The etiopathogenesis of gastrointestinal diseases is varied in nature.Various etiogenic factors described are infective,inflammatory,viral,bacterial,parasitic,dietary and lifestyle change.Rare causative agents are imm...The etiopathogenesis of gastrointestinal diseases is varied in nature.Various etiogenic factors described are infective,inflammatory,viral,bacterial,parasitic,dietary and lifestyle change.Rare causative agents are immunological,and others associated as idiopathic,are undiagnosed by all possible means.Some of the rare diseases are congenital in nature,passing from the parent to the child.Many of the undiagnosed diseases are now being diagnosed as genetic and the genes have been implicated as a causative agent.There is a search for newer treatments for such diseases,which is called genomic medicine.Genomic medicine is an emerging medical discipline that involves the use of genomic information about an individual.This is used both for diagnostic as well as therapeutic decisions to improve the current health domain and pave the way for policymakers for its clinical use.In the developing era of precision medicine,genomics,epigenomics,environmental exposure,and other data would be used to more accurately guide individual diagnosis and treatment.Genomic medicine is already making an impact in the fields of oncology,pharmacology,rare,infectious and many undiagnosed diseases.It is beginning to fuel new approaches in certain medical specialties.Oncology is at the leading edge of incorporating genomics,as diagnostics for genetic and genomic markers are increasingly included in cancer screening,and to guide tailored treatment strategies.Genetics and genetic medicine have been reported to play a role in gastroenterology in several ways,including genetic testing(hereditary pancreatitis and hereditary gastrointestinal cancer syndromes).Genetic testing can also help subtype diseases,such as classifying pancreatitis as idiopathic or hereditary.Gene therapy is a promising approach for treating gastrointestinal diseases that are not effectively treated by conventional pharmaceuticals and surgeries.Gene therapy strategies include gene addition,gene editing,messenger RNA therapy,and gene silencing.Understanding genetic determinants,advances in genetics,have led to a better understanding of the genetic factors that contribute to human disease.Family-member risk stratification and genetic diagnosis can help identify family members who are at risk,which can lead to preventive treatments,lifestyle recommendations,and routine follow ups.Selecting target genes helps identify the gene targets associated with each gastrointestinal disease.Common gastrointestinal diseases associated with genetic abnormalities include-inflammatory bowel disease,gastroesophageal reflux disease,non-alcoholic fatty liver disease,and irritable bowel syndrome.With advancing tools and technology,research in the search of newer and individualized treatment,genes and genetic medicines are expected to play a significant role in human health and gastroenterology.展开更多
BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Resear...BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Research in developing nations relating to the cost of treatment is scarce when compared with developed countries.Thus,the drug utilization research studies from developing nations are most needed,and their number has been growing.AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia.METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization(WHO)core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators.We also calculated direct medical costs for a period of 6 months.RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia.The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019.The total mean drug cost of our study was 1396 Indian rupees.The total mean cost due to the investigation in our study was 1017.34 Indian rupees.Therefore,the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees.CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.展开更多
This study focuses on developing a deep learning model capable of recognizing vehicle brands and models,integrated with a law enforcement intelligence platform to overcome the limitations of existing license plate rec...This study focuses on developing a deep learning model capable of recognizing vehicle brands and models,integrated with a law enforcement intelligence platform to overcome the limitations of existing license plate recognition techniques—particularly in handling counterfeit,obscured,or absent plates.The research first entailed collecting,annotating,and classifying images of various vehiclemodels,leveraging image processing and feature extraction methodologies to train themodel on Microsoft Custom Vision.Experimental results indicate that,formost brands and models,the system achieves stable and relatively high performance in Precision,Recall,and Average Precision(AP).Furthermore,simulated tests involving illicit vehicles reveal that,even in cases of reassigned,concealed,or missing license plates,the model can rely on exterior body features to effectively identify vehicles,reducing dependence on plate-specific data.In practical law enforcement scenarios,these findings can accelerate investigations of stolen or forged plates and enhance overall accuracy.In conclusion,continued collection of vehicle images across broadermodel types,production years,and modification levels—along with refined annotation processes and parameter adjustment strategies—will further strengthen themethod’s applicability within law enforcement intelligence platforms,facilitating more precise and comprehensive vehicle recognition and control in real-world operations.展开更多
Ischemic stroke is one of the major causes of long-term disability and mortality worldwide.It results from an interruption in the cerebral blood flow,triggering a cascade of detrimental events like oxidative stress,mi...Ischemic stroke is one of the major causes of long-term disability and mortality worldwide.It results from an interruption in the cerebral blood flow,triggering a cascade of detrimental events like oxidative stress,mitochondrial dysfunction,neuroinflammation,excitotoxicity,and apoptosis,causing neuronal injury and cellular death.Melatonin,a pleiotropic indoleamine produced by the pineal gland,has multifaceted neuroprotective effects on stroke pathophysiology.Interestingly,the serum melatonin levels are associated with peroxidation and antioxidant status,along with mortality score in patients with severe middle cerebral artery infarction.Melatonin exhibits strong antioxidant,anti-inflammatory,and anti-apoptotic properties and preserves mitochondrial function and homeostasis.Several preclinical studies have shown that melatonin administration conserves blood-brain barrier integrity,reduces infarct size,and edema.These mechanisms contribute to minimizing tissue damage and improving the neurological outcomes following ischemic events.Therefore,the present review evaluates evidence from experimental studies furthered with limited clinical investigations and explores the mechanistic pathways ofmelatonin functions to establish its therapeutic potential in stroke management.展开更多
Trajectory tracking for nonlinear robotic systems remains a fundamental yet challenging problem in control engineering,particularly when both precision and efficiency must be ensured.Conventional control methods are o...Trajectory tracking for nonlinear robotic systems remains a fundamental yet challenging problem in control engineering,particularly when both precision and efficiency must be ensured.Conventional control methods are often effective for stabilization but may not directly optimize long-term performance.To address this limitation,this study develops an integrated framework that combines optimal control principles with reinforcement learning for a single-link robotic manipulator.The proposed scheme adopts an actor–critic structure,where the critic network approximates the value function associated with the Hamilton–Jacobi–Bellman equation,and the actor network generates near-optimal control signals in real time.This dual adaptation enables the controller to refine its policy online without explicit system knowledge.Stability of the closed-loop system is analyzed through Lyapunov theory,ensuring boundedness of the tracking error.Numerical simulations on the single-link manipulator demonstrate that themethod achieves accurate trajectory followingwhile maintaining lowcontrol effort.The results further showthat the actor–critic learning mechanism accelerates convergence of the control policy compared with conventional optimization-based strategies.This work highlights the potential of reinforcement learning integrated with optimal control for robotic manipulators and provides a foundation for future extensions to more complex multi-degree-of-freedom systems.The proposed controller is further validated in a physics-based virtual Gazebo environment,demonstrating stable adaptation and real-time feasibility.展开更多
BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remain...BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan region of China.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.展开更多
Background:The long-term outcomes of robotic-assisted surgery and the prognostic significance of the pretreatment neutrophil-to-lymphocyte ratio(NLR)in locally advanced rectal cancer(LARC)remain uncertain.This study a...Background:The long-term outcomes of robotic-assisted surgery and the prognostic significance of the pretreatment neutrophil-to-lymphocyte ratio(NLR)in locally advanced rectal cancer(LARC)remain uncertain.This study aimed to assess the long-term outcomes of patients with LARC undergoing robotic-assisted surgery and to determine the prognostic value of pretreatment NLR.Methods:We retrospectively reviewed 252 patients with LARC who were treated at a single medical center in Taiwan between January 2012 and January 2023.All patients underwent neoadjuvant concurrent chemoradiotherapy(CRT)followed by robotic-assisted surgery with total mesorectal excision(TME).Patients were stratified into four groups on the basis of pretreatment NLRs and carcinoembryonic antigen(CEA)levels.Univariate and multivariate analyses were conducted to identify prognostic indicators for overall survival(OS)and disease-free survival(DFS).Results:Patients with a pretreatment NLR of≥3.2 exhibited significantly worse OS and DFS compared with those with an NLR of<3.2(OS:94.4 vs.116.5 months,p=0.001;DFS:78.8 vs.101.7 months,p=0.003).Group A exhibited the poorest prognosis,whereas Group D had the most favorable outcomes.Multivariate analysis revealed NLR≥3.2 as an independent predictor of poor OS(hazard ratio[HR]=2.306,95%CI:1.149-3.747;p=0.001)and DFS(HR=2.055,95%CI:1.341-3.148;p=0.001).Conclusion:Neoadjuvant concurrent CRT followed by robotic-assisted TME is an effective treatment strategy for LARC.A higher pretreatment NLR(≥3.2)independently predicted worse OS and DFS.Stratification using the NLR in combination with CEA levels may enhance prognostic accuracy for patients undergoing robotic-assisted surgery for LARC.展开更多
Background:Corchorus olitorius L.(Malvaceae)is a green leafy vegetable widely consumed in the Middle East and valued for its rich nutritional content.Its essential oils,an important class of secondary metabolites,are ...Background:Corchorus olitorius L.(Malvaceae)is a green leafy vegetable widely consumed in the Middle East and valued for its rich nutritional content.Its essential oils,an important class of secondary metabolites,are of growing interest for potential use in cosmetics and fragrance industries due to their bioactive properties.Methods:Leaves of C.olitorius cultivated in Egypt were extracted using microwave-assisted hydrodistillation(MAHD)and conventional hydrodistillation(HD).The oils were analyzed by gas chromatography-mass spectrometry(GC-MS)to characterize their chemical profiles.In vitro assays were conducted to evaluate their anti-elastase and anti-collagenase activities,and in silico studies were performed to predict the pharmacokinetic and pharmacodynamic properties of major constituents.Results:GC-MS analysis showed that aldehydes,alkanes,fatty alcohols,fatty acids,and their derivatives were the predominant compound classes in both oils.Notably,oxygenated diterpenes(11.22%)were present exclusively in the MAHD oil,while triterpenoids(16.37%)were found only in the HD oil.The MAHD oil demonstrated stronger In vitro anti-elastase(IC_(50)=42.5μg/mL)and anti-collagenase(IC_(50)=131.5μg/mL)activities compared to the HD oil(IC_(50)=66.7 and 206.8μg/mL,respectively),reflecting an approximate 36.3%improvement in elastase inhibition and 36.4%improvement in collagenase inhibition.In silico docking indicated that the triterpenoidβ-amyrin acetate showed the highest predicted binding affinity for porcine pancreatic elastase(PDB ID:6QEO,ΔG=−8.1 kcal/mol)and collagenase(PDB ID:456C,ΔG=−9.1 kcal/mol)among the major compounds analyzed.Conclusion:These findings demonstrate that MAHD is a greener and more efficient extraction method,yielding oil with enhanced enzyme inhibitory activity compared to conventional HD.The promising anti-elastase and anti-collagenase properties suggest that C.olitorius MAHD oil could serve as a potential candidate for anti-aging cosmetic formulations,following further validation.展开更多
Mango is a plant with high economic value in the agricultural industry;thus,it is necessary to maximize the productivity performance of the mango plant,which can be done by implementing artificial intelligence.In this...Mango is a plant with high economic value in the agricultural industry;thus,it is necessary to maximize the productivity performance of the mango plant,which can be done by implementing artificial intelligence.In this study,a lightweight object detection model will be developed that can detect mango plant conditions based on disease potential,so that it becomes an early detection warning system that has an impact on increasing agricultural productivity.The proposed lightweight model integrates YOLOv7-Tiny and the proposed modules,namely the C2S module.The C2S module consists of three sub-modules such as the convolutional block attention module(CBAM),the coordinate attention(CA)module,and the squeeze-and-excitation(SE)module.The dataset is constructed by eight classes,including seven classes of disease conditions and one class of health conditions.The experimental result shows that the proposed lightweight model has the optimal results,which increase by 13.15% of mAP50 compared to the original model YOLOv7-Tiny.While the mAP50:95 also achieved the highest results compared to other models,including YOLOv3-Tiny,YOLOv4-Tiny,YOLOv5,and YOLOv7-Tiny.The advantage of the proposed lightweightmodel is the adaptability that supports it in constrained environments,such as edge computing systems.This proposedmodel can support a robust,precise,and convenient precision agriculture system for the user.展开更多
BACKGROUND The incidence of diabetic atherosclerosis(DMA)is increasing worldwide,but its pathogenesis remains incompletely understood.In addition to cardiovascular complications,bladder dysfunction is one of the commo...BACKGROUND The incidence of diabetic atherosclerosis(DMA)is increasing worldwide,but its pathogenesis remains incompletely understood.In addition to cardiovascular complications,bladder dysfunction is one of the common comorbidities associated with DMA but is often refractory to current treatments.AIM To investigate the therapeutic effect of human amniotic fluid stem cell-derived extracellular vesicles(hAFSC-EVs)on the recovery of bladder dysfunction in DMA rats.METHODS Eighty rats were divided into normal control,streptozotocin-induced diabetic rats,diabetic rats subjected to arterial balloon endothelial injury of common iliac artery(DMA),and DMA rats treated with hAFSC-EVs(DMA+hAFSC-EVs).At 4 weeks and 12 weeks after DMA induction,levels of blood glucose,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homeostasis model assessment(HOMA)-insulin resistance,and HOMA-βwere measured.Cystometry,common iliac artery wall thickness,and bladder tumor necrosis factor(TNF)-α,interleukin(IL)-6,transforming growth factor(TGF)-β1,Smad3,connective tissue growth factor(CTGF)and fibronectin were also evaluated.RESULTS Bladder weight and blood glucose,triglyceride,HOMA-insulin resistance,common iliac artery intima thickness,voided volume,intercontraction interval,bladder capacity,and mRNA expression of TNF-α,IL-6,TGF-β1,Smad3,CTGF and fibronectin were significantly increased at 4 weeks and 12 weeks after induction,while the HOMA-βlevel decreased at 4 weeks and 12 weeks,and the high-density lipoprotein cholesterol level decreased at 12 weeks.hAFSC-EVs treatment in DMA rats significantly reduced bladder weight and blood glucose,thickness of common iliac arterial intima,voided volume,intercontraction interval and bladder capacity at 4 weeks.The mRNA expression of TNF-α,TGF-β1,and CTGF in DMA rats treated with hAFSC-EVs were significantly decreased at 4 weeks,while the mRNA expressions of IL-6 and Smad3 were significantly decreased 12 weeks.CONCLUSION hAFSC-EVs treatment can help restore DMA-induced bladder dysfunction,which is associated with lowered blood glucose levels,reduced arterial wall thickness,and decreased TNF-α,IL-6,TGF-β1,Smad3,and CTGF expression.展开更多
