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Background: Acupressure is one of the recommended non-pharmacologic treatments for cancer-related fatigue (CRF) according to the National Comprehensive Cancer Network guidelines. However, few systematic review or metaanalysis studies have focused on the effect of acupressure on CRF. Purpose: The purpose of this study was to examine the effectiveness of acupressure in reducing CRF and to identify the effective acupoints and frequencies of acupressure treatments. Methods: The search and screening procedures were conducted in accordance with PRISMA 2009 guidelines. The search database included Embase, CINAHL, Cochrane Library, MEDLINE and Google Scholar. RoB 2.0 and ROBINS-I were used as appraisal tools. The statistical analysis, including effect size estimation, was computed using RevMan 5.4. Results: Twelve studies (15 sets of data) were included in the review and analysis. Nine hundred sixty patients with cancer who were currently undergoing or had completed treatment were enrolled as participants and receive

背景：穴位指壓為美國國家癌症資訊網建議之癌因性疲憊非藥物治療方式之一。目前國內外少有探討穴位指壓緩解癌因性疲憊之系統性回顧及統合分析研究。目的：本文欲檢驗穴位指壓介入對於癌因性疲憊緩解之效果量，及不同指壓部位之建議穴位點、頻次。方法：本研究依PRISMA 2009進行文獻篩選，收錄2020年10月前文獻，採用Cochrane Library、Embase、CINAHL、MEDLINE、Google學術引擎資料庫進行搜尋。評讀工具為RoB 2.0（risk of bias 2.0）及ROBINS-I（risk of bias in non-randomised studies of interventions），並使用RevMan 5.4軟體進行資料分析。結果：經篩選341篇文獻後，最終收錄12篇文獻（15組數據），研究對象共960位。整體穴位指壓效果量為SMD = -0.77，95% CI [-0.90, -0.65]。在次群組分析中，耳穴指壓組SMD = -0.98，95% CI [-1.25, -0.71]、身體穴位指壓SMD = -0.70，95% CI [-0.84, -0.56]。結論／實務應用：穴位指壓能有效緩解癌因性疲憊，建議穴位點為合谷穴（LI4）、足三里穴（ST36）、三陰交穴（SP6），常見介入頻次為一天一次、每次一分鐘至三分鐘；耳神門穴和耳皮質下穴，各按壓一天一次，每次三分鐘。藉此結論，期望未來提供臨床端對癌因性疲憊照護措施參考建議。

Triple-negative breast cancer (TNBC) patients usually lead to poor prognosis and survival because of metastasis. The major sites for TNBC metastasis include the lungs, brain, liver, and bone. Long non-coding RNAs (lncRNAs) are non-protein-coding transcripts longer than 200 nucleotides and have been reported as important regulators in BC metastasis. However, the underlying mechanisms for lncRNAs regulating TNBC metastasis are not fully understood. Here we found that linc-ZNF469-3 was highly expressed in lung-metastatic LM2-4175 TNBC cells and overexpression of linc-ZNF469-3 enhanced invasion ability and stemness properties in vitro and lung metastasis in vivo. Furthermore, we found linc-ZNF469-3 physically interacted with miR-574-5p and overexpression of miR-574-5p attenuated ZEB1 expression. Importantly, endogenous high expressions of linc-ZNF469-3 and ZEB1 were correlated with tumor recurrence in TNBC patients with lung metastasis. Taken together, our findings suggested that linc-ZNF469-3 promotes lung metastasis of TNBC through miR-574-5p-ZEB1 signaling axis and may be used as potential prognostic marker for TNBC patients.

