Sex-differential patterns of neuropsychological functioning in adults with attention-deficit/hyperactivity disorder

BACKGROUND

The sex-differential prevalence of attention-deficit/hyperactivity disorder (ADHD) varies across the lifespan, but little is known about sex differences in executive functions in adults with ADHD.

METHODS

We assessed 261 adults, aged 18-40 years, diagnosed with ADHD (170 males [assigned at birth], aged 25.81 ± 5.49; 91 females, aged 27.76 ± 5.42) and 308 neurotypical adults (176 males, aged 24.62 ± 5.14; 132 female, aged 25.37 ± 5.42) via psychiatric interviews to confirm ADHD and other psychiatric diagnoses. They were assessed by the Cambridge Neuropsychological Testing Automated Battery (CANTAB) on Reaction Time (arousal/processing speed), Rapid Visual Information Processing (sustained attention), Spatial Span (spatial memory), Spatial Working Memory, Intradimentional/Extradimensional Shift (set-shifting), and Stocking of Cambridge (spatial planning). The primary analyses were adjusted for age, full-scale IQ, and co-occurring psychiatric conditions.

RESULTS

Adults with ADHD had various co-occurring psychiatric conditions without sex differences in ADHD-neurotypical differences. Both adult males and females with ADHD performed poorer in all CANTAB tasks than same-sex neurotypical adults. Significant sex-moderating effects were observed in neuropsychological performance, including greater ADHD-neurotypical differences in arousal for females than males and in location memory for spatial tasks in males than females.

CONCLUSION

There were no sex-moderating effects in the presence of co-occurring psychiatric conditions in adult ADHD. However, there were sex-moderating effects on how ADHD related to neuropsychological functioning in adulthood. ADHD was associated with more challenges in arousal/processing speed in females and more challenges in strategy use or inhibition in spatial memory in males.

Butyrate reduction and HDAC4 increase underlie maternal high fructose-induced metabolic dysfunction in hippocampal astrocytes in female rats

Maternal nutrient intake influences the health of the offspring via microenvironmental systems in digestion and absorption. Maternal high fructose diet (HFD) impairs hippocampus-dependent memory in adult female rat offspring. However, the underlying mechanisms remain largely unclear. Maternal HFD causes microbiota dysbiosis. In this study, we find that the plasma level of butyrate, a major metabolite of microbiota, is significantly decreased in the adult female maternal HFD offspring. In these rats, GPR43, a butyrate receptor was downregulated in the hippocampus. Moreover, the expressions of mitochondrial transcription factor A (TFAM), and peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) were downregulated in the hippocampus. The decreases of these functional proteins were reversed by fructooligosaccharides (FOS, a probiotic) treatment in adulthood. Astrocytes are critical for energy metabolism in the brain. Primary astrocyte culture from female maternal HFD offspring indicated that GPR43 and the mitochondrial biogenesis were significantly suppressed, which was reversed by supplemental butyrate incubation. The oxygen consumption rate (OCR) was reduced in the HFD group and rescued by butyrate. Intriguingly, the nuclear histone deacetylase 4 (HDAC4) was enhanced in the HFD group, suggesting an inhibitory role of butyrate on histone deacetylase activity. Inhibition of HDAC4 effectively restored the OCR, bioenergetics, and biogenesis of mitochondria. Together, these results suggested that the impaired butyrate signaling by maternal HFD could underlie the reduced mitochondrial functions in the hippocampus via HDAC4-mediated epigenetic changes.

Comparison of miscarriage rates in low prognosis patients according to the POSEIDON criteria

OBJECTIVE

The POSEIDON criteria stratified patients with poor ovarian response into four subgroups with exclusive characteristics and assisted reproductive technology success rates. However, limited studies focused on miscarriage in the POSEIDON population. This study aimed to explore whether the miscarriage rate different among low prognosis patients according to POSEIDON criteria.

MATERIALS AND METHODS

This is a retrospective observational study. All clinical pregnancies achieved after in vitro fertilization or intracytoplasmic sperm injection treatment between January 1998 and April 2021 were analyzed. The primary outcome was miscarriage, defined as the pregnancy loss before 20 weeks of gestation age. Miscarriage rate was estimated per clinical pregnancy and gestational sac.

RESULTS

A total of 1222 clinical pregnancies from 1088 POSEIDON patients met the inclusion criteria. The miscarriage rates per clinical pregnancy in each POSEIDON subgroup were as follows: Group 1: 11.7 %, Group 2: 26.5 %, Group 3: 20.9 %, and Group 4: 37.5 %. The miscarriage rate per gestational sac showed a similar trend as the clinical miscarriage rate. Multivariate regression analysis showed that advanced maternal age is an independent factor for miscarriage (Group 2 vs. 1: OR 2.476; Group 4 vs. 3: OR 2.252). Patients with diminished ovarian reserve (DOR) have higher miscarriage risks but without significance (Group 3 vs. 1: OR 1.322; Group 4 vs. 2: OR 1.202).

CONCLUSION

Miscarriage rates differed among low prognosis patients according to the POSEIDON criteria. Age remains a determined risk for miscarriage. DOR might be a potential factor for miscarriage, but it didn't account for a significant impact in POSEIDON patients.

[A real-world study on the features of postpartum hepatitis flares in pregnant women with chronic HBV infection]

Objective: To analyze the clinical features of postpartum hepatitis flares in pregnant women with hepatitis B virus (HBV) infection. Methods: A retrospective study was conducted. Patients who met the enrollment criteria were included. Liver function and HBV virology tests were collected from pregnant women with chronic HBV infection at delivery, 6, 24, 36, and 48 weeks after delivery through the hospital information and test system. Additionally, antiviral therapy types and drug withdrawal times were collected. Statistical analysis was performed on all the resulting data. Results: A total of 533 pregnant women who met the inclusion criteria were included, with all patients aged (29.5±3.7) years old. A total of 408 cases received antiviral drugs during pregnancy to interrupt mother-to-child transmission. There was no significant difference in the levels of alanine aminotransferase (ALT, z = -1.981, P = 0.048), aspartate aminotransferase (AST, z = -3.956, P < 0.001), HBV load (z = -15.292, P < 0.001), and HBeAg (z = -4.77, P < 0.001) at delivery in patients who received medication and those who did not. All patients ALT, AST, total bilirubin, direct bilirubin, and albumin showed an upward trend within six weeks after delivery. A total of 231 cases developed hepatitis within 48 weeks after delivery. Among them, 173 cases first showed ALT abnormalities within six weeks postpartum. Conclusion: Hepatitis flare incidence peaked six weeks after delivery or six weeks after drug withdrawal in pregnant women with chronic HBV infection.

An IoT Real-Time Potable Water Quality Monitoring and Prediction Model Based on Cloud Computing Architecture

In order to achieve the Sustainable Development Goals (SDG), it is imperative to ensure the safety of drinking water. The characteristics of each drinkable water, encompassing taste, aroma, and appearance, are unique. Inadequate water infrastructure and treatment can affect these features and may also threaten public health. This study utilizes the Internet of Things (IoT) in developing a monitoring system, particularly for water quality, to reduce the risk of contracting diseases. Water quality components data, such as water temperature, alkalinity or acidity, and contaminants, were obtained through a series of linked sensors. An Arduino microcontroller board acquired all the data and the Narrow Band-IoT (NB-IoT) transmitted them to the web server. Due to limited human resources to observe the water quality physically, the monitoring was complemented by real-time notifications alerts via a telephone text messaging application. The water quality data were monitored using Grafana in web mode, and the binary classifiers of machine learning techniques were applied to predict whether the water was drinkable or not based on the data collected, which were stored in a database. The non-decision tree, as well as the decision tree, were evaluated based on the improvements of the artificial intelligence framework. With a ratio of 60% for data training: at 20% for data validation, and 10% for data testing, the performance of the decision tree (DT) model was more prominent in comparison with the Gradient Boosting (GB), Random Forest (RF), Neural Network (NN), and Support Vector Machine (SVM) modeling approaches. Through the monitoring and prediction of results, the authorities can sample the water sources every two weeks.

Association of the Coronal Lateral Collateral Ligament Sign in ACL-Deficient Knees With Greater Anterior Tibial Translation and Femorotibial Rotation in Adults and Adolescents

Background

The coronal lateral collateral ligament (LCL) sign (the entire LCL being seen in 1 coronal slice on a magnetic resonance imaging [MRI] scan), is a new secondary sign of anterior cruciate ligament (ACL) tear.

Purpose

To (1) evaluate the coronal LCL sign in adults with ACL tears and (2) compare the magnitude of the MRI scan parameters between adolescent and adult ACL-deficient knees with positive coronal LCL signs.

Study Design

Cross-sectional study; Level of evidence: 3.

Methods

We retrospectively reviewed patients who underwent ACL reconstruction between February 1, 2013, and May 31, 2021, and divided them into adolescent (10-18 years) and adult (>18 years) groups. Tibial translation, femorotibial rotation, and presence of the coronal LCL sign were evaluated using MRI. The static femorotibial position parameters were also compared between positive and negative coronal LCL sign groups. Independent Student t tests were used to identify statistically significant differences for continuous variables, whereas the categorical variables were compared using the chi-square test.

Results

A total of 65 adolescents and 300 adults with ACL tears were identified. The coronal LCL sign was present in a similar percentage of adolescents and adults with ACL tears (57% vs 58%; P = .873). The anterior tibial translation (ATT) in patients with positive coronal LCL signs (adolescents, 7.9 ± 3.4 mm; adults, 6.6 ± 3.5 mm) was significantly greater compared with those with negative signs (adolescents, 1.5 ± 2.6 mm, P < .001; adults, 2.3 ± 4.2 mm, P < .001). Femorotibial rotation was also statistically greater in positive coronal LCL sign groups (adolescents, 6.4°± 5.6°; adults, 7.0°± 5.0°) compared with negative sign groups (adolescents, 0.7°± 4.7°, P < .001; adults, 3.5°± 4.2°, P < .001).

Conclusion

The occurrence of the coronal LCL sign on MRI scans was comparable between adolescents and adults with ACL-deficient knees. The presence of the LCL sign was associated with a greater ATT and femorotibial rotation in both adolescents and adults with ACL tears.

