A bi-criterion sequence-dependent scheduling problem with order deliveries.

The manufacturing sector faces unprecedented challenges, including intense competition, a surge in product varieties, heightened customization demands, and shorter product life cycles. These challenges underscore the critical need to optimize manufacturing systems. Among the most enduring and complex challenges within this domain is production scheduling. In practical scenarios, setup time is whenever a machine transitions from processing one product to another. Job scheduling with setup times or associated costs has garnered significant attention in both manufacturing and service environments, prompting extensive research efforts. While previous studies on customer order scheduling primarily focused on orders or jobs to be processed across multiple machines, they often overlooked the crucial factor of setup time. This study addresses a sequence-dependent bi-criterion scheduling problem, incorporating order delivery considerations. The primary objective is to minimize the linear combination of the makespan and the sum of weighted completion times of each order. To tackle this intricate challenge, we propose pertinent dominance rules and a lower bound, which are integral components of a branch-and-bound methodology employed to obtain an exact solution. Additionally, we introduce a heuristic approach tailored to the problem's unique characteristics, along with three refined variants designed to yield high-quality approximate solutions. Subsequently, these three refined approaches serve as seeds to generate three distinct populations or chromosomes, each independently employed in a genetic algorithm to yield a robust approximate solution. Ultimately, we meticulously assess the efficacy of each proposed algorithm through comprehensive simulation trials.

Patient Confidential Data Hiding and Transmission System Using Amplitude Quantization in the Frequency Domain of ECG Signals.

The transform domain provides a useful tool in the field of confidential data hiding and protection. In order to protect and transmit patients' information and competence, this study develops an amplitude quantization system in a transform domain by hiding patients' information in an electrocardiogram (ECG). In this system, we first consider a non-linear model with a hiding state switch to enhance the quality of the hidden ECG signals. Next, we utilize particle swarm optimization (PSO) to solve the non-linear model so as to have a good signal-to-noise ratio (SNR), root mean square error (RMSE), and relative root mean square error (rRMSE). Accordingly, the distortion of the shape in each ECG signal is tiny, while the hidden information can fulfill the needs of physiological diagnostics. The extraction of hidden information is reversely similar to a hiding procedure without primary ECG signals. Preliminary outcomes confirm the effectiveness of our proposed method, especially an Amplitude Similarity of almost 1, an Interval RMSE of almost 0, and SNRs all above 30.

Utility of High-Sensitivity Modified Glasgow Prognostic Score in Cancer Prognosis: A Systemic Review and Meta-Analysis.

The suitability of the high-sensitivity modified Glasgow Prognostic Score (HS-mGPS) in cancer patients remains unknown. We performed a systematic database search from 1 January 2010 to 30 September 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Selected studies reported the HS-mGPS and survival outcomes in cancer patients. The association between the HS-mGPS and survival outcomes was evaluated using a random-effects model and expressed as pooled hazard ratios (HRs) with 95% CIs. This meta-analysis evaluated 17 studies with a total of 5828 cancer patients. A higher HS-mGPS was found to be associated with an adverse OS (HR = 2.17; 95% CI: 1.80-2.60), DSS (HR = 3.81; 95% CI: 2.03-7.17), and DFS (HR = 1.96; 95% CI: 1.48-2.58; all p ≤ 0.001). The prognostic value of the HS-mGPS for the OS trended in a consistent direction after subgrouping and sensitivity analysis. In conclusion, the HS-mGPS serves as a valid prognostic biomarker for cancer patients, with a high HS-mGPS associated with adverse survival outcomes.

Clinical outcomes of benign brain tumors treated with single fraction LINAC-based stereotactic radiosurgery: Experience of a single institute.

