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Objectives: Abdominal sepsis is a common, life-threatening condition in critically ill patients, and pseudomonas peritonitis remains a serious clinical complication of peritoneal dialysis. This study was performed to determine whether peritonitis induces lung damage through the c-Jun NH2-terminal kinase.Design: : Prospective, experimental study.Setting: Research laboratory at a university hospital.Subjects: Peritonitis models in the mice.Interventions: Wild-type, c-Jun NH2-terminal kinase1, and c-Jun NH2-terminal kinase1 mice were subjected to peritonitis. A c-Jun NH2-terminal kinase inhibitor, SP600125 or leflunomide, was administered to mice immediately after peritonitis.Measurements and Main Results: The changes of plasma dihydrorhodamine 123 oxidation level, the myeloperoxidase activity, and extravasations of Evans blue dye of lung in wild-type mice with or without c-Jun NH2-terminal kinase inhibitor; c-Jun NH2-terminal kinase1 mice and c-Jun NH2-terminal kinase1 mice; and chimeric mice (wild-type --> wild-type, c-Jun NH2-terminal kinase1 --> wild-type) with Pseudomonas aeruginosa-induced peritonitis were determined to evaluate the role of c-Jun NH2-terminal kinase signaling of the hematopoietic cells in peritonitis-induced lung damage. Our results showed that peritonitis induced dihydrorhodamine 123 oxidation, myeloperoxidase activity, activator protein-1 (AP-1) DNA binding activity, phosphorylated-c-Jun NH2-terminal kinase and inducible nitric oxide synthase expression, and Evans blue dye extravasations in lungs, and administration of specific c-Jun NH2-terminal kinase inhibitor decreased the peritonitis-induced dihydrorhodamine 123 oxidation and lung damage. Also, both c-Jun NH2-terminal kinase1 and c-Jun NH2-terminal kinase1 mice showed a decreased dihydrorhodamine 123 oxidation and lung damage after peritonitis. Finally, dihydrorhodamine 123 oxidation, reactive oxygen species, inducible nitric oxide synthase expression, and lung damage were decreased in c-Jun NH2-terminal kinase1 --> wild-type but not in wild-type --> c-Jun NH2-terminal kinase1 chimeric mice.Conclusions: Collectively, our data suggest that peritonitis-induced inducible nitric oxide synthase expression, peroxynitrite production, and lung damage depend on the c-Jun NH2-terminal kinase signaling of the hematopoietic cells. [ABSTRACT FROM AUTHOR]

Background: Controlling saturated fat and cholesterol intake is important for the prevention of cardiovascular diseases. Although the use of mobile diet-tracking apps has been increasing, the reliability of nutrition apps in tracking saturated fats and cholesterol across different nations remains underexplored., Objective: This study aimed to examine the reliability and consistency of nutrition apps focusing on saturated fat and cholesterol intake across different national contexts. The study focused on 3 key concerns: data omission, inconsistency (variability) of saturated fat and cholesterol values within an app, and the reliability of commercial apps across different national contexts., Methods: Nutrient data from 4 consumer-grade apps (COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!) and an academic app (Formosa FoodApp) were compared against 2 national reference databases (US Department of Agriculture [USDA]-Food and Nutrient Database for Dietary Studies [FNDDS] and Taiwan Food Composition Database [FCD]). Percentages of missing nutrients were recorded, and coefficients of variation were used to compute data inconsistencies. One-way ANOVAs were used to examine differences among apps, and paired 2-tailed t tests were used to compare the apps to national reference data. The reliability across different national contexts was investigated by comparing the Chinese and English versions of MyFitnessPal with the USDA-FNDDS and Taiwan FCD., Results: Across the 5 apps, 836 food codes from 42 items were analyzed. Four apps, including COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, significantly underestimated saturated fats, with errors ranging from -13.8% to -40.3% (all P<.05). All apps underestimated cholesterol, with errors ranging from -26.3% to -60.3% (all P<.05). COFIT omitted 47% of saturated fat data, and MyFitnessPal-Chinese missed 62% of cholesterol data. The coefficients of variation of beef, chicken, and seafood ranged from 78% to 145%, from 74% to 112%, and from 97% to 124% across MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, respectively, indicating a high variability in saturated fats across different food groups. Similarly, cholesterol variability was consistently high in dairy (71%-118%) and prepackaged foods (84%-118%) across all selected apps. When examining the reliability of MyFitnessPal across different national contexts, errors in MyFitnessPal were consistent across different national FCDs (USDA-FNDSS and Taiwan FCD). Regardless of the FCDs used as a reference, these errors persisted to be statistically significant, indicating that the app's core database is the source of the problems rather than just mismatches or variances in external FCDs., Conclusions: The findings reveal substantial inaccuracies and inconsistencies in diet-tracking apps' reporting of saturated fats and cholesterol. These issues raise concerns for the effectiveness of using consumer-grade nutrition apps in cardiovascular disease prevention across different national contexts and within the apps themselves., (© Dang Khanh Ngan Ho, Wan-Chun Chiu, Jing-Wen Kao, Hsiang-Tung Tseng, Cheng-Yu Lin, Pin-Hsiang Huang, Yu-Ren Fang, Kuei-Hung Chen, Ting-Ying Su, Chia-Hui Yang, Chih-Yuan Yao, Hsiu-Yueh Su, Pin-Hui Wei, Jung-Su Chang. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org).)