Automated grading of dandruff severity is a clinically significant but challenging task due to the inherent ordinal nature of severity levels and the high prevalence of label noise from subjective expert annotations.S...Automated grading of dandruff severity is a clinically significant but challenging task due to the inherent ordinal nature of severity levels and the high prevalence of label noise from subjective expert annotations.Standard classification methods fail to address these dual challenges,limiting their real-world performance.In this paper,a novel,three-phase training framework is proposed that learns a robust ordinal classifier directly from noisy labels.The approach synergistically combines a rank-based ordinal regression backbone with a cooperative,semi-supervised learning strategy to dynamically partition the data into clean and noisy subsets.A hybrid training objective is then employed,applying a supervised ordinal loss to the clean set.The noisy set is simultaneously trained using a dualobjective that combines a semi-supervised ordinal loss with a parallel,label-agnostic contrastive loss.This design allows themodel to learn fromthe entire noisy subset while using contrastive learning to mitigate the risk of error propagation frompotentially corrupt supervision.Extensive experiments on a new,large-scale,multi-site clinical dataset validate our approach.Themethod achieves state-of-the-art performance with 80.71%accuracy and a 76.86%F1-score,significantly outperforming existing approaches,including a 2.26%improvement over the strongest baseline method.This work provides not only a robust solution for a practical medical imaging problem but also a generalizable framework for other tasks plagued by noisy ordinal labels.展开更多
Background:Prostate cancer(PCa)is the most prevalent malignancy in men and often correlates with distant metastasis in its advanced stages.The study aimed to investigate the effects of Ugonin J,a natural compound isol...Background:Prostate cancer(PCa)is the most prevalent malignancy in men and often correlates with distant metastasis in its advanced stages.The study aimed to investigate the effects of Ugonin J,a natural compound isolated from Helminthostachys zeylanica,on PCa metastasis.Methods:The effects of Ugonin J on cell motility were assessed using migration and invasion assays.Reverse Transcription Quantitative PCR(RT-qPCR)and Western blotting were used to evaluate the impact of Ugonin J on mRNA and protein expression.RNA sequencing(RNA-seq)analysis was performed to investigate candidate mechanisms.Differential gene expression analysis in PCa patients was conducted using multiple databases.Results:Here,we reveal that Ugonin J blocks migration and invasion in PCa cells without affecting cell viability.RNA-seq analysis suggests that epithelial-mesenchymal transition(EMT)is potentially involved in Ugonin J’s anti-motility effects.Ugonin J also suppresses the expression of mesenchymal markers N-cadherin,β-catenin,Snail,and Slug while upregulating the expression of the epithelial marker E-cadherin.Furthermore,among 13 A disintegrin and metalloproteinase(ADAM)proteins,A disintegrin and metalloproteinase domain-containing protein 9(ADAM9)is the most downregulated following Ugonin J treatment,according to our RNA-seq data.Importantly,clinical data revealed that ADAM9 expression are higher in PCa patients than in healthy controls and are associated with distant metastasis.Transfection with ADAM9 cDNA reverses Ugonin J-regulated downregulation of EMT,migration,and invasion in PCa cells.Ugonin J inhibits ADAM9-dependent motility by downregulating the phosphoinositide 3-kinase(PI3K),protein kinase B(Akt)and nuclear factor-κB(NF-κB)pathways.Conclusions:Our evidence suggests that Ugonin J is a novel therapeutic candidate for further development as a treatment for metastatic PCa.展开更多
The sustainable sourcing of novel bioactive compounds from natural sources is crucial to the success of the pharmaceutical,food,and cosmetics industries.Iris bucharica Foster(syn.Juno bucharica(Foster)Vved.)is a promi...The sustainable sourcing of novel bioactive compounds from natural sources is crucial to the success of the pharmaceutical,food,and cosmetics industries.Iris bucharica Foster(syn.Juno bucharica(Foster)Vved.)is a promising source of novel bioactive molecules,particularly phenolic compounds,which are renowned for their antioxidant properties.In this study,we developed a reliable HPLC-UV-DAD method to identify and quantify phenolic compounds in the leaves and bulbs of I.bucharica,establishing the first set of quality control markers for this species.A total of 21 phenolic compounds were identified in the leaves,with flavonoids isoorientin,guaijaverin,hyperoside,and cosmosiin,the isoflavonoid biochanin A,and the simple phenolic ferulic acid being the most prominent.In comparison,14 compounds were identified in the bulbs,primarily isoflavonoids,including tectoridin and germanaism B,and flavonoid apigenin.The leaves extracts exhibited significant antioxidant activity,whereas the anti-allergic and anti-inflammatory effects were mild.These findings highlight I.bucharica as a sustainable source of bioactive compounds with potential industrial applications.However,further studies are needed to evaluate bioavailability and in vivo efficacy,as well as to optimise extraction methods to realize its industrial potential fully.展开更多
Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and wheth...Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.展开更多
Kidney transplantation(KT)accounts for nearly three-fourths of organ transplants in India,with living donors contributing to 82%of cases.Induction immunosuppression is essential to optimize initial immunosuppression,r...Kidney transplantation(KT)accounts for nearly three-fourths of organ transplants in India,with living donors contributing to 82%of cases.Induction immunosuppression is essential to optimize initial immunosuppression,reduce acute rejections,and enable tailored use of maintenance agents.Rabbit anti-thymocyte globulin(rATG)and interleukin-2 receptor anatagonists(IL-2RA/IL-2RBs)are the most widely used induction therapies.However,data on induction practices across India are limited.To evaluate induction immunosuppression practices across KT centers in India and establish a consensus for different subsets of KT recipients.A nationwide online survey was conducted by the Indian Society of Organ Transplantation(ISOT)among its members(400 KT centers).Responses were analyzed to assess induction practices across diverse donor types,age groups,and immunological risk profiles.Heterogeneity in practices prompted consensus building using a modified Delphi process.Literature review and expert panel discussions(April 2024)were followed by structured voting,and 16 consensus statements were finalized.Of 400 centers approached,254 participated.rATG was the most commonly used induction therapy,followed by IL-2RBs;alemtuzumab was least used.Significant heterogeneity was observed in type,dose,and duration of induction therapy.Consensus recommendations were framed:rATG for high immunological risk recipients and deceased donor KTs;IL-2RB or low-dose rATG for low immunological risk;rituximab in ABOincompatible KTs;and tailoring based on age,diabetes,donor type,infection risk,and affordability.This first ISOT consensus provides 16 India-specific statements on induction therapy in KT.It emphasizes risk-stratified,evidenceinformed,and context-appropriate induction strategies,supporting standardization of care across the country.展开更多
BACKGROUND: As per the "Disaster Management Act, 2005" of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1 900 bed ter...BACKGROUND: As per the "Disaster Management Act, 2005" of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1 900 bed tertiary care hospital, in consultation and involvement of all concerned stakeholders.METHODS: A committee of members from hospital administration, clinical, diagnostic and supportive departments worked on an initial document prepared according to the Act and gave their inputs to frame a final disaster manual.RESULTS: The prepared departmental standard operating procedures involved 116 people(doctors and paramedical staff), and were then synchronized, in 12 committee meetings, to produce the final hospital disaster manual.CONCLUSIONS: The present disaster manual is one of the few comprehensive plans prepared by the stakeholders of a government hospital in India, who themselves form a part of the disaster response team. It also helped in co-ordinated conduction of mock drills.展开更多