Unscarred uterine rupture with catastrophic hemorrhage immediately after vaginal delivery: diagnosis and management of six consecutive cases

BACKGROUND

To describe and explore the risk factors, clinical presentations, timely diagnostic approaches, and management in patients experiencing unscarred uterine rupture with catastrophic hemorrhage.

METHODS

We retrospectively analyzed clinical and imaging data from women who encountered postpartum hemorrhage (PPH) and were diagnosed with unscarred uterine rupture within a three-year timeframe (2018-2020). The data were extracted from medical records obtained from a multi-hospital 24-hour emergency PPH transfer system.

RESULTS

Six patients were identified as having unscarred uterine rupture after vaginal delivery. All six women were para 2, with four of them undergoing vacuum-assisted delivery. One patient experienced out-of-hospital cardiac arrest (OHCA), while five patients presented with hypovolemic shock. Abdominopelvic ultrasound revealed a boggy lower uterine segment. Initially, five patients underwent transarterial embolization (TAE) of the internal iliac arteries in an attempt to achieve hemostasis, but this approach proved unsuccessful. Abdominopelvic computed tomography (CT) confirmed the diagnosis of ruptured uterus by demonstrating disrupted myometrium and hemoperitoneum. Immediate exploratory laparotomy followed by life-saving hysterectomy was performed in all cases. The median estimated total blood loss was 2725 mL ± 900 mL (ranging from 1600 mL to 7100 mL). Lower segment lacerations were observed in all patients, with more extensive uterine damage noted in those who underwent vacuum extraction. The length of hospital stay varied between 9 and 38 days.

CONCLUSION

Instrument-assisted obstetric delivery is a possible contributing factor to unscarred uterine rupture in our study. In specific cases, the use of abdominopelvic CT prior to initiating transarterial embolization (TAE) offers valuable information to complement ultrasound findings. This comprehensive approach helps in accurately identifying the underlying cause of intractable postpartum hemorrhage (PPH). Immediate conversion to laparotomy is essential to explore the intra-abdominal factors causing PPH that cannot be controlled by TAE. The rational etiologies of uterine rupture must be clarified while generating practical guideline in the future.

Optimizing Dental Bond Strength: Insights from Comprehensive Literature Review and Future Implications for Clinical Practice

This review examines the modifying factors affecting bond strength in various bonding scenarios, particularly their relevance to the longevity of dental restorations. Understanding these factors is crucial for improving clinical outcomes in dentistry. Data were gathered from the PubMed database, ResearchGate, and Google Scholar resources, covering studies from 1992 to 2022. The findings suggest that for dentin-resin bonds, minimizing smear layers and utilizing MMP inhibitors to prevent hybrid layer degradation are essential. In the case of resin-resin bonds, reversing blood contamination is possible, but preventing saliva contamination is more challenging, underscoring its critical importance during clinical procedures. Additionally, while pretreatment on ceramics has minimal impact on bond strength, the influence of specific colorings should be carefully considered in treatment planning. This comprehensive review highlights that although established practices recognize significant bond strength factors, ongoing research provides valuable insights to enhance the clinical experience for patients. Once confirmed through rigorous experimentation, these emerging findings should be swiftly integrated into dental practice to improve patient outcomes.

The effect of various air pollution and participants' age on semen quality in southern Taiwan

OBJECTIVE

This study aimed to investigate the association between semen quality and air pollution in southern Taiwan.

MATERIALS AND METHODS

In this retrospective study, 4338 males aged 21-70 years were recruited between 2001 and 2018 from a reproductive medical center. Semen quality was assessed according to standardized methods outlined in the World Health Organization (WHO) Laboratory Manual 1999 and 2010, including total sperm count, progressive sperm motility (%), rapid progressive sperm motility (%), and sperm with normal morphology (%). All designated national air quality automatic continuous monitoring stations measured the levels of air pollution [particulate matter (PM10 and PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3)], and was documented by Environmental Protection Administration in Taiwan. We collected data on the levels of air pollution based on the participants' residential addresses.

RESULTS

In our study, we found that progressive and rapid progressive sperm motility significantly decreased annually (p < 0.05). In addition, increasing age influenced total sperm count, progressive sperm motility, rapid progressive sperm motility, and sperm with normal morphology (p < 0.05). Among different air pollution, we observed SO2 was associated with lower rapid progressive sperm motility and lower sperm with normal morphology (β = -0.103, p = 0.043; β = 0.118, p = 0.001, respectively). However, NO2 was associated with higher rapid progressive sperm motility and a high number of sperm with normal morphology (β = 0.129, p = 0.002; β = 0.127, p < 0.001, respectively).

CONCLUSIONS

The semen quality in southern Taiwan appears to have declined in recent years. The participant's age for semen analysis was most strongly associated with semen parameters, Moreover, a significant association between SO2 and NO2 levels and semen motility was observed, even after adjusting for multiple comparisons. Further study is required to analyze the dose-dependent effect of SO2 and NO2 on semen parameters.

Associations between Smoking Status and Health-Related Physical Fitness and Balance Ability among Older Males in Taiwan

The primary aim of this study was to examine the relationships between smoking status and health-related physical fitness and balance ability in older males residing in Taiwan. This investigation adopted a cross-sectional design, utilizing data from 7688 older males who took part in the 2014-2015 wave of the National Physical Fitness Survey of Taiwan. Various data sources, including a standardized structured questionnaire, anthropometric measurements, health-related physical fitness assessments, and balance ability tests, were analyzed. The participants were divided into three categories based on their smoking habits: never smokers, former smokers, and current smokers. Multiple regression analyses were performed to evaluate the linear association between cigarette smoking status and health-related physical fitness and balance ability performance. Health-related physical fitness and balance performance were significantly greater (p < 0.05) in the never smoker group than in the current smoker group. Current smoking status was significantly negatively (p < 0.05) associated with cardiopulmonary function, muscular endurance, flexibility, and balance performance. A history of smoking (former smoker) was significantly negatively (p < 0.05) associated with the 2-min step test, 30-s arm curl and chair stand, as well as the 8-foot up-and-go test; however, the association was not significant for the back scratch, chair sit-and-reach, and one-leg stance with eyes open performance. These results suggest that current cigarette smoking is detrimental to health-related physical fitness and balance performance in older males. Quitting smoking may reverse the effects of smoking on overall body flexibility and static balance performance in Taiwanese older adults, thereby reducing the risk of falls and incapacity.

Lactobacillus plantarum isolated from kefir enhances immune responses and survival of white shrimp (Penaeus vannamei) challenged with Vibrio alginolyticus

Lactobacillus plantarum is known for its probiotics benefit to host, although the effects vary among strains. This study conducted a feeding experiment of three Lactobacillus strains, MRS8, MRS18 and MRS20, which were isolated from kefir and incorporated into the diets of shrimp to evaluate the effects of non-specific immunity, immune-related gene expression, and disease resistance of white shrimp (Penaeus vannamei) against Vibrio alginolyticus. To prepare the experimental feed groups, the basic feed was mixed with different concentrations of L. plantarum strains MRS8, MRS18, and MRS 20, which were incorporated at 0 CFU (control), 1 × 10⁶ CFU (groups 8-6, 18-6, and 20-6), and 1 × 10⁹ CFU (groups 8-9, 18-9, and 20-9) per gram of diet for an in vivo assay. During the rearing period for 28 days of feeding each group, immune responses, namely the total hemocyte count (THC), phagocytic rate (PR), phenoloxidase activity, and respiratory burst were examined on days 0, 1, 4, 7, 14, and 28. The results showed that groups 20-6, 18-9 and 20-9 improved THC, and groups 18-9 and 20-9 improved phenoloxidase activity and respiratory burst as well. The expression of immunity-related genes was also examined. Group 8-9 increased the expression of LGBP, penaeidin 2 (PEN2) and CP, group 18-9 increased the expression of proPO1, ALF, Lysozyme, penaeidin 3 (PEN3) and SOD, and group 20-9 increased the expression of LGBP, ALF, crustin, PEN2, PEN3, penaeidin 4 (PEN4) and CP (p < 0.05). Groups 18-6, 18-9, 2-6, and 20-9 were further used in the challenge test. After feeding for 7 days and 14 days, Vibrio alginolyticus was injected into white shrimp and observed the shrimp survival for 168 h. The results showed that compared to the control, all groups improved the survival rate. Especially, feeding group 18-9 for 14 days improved the survival rate of white shrimp (p < 0.05). After the challenge test for 14 days, the midgut DNA of survival white shrimps was extracted to analyze the colonization of L. plantarum. Among the groups, (6.61 ± 3.58) × 10⁵ CFU/pre shrimp of L. plantarum in feeding group 18-9 and (5.86 ± 2.27) × 10⁵ CFU/pre shrimp in group 20-9 were evaluated by qPCR. Taken together, group 18-9 had the best effects on the non-specific immunity, the immune-related gene expression, and the disease resistance, which might be due to the benefit of the probiotic colonization.

The Comprehensive Effects of Carassius auratus Complex Formula against Lipid Accumulation, Hepatocarcinogenesis, and COVID-19 Pathogenesis via Stabilized G-Quadruplex and Reduced Cell Senescence

Carassius auratus complex formula (CACF) is a traditional Chinese medicine known for its antidiabetic effects. Hepatocellular carcinoma (HCC) is a major cause of cancer-related deaths worldwide, and there are currently no effective therapies for advanced HCC. This study explores the comprehensive effects and possible mechanisms of CACF on HCC. The results show that CACF reduces the viability of hepatoma cells in vitro, while benefiting normal hepatocytes. In addition, CACF inhibits hepatoma cell growth in a zebrafish xenotransplantation model and decreases lipid accumulation, represses inflammation and cell proliferation markers in fatty acid translocase (CD36) transgenic zebrafish, and inhibits the expression of cell proliferation and β-catenin downstream targets in telomerase (tert) transgenic zebrafish models. Ingenuity Pathway Analysis reveals that CACF exerts multiple functions, including reduction of inflammation and inhibition of lipid transporter and PPAR signaling pathway. Surprisingly, CACF also regulates the expression of genes and reduces coronavirus infection and pathogenesis in a zebrafish model. CACF treatment is validated to regulate the expression of genes for anti-coronavirus activity. Mechanistically, CACF stabilizes G-quadruplex and reduces cell senescence associated β-galactosidase activity. In summary, CACF may be a promising therapeutic agent with multiple functions including anticancer, anti-inflammation, and anti-microorganisms in a zebrafish model.

