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Heat shock proteins (HSPs), which function as chaperones, are activated in response to various environmental stressors. In addition to their role in diverse aspects of protein production, HSPs protect against harmful protein-related stressors. Calycosin exhibits numerous beneficial properties. This study aims to explore the protective effects of calycosin in the heart under heat shock and determine its underlying mechanism. H9c2 cells, western blot, TUNEL staining, flow cytometry, and immunofluorescence staining were used. The time-dependent effects of heat shock analyzed using western blot revealed increased HSP expression for up to 2h, followed by protein degradation after 4h. Hence, a heat shock damage duration of 4h was chosen for subsequent investigations. Calycosin administered post-heat shock demonstrated dose-dependent recovery of cell viability. Under heat shock conditions, calycosin prevented the apoptosis of H9c2 cells by upregulating HSPs, suppressing p-JNK, enhancing Bcl-2 activation, and inhibiting cleaved caspase 3. Calycosin also inhibited Fas/FasL expression and activated cell survival markers (p-PI3K, p-ERK, p-Akt), indicating their cytoprotective properties through PI3K/Akt activation and JNK inhibition. TUNEL staining and flow cytometry confirmed that calycosin reduced apoptosis. Moreover, calycosin reversed the inhibitory effects of quercetin on HSF1 and Hsp70 expression, illustrating its role in enhancing Hsp70 expression through HSF1 activation during heat shock. Immunofluorescence staining demonstrated HSF1 translocation to the nucleus following calycosin treatment, emphasizing its cytoprotective effects. In conclusion, calycosin exhibits pronounced protective effects against heat shock-induced damages by modulating HSP expression and regulating key signaling pathways to promote cell survival in H9c2 cells. [ABSTRACT FROM AUTHOR]

Aim Background Design Methods Results Conclusions To assess heart rate variability (HRV) as a measure to assess job stress and sleep quality among nurses in the post‐COVID‐19 period.The COVID‐19 pandemic significantly affected nurses, with heightened job stress and impaired sleep quality impacting their well‐being and effectiveness in patient care. HRV could offer insights for supporting strategies in the pandemic aftermath.A quantitative cross‐sectional study.This study involved 403 clinical nurses recruited from a teaching hospital in Taiwan. Data on job stress, work frustration, sleep quality and HRV were collected and analysed.Among the nurses surveyed during the COVID‐19 pandemic, 72.7% reported poor sleep quality (PSQI = 9.369). Job stress emerged as a strong predictor of work frustration. High stress levels and poor sleep quality were correlated with significantly decreased HRV, indicating a potential physiological impact of stress on the nurses' health and well‐being.HRV is a valuable and cost‐effective measure for monitoring and managing nurses' well‐being in the post‐COVID‐19 era. Targeted interventions can be implemented to support nurses' overall performance and promote their well‐being by identifying those at high risk of job stress and poor sleep quality. [ABSTRACT FROM AUTHOR]

To improve the inventory management of cold chain logistics, we propose an economic order quantity (EOQ) inventory model for temperature-sensitive deteriorating products. Considering that the products are temperature-sensitive, the deterioration rate of the proposed model is a function of the temperature. In addition, the transportation cost, which is a function of the quantity ordered, is considered in this study. This article aims to find the optimal value of the total profit, selling price, and the length of the ordering cycle. Numerical examples are provided; the sensitivity analysis shows that the total profit is much more sensitive to transportation costs, compared with ordering and holding costs. [ABSTRACT FROM AUTHOR]

A spectroscopic imaging-scanning tunneling microscope (SI-STM) allows for the atomic scale visualization of the surface electronic and magnetic structure of novel quantum materials with a high energy resolution. To achieve the optimal performance, a low vibration facility is required. Here, we describe the design and performance of an ultrahigh vacuum STM system supported by a hybrid vibration isolation system that consists of a pneumatic passive and a piezoelectric active vibration isolation stage. We present the detailed vibrational noise analysis of the hybrid vibration isolation system, which shows that the vibration level can be suppressed below 10−8 m/sec/√Hz for most frequencies up to 100 Hz. Combined with a rigid STM design, vibrational noise can be successfully removed from the tunneling current. We demonstrate the performance of our STM system by taking high resolution spectroscopic maps and topographic images on several quantum materials. Our results establish a new strategy to achieve an effective vibration isolation system for high-resolution STM and other scanning probe microscopies to investigate the nanoscale quantum phenomena. [ABSTRACT FROM AUTHOR]

The Bin–Amphiphysin–Rvs (BAR) domain of endophilin binds to the cell membrane and shapes it into a tubular shape for endocytosis. Endophilin has a Src-homology 3 (SH3) domain at their C-terminal. The SH3 domain interacts with the proline-rich motif (PRM) that is found in proteins such as neural Wiskott–Aldrich syndrome protein (N-WASP). Here, we re-examined the binding sites of the SH3 domain of endophilin in N-WASP by machine learning-based prediction and identified the previously unrecognized binding site. In addition to the well-recognized PRM at the central proline-rich region, we found a PRM in front of the N-terminal WASP homology 1 (WH1) domain of N-WASP (NtPRM) as a binding site of the endophilin SH3 domain. Furthermore, the diameter of the membrane tubules in the presence of NtPRM mutant was narrower and wider than that in the presence of N-WASP and in its absence, respectively. Importantly, the NtPRM of N-WASP was involved in the membrane localization of endophilin A2 in cells. Therefore, the NtPRM contributes to the binding of endophilin to N-WASP in membrane remodeling. [ABSTRACT FROM AUTHOR]

Pendelluft, the shift of air from non-dependent to dependent lung regions, is known to occur during active breathing in ventilated patients. However, information about pendelluft in ARDS patients under assisted mechanical ventilation is limited. In this prospectively collected and retrospectively analyzed study, we combined electrical impedance tomography and respiratory mechanics monitoring to quantitatively examine pendelluft in trigger and reverse triggering breaths in 20 mechanically ventilated patients with ARDS during the transition from controlled to active breaths under volume-cycled ventilation. Besides the 10 resting breaths in each patient, 20% of the counted active breaths were selected based on three levels of esophageal pressure swing (∆Pes): low (< 5 cm H2O, breaths = 471), moderate (≥ 5, < 10 cm H2O, breaths = 906), and high effort (≥ 10 cm H2O, breaths = 565). The pendelluft response to breathing efforts was significantly greater in trigger breaths than in reverse triggering breaths (p < 0.0001). Based on the pendelluft-∆Pes slope (ml/cmH2O), there were two distinct patterns of effort-related pendelluft (high vs. low pendelluft group). For trigger breaths, the high pendelluft group (n = 9, slope 0.7–2.4 ml/cmH2O) was significantly associated with lower peak airway/plateau pressure and lower respiratory system/lung elastance than the low pendelluft group (n = 11, slope − 0.1 to 0.3 ml/cmH2O). However, there was no difference in respiratory mechanics between high and low pendelluft groups for reverse triggering breathes. The use of ∆Pes to predict pendelluft was found to have a low positive predictive value. [ABSTRACT FROM AUTHOR]

Background: Early palliative care (PC) has received more attention for improving health-related outcomes for advanced cancer patients in recent years, but the results of previous studies are inconsistent. Objectives: This study aimed to use meta-analysis and trial sequence analysis to evaluate the effect of early PC on health-related outcomes of advanced cancer patients. Methods: All English publications were searched in PubMed, Web of Science, Embase, and the Cochrane Library from inception to March 2023, with a restriction that the study type was a randomized controlled trial. Results: The results showed that early PC positively affected quality of life, satisfaction with care, and symptom burden reduction. However, early PC had no significant effect on anxiety or survival. Trial sequence analysis results showed that the effect of early PC on the quality of life was stable. Discussion: This systematic review suggested that early PC could positively affect health-related outcomes for advanced cancer patients. Early PC can be used widely in clinical settings to improve health-related outcomes of advanced cancer. However, because of the trial sequence analysis results, further well-designed, clinical, randomized controlled trials with larger sample sizes are necessary to draw definitive conclusions. [ABSTRACT FROM AUTHOR]

