Search Results (194)

Background/Objectives: Lactobacillus kefiranofaciens HL1, isolated from kefir, exhibits antioxidant and anti-aging activities, defined here as improved cognitive function and reductions in oxidative stress and inflammatory markers. However, its poor milk viability limits application. This study developed a novel fermented milk by co-culturing HL1 with Lactococcus lactis subsp. cremoris APL015 (APL15) to enhance fermentation and health benefits. Methods: HL1 and APL15 were co-cultured to produce fermented milk (FM), and fermentation performance, microbial viability, texture, and syneresis were evaluated. A D-galactose-induced aging BALB/c mouse model was used to assess cognitive function, oxidative stress, inflammation, antioxidant enzyme activity, and gut microbiota after 8 weeks of oral administration. Results: FM reached pH 4.6 within 16 h, with high viable counts (~10⁹ CFU/mL) for both strains. HL1 viability and texture were maintained, with smooth consistency and low syneresis. In vivo, FM improved cognitive behavior (Y-maze, Morris water maze), reduced oxidative damage (MDA), lowered IL-1β and TNF-α, and enhanced brain SOD levels. FM-fed mice exhibited increased short-chain fatty acid producers, higher cecal butyrate, and reduced Clostridium perfringens. Conclusions: The co-cultured fermented milk effectively delivers HL1 and provides antioxidant, anti-inflammatory, and anti-aging effects in vivo, likely via gut–brain axis modulation. It shows promise as a functional food for healthy aging. Full article

Objective: Existing clinical data suggest that Huaier granules effectively improve the condition of PLC patients. However, their specific efficacy and safety in PLC patients remain unclear. This study aimed to investigate the effects of Huaier granules as an adjunctive therapy for PLC patients. Methods: This cohort study includes 4577 PLC patients, with data retrieved up to 2024. The patients were divided into the Huaier group (n = 2404) and a control group (n = 2173), and the treatment effects and safety between the two groups were compared. Review Manager 5.3 was used to analyze the clinical data. The fixed-effects and random-effects models were adopted. Stata 17.0 was used for sensitivity and bias analyses to evaluate publication bias. Results: Heterogeneity testing and analysis using a random-effects model showed that the combination of Huaier granules and conventional treatment significantly reduced the recurrence rate (OR = 0.65, 95% CI 0.50–0.85, p = 0.002) and improved the one-year survival rate (OR = 0.79, 95% CI 0.65–0.96, p = 0.02). Huaier granules also improved quality of life, reduced AFP levels (p < 0.00001), and significantly impacted immune function by altering the levels of the T lymphocyte subtypes CD³⁺, CD⁴⁺, CD⁸⁺ and the CD⁴⁺/CD⁸⁺ ratio. When Huaier granules were used in combination with other medications, no significant changes in side effects were observed. Conclusions: Huaier combination therapy shows good therapeutic efficacy and safety in PLC patients. However, this conclusion needs to be further validated through prospective clinical studies. Full article

Early detection of early-stage esophageal cancer (ECA) is crucial for timely intervention and improved treatment outcomes. Hyperspectral imaging (HSI) and artificial intelligence (AI) technologies offer promising avenues for enhancing diagnostic accuracy in this context. This study utilized a dataset comprising 3984 white light images (WLIs) and 3666 narrow-band images (NBIs). We employed the Yolov5 model, a state-of-the-art object detection algorithm, to predict early ECA based on the provided images. The dataset was divided into two subsets: RGB-WLIs and NBIs, and four distinct models were trained using these datasets. The experimental results revealed that the prediction performance of the training model was notably enhanced when using HSI compared to general NBI training. The HSI training model demonstrated an 8% improvement in accuracy, along with a 5–8% enhancement in precision and recall measures. Notably, the model trained with WLIs exhibited the most significant improvement. Integration of HSI with AI technologies improves the prediction performance for early ECA detection. This study underscores the potential of deep learning identification models to aid in medical detection research. Integrating these models with endoscopic diagnostic systems in healthcare settings could offer faster and more accurate results, thereby improving overall detection performance. Full article