A systematic review and meta-analysis was conducted to evaluate the relative effectiveness of different dietary macronutrient patterns on changes in resting energy expenditure (REE) in relation to weight loss, categorized as minimal (<5%) and moderate to high (>5%). Changes in REE were assessed using a DerSimonian and Laird random-effects meta-analysis. A diet lower in carbohydrates (CHO) or higher in fat and protein was associated with smaller reductions in REE, with these trends being more pronounced among participants who experienced moderate to high weight loss. Adjusted meta-regression analysis indicated that, within the participants who experienced moderate to high weight loss, each 1% increase in CHO intake was associated with a reduction of 2.30 kcal/day in REE (95% CI: -4.11 to -0.47, p = 0.013). In contrast, a 1% increase in protein and fat intake was correlated with an increase in REE by 3.00 (95% confidence interval [CI] [1.02, 5.07], p = 0.003) and 0.5 (95% CI [-2.43, 3.41], p = 0.740) kcal/day, respectively. No significant associations were found among participants who experienced minimal weight loss. These findings indicate that, under a caloric deficit, the impact of dietary macronutrient composition on REE may vary depending on the degree of weight loss and individual metabolic responses., (© 2024 World Obesity Federation.)

PM 2.5 concentrations are higher during rush hours at background stations compared to the average concentration across these stations. Few studies have investigated PM 2.5 concentration and its spatial distribution during rush hours using machine learning models. This study employs a geospatial-artificial intelligence (Geo-AI) prediction model to estimate the spatial and temporal variations of PM 2.5 concentrations during morning and dusk rush hours in Taiwan. Mean hourly PM 2.5 measurements were collected from 2006 to 2020, and aggregated into morning (7 a.m.-9 a.m.) and dusk (4 p.m.-6 p.m.) rush-hour mean concentrations. The Geo-AI prediction model was generated by integrating kriging interpolation, land-use regression, machine learning, and a stacking ensemble approach. A forward stepwise variable selection method based on the SHapley Additive exPlanations (SHAP) index was used to identify the most influential variables. The performance of the Geo-AI models for morning and dusk rush hours had accuracy scores of 0.95 and 0.93, respectively and these results were validated, indicating robust model performance. Spatially, PM 2.5 concentrations were higher in southwestern Taiwan for morning rush hours, and suburban areas for dusk rush hours. Key predictors included kriged PM 2.5 values, SO 2 concentrations, forest density, and the distance to incinerators for both morning and dusk rush hours. These PM 2.5 estimates for morning and dusk rush hours can support the development of alternative commuting routes with lower concentrations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Prediabetes is characterized by abnormal glycemic levels below the type 2 diabetes threshold, and effective control of blood glucose may prevent the progression to type 2 diabetes. While the association between the gut microbiota, glucose metabolism, and insulin resistance in diabetic patients has been established in previous studies, there is a lack of research regarding these aspects in prediabetic patients in Asia. We aim to investigate the composition of the gut microbiota in prediabetic patients and their differences compared to healthy individuals. In total, 57 prediabetic patients and 60 healthy adult individuals aged 18 to 65 years old were included in this study. Biochemistry data, fecal samples, and 3 days of food records were collected. Deoxyribonucleic acid extraction and next-generation sequencing via 16S ribosomal ribonucleic acid metagenomic sequencing were conducted to analyze the relationship between the gut microbiota and dietary habits. Prediabetic patients showed a lower microbial diversity than healthy individuals, with 9 bacterial genera being less abundant and 14 others more abundant. Prediabetic patients who consumed a low-carbohydrate (LC) diet exhibited higher diversity in the gut microbiota than those who consumed a high-carbohydrate diet. A higher abundance of Coprococcus was observed in the prediabetic patients on an LC diet. Compared to healthy individuals, the gut microbiota of prediabetic patients was significantly different, and adopting an LC diet with high dietary fiber consumption may positively impact the gut microbiota. Future studies should aim to understand the relationship between the gut microbiota and glycemic control in the Asian population.

Objective: Mobile nutrition applications (apps) provide a simple way for individuals to record their diet, but the validity and inherent errors need to be carefully evaluated. The aim of this study was to assess the validity and clarify the sources of measurement errors of image-assisted mobile nutrition apps., Methods: This was a cross-sectional study with 98 students recruited from School of Nutrition and Health Sciences, Taipei Medical University. A 3-d nutrient intake record by Formosa Food and Nutrient Recording App (FoodApp) was compared with a 24-h dietary recall (24-HDR). A two-stage data modification process, manual data cleaning, and reanalyzing of prepackaged foods were employed to address inherent errors. Nutrient intake levels obtained by the two methods were compared with the recommended daily intake (DRI), Taiwan. Paired t test, Spearman's correlation coefficients, and Bland-Altman plots were used to assess agreement between the FoodApp and 24-HDR., Results: Manual data cleaning identified 166 food coding errors (12%; stage 1), and 426 food codes with missing micronutrients (32%) were reanalyzed (stage 2). Positive linear trends were observed for total energy and micronutrient intake (all P trend < 0.05) after the two stages of data modification, but not for dietary fat, carbohydrates, or vitamin D. There were no statistical differences in mean energy and macronutrient intake between the FoodApp and 24-HDR, and this agreement was confirmed by Bland-Altman plots. Spearman's correlation analyses showed strong to moderate correlations (r = 0.834 ∼ 0.386) between the two methods. Participants' nutrient intake tended to be lower than the DRI, but no differences in proportions of adequacy/inadequacy for DRI values were observed between the two methods., Conclusions: Mitigating errors significantly improved the accuracy of the Formosa FoodApp, indicating its validity and reliability as a self-reporting mobile-based dietary assessment tool. Dietitians and health professionals should be mindful of potential errors associated with self-reporting nutrition apps, and manual data cleaning is vital to obtain reliable nutrient intake data., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The severity of liver functional reserve is an important prognostic predictor in hepatocellular carcinoma (HCC). The albumin-bilirubin (ALBI), easy (EZ)-ALBI, platelet-albumin-bilirubin (PALBI), platelet-albumin (PAL) score, and MELD 3.0 score are used to evaluate the severity of liver dysfunction. However, their prognostic role in HCC patients, specifically with renal insufficiency (RI), is unclear. We aimed to investigate the predictive accuracy of the five models in these patients. A total of 1120 newly diagnosed HCC patients with RI were enrolled. A multivariate Cox proportional analysis was used to identify independent predictors associated with survival. In the Cox model, older age, an α-fetoprotein ≥20 ng/mL, vascular invasion, a medium and high tumor burden score, poor performance status, a higher ALBI grade, an EZ-ALBI grade, a PALBI grade, a PAL grade, and MELD 3.0 score were all independently associated with decreased overall survival (all p < 0.001). Among the five liver reserve models, the ALBI grade is the best surrogate marker to represent liver functional reserve in terms of outcome prediction. The albumin-based liver reserve models (ALBI, EZ-ALBI, PALBI, and PAL) and MELD 3.0 are all feasible prognostic markers to indicate liver injury, specifically in HCC patients with RI. Among them, the ALBI grade is the most robust tool for survival prediction in these patients.

