Purpose: Interviews play a crucial role in the medical school selection process, although little is known about interviewers’ non-verbal observable communications (NoVOC) during the interviews. This study investigates how interviewers perceive NoVOC exhibited by interviewees in two medical schools, one in Taiwan and the other in Australia. The study also explores potential cross-cultural differences in these perceptions. Methods: A 26-item questionnaire was developed using a Delphi-like method to identify NoVOC. Interviewers from the University of New South Wales, Australia, and National Yang Ming Chiao Tung University, Taiwan (n=47 and N=78, respectively) rated these NoVOC between 2018 and 2021. Factor analyses identified and validated underlying factors. Measurement invariance across countries and genders was examined. Results: A total of 125 interviewers completed the questionnaire, including 78 from Taiwan and 47 from Australia. Using exploratory factor analysis, 14 items yielded reliable three factors “charming,” “disengaged,” and “anxious” (Cronbach’s α=0.853, 0.714, and 0.628, respectively). The measurement invariance analysis indicated that the factor models were invariant across genders but significantly different between the two countries. Further analysis revealed inconsistencies in interpreting the “anxious” factor between Taiwan and Australia. Conclusion The three distinct factors revealed in this study provide valuable insights into the NoVOC that interviewers perceive and evaluate during the interview process. The findings highlight the importance of considering non-verbal communication in selecting medical students and emphasize the need for training and awareness among interviewers. Understanding the impact of non-verbal behaviors can improve selection processes to mitigate bias and enhance the fairness and reliability of medical student selection.

Purpose: Interviews play a crucial role in the medical school selection process, although little is known about interviewers’ non-verbal observable communications (NoVOC) during the interviews. This study investigates how interviewers perceive NoVOC exhibited by interviewees in two medical schools, one in Taiwan and the other in Australia. The study also explores potential cross-cultural differences in these perceptions. Methods: A 26-item questionnaire was developed using a Delphi-like method to identify NoVOC. Interviewers from the University of New South Wales, Australia, and National Yang Ming Chiao Tung University, Taiwan (n=47 and N=78, respectively) rated these NoVOC between 2018 and 2021. Factor analyses identified and validated underlying factors. Measurement invariance across countries and genders was examined. Results: A total of 125 interviewers completed the questionnaire, including 78 from Taiwan and 47 from Australia. Using exploratory factor analysis, 14 items yielded reliable three factors “charming,” “disengaged,” and “anxious” (Cronbach’s α=0.853, 0.714, and 0.628, respectively). The measurement invariance analysis indicated that the factor models were invariant across genders but significantly different between the two countries. Further analysis revealed inconsistencies in interpreting the “anxious” factor between Taiwan and Australia. Conclusion The three distinct factors revealed in this study provide valuable insights into the NoVOC that interviewers perceive and evaluate during the interview process. The findings highlight the importance of considering non-verbal communication in selecting medical students and emphasize the need for training and awareness among interviewers. Understanding the impact of non-verbal behaviors can improve selection processes to mitigate bias and enhance the fairness and reliability of medical student selection.

