Evaluation of the transient hypofrontality theory in the context of exercise: A systematic review with meta-analysis

Accumulating research suggests that, as a result of reduced neural activity in the prefrontal cortex (PFC), higher-order cognitive function may be compromised while engaging in high-intensity acute exercise, with this phenomenon referred to as the transient hypofrontality effect. However, findings in this field remain unclear and lack a thorough synthesis of the evidence. Therefore, the purpose of this meta-analysis was to evaluate the effects of in-task acute exercise on cognitive function, and further, to examine whether this effect is moderated by the specific type of cognition (i.e., PFC-dependent vs. non-PFC-dependent). Studies were identified by electronic databases in accordance with the PRISMA guidelines. In total, 22 studies met our inclusion criteria and intercept only meta-regression models with robust variance estimation were used to calculate the weighted average effect sizes across studies. Acute exercise at all intensities did not influence cognitive function (β = -0.16, 95% CI = [-0.58, 0.27], p = .45) when exercise occurred during the cognitive task, and no significant moderation effects emerged. However, there was evidence that cognitive task type (PFC-dependent vs. non-PFC-dependent) moderated the effect of high-intensity acute exercise on a concomitant cognitive performance (β = -0.81, 95% CI = [-1.60, -0.02], p = .04). Specifically, our findings suggest that PFC-dependent cognition is impaired while engaging in an acute bout of high-intensity exercise, providing support for the transient hypofrontality theory. We discuss these findings in the context of reticular-activating and cognitive-energetic perspectives.

[Analysis of 13 cases with pediatric rheumatic disease combined with endocrine disorder]

Objective: To summarize the clinical characteristics of children with rheumatic disease combined with endocrine disorder. Methods: A retrospective analysis was performed on the clinical data, including sex, age, clinical presentation, laboratory tests, treatment and outcome, of 13 patients with rheumatic diseases combined with endocrine disorder, who were admitted to our department in Children's Hospital, Capital Institute of Pediatrics from January 2014 to December 2020. Results: Among the 13 cases, 3 were males and 10 were females, without family history. Their age was (10±4) years. And the average course of disease was 4.1 months. Eight of them were diagnosed with systemic lupus erythematosus (JSLE), 2 with juvenile idiopathic arthritis (JIA), 1 with childhood vasculitis, 1 with juvenile-onset systemic sclerosis (JSSc) and 1 had juvenile dermatomyositis (JDM). Regarding the initial presentation, 10 cases had symptoms of rheumatic disease, 2 had polydipsia and polyuria, and 1 had goiter. All the 13 patients had multiple system involvement. Regarding endocrine disorder, 10 had thyroiditis or subclinical thyroiditis, 4 had diabetes mellitus and one had both thyroid and pancreas involvement. Thyroid stimulating hormone in 10 patient with thyroid involvment was 19.6 (5.2-34.0) mU/L, and their total thyroxine was 75.3 (45.2-105.4) nmol/L. Besides, thyroid peroxidase antibody or thyroglobulin antibody was positive in 7 cases. The blood glucose of 4 children with pancreatic injury was 25.0 (17.0-33.0) mmol/L, and C-peptide was 0.4 (0.3-0.5) mg/L. Glutamate dehydrogenase antibody, protein tyrosine phosphatase antibody and zinc transporter 8 antibody were positive in two cases. After treatement with immunosuppressant or immunoglobulin combined with glucocorticoid or nonsteroidal antiinflammatory drugs for rheumatic symptoms, and levothyroxine or insulin for endocrine diseases, they were all followed up for more than 6 months and maintained clinical stability. Conclusions: Rheumatic diseases in children can be complicated with endocrine disorders, and the involved organs are usually thyroid and pancreas. In children with rheumatic disease, thyroid injury usually has subtle onset, whereas pancreas injury develops rapidly, even life-threatening. Insulin should be used persistently under the instruction of endocrinologist.

Differences in school factors associated with adolescent HPV vaccination initiation and completion coverage in three Australian states

BACKGROUND

Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake.

METHODS

Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage.

RESULTS

Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates.

CONCLUSION

This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.

