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Educational sign language interpreting services (SLIS) are vital for ensuring equal access to classroom information for mainstreamed deaf students. This study conducted interviews with 12 stakeholders, including deaf students and their parents, sign language interpreters, and resource room teachers, to comprehensively explore the status of educational SLIS in Taiwan, utilising the ecological systems theory as the framework. The findings underscore the critical importance of deaf students' sign language proficiency in the personal system. Sign language interpreters play a crucial role in enhancing their skills through additional time and support, leading to improved learning, motivation, and attitudes. At the microsystem level, parents of deaf students are key persons in advocating for the SLIS of primary school, while resource room teachers assist at the university level during the application process. In the mesosystem, interpreter stability is crucial for parents and students. Close collaboration between sign language interpreters and teachers is essential for adjusting teaching methods and seating arrangements, and interpreters should possess qualities like enthusiasm, patience, and an understanding of students' psychological development. At the exosystem level, higher education institutions offer established systems for educational SLIS, but primary schools lack clear regulations. Budget constraints limit comprehensive provision, making it challenging to attract qualified professionals. Increased funding and improved incentives are necessary. In the macrosystem, deaf parents expect early intervention with sign language learning resources to create a conducive environment for early sign language acquisition.

The interleukin-4 (IL-4) cytokine plays a critical role in modulating immune homeostasis. Although there is great interest in harnessing this cytokine as a therapeutic in natural or engineered formats, the clinical potential of native IL-4 is limited by its instability and pleiotropic actions. Here, we design IL-4 cytokine mimetics (denoted Neo-4) based on a de novo engineered IL-2 mimetic scaffold and demonstrate that these cytokines can recapitulate physiological functions of IL-4 in cellular and animal models. In contrast with natural IL-4, Neo-4 is hyperstable and signals exclusively through the type I IL-4 receptor complex, providing previously inaccessible insights into differential IL-4 signaling through type I versus type II receptors. Because of their hyperstability, our computationally designed mimetics can directly incorporate into sophisticated biomaterials that require heat processing, such as three-dimensional-printed scaffolds. Neo-4 should be broadly useful for interrogating IL-4 biology, and the design workflow will inform targeted cytokine therapeutic development.

Abstract The K+ uptake system KtrAB is essential for bacterial survival in low K+ environments. The activity of KtrAB is regulated by nucleotides and Na+. Previous studies proposed a putative gating mechanism of KtrB regulated by KtrA upon binding to ATP or ADP. However, how Na+ activates KtrAB and the Na+ binding site remain unknown. Here we present the cryo-EM structures of ATP- and ADP-bound KtrAB from Bacillus subtilis (BsKtrAB) both solved at 2.8 Å. A cryo-EM density at the intra-dimer interface of ATP-KtrA was identified as Na+, as supported by X-ray crystallography and ICP-MS. Thermostability assays and functional studies demonstrated that Na+ binding stabilizes the ATP-bound BsKtrAB complex and enhances its K+ flux activity. Comparing ATP- and ADP-BsKtrAB structures suggests that BsKtrB Arg417 and Phe91 serve as a channel gate. The synergism of ATP and Na+ in activating BsKtrAB is likely applicable to Na+-activated K+ channels in central nervous system.

Abstract Bacterial genotoxins damage host cells by targeting their chromosomal DNA. In the present study, we demonstrate that a genotoxin of Salmonella Typhi, typhoid toxin, triggers the senescence-associated secretory phenotype (SASP) by damaging mitochondrial DNA. The actions of typhoid toxin disrupt mitochondrial DNA integrity, leading to mitochondrial dysfunction and disturbance of redox homeostasis. Consequently, it facilitates the release of damaged mitochondrial DNA into the cytosol, activating type I interferon via the cGAS-STING pathway. We also reveal that the GCN2-mediated integrated stress response plays a role in the upregulation of inflammatory components depending on the STING signaling axis. These SASP factors can propagate the senescence effect on T cells, leading to senescence in these cells. These findings provide insights into how a bacterial genotoxin targets mitochondria to trigger a proinflammatory SASP, highlighting a potential therapeutic target for an anti-toxin intervention.