ObjectiveThis study leverages structural data from antigen-antibody complexes of the influenza A virus neuraminidase (NA) protein to investigate the spatial recognition relationship between the antigenic epitopes and antibody paratopes. MethodsStructural data on NA protein antigen-antibody complexes were comprehensively collected from the SAbDab database, and processed to obtain the amino acid sequences and spatial distribution information on antigenic epitopes and corresponding antibody paratopes. Statistical analysis was conducted on the antibody sequences, frequency of use of genes, amino acid preferences, and the lengths of complementarity determining regions (CDR). Epitope hotspots for antibody binding were analyzed, and the spatial structural similarity of antibody paratopes was calculated and subjected to clustering, which allowed for a comprehensively exploration of the spatial recognition relationship between antigenic epitopes and antibodies. The specificity of antibodies targeting different antigenic epitope clusters was further validated through bio-layer interferometry (BLI) experiments. ResultsThe collected data revealed that the antigen-antibody complex structure data of influenza A virus NA protein in SAbDab database were mainly from H3N2, H7N9 and H1N1 subtypes. The hotspot regions of antigen epitopes were primarily located around the catalytic active site. The antibodies used for structural analysis were primarily derived from human and murine sources. Among murine antibodies, the most frequently used V-J gene combination was IGHV1-12*01/IGHJ2*01, while for human antibodies, the most common combination was IGHV1-69*01/IGHJ6*01. There were significant differences in the lengths and usage preferences of heavy chain CDR amino acids between antibodies that bind within the catalytic active site and those that bind to regions outside the catalytic active site. The results revealed that structurally similar antibodies could recognize the same epitopes, indicating a specific spatial recognition between antibody and antigen epitopes. Structural overlap in the binding regions was observed for antibodies with similar paratope structures, and the competitive binding of these antibodies to the epitope was confirmed through BLI experiments. ConclusionThe antigen epitopes of NA protein mainly ditributed around the catalytic active site and its surrounding loops. Spatial complementarity and electrostatic interactions play crucial roles in the recognition and binding of antibodies to antigenic epitopes in the catalytic region. There existed a spatial recognition relationship between antigens and antibodies that was independent of the uniqueness of antibody sequences, which means that antibodies with different sequences could potentially form similar local spatial structures and recognize the same epitopes.

Purpose: Zinc finger protein 639 (ZNF639) is often found within the overlapping amplicon of PIK3CA, and previous studies suggest its involvement in the pathogenesis of esophageal and oral squamous cell carcinomas. However, its expression and significance in breast cancer remain uncharacterized. Methods: Immunohistochemical analysis of ZNF639 was performed using tissue microarrays.Functional studies, including colony formation, Transwell cell migration, and in vivo metastasis, were conducted on breast tumor cells with ZNF639 knockdown via small interfering RNA transfection. Results: Reduced ZNF639 immunoreactivity was observed in 82% of the breast cancer samples, independent of hormone receptor and human epidermal growth factor receptor 2 status. In multivariate Cox regression analyses, ZNF639 expression was associated with favorable survival outcomes, including recurrence-free survival (hazard ratio, 0.35; 95% confidence interval [CI], 0.14–0.89) and overall survival (hazard ratio, 0.41; 95% CI, 0.16– 1.05). ZNF639 knockdown increased clonogenicity, cell motility, and lung metastasis in NOD/ SCID mice. Following the ZNF639 knockdown, the expression of Snail1, vimentin, and C-C chemokine ligand 20 (CCL20) was upregulated, and the changes in cell phenotype mediated by ZNF639 were reversed by the subsequent knockdown of CCL20. Conclusion Low ZNF639 expression is a novel prognostic factor for recurrence-free survival in patients with breast cancer.

Purpose: Zinc finger protein 639 (ZNF639) is often found within the overlapping amplicon of PIK3CA, and previous studies suggest its involvement in the pathogenesis of esophageal and oral squamous cell carcinomas. However, its expression and significance in breast cancer remain uncharacterized. Methods: Immunohistochemical analysis of ZNF639 was performed using tissue microarrays.Functional studies, including colony formation, Transwell cell migration, and in vivo metastasis, were conducted on breast tumor cells with ZNF639 knockdown via small interfering RNA transfection. Results: Reduced ZNF639 immunoreactivity was observed in 82% of the breast cancer samples, independent of hormone receptor and human epidermal growth factor receptor 2 status. In multivariate Cox regression analyses, ZNF639 expression was associated with favorable survival outcomes, including recurrence-free survival (hazard ratio, 0.35; 95% confidence interval [CI], 0.14–0.89) and overall survival (hazard ratio, 0.41; 95% CI, 0.16– 1.05). ZNF639 knockdown increased clonogenicity, cell motility, and lung metastasis in NOD/ SCID mice. Following the ZNF639 knockdown, the expression of Snail1, vimentin, and C-C chemokine ligand 20 (CCL20) was upregulated, and the changes in cell phenotype mediated by ZNF639 were reversed by the subsequent knockdown of CCL20. Conclusion Low ZNF639 expression is a novel prognostic factor for recurrence-free survival in patients with breast cancer.