Horizontal transmission of bacteria to varied hosts can maintain and even expand microbial niches. We previously found that the aphid gut bacterium Serratia symbiotica strain SsMj can be transmitted to ladybird beetles via predation, but whether the predator is a new host, a reservoir or a dead end of this bacterium is unknown. This study aims to provide a clear picture of SsMj circulation from aphids to plants and predators. We first found that SsMj in aphids and ladybirds was abundantly distributed not only in digestive tracts but also in droppings. We found no evidence for vertical transmission of SsMj to aphid offspring. Instead, we showed that it could be transmitted to conspecific aphids by sharing the same plant or contacting honeydews. The key finding of this study is that SsMj was transmitted from aphids to ladybirds through predation, while ladybirds could also transfer SsMj back to aphids, possibly through feces. Together, this evidence suggests that SsMj is able to survive in the digestive tracts and droppings of insects and to expand its host range with plants and predators as reservoirs. [ABSTRACT FROM AUTHOR]

A broadband high‐efficiency high‐gain empty substrate integrated waveguide cavity‐backed filtenna with dual beams is proposed. The antenna is vertically stacked by three cavities. Two rectangular slots are etched above the uppermost cavity to realize the radiation function. Since the interior of the cavity is covered with metal, the characteristics of the antenna are independent of the used dielectric substrate. The fractional bandwidth of the proposed filtenna is 21.1%, and the efficiency can reach more than 90% in the operational band. The antenna has good frequency selection properties, and the ratio of the −10 dB impedance bandwidth to the −3 dB impedance bandwidth is 0.88. Good gain flatness is obtained, the maximum gain of the filtenna within the operational band is 8 dBi. The proposed dual‐beam filtenna can realize broadband and filtering simultaneously, with low cost and high efficiency. It can be used in wireless communication systems. [ABSTRACT FROM AUTHOR]

Incidence rates for diseases are widely used in the field of medical research because they lead to clear and simple physical and clinical interpretations. In this study, we propose an efficient estimation method that incorporates auxiliary subgroup information related to the incidence rate into the estimation of the Cox proportional hazard model. The results show that utilizing the incidence rate information improves the efficiency of the estimation of regression parameters based on the double empirical likelihood method compared to that for conventional models that do not incorporation such information. We show that estimators of regression parameters asymptotically follow a multivariate normal distribution with a variance-covariance matrix that can be consistently estimated. Simulation results indicate that the proposed estimators significantly increase efficiency. Finally, an example of the effects of type 2 diabetes on stroke is applied to demonstrate the proposed method. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore practicing speech-language pathologists’ (SLPs’) perceptions of factors that could facilitate or prevent the use of speech-generating devices (SGDs) in bilingual individuals with aphasia. Specifically, this exploratory study sought to identify the facilitators and barriers to SGD use in individuals with culturally and linguistically diverse backgrounds. Method: An online survey was distributed to SLPs through an e-mail listserv and social media of an augmentative and alternative communication company. This article focused on the results of the survey items related to (a) the presence of bilingual individuals with aphasia on an SLP’s caseload, (b) training related to SGD or bilingual aphasia, and (c) barriers and facilitators to SGD use. A thematic analysis was conducted to analyze the barriers and facilitators to SGD use reported by the respondents. Results: A total of 274 SLPs who met the inclusion criteria had experience in implementing SGD for people with aphasia. Regarding relevant training, our results indicated that very few SLPs received bilingual aphasia intervention training (17.22%) or bilingual SGD training (0.56%) in graduate school. The results from our thematic analysis revealed four major themes of barriers and facilitators to SGD use, including (a) hardware and software, (b) cultural and language content, (c) SLP’s cultural and linguistic competency, and (d) resources. Conclusions: Practicing SLPs reported several barriers to SGD use in bilinguals with aphasia. Most notably, language barriers for monolingual SLPs were seen as the greatest barrier to language recovery in individuals with aphasia whose primary language is not English. Several other barriers were consistent with previous research, such as financial factors and insurance disparities. The top three most important factors that facilitate SGD use in bilinguals with aphasia, as identified by the respondents, include user-friendly symbol organization, personalized words, and ease of programming. [ABSTRACT FROM AUTHOR]

SUMMARY: Ethylene‐responsive factors (ERFs) have diverse functions in the regulation of various plant developmental processes. Here, we demonstrate the dual role of an Arabidopsis ERF gene, AtERF19, in regulating reproductive meristem activity and flower organ size through the regulation of genes involved in CLAVATA–WUSCHEL (CLV–WUS) and auxin signaling, respectively. We found that AtERF19 stimulated the formation of flower primordia and controlled the number of flowers produced by activating WUS and was negatively regulated by CLV3. 35S::AtERF19 expression resulted in significantly more flowers, whereas 35S::AtERF19 + SRDX dominant‐negative mutants produced fewer flowers. In addition, AtERF19 also functioned to control flower organ size by promoting the division/expansion of the cells through activating Small Auxin Up RNA Gene 32 (SAUR32), which positively regulated MYB21/24 in the auxin signaling pathway. 35S::AtERF19 and 35S::SAUR32 resulted in similarly larger flowers, whereas 35S::AtERF19 + SRDX and 35S::SAUR32‐RNAi mutants produced smaller flowers than the wild type. The functions of AtERF19 were confirmed by the production of similarly more and larger flowers in 35S::AtERF19 transgenic tobacco (Nicotiana benthamiana) and in transgenic Arabidopsis which ectopically expressed the orchid gene (Nicotiana benthamiana) PaERF19 than in wild‐type plants. The finding that AtERF19 regulates genes involved in both CLV–WUS and auxin signaling during flower development significantly expands the current knowledge of the multifunctional evolution of ERF genes in plants. The results presented in this work indicate a dual role for the transcription factor AtERF19 in controlling the number of flowers produced and flower organ size through the regulation of genes involved in CLV–WUS and auxin signaling, respectively. Our findings expand the knowledge of the roles of ERF genes in the regulation of reproductive development. Significance Statement: The results presented in this work indicate a dual role for the transcription factor AtERF19 in controlling the number of flowers produced and flower organ size through the regulation of genes involved in CLAVATA–WUSCHEL and auxin signaling, respectively. Our findings expand the knowledge of the roles of ERF genes in the regulation of reproductive development. [ABSTRACT FROM AUTHOR]

Remarkable exertions are directed to reveal and understand topographic cues that induce cell mechanical sensitive responses including lineage determination. Extracellular matrix (ECM) is the sophisticated ensemble of diverse factors offering the complicated cellular microenvironment to regulate cell behaviors. However, the functions of only a few of these factors are revealed; most of them are still poorly understood. Herein, the focus is on understanding the curved structure in ECM network for regulating stem cell mechanotransduction. A curved nanofiber network mimicking the curved structure in ECM is fabricated by an improved electrospinning technology. Compared with the straight fibers, the curved fibers promote cell bridge formation because of the cytoskeleton tension. The actomyosin filaments are condensed near the curved edge of the non‐adhesive bridge in the bridging cells, which generates higher myosin‐II‐based intracellular force. This force drives cell lineage commitment toward osteogenic differentiation. This study enriches and perfects the knowledge of the effects of topographic cues on cell behaviors and guides the development of novel biomaterials. [ABSTRACT FROM AUTHOR]

