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Abstract Background This study determined (1) whether a change in frailty status after a 1 year follow up is associated with healthcare utilization and evaluated (2) whether a change in frailty status after a 1 year follow up and health care utilization are associated with all-cause mortality in a sample of Taiwan population. Methods This work is a population-based prospective cohort study involving residents aged ≥65 years in 2009. A total of 548 elderly patients who received follow-ups in the subsequent year were included in the current data analysis. Fried frailty phenotype was measured at baseline and 1 year. Information on the outpatient visits of each specialty doctor, emergency care utilization, and hospital admission during the 2 month period before the second interview was collected through standardized questionnaires administered by an interviewer. Deaths were verified by indexing to the national database of deaths. Results At the subsequent 1 year follow-up, 73 (13.3%), 356 (64.9%), and 119 (21.7%) elderly participants exhibited deterioration, no change in status, and improvement in frailty states, respectively. Multivariate logistic analysis showed the high risk of any type of outpatient use (odds ratios [OR] 1.94, 95% confidence interval [CI] 1.02–3.71) among older adults with worse frailty status compared with those who were robust at baseline and had unchanged frailty status after 1 year. After multivariate adjustment, participants with high outpatient clinic utilization had significantly higher mortality than those with low outpatient clinic visits among unchanged pre-frail or frail (hazard ratios [HR] 2.79, 95% CI: 1.46–5.33) and frail to pre-frail/robust group (HR 9.32, 95% CI: 3.82–22.73) if the unchanged robustness and low outpatient clinic visits group was used as the reference group. Conclusions The conditions associated with frailty status, either after 1 year or at baseline, significantly affected the outpatient visits and may have increased medical expenditures. Combined change in frailty status and number of outpatient visits is related to increased mortality.

Abstract Background The use of home health care (HHC) is increasing worldwide. This may have an impact not only on patients and their caregivers’ health but on care resource utilization and costs. We lack information on the impact of HHC on the broader dimensions of health status and care resource utilization. More understanding of the longitudinal HHC impact on HHC patients and caregivers is also needed. Moreover, we know little about the synergy between HHC and social care. Therefore, the present study aims to observe longitudinal changes in health, care resource utilization and costs and caregiving burden among HHC recipients and their caregivers in Taiwan. Methods A prospective cohort study “Home-based Longitudinal Investigation of the Multidisciplinary Team Integrated Care (HOLISTIC)” will be conducted and 600 eligible patient-caregiver dyads will be recruited and followed with comprehensive quantitative assessments during six home investigations over two years. The measurements include physical function, psychological health, cognitive function, wellbeing, shared decision making and advance care planning, palliative care and quality of dying, caregiving burden, continuity and coordination of care, care resource utilization, and costs. Discussion The HOLISTIC study offers the opportunity to comprehensively understand longitudinal changes in health conditions, care resource utilization and costs and caregiving burden among HHC patients and caregivers. It will provide new insights for clinical practitioners and policymakers. Trial registration ClinicalTrials.gov Identifier is NCT04250103 which has been registered on 31st January 2020.

Background/Aims: Awareness of chronic kidney disease (CKD) has been low among affected patients, particularly the older ones. However, whether such awareness is synonymous with the presence of laboratory-diagnosed CKD among older adults is currently unclear. Methods: We enrolled community-dwelling old adults (≥ 65 years) who received health examinations between 2013 and 2016 from a regional metropolitan hospital. Clinical information and geriatric syndromes including depression, cognitive impairment, fall, quality of life, and visual disturbance were evaluated during the medical interview. We compared the differences in clinical features between those with and without self-reported or estimated glomerular filtration rate (eGFR)-based CKD and investigated their influences and interactions on the risk of CKD complications and geriatric syndromes. Results: Among the 2932 enrolled older adults (mean 73.4 ± 7 years), 93 (3%) reported that they had CKD by history, while 306 (10%) had an eGFR < 60 mL/min/1.73m2 persisted for over 3 months. The prevalence of hyperlipidemia, body mass index, waist circumference, leukocyte count, and the incidence of fall differed only between those with and without eGFR-based CKD, but not between those with and without self-reported CKD. A synergistic effect was found between self-reported and eGFR-based CKD regarding the CKD complication severity, including malnutrition (albumin), anemia (hemoglobin), dyslipidemia (serum cholesterol), and geriatric syndromes (cognitive and quality of life impairment). Multivariate regression analyses showed that self-reported CKD exhibited better predictive efficacy for lower serum albumin and hemoglobin than eGFR-based CKD, while the latter outperformed the former for predicting lower serum cholesterol and a higher risk of cognitive impairment. Conclusion: Among older adults, self-reported CKD may not be a surrogate for laboratory-diagnosed CKD and has an independent effect on CKD-related complications.