Objectives: To review the outcomes of patients who underwent repeated vertebroplasty (VP) surgery for adjacent segment fractures (ASF), defined as new osteoporotic vertebral fractures occurring at levels immediately above or below a previously treated vertebra. Methods: From 1 January 2018, to 31 December 2020, forty-one patients who developed ASF following initial VP and underwent repeated VP were enrolled in our study. Radiographic measurements included single and two-segment kyphotic angles (SKA and TKA), and anterior and mid-vertebral body height (AVH and MVH). Patient-reported outcomes included back pain assessed with the visual analog scale (VAS) and the Oswestry Disability Index (ODI). Results: The procedure significantly reduced the mean single kyphotic angle (SKA) by 4.8° ± 6.8° (p < 0.01) and the two-segment kyphotic angle (TKA) by 3.0° ± 7.9° (p = 0.02), along with increases in anterior and mid-body height by 0.3 ± 0.5 cm and 0.3 ± 0.6 cm (both p < 0.01). However, there was a slight restoration loss in SKA and TKA at a 20.1-month follow-up. Patient-reported outcomes revealed substantial pain reduction, with the VAS score dropping from 8 to 1 (p < 0.0001) and the mean ODI score improving from 59.7 to 28.9 (p < 0.0001). The complication rate was 34.1%, including nonunion, de novo fractures, cement leakage, and neurological deficits. Additionally, 7.3% of cases necessitated further surgical interventions. Conclusions: Repeated VP for ASF improves vertebral alignment parameters and patient-reported outcomes, but with a high rate of complications and reoperation. Full article

Background: Hallux valgus is a common forefoot disorder with hundreds of proposed management techniques. Distal chevron osteotomy with a modified McBride procedure has been traditionally recommended for mild hallux valgus because of its simple and less invasive nature with fewer complications, faster recovery, and reliable outcomes. In recent years, the indications for this procedure have expanded to include hallux valgus with severe deformities. This study aims to compare the radiographic outcomes of the surgical treatment for moderate versus severe hallux valgus patients from the perspective of sesamoid bone reduction. Materials and Methods: A retrospective review of medical records identified 99 feet from 94 patients that were treated with distal chevron osteotomy with a modified McBride procedure. These feet were divided by the preoperative hallux valgus angle and intermetatarsal angle into the moderate and severe groups. Results: Postoperative radiographic parameters significantly improved in both groups after treatment, indicating adequate deformity correction. Improvement in the sesamoid position was better in the moderate group compared to that in the severe group. The recurrence rate in the severe group was higher than that in the moderate group without statistical significance. Conclusions: Based on the radiographic results of the postoperative position following sesamoid reduction, the distal chevron osteotomy with a modified McBride procedure is effective for treating moderate hallux valgus deformities. However, this treatment strategy may be associated with a higher recurrence rate in cases of severe hallux valgus deformity. A complete reduction in the sesamoids should be emphasized during the management of severe hallux valgus deformity. Full article

In recent years, numerous researchers have incorporated plant fibers into polymers to alter the thermal and mechanical properties of materials. Grapevines, considered agricultural waste, have led to burdens for farmers and environmental challenges due to their mass production. This study aims to reduce the brittleness of polylactic acid (PLA) by adding polybutylene succinate (PBS) as a toughening agent and employing grapevine fiber (GVF) as a biomass filler. Additionally, the influence of GVF, toughening agents, compatibilizers, and lubrication agents on the tensile strength, heat deflection temperature (HDT), and impact strength of the composites was examined. The findings revealed that the addition of 10% GVF and 5% PBS increased the impact and tensile strengths of PLA from 17.47 J/m and 49.74 MPa to 29.7 J/m and 54.46 MPa, respectively. Moreover, the HDT of the composites exceeded 120 °C when the GVF content was more than 40 wt%. Additionally, the inclusion of a compatibilizer and a lubrication agent enabled the composite containing 30% GVF to achieve tensile and impact strengths of 45.30 MPa and 25.52 J/m, respectively. Consequently, these GVF/PLA green bio-composites not only improve the mechanical and thermal properties of PLA but also promote the reuse of waste grapevines. Full article