The vibrational and electronic structures of diruthenium nickel and copper complexes [Ru2Ni(dpa)4Cl2]0,1+ and [Ru2Cu(dpa)4Cl2]0,1+ were studied by using temperature‐controlled Raman spectroscopy and density functional theory (DFT) calculations. In the neutral species, the Ru−Ru stretching mode νRu−Ru was assigned to the 333/325 cm−1 band for the diruthenium Ni/Cu complexes, and this band greatly red shifted to 317/321 cm−1 at high temperatures. In contrast, this νRu−Ru band showed no shift in the oxidized forms. The time‐dependent DFT (TD‐DFT) calculations yielded that these complexes in the neutral form, have [Ru2]5+[M]1+ cores with [Ru2] moiety configuration (π*)2(δ*)1 and two low‐lying electronic excited states with [Ru2]4+[M]2+ cores and [Ru2] configurations of (π*)2(δ*)2 and (π*)3(δ*)1, respectively. The significant red shift of νRu−Ru band was explained to thermally access to these two excited states which have [Ru2]4+ cores and weak Ru−Ru bonding. These two states were resulted from metal‐to‐metal intramolecular charge transfer processes from [Ru2]5+[Ni/Cu]1+ to [Ru2]4+[Ni/Cu]2+. This charge transfer reaction is prohibited in the oxidized form. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinicopathologic features of primary ovarian carcinoid. Methods: A case of primary ovarian carcinoid of the ovary were reported. Clinicopathological analysis was performed. Results: The case was just an island-like carcinoid. The tumor cells were round or polygonal, arranged into island-like or pseudo chrysanthemum clusters, and got bilateral tubal and oophorectomy. No evidence of recurrence was consulted in 28 months of follow-up. Conclusion: Primary ovarian carcinoid is rare in clinic. The diagnosis should be differentiated from granulosa cell tumor and sertolithoid cell tumor, and metastatic carcinoid should be excluded. As a low-grade malignant tumor, most ovarian carcinoids have a real good prognosis. [ABSTRACT FROM AUTHOR]

Recurrent event and terminal event data commonly arise in clinical and observational studies. To evaluate the efficacy of a treatment effect for both types of events, a composite endpoint has been used as a possible assessment, particularly when faced with high costs and a longer follow‐up study. To model recurrent event processes complicated by the existence of a terminal event, joint frailty modeling has been typically employed. In this study, the objective was to develop some target‐driven response adaptive randomization strategies using a composite endpoint based on joint frailty modeling. We first implemented a balanced randomized design and then investigated the response adaptive randomization. The former is intuitively first adopted while the latter is expected to be desirable and ethical in terms of allocating more subjects to the more effective treatment. The results show that the proposed procedures using a composite endpoint are capable of reducing the number of trial participants who receive inferior treatment while simultaneously reaching a desired optimal target as compared to a balanced randomized design. The R shiny application for calculating the sample size and allocation probabilities is also available. Finally, two clinical trials were used as pilot datasets to introduce the proposed procedures. [ABSTRACT FROM AUTHOR]

Background. Preoperative eye-covering training for 3 hours has been reported to effectively reduce the incidence of emergence delirium (ED) in preschool children. However, most children can only maintain the eye being covered for less than 60 min, and shortening eye-covering duration can also achieve similar clinical effects as long duration of eye-covering. This study was designed to compare the effects of 30-min and 60-min eye-covering pretreatment based on cartoon education only on preoperative anxiety, postoperative ED, and pain score after ophthalmic surgery with general anesthesia in preschool-aged children. Methods. Preschool-aged children (3–7 years) who were diagnosed with cataract, blepharoptosis, trichiasis, strabismus, eyelid tumor, and underwent ophthalmic surgery with general anesthesia from August 2021 to January 2022 were recruited. A total of 228 patients were randomly assigned at a 1 : 1:1 ratio to receive 30-min eye covering (30-min group), 60-min eye covering (60-min group) pretreatment, or programmed education only (C group). The preoperative anxiety, postoperative emergence delirium, and pain were compared between the groups. Results. The preoperative anxiety score, postoperative ED score, and incidence of ED in the 30-min group (n = 76) and 60-min group (n = 72) were significantly lower than those in the C group (n = 76), demonstrating a significant between-group difference (P < 0.001). However, the 30-min group and 60-min group had no significant difference in the abovementioned outcome measures (P > 0.05). Moreover, no significant difference was found in postoperative pain scores among the three groups (H = 0.274, P = 0.872). Conclusion. Both 30-min and 60-min eye-covering pretreatments significantly reduce preoperative anxiety and postoperative ED after ophthalmic surgery with general anesthesia in preschool-aged children. The effects of the two groups show no intergroup difference, but the 30-min eye-covering pretreatment may be more convenient for practicing. Trial Registration. This study was registered with the No. NCT04973150. [ABSTRACT FROM AUTHOR]

Collagen (COL) is the most widespread functional protein. Designing and developing dual-dynamic-bond cross-linked COL adhesive hydrogel sealants with multifunctional is highly advantageous for achieving a superior wound closure effect and hemostasis. In this study, we developed hybrid hydrogels consisting of fish-skin COL, oxidized sodium alginate (OSA), borax and polyvinyl alcohol (PVA) to enhance full-thickness wound healing. The hydrogels were furnished with first-rate self-healing capabilities through the dual-dynamic-bond cross-linking of dynamic Schiff base bonds (COL-OSA) and diol boric acid bonds (OSA-borax) with reversible breakage and re-formation. Moreover, the incorporation of PVA stimulated the formation of hydrogen bonds in the system, bolstering the stability of the hydrogel framework. The prepared hydrogel manifests self-healing, injectability, multifunctional adhesiveness and biodegradability. In vivo assessment of the hemostatic capacity of COSP 20 hydrogel was superior to gauze both in the mice liver injury model and mice tail amputation model. In addition, a full-thickness skin wound model in mice revealed that the COSP 20 hydrogel facilitated faster wound closure by accelerating reepithelialization, COL deposition and angiogenesis. These findings illustrate the potential of hybrid fish-skin COL-based hydrogels to enhance wound healing and promote rapid tissue repair, and provide new possibilities for the effective utilization of marine fishery resources. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Wearable devices have been found effective in training ankle control in patients with neurological diseases. However, the neural mechanisms associated with using wearable devices for ankle training remain largely unexplored. This study aimed to investigate the ankle tracking performance and brain white matter changes associated with ankle tracking learning using a wearable-device system and the behavior-brain structure relationships in middle-aged and older adults.Methods: Twenty-six middle-aged and older adults (48-75 years) participated in this study. Participants underwent 5-day ankle tracking learning with their non-dominant foot using a custom-built ankle tracking system equipped with a wearable sensor and a sensor-computer interface for real-time visual feedback and data acquisition. Repeated and random sequences of target tracking trajectories were both used for learning and testing. Ankle tracking performance, calculated as the root-mean-squared-error (RMSE) between the target and actual ankle trajectories, and brain diffusion spectrum MR images were acquired at baseline and retention tests. The general fractional anisotropy (GFA) values of eight brain white matter tracts of interest were calculated to indicate their integrity. Two-way (Sex × Time) mixed repeated measures ANOVA procedures were used to investigate Sex and Time effects on RMSE and GFA. Correlations between changes in RMSE and those in GFA were analyzed, controlling for age and sex.Results: After learning, both male and female participants reduced the RMSE of tracking repeated and random sequences (both p < 0.001). Among the eight fiber tracts, the right superior longitudinal fasciculus II (R SLF II) was the only one which showed both increased GFA (p = 0.039) after learning and predictive power of reductions in RMSE for random sequence tracking with its changes in GFA [β = 0.514, R2 change = 0.259, p = 0.008].Conclusions: Our findings implied that interactive tracking movement learning using wearable sensors may place high demands on the attention, sensory feedback integration, and sensorimotor transformation functions of the brain. Therefore, the SLF II, which is known to perform these brain functions, showed corresponding neural plasticity after such learning, and its plasticity also predicted the behavioral gains. The SLF II appears to be a very important anatomical neural correlate involved in such learning paradigms. [ABSTRACT FROM AUTHOR]

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a hereditary disease of the heart muscle. Clinical challenges remain, however, in identifying patients with ARVC in the early or concealed stages with subtle clinical manifestations. Therefore, we wanted to identify potential targets by immunohistochemical (IHC) analysis in comparison with controls. Pathogenic mutations were identified in 11 of 37 autopsied patients with ARVC. As observed from IHC analysis of the RV, expression of αT-catenin and plakophilin-2 is significantly decreased in autopsied patients with ARVC as compared to controls, and the decreased expression is consistent in patients with and without pathogenic mutations. Furthermore, ARVC specimens demonstrated a reduced localization of αT-catenin, desmocollin-2, desmoglein-2, desmoplakin, and plakophilin-2 on intercalated discs. These findings have been validated by comparing RV specimens obtained via endomyocardial biopsy between patients with ARVC and those without. The pathogenic mutation was present in 3 of 5 clinical patients with ARVC. In HL-1 myocytes, siRNA was used to knockdown CTNNA3, and western blotting analysis demonstrated that the decline in αT-catenin expression was accompanied by a significant decline in the expression of plakophilin-2. The aforementioned effect was directed towards protein degradation rather than mRNA stability. Plakophilin-2 expression decreases concurrently with the decline in CTNNA3 expression. Therefore, the expression of αT-catenin and plakophilin-2 could be potential surrogates for the diagnosis of ARVC. [ABSTRACT FROM AUTHOR]