Correlation between Psoas Muscle Index and Degeneration of Spinal Back Muscle in Patients with Back Pain

Sarcopenia is characterized by a decline in systemic muscle mass and physical performance. Disc degeneration also causes back muscle atrophy. Therefore, we aimed to evaluate the influence of systemic muscle mass decline on back muscle atrophy and fatty infiltration compared to disc degeneration. We included 127 patients (65.54 ± 14.93 years) with back pain who underwent lumbar spine magnetic resonance imaging (MRI). Axial T2-weighted MRI data of the L4-5 and L5-S1 levels were used to measure the cross-sectional area (CSA) of the psoas and spinal muscles. The psoas index (cm²/m²) was used as a surrogate for systemic muscle mass. The Pfirrmann grading system was used to evaluate intervertebral disc degeneration. The functional area of the back muscles was calculated by subtracting the fat infiltration area from the CSA; the functional CSA ratio was calculated by dividing the functional CSA by the CSA. Image-processing software (ImageJ; National Institutes of Health, Bethesda, MD, USA) was used for analysis. Psoas index and aging significantly affected CSA and the ratio of functional CSA of the back muscles and multifidi. Disc degeneration did not significantly affect the back muscles beyond aging in patients with back pain. Males showed substantially higher CSA of the back muscles and multifidi than females; however, sex did not affect the functional CSA ratio of these muscles. Systemic muscle mass decline showed a more powerful influence on back muscle atrophy and fatty infiltration than disc degeneration. Therefore, proper evaluation of sarcopenia is needed for patients with chronic back pain and back muscle degeneration.

Blocking the activin IIB receptor with bimagrumab (BYM338) increases walking performance: A meta-analysis

AIM

Diseases and bed rest may result in decreased muscle size and function. While exercise is recommended as a countermeasure, there are times when diseases or injuries make it difficult for the patient to partake in an exercise intervention. Pharmaceutical interventions using a myostatin inhibitor, BYM338, have been investigated as a way to increase or maintain muscle function. Of interest in the present analysis was the 6-min walk test. The 6-min walk test was selected, as there is an association between walking ability and the ease of performing activities of daily living. Thus, our aim was to investigate the effects of BYM338 on walking performance relative to a placebo.

METHODS

A meta-analysis using a random effects model was conducted in April 2021.

RESULTS

Four studies were included with a total sample size of 244 participants receiving BYM338 and 114 participants receiving a placebo. The average age of the participants included was 68 years. The main analysis produced a weighted mean effect size of 10 m (SE 5) (P = 0.05) for BYM338 over a placebo. Excluding the lowest dosage (1 mg/kg) provided similar results (12 m [SE 5], P = 0.033). Of note, the weighted mean effect with or without the lowest dosage is surrounded by a large degree of uncertainty.

CONCLUSIONS

Our results suggest that BYM338 is a viable drug for improving 6-min walk test in populations associated with impaired function. Geriatr Gerontol Int 2021; 21: 939-943.

Role of small leucine zipper protein in hepatic gluconeogenesis and metabolic disorder

Hepatic gluconeogenesis is the central pathway for glucose generation in the body. The imbalance between glucose synthesis and uptake leads to metabolic diseases such as obesity, diabetes, and cardiovascular diseases. Small leucine zipper protein (sLZIP) is an isoform of LZIP and it mainly functions as a transcription factor. Although sLZIP is known to regulate the transcription of genes involved in various cellular processes, the role of sLZIP in hepatic glucose metabolism is not known. In this study, we investigated the regulatory role of sLZIP in hepatic gluconeogenesis and its involvement in metabolic disorder. We found that sLZIP expression was elevated during glucose starvation, leading to the promotion of phosphoenolpyruvate carboxylase and glucose-6-phosphatase expression in hepatocytes. However, sLZIP knockdown suppressed the expression of the gluconeogenic enzymes under low glucose conditions. sLZIP also enhanced glucose production in the human liver cells and mouse primary hepatic cells. Fasting-induced cyclic adenosine monophosphate impeded sLZIP degradation. Results of glucose and pyruvate tolerance tests showed that sLZIP transgenic mice exhibited abnormal blood glucose metabolism. These findings suggest that sLZIP is a novel regulator of gluconeogenic enzyme expression and plays a role in blood glucose homeostasis during starvation.