Objectives: Accelerator-based stereotactic radiosurgery (SRS) is a noninvasive and effective treatment modality widely used for benign brain tumors. This study aims to report 20-year treatment outcomes in our institute. Materials and Methods: From May 2001 to December 2020, 127 patients treated with LINAC-based single-fraction SRS for their benign brain lesions were included. A neurosurgeon and two radiation oncologists retrospectively reviewed all data. Computed tomography (CT) simulation was performed after head-frame fixation under local anesthesia. All planning CT images were co-registered and fused with gadolinium-enhanced magnetic resonance imaging taken within 3 months for lesions targeting and critical organs delineation. The marginal dose was prescribed at 60%-90% isodose lines, respectively, to cover ≥95% planning target volume. Outcome evaluations included clinical tumor control rate (TCR), defined as the need for salvage therapy, and radiological response, defined as no enlargement of >2 cm in the maximal diameter. Overall survival (OS) and adverse reaction (defined according to CTCAE 5.0) were also analyzed. Results: The present study included 76 female and 51 male patients for analysis. The median age was 59 years (range, 20-88 years). Their diagnoses were vestibular schwannoma (VS, n = 54), nonvestibular cranial nerve schwannoma (n = 6), meningioma (n = 50), and pituitary adenoma (n = 17). Totally 136 lesions were treated in a single fraction, predominantly skull base tumors, accounting for 69.1%. Median and mean follow-up duration was 49 and 61 months (range, 1-214 months), Overall TCR was 92.9%. The 5-year disease-specific TCR for VS, nonvestibular schwannoma, meningioma, and pituitary adenoma were 97.4%, 91.7%, 93.8%, and 83.3%. Salvage therapy was indicated for eight patients at 4-110 months after SRS. Among symptomatic patients, post-SRS symptom(s) was improved, stable, and worse in 68.2%, 24.3%, and 3.6%, respectively. Radiological response rate for 111 evaluable patients was 94.6% (shrinkage, 28.8%; stable, 65.8%). OS was 96.1% without treatment-related mortality. One patient with post-SRS cranial nerve injury (0.8%, involving the trigeminal nerve, grade 2 toxicities). No grade 3-4 acute or late toxicity was found. Conclusion: Our results suggested that LINAC-based SRS effectively controls tumor growth and tumor-related neurological symptoms for patients with benign brain tumors. SRS is less aggressive, associated with low neurological morbidity and no mortality. Continuous follow-up is indicated to conclude longer outcomes.

End-of-Life Decisions of Intracranial Hemorrhage Patients Successfully Weaned From Prolonged Mechanical Ventilation.

Factors related to the end-of-life decisions of patients with intracranial hemorrhage who were successfully weaned from prolonged mechanical ventilation remain unclear. This study aimed to evaluate factors that influence the end-of-life decisions of these patients. METHODS: This retrospective study examined patients with intracranial hemorrhage successfully weaned from prolonged mechanical ventilation between January 2012 and December 2017. The following data was collected and analyzed: age, gender, comorbidities, Glasgow Coma Scale scores, receipt or non-receipt of intracranial hemorrhage surgery, discharge status, and end-of-life decisions. RESULTS: In total, 91 patients with intracranial hemorrhage were successfully weaned from prolonged mechanical ventilation. The families of 62 (68.1%) patients signed the do-not-resuscitate order. A Glasgow Coma Scale score of ≥10 at discharge from the respiratory care center and zero comorbidities were the influencing factors between patients whose do-not-resuscitate orders were signed and those whose orders were not signed. Patients with intracranial hemorrhage successfully weaned from prolonged mechanical ventilation had chronic kidney disease comorbidity and Glasgow Coma Scale score of <7 on admission to respiratory care center with a general ward mortality rate of 83.3%. CONCLUSIONS: The families of intracranial hemorrhage patients with multiple comorbidities and higher neurologic impairment after successful weaning from the ventilator believed that palliative therapy would provide a greater benefit. Patients with intracranial hemorrhage successfully weaned from prolonged mechanical ventilation with chronic kidney disease comorbidity and Glasgow Coma Scale score of <7 on admission to respiratory care center are candidates for the consideration of hospice care with ventilator withdrawal.

Utilizing High-Throughput Screening Data, Integrative Toxicological Prioritization Index Score, and Exposure-Activity Ratios for Chemical Prioritization: A Case Study of Endocrine-Active Pesticides in Food Crops.

