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In this paper, two improved ultra-wideband (UWB) balanced power amplifiers based on the flip-chip system-in-package technique and electronic design automation (EDA) are proposed. The conventional approach to system-on-chip (SoC) involves integrating all sub-circuit designs into a single manufacturing process. However, in radio frequency circuits, adopting the SoC approach necessitates intricate matching designs, leading to an increase in development costs. In this study, two types of SiGe unit power amplifiers attempted to achieve a flat S21 response using simpler matching for input/output. The cascode architecture was adopted as the main structure for the first type of unit power amplifier (type I). Subsequently, the design of the second type unit power amplifier was built upon the foundation of the first type, with the only difference being the implementation of two parallel cascode structures (type II), and the primary goal is to enhance both gain and output power compared to the first type. In addition, for this second type unit power amplifier, in conjunction with a quadrature hybrid coupler, the optimal impedance matching value was selected to maintain the flatness of gain across the entire UWB range. Furthermore, the poor performance of S11,22 of these two types of unit power amplifiers was improved by using quadrature hybrid couplers using the WIPD process combined with EDA simulation. Therefore, using flip-chip packaging technology can effectively reduce the increased wafer fabrication costs caused by complex matching designs in active circuits. This improved system has the potential to offer a new practical application for UWB power amplifier design.

This paper designs two single-stage LC-tank injection-locked frequency sixtuplers (ILFSs) fabricated in a 90 nm CMOS process and it describes the circuit design, operation principle, and measurement results of the ILFSs. The ILFS circuit with a differential input and single-phase output is made of a first-harmonic injection-locked oscillator (ILO), a frequency tripler, and a push-push doubler. The first ILFS uses an octagonal inductor. For a supply voltage of 0.4 V, the free-running frequency is around 41.52 GHz, DC power consumption is 9.03 mW at the incident power of 0 dBm, and the output locking range at 0 dBm input power is 10.21 %. The second ILFS uses an 8-shaped inductor for low electromagnetic (EM) noise generation. The free-running frequency is around 37.2 GHz, DC power consumption is 7.72 mW at the incident power of 0 dBm, and the output locking range at 0 dBm input power is 17.4 %. The two chips have the same area, $0.7\times0.7$ mm2. This paper also provides a further analysis and comparison of the RF performance of on-chip inductors designed. Simulation shows the substrate noise coupling and distance noise coupling between victim and aggressor, the 8-shaped inductor exhibits a significant reduction in coupling. By the measurement results, it is evident that the performance of the 8-shaped inductor ILFS is superior to that of the octagonal inductor ILFS.

This study aims explore the feasibility of using neural network (NNs) and deep learning to diagnose three common respiratory diseases with few symptom words. These three diseases are nasopharyngitis, upper respiratory infection, and bronchitis/bronchiolitis. Through natural language processing, the symptom word vectors are encoded by GPT-2 and classified by the last linear layer of the NN. The experimental results are promising, showing that this model achieves a high performance in predicting all three diseases. They revealed 90% accuracy, which suggests the implications of the developed model, highlighting its potential use in assisting patients’ understanding of their conditions via a remote diagnosis. Unlike previous studies that have focused on extracting various categories of information from medical records, this study directly extracts sequential features from unstructured text data, reducing the effort required for data pre-processing.

Abstract Background The treatment of recurrent or metastatic head and neck squamous-cell carcinoma (R/M HNSCC) remains challenging. Preclinical studies revealed that B cell depletion could modulate the microenvironment and overcome chemoresistance. We conducted a phase I study to evaluate the feasibility and safety of B cell depletion using the anti-CD20 antibody rituximab to treat HNSCC. Methods Ten patients were enrolled in two protocols. The first four patients treated using protocol 1 received rituximab 1000 mg on days −14 and −7, followed by gemcitabine/cisplatin every 3 weeks, and rituximab was administered every 6 months thereafter. Because of disease hyperprogression, protocol 1 was amended to protocol 2, which consisted of the concomitant administration of rituximab 375 mg/m2 and gemcitabine/cisplatin every 3 weeks. Another six patients were enrolled and treated using protocol 2. Results Three patients treated using protocol 1 exhibited rapid disease progression, and the remaining patient could not undergo evaluation after rituximab treatment. Conversely, no unpredicted harm was observed in the six patients treated using protocol 2. Among these patients, one achieved complete response, and two had partial responses. The disease-free durations in these patients were 7.0, 6.2, and 7.1 months, respectively. Immune cell analysis revealed a higher ratio of cytotoxic T cells to regulatory T cells in responders than in non-responders. Conclusions B cell depletion using rituximab alone in patients with HNSCC can cause hyperprogressive disease. Contrarily, the co-administration of rituximab and cisplatin/gemcitabine was feasible and safe. Trial registration ClinicalTrials.gov Identifier: NCT04361409 , 24 April 2020, retrospectively registered

In this study, ZnO nanorods with a porous structure were successfully prepared using the chemical bath deposition (CBD) method. According to the surface and cross-sectional images photographed by scanning electron microscopy, we found that the diameters of samples with concentrations of 10, 30, 50, and 70 mM were 90, 141, 214, and 259 nm, respectively, with 6 h of deposition. The height of the nanorods was maintained at approximately 1.3 μm. The EDS material analysis showed that the ratio of zinc atoms and oxygen atoms in samples with different concentrations changed with the concentration of the growth solution. The column diameter of the zinc oxide nanorods prepared by the chemical bath deposition method was closely related to the concentration of the growth solution. The higher the concentration, the larger the column diameter. The height of the nanorods was directly proportional to the deposition time and was not influenced by solution concentration.

With the increasing demand for unmanned aircraft system (UAS) traffic management (UTM) airspace comes the need to ensure the safe operation and management of said airspace. One layer of defense against mid-air-collision and the ensuing third-party injury or fatality is the pre-flight separation assurance. This could be achieved by establishing the separation requirements for the UTM traffic based on the flight dynamics and communication navigation surveillance (CNS) performance that could be achieved in the airspace in question. A modified Reich collision risk model, typically used in civil aviation for separation minima evaluation, was used for the evaluation of the initial separation that would meet the target level of safety within a prescribed look-ahead time. This paper presents the parametric evaluation of using this physics-based and Monte Carlo-driven Reich collision risk model to evaluate the separation recommendation needed to achieve 10−7 mid-air-collision risk in UTM. The evaluation was conducted for an encounter pair consisting of identical ∼1.2 kg quadrotors with various encounter geometries, cruise velocities, navigation uncertainties, and communication latency.