Biomineralization of Dental Tissues Treated with Silver Diamine Fluoride

Silver diamine fluoride (SDF) is a dental biomaterial used to arrest dental caries. To better understand SDF's mechanism of action, we examined the localization of silver within the tissues of SDF-treated teeth. Carious primary teeth fixed within 2 min of SDF application (SDF-minutes, n = 3), at 3 wk after SDF application in vivo (SDF-weeks, n = 4), and at 2 y after multiple SDF applications in vivo (SDF-multiple, n = 1) were investigated in this study. Carious primary teeth without SDF application (no-SDF, n = 3) served as controls. Mineral density and structural analyses were performed via micro-X-ray computed tomography and scanning electron microscopy. Elemental analyses were performed through X-ray fluorescence microprobe and energy-dispersive X-ray spectroscopic techniques. SDF-treated teeth revealed higher X-ray-attenuated surface and subsurface regions within carious lesions, and similar regions were not present in no-SDF teeth. Regions of higher mineral density correlated with regions of silver abundance in SDF-treated teeth. The SDF penetration depth was approximated to 0.5 ± 0.02 mm and 0.6 ± 0.05 mm (mean ± SD) for SDF-minutes and SDF-weeks specimens, respectively. A higher percentage of dentin tubular occlusion by silver or calcium phosphate particles was observed in primary teeth treated with SDF-weeks as compared with SDF-minutes. Elemental analysis also revealed zinc abundance in carious lesions and around the pulp chamber. SDF-weeks teeth had significantly increased tertiary dentin than SDF-minutes and no-SDF teeth. These results suggest that SDF treatment on primary teeth affected by caries promotes pathologic biomineralization by altering their physicochemical properties, occluding dentin tubules, and increasing tertiary dentin volume. These seemingly serendipitous effects collectively contribute to the cariostatic activity of SDF.

Patterns of Weight Change in a Commercial Weight Loss Program

Objectives: In this study, we examined compliance and progress factors associated with weight loss and maintenance, individual patterns of weight trends following weight loss, and impact of early weight loss on longer-term weight change. Methods: We conducted secondary analysis of pre-post data. Participants were 8769 persons (mean age = 47.63 ± 13.78 years; 77.74% women; mean weight = 97.20 ± 22.82 kilograms; BMI = 34.09 ± 6.84) in a commercial weight management program. We carried out multiple regression analyses on weight change and percentage, and used ANOVA and the Pearson chi-square test to examine participant characteristics, weight change patterns, and early weight loss success. Results: Participants were active in the program for 222 ± 158 days, completed 15 ± 13 appointments, achieving -8.53 ± 7.87 kilograms lost (-8.61% ± 7.64%). Greater weight loss was associated with appointment frequency (β = -0.46) and total spending (β = -2.89) (p < .01). We identified 5 weight change patterns (F = 37.56, p < .001) (total weight loss for each group was: Stable = -10.4% [N=2036]; Minimal Regain = -10.5% [N=3766]; Modest Regain = -8.8% [N=1476]; Large Regain = -7.3% [N=753]; No Loss/Gain = +3.7% [N=737]; all p < .05). Over 5000 participants achieved early weight loss (losing > 5%) within the first 2 months resulting in significantly greater final weight loss (-8.43% to -14.56% vs -1.18% to -3.15%). Conclusions: We identified several weight patterns; increased health coaching attendance was associated with greater weight loss.

Small leucine zipper protein promotes the metastasis of castration-resistant prostate cancer through transcriptional regulation of matrix metalloproteinase-13

Matrix metalloproteinases (MMPs) function as central modulators of tissue remodeling. Abnormal expression and altered activity of MMPs result in excessive extracellular matrix degradation and increased tumor metastasis in various cancers. Small leucine zipper protein (sLZIP), belonging to the leucine zipper transcription factor family, functions as a transcriptional regulator of genes involved in various cellular processes. However, its role in MMP expression and castration-resistant prostate cancer (CRPC) metastasis remains unclear. In this study, we investigated the role of sLZIP in MMP-13 expression and its involvement in CRPC metastasis. sLZIP increased MMP-13 transcription by directly binding to its promoter in CRPC cells. We found that the expression levels of GR, which represses MMP transcription, were elevated in CRPC cells. However, sLZIP suppressed the inhibitory effect of GR and enhanced the secretion of MMP-13 in CRPC cells. sLZIP promoted cell migration and invasion; however, a specific MMP-13 inhibitor blocked sLZIP-induced cell motility. Depletion of sLZIP using the CRISPR/Cas9 system downregulated MMP-13 mRNA expression in PC3 cells. Mice injected with sLZIP-depleted PC3 cells showed significantly reduced metastatic tumor volume in the lung compared to mice injected with control PC3 cells. Our findings suggest that sLZIP plays an important role in MMP-13 induction and CRPC metastasis. Therefore, sLZIP inhibition could be a novel therapeutic strategy for metastatic GR-enriched CRPC.