Background: Older adults are at an increased risk of frailty, but laboratory surrogates for identifying frailty in this population remain controversial and clinicians frequently encounter difficulty during frailty screening. We examined whether having a high red cell distribution width (RDW) was associated with an increased probability of frailty in older adults.Methods: We prospectively included community-dwelling older adults between 2013 and 2016 from a single institute, with their clinical features/laboratory parameters documented. We used the Study of Osteoporotic Fractures index (malnutrition, poor physical performance, and fatigue) to delineate frailty, and harnessed multiple logistic regression to investigate whether having a high RDW (≥ 15.7%) was associated with an increased risk of having frailty among these participants.Results: A total of 2,932 older adults (mean 73.5 ± 6.7 years; 44.6% male) were included, among whom 113 (3.9%) and 76 (2.6%) had a high RDW and presented frailty, respectively. Older adults with a high RDW were more likely to be frail (p = 0.002) and had more positive SOF items than those with normal RDW levels (p = 0.013). Those with a high RDW exhibited a significantly higher risk of having frailty (odds ratio [OR] 2.689, 95% confidence interval [CI] 1.184–6.109) compared to those without. Sensitivity analyses using RDW as a continuous variable similarly showed that RDW levels were positively associated with frailty risk (OR 1.223 per 1% RDW higher).Conclusions: In older adults, higher RDW can be regarded as a frailty indicator, and the readiness in RDW assessment supports its screening utility.

Summary: Background: The frail older population is increasing rapidly. More understanding for the frail status and quality of life (QOL) among older adults is important. Methods: This study was a cross-sectional survey. The Fried Frailty Criteria (FFC), Barthel Index scale, and World Health Organization Quality of Life questionnaire (WHOQOL-BREF) were used as measurements for all participants. In total, 180 frail or pre-frail older adults were recruited and completed all questionnaires. Results: The slow working speed and weakness of grip strength were two significant FFC criteria for lower scores of QOL (t = 2.89, 2.41; p

Abstract Background Residents of long-term care facilities (LTCFs) colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation to ensure appropriate infection control. This isolation may reduce opportunities for rehabilitation and social stimuli and may also increase medical costs. However, the number of previous studies investigating the duration of colonization in LTCFs is limited. This study was conducted to determine the duration of colonization and risk factors for prolonged carriage of MDROs among residents of a LTCF. Methods This retrospective study was conducted in a hospital-affiliated nursing home with 59 beds. Fifty-four residents in the nursing home were isolated for MDROs between January 1, 2013 and December 31, 2015. Clinical data were collected from the charts of these 54 residents, including catheter use, colonizing MDRO species and site, underlying diseases, Charlson Comorbidity Index (CCI) scores, and Barthel index scores before and after isolation. Forty-seven residents were included into the statistic analysis. Multivariate Cox regression analyses were performed using duration of colonization as the dependent variable. Results The most frequently isolated MDROs were vancomycin-resistant enterococci (VRE) (44.7%), and the median duration of colonization was 72 (4–407) days. An increased CCI score significantly increased the risk of prolonged colonization (HR: 0.86, 95% CI: 0.76–0.98, p value 0.02). Conclusion Among residents of the LTCF, the average duration of MDRO colonization was approximately 3 months. CCI scores were positively associated with the duration of the MDRO colonization of the LTCF residents. Further studies should be conducted to determine whether implementing isolation protocols for MDRO-colonized LTCF residents is associated with a decline in ADL. Trial registration The study protocol was approved by the National Center of Excellence for Clinical Trial and Research of the National Taiwan University Hospital ( 201512080RINB ). The date of registration was December 24, 2015.