Purpose: Interviews play a crucial role in the medical school selection process, although little is known about interviewers’ non-verbal observable communications (NoVOC) during the interviews. This study investigates how interviewers perceive NoVOC exhibited by interviewees in two medical schools, one in Taiwan and the other in Australia. The study also explores potential cross-cultural differences in these perceptions. Methods: A 26-item questionnaire was developed using a Delphi-like method to identify NoVOC. Interviewers from the University of New South Wales, Australia, and National Yang Ming Chiao Tung University, Taiwan (n=47 and N=78, respectively) rated these NoVOC between 2018 and 2021. Factor analyses identified and validated underlying factors. Measurement invariance across countries and genders was examined. Results: A total of 125 interviewers completed the questionnaire, including 78 from Taiwan and 47 from Australia. Using exploratory factor analysis, 14 items yielded reliable three factors “charming,” “disengaged,” and “anxious” (Cronbach’s α=0.853, 0.714, and 0.628, respectively). The measurement invariance analysis indicated that the factor models were invariant across genders but significantly different between the two countries. Further analysis revealed inconsistencies in interpreting the “anxious” factor between Taiwan and Australia. Conclusion The three distinct factors revealed in this study provide valuable insights into the NoVOC that interviewers perceive and evaluate during the interview process. The findings highlight the importance of considering non-verbal communication in selecting medical students and emphasize the need for training and awareness among interviewers. Understanding the impact of non-verbal behaviors can improve selection processes to mitigate bias and enhance the fairness and reliability of medical student selection.

Purpose: Zinc finger protein 639 (ZNF639) is often found within the overlapping amplicon of PIK3CA, and previous studies suggest its involvement in the pathogenesis of esophageal and oral squamous cell carcinomas. However, its expression and significance in breast cancer remain uncharacterized. Methods: Immunohistochemical analysis of ZNF639 was performed using tissue microarrays.Functional studies, including colony formation, Transwell cell migration, and in vivo metastasis, were conducted on breast tumor cells with ZNF639 knockdown via small interfering RNA transfection. Results: Reduced ZNF639 immunoreactivity was observed in 82% of the breast cancer samples, independent of hormone receptor and human epidermal growth factor receptor 2 status. In multivariate Cox regression analyses, ZNF639 expression was associated with favorable survival outcomes, including recurrence-free survival (hazard ratio, 0.35; 95% confidence interval [CI], 0.14–0.89) and overall survival (hazard ratio, 0.41; 95% CI, 0.16– 1.05). ZNF639 knockdown increased clonogenicity, cell motility, and lung metastasis in NOD/ SCID mice. Following the ZNF639 knockdown, the expression of Snail1, vimentin, and C-C chemokine ligand 20 (CCL20) was upregulated, and the changes in cell phenotype mediated by ZNF639 were reversed by the subsequent knockdown of CCL20. Conclusion Low ZNF639 expression is a novel prognostic factor for recurrence-free survival in patients with breast cancer.