Six weeks effect of different nanocellulose on blood lipid level and small intestinal morphology in mice

AIMS

Cellulose nanofibrils (CNF, or NFC), cellulose nanocrystals (CNC, or NCC), and Tempo (2,2,6,6-tetramethylpiperidine-1-oxyl radical) oxidized CNF (Tempo-CNF) were compared for the short-term effect on mice fed with a high-fat and high-sugar (Western diet, WD) to investigate their effect when combined with a sub-optimal diet.

SCOPE

Thirty C57B/C female mice (10 weeks old; 5-6 mice/group) were given water, cellulose, or three types of nanocellulose once daily in a dose of 30 mg/kg body weight by oral gavage. After six weeks, weight changes, fecal output, glucose homeostasis, and gut permeability showed no significant among groups. Serum analysis including triglycerides, cholesterol and total bile acids and small intestinal morphology including villus length, villus width, crypt depth, goblet cell count and goblet cell density were no difference for all groups. Only CNC group had higher excretion of bile acids in the feces.

CONCLUSIONS

These results suggest that current treated dose using three types of nanocellulose had no detrimental effects on blood lipid level and small intestinal morphology.

Improving red-color performance, immune response and resistance to Vibrio parahaemolyticus on white shrimp Penaeus vannamei by an engineered astaxanthin yeast

Astaxanthin (AST), a super antioxidant with coloring and medical properties, renders it a beneficial feed additive for shrimp. This study conducted a white shrimp feeding trial of 3S, 3'S isoform AST, which was derived from metabolic-engineered Kluyveromyces marxianus fermented broth (TB) and its extract (TE) compared to sources from two chemically synthetic ASTs (Carophyll Pink [CP] and Lucantin Pink [LP]), which contain 3S, 3'S, 3R, 3'S (3S, 3'R) and 3R, 3'R isoforms ratio of 1:2:1. The effects on red coloration, immune parameters and resistance to Vibrio infection were evaluated. Four AST sources were incorporated into the diets at concentrations of 0 (control), 100 mg kg^-1 (TB100, TE100, CP100, and LP100), and 200 mg kg^-1 (TB200, TE200, CP200, and LP200). Results revealed that in week 4, shrimps that received AST-supplemented feeds, especially TB100, TB200, and TE200, significantly increased redness (a*) values. Immune responses including phagocytosis activity, superoxide-anion production, phenoloxidase activity, and immune-related genes were examined on days 0, 1, 2, 4, 7, 14, 21, and 28. Generally, shrimps that received AST-supplemented feeds exhibited higher immune responses on days 7 and 14 than the control feed. Gene expression levels of superoxide dismutase and glutathione peroxidase were significantly upregulated on days 7 and 14 in shrimps that received AST-supplemented feeds, while genes of penaeidins, antilipopolysaccharide factor, and lysozyme were upregulated on days 4, 7, and 14, especially received TB200 and TE200. Furthermore, shrimps that received TB100, TE100, CP100, and LP100 7 days were then challenged with Vibrio parahaemolyticus and the result demonstrated higher survival rates especially TB100 at 168 h than the control feed. In conclusion, incorporating AST into the diets enhanced shrimp red coloration, immune parameters, and resistance against V. parahaemolyticus infection. The K. marxianus-derived AST exhibited higher performance than did chemical AST to be a potential feed additive in shrimp aquaculture.

A major outbreak of the COVID-19 on the Diamond Princess cruise ship: Estimation of the basic reproduction number

BACKGROUND

The COVID-19 pandemic, which broke out in Wuhan, China, in 2019, was declared an international public health emergency by the World Health Organization on January 31, 2020. The outbreak on the Diamond Princess cruise ship had appeared first as a cluster infection outside China during the early pandemic. The incident occurred on February 1, 2020, involved an 80-year-old Hong Kong man who was diagnosed with COVID-19. The cruise ship docked in Yokohama, Japan, for 14 days of onboard quarantine; however, cluster infection outbroke rapidly.

METHODS

We constructed a SIR mathematical model and conducted an epidemiological study of the COVID-19 outbreak on the Diamond Princess cruise ship, covering the period from February 5 (start of quarantine) to February 20 (completion of 14-day quarantine). We estimated the basic reproduction number (R 0 ) using a novel method of nonlinear least-squares curve fitting under Microsoft Excel Solver. The 95% confidence interval (CI) values were estimated by the jackknife procedures.

RESULTS

Six hundred thirty-four (17.1%) cases were diagnosed in a total population of 3711 cruise passengers, and 328 (51.7%) cases were asymptomatic. As of April 24, 2020, 712 cases had been diagnosed and 14 (1.96%) deaths had occurred. The R 0 with 95% CI of the COVID-19 outbreak was 3.04 (2.72-3.36). Without an evacuation plan for passengers and crew, we estimated the total number of cumulative cases would reach 3498 (CI, 3464-3541). If the R 0 value was reduced by 25% and 50%, the cumulative cases would be reduced to 3161 (CI, 3087-3254) and 967 (CI, 729-1379), respectively. The abovementioned R 0 value was estimated from the original Wuhan strain.

CONCLUSION

Cruise conditions would accelerate the spread of infectious diseases and were not suitable for onboard quarantine. Early evacuation and isolation of all passengers and crew members would reduce the R 0 value and avoid further infections.

Probable Aerosol Transmission of SARS-CoV-2 through Floors and Walls of Quarantine Hotel, Taiwan, 2021

We investigated a cluster of SARS-CoV-2 infections in a quarantine hotel in Taiwan in December 2021. The cluster involved 3 case patients who lived in nonadjacent rooms on different floors. They had no direct contact during their stay. By direct exploration of the space above the room ceilings, we found residual tunnels, wall defects, and truncated pipes between their rooms. We conducted a simplified tracer-gas experiment to assess the interconnection between rooms. Aerosol transmission through structural defects in floors and walls in this poorly ventilated hotel was the most likely route of virus transmission. This event demonstrates the high transmissibility of Omicron variants, even across rooms and floors, through structural defects. Our findings emphasize the importance of ventilation and integrity of building structure in quarantine facilities.

Maternal Metformin Treatment Reprograms Maternal High-Fat Diet-Induced Hepatic Steatosis in Offspring Associated with Placental Glucose Transporter Modifications

Maternal high-fat (HF) diet exposure in utero may affect fetal development and cause metabolic problems throughout life due to lipid dysmetabolism and oxidative damage. Metformin has been suggested as a potential treatment for body weight reduction and nonalcoholic fatty liver disease, but its reprogramming effect on offspring is undetermined. This study assesses the effects of maternal metformin treatment on hepatic steatosis in offspring caused by maternal HF diet. Female rats were fed either a control or an HF diet before conception, with or without metformin treatment during gestation, and placenta and fetal liver tissues were collected. In another experiment, the offspring were fed a control diet until 120 d (adult stage). Metformin treatment during pregnancy ameliorates placental oxidative stress and enhances placental glucose transporter 1 (GLUT1), GLUT3, and GLUT4 expression levels through 5' adenosine monophosphate-activated protein kinase (AMPK) activation. Maternal metformin treatment was shown to reprogram maternal HF diet-induced changes in offspring fatty liver with the effects observed in adulthood as well. Further validation is required to develop maternal metformin therapy for clinical applications.

WNK1–OSR1 Signaling Regulates Angiogenesis-Mediated Metastasis towards Developing a Combinatorial Anti-Cancer Strategy

Lysine-deficient protein kinase-1 (WNK1) is critical for both embryonic angiogenesis and tumor-induced angiogenesis. However, the downstream effectors of WNK1 during these processes remain ambiguous. In this study, we identified that oxidative stress responsive 1b (osr1b) is upregulated in endothelial cells in both embryonic and tumor-induced angiogenesis in zebrafish, accompanied by downregulation of protein phosphatase 2A (pp2a) subunit ppp2r1bb. In addition, wnk1a and osr1b are upregulated in two liver cancer transgenic fish models: [tert x p53^−/−] and [HBx,src,p53^−/−,RPIA], while ppp2r1bb is downregulated in [tert x p53^−/−]. Furthermore, using HUVEC endothelial cells co-cultured with HepG2 hepatoma cells, we confirmed that WNK1 plays a critical role in the induction of hepatoma cell migration in both endothelial cells and hepatoma cells. Moreover, overexpression of OSR1 can rescue the reduced cell migration caused by shWNK1 knockdown in HUVEC cells, indicating OSR1 is downstream of WNK1 in endothelial cells promoting hepatoma cell migration. Overexpression of PPP2R1A can rescue the increased cell migration caused by WNK1 overexpression in HepG2, indicating that PPP2R1A is a downstream effector in hepatoma. The combinatorial treatment with WNK1 inhibitor (WNK463) and OSR1 inhibitor (Rafoxanide) plus oligo-fucoidan via oral gavage to feed [HBx,src,p53^−/−,RPIA] transgenic fish exhibits much more significant anticancer efficacy than Regorafenib for advanced HCC. Importantly, oligo-fucoidan can reduce the cell senescence marker-IL-1β expression. Furthermore, oligo-fucoidan reduces the increased cell senescence-associated β-galactosidase activity in tert transgenic fish treated with WNK1-OSR1 inhibitors. Our results reveal the WNK1–OSR1–PPP2R1A axis plays a critical role in both endothelial and hepatoma cells during tumor-induced angiogenesis promoting cancer cell migration. By in vitro and in vivo experiments, we further uncover the molecular mechanisms of WNK1 and its downstream effectors during tumor-induced angiogenesis. Targeting WNK1–OSR1-mediated anti-angiogenesis and anti-cancer activity, the undesired inflammation response caused by inhibiting WNK1–OSR1 can be attenuated by the combination therapy with oligo-fucoidan and may improve the efficacy.

