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Menstrual disorders are common health concerns that can negatively impact psychological well-being. This study examined the mediating role of future anxiety in the relationship between various menstrual disorders and well-being. Methods A cross-sectional study was conducted among 399 Taiwanese women aged 18–48 from June 2021 to May 2022. Participants reported their menstrual cycles during the last six months. Individuals suffer from menstrual disorders if they have one of the following symptoms: infrequency, irregularity, abnormal flow volume, intermenstrual bleeding, pain/cramps, premenstrual symptoms, and one or more missed menstrual periods. Anxiety was evaluated using the Dark Future Scale. Well-being was measured using the World Health Organization’s Well-being Index. Results Mediation analysis revealed that premenstrual symptoms were directly associated with well-being (coefficient (B) = -4.39, p  = 0.018) and indirectly via future anxiety (B = -2.22, 95% confidence interval (CI) [-3.77, -0.86]). Additionally, the indirect effect of menstrual pains/cramps on well-being through future anxiety was significant, as the 95% CI did not include zero (B = -2.14, 95% CI [-3.81 to -0.71]). Intermenstrual bleeding between periods and abnormal light bleeding have indirect effects on well-being only via future anxiety (B = -1.84, 95% CI [-3.47, -0.41] and B = -1.58, 95% CI [-3.24, -0.06], respectively). However, for missed, infrequent, or irregular menstrual periods, future anxiety was not a significant mediator. We did not observe a significant relationship between heavy and well-being. Conclusions This study highlights that future anxiety partially mediates the link between premenstrual symptoms and well-being, suggesting both direct and indirect effects. Intermenstrual bleeding, abnormal light bleeding, and menstrual pains/cramps have no direct impact on well-being but influence well-being only through future anxiety. However, missed, infrequent, or heavy/prolonged bleeding or irregular menstrual periods showed no significant association with well-being. Plain english summary Menstrual disorders are common and can affect women’s well-being. This study examined how anxiety about the future may contribute to mediating the relationship between menstrual problems and overall well-being. Researchers surveyed 399 Taiwanese women aged 18 to 48 between June 2021 and May 2022. The women answered questions about their menstrual cycles over the past six months. Participants also completed questionnaires measuring their level of future anxiety and general well-being. The study found that women who experienced premenstrual symptoms reported lower well-being, both directly and because they felt more anxious about the future. Pain or cramps during menstruation were related to lower well-being, but this relationship happened only indirectly through future anxiety. Similarly, light bleeding between periods and unusual light bleeding were linked to lower well-being, but only because they increased future anxiety. On the other hand, missed, infrequent, or irregular periods, as well as heavy bleeding, were not significantly linked to well-being, either directly or through anxiety. In summary, the study suggests that anxiety about the future plays an important role in how certain menstrual symptoms affect a woman’s overall well-being. Helping women manage future-related anxiety might improve their mental health, especially for those dealing with pain, premenstrual symptoms, or irregular bleeding patterns.

Purposes: To explore the associated factors of COVID-19 vaccine hesitancy and examine psychometric properties of the coronavirus-related health literacy questionnaire (HLS-COVID-Q22) and Oxford COVID-19 Vaccine Hesitancy questionnaire. Methods: An online survey was conducted from 23 June to 16 July 2021 on 387 school principals across Taiwan. Data collection included socio-demographic characteristics, information related to work, physical and mental health, COVID-19 related perceptions, sense of coherence, coronavirus-related health literacy, and vaccine hesitancy. Principal component analysis, correlation analysis, linear regression models were used for validating HLS-COVID-Q22, Oxford COVID-19 Vaccine Hesitancy, and examining the associations. Results: HLS-COVID-Q22 and Oxford COVID-19 Vaccine Hesitancy were found with satisfactory construct validity (items loaded on one component with factor loading values range 0.57 to 0.81, and 0.51 to 0.78), satisfactory convergent validity (item-scale correlations range 0.60 to 0.79, and 0.65 to 0.74), high internal consistency (Cronbach’s alpha = 0.96 and 0.90), and without floor or ceiling effects (percentages of possibly lowest score and highest score <15%), respectively. Low scores of vaccine hesitancy were found in male principals (regression coefficient, B, −0.69; 95% confidence interval, 95%CI, −1.29, −0.10; p = 0.023), principals with better well-being (B, −0.25; 95%CI, −0.47, −0.03; p = 0.029), and higher HLS-COVID-Q22 (B, −1.22; 95%CI, −1.89, −0.54; p < 0.001). Conclusions: HLS-COVID-Q22 and Oxford COVID-19 Vaccine Hesitancy were valid and reliable tools. Male principals and those with better well-being, and higher health literacy had a lower level of vaccine hesitancy. Improving principals’ health literacy and well-being is suggested to be a strategic approach to increase vaccine acceptance for themselves, their staff, and students.

