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Zearalenone (ZEN) is a mycotoxin produced by Fusarium species, which is one of the main animal feed contaminants causing reproductive disorders in livestock. The aim of this study was to evaluate the probiotic characteristics and ZEN removal ability of a Bacillus licheniformis strain CK1. The probiotic properties, including acidic tolerance, bile salt tolerance, adherence capability, and anti-pathogenic activities of CK1 were evaluated. CK1 survived after incubation at pH 2.0 or 3.0 for 3 h, grew well in LB broth containing 0.3% oxgall, possessed adherence capability to Caco-2 cells, and inhibited the growth of Escherichia coli O157:H7 and Listeria monocytogenes. The ZEN removal ability of CK1 was compared with a mineral mycotoxin-adsorbing agent, hydrated sodium calcium aluminosilicate (HSCAS), and a well-characterized biological mycotoxin-adsorbing agent, Lactobacillus rhamnosus GG (LGG). At 37°C in phosphate-buffered saline (PBS, pH 7.0) containing 5 μg mL-1 of ZEN, the ZEN removal percentage of CK1 was 73.0%, which was significantly higher than that of HSCAS and LGG (45.9% and 48.4%, respectively). In the pH range of 2.5-8.0, CK1 removed up to 65% of ZEN. At temperatures between 4 and 42°C, CK1 removed more than 75% of ZEN. In the adsorption stability analysis, the amounts of ZEN removed by CK1 was over 30% even after five consecutive rounds of washing procedures. These findings demonstrated that CK1 displayed probiotic characteristics and removed ZEN effectively. Therefore, CK1 has a great potential for the development of feed additive to remove ZEN.

Urban heat islands will occur if city neighborhoods contain insufficient green spaces to create a comfortable environment, and residents’ health will be adversely affected. Current satellite imagery can only effectively identify large-scale green spaces and cannot capture street trees or potted plants within three-dimensional building spaces. In this study, we used a deep convolutional neural network semantic segmentation model on Google Street View to extract environmental features at the neighborhood level in Taipei City, Taiwan, including the green vegetation index (GVI), building view factor, and sky view factor. Monthly temperature data from 2018 to 2021 with a 0.01° spatial resolution were used. We applied a linear mixed-effects model and geographically weighted regression to explore the association between pedestrian-level green spaces and ambient temperature, controlling for seasons, land use information, and traffic volume. Their results indicated that a higher GVI was significantly associated with lower ambient temperatures and temperature differences. Locations with higher traffic flows or specific land uses, such as religious or governmental, are associated with higher ambient temperatures. In conclusion, the GVI from street-view imagery at the community level can improve the understanding of urban green spaces and evaluate their effects in association with other social and environmental indicators.

In this study, we proposed a novel CoIn2S4/reduced graphene oxide (CoIn2S4/rGO) composite anode using a hydrothermal method. By introducing electronic-conductive reduced graphene oxide (rGO) to buffer the extreme volume expansion of CoIn2S4, we prevented its polysulfide dissolution during the lithiation/de-lithiation processes. After 100 cycles, the pristine CoIn2S4 electrode demonstrated poor cycle performance of only 120 mAh/g at a current density of 0.1 A/g. However, the composition-optimized CoIn2S4/rGO composite anode demonstrated a reversible capacity of 580 mAh/g for 100 cycles, which was an improvement of 4.83 times. In addition, the ex situ XRD measurements of the CoIn2S4/rGO electrode were conducted to determine the reaction mechanism and electrochemical behavior. These results suggest that the as-synthesized CoIn2S4/rGO composite anode is a promising anode material for lithium ion batteries.