Endocrine-active chemicals can directly act on nuclear receptors and trigger the disturbances of metabolism and a homeostatic system, which are important risk factors for complicating chronic diseases in humans. The endocrine-active potentials of pesticides acting on estrogen, androgen, and thyroid hormone receptors have been extensively evaluated for pesticides; however, the effects on other receptors are less understood. This study aims to comprehensively characterize and prioritize the endocrine-active pesticides using an exposure-activity ratio (EAR) method and toxicological prioritization index (ToxPi). The aggregate exposure assessment of pesticides was performed using a computational exposure model [stochastic human exposure and dose simulation high-throughput model (SHEDS-HT)]. Minimum in vitro point of departure values were converted to human oral equivalent doses via in vitro-to-in vivo extrapolation. The overall endocrine-disrupting potentials of pesticides were evaluated via 76 assays, representing 11 nuclear receptors. EARs and ToxPi scores were then derived to prioritize 79 pesticides in food. This case study demonstrates that EAR profiling can inform the regulatory agencies for a relevant chemical prioritization, which would direct in-depth health risk assessments in the future.

Effect of mirabegron on erectile function in sexually active men with bothersome overactive bladder symptoms.

BACKGROUND: To evaluate the change of erectile function (EF) in sexually active male overactive bladder (OAB) patients treated with Mirabegron. Mirabegron, a selective ß3 adrenoceptor agonist, approved for the treatment of OAB, has been reported to relax human and rat corpus cavernosum and might have beneficial effect on EF. METHODS: A total of 128 consecutive men with lower urinary tract symptoms attended urology outpatient clinic were evaluated for OAB and EF. Thirty-four sexually active OAB patients were prospectively enrolled in this study and received mirabegron 50 mg oral once a day. The evaluation of EF and OAB was based on a self-administered questionnaire containing International Index of Erectile Function (IIEF-5) and OAB symptom score (OABSS), respectively. Men with an OABSS urgency score of ≥2 and sum score of ≥3 were considered to have OAB. The therapeutic outcomes were assessed at baseline, 4, and 12 weeks. RESULTS: Mirabegron usage was associated with a statistically significant improvement of OAB symptoms (OABSS 32.1% decrease) at 4-week follow-up and the therapeutic effects were maintained at 12-week follow-up. Mirabegron usage did not improve EF (IIEF-5 4.9% decrease at 4-week; p = 0.106, and 9.1% decrease at 12-week follow-up; p = 0.077). However, the IIEF-5 was significantly decreased in the higher baseline IIEF-5 (≥17) group (11.7% decrease; p = 0.044), noncoronary artery disease (13.2%; p = 0.007), or non-DM group (13.9% decrease; p = 0.021) at 12-week follow-up. CONCLUSION: This preliminary study demonstrates that mirabegron treatment of men with OAB improved OAB symptoms, but has no beneficial effect on EF.

Characterization of the interactions between inhibitor-1 and recombinant PP1 by NMR spectroscopy.

Inhibitor-1 is converted into a potent inhibitor of native protein phosphatase-1 (PP1) when Thr35 is phosphorylated by cAMP-dependent protein kinase (PKA). However, PKA-phosphorylated form of inhibitor-1 displayed a weak activity in inhibition of recombinant PP1. The mechanism for the impaired activity of PKA-phosphorylated inhibitor-1 toward inhibition of recombinant PP1 remained elusive. By using NMR spectroscopy in combination with site-directed mutagenesis and inhibitory assay, we found that the interaction between recombinant PP1 and the consensus PP1-binding motif of PKA-thiophosphorylated form of inhibitor-1 was unexpectedly weak. Unlike binding to native PP1, the subdomains 1 (residues around and including the phosphorylated Thr35) and 2 (the consensus PP1-binding motif) of PKA-thiophosphorylated form of inhibitor-1 do not exhibit a synergistic effect in inhibition of recombinant PP1. This finding implied that a slight structural discrepancy exists between native and recombinant PP1, resulting in PKA-thiophosphorylated form of inhibitor-1 displaying a different affinity to native and recombinant enzyme.

Cross-Validation of Two Commonly Used Self-Stigma Measures, Taiwan Versions of the Internalized Stigma Mental Illness Scale and Self-Stigma Scale-Short, for People With Mental Illness.