[Research progress of polyetheretherketone and its composites in the field of dental implant]

Polyetheretherketone (PEEK) is a polymer material composed of aromatic rings connected by ether and ketone groups. It has advantages of excellent biocompatibility, stable chemical properties, and appropriate elasticity modulus. Since PEEK are increasingly used in dentistry in recent years, the properties, modification methods, and research advances of them in oral implantology were discussed in this review.

[Modified mattress inversion suturing with double barbed sutures used for totally laparoscopic esophagojejunostomy overlap anastomosis after radical total gastrectomy]

Objective: To explore the advantages and safety of a modified mattress inversion suturing using double barbed sutures compared with the traditional overlap method in totally laparoscopic esophagojejunostomy overlap anastomosis. Methods: A retrospective cohort study was conducted. The inclusion criteria were as follows: (1) patients were aged 18 - 80 years old; (2) adenocarcinoma was preoperatively confirmed by pathological analysis; (3) patients had undergone a complete laparoscopic radical total gastrectomy; (4) patients had undergone esophagojejunostomy using the overlap method; (5) patients received a grade of I-III on the American Society of Anesthesiologists physical status classification system; (6) patients' complete follow-up data had been collected. Patients with a history of other malignant tumors, multi-origin tumors, emergency surgery, non-R0 radical resection or distant metastasis were excluded. The clinical data of 89 gastric cancer patients who underwent total laparoscopic radical total gastrectomy in the Department of Gastrointestinal Surgery in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2020 were collected. These patients were grouped according to the esophagojejunostomy method used. Of 89 patients, 32 received modified mattress inversion suturing with double barbed sutures to close the common opening of esophagojejunostomy (the modified anastomosis group), while 57 received traditional overlap anastomosis in which the common opening was closed by barbed suture (the traditional anastomosis group). The operation conditions (incision length, conversion to laparotomy, duration of esophagojejunostomy) and postoperative recovery (time to commencement of a liquid diet, duration of postoperative hospital stay, anastomotic leakage, anastomotic stenosis, and anastomotic bleeding) were compared between the two groups. Results: There was no significant difference in the baseline data of the two groups for any parameter (all P>0.05). All patients received complete laparoscopic radical gastrectomy without conversion to laparotomy. There were no significant differences in the length of the median incision, the proportion of food intake on the first day after surgery, or in the incidence of anastomotic complications such as anastomotic leakage, anastomotic stenosis, and anastomotic bleeding between the two groups (P>0.05). Compared with the traditional anastomosis group, patients in the modified anastomosis group had shorter anastomosis time [26 (19-62) minutes vs. 36 (20-50) minutes, Z=-2.546, P=0.011] and postoperative hospital stay [7 (6-12) days vs. 9 (7-42) days, Z=-4.202, P<0.001]. The differences were statistically significant (all P<0.05). In a subgroup analysis of tumor TNM stage III, Siewert type II and neoadjuvant chemotherapy patients, there was no significant difference in the incidence of anastomotic complications between the modified group and the traditional group. However, the postoperative hospital stay duration in the modified anastomosis group was less than in the traditional anastomosis group. The duration of anastomosis in Siewert type II patients was also shorter in the modified anastomosis group than in the traditional anastomosis group [26 (19-62) minutes vs. 38 (21-50) minutes, Z=-2.105, P=0.035], and the difference was statistically significant (all P<0.05). Conclusion: Complete laparoscopic esophagojejunostomy using modified mattress inversion suturing with double barbed sutures is a safe and feasible anastomosis method to close the common opening of esophagojejunostomy, with shorter operation time, faster postoperative recovery and shorter hospital stay than the traditional method.

[Cone-beam CT analysis of the correlation between incisor root resorption rate and tooth movement index in adult patients with fixed orthodontics appliance]

Objective: To analyze the correlation between the root resorption rate and tooth movement of the maxillary and mandibular incisors before and after orthodontic treatment in adult patients using cone-beam CT (CBCT), and to explore the related factors that affect the apical root resorption. Methods: In this retrospective study, 23 adult patients with classⅠor class Ⅱ division 1 malocclusion [2 males and 21 females, mean age (23.4±6.3) years, treatment time (2.1±0.7) years] who received orthodontic treatment with fixed appliance in Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital from January 2017 to June 2021 were enrolled. Full-column CBCT examination was performed before and after treatment. A three-dimensional model was established to observe and record the volume of the maxillary and mandibular central and lateral incisors before and after treatment. The change of the incisal edge, the angle of rotation of the incisal edge, and the direction of the long axis of the tooth were also measured. The root resorption in each tooth before and after treatment was compared, and the root resorption rate was calculated. Pearson correlation analysis was performed on the root absorption rate before and after treatment with age, treatment time and tooth movement. Results: After treatment, the tooth volume of the maxillary and mandibular central and lateral incisors decreased significantly (P<0.01). The root absorption volumes were (20.2±6.0) mm3 and (11.2±4.7) mm3 in maxillary central and lateral incisors, and (14.7±4.6) mm3 and (14.8±5.0) mm3 in mandibular central and lateral incisors, respectively. The root absorption rates were (9.49±1.75)% and (9.13±3.24)% in maxillary central and lateral incisors, and (8.56±3.43)% and (9.13±3.24)%, in mandibular central and lateral incisors, respectively (F=0.56, P=0.640). The root resorption rate of maxillary central incisors had a weak positive correlation with the change of sagittal distance of incisal edge (r=0.36, P=0.015). The root resorption rate of mandibular central incisors had a moderate positive correlation with the vertical movement distance (r=0.48, P=0.001). The root resorption rate of mandibular lateral incisors was weakly positively correlated with the vertical movement of incisal edge and the treatment time (r=0.35, P=0.016; r=0.34, P=0.021), and was moderately positively correlated wit the change of sagittal movement of incisal edge (r=0.44, P=0.002). Conclusions: During orthodontic treatment, both maxillary and mandibular incisors had a certain degree of root resorption, which was related to sagittal and vertical movement of the incisors and the time of orthodontic treatment.

Improvement in the metabolic markers of prediabetic subjects due to the partial substitution of Taiken9 rice by RD43 rice in their daily diet: a randomized clinical trial

Although RD43 rice is characterized by high amounts of undigestible starch, its potential health benefits for prediabetic individuals remain unknown. Thus, the effect of regular consumption of RD43 rice on the glycemic response, body composition, and metabolic markers was investigated in a sample of 34 participants with prediabetes (aged from 32 to 68 years) who were randomly allocated to either the treatment or the control group. The first were required to consume RD43 rice (Glycemic Index [GI] = 78) containing 14.1 g of undigestible starch daily as a substitute for two meals per day while the second were given the Taiken9 rice (GI = 98) for 12 continuous weeks. The evaluations were performed at baseline, at the end of week 6 and 12, and at follow-up conducted two weeks after the intervention had ended. The results obtained at the week 12 assessment clearly showed a significant decrease in fasting plasma glucose, insulin, HbA1c, and HOMA-IR in the group that consumed RD43 rice. In addition, daily ingestion of RD43 rice markedly reduced body weight, Body Mass Index (BMI), total fat mass, and waist circumference at both week 6 and 12 compared with the baseline. When compared with the controls, the treatment group also exhibited a significant decrease in fasting plasma insulin and HOMA-IR at week 12. However, no significant inter- or intra-group differences in lipid profiles were detected. These findings suggest that RD43 rice could be a potential staple food with the capacity to improve glycemic control and body composition in prediabetic individuals.

What does engram encode?: Heterogeneous memory engrams for different aspects of experience

Long-lasting synaptic changes within the neuronal network mediate memory. Neurons bearing such physical traces of memory (memory engram cells) are often equated with neurons expressing immediate early genes (IEGs) during a specific experience. However, past studies observed the expression of different IEGs in non-overlapping neurons or synaptic plasticity in neurons that do not express a particular IEG. Importantly, recent studies revealed that distinct subsets of neurons expressing different IEGs or even IEG negative-(yet active) neurons support different aspects of memory or computation, suggesting a more complex nature of memory engram cells than previously thought. In this short review, we introduce studies revealing such heterogeneous composition of the memory engram and discuss how the memory system benefits from it.

Evaluation of Three Sample Introduction Systems for Impurity Analysis of an Ultrapure Reagent Using a Scanning Mobility Particle Sizer

The semiconductor industry continues to shrink the device sizes while applying more complex shapes and using diverse materials, which requires parallel improvements in the quality of ultrapure reagents. The need for ultrapure reagents has led to ever-higher demands for the performance of analytical instruments used to detect ultratrace impurities. In this study, nonvolatile impurities in ultrapure reagents were quantified using a scanning mobility particle sizer (SMPS). The performances of three different sample introduction systems, i.e., an electrospray (ES), an aerosol generator with a heating chamber and a Nafion desolvation membrane (NB-II), and a MicroMist nebulizer with a heated cyclonic spray chamber and a three-stage Peltier-cooled desolvation system (MM-APEX), were evaluated for the lower limit of detection of a SMPS. The MM-APEX equipped with the SMPS was able to detect NaCl additives at a concentration of 100 parts per trillion (ppt, ng/L) in ultrapure water, which was approximately 10⁴- and 10²-fold lower than those of ES and NB-II, respectively. The practical application of MM-APEX with the SMPS for commercial isopropanol samples was also studied. The results clearly demonstrate that the impurity concentrations presented by the NaCl-equivalent concentrations among different sources of isopropanol were at the ppt to parts-to-billion (ppb) scale. The SMPS system equipped with MM-APEX is capable of recognizing impurities with concentrations ranging from tens ppt to thousands of parts per million (ppm), which is beneficial for an ultratrace analysis of nonvolatile impurities in semiconductor process chemicals.