BACKGROUND:The ageing process may lead to reductions in physical fitness, a known risk factor in the development of metabolic syndrome. The purpose of the current study was to evaluate cross-sectional and combined associations of metabolic syndrome with body composition and physical fitness in a community based geriatric population. METHODS:A total of 628 community-dwelling elders attending a geriatric health examination were enrolled in the study. The diagnosis of metabolic syndrome was based on the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criterion with Asian cutoff of waist girth was adopted in this study. Body composition was obtained using bioimpedance analysis, and physical fitness was evaluated through the measurement of muscle strength (handgrip force), lower extremity muscle endurance (sit-to-stand test), flexibility (sit-and-reach test), and cardiorespiratory endurance (2-minute step test). Multivariable logistic regression and correlation analysis were performed to determine the association of metabolic syndrome with body composition and functionality variables. RESULTS:Metabolic syndrome was associated with increased skeletal muscle index (SMI) (odds ratio (OR), 1.61, 95% confidence interval (CI), 1.25-2.07) and decreased flexibility (OR, 0.97, 95% CI, 0.95-0.99) compared with those without metabolic syndrome. When body mass index was accounted for in the analysis, the association of SMI with metabolic syndrome was reduced. Waist circumference was positively correlated with SMI but negatively correlated with flexibility, whereas high density lipoprotein was positively correlated with flexibility but negatively correlated with SMI. CONCLUSION:Reduced flexibility was positively associated with metabolic syndrome independent of age, gender, body composition, and functionality measurements in a community based geriatric population. Significant associations between metabolic syndrome with muscle strength and cardiorespiratory fitness in the elderly were not observed. Furthermore, flexibility should be included in the complete evaluation for metabolic syndrome.

Background/purpose: Accumulating evidence has suggested that treatment failure of cancer therapy can be attributed to cancer stem cells (CSCs). Among numerous regulators of cancer stemness, non-coding RNAs (ncRNAs) have gained significant attention recently. In this study, we examined the role of gastric adenocarcinoma predictive long intergenic noncoding RNA (GAPLINC) in oral CSCs (OCSCs). Materials and methods: RNA Sequencing and quantitative real-time polymerase chain reaction (qRT-PCR) were used to determine the expression of GAPLINC. Flow cytometry and sphere-forming assay were exploited to isolate OCSCs. Measurement of aldehyde dehydrogenase 1 (ALDH1) activity, CD44 expressing cells, and various phenotypic assays, such as self-renewal, migration, invasion, and colony-forming abilities, were conducted in CSCs of two types of oral cancer cells (SAS and GNM) following the knockdown of GAPLINC. A luciferase reporter was also carried out to validate the direct interaction between GAPLINC and microRNA (miR)-331-3p. Results: Our results showed that GAPLINC was overexpressed in OCSCs from patient-derived and oral cancer cell lines. We demonstrated that silencing of GAPLINC in OCSCs downregulated various CSC hallmarks, such as ALDH1 activity, percentage of CD44-expressing cells, self-renewal capacity, and colony-forming ability. Moreover, our results revealed that the effect of GAPLINC on cancer stemness was mediated by direct repression of miR-331-3p. Conclusion: These data have potential clinical implications in that we unraveled the aberrant upregulation of GAPLINC and demonstrated that suppression of GAPLINC may reduce cancer stemness via sequestering miR-331-3p.