Surface-enhanced Raman spectroscopy (SERS) is commonly used for super-selective analysis through nanostructured silver layers in the environment, food quality, biomedicine, and materials science. To fabricate a high-sensitivity but a more accessible device of SERS, DC magnetron sputtering technology was used to realize high sensitivity, low cost, a stable deposition rate, and rapid mass production. This study investigated various thicknesses of a silver film ranging from 3.0 to 12.1 nm by field emission scanning electron microscope, X-ray diffraction, and X-ray photoelectron spectroscopy. In the rhodamine 6G (R6G) testing irradiated by a He-Ne laser beam, the analytical enhancement factor (AEF) of 9.35 × 108, the limit of detection (LOD) of 10−8 M, and the relative standard deviation (RSD) of 1.61% were better than the other SERS substrates fabricated by the same DC sputtering process because the results showed that the 6 nm thickness silver layer had the highest sensitivity, stability, and lifetime. The paraquat and acetylcholine analytes were further investigated and high sensitivity was also achievable. The proposed SERS samples were evaluated and stored in a low humidity environment for up to forty weeks, and no spectrum attenuation could be detected. Soon, the proposed technology to fabricate high sensitivity, repeatability, and robust SERS substrate will be an optimized process technology in multiple applications.

Context: Butylidenephthalide (Bdph) has been reported to inhibit rat uterine contractions, but significantly potentiate the noradrenaline (NA)-induced contractions in guinea-pig vas deferens (GPVDs). Objective: The present study elucidates the binding specificity of Bdph in GPVD to potentiate contractions. Materials and methods: Electrical field stimulation (EFS, supramaximal voltage, 1 ms and 1 Hz) or exogenous NA (50 μM) was applied to the GPVD in Krebs or 1/10 Mg-Tyrode’s solution, respectively. After the clonidine (10 nM)-induced twitch inhibition or the exogenous NA-induced contractions reached a constant, Bdph (50 µM) was added 2 min prior to the subsequent addition of NA (50 µM). Three experiments were performed. In the presence of Bdph (100 μM), the release of NA in the medium and remaining NA content in the tissues were determined after EFS-stimulation. Results: Bdph (100 μM) significantly antagonized the clonidine (10 nM)-induced twitch inhibition from 22.5 ± 2.1 to –11.4 ± 1.6% (n = 6) and dibutyryl-cAMP (300 μM) from 25.7 ± 3.2 to 7.9 ± 4.0% (n = 8). Bdph (100 μM) significantly increased the electrically stimulated release of NA from 393.0 ± 109.5 to 1000.0 ± 219.1 ng/g (n = 6). Bdph (50 μM) potentiated the exogenous NA (50 μM)-induced contractions from 3.0 ± 0.06 to 3.9 ± 0.06 g (n = 3), but after washout of Bdph, the response to NA gradually curtailed. Discussion and conclusions: Bdph action may be through the nonspecific binding of the butylidene group to prejunctional α2- and postjunctional α1-adrenoceptors to reversibly block K+ channels, and irreversibly block VDCCs on the smooth muscle cell membrane, respectively.

One of the causes of positioning inaccuracies in the Unmanned Aircraft System (UAS) is navigation error. In urban environment operations, multipaths could be the dominant contributor to navigation errors. This paper presents a study on how the operation environment affects the lateral (horizontal) navigation performance when a self-built UAS is going near different types of urban obstructions in real flight tests. Selected test sites are representative of urban environments, including open carparks, flight paths obstructed by buildings along one or both sides, changing sky access when flying towards corners formed by two buildings or dead ends, and buildings with reflective glass-clad surfaces. The data was analysed to obtain the horizontal position error between Global Positioning System (GPS) position and ground truth derived from Real Time Kinematics (RTK), with considerations for (1) horizontal position uncertainty estimate (EPH) reported by the GPS receiver, (2) no. of visible satellites, and (3) percentage of sky visible (or sky openness ratio, SOR) at various altitudes along the flight paths inside the aforementioned urban environments. The investigation showed that there is no direct correlation between the measured horizontal position error and the reported EPH; thus, the EPH could not be used for the purpose of monitoring navigation performance. The investigation further concluded that there is no universal correlation between the sky openness ratio (SOR) seen by the UAS and the resulting horizontal position error, and a more complex model would need to be considered to translate 3D urban models to expected horizontal navigation uncertainty for the UAS Traffic Management (UTM) airspace.

The EU’s 2015 new trade strategy: Trade for all: toward a more responsible trade and investment policy, highlights its key role in keeping markets open worldwide and lists the Asia-Pacific region as the priority party for signing Regional Trade Arrangements (RTAs) with the EU. The new strategy allows the EU and its member states to initiate talks on economic cooperation agreement (ECA) with Taiwan. This article takes the EU-Asia interregional cooperation as a case study while exploring the role of Taiwan in the region. The first section describes the shift in EU’s trade policies and the special features of the types of interregionalism between the EU and Asia. The second section explores the bilateral trade relations. The third section evaluates the opportunities and the internal and external challenges and limitations of an EU-Taiwan ECA, emphasizing the factor of mainland China. The final section provides conclusions on the influence of an EU-Taiwan ECA on the relations of EUTaiwan considering economic and non-economic factor

Context: The rhizome of Ligusticum chuaxiong Hort. (Umbelliferae) has been used by Chinese for several thousand years. Its main constituent, butylidenephthalide (Bdph), was proved to be active in inhibiting rat uterine contractions induced by prostaglandin F2α and was reported to be a nonspecific antispamodic and a blocker of voltage-dependent Ca2+ channels (VDCCs). Objectives: The present study investigates the mechanisms of Bdph for twitch facilitation in ICR mouse vas deferens (MVD). Materials and methods: Electrical field stimulation (EFS, supramaximal voltage ranging from 60–90 V, 1 ms, 0.2 Hz) was applied to the isolated MVD in Krebs solution. Interactions between Bdph (50 µM) and calcium antagonist (verapamil, diltiazem or aspaminol) on the EFS-evoked twitch responses were determined. The number of experiments was 3–18. Results: Bdph (50 µM)-induced twitch facilitations from 100 to 391.9% were unrelated to activation of postjunctional cholinergic or adrenergic receptors. Verapamil and Bdph unabolished the twitch facilitation each other. Diltiazem unabolished the Bdph-induced twitch facilitation. In contrast, Bdph abolished those induced by diltiazem. Aspaminol at 20 μM abolished the Bdph-induced twitch facilitation. In contrast, Bdph abolished those induced by aspaminol. Tetraethylammonium and 4-aminopyridine, the K+ channel blockers, significantly augmented the Bdph-induced twitch facilitation. Discussion and conclusions: Bdph may bind to the different, more and same subtypes of VDCCs from verapamil, than diltiazem, and as aspaminol does on prejunctional membrane, respectively. Besides a blocker of VDCCs, Bdph may be a blocker of K+ channels on prejunctional membrane. Thus, Bdph depolarized the membrane and facilitated the cumulative Ca2+-induced twitch responses.