Abstract Background A dual-function phantom designed to quantify the apparent diffusion coefficient (ADC) in different fat contents (FCs) and glass bead densities (GBDs) to simulate the human tissues has not been documented yet. We propose a dual-function phantom to quantify the FC and to measure the ADC at different FCs and different GBDs. Methods A fat-containing diffusion phantom comprised by 30 glass-bead-containing fat-water emulsions consisting of six different FCs (0, 10, 20, 30, 40, and 50%) multiplied by five different GBDs (0, 0.1, 0.25, 0.5, and 1.0 g/50 mL). The FC and ADC were measured by the “iterative decomposition of water and fat with echo asymmetry and least squares estimation-IQ,” IDEAL-IQ, and single-shot echo-planar diffusion-weighted imaging, SS-EP-DWI, sequences, respectively. Linear regression analysis was used to evaluate the relationship among the fat fraction (FF) measured by IDEAL-IQ, GBD, and ADC. Results The ADC was significantly, negatively, and linearly associated with the FF (the linear slope ranged from -0.005 to -0.017, R2 = 0.925 to 0.986, all p < 0.001). The slope of the linear relationship between the ADC and the FF, however, varied among different GBDs (the higher the GBD, the lower the slope). ADCs among emulsions across different GBDs and FFs were overlapped. Emulsions with low GBDs plus high FFs shared a same lower ADC range with those with median or high GBDs plus median or lower FFs. Conclusions A novel dual-function phantom simulating the human tissues allowed to quantify the influence of FC and GBD on ADC. Relevance statement The study developed an innovative dual-function MRI phantom to explore the impact of FC on ADC variation that can affect clinical results. The results revealed the superimposed effect on FF and GBD density on ADC measurements. Key points • A dual-function phantom made of glass bead density (GBD) and fat fraction (FF) emulsion has been developed. • Apparent diffusion coefficient (ADC) values are determined by GBD and FF. • The dual-function phantom showed the mutual ADC addition between FF and GBD. Graphical Abstract

Pancreatic ductal adenocarcinoma (PDAC) has an extremely devastating nature with poor prognosis and increasing incidence, making it a formidable challenge in the global fight against cancer-related mortality. In this innovative preclinical investigation, the VCP/p97 inhibitor CB-5083 (CB), miR-142, a PD-L1 inhibitor, and immunoadjuvant resiquimod (R848; R) were synergistically encapsulated in solid lipid nanoparticles (SLNs). These SLNs demonstrated features of peptides targeting PD-L1, EGFR, and the endoplasmic reticulum, enclosed in a pH-responsive polyglutamic (PGA)-polyethylene glycol (PEG) shell. The homogeneous size and zeta potential of the nanoparticles were stable for 28 days at 4°C. The study substantiated the concurrent modulation of key pathways by the CB, miR, and R-loaded nanoformulation, prominently affecting VCP/Bip/ATF6, PD-L1/TGF-β/IL-4, −8, −10, and TNF-α/IFN-γ/IL-1, −12/GM-CSF/CCL4 pathways. This adaptable nanoformulation induced durable antitumor immune responses and inhibited Panc-02 tumor growth by enhancing T cell infiltration, dendritic cell maturation, and suppressing Tregs and TAMs in mice bearing Panc-02 tumors. Furthermore, tissue distribution studies, biochemical assays, and histological examinations highlighted enhanced safety with PGA and peptide-modified nanoformulations for CB, miR, and/or R in Panc-02-bearing mice. This versatile nanoformulation allows tailored adjustment of the tumor microenvironment, thereby optimizing the localized delivery of combined therapy. These compelling findings advocate the potential development of a pH-sensitive, three-in-one PGA-PEG nanoformulation that combines a VCP inhibitor, a PD-L1 inhibitor, and an immunoadjuvant for cancer treatment via combinatorial chemo-immunotherapy.