Developmental Changes of Autistic Symptoms, ADHD Symptoms, and Attentional Performance in Children and Adolescents with Autism Spectrum Disorder

This study followed up ADHD/autistic symptoms and attentional performance in children/adolescents with ASD and typically developing ones (TD) over 5-7 years. The participants were stratified by age at baseline into child (< 12 years) and adolescent (12-19 years) groups. ADHD symptoms, especially hyperactivity, and attentional functions significantly improved during follow-up, more in children than in adolescents, in both ASD and TD. Significantly more omission errors and perseverations were noted in ASD than TD through the follow-up. Children with ASD had more improvement in reaction time while adolescents with ASD had less improvement in commission errors and detectability than TD. No correlation of attentional functions and ADHD symptoms in ASD implied different neural mechanisms of ADHD symptoms between ASD and ADHD.

[Tracing investigation and analysis of a Clostridium botulinum food poisoning incident in Bayingolin Mongolian Autonomous Prefecture, Xinjiang]

To analyze a suspected case of Clostridium botulinum food poisoning in Bayingolin Mongolian Autonomous Prefecture, Xinjiang and to help validating the diagnosis and providing technical support for clinical treatment. The basic information and clinical manifestations of food poisoning cases were investigated by using the epidemiological method of food safety accidents. The botulinum toxin genes in the samples were detected by real-time PCR and inoculation of KM mouse. The enriched bacteria were further purified and validated. PFGE and cluster analysis were performed on five isolates. Clostridium botulinum type A was detected in two homemade fermented bean samples and stool lavage fluid samples of three patients from enriched samples by toxin test and real-time PCR, and were further validated after isolation of Clostridium botulinum. PFGE showed 100% homology among five isolates. Five isolates of bacteria isolated from the stool lavage fluid of three patients and two homemade fermented bean curd were identified as the same source through PFGE. The cause of this food poisoning cases is food pollution of Clostridium botulinum type A.

A 3.1-5.2GHz, Energy-Efficient Single Antenna, Cancellation-Free, Bitwise Time-Division Duplex Transceiver for High Channel Count Optogenetic Neural Interface

We report an energy-efficient, cancellation-free, bit-wise time-division duplex (B-TDD) transceiver (TRX) for real-time closed-loop control of high channel count neural interfaces. The proposed B-TDD architecture consists of a duty-cycled ultra-wide band (UWB) transmitter (3.1-5 GHz) and a switching U-NII band (5.2 GHz) receiver. An energy-efficient duplex is realized in a single antenna without power-hungry self-interference cancellation circuits which are prevalently used in the conventional full-duplex, single antenna transceivers. To suppress the interference between up- and down-links and enhance the isolation between the two, we devised a fast-switching scheme in a low noise amplifier and used 5× oversampling with a built-in winner-take-all voting in the receiver. The B-TDD transceiver was fabricated in 65 nm CMOS RF process, achieving low energy consumption of 0.32 nJ/b at 10 Mbps in the receiver and 9.7 pJ/b at 200 Mbps in the transmitter, respectively. For validation, the B-TDD TRX has been integrated with a μLED optoelectrode and a custom analog frontend integrated circuit in a prototype wireless bidirectional neural interface system. Successful in-vivo operation for simultaneously recording broadband neural signals and optical stimulation was demonstrated in a transgenic rodent.

Adult patients with ACL tears have greater tibial internal rotation in MRI compared to adolescent patients

Purpose

To compare the anterior translation and internal rotation of tibia on magnetic resonance imaging (MRI) between adult and adolescent patients with anterior cruciate ligament (ACL) tears.

Methods

Patients who underwent isolated ACL reconstruction from January 2013 to May 2021 were retrospectively reviewed. The exclusion criteria included incomplete data, poor image quality, a prior ACL surgery, and concomitant fractures or other ligament injuries. The enrolled patients were divided into two groups based on their ages: an adult group (age > 19 years) and an adolescent group (15 to 19 years of age). Anterior tibial translation and femorotibial rotation were measured on MRI. A Student’s t-test was used for the statistical analysis comparing the adult and adolescent groups.

Results

A total of 365 patients (279 adults and 86 adolescents) were enrolled in the present study. The anterior tibial translation in the adult group (4.8 ± 4.4 mm) and the adolescent group (5.0 ± 4.2 mm) was not significantly different (p = 0.740). On the other hand, the tibial internal rotation in the adult group (5.6 ± 5.0 degree) was significantly greater compared to the adolescent group (4.2 ± 5.6 degree) (p = 0.030). The intraclass correlation coefficients (ICC) of the measured data from two independent observers showed excellent reliability (0.964 and 0.961 for anterior tibial translation and tibial internal rotation, respectively).

Conclusion

The adult patients with ACL tears exhibited significant greater tibial internal rotation compared to the adolescent patients, whereas the magnitude of the anterior tibial translation was similar in both groups. Care should be taken if clinicians plan to establish the cutoff point values for diagnosis of ACL tears using the femorotibial internal rotation angle.

Maternal Obesity Related to High Fat Diet Induces Placenta Remodeling and Gut Microbiome Shaping That Are Responsible for Fetal Liver Lipid Dysmetabolism

Background: Maternal obesity in utero may affect fetal development and cause metabolic problems during childhood and even adulthood. Diet-induced maternal obesity can impair gut barrier integrity and change the gut microbiome, which may contribute to adverse placental adaptations and increase the obesity risk in offspring. However, the mechanism through which maternal obesity causes offspring metabolic disorder must be identified.

Methods: Eight-week-old female rats received a control diet or high-fat (HF) diet for 11 weeks before conception and during gestation. The placentas were collected on gestational day 21 before offspring delivery. Placental tissues, gut microbiome, and short-chain fatty acids of dams and fetal liver tissues were studied.

Results: Maternal HF diet and obesity altered the placental structure and metabolism-related transcriptome and decreased G protein–coupled receptor 43 expression. HF diet and obesity also changed the gut microbiome composition and serum propionate level of dams. The fetal liver exhibited steatosis, enhanced oxidative stress, and increased expression of acetyl-CoA carboxylase 1 and lipoprotein lipase with changes in maternal HF diet and obesity.

Conclusions: Maternal HF diet and obesity shape gut microbiota and remodel the placenta of dams, resulting in lipid dysmetabolism of the fetal liver, which may ultimately contribute to the programming of offspring obesity.

Moringa oleifera Leaves' Extract Enhances Nonspecific Immune Responses, Resistance against Vibrio alginolyticus, and Growth in Whiteleg Shrimp (Penaeus vannamei)

Simple Summary

This study found that moringa (Moringa oleifera) leaves’ water extract triggered phenoloxidase activity, phagocytic rate, and superoxide anion production in whiteleg shrimp (Penaeus vannamei) hemocytes by an in vitro assay. By an in vivo assay, a dietary moringa extract enhanced the total hemocyte count, phenoloxidase activity, phagocytic rate, immune-related gene expressions, and growth performance of the whiteleg shrimp. The administration of dietary moringa extract increased the survival rate after challenging the whiteleg shrimp with Vibrio alginolyticus.

Abstract

Moringa is widely known as a plant with high medicinal properties. Therefore, moringa has a high potential for use as an immunostimulant in shrimp. This study investigated the effect of a moringa water extract on the immune response, resistance against V. alginolyticus, and growth performance of whiteleg shrimp. To perform the in vitro assay, hemocytes were incubated with different concentrations of the moringa extract. Furthermore, the moringa extract was incorporated at 0 (control), 1.25 g (ME1.25), 2.5 g (ME2.5), and 5.0 g (ME5.0) per kg of diet for the in vivo assay. During the rearing period, immune responses, namely the total hemocyte count (THC), phenoloxidase (PO) activity, phagocytosis activity, superoxide anion production, and immune-related gene expression were examined on days 0, 1, 2, 4, 7, 14, 21, and 28. Growth performance was measured 60 days after the feeding period. Furthermore, the shrimp were challenged with V. alginolyticus after being fed for different feeding durations. The results of the in vitro assay revealed that 100–250 ppm of the moringa extract enhanced the PO activity, phagocytic rate (PR), and superoxide anion production. The findings of the in vivo assay demonstrated that the THC, PO activity, PR, and immune-related gene expression, including alpha-2-macroglobulin, prophenoloxidase II, penaeidin2, penaeidin3, anti-lipopolysaccharide factor, crustin, lysozyme, superoxide dismutase, and clotting protein, were higher in the group of ME.25 and ME5.0 than in the control and ME1.25 at several time points. Growth performance was significantly increased (p < 0.05) in the ME2.5 group compared to the control group. Furthermore, the dietary ME2.5 resulted in a higher survival rate compared to that of the control group after challenging with V. alginolyticus, especially at ME2.5 administered for 4 and 7 days. This study indicated that the incorporation of the moringa extract at 2.5 g per kg of diet enhanced the immune response, the growth performance of the whiteleg shrimp, and the resistance against V. alginolyticus infection.

Guava (Psidium guajava) leaf extract enhances immunity, growth, and resistance against Vibrio parahaemolyticus in white shrimp Penaeus vannamei

This study investigated the effects of guava leaf extract (GLE) on immune responses, growth performance, and resistance to Vibrio parahaemolyticus in white shrimp (Penaeus vannamei). To examine the effect of GLE on the immune response of white shrimps, they were treated with various concentrations of GLE on hemocyte (in vitro) and were orally administered (in vivo) feed containing various concentrations of 0, 1, 5, and 10 g kg^-1 GLE (control, GLE1, GLE5, and GLE10, respectively) for 28 days. Furthermore, their growth performance was evaluated for 56 days. In a separate experiment, the shrimps were challenged with V. parahaemolyticus injection after 7 days of culture. In vitro experiments indicated that GLE is nontoxic and can activate immune response. In vivo experiments revealed that the GLE5 led to the highest total hemocyte count, phenoloxidase activity, phagocytic activity, and superoxide anion production and the highest upregulation of lipopolysaccharide, β-1,3-glucan-binding protein, peroxinectin, lysozyme, crustin, penaeidin 2, penaeidin 3, clotting protein, superoxide dismutase, and glutathione peroxidase. Moreover, better growth performance was observed in the GLE groups, with GLE5 exhibiting the highest specific growth rate, weight gain, and feed conversion rate. In addition, GLE5 enhanced resistance to V. parahaemolyticus, with a survival rate of 72.27%. In conclusion, GLE was found to be effective in enhancing nonspecific immune response and growth performance and in reducing V. parahaemolyticus infection in white shrimp.