Low-Temperature and High-Quality Growth of Bi2O2Se Layered Semiconductors via Cracking Metal-Organic Chemical Vapor Deposition

Ternary metal-oxy-chalcogenides are emerging as next-generation layered semiconductors beyond binary metal-chalcogenides (i.e., MoS₂). Among ternary metal-oxy-chalcogenides, especially Bi₂O₂Se has been demonstrated in field-effect transistors and photodetectors, exhibiting ultrahigh performance with robust air stability. The growth method for Bi₂O₂Se that has been reported so far is a powder sublimation based chemical vapor deposition. The first step for pursuing the practical application of Bi₂O₂Se as a semiconductor material is developing a gas-phase growth process. Here, we report a cracking metal-organic chemical vapor deposition (c-MOCVD) for the gas-phase growth of Bi₂O₂Se. The resulting Bi₂O₂Se films at very low growth temperature (∼300 °C) show single-crystalline quality. By taking advantage of the gas-phase growth, the precise phase control was demonstrated by modulating the partial pressure of each precursor. In addition, c-MOCVD-grown Bi₂O₂Se exhibits outstanding electrical and optoelectronic performance at room temperature without passivation, including maximum electron mobility of 127 cm²/(V·s) and photoresponsivity of 45134 A/W.

FoxO1 as a Regulator of Aquaporin 5 Expression in the Salivary Gland

Forkhead box O1 (FoxO1) is a multifunctional initiator, mediator, and repressor of autoimmune diseases in an organ- or disease-specific manner. However, the role of FoxO1 in the salivary gland has not yet been elucidated. In this study, we discovered that FoxO1 and aquaporin 5 (AQP5) are both significantly downregulated in the patients with primary Sjögren syndrome, an autoimmune disease accompanying salivary gland dysfunction. Pharmacologic or genetic perturbation of FoxO1 in the rat salivary gland acinar cell line, SMG-C6, induced a significant downregulation of AQP5 expression, as observed in clinical specimens. There was a strong correlation between FoxO1 and AQP5 expression because FoxO1 is a direct regulator of AQP5 expression in salivary gland acinar cells through its interaction with the promoter region of AQP5. Serial injection of a FoxO1 inhibitor into mice induced a reduction of AQP5 expression in submandibular glands and, consequently, hyposalivation, which is one of the major clinical symptoms of primary Sjögren syndrome. However, there was no sign of inflammation or cell damage in the submandibular glands harvested from mice treated with the FoxO1 inhibitor. In conclusion, our findings indicate that FoxO1 in salivary gland tissue acts as a direct regulator of AQP5 expression. Thus, downregulation of FoxO1 observed in primary Sjögren syndrome is a putative mechanism for hyposalivation without the involvement of previously reported soluble factors in primary Sjögren syndrome patient sera.

Association among length of residence, physical activity, and obesity in the US immigrants: A regression-based mediation analysis

OBJECTIVES

To examine the mediated relationship between objectively measured obesity, accelerometer-based moderate-to-vigorous physical activity (MVPA), and length of residence among US immigrants.

METHODS

A total of 885 adults (≥18 years) who were born outside the United States from the 2003 to 2006 National Health and Nutrition Examination Survey were included in the analysis. The participants were categorized into two groups (i.e., living in the United States ≥15 years vs. <15 years). MVPA time (minutes/day) was measured by ActiGraph accelerometry. Obesity was defined as body fat percentage measured by dual-energy X-ray absorptiometry. Regression-based mediation analysis was conducted using SURVEY procedures in SAS version 9.4.