Purpose: Interviews play a crucial role in the medical school selection process, although little is known about interviewers’ non-verbal observable communications (NoVOC) during the interviews. This study investigates how interviewers perceive NoVOC exhibited by interviewees in two medical schools, one in Taiwan and the other in Australia. The study also explores potential cross-cultural differences in these perceptions. Methods: A 26-item questionnaire was developed using a Delphi-like method to identify NoVOC. Interviewers from the University of New South Wales, Australia, and National Yang Ming Chiao Tung University, Taiwan (n=47 and N=78, respectively) rated these NoVOC between 2018 and 2021. Factor analyses identified and validated underlying factors. Measurement invariance across countries and genders was examined. Results: A total of 125 interviewers completed the questionnaire, including 78 from Taiwan and 47 from Australia. Using exploratory factor analysis, 14 items yielded reliable three factors “charming,” “disengaged,” and “anxious” (Cronbach’s α=0.853, 0.714, and 0.628, respectively). The measurement invariance analysis indicated that the factor models were invariant across genders but significantly different between the two countries. Further analysis revealed inconsistencies in interpreting the “anxious” factor between Taiwan and Australia. Conclusion The three distinct factors revealed in this study provide valuable insights into the NoVOC that interviewers perceive and evaluate during the interview process. The findings highlight the importance of considering non-verbal communication in selecting medical students and emphasize the need for training and awareness among interviewers. Understanding the impact of non-verbal behaviors can improve selection processes to mitigate bias and enhance the fairness and reliability of medical student selection.

Diabetic cardiomyopathy is a distinct form of cardiomyopathy that can lead to heart failure, arrhythmias, cardiogenic shock, and sudden death. It has become a major cause of mortality in diabetic patients. The pathogenesis of diabetic cardiomyopathy is complex, involving increased oxidative stress, activation of inflammatory responses, disturbances in glucose and lipid metabolism, accumulation of advanced glycation end products (AGEs), abnormal autophagy and apoptosis, insulin resistance, and impaired intracellular Ca²⁺ homeostasis. Recent studies have shown that adenosine monophosphate-activated protein kinase (AMPK) plays a crucial protective role by lowering blood glucose levels, promoting lipolysis, inhibiting lipid synthesis, and exerting antioxidant, anti-inflammatory, anti-apoptotic, and anti-ferroptotic effects. It also enhances autophagy, thereby alleviating myocardial injury under hyperglycemic conditions. Consequently, AMPK is considered a key protective factor in diabetic cardiomyopathy. As part of diabetes prevention and treatment strategies, both pharmacological and exercise interventions have been shown to mitigate diabetic cardiomyopathy by modulating the AMPK signaling pathway. However, the precise regulatory mechanisms, optimal intervention strategies, and clinical translation require further investigation. This review summarizes the role of AMPK in the prevention and treatment of diabetic cardiomyopathy through drug and/or exercise interventions, aiming to provide a reference for the development and application of AMPK-targeted therapies. First, several classical AMPK activators (e.g., AICAR, A-769662, O-304, and metformin) have been shown to enhance autophagy and glucose uptake while inhibiting oxidative stress and inflammatory responses by increasing the phosphorylation of AMPK and its downstream target, mammalian target of rapamycin (mTOR), and/or by upregulating the gene expression of glucose transporters GLUT1 and GLUT4. Second, many antidiabetic agents (e.g., teneligliptin, liraglutide, exenatide, semaglutide, canagliflozin, dapagliflozin, and empagliflozin) can promote autophagy, reverse excessive apoptosis and autophagy, and alleviate oxidative stress and inflammation by enhancing AMPK phosphorylation and its downstream targets, such as mTOR, or by increasing the expression of silent information regulator 1 (SIRT1) and peroxisome proliferator-activated receptor‑α (PPAR‑α). Third, certain anti-anginal (e.g., trimetazidine, nicorandil), anti-asthmatic (e.g., farrerol), antibacterial (e.g., sodium houttuyfonate), and antibiotic (e.g., minocycline) agents have been shown to promote autophagy/mitophagy, mitochondrial biogenesis, and inhibit oxidative stress and lipid accumulation via AMPK phosphorylation and its downstream targets such as protein kinase B (PKB/AKT) and/or PPAR‑α. Fourth, natural compounds (e.g., dihydromyricetin, quercetin, resveratrol, berberine, platycodin D, asiaticoside, cinnamaldehyde, and icariin) can upregulate AMPK phosphorylation and downstream targets such as AKT, mTOR, and/or the expression of nuclear factor erythroid 2-related factor 2 (Nrf2), thereby exerting anti-inflammatory, anti-apoptotic, anti-pyroptotic, antioxidant, and pro-autophagic effects. Fifth, moderate exercise (e.g., continuous or intermittent aerobic exercise, aerobic combined with resistance training, or high-intensity interval training) can activate AMPK and its downstream targets (e.g., acetyl-CoA carboxylase (ACC), GLUT4, PPARγ coactivator-1α (PGC-1α), PPAR-α, and forkhead box protein O3 (FOXO3)) to promote fatty acid oxidation and glucose uptake, and to inhibit oxidative stress and excessive mitochondrial fission. Finally, the combination of liraglutide and aerobic interval training has been shown to activate the AMPK/FOXO1 pathway, thereby reducing excessive myocardial fatty acid uptake and oxidation. This combination therapy offers superior improvement in cardiac dysfunction, myocardial hypertrophy, and fibrosis in diabetic conditions compared to liraglutide or exercise alone.