Survival analyses are heavily used to analyze data in which the time to event is of interest. The purpose of this paper is to introduce some fundamental concepts for survival analyses in medical studies. We comprehensively review current survival methodologies, such as the nonparametric Kaplan-Meier method used to estimate survival probability, the log-rank test, one of the most popular tests for comparing survival curves, and the Cox proportional hazard model, which is used for building the relationship between survival time and specific risk factors. More advanced methods, such as time-dependent receiver operating characteristic, restricted mean survival time, and time-dependent covariates are also introduced. This tutorial is aimed toward covering the basics of survival analysis. We used a neurosurgical case series of surgically treated brain metastases from non-small cell lung cancer patients as an example. The survival time was defined from the date of craniotomy to the date of patient death. This work is an attempt to encourage more investigators/medical practitioners to use survival analyses appropriately in medical research. We highlight some statistical issues, make recommendations, and provide more advanced survival modeling in this aspect. [ABSTRACT FROM AUTHOR]

Introduction: Subarachnoid hemorrhage (SAH) is a critical disease, and people may get mortality on SAH. Another severe disease induced cardiac arrest is acute coronary syndrome (ACS), and our two cases share the typical characteristics of ACS electrocardiogram (ECG) with ST-segment elevation. The experience is rare and educable, so we present this article to remind emergency physicians in similar cases. Case presentation: Two post-resuscitation electrocardiogram (ECG)-proven cases of out-of-hospital cardiac arrest (OHCA) revealed ST-segment elevation. Discussion: However, the etiology of the arrest was proven to be subarachnoid hemorrhage (SAH) in the Emergency Department. In this article, we shared ECGs and brain CT scans as a reminder to ED doctors to bear in mind other differential diagnoses when ECGs show ST-segment elevation post-resuscitation. Conclusion: Cases such as these alert frontline ED physicians to the possibility of SAH in cardiac arrest patients and the potentially lethal consequence of inappropriate treatment. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of symbol format and verb argument structure on the naming, identification, and sentence generation in people with aphasia (PWA). Methods: A 2 × 2 randomized, mixed factorial design was used. Symbol format was the between-subjects variable with a photograph condition and a video condition. Verb argument structure was the within-subjects variable and included two- and three-argument verbs. Twenty-one participants were recruited and randomly assigned into either the photograph condition (n = 9) or the video condition (n = 12). Independent t-tests determined if any differences between the groups were present with respect to their standard language scores in Western Aphasia Battery-Revised (WAB-R) and the Northwestern Assessment of Verbs and Sentences (NAVS). A MANOVA was conducted to determine the effects of symbol format and argument structure on the three experimental tasks, including verb naming task, identification task, and sentence generation task. Results: No significant differences were found between groups on the WAB-R or the NAVS. A significant multivariate and univariate effect was found for argument structure on all three experimental tasks. Two- argument verbs were easier to name, identify, and use in a sentence when compared to three-argument verbs. While there was no multivariate or univariate effect for symbol format, there was a medium effect size. The participants accurately named more verbs in the video condition when compared to the photograph condition. Conclusion: These findings add support to the Argument Structure Complexity Principle. The effect of symbol format requires further research with respect to sentence generation, but videos may be used to support naming in PWA. [ABSTRACT FROM AUTHOR]

Recurrent events, including cardiovascular events, are commonly observed in biomedical studies. Understanding the effects of various treatments on recurrent events and investigating the underlying mediation mechanisms by which treatments may reduce the frequency of recurrent events are crucial tasks for researchers. Although causal inference methods for recurrent event data have been proposed, they cannot be used to assess mediation. This study proposed a novel methodology of causal mediation analysis that accommodates recurrent outcomes of interest in a given individual. A formal definition of causal estimands (direct and indirect effects) within a counterfactual framework is given, and empirical expressions for these effects are identified. To estimate these effects, a semiparametric estimator with triple robustness against model misspecification was developed. The proposed methodology was demonstrated in a real‐world application. The method was applied to measure the effects of two diabetes drugs on the recurrence of cardiovascular disease and to examine the mediating role of kidney function in this process. [ABSTRACT FROM AUTHOR]

Background: The 24-h rooming-in policy is crucial to the Baby-Friendly Hospital Initiative (BFHI) for promoting breastfeeding. However, this policy may restrict maternal autonomy. In 2018, to integrate women's preferences into care decisions, Taiwan's Baby-Friendly certification included prenatal shared decision-making (SDM) for rooming-in. Prior to 2018, maternal knowledge, considerations, and intentions regarding rooming-in and the impact of prenatal SDM were unknown. Methods: A retrospective electronic medical record cohort study was conducted in southern Taiwan. Data on healthy postpartum women eligible for rooming-in and breastfeeding for the years 2017 and 2019, reflecting the periods before and after prenatal SDM was introduced, were gathered. Maternal and newborn characteristics, maternal knowledge, considerations, and prenatal intentions for postpartum rooming-in and breastfeeding during hospitalization were collected. Additionally, data on actual postpartum rooming-in practices during hospitalization and exclusive breastfeeding (EBF) practices from birth to hospital discharge, to 1 month, and to 2 months postpartum were collected. Descriptive and non-parametric statistics were applied to analyze the data. Results: A total of 621 women in 2017 and 311 women in 2019 were included. After prenatal SDM was introduced, the rooming-in rate during hospitalization fell from 42.2% in 2017 to 25.6% in 2019 (p < 0.001), and the EBF rate declined from 45.9% to 35.7% (p = 0.01). Additionally, the 1-month postpartum EBF rate decreased from 46.4% in 2017 (n = 571) to 44.3% in 2019 (n = 264), and the 2-month postpartum EBF rate dropped from 45.5% in 2017 (n = 591) to 40.2% (n = 308). According to the 2019 Patient Decision Aids responses (n = 236), women demonstrated limited understanding of rooming-in, with only 40.7% expressing an intention toward 24-h rooming-in. Women of older maternal age (p < 0.001), with a graduate degree (p = 0.02), full-time employment (p = 0.04), and concerns about rest disruption (p < 0.001), were more likely to prefer non-24-h rooming-in. Conclusions: Initiatives must promote prenatal SDM to enable healthcare providers to address misconceptions and tailor education, thereby increasing women's intention toward 24-h rooming-in and EBF. Future research should explore women's experiences and unmet needs at BFHI facilities to inform the construction of a baby- and mother-friendly environment. [ABSTRACT FROM AUTHOR]

Objective: We assessed the quality of life (QoL) and pregnancy outcomes of in vitro fertilization (IVF) treatment among infertile women with endometriosis, as compared to infertile women without endometriosis.Study Design: Eighty-one (81) endometriosis women (with 142 embryo transfer [ET] cycles) and 605 non-endometriosis women (with 1063 ET cycles) were included. QoL was measured by FertiQoL at the date before ET. Pregnancy outcomes included biochemical pregnancy, ongoing pregnancy and live birth. Generalized estimating equation analyses were performed to assess the association between QoL and IVF pregnancy.Results: Endometriosis-affected women had significantly lower QoL, as indicated by mind/body, treatment environment and total treatment scores, and total scores of FertiQoL (p < .05), compared to those without endometriosis. Among non-endometriosis women, QoL scores were significantly associated with successful IVF pregnancy; with one unit increase in QoL scores as measured by emotional domain of FertiQoL, the probabilities of ongoing pregnancy and live birth significantly increased by 2.5% and 2.8%, respectively (p < .05). This association was also observed among endometriosis women but it did not reach statistical significance.Conclusions: Lower QoL among women with endometriosis versus non-endometriosis during IVF treatment highlights the importance of developing strategies to improve their QoL, which may enhance following pregnancy rates in this population. [ABSTRACT FROM AUTHOR]