[Applying Self-Management Strategies to the Control of Interdialytic Weight Gain in Hemodialysis Patients]

BACKGROUND & PROBLEMS

The control of interdialytic weight gain (IDWG) in hemodialysis patients is crucial for maintaining dialysis quality. The results of a survey in our department revealed patients to be unmotivated, have poor self-control, not regularly manage their fluid intake or measure their body weight, and discount the importance of controlling IDWG. The nursing instruction adherence for IDWG control among nurses was only 61.6%. Moreover, the leaflet used for nursing instruction used highly repetitive messaging and lacked pictorial aids. Consequently, up to 48.6% of the patients in our department had an IDWG dry weight percentage of ≥ 5%.

PURPOSE

To reduce the proportion of hemodialysis patients with an IDWG dry weight percentage of ≥ 5% from the current 48.6% to 29.2%.

RESOLUTION

From August 1, 2019 to May 31, 2020, the improvement program developed in this project included: (1) the addition of an IDWG calculation and reminder function in the information system; (2) development of nursing instruction tools for IDWG control; (3) utilization of self-management strategies to establish care operations for IDWG control; (4) the organization of group health education sessions, dialysis patient seminars, and on-the-job training sessions; and (5) implementation of an audit program for IDWG-control nursing instruction.

RESULTS

The proportion of patients with an IDWG dry weight percentage of ≥ 5% decreased to 28.8% and the number of patients who developed acute complications during dialysis decreased from 42 to 15 (35.7%).

CONCLUSIONS

IDWG in dialysis patients was effectively decreased by establishing a standard operating procedure for IDWG control, designing a self-management record form, and implementing nursing instruction for IDWG control. It is hoped that the adopted measures promote dialysis quality and reduce complications during dialysis.

Improving K-12 Teachers' Acceptance of Open Educational Resources by Open Educational Practices: A Mixed Methods Inquiry

Teachers in K-12 settings increasingly demand instructional materials beyond textbooks to follow the upward momentum of personalized instruction. Especially during the outbreak of COVID-19, K-12 teachers are forced to quickly adapt to online teaching and thus have more difficulties of delivering personalized instruction in a relatively resource-restraint situation. Open educational resources (OER), allowing teachers to retain, reuse, revise, remix, and redistribute high-quality educational resources at no costs, can be a viable option for teachers. However, the acceptance of OER in K-12 education still remains low. Effective strategies are needed to reinforce teacher intention to adopt OER. This research showcased a two-phase sequential explanatory mixed method inquiry to investigate whether engaging K-12 teachers in open educational practices (OEP)-such as renewable assignments-increased their acceptance of OER. The quantitative phase, referring to the technology acceptance model (TAM), examined the change in factors influencing teachers' acceptance of OER. The qualitative phase was followed up to provide supplementary perspectives of the quantitative findings. By integrating complementary findings, this research found that OEP increased teachers' perceived ease of and self-efficacy towards using OER. Although teachers' intention of implementing OER is not significantly improved, qualitative findings offered additional insights into the benefits of OEP in promoting OER usage and the recommended directions for future effort. Practical implications on improving teachers' acceptance of OER in K-12 curriculum are discussed at the end.

Genetic variants associated with serum alanine aminotransferase levels among patients with hepatitis C virus infection: A genome-wide association study

Information on genetic variants associated with elevated serum alanine aminotransferase (ALT) levels remains limited. A genome-wide association study was performed to identify single-nucleotide polymorphisms (SNPs) associated with ALT levels. The ALT-associated SNP was further evaluated for hepatocellular carcinoma (HCC) risk. A cohort of 892 anti-HCV seropositive patients was used for genome-wide SNP array to examine the associations with baseline ALT levels. SNPs <10^-5 were further tested for associations with serial ALT levels then validated in 486 anti-HCV seropositives. Multinomial logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals of SNPs associated with ALT. The SNP was evaluated for HCC risk by using Cox's proportional hazards models. After quality control, 803 participants with 564,464 SNPs were included in the analysis. Of these, 12 SNPs were associated with ALT (p < 10^-5 ). Among the participants, 158 (19.7%) had ALT persistently ≤15 U/L, 327 (40.7%) ever >15 U/L but never >45 U/L, and 318 (39.6%) ever >45 U/L during follow-up. The rs568800 was associated with serial ALT levels, and this was replicated in the external population significantly (p < .05). The A allele (vs C) of rs568800 was associated with ALT >15 U/L but ≤45 U/L and ALT >45 U/L, with the adjusted ORs of 1.41 (1.11-1.78) and 1.86 (1.34-2.60), respectively. The adjusted HRs for HCC were 2.09 (0.90-4.89) for AC and 2.64 (1.13-6.17) for AA (CC as a reference). In conclusion, the rs568800 was associated with serum ALT levels and HCC risk. Clinical utility should be evaluated among patients who have received antivirals.

Macro-Ck type 2 syndrome in prostate adenocarcinoma: Case report and review article

A 67-year-old male had prostate adenocarcinoma with liver, bone metastases, iliac lymph nodes invasion ever receive hormone and chemotherapy. He was presented to our emergency department with acute onset of mild dizziness and shortness of breath. Elevated CK (1477 U/L) and elevated CK-MB (1602 U/L) was noticed. Electrocardiogram was unremarkable for myocardial ischemia. CK-isoenzyme lab test (electrophoresis) was obtained, which revealed macro CK type 2 accounting for 6.2% of total CK. Type 2 macro CK syndrome was impressed. The falsely elevated CK-MB and macro CK type 2 in serum may be associated with the patient's worsening metastatic disease.

The Functional DNA Methylation Signatures Relevant to Altered Immune Response of Neonatal T Cells with l-Arginine Supplementation

l-Arginine is an important nutrient in the infant diet that significantly regulates the maturation of the immune system in neonates, including the maturation of CD4⁺ T cells. The biological activities of CD4⁺ T cells differ substantially between neonates and adults, and these differences may be governed by epigenetic processes. Investigating these differences and the causative processes may help understand neonatal and developmental immunity. In this study, we compared the functional DNA methylation profiles in CD4⁺ T cells of neonates and adults, focusing on the role of l-arginine supplementation. Umbilical cord blood and adult CD4⁺ T cells were cultured with/without l-arginine treatment. By comparing DNA methylation in samples without l-arginine treatment, we found that CD4⁺ T cells of neonatal cord blood generally showed higher DNA methylation than those of adults (average CpG methylation percentage 0.6305 for neonate and 0.6254 for adult, t-test p-value < 0.0001), suggesting gene silencing in neonates. By examining DNA methylation patterns of CpG dinucleotides induced by l-arginine treatment, we found that more CpG dinucleotides were hypomethylated and more genes appeared to be activated in neonatal T-cells as compared with adult. Genes activated by l-arginine stimulation of cord blood samples were more enriched regarding immune-related pathways. CpG dinucleotides at IL-13 promoter regions were hypomethylated after l-arginine stimulation. Hypomethylated CpG dinucleotides corresponded to higher IL-13 gene expression and cytokine production. Thus, DNA methylation partially accounts for the mechanism underlying differential immune function in neonates. Modulatory effects of l-arginine on DNA methylation are gene-specific. Nutritional intervention is a potential strategy to modulate immune function of neonates.

Association of sibling presence with language development before early school age among children with developmental delays: A longitudinal study

BACKGROUND/PURPOSE

Having siblings is a crucial ecological factor in children's language development. Whether siblings play a role in the language development of children with developmental delays remains unknown. This study therefore aimed to assess the association between sibling presence and changes in language trajectories of children with developmental delays before reaching early school age.

METHODS

This retrospective cohort-sequential longitudinal study analyzed data from an institution designated by Taiwan's Ministry of Health and Welfare for assessing and identifying young children with developmental delays between December 2008 and February 2016. We included 174 children, aged 10-58 months (mean [standard deviation (SD)], 31.74 [10.15] months), with developmental delays who underwent at least three waves of evaluation. The final evaluation occurred at 37-90 months of age. Data collection spanned over an age from 10 to 90 months. The primary outcome was language delays as determined by board-certified speech-language pathologists.

RESULTS

Of the 174 participants (131 boys), 64.94 % (n = 113) had siblings. The likelihood of both receptive language delay and expressive language delay for participants with siblings increased gradually from 10 to 90 months and exceeded that of participants without siblings, respectively (adjusted odds ratios [aOR], 1.04, 1.04; 95 % confidence interval [CI], 1.01-1.07, 1.01-1.07; P = 0.014, 0.020).

CONCLUSIONS

Having siblings does not necessarily positively associate with language development in children with developmental delays. Clinicians should consider the association of sibling presence with language development for these children in a broader familial-ecological context before they reach early school age.

Monopronucleated (1PN) and tripronuclear (3PN) zygotes formation during assisted reproduction in POSEIDON group 4 patients: Emphasizing on polar bodies

AIM

Abnormal fertilization (1PN/3PN) and its accompanying polar body (PB) conditions have been less discussed in poor ovarian responders. By observing the PBs, we analyzed the mechanisms of abnormal fertilization and aimed to explore the role of intracytoplasmic sperm injection/in vitro fertilization (ICSI/IVF) in POSEIDON group 4 patients.

METHODS

An observational study. All fresh IVF/ICSI cycles from January 2018 to December 2019 were evaluated. The inclusion criteria were POSEIDON group 4. Fertilization and PB conditions were assessed 16-18 h post-insemination. Primary observation endpoints including normal fertilization, abnormal fertilization, and total fertilization failure rate.

RESULTS

A total of 351 cycles involving 180 patients met the inclusion criteria. Of these, 15 cycles reported no retrieved oocytes. Finally, 336 cycles (IVF, n = 267; ICSI, n = 69) were included. A total of 1005 oocytes and 939 embryos were assessed. The mean female age was 40.8 years, and the mean AMH level was 0.6 ng/mL. The normal fertilization rate was 69.7%. The zygote distribution was 18.7% 0PN, 3.9% 1PN, 66.9% 2PN, 9.5% 3PN, and 1.0% ≥4PN. For 1PN zygotes, 59% were denoted as 1PN2PB. The mean 3PN rate was 8.9%.