Objective: To analyze the status and correlation between screen time, screen behavior type, and anxiety, depression among children and adolescents in Jiangxi Province, so as to provide a basis for effective intervention measures. Methods: Using the method of stratified random sampling, 8 851 primary and secondary school students in 11 districts of Jiangxi Province were investigated by questionnaire during September to December in 2020. Anxiety and depression status were investigated using the State Trait Anxiety Inventory (STAI) and the Center for Epidemiological Studies Depression Scale for Children(CES-DC), respectively. Single factor analysis using χ 2-test, t-test,analysis of variance,and multivariate analysis using generalized linear models. Results: On school days and weekends, 4.7% and 20.4% of primary and secondary school students in Jiangxi Province had a total screen time of over 2 hours per day, respectively. The weighted scores of the total screen time (primary school students: 1.88± 0.68, junior middle school students: 1.96±0.71, high school students: 2.03±0.80) and time spent for playing video games (primary school students: 1.51±0.64, junior middle school students: 1.62±0.69, high school students: 1.68±0.75) daily showed an upward trend with the increase of educational stage ( F =31.48, 42.13), and with significantly higher in boys (1.97±0.74, 1.66± 0.72) than girls (1.93±0.72, 1.53±0.66)( t =2.48, 9.07)( P <0.05). The average scores of state anxiety and trait anxiety were (42.20±9.05) and (40.65±9.85), which showed an upward trend with the increase of educational stage ( F =168.12, 241.98 ), and were higher in girls than boys ( t =6.63, 8.48)( P <0.01). The average score of depression was (11.99±11.00), which was lower in elementary school students than middle school students and high school students ( F =136.42), with significantly higher in girls ( t =6.85)( P <0.01). On school days, with the increase of total screen time and time spent for playing video games daily, the risk of state anxiety, trait anxiety, and depression among primary and secondary school students significantly increased ( OR = 6.70- 818.98, P <0.01). On weekends, among primary and secondary school students, the total screen time of >1-2 hours daily reduced the risk of state anxiety ( OR =0.30). The risk of developing trait anxiety among students playing video games for more than 2 hours daily was 2.50 times higher than those without screen behavior ( OR =2.50). The risk of developing depression with a total screen time of more than 2 hours daily was 3.15 times higher those whithout screen behavior ( OR =3.15). The risk of developing depression among students playing video games >0-1, >1-2, >2 h daily was 2.14, 2.50, 4.90 times that of those without screen behaviors ( OR =2.14, 2.50, 4.90), and showed an upward trend with the increase of educational stage ( P <0.05). Conclusions Screen behaviors of primary and middle school students in Jiangxi Province are positively associated with the risk of anxiety and depression, but the total daily video time of >1-2 h on weekends was negatively associated with state anxiety. It is necessary to control the screen time as much as possible and reduce the risk of anxiety and depression.