Background: Women with threatened preterm labor (TPTL) resting at home face several life challenges, but their psychological well-being has been ignored. This study aimed to explore the status and related factors of the psychological status of women with TPTL resting at home, and to compare the psychological status differences between TPTL and healthy pregnant women.Methods: A cross-sectional, multiple time-point study was conducted to repeatedly assess depression, perceived stress, and distress in 49 TPTL women and 62 healthy pregnant women during pregnancy in Taiwan. Mann-Whitney U tests were used to compare the psychological status differences between these women and the generalized estimating equation was used to identify the factors related to their psychological status.Results: The TPTL women's perceived stress at 24-27 weeks (p=0.047) and 32-35 weeks (p=0.04) and distress at each time point was significantly greater than that of healthy pregnant women (p<0.001). The common distress experienced by TPTL women was the inability to provide self-care and family care, the baby's health and safety, and to request leave from work for bed rest. Positive personalities, gestational age, preterm birth history, follow-up status and employment have been shown to be related to the psychological status of TPTL women.Limitations: The major limitation of this study is the small sample size.Conclusion: This study contributed to a better understanding of the emotional burdens of women with TPTL resting at home. Such findings highlight the need for constructing effective interventions to alleviate the psychological burden of these women. [ABSTRACT FROM AUTHOR]

• This study proposes a guideline to create a predictive persona by using data-mining predictive algorithms. • The proposed method aims to improve the accuracy and credibility of personas. • We discuss the strengths, weaknesses, and using scenarios of each types of persona creating methods. A persona is a widely used tool in the design field to help understand users' needs, experiences, behaviors, and goals. Quantitatively creating personas is gaining importance for its greater representability, objectivity, and fast creative speed. However, quantitative personas built using traditional statistical methods may not reflect the marketing goals of decision-makers, and they mainly focus on categorizing existing users rather than predicting target customers. To address the research gap, this study proposes a guideline to create a predictive persona by using data-mining algorithms resulting in personas that can be validated. The proposed method aims to improve the accuracy and credibility of personas to effectively predict new customers for target marketing. We demonstrate a step-by-step guideline for creating the proposed predictive persona using real user data, validating its credibility, and comparing its predictive power against traditional quantitative personas. We thoroughly discuss the strengths and weaknesses of qualitative personas, traditional quantitative personas, and predictive personas while portraying suitable scenarios in which each type of persona is appropriate. [ABSTRACT FROM AUTHOR]

Statistical methods for analyzing recurrent events have attracted significant attention. The majority of existing works consider situations in which subjects are observed over time periods and events of interest that occurred during the course of follow-up are recorded. In some applications, a subject may leave the study for a period of time and then resume due to various reasons. During the absence, which is referred to as an intermittent gap in this study, it may be impossible to observe a recording of the event. A naive analysis disregards gaps and considers events to be a typical recurrent event dataset. However, this may result in biased estimations and misleading results. In this study, we build an additive rates model for recurrent event data considering intermittent gaps. We provide the asymptotic theories behind the proposed model, as well as the goodness of fit between observed and modeled values. Simulation studies reveal that the estimations perform well if intermittent gaps are taken into account. In addition, we utilized the longitudinal cohort of elderly patients who have type 2 diabetes and at least one record of a severe recurrent complication, hypoglycemia, from the National Health Insurance Research Database in Taiwan to demonstrate the proposed method. [ABSTRACT FROM AUTHOR]

The alginate lyase AlyQ from Persicobacter sp. CCB-QB2 is a three-domained enzyme with a carbohydrate-binding module (CBM) from family 32. The CBM32 domain, AlyQ B , binds enzymatically cleaved but not intact alginate. Co-crystallisation of AlyQ B with the cleaved alginate reveals that it binds to the 4,5-unsaturated mannuronic acid of the non-reducing end. The binding pocket contains a conserved R248 that interacts with the sugar's carboxyl group, as well as an invariant W303 that stacks against the unsaturated pyranose ring. Targeting specifically the non-reducing end is more efficient than the reducing end since the latter consists of a mixture of mannuronic acid and guluronic acid. AlyQ B also seems unable to bind these two saturated sugars as they contain OH groups that will clash with the pocket. Docking analysis of Ye CBM32, which binds oligogalacturonic acid, shows that the stacking of the pyranose ring is shifted in order to accommodate the sugar's axial C1–OH, and its R69 is accordingly elevated to bind the sugar's carboxyl group. Unlike AlyQ B , Ye CBM32's binding pocket is able to accommodate both saturated and unsaturated galacturonic acid. • Structure of the CBM32 AlyQ B in complex with 4,5-unsaturated mannuronic acid. • R248 binds the sugar's carboxyl group while W303 stacks against the pyranose ring. • AlyQ B 's binding pocket is unable to accommodate mannuronic acid or guluronic acid. • Unsaturated galacturonic acid could be similarly docked into Ye CBM32. • Ye CBM32 may also accommodate saturated galacturonic acid and glucuronic acid. [ABSTRACT FROM AUTHOR]

Objectives: Taiwan has implemented the Diagnosis Related Groups (DRGs) since 2010, and the quality of care under the DRG-Based Payment System is concerned. This study aimed to examine the characteristics, related factors, and time distribution of emergency department (ED) visits, readmission, and hospital transfers of inpatients under the DRG-Based Payment System for each Major Diagnostic Category (MDC). Methods: We conducted a retrospective cohort study using data from the National Health Insurance Research Database (NHIRD) from 2012 to 2013 in Taiwan. Multilevel logistic regression analysis was used to examine the factors related to ED visits, readmissions, and hospital transfers of patients under the DRG-Based Payment System. Results: In this study, 103,779 inpatients were under the DRG-Based Payment System. Among these inpatients, 4.66% visited the ED within 14 days after their discharge. The factors associated with the increased risk of ED visits within 14 days included age, lower monthly salary, urbanization of residence area, comorbidity index, MDCs, and hospital ownership (p < 0.05). In terms of MDCs, Diseases and Disorders of the Kidney and Urinary Tract (MDC11) conferred the highest risk of ED visits within 14 days (OR = 4.95, 95% CI: 2.69–9.10). Of the inpatients, 6.97% were readmitted within 30 days. The factors associated with the increased risk of readmission included gender, age, lower monthly salary, comorbidity index, MDCs, and hospital ownership (p < 0.05). In terms of MDCs, the inpatients with Pregnancy, Childbirth and the Puerperium (MDC14) had the highest risk of readmission within 30 days (OR = 20.43, 95% CI: 13.32–31.34). Among the inpatients readmitted within 30 days, 75.05% of them were readmitted within 14 days. Only 0.16% of the inpatients were transferred to other hospitals. Conclusion: The study shows a significant correlation between Major Diagnostic Categories in surgery and ED visits, readmission, and hospital transfers. The results suggested that the main reasons for the high risk may need further investigation for MDCs in ED visits, readmissions, and hospital transfers. [ABSTRACT FROM AUTHOR]

Background: To assess the associations of various HbA1c measures, including a single baseline HbA1c value, overall mean, yearly updated means, standard deviation (HbA1c-SD), coefficient of variation (HbA1c-CV), and HbA1c variability score (HVS), with microvascular disease (MVD) risk in patients with type 2 diabetes. Methods: Linked data between National Cheng Kung University Hospital and Taiwan's National Health Insurance Research Database were utilized to identify the study cohort. The primary outcome was the composite MVD events (retinopathy, nephropathy, or neuropathy) occurring during the study follow-up. Cox model analyses were performed to assess the associations between HbA1c measures and MVD risk, with adjustment for patients' baseline HbA1c, demographics, comorbidities/complications, and treatments. Results: In the models without adjustment for baseline HbA1c, all HbA1c variability and mean measures were significantly associated with MVD risk, except HVS. With adjustment for baseline HbA1c, HbA1c-CV had the strongest association with MVD risk. For every unit of increase in HbA1c-CV, the MVD risk significantly increased by 3.42- and 2.81-fold based on the models without and with adjustment for baseline HbA1c, respectively. The associations of HbA1c variability and mean measures with MVD risk in patients with baseline HbA1c < 7.5% (58 mmol/mol) were stronger compared with those in patients with baseline HbA1c ≥ 7.5% (58 mmol/mol). Conclusions: HbA1c variability, especially HbA1c-CV, can supplement conventional baseline HbA1c measure for explaining MVD risk. HbA1c variability may play a greater role in MVD outcomes among patients with relatively optimal baseline glycemic control compared to those with relatively poor baseline glycemic control. [ABSTRACT FROM AUTHOR]