Background/purpose: Periodontitis is an inflammatory condition of the tooth-supporting structures triggered by the host's immune response towards the bacterial deposits around the teeth. It is well acknowledged that pro-inflammatory interleukin (IL)-6, IL-8, MCP-1 as well as the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome, are the key modulators in the activation of this response. Erbium-doped yttrium-aluminium-garnet (Er:YAG) laser, a solid-state crystal laser have been commonly used in the treatment of periodontal diseases. However, little is understood about the molecular mechanism of the Er:YAG laser, especially in targeting the host immune response brought on by periodontal pathogens. Hence, the current study focused on the protective effects of Er:YAG laser on periodontitis in-vitro in terms of pro-inflammatory cytokines, chemokines and NLRP3 inflammasome expressions. Materials and methods: Human periodontal ligament fibroblast (PDLFs) were first stimulated with lipopolysaccharides (LPS) from P. gingivalis (Pg-LPS) to simulate periodontitis. Cells were then irradiated with Er:YAG laser of ascending energy densities (3.6–6.3 J/cm2), followed by cell proliferation and wound healing assay. Next, the effects of Er:YAG laser on the expressions of IL-6, IL-8, MCP-1, NLRP3, and cleaved GSDMD were examined. Results: Pg-LPS was found to reduce cell's proliferation rate and wound healing ability in PDLFs and these were rescued by Er:YAG laser irradiation. In addition, LPS stimuli resulted in a marked upregulation in the secretion of IL-6, IL-8 and MCP-1 as well as the mRNA and protein expression of NLRP3 and cleaved-GSDMD protein whereas Er:YAG laser suppressed the elicited phenomena. Conclusion: To our knowledge, this is the first study to look into the laser's implication on the NLRP3 inflammasome in periodontitis models. Our study reveals a crucial role of Er:YAG laser in ameliorating periodontitis in-vitro through the modulation of IL-6, IL-8, MCP-1 and the NLRP3 inflammasome and highlights that the control of the NLRP3 inflammasome may become a potential approach for periodontitis.

Background/purpose: The teaching practice research program was initiated by Taiwan's Ministry of Education in 2018 to improve medical teaching quality. This study analyzed dental teaching projects conducted under this program from 2018 to 2023. Materials and methods: Data of submitted and approved medical (including dental) teaching projects from 2018 to 2023 were obtained from the annual reports released by the program committee. The annual passing rates were calculated by dividing the number of approved dental teaching projects by the total number of approved medical teaching projects in the category of medical and healthcare sciences in a particular year. The 24 approved dental teaching projects were reviewed, classified into different topics in the dental field, and then reported. Results: There were 24 approved dental teaching projects out of a total of 822 approved medical teaching projects from 2018 to 2023. The annual passing rates increased gradually from 2018 (1.4 %) to 2022 (3.9 %) and 2023 (3.8 %) with an overall mean passing rate of 2.9 % over a period of 6 years. Of the 24 approved dental teaching projects, digital dentistry was the most common teaching research topic (9 projects), followed by new teaching models (7 projects), 3D technology (3 projects), endodontics (3 projects), dental histology (one project), and evidence-based method (one project). Conclusion: Digital dentistry and new teaching models were the two predominant dental teaching research topics, suggesting that both are the modern trends in the dental education. However, the dental teaching research projects are still very limited in 8 Taiwanese dental schools.