CONCLUSIONS

In POSEIDON group 4, most of the monopronucleated zygotes were 1PN2PB. Digyny (3PN1PB), due to failure to extrude the second PB, was the major cause of triploidy in which ICSI could not circumvent. The distribution of abnormally fertilized zygotes was similar in IVF and ICSI. To investigate the mechanisms of abnormal fertilization and assess whether ICSI is necessary, analysis of PB will provide important clues.

Prenatal Exposure to Di-Ethyl Phthalate (DEP) Is Related to Increasing Neonatal IgE Levels and the Altering of the Immune Polarization of Helper-T Cells

Introduction: Phthalates are substances that are added to plastic products to increase their plasticity. These substances are released easily into the environment and can act as endocrine disruptors. Epidemiological studies in children have showed inconsistent findings regarding the relationship between prenatal or postnatal exposure to phthalates and the risk of allergic disease. Our hypothesis is that prenatal exposure to phthalates may contribute to the development of allergies in children. Material and methods: The objective of this study was to determine the associations between urinary phthalate metabolite concentrations in pregnant women, maternal atopic diathesis, maternal lifestyle, and cord blood IgE. Pregnant mothers and paired newborns (n = 101) were enrolled from an antenatal clinic. The epidemiologic data and the clinical information were collected using standard questionnaires and medical records. The maternal blood and urine samples were collected at 24–28 weeks gestation, and cord blood IgE, IL-12p70, IL-4, and IL-10 levels were determined from the newborns at birth. The link between phthalates and maternal IgE was also assessed. To investigate the effects of phthalates on neonatal immunity, cord blood mononuclear cells (MNCs) were used for cytokine induction in another in vitro experiment. Results: We found that maternal urine monoethyl phthalate (MEP) (a metabolite of di-ethyl phthalate (DEP)) concentrations are positively correlated with the cord blood IgE of the corresponding newborns. The cord blood IL-12p70 levels of mothers with higher maternal urine MEP groups (high DEP exposure) were lower than mothers with low DEP exposure. In vitro experiments demonstrated that DEP could enhance IL-4 production of cord blood MNCs rather than adult MNCs. Conclusion: Prenatal DEP exposure is related to neonatal IgE level and alternation of cytokines relevant to Th1/Th2 polarization. This suggests the existence of a link between prenatal exposure to specific plasticizers and the future development of allergies.

Evolutionary history of H5 highly pathogenic avian influenza viruses (clade 2.3.4.4c) circulating in Taiwan during 2015-2018

The highly pathogenic avian influenza (HPAI) virus A/goose/Guangdong/1/96 H5N1 (Gs/GD) lineage has been transmitted globally and has caused deaths in wild birds, poultry, and humans. Clade 2.3.4.4c, one of the subclades of the Gs/GD lineage, spread through Taiwan in late 2014 and become an endemic virus. We analyzed 239 newly sequenced HPAI clade H5Nx isolates to explore the phylogenetic relationships, divergence times, and evolutionary history of Taiwan HPAI H5Nx viruses from 2015 to 2018. Overall, 15 reassortant genotypes were identified among H5N2, H5N3, and H5N8 viruses. Maximum likelihood and Bayesian phylogenies based on homologous hemagglutinin (HA) and matrix protein (MP) genes suggest that Taiwan HPAI H5Nx viruses share a most recent common ancestor that has diversified since October 2014 and is closely related to two HPAI H5N8 viruses identified from wild birds in Japan. Two waves of HPAI caused by multiple reassortants were identified, the first occurring in late 2014 and the second beginning in late 2016. The first wave consisted of seven H5Nx reassortants that spread through Taiwan. In the second wave, eight novel reassortants were detected which had newly introduced internal genes, mostly derived from the avian influenza virus gene pool maintained in wild birds in Asia. Phylodynamic reconstruction using the Bayesian Skygrid model revealed varied fluctuating patterns of relative genetic diversity among reassortants. The mean evolutionary rate also varied among reassortants and subtypes. The neuraminidase (NA) gene evolved faster than the HA gene in H5N2 viruses, while HA evolved faster than NA in H5N8 viruses. The HA mean evolutionary rate ranged from 6.10 × 10^-3 to 7.73 × 10^-3 and from 5.81 × 10^-3 to 9.45 × 10^-3 substitutions/site/year for H5N2 and H5N8 viruses, respectively. The continuous circulation of HPAI H5Nx variants and the emergence of novel reassortants in Taiwan highlight that the surveillance, biosecurity, and management systems of poultry farms need to be improved and carefully executed.

Transmembrane and coiled-coil domain family 3 (TMCC3) regulates breast cancer stem cell and AKT activation

Cancer stem cells (CSC) play a pivotal role in cancer metastasis and resistance to therapy. Previously, we compared the phosphoproteomes of breast cancer stem cells (BCSCs) enriched subpopulation and non-BCSCs sorted from breast cancer patient-derived xenograft (PDX), and identified a function unknown protein, transmembrane and coiled-coil domain family 3 (TMCC3) to be a potential enrichment marker for BCSCs. We demonstrated greater expression of TMCC3 in BCSCs than non-BCSCs and higher expression of TMCC3 in metastatic lymph nodes and lungs than in primary tumor of breast cancer PDXs. TMCC3 silencing suppressed mammosphere formation, ALDH activity and cell migration in vitro, along with reduced tumorigenicity and metastasis in vivo. Mechanistically, we found that AKT activation was reduced by TMCC3 silencing, but enhanced by TMCC3 overexpression. We further demonstrated that TMCC3 interacted directly with AKT through its 1-153 a.a. domain by cell-free biochemical assay in vitro and co-immunoprecipitation and interaction domain mapping assays in vivo. Based on domain truncation studies, we showed that the AKT-interacting domain of TMCC3 was essential for TMCC3-induced AKT activation, self-renewal, and metastasis. Clinically, TMCC3 mRNA expression in 202 breast cancer specimens as determined by qRT-PCR assay showed that higher TMCC3 expression correlated with poorer clinical outcome of breast cancer, including early-stage breast cancer. Multivariable analysis identified TMCC3 expression as an independent risk factor for survival. These findings suggest that TMCC3 is crucial for maintenance of BCSCs features through AKT regulation, and TMCC3 expression has independent prognostic significance in breast cancer. Thus, TMCC3 may serve as a new target for therapy directed against CSCs.

[A Project to Improve the Ability of Hemodialysis Staff to Respond to Fire Emergencies]

BACKGROUND & PROBLEMS

In case of fire in the hemodialysis room, it is necessary to help patients get away from dialysis machines smoothly and safely and evacuate the room rapidly. Our unit is located on a higher floor. An investigation showed that the accuracy rate for fire response awareness among the staffs in our unit was only 57.9%, while the accuracy rate of fire response skill operations was only 57.4%. Moreover, 62.0% of the staffs were not clear about the task grouping and task content of fire response. Confusion in our unit regarding the definition of patient mobility led to staffs classifying patients based on subjective perceptions and standards. Moreover, the unit also lacked an audit system for fire emergency operations and fire-response-related learning materials.

PURPOSE

To improve staff knowledge and skills related to fire emergency response in the hemodialysis room to 100%.

RESOLUTION

The project team worked out solutions such as adding a self-defense fire-fighting group to the dialysis information system, producing fire emergency response learning materials, establishing a seed personnel system, organizing on-the-job education, organizing fire response simulation drills, and implementing an audit system.

RESULTS

The awareness of fire emergency response and the accuracy of skill operation among the staff were both improved to 100%, and there were statistically significant differences between the pre-test and post-test paired t-test results. Furthermore, consistent implementation of these resolution measures maintained the staff`s fire emergency response skills at 100% between June 2019 and May 2020.

CONCLUSIONS

Tabletop simulation, practice drills, and skill operation audits are effective tools for improving the ability of staff in the hemodialysis room to respond to fire emergencies. It is recommended that institutions produce tabletop simulation props and combine regular on-site drills to improve the readiness of their staffs to respond to fire emergencies, which will shorten the response time during incidents.

An analysis of the continuing professional development needs of radiographers and radiation therapists in Singapore

INTRODUCTION

Continuing Professional development (CPD) is deemed essential for the Radiographers (DR) and Radiation Therapists (RT) after Singapore commenced state registration. Diagnostic imaging and radiotherapy treatment services are constantly revolutionizing and those working in this field requires sufficient knowledge of the uptrends for training and development. The purpose of this survey is to identify the current training needs of the registered DR and RT in Singapore, and to understand their views about CPD activities.

METHODS

An online questionnaire was disseminated by the Singapore Society of Radiographers (SSR) to all registered DR and RT in Singapore, and all practicing in restructured and private hospitals were included. Data collection took place from January 2018 to April 2018.

RESULTS

102 responses were analysed, where 89 were DR and 13 were RT. CPD was provided in 72.5% (n = 74) of the participants' institutions, and 69.6% (n = 71) of participants were aware of CPD. Interestingly, participants were significantly more likely to be unaware of CPD when working in an institution which do not offer CPD. Training programme objective was the most important factor for selecting a programme. 93.1% (n = 95) preferred SSR to support them for CPD. There were a few constraints to CPD engagements identified such as financial factors, lack of time, and institution availability.

CONCLUSION

There was significant intrinsic motivation in a quality CPD activity. CPD activities should be current, accessible and relevant for the healthcare professionals to increase participation, which directly contributes to high standards of clinical care.

IMPLICATIONS FOR PRACTICE

Local healthcare institutions should be aware and address needs, gaps and aspirations of the local DR and RT community to ensure adequate preparation has been made upon initiation of mandatory CPD.