Objective: To investigate the risk factors for osteonecrosis of the femoral head (ONFH) after the treatment of femoral neck fracture in patients under 60 years old. Methods: A total of 250 cases of femoral neck fracture treated at 3 hospitals in Xuzhou from January 2002 to January 2016 were studied. The patients were followed up for 1~15 years, and the clinical data on femoral head necrosis after the femoral neck operation were analysed retrospectively. Risk factors were recorded, including age, gender, preoperative traction, time from injury to operation, reduction method, type of reduction, BMI, ASA classification, and quality of reduction. Logistic regression analysis was used to evaluate the independent risk factors for ONFH after treatment of femoral neck fracture. Results: The duration of follow-up was 1~15 years, with an average of 7.5 years. None of the 250 patients had fracture non-union, but 40 (16%) had necrosis of the femoral head. The time to necrosis of the femoral head was 1~7 years after the operation, with an average of 3.8 years. Univariate analysis showed that the type of fracture, the quality of reduction, the removal of internal fixation, BMI and ASA classification were risk factors affecting necrosis of the femoral head in patients with femoral neck fracture, and the difference was statistically significant (P < 0.05). Multivariate analysis showed that internal fixation, fracture type (displacement), reduction quality (dissatisfaction), BMI (> 25), and ASA grade (III + IV) were independent risk factors affecting femoral head necrosis in patients with femoral neck fracture. Conclusion: A variety of high-risk factors for femoral head necrosis are present after surgery with hollow compression screws for femoral neck fracture in adults. Removal of internal fixation, type of fracture, quality of reduction, BMI, and ASA classification were the most important risk factors influencing the development of femoral head necrosis. During treatment, there should be some targeted measures to reduce the incidence of necrosis of the femoral head. [ABSTRACT FROM AUTHOR]

In long‐term clinical studies, recurrent event data are sometimes collected and used to contrast the efficacies of two different treatments. The event reoccurrence rates can be compared using the popular negative binomial model, which incorporates information related to patient heterogeneity into a data analysis. For treatment allocation, a balanced approach in which equal sample sizes are obtained for both treatments is predominately adopted. However, if one treatment is superior, then it may be desirable to allocate fewer subjects to the less‐effective treatment. To accommodate this objective, a sequential response‐adaptive treatment allocation procedure is derived based on the doubly adaptive biased coin design. Our proposed treatment allocation schemes have been shown to be capable of reducing the number of subjects receiving the inferior treatment while simultaneously retaining a test power level that is comparable to that of a balanced design. The redesign of a clinical study illustrates the advantages of using our procedure. [ABSTRACT FROM AUTHOR]

To investigate the functions of NAC-like genes, we reported the characterization and functional analysis of one Arabidopsis NAC-like gene which showed a novel function in the regulation of gibberellin biosynthesis and named as GIBBERELLIN SUPPRESSING FACTOR (GSF). GSF acts as a transcriptional activator and has transactivation capacity based on yeast transcription activity assays. YFP + GSF-TM (lacking a transmembrane domain) fusion proteins accumulated in the nuclei, while the YFP + GSF fusion proteins only accumulated in the ER membrane and were absent from the nuclei. These results revealed that GSF requires processing and release from the ER and transportation into the nucleus to perform its function. The ectopic expression of GSF-TM caused a dwarfism phenotype, which was correlated with the upregulation of the gibberellin (GA) deactivation genes GA2-oxidases 2/6 (GA2ox2/6) and the downregulation of the GA biosynthetic genes GA20-oxidases 1–4 (GA20ox1-4). The external application of GA rescued the dwarfism in the 35 S::GSF-TM plants, indicating that GSF affects GA biosynthesis, rather than the GA signaling pathway. Further analysis indicated that the upregulation of GA2ox2/6 is a key factor for the GSF function to regulate the GA level, since 35 S::GA20ox1 could not rescue the dwarfism in the 35 S::GSF-TM plants. Cold treatment induced the processing of the YFP + GSF fusion proteins from the ER membrane and their entry into the nuclei, which is correlated with the cold-induced upregulation of GA2oxs. In addition, the expression of GA2oxs was induced by drought, and the 35 S::GSF-TM plants showed drought tolerance compared to the wild-type plants. Our data suggest a role for GSF in response to abiotic stresses, such as cold and drought, by suppressing the biosynthesis of GA in Arabidopsis. [ABSTRACT FROM AUTHOR]

Background: Drawing has long been a focus in aphasia research as a compensatory strategy for improving functional communication in individuals with aphasia, but fewer studies have addressed drawing as a facilitative tool to improve their verbal output. Aims: The purpose of the current study was to investigate differences in naming accuracy in individuals with aphasia during a drawing versus a writing condition. Two research questions were formed to examine the role of drawing in facilitating naming: 1) Will participants perform better when naming with drawing compared to confrontation naming only or when naming with writing? and 2) Is the quality of the picture drawn related to the naming accuracy? Methods & Procedures: Across three separate one-hour sessions, fifteen individuals with aphasia (n = 15) aged 44–81 years (M = 61.47, SD = 13.27) were evaluated using two standardized language assessments, the Western Aphasia Battery-Revised and Pyramid and Palm Tree Test, and three naming tasks designed to assess the effect of writing and drawing on naming performance. The three naming conditions consisted of confrontation naming only, naming with drawing, and naming with writing. Outcomes & Results: A one-way, repeated measures analysis of variance (ANOVA) was computed to analyze the impact of naming conditions on the participants' naming accuracy. The main effect of naming conditions was statistically significant, F (1, 14) = 5.87, p < 0.05, and Bonferroni correction revealed that the participants performed significantly better in the naming with drawing condition than with writing condition. In addition, no correlation between the quality of the pictures drawn and the participants' naming performance was found which suggested that the quality of drawing did not affect the accuracy of naming. Conclusions: When attempting to name a picture along with drawing its representation, the act of drawing may facilitate word retrieval by stimulating the semantic network associated with the word and involving the right cerebral hemisphere in the word retrieval process. Through drawing, these semantic features of the target word are more strongly activated than other related words. When the semantic features are more strongly activated, the probabilities of retrieving the target word may increase. In contrast, writing heavily relies on the left hemisphere and linguistic systems. Thus, naming when attempting to write the associated word may be a more cognitively and linguistically demanding task for individuals with aphasia. [ABSTRACT FROM AUTHOR]

Two phosphite-stabilized titanium-oxo clusters (TOCs) functionalized with ferrocenecarboxylate ligands, namely, [Ti6(μ3-O)2(μ2-O)2(μ2-OiPr)4(OiPr)6(O3PH)2(O2CFc)2] (Fc = ferrocenyl) and [Ti5(μ3-O)2(μ2-O)(μ2-OiPr)2(OiPr)4(O3PH)2(O2CFc)4] were synthesized and structurally characterized by single-crystal X-ray diffraction analysis. The photophysical, photoelectrochemical, and photocatalytic properties of the clusters were investigated. These two clusters exhibit intense visible absorption with narrow band gap of ~ 2.2 eV. The photocurrent response and dye degradation experiments show that the Ti-oxo core structures have influence on the photoelectrochemical and photocatalytic properties of these ferrocenecarboxylate-functionalized titanium-oxo clusters. [ABSTRACT FROM AUTHOR]

The deposition of colloidal silica particles during the evaporation of sessile drops on a smooth substrate has been modeled by the simultaneous solution of the Navier–Stokes equations, the convective-diffusive equation for particles, and the diffusion equation for evaporated vapor in the gas phase. Isothermal conditions were assumed. A mapping was created to show the conditions for various deposition patterns for very dilute suspensions. Based on values of the Peclet (Pe) number and Damkholer numbers (Da and Da−1), the effects of adsorption and desorption were discussed according to the map. Simulations were also done for suspensions with a high particle concentration to form a solid phase during the evaporation by using a packing criterion. The simulations predicted the height and width of the ring deposit near the contact line, and the results compared favorably to experimental particle deposition patterns. [ABSTRACT FROM AUTHOR]