Background: Anti-desiccant is a class of agrochemicals widely used to protect plants from water stresses, rapid temperature variations, heat and sunburn, frost and freeze damages, transplant shock, and pathogen and pest attack. Although anti-desiccants are generally considered non-toxic to organisms, it is unclear whether they may impact the phyllosphere microbial communities. In this study, three film-forming anti-desiccant products, TransFilm, Vapor Gard, and Wilt-Pruf were applied to the canopy of two boxwood cultivars 'Vardar Valley' and 'Justin Brouwers' on April 13 and August 26, 2021. Shoot samples were collected from boxwood plants treated with each of the three products, as well as nontreated control on June 16, August 26 (before the second treatment), and October 18. Microbial and plant genomic DNA was isolated together and 16S rRNA gene and the extended internal transcribed spacer regions were amplified with PCR and sequenced on a Nanopore MinION platform for bacterial and fungal identification., Results: Bacterial communities were more diverse than fungal communities. At the phylum level, the boxwood phyllosphere was dominated by Proteobacteria and Ascomycota; at the genus level, Methylobacterium and Shiraia were the most abundant bacteria and fungi, respectively. Among the three film-forming anti-desiccants, Vapor Gard and Wilt-Pruf had more impact than TransFilm on the microbial communities. Specifically, broader impacts were observed on fungal than bacterial community composition and structure, with most affected fungi being suppressed while bacteria promoted., Conclusion: This study addressed several major knowledge gaps regarding boxwood phyllosphere microbiota and the impact of anti-desiccants on plant microbiome. We identified diverse microbial communities of boxwood, a major evergreen woody crop and an iconic landscape plant. We also found differential effects of three film-forming anti-desiccants on the composition and structure of bacterial and fungal communities. These findings advanced our understanding of the associated microbiome of this landmark plant, enabling growers to fully utilize the potentials of microbiome and three anti-desiccants in improving boxwood health and productivity., (© 2023. BioMed Central Ltd., part of Springer Nature.)

In recent years, many things have been held via video conferences due to the impact of the COVID-19 epidemic around the world. A webcam will be used in conjunction with a computer and the Internet. However, the network camera cannot automatically turn and cannot lock the screen to the speaker. Therefore, this study uses the objection detector YOLO to capture the upper body of all people on the screen and judge whether each person opens or closes their mouth. At the same time, the Time Difference of Arrival (TDOA) is used to detect the angle of the sound source. Finally, the person's position obtained by YOLO is reversed to the person's position in the spatial coordinates through the distance between the person and the camera. Then, the spatial coordinates are used to calculate the angle between the person and the camera through inverse trigonometric functions. Finally, the angle obtained by the camera, and the angle of the sound source obtained by the microphone array, are matched for positioning. The experimental results show that the recall rate of positioning through YOLOX-Tiny reached 85.2%, and the recall rate of TDOA alone reached 88%. Integrating YOLOX-Tiny and TDOA for positioning, the recall rate reached 86.7%, the precision rate reached 100%, and the accuracy reached 94.5%. Therefore, the method proposed in this study can locate the speaker, and it has a better effect than using only one source.

Cardiac transplant recipients face many complications due to transplant rejection. Scientists must conduct animal experiments to study disease onset mechanisms and develop countermeasures. Therefore, many animal models have been developed for research topics including immunopathology of graft rejection, immunosuppressive therapies, anastomotic techniques, and graft preservation techniques. Small experimental animals include rodents, rabbits, and guinea pigs. They have a high metabolic rate, high reproductive rate, small size for easy handling, and low cost. Additionally, they have genetically modified strains for pathological mechanisms research; however, there is a lacuna, as these research results rarely translate directly to clinical applications. Large animals, including canines, pigs, and non-human primates, have anatomical structures and physiological states that are similar to those of humans; therefore, they are often used to validate the results obtained from small animal studies and directly speculate on the feasibility of applying these results in clinical practice. Before 2023, PubMed Central ® at the United States National Institute of Health's National Library of Medicine was used for literature searches on the animal models for heart transplantation focusing on the pathological conditions. Unpublished reports and abstracts from conferences were excluded from this review article. We discussed the applications of small- and large-animal models in heart transplantation-related studies. This review article aimed to provide researchers with a complete understanding of animal models for heart transplantation by focusing on the pathological conditions created by each model.