Background/purpose: Gingival overgrowth is a common side effect of medication with the immunosuppressant cyclosporine A (CsA). This study proposed to verify whether Nanog, an embryonic stem cell marker, contributes to gingival overgrowth stimulated with CsA in human gingival fibroblasts (HGFs). Materials and methods: The effect of CsA on HGFs was used to elucidate whether Nanog expression could be induced by CsA using quantitative real-time reverse transcription-polymerase chain reaction and Western blotting. Cell growth in CsA-treated HGFs with Nanog lentivirus-mediated short hairpin RNA interference knockdown was evaluated by tetrazolium bromide reduction assay. Results: CsA upregulated Nanog transcript in HGFs in a dose-dependent manner (P

The WSe2 homostructure rectifying diode is demonstrated, p-type and n-type WSe2 regions were formed by adopting different layer WSe2 thicknesses. Typically, the common way to fabricate two dimensional material based diode is to use heterostructure by stacking two different carrier type and band gap energies materials. However, there is always lattice mismatch at the junction, leading to the degraded photoresponse of the diodes. In order to reduce the problems of heterostructure diode, layer thickness dependent band gap energy of WSe2 is reported and applied to fabricate homostructure diode. The ideality factor of the current-voltage characteristic is 1.64 and the current rectification ratio can reach to 103. The optical properties of the diode, including fill factor 45.7%, responsivity 16.02 mA/W and EQE 3.06% are reported. It is concluded that the WSe2 homojunction diode can be applied in photodetectors, switches, solar cells etc.

The principle of olfactory perception had been widely studied. The core of the olfactory theory is based on two different mechanisms or the combination of the two. The first is the shape (weak shape) theory that the olfactory receptor only accepts the molecule with a complementary shape (lock to the key). The second is the vibrational theory that electrons on an odor molecule will be able to tunnel to the olfactory receptors quantum mechanically only when they are assisted by the specific bond vibrational energy of the molecules. Previous studies indicated that human subjects can distinguish the difference between the musk odorant molecules and its deuterated counterparts as evidence to advocate the theory. Scientists who refuted the vibration theory studied “musk-recognizing receptor”, OR5AN1 and discovered that these receptors responded strongly and identically to the deuterated and normal musk odorants in the vitro environmental condition albeit they have different vibrational energies. In this paper, a new method is adopted to investigate the bond vibration-assisted olfactory theory. Narrow bandwidth infrared light sources with specific wavelengths were utilized to illuminate and excite molecular bond oscillation of the odorant molecules. By analyzing the experimental results of 23 human subjects. This study also supported the hypothesis of the “spin residual information theory” that the olfactory perception is aroused by the “residual spin information” of infrared photons left near the odor and receptor molecular bonding sites which absorbed or emitted the infrared photons.

Zotarolimus is a semi-synthetic derivative of rapamycin and an inhibitor of mammalian target of rapamycin (mTOR) signaling. Currently, zotarolimus is used to prolong the survival time of organ grafts, but it is also a novel immunosuppressive agent with potent anti-proliferative activity. Here, we examine the anti-tumor effect of zotarolimus, alone and in combination with 5-fluorouracil, on HCT-116 colorectal adenocarcinoma cells implanted in BALB/c nude mice. Compared with the control mice, mice treated with zotarolimus or zotarolimus combined with 5-FU showed retarded tumor growth; increased tumor apoptosis through the enhanced expression of cleaved caspase 3 and extracellular signal-regulated kinase (ERK) phosphorylation; reduced inflammation-related factors such as IL-1β, TNF-α, and cyclooxygenase-2 (COX-2) protein; and inhibited metastasis-related factors such as CD44, epidermal growth factor receptor (EGFR), transforming growth factor β (TGF-β), and vascular endothelial growth factor (VEGF). Notably, mice treated with a combination of zotarolimus and 5-FU showed significantly retarded tumor growth, reduced tumor size, and increased tumor inhibition compared with mice treated with 5-FU or zotarolimus alone, indicating a strong synergistic effect. This in vivo study confirms that zotarolimus or zotarolimus combined with 5-FU can be used to retard colorectal adenocarcinoma growth and inhibit tumorigenesis. Our results suggest that zotarolimus may increase the chemo-sensitization of tumor cells. Therefore, zotarolimus alone and zotarolimus combined with 5-FU may be potential anti-tumor agents in the treatment of human colon adenocarcinoma. Future research on zotarolimus may lead to the development of new therapeutic strategies.

The combination of education and robots is becoming an increasingly important issue. Although researchers have conducted some studies on educational robotics in STEM education at the undergraduate level, no research examined the effects of gamified educational robotics on participants' motivation and creativity. Therefore, this study examines the effects of gamified educational robots on participants' learning motivation and creativity in STEM. A quasi-experimental research design was used in this study. A total of 108 students from two classes enrolled in the information technology course were involved as participants. Learning motivation and creativity scales were used to collect data. The participants were introduced to a gamified educational robot as the course objective, learning content, and game mechanism to increase motivation and help students solve problems. In contrast, students in the control group received conventional instruction consisting of group discussions and lectures. Activities in both groups were held for eighteen weeks in three phases. The results showed that gamified educational robots could enhance learning motivation and positively influence learners' creativity. The results also indicate that learning motivation has significant effects on creativity, and students with high motivation perform better in terms of creativity. The results strengthen interdisciplinary STEM teaching and promote students' learning outcomes.