Background:With the global popularity of short videos,particularly among young people,short video addiction has become a worrying phenomenon that poses significant risks to individual health and adaptability.Self-regu...Background:With the global popularity of short videos,particularly among young people,short video addiction has become a worrying phenomenon that poses significant risks to individual health and adaptability.Self-regulated learning(SRL)strategies are key factors in predicting learning outcomes.This study,based on the SRL theory,uses short video addiction as the independent variable,SRL strategies as the mediating variable,and learning well-being as the outcome variable,aiming to reveal the relationships among short video addiction,self-regulated learning,and learning well-being among Chinese college students.Methods:Using a cross-sectional study design and applying the snowball sampling technique,an online survey was administered to Chinese undergraduate students.A total of 706 valid questionnaires were collected,with an effective response rate of 85.7%.The average age of the participants was 20.5 years.Results:The results of structural equation modeling indicate that 7 hypotheses were supported.Short video addiction was negatively correlated with self-regulated learning strategies(preparatory,performance,and appraisal strategy),while SRL strategies were positively correlated with learning well-being.Additionally,short video addiction had a mediating effect on learning well-being through the three types of SRL strategies.The three types of SRL strategies explained 39%of the variance in learning well-being.Conclusion:Previous research has typically focused on the impact of self-regulated learning strategies on media addiction or problematic media use.This study,based on the SRL model,highlights the negative issues caused by short video addiction and emphasizes the importance of cultivating self-regulation abilities and media literacy.Short video addiction stems from failures in trait self-regulation,which naturally impairs the ability to effectively engage in self-regulation during the learning process.This study confirms and underscores that the SRL model can serve as an effective theoretical framework for helping students prevent short video addiction,engage in high-quality learning,and consequently enhance their learning well-being.展开更多
Objective:Pediatric burns pose difficult healthcare issues in underdeveloped nations.Due to the scarcity of pediatric burn care facilities and qualified burn‑care staff,patients are frequently referred from a rural ho...Objective:Pediatric burns pose difficult healthcare issues in underdeveloped nations.Due to the scarcity of pediatric burn care facilities and qualified burn‑care staff,patients are frequently referred from a rural hospital.This study explores the burn‑treatment approach that could be used in rural hospitals in the absence of a dedicated pediatric burn care facility.Materials and Methods:A retrospective analysis of clinical data of 199 children who received treatment for burn‑injury in an isolated general surgical ward.Wound debridement under anesthesia at the earliest was the cornerstone of the treatment plan for this cohort.Until the wounds healed,the treatment was repeated every alternate day.The patient’s demographic data,number of surgical dressings,length of hospital stay,and outcome were analyzed.Results:The mean age of the patients was 51.68±23.79 months.The male‑female ratio was 1.45:1.The survival rate was 99.00%.The disability rate was 4.52%.Univariate logistic regression identified the age group,total body surface area affected,depth of the wound,and time of intervention as statistically significant variables(P<0.05)predicting the disfigurement.Multivariate logistic regression identified the time intervals between surgical intervention and injury as an important predictor of morbidity.In addition,delayed presentation and delayed intervention led to a longer hospital stay,and more interventions than the early intervention cohort.Conclusions:Early debridement accelerates recovery and lessens the need for future skin grafts or contracture procedures.This approach can be used in rural hospitals as well because pediatric burns can be manageable in an isolated general ward.展开更多
BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improp...BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and mortality.AIM To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with SBO.METHODS Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were reviewed.RESULTS Out of 586 patients,7(1.2%)were diagnosed with IH.Among these,4 had congenital IH and 3 had acquired IH.The male-to-female ratio was 4:3.The median age at presentation was 32 years.Contrast-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel loops.Left paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of gut.During follow-up,no recurrences were reported.CONCLUSION IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.展开更多
The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future car...The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)diseases.Chronic kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the endothelium.ED is also associated with a decline in estimated glomerular filtration rate.After kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV health.However,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft survival.ED in kidney transplant recipients is an underrecognized and poorly studied entity.CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts.ED contributes to the pathogenesis of many of the CV diseases.Various biomarkers and vasoreactivity tests are available to study endothelial functions.With an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.展开更多
文摘The etiopathogenesis of gastrointestinal diseases is varied in nature.Various etiogenic factors described are infective,inflammatory,viral,bacterial,parasitic,dietary and lifestyle change.Rare causative agents are immunological,and others associated as idiopathic,are undiagnosed by all possible means.Some of the rare diseases are congenital in nature,passing from the parent to the child.Many of the undiagnosed diseases are now being diagnosed as genetic and the genes have been implicated as a causative agent.There is a search for newer treatments for such diseases,which is called genomic medicine.Genomic medicine is an emerging medical discipline that involves the use of genomic information about an individual.This is used both for diagnostic as well as therapeutic decisions to improve the current health domain and pave the way for policymakers for its clinical use.In the developing era of precision medicine,genomics,epigenomics,environmental exposure,and other data would be used to more accurately guide individual diagnosis and treatment.Genomic medicine is already making an impact in the fields of oncology,pharmacology,rare,infectious and many undiagnosed diseases.It is beginning to fuel new approaches in certain medical specialties.Oncology is at the leading edge of incorporating genomics,as diagnostics for genetic and genomic markers are increasingly included in cancer screening,and to guide tailored treatment strategies.Genetics and genetic medicine have been reported to play a role in gastroenterology in several ways,including genetic testing(hereditary pancreatitis and hereditary gastrointestinal cancer syndromes).Genetic testing can also help subtype diseases,such as classifying pancreatitis as idiopathic or hereditary.Gene therapy is a promising approach for treating gastrointestinal diseases that are not effectively treated by conventional pharmaceuticals and surgeries.Gene therapy strategies include gene addition,gene editing,messenger RNA therapy,and gene silencing.Understanding genetic determinants,advances in genetics,have led to a better understanding of the genetic factors that contribute to human disease.Family-member risk stratification and genetic diagnosis can help identify family members who are at risk,which can lead to preventive treatments,lifestyle recommendations,and routine follow ups.Selecting target genes helps identify the gene targets associated with each gastrointestinal disease.Common gastrointestinal diseases associated with genetic abnormalities include-inflammatory bowel disease,gastroesophageal reflux disease,non-alcoholic fatty liver disease,and irritable bowel syndrome.With advancing tools and technology,research in the search of newer and individualized treatment,genes and genetic medicines are expected to play a significant role in human health and gastroenterology.