Background: The combination of anti-angiogenic therapy and immune checkpoint inhibitors has revolutionized the management of unresectable hepatocellular carcinoma (uHCC). While an early-phase study demonstrated promising outcomes for lenvatinib plus pembrolizumab (L+P) in treating uHCC, the LEAP-002 trial did not meet its primary endpoint. However, the comparative efficacy between L+P and atezolizumab plus bevacizumab (A+B) as first-line treatment remains a topic of uncertainty. This study aimed to assess the effectiveness and safety of L+P in contrast to A+B among patients diagnosed with uHCC. Methods: We conducted a retrospective analysis of enrolled patients with uHCC who received L+P or A+B as initial systemic treatment at Chang Gung Memorial Hospital from June 2019 to December 2022. The overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) by modified RECIST were compared. Results: 121 patients were recruited, with 37 receiving L+P and 84 receiving A+B. Among them, 95 (78.5%) patients were BCLC stage C, and 99 (81.8%) patients had viral etiology for HCC, predominantly chronic HBV (68.6%). Both the L+P and the A+B groups demonstrated comparable OS (18.2 months versus 14.6 months, p = 0.35) and PFS (7.3 months versus 8.9 months, p = 0.75). The ORR and DCR were similar. After propensity score matching, the results remained consistent between the matched patients. Treatment-related adverse events of any grade occurred in 30 (81.1%) in the L+P group and 62 (73.8%) in the A+B group. Conclusions: Our findings suggest that L+P and A+B exhibit comparable efficacy and safety profiles in real-world settings. Full article

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by widespread inflammation and multi-organ damage. Toll-like receptor 7 (TLR-7) and autophagy have been implicated in SLE pathogenesis. Rice husk silica liquid (RHSL) has shown potential for modulating inflammatory responses, but its effects on SLE have not been thoroughly investigated. This study aims to evaluate the impact of RHSL on immune responses and autophagy in cell culture experiments, focusing on its effects on TLR-7 signaling, cytokine production, and autophagy modulation. RAW264.7 cells and human peripheral blood mononuclear cells (PBMCs) from healthy donors and SLE patients were used. Cells were stimulated with LPS or TLR-7 agonists and treated with RHSL. Cell viability was assessed, and cytokine levels (TNF-α and IL-6) were measured by ELISA. Autophagy-related proteins (LC3II, ATG5-ATG12) were analyzed by Western blotting. The effect of autophagy inhibition was studied using 3-methyladenine (3-MA). A concentration of 100 μg/mL RHSL did not affect cell viability but significantly reduced the TNF-α production in TLR-7 agonist-stimulated RAW264.7 cells (compared to TLR-7 alone, 3.41 ± 0.54 vs. 6.72 ± 0.07 folds) and PBMCs (compared to TLR-7 alone, 0.97 ± 0.19 vs. 1.40 ± 0.33 folds). RHSL enhanced autophagy, as evidenced by increased LC3II (4.35 ± 1.08 folds) and ATG5-ATG12 (7.07 ± 1.30 folds) conjugation in both RAW264.7 cells and SLE patient-derived PBMCs. The reduction in TNF-α production by RHSL was attenuated by 3-MA, indicating that autophagy plays a role in this process. RHSL also inhibited the translocation of phosphorylated NF-κB into the nucleus, suggesting a mechanism for its anti-inflammatory effects. RHSL exhibits potential as an immunomodulatory agent in SLE by enhancing autophagy and modulating TLR-7 signaling pathways. These findings suggest that RHSL could offer therapeutic benefits for managing inflammatory responses in SLE and warrant further investigation into its clinical applications. Full article

Hypokalemic paralysis is a clinical syndrome characterized by acute flaccid paralysis with concomitant hypokalemia. Complications, such as acute respiratory failure and cardiac arrhythmias, can be fatal. If treated appropriately, the patient can recover without any sequelae. We present a rare case of life-threatening hypokalemic paralysis following the ingestion of an unknown substance. At presentation, her serum potassium concentration was 1.9 mmol/L. A review of the patient’s history confirmed the ingestion of barium chloride. She was diagnosed with acute barium poisoning characterized by high serum and urine barium levels. Aggressive potassium repletion was administered intravenously and orally. Her serum potassium concentration dropped to 1.5 mmol/L and peaked at 5.4 mmol/L following treatment. The patient achieved a complete recovery and was discharged without sequelae. Barium can competitively block the potassium inward rectifier channels and interfere with the efflux of intracellular potassium, leading to severe hypokalemia. Our report illustrates a rare presentation of acute barium intoxication and a differential diagnosis indicating hypokalemic paralysis. We also discuss the pathophysiological features and compare the clinical findings with cases of rebound hyperkalemia. Full article