Gingival overgrowth occurs as a side effect of systemic medication with immunosuppressant cyclosporine A (CsA). Slug, a master regulator of epithelial–mesenchymal transition, is dramatically upregulated in a variety of fibrotic diseases. The aim of this study is to investigate the role of epithelial–mesenchymal transition marker Slug in the pathogenesis of CsA-induced gingival overgrowth. Methods: Clinically healthy gingiva and CsA-induced gingival overgrowth specimens were analyzed by immunohistochemistry. The effect of CsA on normal human gingival fibroblasts (HGFs) was used to elucidate whether Slug expression could be affected by CsA by real-time reverse transcription-polymerase chain reaction and western blot. Cell proliferation in CsA-treated HGFs with Slug lentiviral-mediated shRNAi knockdown was evaluated by tetrazolium bromide reduction assay. Results: Slug expression was higher in CsA-induced gingival overgrowth specimens than in clinical healthy gingiva (p

Ionic liquids have been employed to deconstruct and fractionate lignocellulosic biomasses because of their capacity to dissolve cellulose. However, there is limited literature reporting the use of ionic liquids in biomass saccharification, which mostly involves the addition of acid or water that conceals the true action of ionic liquid in saccharification. This article assesses the performance of molten Brӧnsted acidic 1-ethyl-3-methylimidazolium hydrogen sulphate ([EMIM][HSO4]) in saccharifying three agricultural biomasses, namely sago hampas, sugarcane bagasse, and rice husk, via saccharification kinetics. At 100 °C, [EMIM][HSO4] saccharification of the biomasses achieved equilibrium reducing sugar yields at various durations (sago hampas, 3 h; sugarcane bagasse, 1 h; rice husk, 5 h). The kinetic rate constant was obtained from model fitting, indicated that [EMIM][HSO4] showed a preference for saccharifying less recalcitrant sugarcane bagasse (37.9%) than sago hampas (7.0%) and rice husk (1.1%). Compared to H2SO4 saccharification, reducing sugar yields of [EMIM][HSO4] were consistently lower. The difference in yields might be attributed to the hydrous/anhydrous state of reaction and limited availability of component ions of the ionic liquid for dissolution and saccharification. This study demonstrates the feasible technical aspects of applying [EMIM][HSO4] to saccharify agricultural biomasses, which may lead to economic feasibility, recyclability, and cost effectiveness of ionic liquids in saccharification.

Pluripotent-cell-derived cardiomyocytes have great potential for use in research and medicine, but limitations in their maturity currently constrain their usefulness. Here, we report a method for improving features of maturation in murine and human embryonic-stem-cell-derived cardiomyocytes (m/hESC-CMs). We found that coculturing m/hESC-CMs with endothelial cells improves their maturity and upregulates several microRNAs. Delivering four of these microRNAs, miR-125b-5p, miR-199a-5p, miR-221, and miR-222 (miR-combo), to m/hESC-CMs resulted in improved sarcomere alignment and calcium handling, a more negative resting membrane potential, and increased expression of cardiomyocyte maturation markers. Although this could not fully phenocopy all adult cardiomyocyte characteristics, these effects persisted for two months following delivery of miR-combo. A luciferase assay demonstrated that all four miRNAs target ErbB4, and siRNA knockdown of ErbB4 partially recapitulated the effects of miR-combo. In summary, a combination of miRNAs induced via endothelial coculture improved ESC-CM maturity, in part through suppression of ErbB4 signaling.

Neuroticism may have great impact on mental and physical health in both sexes. The aims of this study were to explore whether relationships between neuroticism scores and psychosocial indicators as well as metabolic syndrome in a population of incoming university students existed in the different sexes. In total, 4266 incoming students were included in this study. The test battery comprised a self-administered structured questionnaire, including the neuroticism subscale of the Maudsley Personality Inventory, the 12-item Chinese Health Questionnaire, the Chinese Internet Addiction Scale-Revision, the measurement of support functions, and the Pittsburgh Sleep Quality Index. Multivariate logistic regression showed that higher Pittsburgh Sleep Quality Index scores, higher Chinese Internet Addiction Scale-Revision scores, and higher 12-item Chinese Health Questionnaire scores were significantly correlated with neuroticism in both sexes, but lower perceived routine support: measurement of support functions scores were associated only with the male participants. No significant differences were found in terms of body mass index or other metabolic profiles. Individuals with poorer mental health and a poorer personal lifestyle had higher neuroticism scores, and sex effects may influence the scale of perceived social support in the neuroticism group. However, the lack of an association between neuroticism score and metabolic syndrome may be due to the recruitment of younger participants in this study.

In contrast to conventional manufacturing, digital manufacturing is not affected by marginal costs; that is, the cost for producing a single prototype is not different from producing several thousand ones. Digital manufacturing consequently eliminates the requirement for large sums of capital necessary for conventional manufacturing. Digital manufacturing combined with cloud platforms and cloud-enabled databases will allow large-quantity virtual product development while minimizing costs, which will consequently reflect on the efficient manufacturing of physical products.

The prominent side effect of the immunosuppressive drug cyclosporine A (CsA) is gingival overgrowth. Hypoxia-inducible factor (HIF)-1α regulates a wide variety of profibrogenic genes, which are closely associated with tissue fibrosis. The aim of this study was to compare HIF-1α expression in normal gingival tissues and CsA-induced gingival overgrowth specimens and further explore the potential mechanisms that may lead to induction of HIF-1α expression. Methods: Fifteen CsA-induced gingival overgrowth specimens and five normal gingival tissues were examined by immunohistochemistry. Western blot was used to investigate the effects of CsA on the expression of HIF-1α in cultured human gingival fibroblasts. The effects of CsA on plasminogen activator inhibitor (PAI)-1 expression were evaluated in environmental hypoxia. Results: HIF-1α staining in gingival tissue was stronger in CsA-induced gingival overgrowth group than normal gingival group (p

Malic acid (MA) has been commonly used in cosmetic products, but the safety reports in skin are sparse. To investigate the biological effects of MA in human skin keratinocytes, we investigated the potential cytotoxicity and apoptotic effects of MA in human keratinocyte cell lines (HaCaT). The data showed that MA induced apoptosis based on the observations of DAPI staining, DNA fragmentation, and sub-G1 phase in HaCaT cells and normal human epidermal keratinocytes (NHEKs). Flow cytometric assays also showed that MA increased the production of mitochondrial superoxide (mito-SOX) but decreased the mitochondrial membrane potential. Analysis of bioenergetics function with the XF 24 analyzer Seahorse extracellular flux analyzer demonstrated that oxygen consumption rate (OCR) was significantly decreased whereas extracellular acidification rate (ECAR) was increased in MA-treated keratinocytes. The occurrence of apoptosis was proved by the increased expressions of FasL, Fas, Bax, Bid, caspases-3, -8, -9, cytochrome c, and the declined expressions of Bcl-2, PARP. MA also induced endoplasmic reticulum stress associated protein expression such as GRP78, GADD153, and ATF6α. We demonstrated that MA had anti-proliferative effect in HaCaT cell through the inhibition of cell cycle progression at G0/G1, and the induction of programmed cell death through endoplasmic reticulum stress- and mitochondria-dependent pathways.