文摘BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know,compute,and refine the prescription whose principal objective is to enable the rational use of drugs.Research in developing nations relating to the cost of treatment is scarce when compared with developed countries.Thus,the drug utilization research studies from developing nations are most needed,and their number has been growing.AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia.METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization(WHO)core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators.We also calculated direct medical costs for a period of 6 months.RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia.The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019.The total mean drug cost of our study was 1396 Indian rupees.The total mean cost due to the investigation in our study was 1017.34 Indian rupees.Therefore,the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees.CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.
基金the National Science and Technology Council,Taiwan,for financially supporting this research(grant No.NSTC 114-2221-E-018-003)the Ministry of Education’s Teaching Practice Research Program,Taiwan(PSK1142780).
文摘This study focuses on developing a deep learning model capable of recognizing vehicle brands and models,integrated with a law enforcement intelligence platform to overcome the limitations of existing license plate recognition techniques—particularly in handling counterfeit,obscured,or absent plates.The research first entailed collecting,annotating,and classifying images of various vehiclemodels,leveraging image processing and feature extraction methodologies to train themodel on Microsoft Custom Vision.Experimental results indicate that,formost brands and models,the system achieves stable and relatively high performance in Precision,Recall,and Average Precision(AP).Furthermore,simulated tests involving illicit vehicles reveal that,even in cases of reassigned,concealed,or missing license plates,the model can rely on exterior body features to effectively identify vehicles,reducing dependence on plate-specific data.In practical law enforcement scenarios,these findings can accelerate investigations of stolen or forged plates and enhance overall accuracy.In conclusion,continued collection of vehicle images across broadermodel types,production years,and modification levels—along with refined annotation processes and parameter adjustment strategies—will further strengthen themethod’s applicability within law enforcement intelligence platforms,facilitating more precise and comprehensive vehicle recognition and control in real-world operations.
基金supported by Chulabhorn Graduate Institute(Fundamental Fund by National Science Research and Innovation Fund(NSRF):fiscal year 2025)(FRB680079/0518 Project code 209041)Chulabhorn Graduate Institute(651-AB01).
文摘Ischemic stroke is one of the major causes of long-term disability and mortality worldwide.It results from an interruption in the cerebral blood flow,triggering a cascade of detrimental events like oxidative stress,mitochondrial dysfunction,neuroinflammation,excitotoxicity,and apoptosis,causing neuronal injury and cellular death.Melatonin,a pleiotropic indoleamine produced by the pineal gland,has multifaceted neuroprotective effects on stroke pathophysiology.Interestingly,the serum melatonin levels are associated with peroxidation and antioxidant status,along with mortality score in patients with severe middle cerebral artery infarction.Melatonin exhibits strong antioxidant,anti-inflammatory,and anti-apoptotic properties and preserves mitochondrial function and homeostasis.Several preclinical studies have shown that melatonin administration conserves blood-brain barrier integrity,reduces infarct size,and edema.These mechanisms contribute to minimizing tissue damage and improving the neurological outcomes following ischemic events.Therefore,the present review evaluates evidence from experimental studies furthered with limited clinical investigations and explores the mechanistic pathways ofmelatonin functions to establish its therapeutic potential in stroke management.
基金supported in part by the National Science and Technology Council under Grant NSTC 114-2221-E-027-104.
文摘Trajectory tracking for nonlinear robotic systems remains a fundamental yet challenging problem in control engineering,particularly when both precision and efficiency must be ensured.Conventional control methods are often effective for stabilization but may not directly optimize long-term performance.To address this limitation,this study develops an integrated framework that combines optimal control principles with reinforcement learning for a single-link robotic manipulator.The proposed scheme adopts an actor–critic structure,where the critic network approximates the value function associated with the Hamilton–Jacobi–Bellman equation,and the actor network generates near-optimal control signals in real time.This dual adaptation enables the controller to refine its policy online without explicit system knowledge.Stability of the closed-loop system is analyzed through Lyapunov theory,ensuring boundedness of the tracking error.Numerical simulations on the single-link manipulator demonstrate that themethod achieves accurate trajectory followingwhile maintaining lowcontrol effort.The results further showthat the actor–critic learning mechanism accelerates convergence of the control policy compared with conventional optimization-based strategies.This work highlights the potential of reinforcement learning integrated with optimal control for robotic manipulators and provides a foundation for future extensions to more complex multi-degree-of-freedom systems.The proposed controller is further validated in a physics-based virtual Gazebo environment,demonstrating stable adaptation and real-time feasibility.
基金Supported by National Science and Technology Council,Taiwan,No.MOST 111-2629-H-227-001-MY2.
文摘BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan region of China.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.