RESULTS

When controlling for covariates, immigrants living in the United States for ≥15 years were significantly less likely to spend time participating in MVPA (c; β = -4.50, p = .04), and more likely to be at high risk of obesity (a; β = 1.70, p = .01) compared to those living in the United States for <15 years. Also, the relationship between obesity and MVPA was statistically significant (b; β = -0.80, p = .003). Length of residence was indirectly associated with MVPA (ab; β = -1.37, p = .03), suggesting that obesity mediated the association of length of residence on MVPA (c'; β = -3.13, p = .20).

CONCLUSIONS

Obesity mediated the association between length of residence and MVPA in the US immigrants. These findings may encourage long-term US immigrants to prevent and treat obesity for increasing the amount of MVPA time.

Calcium Signaling in T Cells and Chronic Inflammatory Disorders of the Oral Cavity

Acute immune responses to microbial insults in the oral cavity often progress to chronic inflammatory diseases such as periodontitis and apical periodontitis. Chronic oral inflammation causes destruction of the periodontium, potentially leading to loss of the dentition. Previous investigations have demonstrated that the composition of oral immune cells, rather than the overall extent of cellular infiltration, determines the pathological development of chronic inflammation. The role of T lymphocyte populations, including Th1, Th2, Th17, and Treg cells, has been extensively described. Studies now propose pathogenic Th17 cells as a distinct subset, uniquely classifiable from traditional Th17 populations. In situ differentiation of pathogenic Th17 cells has been verified as a source of destructive inflammation, which critically drives pathogenesis in chronic inflammatory diseases such as diabetes, rheumatoid arthritis, and inflammatory bowel disease. Pathogenic Th17 cells resemble a Th1 penotype and produce not only interleukin 17 (IL-17) but also γ-interferon (IFN-γ) and granulocyte-macrophage colony-stimulating factor (GM-CSF). The proinflammatory cytokine-specific mechanisms known to induce IL-17 expression in Th17 cells are well characterized; however, differentiation mechanisms that lead to pathogenic Th17 cells are less understood. Recently, Ca2⁺ signaling through Ca²⁺ release-activated Ca²⁺ channels (CRAC) in T cells has been uncovered as a major signaling axis involved in the regulation of T-cell-mediated chronic inflammation. In particular, pathogenic Th17 cell-mediated immunological diseases appear to be effectively targeted via such Ca²⁺ signaling pathways. Pathogenic plasticity of Th17 cells has been extensively illustrated in autoimmune and chronic inflammatory diseases. Although their specific causal relationship to oral infection-induced chronic inflammatory diseases is not fully established, pathogenic Th17 cells may be involved in the underlining mechanism. This review highlights the current understanding of T-cell phenotype regulation, calcium signaling pathways in this event, and the potential role of pathogenic Th17 cells in chronic inflammatory disorders of the oral cavity.

Endovascular and percutaneous transabdominal embolisation of pseudoaneurysms in pancreatitis: an experience from a tertiary-care referral centre

AIM

To analyse the technical challenges, clinical success, and associated complications of endovascular and percutaneous embolisation of pancreatitis-related pseudoaneurysms.

MATERIALS AND METHODS

A retrospective study of patients referred for embolisation of pancreatitis-related pseudoaneurysms between January 2014 and March 2019 was conducted. Computed tomography angiography (CTA) was performed to assess the morphology of the aneurysms prior to any intervention. Percutaneous or endovascular embolisation was performed. Details of CTA and methods of embolisation were recorded. Technical success, clinical success, and complications were reported.

RESULTS

A total of 80 patients (mean age, 40.69 ± 13.41 years, 73 male) underwent embolisation during the study period. Pseudoaneurysms were related to chronic pancreatitis (CP) in 44 (55%) patients and acute pancreatitis (AP) in 36 (45%) patients. Pseudoaneurysms were detected in 65 (81.2%) patients on CTA. The most common site of pseudoaneurysms was gastroduodenal artery (GDA) followed by splenic artery. Seven patients were treated with percutaneous thrombin injection and five were treated with percutaneous glue injection under ultrasound/fluoroscopy guidance. The remaining patients (n=68) underwent catheter angiography with endovascular embolisation. Technical success was achieved in 4/7 (57%) percutaneous thrombin cases and in all the cases (5/5, 100%) with percutaneous glue or endovascular (68/68,100%) embolisation.

CONCLUSION

Endovascular or percutaneous embolisation of pseudoaneurysms has high technical success with an excellent safety profile.