Ocean deoxygenation is predicted to threaten marine ecosystems globally. However, current and future oxygen concentrations and the occurrence of hypoxic events on coral reefs remain underexplored. Here, using autonomous sensor data to explore oxygen variability and hypoxia exposure at 32 representative reef sites, we reveal that hypoxia is already pervasive on many reefs. Eighty-four percent of reefs experienced weak to moderate (≤153 µmol O2 kg−1 to ≤92 µmol O2 kg−1) hypoxia and 13% experienced severe (≤61 µmol O2 kg−1) hypoxia. Under different climate change scenarios based on four Shared Socioeconomic Pathways (SSPs), we show that projected ocean warming and deoxygenation will increase the duration, intensity and severity of hypoxia, with more than 94% and 31% of reefs experiencing weak to moderate and severe hypoxia, respectively, by 2100 under SSP5-8.5. This projected oxygen loss could have negative consequences for coral reef taxa due to the key role of oxygen in organism functioning and fitness.Using data on oxygen variability taken from 32 representative reef sites, the authors show that hypoxia is already common. Under future scenarios of ocean warming and deoxygenation, the duration, intensity and severity of hypoxia will increase, with nearly one-third of reefs experiencing severe hypoxia.

As Taiwan heads steadily toward becoming a super-aged society, the impact of aging on society at large will become increasingly extensive and intense. Therefore, establishing an age-friendly environment in Taiwan is an important issue for the government. Feasible guidelines for age-friendly communities are necessary to ensure that appropriate social welfare measures are enacted to achieve the national goal of aging in place. The first draft of the guideline questionnaire was developed based on the World Health Organization Guidelines for Age-Friendly Cities, a literature review, and input from seven experts on aging. Three rounds of questionnaire surveys were then conducted to assess the correctness, appropriateness, and importance of the guidelines, with amendments, additions, and deletions made based on the experts' responses until they all expressed a high degree of satisfaction with all of the guidelines. The Taiwan Age-friendly Community Guidelines document discussed in this article includes 38 guideline

INTRODUCTIONInfluenza vaccination (INV) and smoking cessation (SC) have individual positive effects on COPD, but their synergistic impact has yet to be extensively studied. This retrospective study aimed to assess the combined effect of SC and IV on the medical burden of COPD, including medical visits, hospitalization, medical expenses, and the occurrence of respiratory failure. METHODSPatients with COPD who visited our medical center between January and October 2018 were included in the study. The patients were categorized into four groups: Group I (no SC or INV), Group II (INV only), Group III (SC only), and Group IV (both SC and INV). The outcomes analyzed were emergency utilization, hospital utilization, and occurrence of respiratory failure. Airflow limitation was stratified according to GOLD guidelines, and successful smoking cessation was defined as not smoking for at least one year. RESULTSA total of 357 patients were included in the study. Group I (119 patients) neither smoking cessation nor influenza vaccination; Group II (66 patients) had only influenza vaccination; Group III (94 patients), had only smoking cessation, Group IV (78 patients), with both smoking cessation and influenza vaccination. Group IV had lower odds of emergency utilization (OR=0.13; 95% CI: 0.07-0.25), hospital utilization (OR=0.13; 95% CI: 0.05-0.30, p<0.001), and occurrence of respiratory failure (OR=0.13; 95% CI: 0.04-0.40, p<0.001). CONCLUSIONSCombined smoking cessation and influenza vaccination are more effective in reducing the medical burden of COPD compared to either intervention alone or neither. These findings highlight the importance of promoting both smoking cessation and influenza vaccination in the management of COPD.