基金supported by grants through funding from the National Science and Technology Council(NSTC112-2314-B-037-050-MY3,NSTC114-2314-B-037-103-MY3,NSTC114-2321-B-037-003)the Ministry of Health and Welfare(MOHW113-TDU-B-222-134014)+3 种基金funded by the health and welfare surcharge of on tobacco products,and the Kaohsiung Medical University Hospital(KMUH113-3R31,KMUH113-3R32,KMUH113-3R33,KMUH113-3M58,KMUH113-3M59,KMUH-S11412,KMUH-SH11403)Kaohsiung Medical University Research Center Grant(KMU-TC113A04)National Tsing Hua University-Kaohsiung Medical University Joint Research Project(NTHU-KMU-KT114P008)supported by the Grant of Taiwan Precision Medicine Initiative and Taiwan Biobank,Academia Sinica,Taiwan.
文摘Background:The long-term outcomes of robotic-assisted surgery and the prognostic significance of the pretreatment neutrophil-to-lymphocyte ratio(NLR)in locally advanced rectal cancer(LARC)remain uncertain.This study aimed to assess the long-term outcomes of patients with LARC undergoing robotic-assisted surgery and to determine the prognostic value of pretreatment NLR.Methods:We retrospectively reviewed 252 patients with LARC who were treated at a single medical center in Taiwan between January 2012 and January 2023.All patients underwent neoadjuvant concurrent chemoradiotherapy(CRT)followed by robotic-assisted surgery with total mesorectal excision(TME).Patients were stratified into four groups on the basis of pretreatment NLRs and carcinoembryonic antigen(CEA)levels.Univariate and multivariate analyses were conducted to identify prognostic indicators for overall survival(OS)and disease-free survival(DFS).Results:Patients with a pretreatment NLR of≥3.2 exhibited significantly worse OS and DFS compared with those with an NLR of<3.2(OS:94.4 vs.116.5 months,p=0.001;DFS:78.8 vs.101.7 months,p=0.003).Group A exhibited the poorest prognosis,whereas Group D had the most favorable outcomes.Multivariate analysis revealed NLR≥3.2 as an independent predictor of poor OS(hazard ratio[HR]=2.306,95%CI:1.149-3.747;p=0.001)and DFS(HR=2.055,95%CI:1.341-3.148;p=0.001).Conclusion:Neoadjuvant concurrent CRT followed by robotic-assisted TME is an effective treatment strategy for LARC.A higher pretreatment NLR(≥3.2)independently predicted worse OS and DFS.Stratification using the NLR in combination with CEA levels may enhance prognostic accuracy for patients undergoing robotic-assisted surgery for LARC.
基金Egyptian Science and Technology and Innovation Fund(STIFA)for the support of the study through grant No.46667 entitled“Sustainability of Lab Capacities of the Center of Drug Discovery Research and Development”.
文摘Background:Corchorus olitorius L.(Malvaceae)is a green leafy vegetable widely consumed in the Middle East and valued for its rich nutritional content.Its essential oils,an important class of secondary metabolites,are of growing interest for potential use in cosmetics and fragrance industries due to their bioactive properties.Methods:Leaves of C.olitorius cultivated in Egypt were extracted using microwave-assisted hydrodistillation(MAHD)and conventional hydrodistillation(HD).The oils were analyzed by gas chromatography-mass spectrometry(GC-MS)to characterize their chemical profiles.In vitro assays were conducted to evaluate their anti-elastase and anti-collagenase activities,and in silico studies were performed to predict the pharmacokinetic and pharmacodynamic properties of major constituents.Results:GC-MS analysis showed that aldehydes,alkanes,fatty alcohols,fatty acids,and their derivatives were the predominant compound classes in both oils.Notably,oxygenated diterpenes(11.22%)were present exclusively in the MAHD oil,while triterpenoids(16.37%)were found only in the HD oil.The MAHD oil demonstrated stronger In vitro anti-elastase(IC_(50)=42.5μg/mL)and anti-collagenase(IC_(50)=131.5μg/mL)activities compared to the HD oil(IC_(50)=66.7 and 206.8μg/mL,respectively),reflecting an approximate 36.3%improvement in elastase inhibition and 36.4%improvement in collagenase inhibition.In silico docking indicated that the triterpenoidβ-amyrin acetate showed the highest predicted binding affinity for porcine pancreatic elastase(PDB ID:6QEO,ΔG=−8.1 kcal/mol)and collagenase(PDB ID:456C,ΔG=−9.1 kcal/mol)among the major compounds analyzed.Conclusion:These findings demonstrate that MAHD is a greener and more efficient extraction method,yielding oil with enhanced enzyme inhibitory activity compared to conventional HD.The promising anti-elastase and anti-collagenase properties suggest that C.olitorius MAHD oil could serve as a potential candidate for anti-aging cosmetic formulations,following further validation.
基金supported by National Science and Technology Council(NSTC)Taiwan,Grant No.NSTC 113-2221-E-167-023.
文摘Mango is a plant with high economic value in the agricultural industry;thus,it is necessary to maximize the productivity performance of the mango plant,which can be done by implementing artificial intelligence.In this study,a lightweight object detection model will be developed that can detect mango plant conditions based on disease potential,so that it becomes an early detection warning system that has an impact on increasing agricultural productivity.The proposed lightweight model integrates YOLOv7-Tiny and the proposed modules,namely the C2S module.The C2S module consists of three sub-modules such as the convolutional block attention module(CBAM),the coordinate attention(CA)module,and the squeeze-and-excitation(SE)module.The dataset is constructed by eight classes,including seven classes of disease conditions and one class of health conditions.The experimental result shows that the proposed lightweight model has the optimal results,which increase by 13.15% of mAP50 compared to the original model YOLOv7-Tiny.While the mAP50:95 also achieved the highest results compared to other models,including YOLOv3-Tiny,YOLOv4-Tiny,YOLOv5,and YOLOv7-Tiny.The advantage of the proposed lightweightmodel is the adaptability that supports it in constrained environments,such as edge computing systems.This proposedmodel can support a robust,precise,and convenient precision agriculture system for the user.
基金the Ministry of Science and Technology Taiwan,No.MOST 109-2314-B-182A-091,No.NSTC 112-2314-B-182A-062, No.NSTC 113-2314-B-182A-125.