Platelet-rich fibrin (PRF) created by Choukroun’s protocol concentrates most platelets and leukocytes from a blood harvest into a single autologous fibrin biomaterial. However, no current data is available concerning the use of PRF for the treatment of periapical lesions. Two cases of radicular cysts were reported using an interdisciplinary approach, including regular endodontic therapy followed by surgical management with PRF and bioactive glass. Two cases of radicular cysts presented as an incidental radiographic finding, appearing as an apical radiolucency with well-circumscribed sclerotic borders. After regular endodontic retreatment, cystic lining/granulation tissues were enucleated and the periradicular bony defect was grafted using PRF and bioactive glass. Then, PRF was applied to serve as a membrane over the grafted defects. Recall periapical radiographs of Case 1 and cone beam computer tomography of Case 2 showed satisfactory healing of the periapical pathosis. In Case 2, the bony defect appeared completely healed at 4 months surgical reentry and the new bone was clinically very dense and mature. The results of these case reports show that the combination of PRF and bioactive glass is an effective modality of regenerative treatment for radicular cysts.

An oil spill from a vessel is a critical maritime accident that can severely damage the environment. In this study; we utilize the basic construction of grey relational analysis to explore oil spill events statistics from 1974 to 2015 and successfully analyze the causes of incidents in 2016. The results illustrate that grey relational analysis effectively identifies the factors causing oil spills with an accuracy of over 96%. The research is aimed to reduce the marine accidents and predict the cause of oil spill in advance. The analysis is dealing with the incidents to approach the circumstance in various intensity of oil spill in the last 40 years. Moreover, an application of grey theory demonstrates accurate and reliable methodology to decision maker. Thus, the investigation can predict the causes of pollution from oil spill accidents in the future.

One concern to the patients is the off-line detection of pneumonia infection status after using the ventilator in the intensive care unit. Hence, machine learning methods for ventilator-associated pneumonia (VAP) rapid diagnose are proposed. A popular device, Cyranose 320 e-nose, is usually used in research on lung disease, which is a highly integrated system and sensor comprising 32 array using polymer and carbon black materials. In this study, a total of 24 subjects were involved, including 12 subjects who are infected with pneumonia, and the rest are non-infected. Three layers of back propagation artificial neural network and support vector machine (SVM) methods were applied to patients’ data to predict whether they are infected with VAP with Pseudomonas aeruginosa infection. Furthermore, in order to improve the accuracy and the generalization of the prediction models, the ensemble neural networks (ENN) method was applied. In this study, ENN and SVM prediction models were trained and tested. In order to evaluate the models’ performance, a fivefold cross-validation method was applied. The results showed that both ENN and SVM models have high recognition rates of VAP with Pseudomonas aeruginosa infection, with 0.9479 ± 0.0135 and 0.8686 ± 0.0422 accuracies, 0.9714 ± 0.0131, 0.9250 ± 0.0423 sensitivities, and 0.9288 ± 0.0306, 0.8639 ± 0.0276 positive predictive values, respectively. The ENN model showed better performance compared to SVM in the recognition of VAP with Pseudomonas aeruginosa infection. The areas under the receiver operating characteristic curve of the two models were 0.9842 ± 0.0058 and 0.9410 ± 0.0301, respectively, showing that both models are very stable and accurate classifiers. This study aims to assist the physician in providing a scientific and effective reference for performing early detection in Pseudomonas aeruginosa infection or other diseases.

Background/Aims: During the resolution phase of inflammation, release of “find-me” signals by apoptotic cells is crucial in the chemoattraction of macrophages toward apoptotic cells for subsequent phagocytosis, in which microparticles derived from apoptotic cells (apo-MPs) are involved. A recent study reports that CX3CL1 is released from apoptotic cells to stimulate macrophages chemotaxis. In this study, we investigated the role of CX3CL1 in the apo-MPs in the cell-cell interaction between alveolar macrophage NR8383 cells and apoptotic all-trans retinoic acid-treated NB4 (ATRA-NB4) cells. Methods/Results: Apoptotic ATRA-NB4 cells and their conditioning medium (CM) enhanced the chemoattraction of NR8383 cells as well as their phagocytosis activity in engulfing apoptotic ATRA-NB4 cells. The levels of CX3CL1(+) apo-MPs and CX3CL1 were rapidly elevated in the CM of ATRA-NB4 cell culture after induction of apoptosis. Both exogenous CX3CL1 and apo-MPs enhanced the transmigration of NR8383 cells toward apoptotic ATRA-NB4 cells. This pro-transmigratory activity was able to be partially inhibited either by blocking the CX3CR1 (CX3CL1 receptor) of NR8383 cells with its specific antibody or by blocking the surface CX3CL1 of apo-MPs with its specific antibody before incubating these apo-MPs with NR8383 cells. Conclusion: CX3CL1(+) apo-MPs released by apoptotic cells mediate the chemotactic transmigration of alveolar macrophages.

In traditional Chinese medicine (TCM), a combination of kudzu and Chen-Pi is frequently prescribed for relieving colds, fever, bronchitis and cough. It contains daidzein and hesperetin, selective inhibitors of family 3 (PDE3) and 4 (PDE4) of phosphodiesterases (PDEs), respectively. In passively sensitized human airways, allergen-induced contraction was reported to be inhibited only by the simultaneous inhibition of PDE3 and PDE4, but not by single inhibition of either isozyme. Therefore, we are interested in investigating the interaction between daidzein and hesperetin on their antispasmodic effects in the isolated sensitized and non-sensitized guinea-pig tracheas, to clarify the difference between these two tissues, because effects of TCM prescription on patients with or without allergic asthma are often different. Guinea-pigs were sensitized by subcutaneous injection of ovalbumin (OVA) into legs. After sensitization, the baseline and cumulative OVA-induced contractions of the sensitized trachea were isometrically recorded on a polygraph. In the same way, the histamine (30 μM)-induced tonic contraction of non-sensitized guinea-pig trachea was recorded. The isobole method was used to analyse the antagonism and synergism between daidzein and hesperetin. The isoboles showed antagonism between daidzein and hesperetin on baseline relaxant effect and OVA (100 μg/ml)-induced contraction in the sensitized guinea-pig trachea. In contrast, the isobole showed synergism between daidzein and hesperetin on the relaxant effect of histamine-induced tonic contraction in non-sensitized guinea-pig trachea. These results suggest that the combination of kudzu and Chen-Pi for relieving colds, fever, bronchitis and cough is effective in patients without, but might show little effect in patients with allergic asthma.

