Background/Aims: Data from Asia regarding the short-term and long-term outcomes for acute severe ulcerative colitis (ASUC) are limited. We assessed the outcomes of ASUC, identified the risk factors for colectomy, and compared colectomy rates between the pre-biologics and post-biologics eras in Taiwan. Methods: The patients with an ASUC diagnosis between January 2013 and March 2022 at 5 tertiary medical centers were retrospectively analyzed. Results: In total, 98 patients were enrolled, with 68.4% diagnosed in the post-biologics era. In 78.6% of the ASUC patients initially received intravenous steroid therapy, for which the success rate was 74.1%. As for rescue therapy, 15 patients (93.8%) received biologics and 1 (6.3%) received cyclosporin. Biologics rescue therapy had a 93.3% success rate. One (1%) mortality due to septic shock occurred. The colectomy rate for index ASUC admission was 11.2%. Patients receiving colectomy were predominantly male (P= 0.012) and at older age (P= 0.016). Higher C-reactive protein (P= 0.035), lower albumin (P= 0.017), and hemoglobin (P= 0.023) levels were associated with colectomy risk. During a median follow-up of 24 months, 13 patients (15.1%) had recurrent ASUC and 23.1% of patients received colectomy. The accumulated colectomy rate at 3 years did not differ between the pre- and post-biologics eras (16.1% vs. 13.4%, P= 0.270). Conclusions This is the first Asian study on ASUC to compare colectomy rates between the prebiologics and post-biologics eras, revealing no significant difference. The recurrent ASUC had a higher colectomy rate than the index ASUC.

Background: Patients with coarctation of the aorta (CoA) and an interrupted aortic arch (IAA) may present with small mitral valves (MVs) and a reduced left ventricular (LV) volume. Biventricular repair (BVR) in these patients is dependent on adequate size of the left cardiac structures.Purpose: This study evaluated the impact of the hemodynamic characteristics of atrial septal defects (ASDs) on MV growth following surgical repair. Methods: We retrospectively reviewed the data of patients diagnosed with CoA or IAA between 2007 and 2024. The z score for MV size measured 6 months postoperatively (Z2) was compared with the preoperative MV size (Z1). The factors associated with MV growth were also studied. Results: A total of 161 patients with CoA or IAA were included. Transthoracic echocardiography was used to assess the MV and LV dimensions preoperatively and 6 months postoperatively. Of the cohort, 155 (96.3%) underwent initial BVR and 6 underwent single-ventricle palliation. MV z scores significantly increased following BVR (mean change: +0.45±1.35; P<0.001) but decreased after single-ventricle repair (-0.56±0.49, P=0.04). Multivariate analysis identified the initial MV z score and ASD pressure gradient as independent predictors of MV growth (R2=0.39). Conclusion Annular growth of the MV was not observed in patients who underwent single-ventricle palliation. In contrast, among patients who achieved BVR, those with a small preoperative MV annulus and low ASD pressure gradient demonstrated subsequent catch-up MV growth, suggesting that adequate left-sided preload is essential for MV development.

Objective: The study was to develop the instrumental activities of daily living scale-ability and actual performance (IADL-AA) to assess the ability and actual performance constructs of instrumental activities of daily living (IADL). Methods: Eight experts reviewed the items of the IADL-AA. Additionally, 30 and 266 people with schizophrenia participated in cognitive interviews and validation analysis, respectively. Expert consultations and cognitive interviews were conducted to examine face validity and content validity, respectively. Construct validity was evaluated through Rasch analysis to ensure unidimensionality. Convergent validity was investigated using Pearson’s r, discriminative validity was examined through floor and ceiling effects, and internal consistency was assessed using Cronbach’s alpha (α). Results: The IADL-AA comprised 23 items showing the unidimensionality of each domain. The infit and outfit mean squares were 0.76–1.21 and 0.68–1.40, respectively. A moderate correlation was observed between ability and actual performance domains (r=0.63). No floor or ceiling effects were found for the two domains (0.0%–6.0% and 1.5%–3.0%, respectively). Cronbach’s α of the two domains was 0.83–0.90. Conclusion The IADL-AA demonstrates satisfactory psychometric properties, including face validity, content validity, construct validity, convergent validity, discriminative validity, and internal consistency. This measure can effectively identify the capacity and degree of independence of IADL function in people with schizophrenia.

