength, and range of motion in TCTS improved significantly better than NCTS and DCTS. 70% of patients were complaint-free in TCTS group, which was higher than the NCTS group (15%) and DCTS group (25%) (p<0.05). Conclusion. The present study indicated that the high-dose ESWT posed superior clinical efficacy in type II/III calcification tendinosis rather than type I calcification and noncalcific shoulder tendinosis. [ABSTRACT FROM AUTHOR]

Photodeposition has been used extensively for nanomaterial growth on a substrate, but direct photodeposition of 2D transition metal dichalcogenides (TMDs) remains challenging. An alternative approach is to deposit 2D TMDs on a suitable nanomaterial template. In this work, large-scale MoS 2 /Cu 2 O/ZnO heterostructure arrays are formed by low-temperature in situ photodeposition and the nanocomposites are used for chemiresistive gas sensing at room temperature. Using 254 nm UV irradiation, Cu 2 O nanoclusters are photodeposited in solution on hydrothermally grown ZnO nanorod arrays and Cu 2 O/ZnO heterostructure arrays are first formed. MoS 2 nanoparticles are subsequently photodeposited on Cu 2 O and MoS 2 /Cu 2 O/ZnO heterostructure arrays with good uniformity on a sub-millimeter scale are consequently produced. The ternary nanocomposite with a 45 min MoS 2 photodeposition time shows the highest response of 890% toward 500 ppb NO 2 under UV-activated sensing. An excellent linear sensitivity of 18.7 ppm–1 has been achieved and the estimated lowest detection limit is 1.3 ppb, exhibiting good potential for monitoring of environmental NO 2 content. The outstanding performance is attributed to the combined chemical and electronic sensitization effects of the abundant heterojunctions in the nanocomposite. The present work reveals that facile in situ photodeposition is suitable for synthesis of large-scale MoS 2 /Cu 2 O/ZnO heterostructure arrays with remarkable gas sensing performance. [Display omitted] • Large-scale MoS 2 /Cu 2 O/ZnO nanostructure arrays with good uniformity are formed. • Low-temperature solution-phase in situ photodeposition was used for synthesis. • The ternary nanocomposites are used for UV-activated RT NO 2 gas sensing. • The linear sensitivity is 18.7 ppm–1 and the lowest detection limit is 1.3 ppb. • Chemical and electronic sensitization effects of heterojunctions enhance performance. [ABSTRACT FROM AUTHOR]

Abstract: Although construction contractor prequalification highly prioritizes the financial capacity of the construction contractors, a special assessment of contractors' financial capacities has seldom been performed in the construction industry. Cash flows largely reflect a contractor's capacity to meet its financial obligations, this study assesses the credit qualities of construction contractors by using a cash flow based credit model (CFB credit model). The model uses historical continuously free cash flow to firm of construction contractors to simulate possible future cash flow paths. The credit quality scores of construction contractors are then assessed using the CFB credit model. The results demonstrate the effectiveness of assessment of the credit quality of construction contractors, and recommend the clients to adopt it in prequalification of the contractors' financial abilities. [Copyright &y& Elsevier]

Abstract: The financial health of construction contractors is critical in successfully completing a project, and thus default prediction is highly concerned by owners and other stakeholders. In other industries many previous studies employ support vector machine (SVM) or other Artificial Neural Networks (ANN) methods for corporate default prediction using the sample-matching method, which produces sample selection biases. In order to avoid the sample selection biases, this paper used all available firm-years samples during the sample period. Yet this brings a new challenge: the number of non-defaulted samples greatly exceeds the defaulted samples, which is referred to as between-class imbalance. Although the SVM algorithm is a powerful learning process, it cannot always be applied to data with extreme distribution characteristics. This paper proposes an enforced support vector machine-based model (ESVM model) for the default prediction in the construction industry, using all available firm-years data in our sample period to solve the between-class imbalance. The traditional logistic regression model is provided as a benchmark to evaluate the forecasting ability of the ESVM model. All financial variables related to the prediction of contractor default risk as well as 7 variables selected by the Multivariate Discriminant Analysis (MDA) stepwise method are put in the models for comparison. The empirical results of this paper show that the ESVM model always outperforms the logistic regression model, and is more convenient to use because it is relatively independent of the selection of variables. Thus, we recommend the proposed ESVM model as an alternative to the traditionally used logistic model. [Copyright &y& Elsevier]