Cysteinyl leukotrienes (CysLTs) play a major role in the pathogenic changes of airway inflammation in asthma treatment. The matrix metalloproteinase (MMP) family, especially MMP-9 and MMP-2 levels, can reflect the status of airway remodeling. This study was undertaken to determine the role of a specific CysLT receptor antagonist in inhibition of airway inflammation and reversal of airway remodeling. Methods: Ovalbumin (OVA)-sensitized BALB/c mice were fed with a specific leukotriene receptor antagonist (MK-679), prednisolone or placebo from Days 15 to 27. Airway hyperreactivity, bronchoalveolar lavage fluid (BALF), and sera were analyzed. Pulmonary histology was obtained, and the levels of MMP-2 and MMP-9 in BALF were measured. Results: The OVA-sensitized mice developed significant airway inflammatory responses, including extensive eosinophils trafficking into BALF and lung interstitium, goblet cell hyperplasia, mucus hypersecretion, elevated serum immunoglobulin (Ig) E, and decreased level of serum IgG2a. Administration of MK-679 could reduce airway inflammation but was not as effective as prednisolone. However, MK-679 was more effective than prednisolone for reversing subepithelial fibrotic and myofibrotic reactions of airway remodeling. The levels of MMP-2 and -9 in BALF were proportional to the extent of airway remodeling, which can reflect the effects of treatment. Both prednisolone and MK-679 reverse airway hyperresponsiveness induced by OVA-sensitized mice. Conclusion: Cysteinyl leukotriene receptor plays a more important role than CysLT in the pathogenesis of allergic airway inflammation. MMP-2 and -9 may be more sensitive indicators of airway remodeling.

Nuclear localization of β-catenin is known to associate with malignant transformation of many squamous cell carcinomas. The aim of this study was to compare β-catenin expression in normal human oral epithelium and areca quid chewing associated oral squamous cell carcinomas (OSCCs) and further to explore the potential mechanisms that may lead to induce β-catenin expression. Methods: A total of 40 areca quid chewing-associated OSCCs and 10 normal oral tissue biopsy samples without areca quid chewing were analyzed by immunohistochemistry. The oral epithelial cell line GNM cells were challenged with arecoline, a major areca nut alkaloid, by using Western blot analysis. Furthermore, extracellular signal-regulated protein kinase inhibitor PD98059, glutathione precursor N-acetyl-l-cysteine (NAC), tyrosine kinase inhibitor herbimycin-A, p38 inhibitor SB203580, and phosphatidylinositaol 3-kinase inhibitor LY294002 were added to find the possible regulatory mechanisms. Results: β-catenin expression was significantly higher in OSCC specimens than that in normal oral epithelial specimens (p

Platelet-rich fibrin (PRF) is an immune and platelet concentrate that contains all constituents of a blood sample favorable to healing and immunity on a single fibrin membrane. However, limited information is currently available concerning the histologic healing of extraction sockets using PRF. This report presents the clinical and histologic characteristics of a patient who underwent a tooth extraction which was filled with PRF. The right mandibular second molar was removed from a 47-year-old male patient, and the socket was filled with PRF as the sole grafting material in preparation for placing an implant after wound healing. The extraction site was reentered surgically for implant placement. A cylindrical sample core of the newly formed tissue was collected from the socket for histological evaluation. During clinical healing, neither infectious episodes nor untoward clinical symptoms were seen. At the time of implant insertion, the socket was completely filled by a hard material, which on probing exhibited the consistency of bone. A histological exanimation of the core taken from the socket revealed new bone formation. There was also no evidence of inflammatory infiltrates. The clinical and histological findings suggest that filling a fresh extraction socket with PRF provides a viable therapeutic alternative for implant site preparation.

Some remnants of thymic tissue may be deposited along the pathway of the descent of the neck during embryologic development of the thymus. Ectopic thymic tissue is usually deposited along the pathway from the mandibular angle to the manubrium of the sternum. Most reported cases of an ectopic thymus occurred in children, and cases are less common in adults. We report a 26-year-old woman, who was incidentally found to have 2 neck nodules on the posterior side of the bilateral upper pole of the thyroid gland while undergoing a subtotal thyroidectomy. The left-side neck nodule showed accessory thyroid follicles intermixed with ectopic thymic tissue, and the right-side neck nodule was ectopic parathyroid tissue together with ectopic thymic tissue.

Background/purpose: Periodontal disease is a plaque-induced infection; therefore successful periodontal therapy is dependent on anti-infective procedures. Currently, many clinicians use a combination of adjunctive chemotherapeutic agents in non-surgical periodontal therapy. The purpose of this study was to evaluate the clinical efficacy of using triclosan/copolymer toothpaste on improving the periodontal health during phase I periodontal treatment. Materials and methods: This study was performed at the Department of Periodontics, Chung Shan Medical University Hospital. Forty participants with generalized chronic periodontitis who provided informed consent were included in the study. At the baseline examination, the pocket depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), and full-mouth plaque score (FMPS) were recorded before phase I therapy began. The subjects were assigned to 2 groups. The experimental group used a triclosan/copolymer-containing toothpaste, whereas the control group used only a standard fluoride toothpaste without antibacterial ingredients. All participants received full-mouth ultrasonic scaling and root planing with intensive oral hygiene instruction. After 6 weeks, the examinations were repeated and results recorded. Results: There were no statistical significant differences (P>0.05) in the baseline data collected between the experimental and control groups. After phase I therapy, the PD, CAL, BOP, and FMPS all improved in both the control and experimental groups (P6 mm, the PD and CAL also showed significant improvements versus the control group (P

As stated by the recent report published by Global Industry Analysts Inc. (GIA), driven by widespread consumer awareness, lifestyle trends and growing compatibility among equipments because of standardization, the world digital camera market is projected to reach 122 million units by the year 2010. The traditional one-way quality model is focused on one particular quality element; only when the element is present are customers satisfied, and viceversa. Using the traditional way to improve customer satisfaction, it is possible that the customer will not be satisfied with a certain quality element, or maybe the customer satisfaction target will be over-fulfilled (Tan & Shen, 2000). Kano's model provides an effective approach to categorizing the customer attributes into different types. Professor Kano has developed a methodology to identify which customer attributes are must-be, which are one-dimensional and which are attractive. Therefore, understanding the product quality attribute is beneficial to improvement of quality as well as product development. Therefore, the purposes of this article are 1. To classify customer attributes into Kano categories. 2. To apply IPA to analyze the correlation between importance and satisfaction toward product attributes. 3. To exam a significant difference between demographic characteristics and Kano's quality requirements. The findings are as follows: 1. Kano' model successful classifying product features of digital cameras. Kano's quality requirements are also correlated with importance and satisfaction of IPA analysis. 2. When quality have improved for all product features, after sales services, Image Stabilizer and Recording Mode will lead to most satisfaction for all users based on customer satisfaction coefficient. 3. Demographical characteristics have significantly influenced perceived quality requirement for digital camera users.