Objective To investigate the mechanical effects of various height combinations of canine long-arm hooks and micro-im-plant anchorage on the retraction of maxillary anterior teeth in clear aligner treatment.It focuses on analyzing the stress distribution within the periodontal ligament and the movement tendencies of the anterior teeth,providing scientific evidence for optimizing orthodon-tic treatment strategies.Methods Three-dimensional finite element models were developed using CBCT scan data of patients and soft-ware including Mimics,Geomagic Studio,and Hypermesh.The models incorporated 16 different configurations of canine long-arm hooks(4,6,8,10 mm)and micro-implant anchorage(6,8,10,12 mm).Elastic traction forces of 3/16,3.5 oz were applied to these models.Simulations assessed how these variables influenced periodontal ligament stress distribution and the movement patterns of the maxillary anterior teeth.Results Stress during anterior teeth retraction was predominantly concentrated in the cervical and apex re-gions of the periodontal ligament,where it interfaced with the alveolar bone,indicating significant local concentration.Increasing the height of micro-implant anchorage and traction hooks markedly reduced positional changes in both the crown and apex.Specifically,when hooks exceeded 8 mm and anchorage heights surpassed 10 mm,canine movement became more uniform,preventing extrusion and minimizing the deepening of the overbite.Additionally,combinations of high traction hooks and high micro-implant anchorage promoted more uniform tooth movement,reducing unnecessary tipping and rotation.Conclusion In the retraction of maxillary anterior teeth with clear aligners,using high-position micro-implant anchorage and high-position traction hooks significantly enhances torque control of anterior teeth and effectively prevents deepening of the overbite.

AIM To investigate the effects of Huazhuo Jiedu Shugan Formula(HJSGF)on improving learning and memory impairment in a rat model of vascular dementia(VD)via SIRT1/PGC-1α/PPARγ pathway.METHODS The SD rats were randomly divided into the sham control group,the model group,the donepezil group(0.5 mg/kg),and the low-,medium-and high-dose HJSGF groups(2.7,5.4,10.8 g/kg),with 10 rats in each group.The VD rat models established by bilateral common carotid artery permanent ligation(2-VO)had their neurological behavior assessment using the Longa5-point scale,and their modeling success confirmed by the Morris water maze test and their 3-week corresponding dosing of drugs by gavage afterward.After the drug administration,the rats had their spatial memory ability tested through behavioral experiments;their serum levels of IL-18 and IL-1β measured by ELISA;their histopathological changes and neuronal morphology in the hippocampal CA1 region observed by HE staining and Nissl staining;and their hippocampal protein expressions of SIRT1,PGC-1α and PPARγ detected by immunohistochemistry and Western blot.RESULTS Compared with the sham control group,the model group showed prolonged escape latency(P＜0.01);decreased platform crossing times and target quadrant residence time(P＜0.01);disorganized arrangement of hippocampal CA1 neurons,nuclear condensation,reduced Nissl bodies,increased secretion and protein expressions of IL-1β and IL-18(P＜0.01);and reduced hippocampal protein expressions of SIRT1,PGC-1α and PPARγ(P＜0.01).Compared with the model group,the groups intervened with donepezil or HJSGF showed shortened escape latency(P＜0.05,P＜0.01);increased platform crossing times and target quadrant residence time(P＜0.05,P＜0.01);alleviated damage of the hippocampal CA1 region,reduced secretion and protein expressions of IL-1β and IL-18(P＜0.05,P＜0.01);and elevated hippocampal protein expressions of SIRT1,PGC-1α and PPARγ(P＜0.05,P＜0.01).CONCLUSION HJSGF may alleviate the inflammatory responses in VD rats and therefore improve their learning and memory impairment by activating the SIRT1/PGC-1α/PPARγ signaling pathway.

Objective To investigate the mechanical effects of various height combinations of canine long-arm hooks and micro-im-plant anchorage on the retraction of maxillary anterior teeth in clear aligner treatment.It focuses on analyzing the stress distribution within the periodontal ligament and the movement tendencies of the anterior teeth,providing scientific evidence for optimizing orthodon-tic treatment strategies.Methods Three-dimensional finite element models were developed using CBCT scan data of patients and soft-ware including Mimics,Geomagic Studio,and Hypermesh.The models incorporated 16 different configurations of canine long-arm hooks(4,6,8,10 mm)and micro-implant anchorage(6,8,10,12 mm).Elastic traction forces of 3/16,3.5 oz were applied to these models.Simulations assessed how these variables influenced periodontal ligament stress distribution and the movement patterns of the maxillary anterior teeth.Results Stress during anterior teeth retraction was predominantly concentrated in the cervical and apex re-gions of the periodontal ligament,where it interfaced with the alveolar bone,indicating significant local concentration.Increasing the height of micro-implant anchorage and traction hooks markedly reduced positional changes in both the crown and apex.Specifically,when hooks exceeded 8 mm and anchorage heights surpassed 10 mm,canine movement became more uniform,preventing extrusion and minimizing the deepening of the overbite.Additionally,combinations of high traction hooks and high micro-implant anchorage promoted more uniform tooth movement,reducing unnecessary tipping and rotation.Conclusion In the retraction of maxillary anterior teeth with clear aligners,using high-position micro-implant anchorage and high-position traction hooks significantly enhances torque control of anterior teeth and effectively prevents deepening of the overbite.