Phyllosphere bacterial communities play important roles in plant fitness and growth. The objective of this study was to characterize the epiphytic and endophytic bacterial communities of boxwood shoots and determine how they may respond to commonly used fungicides. In early summer and early fall, shoot samples were collected immediately before and 1, 7, and 14 days after three fungicides containing chlorothalonil and/or propiconazole were applied to the canopy. Total genomic DNA from shoot surface washings and surface-sterilized shoot tissues was used as the template for 16S rRNA metabarcoding, and the amplicons were sequenced on a Nanopore MinION sequencer to characterize the epiphytic and endophytic communities. The bacterial communities were phylogenetically more diverse on the boxwood shoot surface than in the internal tissue, although the two communities shared 12.7% of the total 1,649 identified genera. The most abundant epiphytes were Methylobacterium and Pantoea , while Stenotrophomonas and Brevundimonas were the dominant endophytes. Fungicide treatments had strong impacts on epiphytic bacterial community structure and composition. Analysis of compositions of microbiomes with bias correction (ANCOM-BC) and analysis of variance (ANOVA)-like differential expression (ALDEx2) together identified 312 and 1,362 epiphytes changed in abundance due to fungicide treatments in early summer and early fall, respectively, and over 50% of these epiphytes were negatively impacted by fungicide. The two chlorothalonil-based contact fungicides demonstrated more marked effects than the propiconazole-based systemic fungicide. These results are foundational for exploring and utilizing the full potential of the microbiome and fungicide applications and developing a systems approach to boxwood health and production. IMPORTANCE Agrochemicals are important tools for safeguarding plants from invasive pathogens, insects, mites, and weeds. How they may affect the plant microbiome, a critical component of crop health and production, was poorly understood. Here, we used boxwood, an iconic low-maintenance landscape plant, to characterize shoot epiphytic and endophytic bacterial communities and their responses to contact and systemic fungicides. This study expanded our understanding of the above-ground microbiome in ornamental plants and is foundational for utilizing the full benefits of the microbiome in concert with different fungicide chemistries to improve boxwood health. This study also sets an example for a more thorough evaluation of these and other agrochemicals for their effects on boxwood microbiomes during production and offers an expanded systems approach that could be used with other crops for enhanced integrated pest management.

In December 2019, the COVID-19 pandemic began to ravage the world quickly, causing unprecedented losses in human life and the economy. A statistical study revealed that the proportion of solid organ transplant (SOT) recipients with severe symptoms and deaths after being infected by SARS-CoV-2 is considerably higher than that of non-SOT recipients, and the prognosis is relatively poor. In addition, the clinical manifestation of SOT recipients suffering from COVID-19 is different from that of general COVID-19 patients. Acute kidney injury (AKI) is a common complication in COVID-19 patients, and it is likely more common among SOT recipients infected with SARS-CoV-2. Clinical experts consider that SOT recipients have long-term treatment with immunosuppressants, and the comorbidities are driven by a high rate of severe symptoms and mortality. Orthotopic kidney allograft transplantation is an effective treatment for patients suffering from end-stage kidney disease/kidney failure through which they can easily extend their life. Indeed, kidney transplant recipients have suffered significant damage during this pandemic. To effectively reduce the severity of symptoms and mortality of kidney transplant recipients suffering from COVID-19, precise application of various drugs, particularly immunosuppressants, is necessary. Therefore, herein, we will collate the current clinical experience of treating COVID-19 infection in kidney transplant recipients and discuss the adjustment of patients using immunosuppressive agents in the face of COVID-19.

Bladder cancer, the ninth most common cancer worldwide, requires fast diagnosis and treatment to prevent disease progression and improve patient survival. However, patients with bladder cancer often experience considerable delays in diagnosis. One reason for such delays is that hematuria, a major symptom of bladder cancer, has a high probability of also being a warning sign for urinary tract diseases. Another reason is that the sensitivity of the body parts affected by bladder cancer deters patients from undergoing cystoscopy and influences patients' "physician shopping" behavior. In this study, the analytic hierarchy process was used to determine critical variables influencing delayed diagnosis; moreover, the variables were used to construct models for predicting delayed diagnosis in patients with hematuria by using several machine learning techniques. Furthermore, the critical variables associated with delayed diagnosis of bladder cancer in patients with hematuria were evaluated using GainRatio technology. The study sample was selected from a population-based database. The model evaluation results indicated that the prediction model established using decision tree algorithms outperformed the other models. The critical risk factors for delayed diagnosis of bladder cancer were as follows: (1) cystoscopy performed 6 months after hematuria diagnosis and (2) physician shopping., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2021 Chia-Lun Lo et al.)