Myopia is a highly prevalent refractive disorder. We investigated the effect of diacerein on monocular form deprivation (MFD) in hamsters as a possible therapeutic intervention. Diacerein is an anthraquinone derivative drug whose active metabolite is rhein. Diacerein or atropine was applied to the MFD hamsters, and their refractive error and axial length were measured after 21 days. The refractive error (control: −0.91±0.023, atropine: −0.3±0.08, and diacerein: −0.27±0.07 D) and axial length (control: 0.401±0.017, atropine: 0.326±0.017, and diacerein: 0.334±0.016 mm) showed statistically significant differences between control, atropine-treated, and diacerein-treated MFD eyes. Furthermore, we determined the level of transforming growth factor-beta- (TGF-) β1, matrix metalloproteinase- (MMP-) 2, type I collagen, interleukin- (IL-) 6, IL-8, and monocyte chemoattractant protein- (MCP-) 1 in the retina. Atropine and diacerein suppressed levels of the myopia-related TGF-β1 and MMP-2 while increasing type I collagen expression. They also inhibited the interleukin IL-6, IL-8, and MCP-1 levels. Diacerein reduced the IL-6, IL-8, and MCP-1 expression in ARPE-19 cells. Furthermore, diacerein inhibited inflammation by attenuating the phosphorylation of protein kinase B (AKT) and nuclear factor kappa-light-chain-enhancer of activated B (NF-κB) pathway. This suggests that diacerein has a therapeutic effect on myopia and is a potential treatment option.

Background Galectin-9 is a β-galactoside-binding protein with two carbohydrate recognition domains. Recent studies have revealed that galectin-9 regulates cellular biological reactions and plays a pivotal role in fibrosis. The aim of this study was to determine the role of galectin-9 in the pathogenesis of bleomycin-induced systemic sclerosis (SSc). Methods Human galectin-9 levels in the serum of patients with SSc and mouse sera galectin-9 levels were measured by a Bio-Plex immunoassay and enzyme-linked immunosorbent assay. Lung fibrosis was induced using bleomycin in galectin-9 wild-type and knockout mice. The effects of galectin-9 on the fibrosis markers and signaling molecules in the mouse lung tissues and primary lung fibroblast cells were assessed with western blotting and quantitative polymerase chain reaction. Results Galectin-9 levels in the serum were significantly higher (9-fold) in patients compared to those of healthy individuals. Galectin-9 deficiency in mice prominently ameliorated epithelial proliferation, collagen I accumulation, and α-smooth muscle actin expression. In addition, the galectin-9 knockout mice showed reduced protein expression levels of fibrosis markers such as Smad2/3, connective tissue growth factor, and endothelin-1. Differences between the wild-type and knockout groups were also observed in the AKT, mitogen-activated protein kinase, and c-Jun N-terminal kinase signaling pathways. Galectin-9 deficiency decreased the signal activation induced by transforming growth factor-beta in mouse primary fibroblasts, which plays a critical role in fibroblast activation and aberrant catabolism of the extracellular matrix. Conclusions Our findings suggest that lack of galectin-9 protects against bleomycin-induced SSc. Moreover, galectin-9 might be involved in regulating the progression of fibrosis in multiple pathways.

The study aims to utilize the convergence–confinement method (CCM) by considering non-hydrostatic stress assumptions in the analysis of the surrounding rock in a circular tunnel. The rock mass properties should adhere to the criteria of the non-linear Hoek–Brown failure criterion. Through a thorough theoretical analysis approach, an analytical solution was derived to determine the stress and displacement induced by tunnel excavation, particularly in the elastic and plastic zones. This solution, applicable under anisotropic stress conditions, involves accounting for confinement loss incrementally for computational feasibility. The implementation of this analytical solution, facilitated by a straightforward spreadsheet, was validated against existing data to evaluate the impact of non-linear failure criteria on ground reaction behavior. The study scrutinizes the mechanical response at the tunnel’s inner curve and assesses stress–displacement distribution across the tunnel cross-section. A comparison between the proposed solution and published results demonstrates a consistent and promising correlation.

It is well documented that the demand for fresh produce, to a great extent, depends on how fresh it is and an increase in shelf space for displayed stocks may induce more purchase of the produce. However, relatively little attention has been paid to the effect of expiration date despite the fact that produce deteriorates over time and expiration dates are often an important factor in consumers' purchase decision. In this paper, we propose an economic order quantity model in which we explicitly specify the demand for fresh produce to be a function of its freshness-expiration date and displayed volume. With the demand being freshness-and-stock dependent, it may be profitable to maintain high stock level at the end of the replenishment cycle. Hence, we relax the traditional assumption of zero ending inventory to non-zero ending inventory. Consequently, the objective here is to determine the optimal level of shelf space size, replenishment cycle time, and/or ending inventory level in an effort of maximizing the total annual profit. We found that the total annual profit is strictly pseudo-concave with regard to the three decision variables, which simplifies the search for the global solution to a local optimal. Numerical examples are then presented to highlight the theoretical implications and managerial insights.