Tumor recurrence is the most common cause of disease failure after surgical resection in early‐stage lung adenocarcinoma. Identification of clinically relevant prognostic markers could help to predict patients with high risk of disease recurrence. A meta‐analysis of available lung adenocarcinoma microarray datasets revealed that T‐LAK cell‐originated protein kinase (TOPK), a serine/threonine protein kinase, is overexpressed in lung cancer. Using stable cell lines with overexpression or knockdown of TOPK, we have shown that TOPK can promote cell migration, invasion, and clonogenic activity in lung cancer cells, suggesting its crucial role in lung tumorigenesis. To evaluate the prognostic value of TOPK expression in resected stage I lung adenocarcinoma, a retrospective analysis of 203 patients diagnosed with pathological stage I lung adenocarcinoma was carried out to examine the expression of TOPK by immunohistochemistry (IHC). The prognostic significance of TOPK overexpression was examined. Overexpression of TOPK (IHC score >3) was detected in 67.0% of patients, and these patients were more frequently characterized with disease recurrence and angiolymphatic invasion. Using multivariate analysis, patient age (>65 years old; P = 0.002) and TOPK overexpression (IHC score >3; P < 0.001) significantly predicted a shortened overall survival. Moreover, TOPK overexpression (IHC score >3; P = 0.005) also significantly predicted a reduced time to recurrence in the patients. Our results indicate that overexpression of TOPK could predetermine the metastatic capability of tumors and could serve as a significant prognostic predictor of shortened overall survival and time to recurrence. (Cancer Sci 2012; 103: 731–738)

We investigated whether chronological changes in portal flow and clinical factors play a role in the liver regeneration (LR) process after right donor-hepatectomy. Participants in this prospective study comprised 58 donors who underwent right donor-hepatectomy during the period February 2014 to February 2015 at a single medical institution. LR was estimated using two equations: remnant left liver (RLL) growth (%) and liver volumetric recovery (LVR) (%). Donors were classified into an excellent regeneration (ER) group or a moderate regeneration (MR) group based on how their LR on postoperative day 7 compared to the median value. Multivariate analysis revealed that low residual liver volume (OR = .569, 95% CI: .367- .882) and high portal venous velocity in the immediate postoperative period (OR = 1.220, 95% CI: 1.001-1.488) were significant predictors of LR using the RLL growth equation; high portal venous velocity in the immediate postoperative period (OR = 1.325, 95% CI: 1.081-1.622) was a significant predictor of LR using the LVR equation. Based on the two equations, long-term LR was significantly greater in the ER group than in the MR group (p < .001). Portal venous velocity in the immediate postoperative period was an important factor in LR. The critical time for short-term LR is postoperative day 7; it is associated with long-term LR in donor-hepatectomy.

The present paper is dedicated to investigating weighted allocation rules under fuzzy multicriteria situations. In real-world situations, participants may represent administrative departments of different natures in the management system; participants may be able to perform their duties in the economic model. In addition, participants may adopt relative operating levels to different situations and effectively engage multiple objectives under operational processes. Therefore, considering fuzzy behavior and multicriteria situations, it is reasonable to assign corresponding weights to participants and their relative behavior and to allocate efficiency according to weights in proportion to relative weights, even if it will lead to an asymmetrical situation. In existing studies on fuzzy allocation rules, weights are always given to “participants” or their “operating levels” and then the differences between participants and their operating levels are adjusted. Inspired by the above considerations, relative major results are as follows. (1) By simultaneously assigning weights to participants and their operating levels (strategies), this study seeks to use the supreme marginal variations among operating level vectors to define a new asymmetric allocation rule under fuzzy multicriteria situations. (2) This study further utilizes axiomatic results to illustrate the expedience for this weighted fuzzy asymmetric allocation rule. (3) Finally, an extended index is also proposed by replacing weights with the supreme marginal dedications.

This study developed indicators of age-friendliness for communities in Taiwan that conform to international standards by referring to the World Health Organization Checklist of Essential Features of Age-Friendly Cities and Taiwan's existing indicators. The first stage of the research was based on the WHO's framework and involved a literature review to identify candidate indicators. In the second stage, experts' opinions were collected through a modified Delphi method, and the indicators were screened and revised on the basis of their importance, community enforceability, and generality. The third stage focused on practical feasibility. External parties were invited to offer their opinions regarding the indicators, which were adjusted accordingly. After three rounds of review and re-examination based on the modified Delphi method, the final set of indicators comprised five core indicators and five optional indicators. These indicators can be used to monitor various aspects of communities and determine their age-friendliness.