Many adults suffer from sensitivity, and dentin hypersensitivity is most commonly the result of exposed dentin which can sometimes trigger pain or discomfort when eating, drinking or simply brushing. The purpose of this study was to evaluate the clinical efficacy of desensitizing toothpaste containing potassium citrate in treating dentin hypersensitivity. Materials and methods: This study was performed at the Department of Periodontics, Chung Shan Medical University Hospital. In total, 172 volunteers who provided informed consent were included in the study. A visual analog scale (VAS) was used to indicate dentin sensitivity in response to an air stimulus. Participants who had a VAS score of 30-80 were qualified for the study and were provided with their assigned desensitizing toothpaste containing potassium citrate (Colgate Sensitive Multi Protection) and a soft-bristled adult toothbrush for home use. After 4 weeks, the hypersensitive teeth were examined again, and the VAS score was also recorded. Results: In this study, 38% (65/172) participants were found to suffer from dentin hypersensitivity, 40 persons who reported VAS scores of 30-80 were qualified for the clinical trial. Among these, 34 (85%) participants reported reduced dentin hypersensitivity after using the desensitizing toothpaste containing potassium cit-rate for 4 weeks. The mean value of the VAS score prior to the use of the toothpaste was 50.72, while the mean value of the VAS score after use was 30.68. The use of Colgate Sensitive Multi Protection was found to significantly reduce dentin hypersensitivity after 4 weeks (P < 0.01). Conclusion: The prevalence of dentin hypersensitivity in this study was 38%. The use of desensitizing toothpaste containing potassium citrate with oral hygiene instruction can effectively reduce dentin hypersensitivity.

Platelet-rich fibrin (PRF) is a second-generation platelet concentrate which allows one to obtain fibrin membranes enriched with platelets and growth factors, after an anticoagulant-free blood harvest. However, limited information is currently available concerning the biologic effects of PRF on periodontally related cells. To provide clear evidence for the clinical use of PRF, we investigated the biologic effects of PRF on human gingival fibroblasts (GFs), periodontal ligament (PDL) cells, oral epithelial cells, and osteoblasts. Materials and methods: Blood collection was carried out on 10 healthy volunteers. PRF was obtained by centrifugation at 3000 rpm for 12 minutes with a PC-02 table centrifuge. Primary cultured human GFs and PDL cells, the GNM oral epithelial cell line, and the U2OS osteoblast cell line were used to evaluate cell viability and proliferation resulting from PRF according to trypan blue and tetrazolium bromide reduction assays. Results: PRF did not interfere with cell viability of periodontally related cells (P > 0.05). PRF stimulated cell proliferation of osteoblasts (135% of the control), PDL cells (130% of the control), and GFs (120% of the control) during a 3-day culture period (all P < 0.05). However, PRF suppressed oral epithelial cell growth to as low as 80% of the control (P < 0.05). In addition, GFs, PDL cells, and osteoblasts were observed to attach at the margins of PRF by phase-contrast microscopy. Conclusion: Our results suggest that PRF modulates cell proliferation in a cell type- specific manner. These cell type-specific actions may be beneficial for periodontal regeneration.

Lysyl oxidase (LOX) is involved in the initial steps of converting soluble monomers of collagen and elastin into insoluble fibers in the extracellular matrix. LOX was found to be upregulated in some fibrotic diseases. However, little is known about the correlation between LOX and cyclosporin A (CsA)-induced gingival overgrowth. The aim of this study was to compare LOX expression in normal healthy gingival tissues and CsA-induced gingival overgrowth specimens. Materials and methods: Fifteen CsA-induced gingival overgrowth specimens and five normal gingival tissues were examined by immunohistochemistry. Three oral submucous fibrosis specimens were used as positive controls. In addition, one section from each CsA-induced gingival overgrowth specimen was stained with hematoxylin and eosin to evaluate the magnitude of inflammation at the histologic level. Differences in LOX expression between tissues with low and high levels of inflammation were subsequently analyzed using Fisher's exact test. Results: LOX staining in gingival tissue was stronger in the CsA-induced gingival over-growth group than in the normal gingival group (P < 0.05). LOX staining was detected in the epithelium, connective tissue, inflammatory infiltrates, and endothelium. The LOX signal was mainly expressed in inflammatory cells (100%), followed by endothelial cells (93.3%), fibroblasts (80%) and epithelial cells (60%). In addition, LOX expression was significantly higher in CsA-induced gingival overgrowth specimens with higher levels of inflammatory infiltrates (P = 0.017). Conclusion: LOX expression was significantly upregulated in CsA-induced gingival overgrowth specimens. In addition, the expression of LOX increased with the grade of inflammation in CsA-induced gingival overgrowth.

Oral lichen planus (OLP) is a chronic inflammatory disorder characterized by a T cell-mediated immune response against epithelial cells. Matrix metalloproteinases (MMPs) are an important group of zinc enzymes and are thought to play an important role in the degradation of components of the extracellular matrix. The aim of this study was to assess the expression of MMP-2 and MMP-9 in both tissue specimens and circulating plasma. Materials and methods: Twelve cases of OLP were collected. In addition, six cases with chronic inflammation and six normal subjects were also recruited. Oral tissue specimens were collected for measurement of MMPs by immunohistochemistry, and sera prepared from peripheral blood were used for gelatin zymography to determine MMP levels in plasma. Results: The level of MMP-2 in patients with OLP was significantly higher than that in the other two groups, both in tissues and sera (P < 0.0001). However, there was no difference in the expression of MMP-9 among these groups. Conclusion: MMP-2 overexpression in OLP is consistent with its upregulation in peripheral serum. This result also indicates that MMP-2 might play a role in the pathogenesis of OLP.