Background The increased global incidence of myopia requires the establishment of therapeutic approaches. This study aimed to investigate the effect of Fallopia Japonica (FJ) and Prunella vulgaris (PV) extract on myopia caused by monocular form deprivation (MFD). Methods We used human retinal pigment epithelial cell to study the molecular mechanisms on how FJ extract (FJE) and PV extract (PVE) lowering the inflammation of the eye. The effect of FJE and PVE in MFD induced hamster model and explore the role of inflammation cytokines in myopia. Results FJE + PVE reduced IL-6, IL-8, and TNF-α expression in RPE cells. Furthermore, FJE and PVE inhibited inflammation by attenuating the phosphorylation of protein kinase B (AKT), and nuclear factor kappa-light-chain-enhancer of activated B (NF-κB) pathway. In addition, we report two resveratrol + ursolic acid compounds from FJ and PV and their inhibitory activities against IL-6, IL-8, and TNF-α expression levels in RPE cells treated with IL-6 and TNF-α. FJE, PVE, and FJE + PVE were applied to MFD hamsters and their axial length was measured after 21 days. The axial length showed statistically significant differences between phosphate-buffered saline- and FJE-, PVE-, and FJE + PVE-treated MFD eyes. FJE + PVE suppressed expressions of IL-6, IL-8, and TNF-α. They also inhibited myopia-related transforming growth factor-beta (TGF)-β1, matrix metalloproteinase (MMP)-2, and NF-κB expression while increasing type I collagen expression. Conclusions Overall, these results suggest that FJE + PVE may have a therapeutic effect on myopia and be used as a potential treatment option.

Bisphenol A (BPA) is an endocrine-disrupting chemical that affects lipid metabolism and contributes to non-alcoholic fatty liver disease (NAFLD). The mechanism of BPA exposure in hepatic lipid accumulation and its potential effect on NAFLD remain unclear. This study investigated the effect of BPA-exposure-induced hepatic lipid deposition on the pathology of NAFLD and its underlying mechanism in vitro and in vivo. BPA increased intracellular reactive oxygen species (ROS) levels, and promoted fatty acid uptake through upregulation of a free fatty acid uptake transporter, cluster of differentiation 36 (CD36), in HUH-7 cells. Additionally, C57BL/6 mice administered a high-fat/high-cholesterol/high-cholic acid diet (HFCCD) and BPA (50 mg/kg body weight) for 8 weeks developed a steatohepatitis-like phenotype, characterized by alpha-smooth muscle actin (α-SMA, an indicator of hepatic fibrosis) and cleaved caspase 3 (an indicator of apoptosis) in hepatic tissue; moreover, they had a higher oxidative stress index of 8-hydroxydeoxyguanosine (8-OHdG) in liver tissue compared to the control group. Treatment with ROS scavenger n-acetylcysteine (NAC) ameliorated BPA-mediated HFCCD-induced lipid accumulation and steatohepatitis in the livers of treated mice. Our study indicates that BPA acts synergistically to increase hepatic lipid uptake and promote NAFLD development by stimulating ROS-induced CD36 overexpression.

Myopia is one of the major public health conditions with significant complications. This study investigates the role of transforming growth factor (TGF)-β2, complement activation, and inflammasome pathways in myopia progression using a Brown Norway rat model. Myopia was induced, and complement regulation was manipulated using gene therapy via adeno-associated virus (AAV) vectors delivering CD55 or CD55 siRNA. Results showed that TGF-β2 exacerbated myopia by upregulating complement components C3 and C5, suppressing CD55, and activating inflammasome pathways through nuclear factor (NF)-κB signaling, leading to axial elongation and increased refractive errors. Overexpression of CD55 via AAV gene therapy effectively counteracted these effects, reducing axial length elongation and inflammation by suppressing inflammasome markers interleukin (IL)-1β and NLR family pyrin domain containing 3 (NLRP3), as confirmed by real-time quantitative PCR and immunofluorescence analyses. Conversely, silencing CD55 intensified TGF-β2-induced effects, further promoting axial elongation and inflammation. These findings highlight the critical role of CD55 in modulating TGF-β2-driven complement and inflammasome activation during myopia progression. The study suggests that gene therapy targeting CD55 could serve as a novel therapeutic strategy to mitigate myopia and related inflammatory processes, offering a promising avenue for managing this significant public health challenge.

Despite increasing application of the pre-grafting expansion during autologous fat transplantation in breast reconstruction, little is known about its mechanism of action. To address that, ventral skins of miniature pigs were treated over a 10-day or 21-day period, with continuous suction at −50 mm Hg via a 7-cm diameter rubber-lined suction-cup device. Soft tissue thickness increased immediately after this external volume expansion (EVE) treatment, such increase completely disappeared by the next day. In the dermis and subcutaneous fat, the EVE treated groups showed significant increases in blood vessel density evident by CD31 staining as well as in vascular networks layered with smooth muscle cells when compared with the control group. This finding was corroborated by the increased percentage of endothelial cells present in the treatment groups. There was no significant difference in the percentages of proliferating basal keratinocytes or adipocytes, nor in epidermal thickness. Moreover, the EVE had no effect on proliferation or differentiation potential of adipose stem cells. Taken together, the major effects of EVE appeared to be vascular remodeling and maturation of functional blood vessels. This understanding may help clinicians optimize the vascularity of the recipient bed to further improve fat graft survival.