The plasmon-activated water (PAW) that reduces hydrogen bonds is made of deionized reverse osmosis water (ROW). However, compared with ROW, PAW has a significantly higher diffusion coefficient and electron transfer rate constant in electrochemical reactions. PAW has a boiling point of97 °C and specific heat of0.94; the energy of PAW is also 1121 J/mol higher than ordinary water. The greater the force of hydrogen bonds between H 2 O, the larger the volume of the H 2 O cluster, and the easier it is to lose the original characteristics. The hydrogen bonding force of PAW is weak, so the volume of its cluster is small, and it exists in a state very close to a single H 2 O. PAW has a high permeability and diffusion rate, which can improve the needs of biological applications and meet the dependence of biological organisms on H 2 O when performing physiological functions. PAW can successfully remove free radicals, and efficiently reduce lipopolysaccharide (LPS)-induced monocytes to release nitric oxide. PAW can induce expression of the antioxidant gene Nrf2 in human gingival fibroblasts, lower amyloid burden in mice with Alzheimer's disease, and decrease metastasis in mice grafted with Lewis lung carcinoma cells. Because the transferring plasmon effect may improve the abnormality of physiological activity in a biological system, we aimed to evaluate the influence of PAW on orthotopic allograft transplantation (OAT)-induced vasculopathy in this study. Here, we demonstrated that daily intake of PAW lowered the progression of vasculopathy in OAT-recipient ACI/NKyo rats by inhibiting collagen accumulation, proliferation of smooth muscle cells and fibroblasts, and T lymphocyte infiltration in the vessel wall. The results showed reduced T and B lymphocytes, plasma cells, and macrophage activation in the spleen of the OAT-recipient ACI/NKyo rats that were administered PAW. In contrast to the control group, the OAT-recipient ACI/NKyo rats that were administered PAW exhibited higher mobilization and levels of circulating endothelial progenitor cells associated with vessel repair. We use the transferring plasmon effect to adjust and maintain the biochemical properties of water, and to meet the biochemical demand of organisms. Therefore, this study highlights the therapeutic roles of PAW and provides more biomedical applicability for the transferring plasmon effect.

We previously demonstrated that seizure occurrences at different zeitgeber times alter sleep and circadian rhythm differently. On the other hand, the synchronized delta wave of electroencephalogram (EEG) during non-rapid eye movement (NREM) sleep facilitates seizure, while the desynchronized EEG of rapid eye movement (REM) sleep suppresses it. We also elucidated that unilateral deep brain stimulation (DBS) of the anterior nucleus of thalamus (ANT) suppresses seizure recurrence. In the present study, we intraperitoneally injected pentylenetetrazol (PTZ, 40 mg/kg) for 14 consecutive days (PTZ kindling) to induce spontaneous seizure in rats, and a 30-min (delivered 10 min before each PTZ injection) or a 3-h DBS of unilateral ANT (delivered 1 h before each PTZ injection) was applied to suppress seizure. The frequency of DBS stimulation was 200 Hz and the electrical current consisted of biphasic square pulses with 50-μA intensity, 100-μs pulse width, and 4.1-ms stimulation interval. Our results found that PTZ-induced spontaneous seizure did not cause a significant change in the quantity of NREM sleep but suppressed the amount of REM sleep. Unilateral ANT DBS prolonged the onset latency of ictal seizure, decreased the spontaneous seizure duration, and increased the survival rate but did not change the amplitude of epileptiform EEGs during ictal period. Unilateral ANT DBS did not significantly alter NREM sleep but increased the amount of REM sleep. An analysis of the spectrograms of fast Fourier transform indicated that the intensities of all frequencies were enhanced during the PTZ-induced ictal period and the subsequent spontaneous seizure. Thirty minutes of unilateral ANT DBS suppressed the augmentation of low-frequency (<10 Hz) intensities during the spontaneous seizure induced by PTZ kindling. We further found that consecutive injections of PTZ progressively increased the enhancement of the delta powers during NREM sleep, whereas unilateral ANT DBS inhibited this progressive enhancement. It was also noticed that 30 min of ANT DBS exhibited a better efficacy in epilepsy suppression than 3 h of ANT DBS. These results elucidated that unilateral ANT DBS enhanced the seizure threshold by increasing the amount of REM sleep and decreasing the progressive enhancement of delta power during NREM sleep to suppress spontaneous seizure recurrences in PTZ kindling-induced epileptic rats., (Copyright © 2020 Tseng, Hsiao, Yi and Chang.)

Accumulating evidence has shown that soy intake is associated with the promotion of health and prevention of cancers. However, the relationship between the intake of soy compounds and the risk of breast cancer is still debatable. In this study, we use mathematical models for assessing the impact of soy phytoestrogens and protein/peptide intervention on breast cancer development using the datasets acquired from a large number of published studies. We used data mining models, including the decision tree classification and association rule methods, to analyze 478 data collected from 201 research papers. The results indicated that the intervention of soy proteins and peptides, especially lunasin (LUN) and bowman-birk protease inhibitor (BBI), has a positive impact on different types of breast cancer, while the effects of soy phytoestrogens are inconsistent in breast cancer development. Among soy phytoestrogens, daidzein (DAI) exhibited the highest negative impact on breast cancer, followed by coumestrol (COU), soysapogenol (SAP), genistein (GEN), and equol (EQ). With regard to the type of cancer, phytoestrogens should be carefully considered in estrogen receptor (ER)+ or progesterone receptor (PR)+ breast cancer. In the case of ER-, PR- or triple negative type, both soy categories can be used as auxiliary interventions. In summary, this is the first study to use data mining to explore the relationship between the intake of soy phytoestrogens or proteins/peptides and breast cancer development. Our findings indicate that soy intervention might reduce breast cancer development. However, the specific soy compound and cancer type should be considered before allocating a precise nutrient intervention.

Nurses play a key role in healthcare but work in a highly stressful and unfriendly environment. Therefore, many medical institutions have adopted nurse healthcare management information systems for nurses to relieve symptoms of mental stress and even improve their psychological health. The key to the success of these systems depends on how nurses intend to use them. In this study, the moderating effect of nurses' psychological health status on their usage of these systems are discussed. This study used a mail survey method for nurses to obtain 1565 valid samples. The results show that perceived usefulness is insignificant toward the usage intention of nurses with a positive psychological health status, which indicates that this system does not meet the needs of these healthy nurses. Furthermore, perceived ease of use is insignificant toward the usage intention of nurses with a negative psychological health status, which indicates that a negative psychological health status may affect one's behavior due to impatience. This study raises the serious issue that nurses should maintain their psychological health in order to ensure the quality of care for patients. People in various fields are expected to pay attention to the psychological health status of nurses and create a win-win situation for both patients and nurses.