Abstract: This work describes the morphology and electro-optical properties of polymer-dispersed liquid crystals (PDLCs). These composites consist of the nematic liquid crystal E7, filled with different types of inorganic nanoparticles in Norland optical adhesive (NOA65) polymer matrices. Natural clays CL120 (trade name: CN-C34 with higher cation exchange capacity CEC) and CL42 (trade name: PK802 with lower CEC) are used as various inorganic nanofillers. Wide angle X-ray diffraction was exploited to examine the dispersion of the inorganic nanoparticles in PDLCs. The morphology of liquid crystal droplets in PDLCs is investigated by the field emission scanning electron microscope (FESEM) and transmission electron microscope (TEM) as well. Transmittance vs. applied voltage is measured to study the electro-optical properties and the response times of the PDLCs. It is suggested that doping with inorganic nanoparticles in PDLCs effectively reduces the driving voltage and improves the electro-optical characteristics. [Copyright &y& Elsevier]

• Toona sinensis (TS) leaf extract may modulate autophagy during inflammation. • TS leaf extract does not exhibit toxicity against RAW264.7 cells. • TS leaf extract inhibited mammalian target of rapamycin phosphorylation. • TS leaf extract may prevent cell damage via anti-inflammation and anti-oxidation. • TS leaf extract modulated the expression of interleukin-6 and -10. Toona sinensis (TS) is a medicinal herb possessing anti-apoptotic, anti-oxidant, and anti-inflammatory properties and is used to treat diabetes, cancer, and inflammatory diseases. In traditional Chinese medicine theory, TS clears dampness and heat, strengthens the stomach function, and regulates vital energy flow. TS is also used as an astringent and a pesticide. In this study, we aimed to evaluate how TS influences autophagy and cytokines during the inflammatory process in RAW 264.7 macrophages. The treatment groups were pre-supplemented with TS leaf extract; rapamycin was used to enhance autophagy and lipopolysaccharide (LPS) was used to induce inflammation. The expression of autophagy-related proteins was analyzed by western blotting. The survival rate of, and chemokine expression and oxidative stress in the cells were also assessed. TS leaf extract inhibited mammalian target of rapamycin (mTOR) phosphorylation at site S2448 in the macrophages. At relatively higher concentrations (50 and 75 μg/mL), TS elevated the expression of light chain 3 II (LC3-II), which further modulated autophagy. Pre-supplementation with TS leaf extract elevated the total glutathione (GSH) level and GSH/oxidized GSH (GSSG) ratio, but it decreased the GSSG, total nitric oxide, nitrate, nitrite, malondialdehyde, and superoxide anion levels. TS reversed the effects of LPS-induced cytokines, including interleukin (IL)-6 and IL-10. TS did not induce significant toxicity at the studied concentrations. In conclusion, TS leaf extract may modulate autophagy during inflammation. Furthermore, it may prevent cell damage via anti-inflammation and anti-oxidation. Thus, this study supports the ethnomedical use of TS in the prevention of inflammation-related diseases. [ABSTRACT FROM AUTHOR]

Purpose: Improve the accuracy of one-stage object detection by modifying the YOLOv7 with Convolutional Block Attention Module (CBAM), known as YOLOv7-CBAM, which can automatically identify torn or intact rotator cuff tendon to assist physicians in diagnosing rotator cuff lesions through ultrasound., Methods: Between 2020 and 2021, patients who experienced shoulder pain for over 3 months and had both ultrasound and MRI examinations were categorized into torn and intact group. To ensure balanced training, we included the same number of patients on both groups. Transfer learning was conducted using a pre-trained model of Yolov7 and an improved model with CBAM. The mean average precision (mAP), sensitivity and F1-score were calculated to evaluate the models. Gradient-weighted Class Activation Mapping (Grad-CAM) method was employed to visualize important regions using a heatmap. Simulation dataset was recruited to evaluate the diagnostic performance of clinical physicians using our AI-assisted model., Results: A total of 280 patients were included in this study, with 80% of 840 ultrasound images randomly allocated for model training. The accuracy for test set was 0.96 for Yolov7 and 0.98 for Yolov7-CBAM, the precision and sensitivity were 0.94 and 0.98 for Yolov7, 0.98 and 0.98 for Yolov7-CBAM. F1-score and mAP@0.5 were higher for Yolov7-CBAM (0.980 and 0.993) than Yolov7 (0.961 and 0.965). Furthermore, the Grad-CAM method elucidated that the deep learning model primarily emphasized hypoechoic anechoic defect within the tendon. Following adopting an AI-assisted model (YOLOv7-CBAM model), diagnostic accuracy improved from 80.86% to 88.86% (p=0.01) and interobserver reliability improved from 0.49 to 0.71 among physicians., Conclusion: The YOLOv7-CBAM model demonstrate high accuracy in detecting torn or intact rotator cuff tendon from ultrasound images. Integrating this model into the diagnostic process can assist physicians in improving diagnostic accuracy and interobserver reliability across different physicians., Clinical Relevance: The attentional deep learning model aids physicians in improving the accuracy and consistency of ultrasound diagnosis of torn or intact rotator cuff tendons., (Copyright © 2024. Published by Elsevier Inc.)

