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Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, a rare autoinflammatory disease, is usually defined by musculoskeletal symptoms and cutaneous manifestations. Cutaneous manifestations include palmoplantar pustulosis or severe acne, which are generally accompanied by osteitis and hyperostosis, and are the hallmark of SAPHO syndrome. Genetic, immune, and microbial factors are involved in the pathophysiology of the SAPHO. Small-molecule targeted therapies and biologic agents have transformed the treatment of inflammatory disorders. Upadacitinib, with efficacy in cytokine-related disorders, represents a therapeutic candidate for SAPHO syndrome. Here we report a patient with a 20-year history of pustular palmoplantar psoriasis (PPP) who developed progressive inflammatory arthralgia over the past decade. Radiographic and scintigraphic evaluations showed distinct sternocostoclavicular hyperostosis and osteitis, confirming a diagnosis of SAPHO syndrome. Conventional therapies, including nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and topical agents, failed to improve cutaneous or articular symptoms. After ineffective treatment with secukinumab (an IL-17A inhibitor), transitioning to upadacitinib (a selective JAK1 inhibitor) improved pustular lesions and reduced joint pain and inflammation, demonstrating clinical improvement. This case illustrates the effectiveness of upadacitinib, a selective JAK1 inhibitor, for the rapid resolution of cutaneous and articular symptoms of SAPHO syndrome following unsuccessful IL-17A inhibition, offering valuable insights for management of refractory SAPHO syndrome.

Background The proper leveling of curve of Spee (CoS) is critical in orthodontic treatment. However, achieving a leveled CoS using clear aligner therapy (CAT), particularly in cases involving premolar extractions, poses significant challenges. This retrospective study aims to evaluate the effectiveness of clear aligners in leveling the CoS in premolar extraction and non-extraction patients, and to identify key factors influencing post-treatment CoS. Methods Thirty non-extraction patients and thirty patients with bilateral mandibular first premolar extractions, all of whom received CAT, were included in the study. The CoS of the pre-treatment, predicted post-treatment, and actual post-treatment dentition models were measured using Geomagic Studio software. Results The pre-treatment CoS showed significant correlations with overbite, overjet, and Angle classification. Both the non-extraction and extraction groups failed to achieve the predicted improvement in CoS. However, the extraction group exhibited a greater discrepancy between the predicted and actual changes (1.38 ± 0.74 mm for the extraction group vs. 0.84 ± 0.58 mm for the non-extraction group). The regression model indicated that the post-treatment CoS was positively correlated with pre-treatment CoS, predicted CoS, and the use of Class II intermaxillary elastics, while it was negatively correlated with initial crowding. Conclusions The extraction group showed less effectiveness in leveling the curve of Spee compared to the non-extraction group. The results of the regression analysis can aid clinicians in identifying factors that impact the post-treatment curve of Spee, thereby contributing to improved treatment outcomes.

Background Maternal influenza vaccine hesitancy plays a vital role in the low rates of vaccination. However, instruments to appropriately assess perinatal influenza vaccine hesitancy are unavailable. This study aimed to develop the Maternal Influenza Vaccine Hesitancy Scale based on the 5C vaccination hesitancy scale, containing the subscales of confidence, complacency, constraints, calculative, and collective responsibility, and to provide a preliminary overview of the current hesitancy on maternal influenza vaccination in China. Methods A cross-sectional survey, from January to March 2024, was carried out among 2035 pregnant and postpartum women from nine provincial-level administrative divisions representing eastern, central, western, and northeastern areas of China. Reliability was evaluated by internal consistency reliability and split-half reliability, and a Cronbach’s alpha coefficient > 0.7 was considered acceptable. Construct validity was assessed using confirmatory factor analysis (CFA), with good model fit defined as root mean square error of approximation (RMSEA) < 0.100, normed fit index (NFI) > 0.9, comparative fit index (CFI) > 0.9, and Tucker-Lewis index (TLI) > 0.9. Results Confirmatory factor analysis results supported the five-factor structure of the scale (RMESA = 0.098, CFI = 0.921, TLI = 0.903, NFI = 0.918). The Cronbach's alpha coefficients for the scale as well as the subscales ranged from 0.802 to 0.958. Among five subscales, collective responsibility (2.73 ± 0.63) scored highest, while complacency (2.16 ± 0.69) and constraints (2.17 ± 0.69) were the lowest. Conclusions The Maternal Influenza Vaccine Hesitancy Scale developed in this study is a reliable and valid instrument to measure the influenza vaccine hesitancy of pregnant and postpartum women. It is recommended that interventions including health education and improving the access to the vaccination service be carried out to reduce the maternal influenza vaccination hesitancy. Graphical Abstract

The global livestock industry is facing a serious threat from a widespread foot-and-mouth disease virus (FMDV) epidemic. The timely detection of FMDV can significantly mitigate its harmful effects. This study aimed to establish and evaluate a TaqMan fluorescence quantitative PCR assay to assess its sensitivity, specificity, reproducibility, and stability. The standard curve equation range is 6.43 × 109–6.43 × 101 copies/µL, with an R2 value of 0.996 and a standard curve equation of y = −3.586x + 36.245. The method successfully detected 64.3 copies/µL of the target gene for FMDV and exhibited high specificity for FMDV. Repeatability tests demonstrated low coefficients of variation within and between groups (<2%), indicating good reproducibility. The clinical samples analyzed using this method showed results consistent with those of the SYBR Green I RT-qPCR assay, confirming the reliability of the method. Overall, the developed test method displayed high sensitivity, specificity, reproducibility, and stability, making it suitable for the rapid diagnosis of foot-and-mouth disease in clinical settings.