Background and Objectives: Acute heart failure (AHF) is a life-threatening condition frequently encountered in the emergency department (ED). Identifying reliable prognostic indicators for in-hospital mortality is crucial for risk stratification and the appropriate management of AHF patients. This study aimed to assess the most effective method for predicting in-hospital mortality among various physiological parameters in patients with AHF presenting to the ED. Additionally, the study evaluated the effectiveness of the RAM index—respiratory rate (RR), age, and mean arterial pressure (MAP)—derived from the shock index (SI) by replacing heart rate with RR, as a novel prognostic tool. This was compared with the SI and its other derivatives to predict in-hospital mortality in adult patients with AHF presenting to the ED. Materials and Methods: This is a retrospective study conducted in the ED of an urban medical center, enrolling adult patients with signs and symptoms of AHF, who met the epidemiological diagnosis criteria, between January 2017 and December 2021. Baseline physiological parameters, including the RR, heart rate, systolic blood pressure, and diastolic blood pressure, were recorded upon ED admission. The RAM index was calculated as the RR multiplied by the age divided by the MAP. Statistical analysis was performed, including univariate analysis, logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: A total of 2333 patients were included in the study. A RAM index > 18.6 (area under ROC curve (AUROC): 0.81; 95% confidence interval (CI): 0.79–0.83) had a superior mortality discrimination ability compared to an SI > 0.77 (AUROC: 0.75; 95% CI: 0.72–0.77), modified shock index > 1.11 (AUROC: 0.75; 95% CI: 0.73–0.77), age shock index > 62.7 (AUROC: 0.74; 95% CI: 0.72–0.76), and age-modified shock index > 79.9 (AUROC: 0.75; 95% CI: 0.73–0.77). A RAM index > 18.6 demonstrated a 7.36-fold higher risk of in-hospital mortality with a sensitivity of 0.80, specificity of 0.68, and negative predictive value of 0.97. Conclusions: The RAM index is an effective tool to predict mortality in AHF patients presenting to the ED. Its superior performance compared to traditional SI-based parameters suggests that the RAM index can aid in risk stratification and the early identification of high-risk patients, facilitating timely and aggressive treatment strategies.

Positive fluid balance is a prognostic factor for mortality in patients with sepsis; however, the association between cumulated fluid balance (CFB) and sepsis-induced multi-organ dysfunction syndrome (MODS) has yet to be elucidated. In this study, we sought to determine whether CFB is correlated with MODS and mortality in cases of septic shock. The study retrospectively recruited patients with septic shock from the intensive care unit of a tertiary care hospital. Multiple organ dysfunction syndrome (MODS) was identified as sequential organ failure assessment (SOFA) score ≥ 2 in more than one organ system. The CFB is the sum of all daily intake and output. An independent t-test, single and multivariate logistic regression, the receiver operating characteristic (ROC) curves, and the Pearson correlation coefficient were used to determine whether a relationship exists between CFB and the development of MODS and mortality. Among the 104 patients enrolled in the study, 58 (55.8%) survived more than 28 days, and 73 (70.2%) developed MODS on day 3. The values of CFB in the first 24 hours and 72 hours after diagnosis of septic shock in patients with MODS were higher than these in patients without MODS (1086.6 ± 176.3 vs. 325.5 ± 205.7 ml, p = 0.013 and 2408 ± 361 vs. 873.1 ± 489 ml, p < 0.0001). In a multivariate logistic regression, the independent factors associated with the development of MODS on day 3 were APACHE II score at ICU admission (27.6 ± 7.6 in patients with MODS vs. 20.5 ± 6.4 in those without; O.R. 1.18; 95% C.1 I. 1.08-1.30; p < 0.001), disseminated intravascular coagulopathy (DIC) (n = 28; 38.4% vs. n = 2; 6.5%; O.R. 23.67; 95% C.I. 3.58-156.5; p = 0.001), and CFB in the first 72 hours (72-hr CFB) > median (1767.50ml) (n = 41; 56.2% vs. n = 11; 35.5%; O.R. 3.67; 95% C.I., 1.18-11.40; p = 0.024). Moreover, a multivariate logistic regression also identified neoplasm (n = 25; 54.3% vs. n = 17; 29.3%; O.R. 3.45; 95% C.I. 1.23-10.0; p = 0.019) and 72-hr CFB > median (n = 30; 65.2% vs. n = 21; 36.2%; O.R. 4.13; 95% C.I. 1.34-12.66; p = 0.013) as independent factors associated with 28-day mortality. 72-hr CFB values were strongly correlated with the SOFA score (r = 0.445, p < 0.0001). The area under the ROC curve revealed that 72-hr CFB has good discriminative power in associating the development of MODS (0.644, p = 0.002) and predicting subsequent 28-day mortality (0.704, p < 0.0001). 72-hr CFB appears to be correlated with the likelihood of developing MODS and mortality in patients with septic shock. Thus, it appears that 72-hr CFB could perhaps be used as an indicator for MODS and a predictor for mortality in those patients.