Abstract The anticonvulsant valproic acid (VPA) despite complex pharmacokinetics has been in clinical use for nearly 6 decades. Previous reports indicated neonates, infants, and toddlers/preschoolers had higher risk of valproate hepatotoxicity than adults. However, dosing recommendations for those less than 10 years of age are lacking. To decipher clinical puzzles, physiologically‐based pharmacokinetic (PBPK) models of VPA and its hepatotoxic metabolite 4‐ene‐VPA were constructed and simulated with particularly integrated information of drug‐metabolizing enzyme ontogeny. Adult and pediatric PK data of VPA (n = 143 subjects) and 4‐ene‐VPA (n = 8 subjects) collected from previous reports were used for model development and validation. Sensitivity analyses were performed to characterize ontogeny impacts of CYP2C9 and UGT2B7 on dispositions of VPA and 4‐ene‐VPA across age groups. Optimal VPA dosing for each pediatric age group was also predicted and objectively judged by ensuring VPA efficacy and avoiding 4‐ene‐VPA hepatotoxicity. The study revealed UGT2B7 ontogeny was quite influential on VPA clearance even in neonates and small children. Intrinsic clearance of CYP2C9 was the most prominent determinant for areas under the concentration‐time curve of VPA and 4‐ene‐VPA in infants, and toddlers/preschoolers, reflecting higher hepatotoxicity risk due to noxious 4‐ene‐VPA accumulation in these groups. The ontogeny‐based PBPK approach complements conventional allometric methods in dosing estimation for the young by providing more mechanistic insight of the processes changing with age. The established ontogeny‐based PBPK approach for VPA therapy deserves further corroboration by real‐world therapeutic data to affirm its clinical applicability.

Increasingly sophisticated techniques for falsifying and forging legal documents demand non-destructive and accurate analysis methods. Researchers have extensively investigated ink discrimination through an interdisciplinary analysis involving Raman spectroscopy and chemometrics, which is now regarded as a leading forensic document analysis approach. In this study, a groundbreaking method was developed to identify the specific origin of blue-ink pens used in written documents. By employing Raman spectroscopy in conjunction with principal component analysis (PCA), we successfully differentiated between 45 different blue-ink pens used on various documents. The Raman spectroscopy analysis provided a visual examination of each blue ink’s unique Raman signature, and PCA was then applied to the processed spectral data. Moreover, we successfully distinguished highly similar ink types in documents through the combined use of Raman spectroscopy, Pearson’s correlation analysis, and a statistical approach (PCA).

This study developed a DC-free technique that used dark-mode scanning capacitance microscopy (DM-SCM) with a small-area contact electrode to evaluate and image equivalent oxide thicknesses (EOTs). In contrast to the conventional capacitance–voltage (C–V) method, which requires a large-area contact electrode and DC voltage sweeping to provide reliable C–V curves from which the EOT can be determined, the proposed method enabled the evaluation of the EOT to a few nanometers for thermal and high-k oxides. The signal intensity equation defining the voltage modulation efficiency in scanning capacitance microscopy (SCM) indicates that thermal oxide films on silicon can serve as calibration references for the establishment of a linear relationship between the SCM signal ratio and the EOT ratio; the EOT is then determined from this relationship. Experimental results for thermal oxide films demonstrated that the EOT obtained using the DM-SCM approach closely matched the value obtained using the typical C–V method for frequencies ranging from 90 kHz to 1 MHz. The percentage differences in EOT values between the C–V and SCM measurements were smaller than 0.5%. For high-k oxide films, DM-SCM with a DC-free operation may mitigate the effect of DC voltages on evaluations of EOTs. In addition, image operations were performed to obtain EOT images showing the EOT variation induced by DC-stress-induced charge trapping. Compared with the typical C–V method, the proposed DM-SCM approach not only provides a DC-free approach for EOT evaluation, but also offers a valuable opportunity to visualize the EOT distribution before and after the application of DC stress.