The primary purpose of this study was to examine patients' concerns surrounding information privacy and their intention toward medical image exchange consent. Patients' concerns about information privacy in terms of collection, unauthorized access, errors and secondary use all have significant relationships with patients' intention toward medical image exchange consent in Taiwan. Trust is the foundation for both parties. In this study, we aimed to determine the moderating effect of trust in order to examine patients' intention toward medical image exchange consent under the influence of their information privacy concerns. Three hundred and fifty patients responded to the survey, which yielded a 92.3% response rate. The results of data analysis revealed that patients' information privacy concerns had no significant relationship with patients' intention toward medical image exchange consent. After considering the moderating effect of trust, patients' information privacy concerns do have a significant relationship with patients' intention toward medical image exchange consent, however, the R-square was only 4.5%. Based on this research result, we modified the research framework in order to examine patients' information privacy concerns in terms of collection/non-collection. The R-square of the modified framework was 18.6%, and both collection and non-collection had significant relationships with patients' intention toward medical image exchange consent. Finally, the implications, limitations and future research have been discussed., Competing Interests: The authors declare no conflicts of interest.

This study examined medical students' perceptions towards medical errors and the policy of the hospital within the internship curriculum, and explored how aspects of personality traits of medical students relate to their attitude toward medical errors. Based on the theory of the Five-Factor-Model (FFM) and related literature review, this study adopted a self-devised structured questionnaire to distribute to 493 medical students in years five to seven in the top three medical schools, representing a 56.7% valid questionnaire response rate. Results showed that agreeableness is more important than other personality traits, and medical students with high agreeableness are good communicators and have a more positive attitude to avoid errors in the future. On the contrary, students with low neuroticism tended to be more relaxed and gentle. If medical educators can recruit new students with high agreeableness, these students will be more likely to effectively improve the quality of medical care and enhance patient safety. This study anticipates that this method could be easily translated to nearly every medical department entry examination, particularly with regards to a consciousness-based education of future physicians.

The Taiwanese government subsidizes healthcare providers offering preventive medicine to patients to help reduce the threats of chronic sickness and halt skyrocketing medical expenditures. Usually, nurses are the primary workers who perform community health promotion; however, because of the chronic shortage of working nurses, many Taiwan hospitals have closed wards and deferred the responsibility of promoting primary prevention. With a community health promotion platform integrating interactive response features and Web sites for community patients and hospital staff, a case hospital efficiently sustained the community health services. The objective of this study was to assess the impact of the integrated community health promotion platform for conducting education. Fifty-four patients/residents were invited to join a quasi-experiment of health education, and a follow-up survey was conducted to assess the acceptance of the community health promotion platform from both the experimental group of learners/users and the hospital staff. The results showed that the community health promotion platform was effective in improving participant health awareness. The experimental group outperformed the control group, with higher posttest scores and longer knowledge retention. Furthermore, users indicated a high acceptance of the community health promotion platform.

Background: Natural orifice transluminal endoscopic surgery (NOTES) has shown its prospection as a minimally invasive endoscopic surgery. This study aimed to examine the safety and efficacy of combined NOTES and vaginal approach, natural orifice transluminal endoscopic surgery-assisted ovarian cystectomy (NAOC), in the conservative management of benign ovarian tumors., Methods: Records were reviewed for the 34 consecutive NAOC procedures between May 2011 and March 2014. Age, body mass index, parity, size of the mass, and bilaterality of the mass were used to select comparable patient who had undergone laparoscopic ovarian cystectomy (LOC)., Results: A total of 277 patients were recruited in this study (243 LOCs and 34 NAOCs, respectively). There was no incidence of switching to abdominal laparotomy. Length of operation and length of postoperative stay were significantly greater in the LOC group than in the NAOC group, but total hospital charges were similar in both groups. There was no difference in febrile morbidity between the two groups but more estimated blood loss (EBL) in NAOC group, although EBL was <50 mL in the two groups. Linear correlations of mass size with operating time and EBL existed in LOC group, but not in NAOC group., Conclusion: NAOC can be safely performed for benign and large ovarian tumors. Besides, NAOC offers a superior operative efficiency compared with LOC.

Background: Osteoarthritis (OA) is a common joint disease that causes disabilities in elderly. However, few agents with high efficacy and low side effects have been developed to treat OA. In this study, we evaluated the effects of the alginate extract named CTX in OA cell and rabbit models., Results: CTX was formulated by hydrolyzing sodium alginate polymers with alginate lyase and then mixing with pectin. HPLC was used to analyze the CTX content. Human chondrosarcoma SW1353 cells treated with interleukin-1β were used as OA model cells to investigate the effects of CTX on chondrocyte inflammation and anabolism. CTX at concentrations up to 1000 μg/ml exerted low cytotoxicity. It inhibited the gene expression of proinflammatory matrix metalloproteinases (MMPs) including MMP1, MMP3 and MMP13 in a dose-dependent manner and increased the mRNA level of aggrecan, the major proteoglycan in articular cartilage, at 1000 μg/ml. Thirteen-week-old New Zealand White rabbits underwent a surgical anterior cruciate ligament transection and were orally treated with normal saline, glucosamine or CTX for up to 7 weeks. Examinations of the rabbit femur and tibia samples demonstrated that the rabbits taking oral CTX at a dosage of 30 mg/kg/day suffered lesser degrees of articular stiffness and histological cartilage damage than the control rabbits., Conclusions: The gene expression profiles in the cell and the examinations done on the rabbit cartilage suggest that the alginate extract CTX is a pharmaco-therapeutic agent applicable for OA therapy.