Well-designed visual displays have the power to convey health messages in clear, effective ways to non-experts, including journalists, patients and policymakers. Poorly designed visual displays, however, can confuse and alienate recipients, undermining health messages. In this Perspective, we propose a structured framework for effective visual communication of health information, using case examples of three common communication tasks: comparing treatment options, interpreting test results, and evaluating risk scenarios. We also show simple, practical ways to evaluate a design’s success and guide improvements. The proposed framework is grounded in research on health risk communication, visualization and decision science, as well as our experience in communicating health data. This Perspective outlines practical considerations for designing and testing visual displays to communicate health information, using illustrative case examples.

The Epidemic Prediction Initiative of U.S. Centers for Disease Control and Prevention holds annual forecasting challenges for various diseases, including influenza, Aedes, and the current forecasting challenge for the ongoing COVID-19 pandemic. Universities, research institutes, independent researchers, corporations, consultancies, and government agencies make such forecasts on many other public health events as well. The value of these forecasts depends on how well people trust and understand them, when making decisions regarding public policy, preparedness, and personal actions. This thesis applies research on risk and science communication, visualization, and decision making to communicating the scientific uncertainties of influenza and COVID-19 forecasts. The thesis (1) designs multiple graphic displays and communication aids for communicating influenza and COVID-19 forecasts, (2) creates hypothetical yet realistic decision scenarios and tasks to examine non-expert users’ performance of interpreting and using such forecasts and risk information in related decision making, and (3) examines how decision makers accomplish these tasks, as a function of both how the forecast information is displayed and their own personal properties, including their perceived and actual ability to interpret the displays and how motivated reasoning may influence their response to risk communication messages. Study 1 (Chapter 2) compares performances in making four influenza-related decisions based on four graphic presentations of influenza forecasts uncertainty, extending Barbara Tversky’s research on conceptual-spatial congruence to probabilistic forecasts. I find that participants have better comprehension with the most familiar display (bar chart), for all four decisions, but do not perceive it as more helpful or have more confidence in their responses. I find that participants who report greater familiarity with a display actually perform more poorly, express greater decision confidence, and rate the display as more helpful.Study 2 (Chapter 3) compares judgments and decisions based on a suite of uncertain forecasts, depending on whether they are presented individually, in aggregate (an ensemble), or both, and in what order. I find that participants who see just the suite or just the ensemble respond differently. However, they respond similarly when they update their judgments and decisions after seeing the other display as well.Study 3 (Chapter 4) compares risk judgments and decisions regarding school attendance and vaccinations, for individuals with different political beliefs. It examines the effects of asking participants, in one experimental group to self-affirm their commitment to good deeds, and intervention that had reduced the impact of beliefs in other settings. I find clear disparities between vaccinated liberals and unvaccinated conservatives in their risk estimates and decision making. However, the self-affirmation intervention had no effect on participants’ risk estimates and decisions here.Overall, this thesis extends risk communication and visualization literature to develop and test graphic displays for uncertainties in epidemiological forecasts and show the value of pretesting the communication aids with potential users. It extends theories of visual information processing, self-identity, and judgment under uncertainty.

Purpose: To investigate the roles of Notoginsenoside R1 (NG-R1) on the proliferation and osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) and explore its possible mechanism. Methods: hPDLSCs were isolated and, then characterized by flow cytometry. Cell-counting kit-8 (CCK-8) and colony assays were used to validate the effect of different NG-R1 concentrations on hPDLSCs proliferation and the optimal concentration was determined. Quantitative detection of alkaline phosphatase (ALP) activity at optimal concentration and the mineralization of the cells was investigated by Alizarin Red S staining. qRT-PCR and Western blot were utilized to examine the factors expression levels of ALP, Runx Family Transcription Factor 2 (RUNX2), Collagen I (Col-1) and catenin beta 1 (CTNNB1; [beta]-catenin). In addition, the tankyrase inhibitor XAV-939 was used to explore NG-R1's role in canonical Wnt signaling. Results: hPDLSCs were positive for surface antigens CD90 while negative for CD34 and CD45, which indicated that we have successfully isolated the hPDLSCs. Furthermore, a concentration of 20[micro]mol NG-R1 dramatically enhanced hPDLSCs proliferation, ALP activity, and mineral deposition. ALP, RUNX2, COL-1, and [beta]-catenin expression were all rised in comparison to control group. After XAV-939 was added to disrupt the canonical Wnt signaling, the impact of NG-R1 appeared to be reversed. Conclusion: These findings suggest that NG-R1 can stimulate osteogenic differentiation of hPDLSCs, which is probably attributable to canonical Wnt signaling activation. Keywords: notoginsenoside R1, NG-R1, human periodontal ligament stem cells, hPDLSCs, osteogenesis, [beta]-catenin