Background: Osteoporosis (OP) is a chronic inflammatory bone disease characterized by reduced bone structure and strength, leading to increased fracture risk. Effective therapies targeting both bone and cartilage are limited. This study compared the therapeutic effects of extracorporeal shockwave therapy (ESWT), bisphosphonate (Aclasta), and human Wharton jelly-derived mesenchymal stem cells (WJMSCs) in a rat model of OP. Methods: Female rats were assigned to four groups: Sham (no surgery or treatment), OP (bilateral ovariectomy, OVX), ESWT (OVX + ESWT on both tibias at 0.25 mJ/mm 2 , 1500 impulses per tibia), Aclasta (OVX + zoledronic acid 0.1 mg/kg via tail vein injection), and WJMSC (OVX + 2 × 10⁶ WJMSCs). Pathological changes, bone microarchitecture (by micro-CT), serum cytokines (by ELISA), and tissue-specific molecular markers (by immunohistochemistry) were evaluated. Results: All treatments improved bone density, preserved cartilage, and modulated cytokines (IL31, IL33, VEGF, and BMP2), with Aclasta showing the greatest improvements in bone parameters and cartilage preservation. ESWT and WJMSC also demonstrated significant effects, with ESWT highlighting non-invasive chondroprotective potential. Conclusions: Aclasta provided the best overall therapeutic response, particularly in bone regeneration. However, ESWT and WJMSC also showed comparable chondroprotective effects. ESWT emerges as a promising non-invasive alternative for OP management when pharmacological or cell-based therapies are not feasible.