Background: Small heterodimer partner (SHP, NR0B2) is involved in diverse metabolic pathways, including hepatic bile acid, lipid and glucose homeostasis, and has been implicated in effects on the peroxisome proliferator-activated receptor γ (PPARγ), a master regulator of adipogenesis and the receptor for antidiabetic drugs thiazolidinediones (TZDs). In this study, we aim to investigate the role of SHP in TZD response by comparing TZD-treated leptin-deficient (ob/ob) and leptin-, SHP-deficient (ob/ob;Shp(-/-)) double mutant mice., Results: Both ob/ob and double mutant ob/ob;Shp(-/-) mice developed hyperglycemia, insulin resistance, and hyperlipidemia, but hepatic fat accumulation was decreased in the double mutant ob/ob;Shp(-/-) mice. PPARγ2 mRNA levels were markedly lower in ob/ob;Shp(-/-) liver and decreased to a lesser extent in adipose tissue. The TZD troglitazone did not reduce glucose or circulating triglyceride levels in ob/ob;Shp(-/-) mice. Expression of the adipocytokines, such as adiponectin and resistin, was not stimulated by troglitazone treatment. Expression of hepatic lipogenic genes was also reduced in ob/ob;Shp(-/-) mice. Moreover, overexpression of SHP by adenovirus infection increased PPARγ2 mRNA levels in mouse primary hepatocytes., Conclusions: Our results suggest that SHP is required for both antidiabetic and hypolipidemic effects of TZDs in ob/ob mice through regulation of PPARγ expression.

A unique feature of hepatitis B virus (HBV) infection in humans is that viral clearance heavily depends on the age of exposure. However, the reason for this remains unclear. Here we show that gut microbiota contribute to the age dependence of HBV immunity in a hydrodynamic transfection mouse model. Although adult (12-wk-old) C3H/HeN mice cleared HBV within 6 wk postinjection (wpi), their young (6-wk-old) counterparts remained HBV-positive at 26 wpi. Sterilization of gut microbiota from 6 to 12 wk of age using antibiotics prevented adult mice from rapidly clearing HBV. Young mice with the Toll-like-receptor (TLR) 4 mutation (C3H/HeJ) exhibited rapid HBV clearance. The results suggest that an immuno-tolerating pathway to HBV prevailed in young mice, before the establishment of gut bacteria, through a TLR4-dependent pathway and that the maturation of gut microbiota in adult mice stimulated liver immunity, resulting in rapid HBV clearance.

This study identifies potential predictors of participation changes in various areas for preschool children with cerebral palsy (CP). Eighty children with CP (2-6 years) were enrolled. Seven potential predictors were identified: age; sex; socioeconomic status, CP subtype; cognitive function, Function Independence Measure for Children (WeeFIM), and motor composite variable from 5 motor factors (gross motor function classification system (GMFCS) level; bimanual fine motor function level; selective motor control score; Modified Ashworth Scale score; and Spinal Alignment and Range of Motion Measure). Outcome was assessed at baseline and at 6-month follow-up using the Assessment of Preschool Children's Participation (APCP) including diversity and intensity scores in the areas of play (PA), skill development (SD), active physical recreation, social activities (SA), and total areas. Dependent variables were change scores of APCP scores at baseline and 6-month follow-up. Regression analyses shows age and sex together predicted for APCP-total, APCP-SD diversity and APCP-total intensity changes (r(2)=0.13-0.25, p<0.001); cognitive function and WeeFIM were negative predictors for APCP-SA and APCP-PA diversity changes, respectively. CP subtype, motor composite variable, and socioeconomic status predicted for APCP changes in some areas. Findings suggest that young boys with poor cognitive function and daily activity predicted most on participation changes., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Mixed background SHP(-/-) mice are resistant to diet-induced obesity due to increased energy expenditure caused by enhanced PGC-1α expression in brown adipocytes. However, congenic SHP(-/-) mice on the C57BL/6 background showed normal expression of PGC-1α and other genes involved in brown adipose tissue thermogenesis. Thus, we reinvestigated the impact of small heterodimer partner (SHP) deletion on diet-induced obesity and insulin resistance using congenic SHP(-/-) mice. Compared with their C57BL/6 wild-type counterparts, SHP(-/-) mice subjected to a 6 month challenge with a Western diet (WestD) were leaner but more glucose intolerant, showed hepatic insulin resistance despite decreased triglyceride accumulation and increased β-oxidation, exhibited alterations in peripheral tissue uptake of dietary lipids, maintained a higher respiratory quotient, which did not decrease even after WestD feeding, and displayed islet dysfunction. Hepatic mRNA expression analysis revealed that many genes expressed higher in SHP(-/-) mice fed WestD were direct peroxisome proliferator-activated receptor alpha (PPARα) targets. Indeed, transient transfection and chromatin immunoprecipitation verified that SHP strongly repressed PPARα-mediated transactivation. SHP is a pivotal metabolic sensor controlling lipid homeostasis in response to an energy-laden diet through regulating PPARα-mediated transactivation. The resultant hepatic fatty acid oxidation enhancement and dietary fat redistribution protect the mice from diet-induced obesity and hepatic steatosis but accelerate development of type 2 diabetes.