Based on uncertainty management theory (Lind & Van den Bos, 2002; Van den Bos & Lind, 2002), we explored whether uncertainty in the workplace (role ambiguity) as well as off the workplace (economic hardship) moderates the relationship between abusive supervision and subordinates' job burnout. Using survey method, we obtained 458 valid responses from employees in a transportation company in Taiwan. The results of moderated hierarchical regression showed that both role ambiguity and economic hardship induce the positive relationship between abusive supervision and subordinates' job burnout. Abusive supervision related more strongly to job burnout when subordinates perceived higher role ambiguity (higher uncertainty) or higher economic hardship (higher uncertainty). As predicted, high uncertainty increases subordinates' attentions to the injustice from abusive supervision and thus strengthens the negative psychological consequences of abusive supervision, regardless of whether the source of uncertainty corresponds to the source of (in)justice perception. [ABSTRACT FROM AUTHOR]

Introduction: Rapid laboratory glucose testing assists prompt on-site treatment for abnormal glycaemic episodes. New generation Point-of-Care Testing (POCT) for whole blood glucose analysis have high sensitivity and short processing time, which is competent for on-site rapid glucose testing. Aim: To assess the accuracy and Turn Around Time (TAT) of the POCT (Rightest GM700 Pro) compared with the Central Laboratory Testing (CLT) at a National Level, Urban Hospital. Materials and Methods: A retrospective study of 1,812 patients was conducted for glucose testing at the Laboratory Department of Cathay General Hospital from November 2016 to November 2017. Consistency between GM700 Pro and Beckman Coulter AU680, used as CLT, was analysed. TAT was measured from phlebotomy to result availability in Laboratory information system (LIS). Two widely accepted standards for blood glucose meters ISO 15197:2013 (for self-monitoring) and USFDA Prescription Point-of-Care Use (for hospital use) were adopted to evaluate the accuracy. Pearson's correlation and Passing-Bablok regression were used for the analysis. Bland-Altman analysis was used to determine the agreement between POCT and CLT glucose results. Results: Linear regression analysis of GM700 Pro showed significant agreement (y=0.97x-0.89, r³ =0.99) with CLT. Results of TAT indicated that POCT generated glucose report for clinical decision-making was 7 times faster than CLT (p<0.0001) in general practice. Conclusion: Point-of-Care Testing GM700 Pro is reliable and efficient for on-site glucose analysis. [ABSTRACT FROM AUTHOR]

A comparison of 2 treatments with survival outcomes in a clinical study may require treatment randomization on clusters of multiple units with correlated responses. For example, for patients with otitis media in both ears, a specific treatment is normally given to a single patient, and hence, the 2 ears constitute a cluster. Statistical procedures are available for comparison of treatment efficacies. The conventional approach for treatment allocation is the adoption of a balanced design, in which half of the patients are assigned to each treatment arm. However, considering the increasing acceptability of responsive-adaptive designs in recent years because of their desirable features, we have developed a response-adaptive treatment allocation scheme for survival trials with clustered data. The proposed treatment allocation scheme is superior to the balanced design in that it allows more patients to receive the better treatment. At the same time, the test power for comparing treatment efficacies using our treatment allocation scheme remains highly competitive. The advantage of the proposed randomization procedure is supported by a simulation study and the redesign of a clinical study. [ABSTRACT FROM AUTHOR]

[Display omitted] • Synthesis of 21 tricyclic and tetracyclic sulfamates as STS inhibitors. • Design novel nonsteroidal tetracyclic coumarin skeleton for STS inhibition. • Para substitutions at the phenyl ring of tricyclic analogs gave the best STS inhibition. • 9e and 10c had k inact / K I of 28.6 and 19.1 nM−1min−1 on human STS, respectively. • Cytotoxicity of 9e (IC 50 of 0.65 µM) and 10c (IC 50 of 4.7 µM) on T-47D cells. Inhibition of steroid sulfatase (STS) decreases estrogen production and thus, suppresses tumor proliferation. Inspired by irosustat, the first STS inhibitor in clinical trials, we explored twenty-one tricyclic and tetra-heterocyclic coumarin–based derivatives. Their STS enzyme kinetic parameters, docking models, and cytotoxicity toward breast cancer and normal cells were evaluated. Tricyclic derivative 9e and tetracyclic derivative 10c were the most promising irreversible inhibitors developed in this study, with K I of 0.05 and 0.4 nM, and k inact / K I ratios of 28.6 and 19.1 nM−1min−1 on human placenta STS, respectively. [ABSTRACT FROM AUTHOR]

Highlights • A surface activation function (SAF) can be expressed as F X = X a 1 - X c. • The intrinsic reaction rate can be expressed as R (X) = k P O 2 m F (X). • The effects of temperature and O 2 concentration on SAF can be ignored in Regime I. • It is suitable to use isothermal SAF to obtain accurate kinetic parameters. Abstract The kinetics of coal/char oxyfuel combustion by isothermal and non-isothermal thermogravimetric analysis is still controversial. The two methods were compared according to the kinetics of two coal chars (NCP anthracite, DT bituminous) combustion in kinetics-controlled regime I under different O 2 /CO 2 and O 2 /N 2 atmospheres. We have developed a surface activation function (SAF, F (X)) to describe the reactive specific surface area of char conversion, and then the intrinsic reaction rate can be expressed by R (X) = k P O 2 m F (X) , the autocatalysis model (ACM) of F X = X a 1 - X c was found to be suitable under both isothermal and non-isothermal conditions, however, the exponents a and c in ACM as well as the activation energies (E) differ under these two conditions. These controversial results may be caused by the exponential function exp(− E / RT), which changes with the conversion ratio under non-isothermal conditions, which in turn affects the nonlinear modeling results of SAF. According to the isothermal study, temperature has no effect on the form of SAF in Regime I. Thus it is reasonable to use the intrinsic SAF obtained from isothermal experiments (F (X) iso) to fit the non-isothermal data. The modeled results show that E NCP = 207–220 kJ/mol under different O 2 /CO 2 and O 2 /N 2 atmospheres, greater than those under isothermal conditions (178–179 kJ/mol). While E DT = 159–165 kJ/mol, this agrees well with the isothermal result (163–167 kJ/mol). Furthermore, it indicates that the O 2 partial pressure (P O 2 ) has no influence on E , even though increasing P O 2 or replacing CO 2 in the O 2 /CO 2 mixture with N 2 increases the intrinsic reaction rate. [ABSTRACT FROM AUTHOR]

Background: We previously isolated a Klebsiella pneumoniae strain, NTUH-K2044, from a community-acquired pyogenic liver abscess (PLA) patient. Analysis of the NTUH-K2044 genome revealed that this strain harbors 2 putative type VI secretion system (T6SS)-encoding gene clusters.Methods: The distribution of T6SS genes in the PLA and intestinal-colonizing K pneumoniae clinical isolates was examined. icmF1-, icmF2-, icmF1/icmF2-, and hcp-deficient K pneumoniae strains were constructed using an unmarked deletion method. The roles of T6SSs in antibacterial activity, type-1 fimbriae expression, cell adhesion, and invasion and intestinal colonization were determined.Results: The prevalence of T6SSs is higher in the PLA strains than in the intestinal-colonizing strains (37 of 42 vs 54 of 130). Deletion of icmF1/icmF2 and hcp genes significantly reduced interbacterial and intrabacterial killing. Strain deleted for icmF1 and icmF2 exhibited decreased transcriptional expression of type-1 fimbriae and reduced adherence to and invasion of human colorectal epithelial cells and was attenuated for in vivo competition to enable colonization of the host gut. Finally, Hcp expression in K pneumoniae was silenced by the histone-like nucleoid structuring protein via direct binding.Conclusions: These results provide new insights into T6SS-mediated bacterial competition and attachment in K pneumoniae and could facilitate the prevention of K pneumoniae infection. [ABSTRACT FROM AUTHOR]