Dynamic random access memory (DRAM) serves as a critical component in medical equipment. Given the exacting standards demanded by medical equipment products, manufacturers face pressure to improve their product quality. The electrical characteristics of these products are based on the resistance value of the DRAM components. Hence, the purpose of this study is to optimize the resistance value of DRAM components in medical equipment. We proposed a novel FMEA-TSTM-NNGA framework that integrates failure mode and effect analysis (FMEA), the two-stage Taguchi method (TSTM), neural networks (NN), and genetic algorithms (GA) to optimize the manufacturing process. Moreover, the proposed FMEA-TSTM-NNGA framework achieved a substantial reduction in experimental trials, cutting the required number by a factor of 85.3 when compared to the grid search method. Our framework successfully identified optimal manufacturing condition settings for the resistance values of DRAM components: Depo time = 27 s, Depo O2 flow = 151 sccm, ARC-LTO etch time = 43 s, ARC-LTO etch pressure = 97 mTorr, Ox-SiCO etch time = 91 s, Ox-SiCO gas ratio = 22%, and Polish time = 84 s. The results helped the case company improve the resistance value of DRAM components from 191.1 × 10−3 Ohm to 176.84 × 10−3 Ohm, which is closer to the target value of 176.5 × 10−3 Ohm. The proposed FMEA-TSTM-NNGA framework is designed to operate efficiently on resource-constrained, facilitating real-time adjustments to production attributes. This capability enables DRAM manufacturers to swiftly optimize product quality.

Purpose: The performance of pulse sequences in vivo can be limited by fast relaxation rates, magnetic field inhomogeneity, and nonuniform spin excitation. We describe here a method for pulse sequence optimization that uses a stochastic numerical solver that in principle is capable of finding a global optimum. The method provides a simple framework for incorporating any constraint and implementing arbitrarily complex cost functions. Efficient methods for simulating spin dynamics and incorporating frequency selectivity are also described. Methods: Optimized pulse sequences for polarization transfer between protons and X‐nuclei and excitation pulses that eliminate J‐coupling modulation were evaluated experimentally using a surface coil on phantoms, and also the detection of hyperpolarized [2‐13C]lactate in vivo in the case of J‐coupling modulation‐free excitation. Results: The optimized polarization transfer pulses improved the SNR by ~50% with a more than twofold reduction in the B1 field, and J‐coupling modulation‐free excitation was achieved with a more than threefold reduction in pulse length. Conclusion: This process could be used to optimize any pulse when there is a need to improve the uniformity and frequency selectivity of excitation as well as to design new pulses to steer the spin system to any desired achievable state. [ABSTRACT FROM AUTHOR]

Ferroelectric HfO2 thin film has been widely explored due to its superior characteristics, such as high switching speed, scalability, and long data retention. However, it still faces challenges in achieving good stability due to the wake-up and split-up effects. In this study, the sub-cycling behavior of Hf0.5Zr0.5O2-based ferroelectric capacitors (FeCaps) with various annealing temperatures is investigated. Our results suggest that the FeCaps with higher annealing temperatures demonstrate an increased resistance to the split-up effect and exhibit less distorted hysteresis loops compared to their lower-temperature counterparts. Symmetrical sub-cycling reveals pronounced current split-up and diminished switching current peaks in the FeCaps with lower annealing temperatures, whereas those annealed at higher temperatures show minimal current split-up and enhanced performance. Asymmetrical sub-cycling shows that lower annealing temperatures cause local domain pinning, while higher temperatures result in imprint-like behavior. Synchrotron-based extended x-ray absorption fine structure and hard x-ray photoelectron spectroscopy analyses reveal the potential of nitrogen doping in HfZrOx under high-temperature annealing processes, forming the Hf–N species to mitigate the amount of charged oxygen vacancy ( V O 2 + ) in the interfacial region. This study elucidates the relationship between V O 2 + distribution and the split-up effect during sub-cycling, providing critical insights for enhancing the sub-cycling performance and stability of HfO2-based devices.