In this work, a fiber Bragg grating (FBG) sensing system which can measure the transient response of out-of-plane point-wise displacement responses is set up on a smart cantilever beam and the feasibility of its use as a feedback sensor in an active structural control system is studied experimentally. An FBG filter is employed in the proposed fiber sensing system to dynamically demodulate the responses obtained by the FBG displacement sensor with high sensitivity. For comparison, a laser Doppler vibrometer (LDV) is utilized simultaneously to verify displacement detection ability of the FBG sensing system. An optical full-field measurement technique called amplitude-fluctuation electronic speckle pattern interferometry (AF-ESPI) is used to provide full-field vibration mode shapes and resonant frequencies. To verify the dynamic demodulation performance of the FBG filter, a traditional FBG strain sensor calibrated with a strain gauge is first employed to measure the dynamic strain of impact-induced vibrations. Then, system identification of the smart cantilever beam is performed by FBG strain and displacement sensors. Finally, by employing a velocity feedback control algorithm, the feasibility of integrating the proposed FBG displacement sensing system in a collocated feedback system is investigated and excellent dynamic feedback performance is demonstrated. In conclusion, our experiments show that the FBG sensor is capable of performing dynamic displacement feedback and/or strain measurements with high sensitivity and resolution.

Background: Bile acids are potentially toxic compounds and their levels of hepatic production, uptake and export are tightly regulated by many inputs, including circadian rhythm. We tested the impact of disrupting the peripheral circadian clock on integral steps of bile acid homeostasis., Methodology/principal Findings: Both restricted feeding, which phase shifts peripheral clocks, and genetic ablation in Per1(-/-)/Per2(-/-) (PERDKO) mice disrupted normal bile acid control and resulted in hepatic cholestasis. Restricted feeding caused a dramatic, transient elevation in hepatic bile acid levels that was associated with activation of the xenobiotic receptors CAR and PXR and elevated serum aspartate aminotransferase (AST), indicative of liver damage. In the PERDKO mice, serum bile acid levels were elevated and the circadian expression of key bile acid synthesis and transport genes, including Cyp7A1 and NTCP, was lost. This was associated with blunted expression of a primary clock output, the transcription factor DBP, which transactivates the promoters of both genes., Conclusions/significance: We conclude that disruption of the circadian clock results in dysregulation of bile acid homeostasis that mimics cholestatic disease.

Background: Penetrating injury by fish fins is common and often overlooked. Vibrio spp. are known worldwide for their virulence, quickly causing soft-tissue infection and lethal septicaemia. Vibrio infection following finning injury is rare, but can result in devastating complications in susceptible individuals., Aim: To elucidate the clinical significance of such injury., Method: Between July 2003 and September 2005, nine cases of Vibrio infection caused by finning injury to the hand were retrospectively reviewed. Clinical data, including skin presentations, treatment course and outcomes, were collected and reviewed., Results: In our group of nine patients, seven had concurrent hepatoma, diabetes mellitus, cirrhosis, chronic renal insufficiency or the effects of long-term steroid use; three had wound infections manifested by cellulitis or tenosynovitis and six had life-threatening necrotising soft-tissue infections. Vibrio spp. were identified from the wound (n=4), blood (n=1), and both (n=4). Symptoms appeared within a few hours to 3 days after injury, with 50% of patients developing symptoms within 24h; three patients were hypotensive upon admission; one patient received antibiotic therapy only and eight required emergency fasciotomy. All patients survived and none required amputation. The mean hospital stay was 23.2 days., Conclusions: Vibrio infections after finning injury can produce bacteraemic necrotising soft tissue-infections, especially in individuals with a systemic illness. Health education should include a recommendation to wear protective gloves while handling fish. Early antibiotic and surgical treatment can avoid potentially life-threatening complications.

During vertebrate embryogenesis, the paraxial mesoderm becomes segmented in a rostro-caudal progression and gives rise to the somites. In this paper we report the isolation of a Xenopus orthologue of paraxis, a member of a family of basic helix-loop-helix proteins, which has been suggested to play a role in paraxial mesoderm development. Xenopus paraxis is initially expressed in the presomitic paraxial mesoderm and later in the dorsal portion of the developing somites. Finally, paraxis expression becomes restricted to the most dorso-lateral region of mature somites.

Development of the visceral mesoderm is a critical process in the organogenesis of the gut. Elucidation of function and regulation of genes involved in the development of visceral mesoderm is therefore essential for an understanding of gut organogenesis. One of the genes specifically expressed in the lateral plate mesoderm, and later in its derivative, the visceral mesoderm, is the Fox gene FoxF1. Its function is critical for Xenopus gut development, and embryos injected with FoxF1 morpholino display abnormal gut development. In the absence of FoxF1 function, the lateral plate mesoderm, and later the visceral mesoderm, does not proliferate and differentiate properly. Region- and stage-specific markers of visceral mesoderm differentiation, such as Xbap and alpha-smooth muscle actin, are not activated. The gut does not elongate and coil. These experiments provide support for the function of FoxF1 in the development of visceral mesoderm and the organogenesis of the gut. At the molecular level, FoxF1 is a downstream target of BMP4 signaling. BMP4 can activate FoxF1 transcription in animal caps and overexpression of FoxF1 can rescue twinning phenotypes, which results from the elimination of BMP4 signaling. The cis-regulatory elements of FoxF1 are located within a 2 kb DNA fragment upstream of the coding region. These sequences can drive correct temporal-spatial expression of a GFP reporter gene in transgenic Xenopus tadpoles. These sequences represent a unique tool, which can be used to specifically alter gene expression in the lateral plate mesoderm.