Ventilator-associated pneumonia (VAP) is a critical hospital-acquired infection following non-cardiac surgeries, leading to poor outcomes. This study identifies VAP risk factors in non-cardiac surgical patients and determines the causative pathogens. A retrospective analysis with 1:4 propensity-score matching was conducted on patients in a surgical intensive care unit (ICU) from 2010 to 2020 at a private tertiary medical center. Among 99 VAP patients, the mortality rate was 64.7%. VAP risk factors included prolonged mechanical ventilation (odds ratio [OR] 6.435; p < 0.001), repeat intubation (OR 6.438; p < 0.001), lower oxygenation levels upon ICU admission (OR 0.950; p < 0.001), and undergoing gastrointestinal surgery (OR 2.257; p = 0.021). The 30-day mortality risk factors in the VAP group were late-onset VAP (OR 3.450; p = 0.022), inappropriate antibiotic treatment (OR 4.083; p = 0.041), and undergoing gastrointestinal surgeries (OR 4.776; p = 0.019). Nearly half of the Gram-negative infections were resistant strains, and a third were polymicrobial infections. Non-cardiac surgical patients with VAP face adverse hospital outcomes. Identifying high-risk patients and understanding VAP’s resistant and microbial nature are crucial for appropriate treatment and improved health outcomes. Full article

We present a novel photon-acid diffusion method to integrate polymer microlenses (MLs) on a four-channel, high-speed photo-receiver consisting of normal-incidence germanium (Ge) p-i-n photodiodes (PDs) fabricated on a 200 mm Si substrate. For a 29 µm diameter PD capped with a 54 µm diameter ML, its dark current, responsivity, 3 dB bandwidth (BW), and effective aperture size at −3 V bias and 850 nm wavelength are measured to be 138 nA, 0.6 A/W, 21.4 GHz, and 54 µm, respectively. The enlarged aperture size significantly decouples the tradeoff between aperture size and BW and enhances the optical fiber misalignment tolerance from ±5 µm to ±15 µm to ease the module packaging precision. The sensitivity of the photo-receiver is measured to be −9.2 dBm at 25.78 Gb/s with a bit error rate of 10⁻¹² using non-return-to-zero (NRZ) transmission. Reliability tests are performed, and the results show that the fabricated Ge PDs integrated with polymer MLs pass the GR-468 reliability assurance standard. The demonstrated photo-receiver, a first of its kind to the best of our knowledge, features decent performance, high yield, high throughput, low cost, and compatibility with complementary metal-oxide-semiconductor (CMOS) fabrication processes, and may be further applied to 400 Gb/s pulse-amplitude modulation four-level (PAM4) communication. Full article

The importance of bacteria detection lies in its role in enabling early intervention, disease prevention, environmental protection, and effective treatment strategies. Advancements in technology continually enhance the speed, accuracy, and sensitivity of detection methods, aiding in addressing these critical issues. This study first reports the fabrication of an inverter constructed using crosslinked-poly(4-vinylphenol) (C-PVP) as the dielectric layer and an organic complementary metal-oxide semiconductor (O-CMOS) based on pentacene and N,N′-ditridecylperylene-3,4,9,10-tetracarboxylic diimide (PTCDI-C₁₃) as a diagnostic biosensor to rapidly detect bacterial concentration. Bacteria including Escherichia coli O157, Staphylococcus aureus ATCC25922, and Enterococcus faecalis SH-1051210 were analysed on the inverters at an ultra-low operating voltage of 2 V. The high density of negative charge on bacteria surfaces strongly modulates the accumulated negative carriers within the inverter channel, resulting in a shift of the switching voltage. The inverter-based bacteria sensor exhibits a linear-like response to bacteria concentrations ranging from 10² to 10⁸ CFU/mL, with a sensitivity above 60%. Compared to other bacterial detectors, the advantage of using an inverter lies in its ability to directly read the switching voltage without requiring an external computing device. This facilitates rapid and accurate bacterial concentration measurement, offering significant ease of use and potential for mass production. Full article