Many dynamic random-access memory (DRAM) manufacturing companies encounter significant resistance value deviations during the PVD sputtering process for manufacturing Ti thin films. These resistance values are influenced by the thickness of the thin films. Current mitigation strategies focus on adjusting film thickness to reduce resistance deviations, but this approach affects product structure profile and performance. Additionally, varying Ti thin film thicknesses across different product structures increase manufacturing complexity. This study aims to minimize resistance value deviations across multiple film thicknesses with minimal resource utilization. To achieve this goal, we propose the TSDTM-ANN-GA framework, which integrates the two-stage dynamic Taguchi method (TSDTM), artificial neural networks (ANN), and genetic algorithms (GA). The proposed framework requires significantly fewer experimental resources than traditional full factorial design and grid search method, making it suitable for resource-constrained and low-power computing environments. Our TSDTM-ANN-GA framework successfully identified an optimal production condition configuration for five different Ti thin film thicknesses: Degas temperature = 245 °C, Ar flow = 55 sccm, DC power = 5911 W, and DC power ramp rate = 4009 W/s. The results indicate that the deviation between the resistance values and their design values for the five Ti thin film thicknesses decreased by 86.8%, 94.1%, 95.9%, 98.2%, and 98.8%, respectively. The proposed method effectively reduced resistance deviations for the five Ti thin film thicknesses and simplified manufacturing management, allowing the required design values to be achieved under the same manufacturing conditions. This framework can efficiently operate on resource-limited and low-power computers, achieving the goal of real-time dynamic production parameter adjustments and enabling DRAM manufacturing companies to improve product quality promptly.

Background/purpose: Emerging evidence has shown that various failures in cancer therapy, such as drug resistance, metastasis, and cancer relapse are attributed to cancer stem cells (CSCs). Also, growing attention has been paid to the regulation of non-coding RNAs in cancer stemness. Here, we aimed to investigate the contribution of LINC01296 in the modulation of oral CSCs. Materials and methods: The phenotypic assays including migration, invasion, and colony-forming abilities were carried out in CSCs of two types of oral cancer cells (SAS and GNM) following the knockdown of LINC01296. In addition, the percentage of cells expressing stemness marker, ALDH1, and drug resistance marker, ABCG2, was examined as well as the self-renewal capacity after silencing of LINC01296. Moreover, a luciferase reporter was used to validate the direct interaction between LINC01296 and miR-143. Results: Our results showed that LINC01296 was significantly overexpressed in oral cancer tissues and positively correlated with stemness markers. The phenotypic and flow cytometry assays demonstrated that suppression of LINC01296 reduced the aggressiveness, cancer stemness features, and colony-forming and self-renewal abilities in oral CSCs. Furthermore, we demonstrated that LINC01296 may enhance cancer stemness features through suppression of the effect of miR-143. Conclusion: Silencing of LINC01296 may be a promising direction for oral cancer therapy by reducing cancer stemness via regulation of miR-143.

Abstract Background Breast cancer is a prevalent disease in women, with high prevalence worldwide. The hypoxic microenvironment of solid tumors develops during the progress of carcinogenesis and leads to greater malignancy and treatment resistance. Recently, accumulating evidence indicates that non-coding RNAs, such as circular RNAs (circRNAs), play a pivotal role in altering cellular functions. However, the underlying mechanisms of circRNAs in breast cancer are still unclear. Therefore, the purpose of this study was to investigate the role of a tumor-suppressive circRNA, circAAGAB, in breast cancer by assuming down-regulation of circAAGAB under hypoxia and the properties of a tumor suppressor. Methods Firstly, circAAGAB was identified from expression profiling by next generation sequencing. Next, the stability of circAAGAB increased by interacting with the RNA binding protein FUS. Moreover, cellular and nuclear fractionation showed that most circAAGAB resided in the cytoplasm and that it up-regulated KIAA1522, NKX3-1, and JADE3 by sponging miR-378 h. Lastly, the functions of circAAGAB were explored by identifying its down-stream genes using Affymetrix microarrays and validated by in vitro assays. Results The results showed that circAAGAB reduced cell colony formation, cell migration, and signaling through p38 MAPK pathway, as well as increased radiosensitivity. Conclusion These findings suggest that the oxygen-responsive circAAGAB acts as a tumor suppressor in breast cancer, and may contribute to the development of a more specific therapeutic regimen for breast cancer.