文摘BACKGROUND The incidence of diabetic atherosclerosis(DMA)is increasing worldwide,but its pathogenesis remains incompletely understood.In addition to cardiovascular complications,bladder dysfunction is one of the common comorbidities associated with DMA but is often refractory to current treatments.AIM To investigate the therapeutic effect of human amniotic fluid stem cell-derived extracellular vesicles(hAFSC-EVs)on the recovery of bladder dysfunction in DMA rats.METHODS Eighty rats were divided into normal control,streptozotocin-induced diabetic rats,diabetic rats subjected to arterial balloon endothelial injury of common iliac artery(DMA),and DMA rats treated with hAFSC-EVs(DMA+hAFSC-EVs).At 4 weeks and 12 weeks after DMA induction,levels of blood glucose,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homeostasis model assessment(HOMA)-insulin resistance,and HOMA-βwere measured.Cystometry,common iliac artery wall thickness,and bladder tumor necrosis factor(TNF)-α,interleukin(IL)-6,transforming growth factor(TGF)-β1,Smad3,connective tissue growth factor(CTGF)and fibronectin were also evaluated.RESULTS Bladder weight and blood glucose,triglyceride,HOMA-insulin resistance,common iliac artery intima thickness,voided volume,intercontraction interval,bladder capacity,and mRNA expression of TNF-α,IL-6,TGF-β1,Smad3,CTGF and fibronectin were significantly increased at 4 weeks and 12 weeks after induction,while the HOMA-βlevel decreased at 4 weeks and 12 weeks,and the high-density lipoprotein cholesterol level decreased at 12 weeks.hAFSC-EVs treatment in DMA rats significantly reduced bladder weight and blood glucose,thickness of common iliac arterial intima,voided volume,intercontraction interval and bladder capacity at 4 weeks.The mRNA expression of TNF-α,TGF-β1,and CTGF in DMA rats treated with hAFSC-EVs were significantly decreased at 4 weeks,while the mRNA expressions of IL-6 and Smad3 were significantly decreased 12 weeks.CONCLUSION hAFSC-EVs treatment can help restore DMA-induced bladder dysfunction,which is associated with lowered blood glucose levels,reduced arterial wall thickness,and decreased TNF-α,IL-6,TGF-β1,Smad3,and CTGF expression.
文摘Automated grading of dandruff severity is a clinically significant but challenging task due to the inherent ordinal nature of severity levels and the high prevalence of label noise from subjective expert annotations.Standard classification methods fail to address these dual challenges,limiting their real-world performance.In this paper,a novel,three-phase training framework is proposed that learns a robust ordinal classifier directly from noisy labels.The approach synergistically combines a rank-based ordinal regression backbone with a cooperative,semi-supervised learning strategy to dynamically partition the data into clean and noisy subsets.A hybrid training objective is then employed,applying a supervised ordinal loss to the clean set.The noisy set is simultaneously trained using a dualobjective that combines a semi-supervised ordinal loss with a parallel,label-agnostic contrastive loss.This design allows themodel to learn fromthe entire noisy subset while using contrastive learning to mitigate the risk of error propagation frompotentially corrupt supervision.Extensive experiments on a new,large-scale,multi-site clinical dataset validate our approach.Themethod achieves state-of-the-art performance with 80.71%accuracy and a 76.86%F1-score,significantly outperforming existing approaches,including a 2.26%improvement over the strongest baseline method.This work provides not only a robust solution for a practical medical imaging problem but also a generalizable framework for other tasks plagued by noisy ordinal labels.
基金supported by the National Science and Technology Council(NSTC 113-2320-B-039-049-MY3 and NSTC 114-2314-B-039-051-MY3)China Medical University(CMU113-ASIA-05,CMU-114-ASIA-01).
文摘Background:Prostate cancer(PCa)is the most prevalent malignancy in men and often correlates with distant metastasis in its advanced stages.The study aimed to investigate the effects of Ugonin J,a natural compound isolated from Helminthostachys zeylanica,on PCa metastasis.Methods:The effects of Ugonin J on cell motility were assessed using migration and invasion assays.Reverse Transcription Quantitative PCR(RT-qPCR)and Western blotting were used to evaluate the impact of Ugonin J on mRNA and protein expression.RNA sequencing(RNA-seq)analysis was performed to investigate candidate mechanisms.Differential gene expression analysis in PCa patients was conducted using multiple databases.Results:Here,we reveal that Ugonin J blocks migration and invasion in PCa cells without affecting cell viability.RNA-seq analysis suggests that epithelial-mesenchymal transition(EMT)is potentially involved in Ugonin J’s anti-motility effects.Ugonin J also suppresses the expression of mesenchymal markers N-cadherin,β-catenin,Snail,and Slug while upregulating the expression of the epithelial marker E-cadherin.Furthermore,among 13 A disintegrin and metalloproteinase(ADAM)proteins,A disintegrin and metalloproteinase domain-containing protein 9(ADAM9)is the most downregulated following Ugonin J treatment,according to our RNA-seq data.Importantly,clinical data revealed that ADAM9 expression are higher in PCa patients than in healthy controls and are associated with distant metastasis.Transfection with ADAM9 cDNA reverses Ugonin J-regulated downregulation of EMT,migration,and invasion in PCa cells.Ugonin J inhibits ADAM9-dependent motility by downregulating the phosphoinositide 3-kinase(PI3K),protein kinase B(Akt)and nuclear factor-κB(NF-κB)pathways.Conclusions:Our evidence suggests that Ugonin J is a novel therapeutic candidate for further development as a treatment for metastatic PCa.
基金supported by grants from the National Science and Technology Council(NSTC),Taiwan(NSTC 114-2320-B-037-020-MY3,113-2320-B-037-023,and 112-2320-B-037-012 granted to M.K.,113-2321-B-255-001,113-2321-B-182-003,112-2321-B-182-003,112-2321-B-255-001,111-2320-B-255-006-MY3,and 111-2321-B-255-001 granted to T.L.H.)Kaohsiung Medical University Research Foundation[KMU-Q113011 awarded to M.K.and KMU-M114020 awarded to B.H.C.]NSYSU-KMU joint research project(NSYSU-KMU-114-P16)awarded to M.K.
文摘The sustainable sourcing of novel bioactive compounds from natural sources is crucial to the success of the pharmaceutical,food,and cosmetics industries.Iris bucharica Foster(syn.Juno bucharica(Foster)Vved.)is a promising source of novel bioactive molecules,particularly phenolic compounds,which are renowned for their antioxidant properties.In this study,we developed a reliable HPLC-UV-DAD method to identify and quantify phenolic compounds in the leaves and bulbs of I.bucharica,establishing the first set of quality control markers for this species.A total of 21 phenolic compounds were identified in the leaves,with flavonoids isoorientin,guaijaverin,hyperoside,and cosmosiin,the isoflavonoid biochanin A,and the simple phenolic ferulic acid being the most prominent.In comparison,14 compounds were identified in the bulbs,primarily isoflavonoids,including tectoridin and germanaism B,and flavonoid apigenin.The leaves extracts exhibited significant antioxidant activity,whereas the anti-allergic and anti-inflammatory effects were mild.These findings highlight I.bucharica as a sustainable source of bioactive compounds with potential industrial applications.However,further studies are needed to evaluate bioavailability and in vivo efficacy,as well as to optimise extraction methods to realize its industrial potential fully.