Background: Extracorporeal shockwave therapy (ESWT) is the primary treatment for calcific tendinitis of the shoulders, but what are the effects of clinical, sonographic, and molecular markers following ESWT in treating calcific tendinitis of the shoulder?, Methods: Twenty-eight patients were categorized into radiodense and radiolucent subgroups. In addition, clinical assessments included the visual analogue scale (VAS), Constant-Murley (CM) score, American Shoulder and Elbow Surgeon (ASES) score, sonographic evaluation, and serum enzyme-linked immunosorbent assay (ELISA). The participants completed a 1-year follow-up. All data were collected before and after treatment., Results: After 1 year of follow-up, all patients showed notable improvement in VAS, CM, and ASES scores, with no significant clinical variations among the subgroups. However, the radiolucent group showed significant complete resorption and size reduction at the final follow-up. The sonographic evaluation revealed improved tissue perfusion and reduced calcification from 3 to 12 months in all patients, including those in the radiolucent group, but complete resorption of calcific deposits did not occur. The percentage of tissue perfusion was improved at 1 and 3 months after ESWT. There were no significant differences in the levels of the molecular markers interleukin-1 beta (IL-1 β) or IL-33, but the level of insulin-like growth factor 1 (IGF-1) was notably increased at 1 and 3 months post-ESWT. The BMP7 level was increased at 3 months and was then decreased significantly at 6 and 12 months., Conclusion: ESWT improved symptoms, reduced calcification, enhanced tissue perfusion, and promoted angiogenesis and BMP7 activity. In particular, it benefited radiolucent type patients with better calcification resorption. Partial resorption led to improvements in transparency, and a second ESWT session at 3 months was recommended for optimal results., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Nonunion of long bone fractures is a significant complication following surgical fixation, with an incidence ranging from 5 to 10%. Surgical intervention is the standard treatment for nonunions, but it may come with potential complications. Nonoperative approaches, such as Extracorporeal Shockwave Therapy (ESWT), have been advocated as alternatives., Methods: In the retrospective study conducted between January 2004 and January 2018, 91 patients who underwent ESWT for tibia or femur nonunions were included. Nonunion was defined based on radiographic criteria and clinical symptoms. The nonunion morphology was categorized as hypertrophic, oligotrophic, or atrophic. ESWT was administered using the OssaTron device in a single treatment session. Bony union was defined as the presence of a bridging callus over the fracture site with more than three-fourths of the circumference in both planes within the 12-month postoperative period., Results: The study included 91 patients, with an overall union rate of 62.6%. A higher healing rate was observed in trophic nonunion(69.9%) than in atrophic nonunion(33.3%). Multivariate analysis identified the number of surgeries, maximum fracture gap, and atrophic nonunion as independent factors influencing the risk of fracture nonunion after ESWT. The receiver operating characteristic curves were generated for these factors, providing more than one surgical intervention, and fracture gap greater than 3.94 mm as negative predictors of ESWT for long bone nonunions., Conclusion: The study's primary findings suggest that ESWT is effective in achieving bony union for nonunions in long bones(62.6%). Despite the overall positive results, the study highlights that atrophic nonunions, larger fracture gaps of more than 3.94 mm, and multiple surgeries are associated with poorer outcomes., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Aims: To explore the efficacy of extracorporeal shockwave therapy (ESWT) in the treatment of osteochondral defect (OCD), and its effects on the levels of transforming growth factor (TGF)-β, bone morphogenetic protein (BMP)-2, -3, -4, -5, and -7 in terms of cartilage and bone regeneration., Methods: The OCD lesion was created on the trochlear groove of left articular cartilage of femur per rat (40 rats in total). The experimental groups were Sham, OCD, and ESWT (0.25 mJ/mm 2 , 800 impulses, 4 Hz). The animals were euthanized at 2, 4, 8, and 12 weeks post-treatment, and histopathological analysis, micro-CT scanning, and immunohistochemical staining were performed for the specimens., Results: In the histopathological analysis, the macro-morphological grading scale showed a significant increase, while the histological score and cartilage repair scale of ESWT exhibited a significant decrease compared to OCD at the 8- and 12-week timepoints. At the 12-week follow-up, ESWT exhibited a significant improvement in the volume of damaged bone compared to OCD. Furthermore, immunohistochemistry analysis revealed a significant decrease in type I collagen and a significant increase in type II collagen within the newly formed hyaline cartilage following ESWT, compared to OCD. Finally, SRY-box transcription factor 9 (SOX9), aggrecan, and TGF-β, BMP-2, -3, -4, -5, and -7 were significantly higher in ESWT than in OCD at 12 weeks., Conclusion: ESWT promoted the effect of TGF-β/BMPs, thereby modulating the production of extracellular matrix proteins and transcription factor involved in the regeneration of articular cartilage and subchondral bone in an OCD rat model., Competing Interests: The authors declare no conflicts of interest., (© 2024 Cheng et al.)

Study Objectives: The prevalence of obstructive sleep apnea (OSA) after stroke is variable, likely due to the time of examination and patient population. Although risk factors for OSA are well established, those for OSA in patients with ischemic stroke have not yet been fully identified. Therefore, we examined the prevalence of OSA and identified risk factors for OSA in the acute stage of ischemic stroke in the Taiwanese population., Methods: A total of 103 patients with acute ischemic stroke were screened for OSA by performing polysomnography. The demographic and clinical data, Epworth Sleepiness Scale score, and other stroke risk factors were recorded. Sleep parameters, namely sleep efficiency, sleep stages, apnea-hypopnea index, and oxygen desaturation index were recorded. Logistic regression analysis was conducted to determine clinical and demographic risk factors for moderate to severe OSA in patients with stroke., Results: We determined that 91.2% of the patients had OSA in the acute stage of ischemic stroke, and 70% of the patients had moderate to severe OSA. Multivariate logistic regression analysis revealed that patients aged ≥65 years had a significantly higher risk of moderate to severe OSA (adjusted OR: 3.04, 95% CI: 1.20-7.69, p < 0.05) compared with patients with ischemic stroke aged <50 years., Conclusion: OSA is highly prevalent among patients with ischemic stroke in the acute stage, and those aged ≥65 years had a significantly increased risk of moderate to severe OSA. In clinical practice, routine PSG screening of OSA may be necessary among older patients with stroke., Competing Interests: Declaration of competing interest The authors declare no financial and non-financial competing interests., (Copyright © 2023. Published by Elsevier B.V.)