Purpose: Puerarin ([C.sub.21][H.sub.20][O.sub.10]) is a phytoestrogen that possesses various pharmacological effect, and several researches have revealed the relationship between puerarin and bone metabolism. This study was aimed to evaluate the potential influence of puerarin on the proliferation and osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells (BMSCs) as well as on new bone formation following rapid maxillary expansion (RME) model in rats. Methods: Rat BMSCs were adopted, and the cell proliferation was detected by cell-counting kit-8 (CCK-8) assay in vitro experiments. Alkaline phosphatase (ALP) activity and alizarin red staining were analyzed quantitatively to show extracellular matrix mineralization. The mRNA and protein expression levels were used to detect osteogenic differentiation of BMSCs. In vivo bone regeneration was analyzed in a rat RME model. Eighteen 6-week-old male Wistar rats were divided into 3 groups: group 1 without any treatment, group 2 received RME and saline solution (15mg/kg), group 3 received RME and puerarin solution (15mg/kg). After 2 weeks, micro-computed tomography (Micro-CT), hematoxylin and eosin (HE) staining, and Masson staining were used to detect the new bone formation and morphological changes. Besides, ALP and bone morphogenetic protein 2 (BMP2) expression levels in midpalatal suture were evaluated by immunohistochemical staining. Results: The results showed that puerarin upregulates cell proliferation dose-dependently. ALP activity and mineralized matrix generation were clearly enhanced at certain specific concentrations ([10.sup.-5] and [10.sup.-6] mol/L); the expression levels of the osteoblastrelated genes and proteins were increased. The measurement of micro-CT imaging revealed that puerarin significantly promoted new bone formation. Concomitantly, the histological examinations showed that puerarin solution enhanced osteogenesis in mid-palatal suture. Conclusion: Those works indicated that puerarin regulates osteogenesis in vitro and exerts a beneficial impact on bone regeneration in vivo, revealing that puerarin treatment may become one of the potential keys for improving the stability and preventing relapse of RME. Keywords: bone marrow-derived mesenchymal stem cells, bone regeneration, micro-CT, rapid maxillary expansion

Purpose: To investigate the effects of sinomenine on orthodontic tooth movement and root resorption in rats, as well as the effect of sinomenine on the osteogenesis of periodontal ligament stem cells (PDLSCs). Methods: Fifty-four male Wistar rats were randomly divided into 3 groups: control group, 20 mg/kg sinomenine group and 40 mg/kg sinomenine group. Fifty-gram orthodontic force was applied to all groups. Each group was injected intraperitoneally with corresponding concentration of sinomenine every day. After 14 days, all rats were sacrificed. Micro-computed tomography (micro-CT) scan was used to analyze tooth movement, root resorption and alveolar bone changes. The effect on periodontal tissue was analyzed by Masson, tartrate-resistant acid phosphatase (TRAP) and immunohistochemical staining. In vitro, PDLSCs were extracted and identified. The effect of sinomenine on proliferation was determined by cell-counting kit-8. The effect of sinomenine on osteogenesis was investigated by alkaline phosphatase (ALP) activity and alizarin red staining. qPCR and Western blotting were performed to explore the effects of sinomenine on the expression levels of ALP, runt-related transcription factor 2 (RUNX2), receptor activator of nuclear factor kappaB ligand (RANKL) and osteoprotegerin (OPG). Results: The tooth movement and root resorption of sinomenine groups were reduced. Sinomenine decreased trabecular spacing on compression side and increased alveolar bone volume and trabecular thickness on tension side. TRAP-positive cells in sinomenine groups decreased significantly. The expressions of TNF-[alpha] and RANKL were decreased, while the expressions of OPG, RUNX2 and osteocalcin were up-regulated. In vitro, 0.1 M and 0.5 M sinomenine enhanced ALP activity, mineral deposition and the expression of ALP, RUNX2 and OPG, and reduced the expression of RANKL. Conclusion: Sinomenine could inhibit tooth movement, reduce root resorption, and exert a positive effect on bone formation in rats. Moreover, sinomenine promoted the osteogenesis of PDLSCs. Keywords: sinomenine, tooth movement, root resorption, osteoclast, osteogenesis

Coal-fired power plants with carbon capture and sequestration (CCS), natural-gas-fired power plants with CCS, and Small Modular Reactors (SMR) are potentially important emerging energy technologies that could help mitigate climate change and contribute to a low-carbon future. Public opinion and preferences towards these technologies will affect their adoption when they are technologically ready to be implemented. This study examines the nature and stability of public preferences among these options. We find that participants have internally consistent preferences, when tested in several ways. Overall, they prefer SMRs to natural gas with CCS to coal with CCS. On a group level, these preferences depend on the choice alternatives, but not on how fully the technologies are described nor how far away a hypothetical power plant would be sited. On the individual level, preferences are related to participants' perceptions of the technology and their political ideology. Our findings suggest that presenting the three technologies together will produce the most balanced, informed judgment, with the least influence of political ideology.