Heme oxygenase-1 (HO-1) is known as an oxidative stress responsive protein that is upregulated by various physiologic and endogenous stimuli. HO-1 has been proposed to provide an important cellular response that protects cells against oxidative damage. Areca quid chewing is a major risk factor in the development and further progression of oral squamous cell carcinoma (OSCC). The aim of the present study was to investigate the difference in HO-1 expression in normal human oral epithelium and OSCC, and further explore the potential mechanism that may lead to HO-1 expression. Methods: Thirty-five OSCC and 10 normal epithelium specimens were examined by immunohistochemistry and analyzed by clinicopathologic profiles. The oral epithelial GNM cell line was challenged with arecoline, a major areca nut alkaloid, by reverse-transcriptase polymerase chain reaction. Furthermore, tobacco smoke carcinogen benzo[a]pyrene (BaP) and glutathione (GSH) precursor N-acetyl-L-cysteine were added to find the possible regulatory mechanisms. Results: HO-1 expression was significantly higher in OSCC specimens (p < 0.05). No significant difference in HO-1 expression was observed with respect to age, sex, T category, and stage (p > 0.05). The high HO-1 expression was associated with lymph node metastasis (p = 0.005). In addition, arecoline was found to elevate HO-1 mRNA in a dose-dependent manner (p < 0.05). The addition of BaP enhanced arecoline-induced HO-1 expression (p < 0.05). Moreover, addition of NAC markedly inhibited arecoline-induced HO-1 expression (p < 0.05). Conclusion: Taken together, these results suggest that HO-1 expression is significantly upregulated in OSCC from areca quid chewers, and arecoline may be responsible for enhanced HO-1 expression in vivo. The compounds of cigarette smoke may act synergistically in the pathogenesis of areca-quid-chewing-associated OSCC. The regulation of HO-1 expression induced by arecoline is critically dependent on intracellular GSH concentration.

Most of Taiwanese robot manufacturers contract sales and after sales service to their European or American distributors, thus isolating them from the end-user market and increasing the difficulty of responding quickly and accurately to end-user requirements, and indirectly restricting opportunities to discover niche markets. Taiwan enjoys significant market share in Europe and the Americas for Cartesian Coordinate and single-axle robots, but still faces strong competition from Japanese and German products. In the low-end market, Taiwan is challenged on price by companies from mainland China. To address these issues, this research recommends robot manufacturers businesses base product development more closely on market demand and adopt a product differentiation strategy to develop products with potential for niche markets. First, businesses should survey demand in European and American end-user markets to obtain guidance for the development of robotic products that better fit the actual needs of European and American end-users and to gain insight into potential niche market for Taiwanese products. Developing products in response to market demand means more than producing single models but also the systemic integration of processing, production efficiency, product yield rates and system responsiveness. By developing a satisfactory production system, Taiwanese industrial robotics manufacturers can enhance their visibility and create new business opportunities.

Compound comparison is an important task for the computational chemistry. By the comparison results, potential inhibitors can be found and then used for the pharmacy experiments. The time complexity of a pairwise compound comparison is O(n2), where n is the maximal length of compounds. In general, the length of compounds is tens to hundreds, and the computation time is small. However, more and more compounds have been synthesized and extracted now, even more than tens of millions. Therefore, it still will be time-consuming when comparing with a large amount of compounds (seen as a multiple compound comparison problem, abbreviated to MCC). The intrinsic time complexity of MCC problem is O(k2n2) with k compounds of maximal length n. In this paper, we propose a GPU-based algorithm for MCC problem, called CUDA-MCC, on single- and multi-GPUs. Four LINGO-based load-balancing strategies are considered in CUDA-MCC in order to accelerate the computation speed among thread blocks on GPUs. CUDA-MCC was implemented by C+OpenMP+CUDA. CUDA-MCC achieved 45 times and 391 times faster than its CPU version on a single NVIDIA Tesla K20m GPU card and a dual-NVIDIA Tesla K20m GPU card, respectively, under the experimental results.

Galectins are β-galactoside-binding proteins implicated in a myriad of biological functions. Despite their highly conserved carbohydrate binding motifs with essentially identical structures, their affinities for lactose, a common galectin inhibitor, vary significantly. Here, we aimed to examine the molecular basis of differential lactose affinities amongst galectins using solution-based techniques. Consistent dissociation constants of lactose binding were derived from nuclear magnetic resonance (NMR) spectroscopy, intrinsic tryptophan fluorescence, isothermal titration calorimetry and bio-layer interferometry for human galectin-1 (hGal1), galectin-7 (hGal7), and the N-terminal and C-terminal domains of galectin-8 (hGal8NTD and hGal8CTD, respectively). Furthermore, the dissociation rates of lactose binding were extracted from NMR lineshape analyses. Structural mapping of chemical shift perturbations revealed long-range perturbations upon lactose binding for hGal1 and hGal8NTD. We further demonstrated using the NMR-based hydrogen–deuterium exchange (HDX) that lactose binding increases the exchange rates of residues located on the opposite side of the ligand-binding pocket for hGal1 and hGal8NTD, indicative of allostery. Additionally, lactose binding induces significant stabilisation of hGal8CTD across the entire domain. Our results suggested that lactose binding reduced the internal dynamics of hGal8CTD on a very slow timescale (minutes and slower) at the expense of reduced binding affinity due to the unfavourable loss of conformational entropy.

AimTo evaluate whether metabolic syndrome is associated with gallstones, independent of hepatitis C infection or chronic kidney disease (CKD), in a non-diabetic population.Materials and methodsA total of 8,188 Chinese adult participants that underwent a self-motivated health examination were recruited into the final analysis after excluding the subjects who had a history of cholecystectomy, diabetes mellitus, or were currently using antihypertensive or lipid-lowering agents. Gallstones were defined by the presence of strong intraluminal echoes that were gravity-dependent or that attenuated ultrasound transmission.ResultsA total of 447 subjects (5.5%) had gallstones, with 239 (5.1%) men and 208 (6.0%) women. After adjusting for age, gender, obesity, education level, and lifestyle factors, included current smoking, alcohol drinking, regular exercise, hepatitis B, hepatitis C, and CKD, there was a positive association between metabolic syndrome and gallstones. Moreover, as compared to subjects without metabolic abnormalities, subjects with one, two, and three or more suffered from a 35, 40, and 59% higher risk of gallstones, respectively.ConclusionsNon-diabetic subjects with metabolic syndrome had a higher risk of gallstones independent of hepatitis C or CKD, and a dose-dependent effect of metabolic abnormalities also exists.