The benefits of branched-chain amino acid (BCAA) administration after hepatic intervention in patients with liver diseases remain unclear. We conducted a systematic review and meta-analysis to evaluate the effects of BCAA on patients undergoing hepatectomy, trans-arterial embolisation and radiofrequency ablation. Relevant randomised controlled trials (RCT) were obtained from PubMed, EMBASE and Cochrane Library databases. A meta-analysis was performed to calculate the pooled effect size by using random-effects models. The primary outcomes were survival and tumour recurrence. The secondary outcomes were hospital stay, nutrition status, biochemistry profile, complication rate of liver treatment and adverse effect of BCAA supplementation. In total, eleven RCT involving 750 patients were included. Our meta-analysis showed no significant difference in the rates of tumour recurrence and overall survival between the BCAA and control groups. However, the pooled estimate showed that BCAA supplementation in patients undergoing hepatic intervention significantly increased serum albumin (mean difference (MD): 0·11 g/dl, 95 % CI: 0·02, 0·20; 5 RCT) at 6 months and cholinesterase level (MD: 50·00 U/L, 95 % CI: 21·08, 78·92; 1 RCT) at 12 months and reduced ascites incidence (risk ratio: 0·39, 95 % CI: 0·21, 0·71; 4 RCT) at 12 months compared with the control group. Additionally, BCAA administration significantly increased body weight at 6 months and 12 months and increased arm circumference at 12 months. In conclusion, BCAA supplementation significantly improved the liver function, reduced the incidence of ascites and increased body weight and arm circumference. Thus, BCAA supplementation may beneficial for selected patients undergoing liver intervention.

Background: Impaired upper limb function in stroke survivors is characterized by muscle weakness, increased muscle tone, contracture, or impaired motor control., Objective: We aimed to evaluate the effectiveness of Kinesio-taping application for functional recovery on the affected arm and forearm during rehabilitation., Methods: Forty-one patients eligible for this study were randomly assigned to either the Kinesio-taping group (n = 21), receiving Kinesio-taping intervention and conventional therapy, or control group (n = 20), receiving sham Kinesio-taping intervention and conventional therapy. The whole intervention lasted for 3 weeks. Fugl-Meyer assessment of the upper extremity, Barthel Index, the Stroke Impact Scale, and modified Ashworth scale were measured at 3 time points: baseline, post-treatment (3rd week), and follow-up (6th week)., Results: In the Kinesio-taping group, there were significant differences in the upper extremity (p = 0.003), wrist (p = 0.000) and hand (p = 0.000) parts of the Fugl-Meyer assessment of the upper extremity between the three assessment times. On the other hand, the Barthel Index showed significant differences in both groups after therapy., Conclusion: Combining conventional rehabilitation with Kinesio-taping intervention may improve functional motor performance of both the proximal and distal parts of the affected upper extremity in stroke survivors, with potential benefits for activity of daily living.

Introduction: Post-stroke depression (PSD) is a serious mental disorder after ischemic stroke. Early detection is important for clinical practice. This research aims to develop machine learning models to predict new-onset PSD using real-world data., Methods: We collected data for ischemic stroke patients from multiple medical institutions in Taiwan between 2001 and 2019. We developed models from 61,460 patients and used 15,366 independent patients to test the models' performance by evaluating their specificities and sensitivities. The predicted targets were whether PSD occurred at 30, 90, 180, and 365 days post-stroke. We ranked the important clinical features in these models., Results: In the study's database sample, 1.3% of patients were diagnosed with PSD. The average specificity and sensitivity of these four models were 0.83-0.91 and 0.30-0.48, respectively. Ten features were listed as important features related to PSD at different time points, namely old age, high height, low weight post-stroke, higher diastolic blood pressure after stroke, no pre-stroke hypertension but post-stroke hypertension (new-onset hypertension), post-stroke sleep-wake disorders, post-stroke anxiety disorders, post-stroke hemiplegia, and lower blood urea nitrogen during stroke., Discussion: Machine learning models can provide as potential predictive tools for PSD and important factors are identified to alert clinicians for early detection of depression in high-risk stroke patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Chen, Chen, Lin, Hung, Chen, Hung, Wang, Wu, Hsu and Kao.)