In this work, the ferroelectric characteristic of a 5 nm Hf0.5Zr0.5O2 (HZO) metal-ferroelectric-insulator-semiconductor (MFIS) device is enhanced through strained complementary metal oxide semiconductor (CMOS)-compatible TiN electrode engineering. Strained TiN top-layer electrodes with different nitrogen (N) concentrations are deposited by adjusting the sputtering process conditions. The TiN electrode with 18% N exhibits a compressive characteristic, which induces tensile stress in a 5 nm HZO film. A device with 18% N in TiN shows a higher remanent polarization (2Pr) and larger capacitance value than the compared sample, indicating that the strained TiN is promising for enhancing the ferroelectricity of sub-5 nm HZO devices.

Tau pathology is instrumental in the gradual loss of neuronal functions and cognitive decline in tauopathies, including Alzheimer's disease (AD). Earlier reports showed that adenosine metabolism is abnormal in the brain of AD patients while consequences remained ill-defined. Herein, we aimed at investigating whether manipulation of adenosine tone would impact Tau pathology, associated molecular alterations and subsequent neurodegeneration. We demonstrated that treatment with an inhibitor (J4) of equilibrative nucleoside transporter 1 (ENT1) exerted beneficial effects in a mouse model of Tauopathy. Treatment with J4 not only reduced Tau hyperphosphorylation but also rescued memory deficits, mitochondrial dysfunction, synaptic loss, and abnormal expression of immune-related gene signatures. These beneficial effects were particularly ascribed to the ability of J4 to suppress the overactivation of AMPK (an energy reduction sensor), suggesting that normalization of energy dysfunction mitigates neuronal dysfunctions in Tauopathy. Collectively, these data highlight that targeting adenosine metabolism is a novel strategy for tauopathies.

Background/purpose: :Both periodontal disease and diabetes mellitus (DM) are long-term inflammatory disorders that are highly prevalent and have a significant health impact. Inflammaging, a state of pre-aging and hyperinflammatory state has been acknowledged for its role in DM patients to have heightened risk of periodontitis. Numerous evidences revealed that inflammaging contributed by cell senescence, acceleration of inflammation and oxidative stress participates in the destruction of periodontium in DM. Abilities of vitamin D in suppressing inflammation and oxidative stress have been revealed in a range of tissues, however in DM’s gingival cells, the effect remain undefined. Materials and methods: : Under the stimulation of advanced glycation end-products (AGEs), we assessed the cell proliferation in human gingival fibroblast (HGF), IL-6 and IL-8 secretions, cellular senescence expression and generation of reactive oxygen species (ROS) with or without vitamin D intervention. Following that, we examined the expression of Nrf2 and HO-1 to see if vitamin D was able to modulate the anti-oxidant signaling. A knockdown experiment was then conducted to proof the participation of Nrf2 on the secretion of pro-inflammatory IL-6 and IL-8. Results: : Following the treatment of vitamin D, AGEs-elicited IL-6 and IL-8 production and cell senescence were dose-dependently repressed. Moreover, vitamin D attenuated AGEs-induced ROS in a dose-dependent pattern. Results from qRT-PCR demonstrated vitamin D reversed the suppression of Nrf2 and HO-1 induced by AGEs. Our findings revealed that the anti-inflammatory and anti-oxidant effect in vitamin D was mediated via the upregulation of Nrf2 expression. Conclusion: : These data showed that high levels of AGEs in the gingiva lead to inflammaging reflected by increased pro-inflammatory cytokines, cell senescence expression and oxidative stress. Vitamin D supplementation can reduce oxidative stress and inflammation via the upregulation of Nrf2 signaling and hence, may be a potential approach for treatment of diabetes-associated periodontitis.