Self-stigma instruments investigate how people with mental illness internalize public stigma. However, information is limited for the psychometric properties of their scores, especially cross-validating scores from different instruments. Thus, we used confirmatory factor analyses (CFAs) and item-response theory (IRT) models to examine the Internalized Stigma Mental Illness (ISMI) scale and the Self-Stigma Scale-Short (SSS-S). Participants with mental illness ( n = 347) completed both instruments. The CFAs that simultaneously accounted for both the instrument (ISMI and SSS-S) and the trait (Affect, Cognitive, and Behavior concepts) effects outperformed those that accounted only for the instrument effect or only the trait effect. All item scores fit the IRT model and were fit with ordered, progressing hierarchies in their step difficulties. We conclude that both instruments are feasible for measuring the self-stigma and that future research can combine the items of both.

Comparing Self-stigma Between People With Different Mental Disorders in Taiwan.

Internalized stigma (or self-stigma), one of the most painful effects of stigma, causes people with mental health problems profound negative consequences, for example, psychological adversity, demoralization, and feelings of hopelessness. However, knowledge about self-stigma in people with different mental disorders is insufficient. We hypothesized that people with different psychiatric diagnoses have different levels of self-stigma. Through convenience sampling, we used the Internalized Stigma of Mental Illness Scale to compare people diagnosed with schizophrenia (n = 161), depressive disorder (n = 98), bipolar disorder (n = 43), and anxiety disorder (n = 45) in southern Taiwan. We found that people with schizophrenia (mean, 2.09-2.30) and those with bipolar disorder (mean, 2.16-2.38) had significantly higher levels of self-stigma, except for the Stigma Resistance, than did those with anxiety disorder (mean, 1.74-1.87). Our results suggest that clinicians should use different interventions to reduce self-stigma for populations with different psychiatric diagnoses.

Further psychometric evaluation of the self-stigma scale-short: measurement invariance across mental illness and gender.

BACKGROUND: This study cross-validated the factor structure of the Self-Stigma Scale-Short (SSS-S) in a cohort of patients with mental illness in southern Taiwan. The measurement invariance of the SSS-S factor structure across mental illness and gender was also examined. METHODS: The sample consisted of 161 patients with schizophrenia (51.6% males; mean age ± SD = 40.53 ± 10.38 years) and 189 patients with other mental illnesses (34.9% males; mean age = 46.52 ± 11.29 years). RESULTS: The internal reliability (total score: α = 0.948) and concurrent validity (r = 0.335 to 0.457 with Depression and Somatic Symptoms Scale; r = -0.447 to -0.556 with WHOQOL-BREF) of the SSS-S were both satisfactory, and the results verified that the factor structure in our Taiwan sample (RMSEA = 0.0796, CFA = 0.992) was the same as that of the Hong Kong population. In addition, the results supported the measurement invariance of the SSS-S across mental illness (ΔRMSEAs = -0.0082 to -0.0037, ΔCFAs = 0.000) and gender (ΔRMSEAs = -0.0054 to -0.0008, ΔCFAs = -0.001 to 0.000). CONCLUSION: Future studies can use the SSS-S to compare self-stigma between genders and between patients with different kinds of mental illnesses.

Psychometric evaluation of the internalized stigma of mental illness scale for patients with mental illnesses: measurement invariance across time.

BACKGROUND: The current investigation examined the psychometric properties of the Internalized Stigma of Mental Illness (ISMI) scale in a sample of patients with mental illness. In addition to the internal consistency, test-retest reliability, and concurrent validity that previous studies have tested for the ISMI, we extended the evaluation to its construct validity and measurement invariance using confirmatory factor analysis (CFA). METHODS: Three hundred forty-seven participants completed two questionnaires (i.e., the ISMI and the Depression and Somatic Symptoms Scale [DSSS]), and 162 filled out the ISMI again after 50.23±31.18 days. RESULTS: The results of this study confirmed the frame structure of the ISMI; however, the Stigma Resistance subscale in the ISMI seemed weak. In addition, internal consistency, test-retest reliability, and concurrent validity were all satisfactory for all subscales and the total score of the ISMI, except for Stigma Resistance (α = 0.66; ICC = 0.52, and r = 0.02 to 0.06 with DSSS). Therefore, we hypothesize that Stigma Resistance is a new concept rather than a concept in internalized stigma. The acceptable fit indices supported the measurement invariance of the ISMI across time, and suggested that people with mental illness interpret the ISMI items the same at different times. CONCLUSION: The clinical implication of our finding is that clinicians, when they design interventions, may want to use the valid and reliable ISMI without the Stigma Resistance subscale to evaluate the internalized stigma of people with mental illness.