[Infliximab in infantile Takayasu arteritis: a case report and literature review]

Objective: To analyze the clinical characteristics of infantile Takayasu arteritis and the efficacy of infliximab (IFX). Methods: Clinical manifestations, laboratory investigations and infliximab intervention of a case with infantile Takayasu arteritis, who was admitted to Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics in January 2018, were reviewed and analyzed. The related literature published from the beginning to March 2020 were retrieved from CNKI, Wanfang, SinoMed and PubMed with the keywords of"Takayasu arteritis","Infant" in both Chinese and English. Results: This case was a 70-day-old boy admitted due to recurrent fever for 20 days. On admission, his blood pressure were 104/90, 95/59, 125/80, and 152/125 mmHg (1 mmHg=0.133 kPa) in the right arm, left arm, right leg, and left leg, respectively. The complete blood cell count showed leukocytosis (22.6×10⁹/L), thrombocytosis (858×10⁹/L) and mild anemia (80 g/L). He also had elevated erythrocyte sedimentation rate (119 mm/1h), serum ferritin (598 μg/L) and C-reactive protein (112 mg/L). Computed tomographic angiography (CTA) showed narrowing of the thoracic and abdominal aorta, with thickening and heterogenous enhancement of the vessel wall. Coronary artery ultrasound detected dilatation and wall thickening of the bilateral coronary arteries, and uneven dilatation of the middle segment of the right coronary artery, showing bead-like change. Vessel wall thickening was also found in the other main arteries, including both femoral arteries, axillary arteries, carotid arteries, and subclavian arteries, and both superficial femoral arteries were slightly narrowed in the distal segments. The diagnosis of TA was confirmed, and the boy was treated with infliximab monotherapy (5 mg/(kg·every time), a total of 13 times). Then his body temperature and all inflammatory markers were normalized, and the vascular pathology was resolved according to the radiography. No side effects such as allergy or infection were noted during the treatment. During the 2 years and 6 months of follow-up, the boy maintained normal growth and development. Literature review found 8 related articles, and one of them was in Chinese but had limited information. In the other 7 papers, a total of 7 infants with TA were reported. The most common symptom was fever (5 cases), and inflammatory markers usually elevated, and the most common affected artery was abdominal aorta (6 cases). Most cases were treated with glucocorticoid. Conclusions: TA is a rare disease in infants, usually presents with fever and increased inflammatory markers. At the early stage, infliximab monotherapy could effectively control the symptoms and ensure normal growth and development.

Surface Modification of Backsheets Using Coupling Agents for Roll-To-Roll Processed Thin-Film Solar Photovoltaic (PV) Module Packaging Application

For many flexible electronic and photonic devices, moisture stability is one of the most important factors that affects its short- and long-term performance. To maintain the performance, the device should be packaged in such a way that it hermetically blocks moisture from the device; however, in practice, it is rather difficult to achieve. The more practical solution is to impede the moisture ingress to the device. In optoelectronic devices that will be outdoors like solar cells, the interfacial adhesion strength between the encapsulant layer (adhesive) and a moisture barrier layer is also a critical parameter. This paper presents surface modifications of poly(ethylene terephthalate) (PET) carrier films, one of the layers in the trilayer barrier film that directly adheres to an encapsulant, using chemical, UV/ozone, and both treatments to improve adhesion with the thermoset encapsulant polymer material. Whereas previous studies also utilized treatment methods to increase the wettability characteristics, in this paper, we not only present the results of the adhesion strength upon various techniques to achieve good adhesion but also screen their behavior upon exposure to a damp-heat (60 °C, 90% RH) environment. We found that the combined treatment method increases the adhesion by up to 12.1-fold and demonstrates up to a 200% increase in adhesion strength even upon our severe damp-heat environmental condition.

[Clinical outcomes of COVID-19 cases and influencing factors in Guangdong province]

Objective: To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods: We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results: Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1 049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days (P(25), P(75): 18, 31 days) and the median length of hospitalization were 20 days (P(25), P(75): 15,27 days). For severe cases, the median time of showing severe manifestations was on the 12(th) day after onset (P(25), P(75): 9(th) to 15(th) days), and the median time of severe manifestation lasted for 8 days (P(25), P(75): 4, 14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (aHR=1.87, 95%CI: 1.43-2.46), older age (aHR=1.67, 95%CI: 1.51-1.85), seeking medical care on day 2-3 after onset (aHR=1.73, 95%CI: 1.20-2.50) pre-existing diabetes (aHR=1.75, 95%CI: 1.12-2.73) and hypertension (aHR=1.49, 95%CI: 1.06-2.09). Conclusions: The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.