Influence of cellulose nanocrystals (CNC) on permeation through intestinal monolayer and mucus model in vitro

Cellulose nanocrystals (CNC) as a novel ingredient in foods and pharmaceuticals still lacks the safety and functionality information. We aimed to assess the absorption of CNC in small intestine and the effect on cell viability. In the second part, the impact of CNC on substance permeation through mucus layer, including the potential functionality in improving high blood cholesterol, was tested. No noticeable amount of CNC was found to penetrate through differentiated Caco-2 monolayer and in vitro mucus layer, and CNC had low toxicity on Caco-2 cell viability up to 10 mg/mL. CNC at 2 % (w/w) may affect the permeability of the mucus layer and larger molecules are more easily influenced. CNC may also alleviate hypercholesteremia by increasing viscosity of digesta, adsorbing cholesterol, and decreasing bile acids permeation. The results suggest CNC may not penetrate the small intestinal lining and may be used as a functional supplement.

Effectiveness and healthcare costs of eribulin versus capecitabine among metastatic breast cancer patients in Taiwan

OBJECTIVE

To compare the real-world effectiveness and costs of eribulin to those of capecitabine in patients with metastatic breast cancer (MBC) pretreated with anthracyclines and taxanes.

METHODS

This study extracted data from the Health and Welfare Database in Taiwan to identify MBC patients, and then eribulin and capecitabine users were matched at a 1:1 ratio by age, residential region, Charlson Comorbidity Index score, and molecular subtype of BC cell. The overall survival (OS) and time-to-treatment discontinuation (TTD) curves were plotted using the Kaplan-Meier method. Healthcare utilization and costs between the two groups were compared.

RESULTS

A total of 24,550 MBC patients were identified, and 298 patients were enrolled in each group after matching. The median OS was 11.8 months for eribulin (95%CI: 11.5-13.5 months) and 15.2 months for capecitabine (95%CI: 15.3-17.9 months; HR = 1.7, p < 0.0001). The median TTD was 4.0 months for eribulin and 6.6 months for capecitabine (HR = 1.6; p < 0.0001). No significant difference was found between the two groups in patients with >4 prior chemotherapy agents (OS: HR 1.1, 95%CI 0.8-1.5; TTD: HR 1.2, 95%CI 0.9-1.7). The total healthcare costs per patient during the treatment period were NT$580,523.8 for eribulin versus NT$497,223.8 for capecitabine (p < 0.0001), and total medication costs were NT$438,335.8 and NT$348,438.4 (p < 0.0001), respectively.

CONCLUSION

Although eribulin showed an attenuated effect in the real-world setting in Taiwan, it may serve as an alternative for capecitabine in a heavy pretreated population. The total healthcare and medication costs were found to be higher with eribulin treatment.

Psychiatric comorbidity and social adjustment difficulties in children with disruptive mood dysregulation disorder: A national epidemiological study

BACKGROUND

We examined correlates, psychiatric comorbidities, and social adjustment difficulties in children with disruptive mood dysregulation disorder (DMDD) from a national epidemiological study in Taiwan.

METHODS

The sample consisted of 4816 children, who were 3^rd, 5^th, and 7^th graders from schools randomly chosen based on the urbanization level in a recent national survey of childhood mental disorders. Among the 4816 children (2520 boys, 52.3%) interviewed using the Kiddie epidemiologic version of the Schedule for Affective Disorders and Schizophrenia (K-SADS-E) for the DSM-5, 30 children were diagnosed as DMDD (23 boys, 76.7%). They and their parents also reported on the Social Adjustment Inventory for Children and Adolescents (SAICA). We conducted regressions for survey data that controlled for stratification and clustering.

RESULTS

The weighted prevalence of DMDD was 0.3~0.76% in Taiwanese children. Lower parental educational levels, male predominance, higher psychiatric comorbidities, and worse self-report school functions (e.g., more behavioral problems with peers) were observed in children with DMDD than those without. Additional analyses revealed that oppositional defiant disorder (ODD) but not DMDD was related to conduct disorder. Children with ODD with or without DMDD had more problems regarding attitudes toward school, academic performance, and parent-child interaction at home than those with DMDD-only.

LIMITATIONS

Small sample size of DMDD.

CONCLUSIONS

DMDD is a rare disorder in the community. Children with DMDD had more psychiatric comorbidities, and subjectively experienced more difficulties than those without. DMDD and ODD both resulted in severe impairment yet in different domains.

Disposition of embryos from women who only produced morphologically poor embryos on day three

Background

The presence of only morphologically poor embryos (MPEs) on day3 is common in autologous in vitro fertilization (IVF), particularly among p Tel: 886-7-7317123 Ext. 8916. Fax: 886-7-7322915.atients who have advanced maternal age or are poor responders. However, there are limited data regarding the disposition of embryos from patients who only produced MPEs on day3. The present study was designed to investigate the possible benefits of extended culturing MPEs. Try to detect whether the extended culture (day4 or day5 culture) can improve the live birth rate per cycle?

Methods

This retrospective, observational, single-center, cohort study examined 224 IVF/intracytoplasmic sperm injection (ICSI) cycles between January 2010 and June 2015, in which women only produced MPEs on day3. A total of 544 MPEs were analyzed. The defines a day3 embryo as an MPE if it fails to develop to eight cells, blastomeres of equal size, and less than 20% cytoplasmic fragments. Of the 224 cycles, 89 (39.7%) underwent fresh embryo transfer on day3, and 135 (60.3%) underwent extended culture. Of the 135 extended cultures, 54 cycles (40.0%) experienced day4, or day5 embryo transfer, 16 cycles (11.9%) had all embryos frozen, and 65 cycles (48.1%) had total embryo arrest.

Results

Analysis of patient baseline demographic data, cycle characteristics, and cycle outcomes for day3 transfer group and extended culture group indicated that a higher body mass index in the day3 transfer group was the only significant difference (p = 0.006). Both fresh transfer groups had low live birth rates (LBRs) (4.5% vs. 7.4% p = 0.46). After extended culture, 65 cycles (48.1%) were cancelled because the embryos exhibited developmental arrest and 70 cycles (51.9%) grew to day4 or day5. Thirteen frozen embryo transfer (FET) cycles and 22 frozen blastocysts derived from MPEs were thawed. There were more high-quality embryos (p < 0.001), higher implantation rates (IRs) (p = 0.038), and higher LBRs (p = 0.042) for embryos that underwent FET cycles. MPES in extended culture transfer have favorable survival than MPES in day3 transfer.

Conclusion

The extended culture of MPEs in fresh transfer cycles did not increase the LBR. However, younger females with the extended culture of MPEs followed by FET resulted in significantly higher LBRs and may be a feasible strategy to improve outcomes for patients with poor embryo quality. However, day3 embryo transfer may be a better choice if a fresh transfer is unrestricted and avoid the cycle cancellation. Extended culture may decrease to the transfer of developmental potential arrest embryos to patients.

High B3GALT5 expression confers poor clinical outcome and contributes to tumor progression and metastasis in breast cancer

BACKGROUND

Existence of breast cancer stem cells (BCSCs) is implicated in disease relapse, metastasis, and resistance of treatment. β1,3-Galactosyltransferase 5 (B3GALT5) has been shown to be a pro-survival marker for BCSCs. However, little is known about the prognostic significance of B3GALT5 in breast cancer.

METHODS

Paired tissues (tumor part and adjacent non-tumor part) from a cohort of 202 women with breast cancer were used to determine the expression levels of B3GALT5 mRNA by qRT-PCR. Kaplan-Meier and multivariable Cox proportional hazard models were used to assess survival differences in terms of relapse-free survival (RFS) and overall survival (OS). Both breast cancer cells and cancer stem cells (BCSCs) were used to see the in vitro effects of knockdown or overexpression of B3GALT5 on cell migration, invasion, and epithelial-to-mesenchymal transition (EMT). A patient-derived xenograft (PDX) model was used to see the in vivo effects of knockdown of B3GALT5 in BCSCs on tumor growth and metastasis.

RESULTS

Higher expression of B3GALT5 in 202 breast cancer tissues, especially in adjacent non-tumor tissue, correlated with poor clinical outcomes including shorter OS and RFS in all patients, especially those with early stage breast cancer. In vitro studies showed B3GALT5 could enhance cell migration, invasion, mammosphere formation, and EMT. Of note, B3GALT5 upregulated the expression of β-catenin and EMT activator zinc finger E-box binding homeobox 1 (ZEB1) pathway in BCSCs. In vivo studies showed B3GALT5 expression in BCSCs is critical for not only tumor growth but also lymph node and lung metastasis in PDX mice.

CONCLUSION

Our results demonstrated the value of B3GALT5 as a prognostic marker of breast cancer, especially among the early stage patients, and its crucial roles in regulating EMT, cell migration, and stemness thereby promoting breast cancer progression.

Epidemiology of Virus Infection and Human Cancer

Seven viruses including the Epstein-Barr virus (EBV), hepatitis B virus (HBV), hepatitis C virus (HCV), Kaposi's sarcoma herpes virus (KSHV), human immunodeficiency virus, type-1 (HIV-1), human T cell lymphotrophic virus, type-1 (HTLV-1), and human papillomavirus (HPV) have been classified as Group 1 human carcinogens by the International Agency for Research on Cancer (IARC). The conclusions are based on the findings of epidemiological and mechanistic studies. EBV, HPV, HTLV-1, and KSHV are direct carcinogens; HBV and HCV are indirect carcinogens through chronic inflammation; and HIV-1 is an indirect carcinogen through immune suppression. Some viruses may cause more than one cancer, while some cancers may be caused by more than one virus. However, only a proportion of persons infected by these oncogenic viruses will develop specific cancers. A series of studies have been carried out to assess the viral, host, and environmental cofactors of EBV-associated nasopharyngeal carcinoma, HBV/HCV-associated hepatocellular carcinoma, and HPV-associated cervical carcinoma. Persistent infection, high viral load, and viral genotype are important risk predictors of these virus-caused cancers. Risk calculators incorporating host and viral risk predictors have been developed for the prediction of long-term risk of hepatocellular carcinoma, nasopharyngeal carcinoma and cervical cancer. These risk calculators are useful for the triage and clinical management of infected patients. Both clinical trials and national programs of immunization, antiviral therapy and screening have demonstrated a significant reduction in the incidence of cancers caused by HBV, HCV, and HPV. Future research on gene-gene and gene-environment interactions of oncogenic viruses and the human host using large-scale longitudinal studies with serial measurements of biosignatures are in urgent need.