基金financial support fromthe Chung Shan Medical University Hospital,Taiwan(CSH-2022-A-009).
文摘Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.
文摘Kidney transplantation(KT)accounts for nearly three-fourths of organ transplants in India,with living donors contributing to 82%of cases.Induction immunosuppression is essential to optimize initial immunosuppression,reduce acute rejections,and enable tailored use of maintenance agents.Rabbit anti-thymocyte globulin(rATG)and interleukin-2 receptor anatagonists(IL-2RA/IL-2RBs)are the most widely used induction therapies.However,data on induction practices across India are limited.To evaluate induction immunosuppression practices across KT centers in India and establish a consensus for different subsets of KT recipients.A nationwide online survey was conducted by the Indian Society of Organ Transplantation(ISOT)among its members(400 KT centers).Responses were analyzed to assess induction practices across diverse donor types,age groups,and immunological risk profiles.Heterogeneity in practices prompted consensus building using a modified Delphi process.Literature review and expert panel discussions(April 2024)were followed by structured voting,and 16 consensus statements were finalized.Of 400 centers approached,254 participated.rATG was the most commonly used induction therapy,followed by IL-2RBs;alemtuzumab was least used.Significant heterogeneity was observed in type,dose,and duration of induction therapy.Consensus recommendations were framed:rATG for high immunological risk recipients and deceased donor KTs;IL-2RB or low-dose rATG for low immunological risk;rituximab in ABOincompatible KTs;and tailoring based on age,diabetes,donor type,infection risk,and affordability.This first ISOT consensus provides 16 India-specific statements on induction therapy in KT.It emphasizes risk-stratified,evidenceinformed,and context-appropriate induction strategies,supporting standardization of care across the country.
文摘BACKGROUND: As per the "Disaster Management Act, 2005" of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1 900 bed tertiary care hospital, in consultation and involvement of all concerned stakeholders.METHODS: A committee of members from hospital administration, clinical, diagnostic and supportive departments worked on an initial document prepared according to the Act and gave their inputs to frame a final disaster manual.RESULTS: The prepared departmental standard operating procedures involved 116 people(doctors and paramedical staff), and were then synchronized, in 12 committee meetings, to produce the final hospital disaster manual.CONCLUSIONS: The present disaster manual is one of the few comprehensive plans prepared by the stakeholders of a government hospital in India, who themselves form a part of the disaster response team. It also helped in co-ordinated conduction of mock drills.
基金supported by Fundamental Research Funds for the Central Universities in China(Grant Number:2022NTSS52)First-Class Education Discipline Development of Beijing Normal University:Excellence Action Project(Grant Number:YLXKPYXSDW202408)Beijing Institute of Education 2024 Youth Research Projects“Research on the Transformation of Training Aimed at Improving the Work of School Principals in the Capital”(Grant Number:QZ2024-02).
文摘Background:With the global popularity of short videos,particularly among young people,short video addiction has become a worrying phenomenon that poses significant risks to individual health and adaptability.Self-regulated learning(SRL)strategies are key factors in predicting learning outcomes.This study,based on the SRL theory,uses short video addiction as the independent variable,SRL strategies as the mediating variable,and learning well-being as the outcome variable,aiming to reveal the relationships among short video addiction,self-regulated learning,and learning well-being among Chinese college students.Methods:Using a cross-sectional study design and applying the snowball sampling technique,an online survey was administered to Chinese undergraduate students.A total of 706 valid questionnaires were collected,with an effective response rate of 85.7%.The average age of the participants was 20.5 years.Results:The results of structural equation modeling indicate that 7 hypotheses were supported.Short video addiction was negatively correlated with self-regulated learning strategies(preparatory,performance,and appraisal strategy),while SRL strategies were positively correlated with learning well-being.Additionally,short video addiction had a mediating effect on learning well-being through the three types of SRL strategies.The three types of SRL strategies explained 39%of the variance in learning well-being.Conclusion:Previous research has typically focused on the impact of self-regulated learning strategies on media addiction or problematic media use.This study,based on the SRL model,highlights the negative issues caused by short video addiction and emphasizes the importance of cultivating self-regulation abilities and media literacy.Short video addiction stems from failures in trait self-regulation,which naturally impairs the ability to effectively engage in self-regulation during the learning process.This study confirms and underscores that the SRL model can serve as an effective theoretical framework for helping students prevent short video addiction,engage in high-quality learning,and consequently enhance their learning well-being.
文摘Objective:Pediatric burns pose difficult healthcare issues in underdeveloped nations.Due to the scarcity of pediatric burn care facilities and qualified burn‑care staff,patients are frequently referred from a rural hospital.This study explores the burn‑treatment approach that could be used in rural hospitals in the absence of a dedicated pediatric burn care facility.Materials and Methods:A retrospective analysis of clinical data of 199 children who received treatment for burn‑injury in an isolated general surgical ward.Wound debridement under anesthesia at the earliest was the cornerstone of the treatment plan for this cohort.Until the wounds healed,the treatment was repeated every alternate day.The patient’s demographic data,number of surgical dressings,length of hospital stay,and outcome were analyzed.Results:The mean age of the patients was 51.68±23.79 months.The male‑female ratio was 1.45:1.The survival rate was 99.00%.The disability rate was 4.52%.Univariate logistic regression identified the age group,total body surface area affected,depth of the wound,and time of intervention as statistically significant variables(P<0.05)predicting the disfigurement.Multivariate logistic regression identified the time intervals between surgical intervention and injury as an important predictor of morbidity.In addition,delayed presentation and delayed intervention led to a longer hospital stay,and more interventions than the early intervention cohort.Conclusions:Early debridement accelerates recovery and lessens the need for future skin grafts or contracture procedures.This approach can be used in rural hospitals as well because pediatric burns can be manageable in an isolated general ward.
文摘BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and mortality.AIM To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with SBO.METHODS Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were reviewed.RESULTS Out of 586 patients,7(1.2%)were diagnosed with IH.Among these,4 had congenital IH and 3 had acquired IH.The male-to-female ratio was 4:3.The median age at presentation was 32 years.Contrast-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel loops.Left paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of gut.During follow-up,no recurrences were reported.CONCLUSION IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.
文摘The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)diseases.Chronic kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the endothelium.ED is also associated with a decline in estimated glomerular filtration rate.After kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV health.However,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft survival.ED in kidney transplant recipients is an underrecognized and poorly studied entity.CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts.ED contributes to the pathogenesis of many of the CV diseases.Various biomarkers and vasoreactivity tests are available to study endothelial functions.With an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.