Abstract The performance enhancement of integrated circuits relying on dimension scaling (i.e., following Moore’s Law) is more and more challenging owing to the physical limit of Si materials. Monolithic three-dimensional (M3D) integration has been considered as a powerful scheme to further boost up the system performance. Two-dimensional (2D) materials such as MoS2 are potential building blocks for constructing upper-tier transistors owing to their high mobility, atomic thickness, and back-end-of-line (BEOL) compatible processes. The concept to integrate 2D material-based devices with Si field-effect transistor (FET) is technologically important but the compatibility is yet to be experimentally demonstrated. Here, we successfully integrated an n-type monolayer MoS2 FET on a p-type Si fin-shaped FET with 20 nm fin width via an M3D integration technique to form a complementary inverter. The integration was enabled by deliberately adopting industrially matured techniques, such as chemical mechanical planarization and e-beam evaporation, to ensure its compatibility with the existing 3D integrated circuit process and the semiconductor industry in general. The 2D FET is fabricated using low-temperature sequential processes to avoid the degradation of lower-tier Si devices. The MoS2 n-FETs and Si p-FinFETs display symmetrical transfer characteristics and the resulting 3D complementary metal-oxide-semiconductor inverter show a voltage transfer characteristic with a maximum gain of ~38. This work clearly proves the integration compatibility of 2D materials with Si-based devices, encouraging the further development of monolithic 3D integrated circuits.

Abstract Objectives This population-based study aimed to collect, analyze, and summarize the long-term trends in medical imaging use in Taiwan. Methods A retrospective cohort population-based study of medical imaging usage for the individuals who received care under the National Health Insurance system from 2000 to 2017. CT and MRI utilization rates were determined overall as well as across certain variables including patient age, hospital type, health care type, hospital characteristics, and geographic area. Results Individuals registered in our health insurance system have received 21,766,745 CT scans and 7,520,088 MRI scans from 2000 to 2017. Annual growth rates for both imaging types were positive over that period, though growth rates have slowed in recent years. The growth rate for CT use was greatest (9–12%) between 2001 and 2004, dropped to 2% in 2005, then generally rose thereafter, reaching 3% in 2017. Similarly, MRI use growth peaked at 24% between 2001 and 2003, dropped to 4% in 2005, then increased in a fluctuating manner, reaching 2% in 2017. Conclusion Over the past 2 decades, CT and MRI use in Taiwan has increased sharply, especially in the oldest age group (≥ 60 years old), but growth rates have slowed in recent years. Increases in imaging use have corresponded with improved clinical outcomes, including greater life expectancy and reduced mortality rates, though further assessment is required to demonstrate a direct link with imaging. Nevertheless, the better clinical outcomes are also predisposed by the comprehensive care covered by the NHI system.

Viruses can cause Colony Collapse Disorder, leading to large losses of honeybee hives globally. In this study, the authors solve capsid structures of honeybee-infecting Lake Sinai viruses and identify distinct features, which advances understanding of viral dynamics, assembly and infection mechanisms.

OBJECTIVES This cohort study investigated the correlation between Parkinson’s disease (PD) risk and chronic obstructive pulmonary disease (COPD) risk under particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) exposure. METHODS Data from the National Health Research Institutes of Taiwan were used in this study. The Environmental Protection Administration of Taiwan established an air quality monitoring network for monitoring Taiwan’s general air quality. COPD was indicated by at least 3 outpatient records and 1 hospitalization for COPD. After the implementation of age, sex, and endpoint matching at a 1:4 ratio, 137 patients and 548 patients were included in the case group and control group, respectively. Based on the 2005 World Health Organization (WHO) standards, monthly air particle concentration data were classified into the following 4 groups in analyses of exposure–response relationships: normal level, and 1.0, 1.5, and 2.0 times the WHO level ([concentration ≥2]×25 μg/m3×number of exposure months). RESULTS A multivariate logistic regression revealed that the 1.0 and 1.5 WHO level groups did not significantly differ from the normal level group, but the 2.0 WHO level did (odds ratio, 4.091; 95% confidence interval, 1.180 to 14.188; p=0.038). CONCLUSIONS Elevated PM2.5 concentrations were significantly correlated with an increased risk of PD among patients with COPD. Furthermore, exposure to high PM2.5 levels can further increase the risk of PD.