Serial-multiple mediation of enjoyment and intention on the relationship between creativity and physical activity

The purpose of the present study was to examine a serial-multiple mediation of physical activity (PA) enjoyment and PA intention in the relationship between creativity and PA level (i.e., moderate-to-vigorous PA). A total of 298 undergraduate and graduate students completed a self-reported questionnaire evaluating creativity, PA enjoyment, PA intention, and PA level. Data analysis was conducted using descriptive statistics, Pearson correlation coefficient, ordinary least-squares regression analysis, and bootstrap methodology. Based on the research findings, both PA enjoyment (β = 0.06; 95% CI [0.003, 0.12]) and PA intention (β = 0.08; 95% CI [0.03, 0.13]) were found to be a mediator of the relationship between creativity and PA level, respectively. Moreover, the serial-multiple mediation of PA enjoyment and PA intention in the relationship between creativity and PA level was statistically significant (β = 0.02; 95% CI [0.01, 0.04]). These findings underscore the importance of shaping both cognitive and affective functions for PA promotion and provide additional support for a neurocognitive affect-related model in the PA domain. In order to guide best practices for PA promotion programs aimed at positively influencing cognition and affect, future PA interventions should develop evidence-based strategies that routinely evaluate cognitive as well as affective responses to PA.

α-Actinin-4 Promotes the Progression of Prostate Cancer Through the Akt/GSK-3β/β-Catenin Signaling Pathway

The first-line treatment for prostate cancer (PCa) is androgen ablation therapy. However, prostate tumors generally recur and progress to androgen-independent PCa (AIPC) within 2–3 years. α-Actinin-4 (ACTN4) is an actin-binding protein that belongs to the spectrin gene superfamily and acts as an oncogene in various cancer types. Although ACTN4 is involved in tumorigenesis and the epithelial–mesenchymal transition of cervical cancer, the role of ACTN4 in PCa remains unknown. We found that the ACTN4 expression level increased during the transition from androgen-dependent PCa to AIPC. ACTN4 overexpression resulted in enhanced proliferation and motility of PCa cells. Increased β-catenin due to ACTN4 promoted the transcription of genes involved in proliferation and metastasis such as CCND1 and ZEB1. ACTN4-overexpressing androgen-sensitive PCa cells were able to grow in charcoal-stripped media. In contrast, ACTN4 knockdown using si-ACTN4 and ACTN4 nanobody suppressed the proliferation, migration, and invasion of AIPC cells. Results of the xenograft experiment revealed that the mice injected with LNCaP^ACTN4 cells exhibited an increase in tumor mass compared with those injected with LNCaP^Mock cells. These results indicate that ACTN4 is involved in AIPC transition and promotes the progression of PCa.

Growth and Interlayer Engineering of 2D Layered Semiconductors for Future Electronics

Layered materials that do not form a covalent bond in a vertical direction can be prepared in a few atoms to one atom thickness without dangling bonds. This distinctive characteristic of limiting thickness around the sub-nanometer level allowed scientists to explore various physical phenomena in the quantum realm. In addition to the contribution to fundamental science, various applications were proposed. Representatively, they were suggested as a promising material for future electronics. This is because (i) the dangling-bond-free nature inhibits surface scattering, thus carrier mobility can be maintained at sub-nanometer range; (ii) the ultrathin nature allows the short-channel effect to be overcome. In order to establish fundamental discoveries and utilize them in practical applications, appropriate preparation methods are required. On the other hand, adjusting properties to fit the desired application properly is another critical issue. Hence, in this review, we first describe the preparation method of layered materials. Proper growth techniques for target applications and the growth of emerging materials at the beginning stage will be extensively discussed. In addition, we suggest interlayer engineering via intercalation as a method for the development of artificial crystal. Since infinite combinations of the host-intercalant combination are possible, it is expected to expand the material system from the current compound system. Finally, inevitable factors that layered materials must face to be used as electronic applications will be introduced with possible solutions. Emerging electronic devices realized by layered materials are also discussed.