Background: This study validates real-time biofeedback for lumbopelvic control training in baseball. The lumbopelvic region is crucial for generating kinetic energy in pitching. Real-time biofeedback enhances training effectiveness and reduces injury risk. The validity and reliability of this system were examined. Purpose: This study was to investigate the validity and reliability of the real-time biofeedback system for lumbopelvic control training. Methods: Twelve baseball players participated in this study, with data collected in two sessions separated by a week. All participants needed to do the lateral slide exercise and single-leg squat exercise in each session. Pelvic angles detected by the real-time biofeedback system were compared to the three-dimensional motion capture system (VICON) during training sessions. Additionally, pelvic angles measured by the biofeedback system were compared between the two training sessions. Results: The real-time biofeedback system exhibited moderate to strong correlations with VICON in both exercises: lateral slide exercise (r = 0.66–0.88, p < 0.05) and single-leg squat exercise (r = 0.70–0.85, p < 0.05). Good to excellent reliability was observed between the first and second sessions for both exercises: lateral slide exercise (ICC = 0.76–0.97) and single-leg squat exercise (ICC = 0.79–0.90). Conclusions: The real-time biofeedback system for lumbopelvic control training, accurately providing the correct pelvic angle during training, could enhance training effectiveness. Full article

Though tremendous advances have been made in the field of in vitro fertilization (IVF), a portion of patients are still affected by embryo implantation failure issues. One of the most significant factors contributing to implantation failure is a uterine condition called displaced window of implantation (WOI), which refers to an unsynchronized endometrium and embryo transfer time for IVF patients. Previous studies have shown that microRNAs (miRNAs) can be important biomarkers in the reproductive process. In this study, we aim to develop a miRNA-based classifier to identify the WOI for optimal time for embryo transfer. A reproductive-related PanelChip^® was used to obtain the miRNA expression profiles from the 200 patients who underwent IVF treatment. In total, 143 out of the 167 miRNAs with amplification signals across 90% of the expression profiles were utilized to build a miRNA-based classifier. The microRNA-based classifier identified the optimal timing for embryo transfer with an accuracy of 93.9%, a sensitivity of 85.3%, and a specificity of 92.4% in the training set, and an accuracy of 88.5% in the testing set, showing high promise in accurately identifying the WOI for the optimal timing for embryo transfer. Full article

Lethal toxin (LT) is the critical virulence factor of Bacillus anthracis, the causative agent of anthrax. One common symptom observed in patients with anthrax is thrombocytopenia, which has also been observed in mice injected with LT. Our previous study demonstrated that LT induces thrombocytopenia by suppressing megakaryopoiesis, but the precise molecular mechanisms behind this phenomenon remain unknown. In this study, we utilized 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced megakaryocytic differentiation in human erythroleukemia (HEL) cells to identify genes involved in LT-induced megakaryocytic suppression. Through cDNA microarray analysis, we identified Dachshund homolog 1 (DACH1) as a gene that was upregulated upon TPA treatment but downregulated in the presence of TPA and LT, purified from the culture supernatants of B. anthracis. To investigate the function of DACH1 in megakaryocytic differentiation, we employed short hairpin RNA technology to knock down DACH1 expression in HEL cells and assessed its effect on differentiation. Our data revealed that the knockdown of DACH1 expression suppressed megakaryocytic differentiation, particularly in polyploidization. We demonstrated that one mechanism by which B. anthracis LT induces suppression of polyploidization in HEL cells is through the cleavage of MEK1/2. This cleavage results in the downregulation of the ERK signaling pathway, thereby suppressing DACH1 gene expression and inhibiting polyploidization. Additionally, we found that known megakaryopoiesis-related genes, such as FOSB, ZFP36L1, RUNX1, FLI1, AHR, and GFI1B genes may be positively regulated by DACH1. Furthermore, we observed an upregulation of DACH1 during in vitro differentiation of CD34–megakaryocytes and downregulation of DACH1 in patients with thrombocytopenia. In summary, our findings shed light on one of the molecular mechanisms behind LT-induced thrombocytopenia and unveil a previously unknown role for DACH1 in megakaryopoiesis. Full article