The timely and precise prediction of cardiovascular disease (CVD) risk is essential for effective prevention and intervention. This study proposes a novel framework that integrates the two-phase Taguchi method (TPTM), the hyperparameter artificial neural network (HANN), and a genetic algorithm (GA) called TPTM-HANN-GA. This framework efficiently optimizes hyperparameters for an artificial neural network (ANN) model during the training stage, significantly enhancing prediction accuracy for cardiovascular disease (CVD) risk. The proposed TPTM-HANN-GA framework requires far fewer experiments than a traditional grid search, making it highly suitable for application in resource-constrained, low-power computers, and edge artificial intelligence (edge AI) devices. Furthermore, the proposed TPTM-HANN-GA framework successfully identified the optimal configurations for the ANN model’s hyperparameters, resulting in a hidden layer of 4 nodes, a tanh activation function, an SGD optimizer, a learning rate of 0.23425849, a momentum rate of 0.75462782, and seven hidden nodes. This optimized ANN model achieves 74.25% accuracy in predicting the risk of cardiovascular disease, which exceeds the existing state-of-the-art GA-ANN and TSTO-ANN models. The proposed TPTM-HANN-GA framework enables personalized CVD prediction to be efficiently conducted on low-power computers and edge-AI devices, achieving the goal of point-of-care testing (POCT) and empowering individuals to manage their heart health effectively.

The complexity of cardiovascular disease onset emphasizes the vital role of early detection in prevention. This study aims to enhance disease prediction accuracy using personal devices, aligning with point-of-care testing (POCT) objectives. This study introduces a two-stage Taguchi optimization (TSTO) method to boost predictive accuracy in an artificial neural network (ANN) model while minimizing computational costs. In the first stage, optimal hyperparameter levels and trends were identified. The second stage determined the best settings for the ANN model’s hyperparameters. In this study, we applied the proposed TSTO method with a personal computer to the Kaggle Cardiovascular Disease dataset. Subsequently, we identified the best setting for the hyperparameters of the ANN model, setting the hidden layer to 4, activation function to tanh, optimizer to SGD, learning rate to 0.25, momentum rate to 0.85, and hidden nodes to 10. This setting led to a state-of-the-art accuracy of 74.14% in predicting the risk of cardiovascular disease. Moreover, the proposed TSTO method significantly reduced the number of experiments by a factor of 40.5 compared to the traditional grid search method. The TSTO method accurately predicts cardiovascular risk and conserves computational resources. It is adaptable for low-power devices, aiding the goal of POCT.

IntroductionOxidative stress is involved in numerous inflammatory diseases, including trauma. Micronutrients, such as selenium (Se), which contribute to antioxidant defense, exhibit low plasma levels during critical illness. This study aimed to investigate the impact of early Se supplementation on trauma patients.Materials and methodsA total of 6,891 trauma patients were registered at a single medical center from January 2018 to December 2021. Twenty trauma patients with Se supplemented according to the protocol were included in the study group. Subsequently, 1:5 propensity score matching (PSM) analysis was introduced. These patients received 100 mcg three times a day for 5 days. The primary outcome was overall survival (OS); the secondary outcomes were hospital/intensive care unit (ICU) length of stay (LOS), serologic change, ventilator dependence days, and ventilation profile.ResultsThe hospital LOS (20.0 ± 10.0 vs. 37.4 ± 42.0 days, p = 0.026) and ICU LOS (6.8 ± 3.6 vs. 13.1 ± 12.6 days, p < 0.006) were significantly shorter in the study group. In terms of serology, improvement in neutrophil, liver function, and C-reactive protein (CRP) level change percentile indicated better outcomes in the study group as well as a better OS rate (100 vs. 83.7%, p = 0.042). Longer ventilator dependence was found to be an independent risk factor for mortality and pulmonary complications in 6,891 trauma patients [odds ratio (OR) = 1.262, 95% confidence interval (CI) = 1.039–1.532, p < 0.019 and OR = 1.178, 95% CI = 1.033–1.344, p = 0.015, respectively].ConclusionEarly Se supplementation after trauma confers positive results in terms of decreasing overall ICU LOS/hospital LOS and mortality. Organ injury, particularly hepatic insults, and inflammatory status, also recovered better.