ObjectiveAs a second messenger in intracellular signal transduction, Ca²⁺ plays an important role in cell migration. Previous studies have demonstrated that extracellular Ca²⁺ influx can promote electric field-guided cell migration, known as electrotaxis. However, the effect of intracellular Ca²⁺ flow on electrotaxis is unclear. Therefore, in this study, we investigate the effect of Ca²⁺ flux on the electrotaxis of Dictyostelium discoideum. MethodsThe electrotaxis of Dictyostelium discoideum was investigated by applying a direct current (DC) electric field. Cell migration was recorded using a real-time imaging system. Calcium channel inhibitors, the extracellular Ca²⁺ chelator EGTA, Ca²⁺-free DB buffer, and caffeine were applied to investigate the impact of intra- and extracellular Ca²⁺ flow on electrotaxis. The involvement of G proteins and ERK2 in directed cell migration mediated by endoplasmic reticulum Ca²⁺ release was explored using mutants. ResultsDictyostelium discoideum migrated toward the cathode in the electric field in a voltage-dependent manner. The intracellular Ca²⁺ concentration of the cells was significantly increased in the electric field. Inhibition of both extracellular Ca²⁺ influx and intracellular Ca²⁺ release suppressed cell electrotaxis migration. Inhibition of endoplasmic reticulum Ca²⁺ release induced by caffeine significantly impaired the electrotaxis of Dictyostelium discoideum. Deletion of Gα2, Gβ, Gγ, and Erk2 notably reduced the electrotaxis of the cells. Enhancing Ca²⁺ release mediated by caffeine restored the electrotaxis of the Gα2^-, Gβ ^-, and Erk2^- mutant cells partially or completely, but did not restore electrotaxis in the Gγ^- mutant cells. ConclusionCa²⁺ release from the endoplasmic reticulum regulates electrotaxis migration in Dictyostelium discoideum and is involved in the regulation of cell electrotaxis by G proteins and ERK2.

Specific learning disorder (SLD) is a common neurodevelopmental disorder in children that significantly affects academic performance and quality of life. At present, diagnosis mainly relies on standardized tests and professional evaluations, a process that is complex and time-consuming. Multiple studies have shown that machine learning can analyze diverse data, including test scores, handwriting samples, eye movement data, neuroimaging data, and genetic data, to automatically learn the relationships between input features and output labels and achieve efficient prediction. It shows great potential for early screening, auxiliary diagnosis, and research on underlying mechanisms in SLD. This article reviews the applications of machine learning in the auxiliary diagnosis of SLD and discusses its performance when handling different data types.
Humans ; Machine Learning ; Specific Learning Disorder/diagnosis* ; Child

AIM To investigate the effects of Huazhuo Jiedu Shugan Formula(HJSGF)on improving learning and memory impairment in a rat model of vascular dementia(VD)via SIRT1/PGC-1α/PPARγ pathway.METHODS The SD rats were randomly divided into the sham control group,the model group,the donepezil group(0.5 mg/kg),and the low-,medium-and high-dose HJSGF groups(2.7,5.4,10.8 g/kg),with 10 rats in each group.The VD rat models established by bilateral common carotid artery permanent ligation(2-VO)had their neurological behavior assessment using the Longa5-point scale,and their modeling success confirmed by the Morris water maze test and their 3-week corresponding dosing of drugs by gavage afterward.After the drug administration,the rats had their spatial memory ability tested through behavioral experiments;their serum levels of IL-18 and IL-1β measured by ELISA;their histopathological changes and neuronal morphology in the hippocampal CA1 region observed by HE staining and Nissl staining;and their hippocampal protein expressions of SIRT1,PGC-1α and PPARγ detected by immunohistochemistry and Western blot.RESULTS Compared with the sham control group,the model group showed prolonged escape latency(P＜0.01);decreased platform crossing times and target quadrant residence time(P＜0.01);disorganized arrangement of hippocampal CA1 neurons,nuclear condensation,reduced Nissl bodies,increased secretion and protein expressions of IL-1β and IL-18(P＜0.01);and reduced hippocampal protein expressions of SIRT1,PGC-1α and PPARγ(P＜0.01).Compared with the model group,the groups intervened with donepezil or HJSGF showed shortened escape latency(P＜0.05,P＜0.01);increased platform crossing times and target quadrant residence time(P＜0.05,P＜0.01);alleviated damage of the hippocampal CA1 region,reduced secretion and protein expressions of IL-1β and IL-18(P＜0.05,P＜0.01);and elevated hippocampal protein expressions of SIRT1,PGC-1α and PPARγ(P＜0.05,P＜0.01).CONCLUSION HJSGF may alleviate the inflammatory responses in VD rats and therefore improve their learning and memory impairment by activating the SIRT1/PGC-1α/PPARγ signaling pathway.

Objective To explore an assessment model for multi-level integrated training in health service based on advanced intelligent trauma simulators in order to innovate health service training.Methods An assessment model for multi-level integrated training that involved advanced trauma simulators was adopted to assess chains of treatment and rescue that were composed of multi-hierarchy medical institutions.The assessment focused on trauma emergency response capabilities at each level and the overall therapeutic effect.Results In terms of capabilities for treatment and rescue,group B was the best one,followed by group C and group A.As for the overall therapeutic effect,group A was outstanding,followed by group B and group C.Based on the priorities of combat casualty care,the final results of assessment were as follows:group A was the best one,followed by group B and group C.Conclusion The analysis of processes and outcomes of assessment reveals the edge of this model,as evidenced by the continuity of treatment and rescue,integrity of overall effectiveness,and adaptability of this assessment model.