Gastric cancer is one of the leading causes of cancer death worldwide. Previous studies demonstrated that activation of STAT3 is crucial for the development and progression of gastric cancer. However, the role of STAT3 in neuronal related gene methylation in gastric cancer has never been explored. In this study, by using DNA methylation microarray, we identified a potential STAT3 target, C11orf87 , showing promoter hypomethylation in gastric cancer patients with lower STAT3 activation and AGS gastric cancer cell lines depleted with STAT3 activation. Although C11orf87 methylation is independent of its expression, ectopic expression of a constitutive activated STAT3 mutant upregulated its expression in gastric cancer cell line. Further bisulfite pyrosequencing demonstrated a progressive increase in DNA methylation of this target in patient tissues from gastritis, intestinal metaplasia, to gastric cancer. Intriguingly, patients with higher C11orf87 methylation was associated with better survival. Furthermore, hypermethylation of C11orf87 was also frequently observed in other GI cancers, as compared to their adjacent normal tissues. These results suggested that C11orf87 methylation may serve as a biomarker for diagnosis and prognosis of GI cancers, including gastric cancer. We further postulated that constitutive activation of STAT3 might be able to epigenetically silence C11orf87 as a possible negative feedback mechanism to protect the cells from the overactivation of STAT3. Targeted inhibition of STAT3 may not be appropriate in gastric cancer patients with promoter hypermethylation of C11orf87 .

Declining fertility and population aging intensify labor shortages, making women’s reemployment after caregiving a policy priority. Using Taiwan as a case study, this study develops a real-time public opinion analysis system to complement delayed surveys and capture emerging barriers in labor-market reintegration. Drawing on 2022–2024 social media posts, the system applies sentiment co.mputing, clustering, and algorithmic attention to map four phases: withdrawal, intention, search, and reintegration. Findings show that younger women stress flexibility and childcare, while older returnees prioritize skill renewal and confidence rebuilding; sectoral variation supports life-cycle and clockspeed theories. Policy recommendations emphasize subsidies, training, quotas, and street-level implementation. Beyond technical contributions, the study embeds digital transformation (DT) into labor governance, showing a shift from as-is retrospective surveys to to-be-real-time monitoring. This transformation enhances policy agility, inclusiveness, and alignment with citizens’ lived experiences. The system thus functions as both a tool for rapid intervention and a DT-driven theoretical lens extending reemployment scholarship, offering transferable insights for aging societies.

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted healthcare systems worldwide. To assess the effects of the pandemic on pediatric emergency department (ED) visits in Taiwan, we conducted a study to evaluate changes in pediatric ED visits during the COVID-19 pandemic. Materials and Methods: This retrospective study included pediatric patients (age ≤ 18) who visited the ED between 21 January 2019 and 30 April 2019, at three hospitals of the Cathay Health System, and compared them with a corresponding period in 2020. Basic information, including mode of arrival, triage level, disposition, chief complaints, and incidence rates, were analyzed before and during the pandemic. Results: A total of 10,116 patients, with 6009 in the pre-pandemic group and 4107 in the pandemic group, were included in this study. The mean number of daily pediatric ED visits decreased from 60.09 before the pandemic to 40.66 during the pandemic, while ambulance use increased significantly by 2.56%. The percentage of patients with high acuity triage levels (levels 1 and 2) was significantly lower during the pandemic period (0.63% and 10.18%, respectively) than the pre-pandemic period (0.7% and 10.9%, respectively). Additionally, a significantly higher proportion of patients were discharged during the pandemic period (89.36%) than during the pre-pandemic period (88.33%). The proportion of COVID-19-related complaints, such as fever and respiratory tract infections, as well as other complaints including gastrointestinal issues, trauma, and psychological problems, significantly increased during the pandemic. Conclusions: In preparation for future pandemics, we recommend increasing emergency medical service capacity, establishing a non-contagious route for obtaining chronic medication prescriptions, optimizing staff allocation in pediatric emergency departments, and increasing the number of hospital social workers for enhanced support.

Key Clinical Message Staphylococcal scalded skin syndrome (SSSS) is a rare condition in premature infants. We report a case of SSSS in a preterm neonate who displayed all clinical manifestations at birth, leading to a fatal outcome from Candida parapsilosis fungemia. The clinical presentation was challenging to differential diagnosis. SSSS diagnosis was confirmed by skin biopsy. This case emphasizes the significance of early recognition and diagnosis of SSSS promptly for clinicians. Congenital SSSS in premature infants can be fatal, but with early recognition and appropriate supportive and antimicrobial therapy, outcomes can be improved and lives can be saved.