Abstract While wastewater and polybrominated diphenyl ethers (PBDEs) are commonly both discharged into aquatic ecosystems, little information is known about how wastewaters with different nutrient levels impact on microbial degradation of PBDEs. In this study, we used an anaerobic microcosm experiment to examine how the removal rates of 2,2′,4,4′-tetrabromodiphenyl ether (BDE-47) from contaminated sediment varied when exposed to three wastewaters with different nutrient properties, namely livestock wastewater (LS), municipal sewage (MS), and shrimp pond wastewater (SP), and to determine the microbial controls on removal processes. We found that BDE-47 degraded relatively rapidly in MS, which had low carbon and nitrogen concentrations, but degraded much more slowly in LS and SP, which had relatively high nutrient concentrations. The variations in BDE-47 removal in different wastewater were related to iron reduction rates and the abundances of organohalide-respiring bacteria (OHRB). The community compositions of both total bacteria and OHRB from the family Dehalococcoidaceae differed significantly among the wastewater treatments. Compared with other treatments, some bacterial groups with PBDE degradation abilities were more abundant in MS where the PBDE-degradation efficiencies were higher. Our results should help support evaluations of the bioremediation potential of sites that are contaminated with both halogenated organic compounds and nutrient-rich wastewater. Graphical abstract Image 1 Highlights • Effect of wastewater on BDE-47 biodegradation was dependent on its nutrient level. • Wastewater type-specific effect was related to iron reduction and OHRB abundance. • Bacterial community composition differed significantly among wastewater treatments. [ABSTRACT FROM AUTHOR]

Medicinal plants have been used as anti-diabetic agents due to their excellent antioxidant properties and polyphenolic compounds. This study was carried out to determine the effects of different solvents (ethanol:water ratio of 100:0. 50:50 and 0:100) and drying methods (freeze dry (FD), oven dry (OD) and air dry (AD)) on phenolic content, antioxidant and antihyperglycemic activities of Melastoma malabathricum. The antioxidant activities were determined by DPPH radical scavenging test, ferric reducing antioxidant power (FRAP) test, total phenolic content (TPC) while the anti-hyperglycemic activity were measured by inhibition of α-glucosidase. A trend can be observed whereby M. malabathricum extracted with 100% ethanol showed significantly higher phenolic content and greater antioxidant capacity compared to 50:50 and 100% water extract in all drying techniques which indicates as the best solvent for extracting compound responsible for the activities measured. FD M. malabathricum extracted with 100% ethanol showed lowest IC50 (DPPH) value (21.30 μg/mL), highest antioxidant activity in FRAP (3.85 mg TEAC/g extract) and α-glucosidase inhibition (95.74%). Highest phenolic content (382.19 mg GAE/g extract) also was shown for OD M. malabathricum extracted with 100% ethanol. Positive correlation between TPC with antioxidant and anti-hyperglycemic activities showed that M. malabathricum have potential as a source of natural antioxidant and anti-hyperglycemic agent with the presence of phenolic compounds. [ABSTRACT FROM AUTHOR]

Nonequilibrium many-body transient dynamics play an important role in the adaptation of active matter systems to environmental changes. However, the generic universal behavior of such dynamics is usually elusive and left as open questions. Here, we investigate the transient dynamics of vortex-like states in a two-dimensional active matter system that consists of self-propelled particles with alignment interactions subjected to extrinsic environmental noise. We identify a universal power-law scaling for the average lifetime of vortex-like states with respect to the speed of the self-propelled particles. This universal scaling behavior manifests strong robustness against the noise, up to the level where influences from environmental fluctuations are large enough to directly randomize the moving directions of particles. Direct experimental observations can be readily performed by related experimental setups operated at a decently low noise level. • A power-law scaling behavior exists for vortex-like states in active matters. • The scaling behavior manifests robustness against the environmental fluctuations. • This scaling behavior originates from the occurrence of "separated particles". [ABSTRACT FROM AUTHOR]

Sample size determination is essential during the planning phases of clinical trials. To calculate the required sample size for paired right-censored data, the structure of the within-paired correlations needs to be pre-specified. In this article, we consider using popular parametric copula models, including the Clayton, Gumbel, or Frank families, to model the distribution of joint survival times. Under each copula model, we derive a sample size formula based on the testing framework for rank-based tests and non-rank-based tests (i.e., logrank test and Kaplan- Meier statistic, respectively). We also investigate how the power or the sample size was affected by the choice of testing methods and copula model under different alternative hypotheses. In addition to this, we examine the impacts of paired-correlations, accrual times, follow-up times, and the loss to follow-up rates on sample size estimation. Finally, two real-world studies are used to illustrate our method and R code is available to the user. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess predictive ability of heart rate variability (HRV) for pregnancy outcomes with in vitro fertilization (IVF) treatment. Research design and method: A total of 180 women with 261 cycles of IVF and 211 embryo transfers (ETs) were analyzed. HRV was measured at four times during IVF treatment: the first date of menstruation, r-HCG (Ovidrel) administration, and before and after ET. Pregnancy indicators included chemical pregnancy, ongoing pregnancy (> 10 weeks), and live birth (pregnancy > 24 weeks). Mixed effect models were applied to identify predictors for IVF pregnancy. The area under the receiver operating characteristic curve (AUC) was used to assess prediction models for pregnancy. Results: The HRV values increased during IVF treatment and then decreased after ET. The trend of changes in HRV values during IVF treatment was significant among patients with chemical pregnancy (p < 0.01) and those with live birth (p = 0.02). Women without pregnancy had lower HRV compared to those with IVF pregnancy (p < 0.05). With a one unit increase in HRV difference before and after ET, the odds of chemical pregnancy decreased by 18% (odds ratio; OR: 0.82, 95% CI: 0.70–0.97, p < 0.02). With a one year increase in maternal age, the odds decreased by 16% (OR: 0.84, 95% CI: 0.76–0.93, p < 0.01), 25% (OR: 0.75, 95% CI: 0.58–0.93, p = 0.02), and 28% (OR: 0.72, 95% CI: 0.54–0.91, p = 0.01) for chemical pregnancy, ongoing pregnancy, and live birth, respectively. The AUCs were 0.77 (95% CI: 0.70, 0.84), 0.89 (0.79, 0.98), and 0.91(0.83, 0.99) for the prediction models for chemical pregnancy, ongoing pregnancy, and live birth, respectively. Conclusions: Reduced HRV may be an indicator for low chance of IVF pregnancy. The changes in HRV before and after ET and maternal age might be prognostic predictors of IVF pregnancy. [ABSTRACT FROM AUTHOR]

While nitrogen (N) fixation and ammonia oxidation by microorganisms are two important N cycling processes, little is known about how the microbes that drive these two processes respond when sediments are contaminated with persistent organic pollutants. In this study, we carried out a laboratory microcosm experiment to examine the effects of decabromodiphenyl ether (BDE-209), either on its own or combined with a common mangrove species, Avicennia marina , on the abundance, diversity, and community composition of N-fixing bacteria (NFB) and ammonia-oxidizing archaea (AOA) and bacteria (AOB) in mangrove sediments. The sediments were very N-limited after one year. The rates of N fixation and NFB abundance were significantly higher in the sediments that contaminated by BDE-209, especially in the planted sediment, indicating that both BDE-209 and planting stimulated N fixation in N-limited mangrove sediments. In contrast, the potential nitrification rate and abundance of AOA and AOB decreased significantly under BDE-209 and planting, and the inhibitory effects were stronger in the sediment with both planting and BDE-209 than in the sediments with either BDE-209 or planting. The results from pyrosequencing showed that the richness and diversity of NFB increased, while those of AOA and AOB decreased, in the sediments treated with BDE-209 only and with BDE-209 combined with planting. The community compositions of NFB, AOA, and AOB in the sediments shifted significantly because of BDE-209, either alone or particularly when combined with planting, as shown by the increases in some NFB from the Proteobacteria phylum and decreases in AOA in the Nitrosopumilus genus and AOB in the Nitrosospira genus, respectively. [ABSTRACT FROM AUTHOR]