Validation of the effects of TGF-ß1 on tumor recurrence and prognosis through tumor retrieval and cell mechanical properties.

BACKGROUND: In vivo, the transforming growth factor-beta1 (TGF-ß1)-induced epithelial to mesenchymal transition (EMT) occurs in seconds during cancer cells intravasation and extravasation. Although it has been established that cellular stiffness can change as a cancer cell transformed, the precise relationship between TGF-ß1-induced mesenchymal stem cell mechanics and cancer prognosis remains unclear. Accordingly, it is hard to define the effects of EMT on cell mechanical properties (CMs), tumor recurrence and metastasis risks. This study bridges physical and pathological disciplines to reconcile single-cell mechanical measurements of tumor cells. METHODS AND RESULTS: We developed a microplate measurement system (MMS) and revealed the intrinsic divergent tumor composition of retrieval cells by cell stiffness and adhesion force and flow cytometry analysis. After flow cytometry sorting, we could measure the differences in CMs of the Sca-1+-CD44+ (mesenchymal-stem-cell-type) and the other subgroups. As well as the stiffer and heterogeneous compositions among tumor tissues with higher recurrence risk were depicted by MMS and atomic force microscopy (AFM). An in vitro experiment validated that Lewis lung carcinoma (LLC) cells acquired higher CMs and motility after EMT, but abrogated by SB-505124 inhibition. Concomitantly, the CD31, MMP13 and TGF-ß1 enriched micro-environment in the tumor was associated with higher recurrence and distal lung metastasis risks. Furthermore, we report a comprehensive effort to correlate CMs to tumor-prognosis indicators, in which a decreased body weight gain ratio (BWG) and increased tumor weight (TW) were correlated with increased CMs. CONCLUSIONS: Together, we determined that TGF-ß1 was significantly associated with malignant tumor progressing. In terms of clinical applications, local tumor excision followed by MMS analysis offers an opportunity to predict tumor recurrence and metastasis risks.

Migration speed and directionality switch of normal epithelial cells after TGF-ß1-induced EMT (tEMT) on micro-structured polydimethylsiloxane (PDMS) substrates with variations in stiffness and topographic patterning.

The epithelial to mesenchymal transition (EMT) involves several physiological and pathological phenomena and endows cells with invasive and migratory properties. However, the effects of substrate stiffness and topography on the migration of cells before or after transforming growth factor-ß1 (TGF-ß1)-induced EMT (tEMT) are unknown. Herein, we seed control or tEMT NMuMG cells on the 2D patterns consisted of 1 µm or 5 µm line-widths and groove or cone patterns on either 2 MPa (1.96 ± 0.48 MPa) or 4 MPa (3.70 ± 0.74 MPa) polydimethylsiloxane (PDMS) substrates. After tEMT, the increased expression of α-SMA with vinculin in focal adhesion (FA) sites led to an acceleration of tEMT cell motility. On the 2 MPa substrate, the most influenced substrate was the 1 µm, cone-patterned substrate, where the tEMT cells' motility decelerated by 0.13 µm/min (36% slower than the cells on groove pattern). However, on the 5 µm, groove-patterned substrate, where the tEMT cells demonstrated the most rapid motility relative to the control cells, with an increment of 0.18 µm/min (100%). Among the different physical cues from substrate, the cone pattern could impede the migration speed of tEMT cells. Furthermore, we recommend the groove-patterned with a 5 µm line-width substrate as a useful tool to differentiate control and tEMT cells by migration speed.

Isolated intraventricular aspergillosis in a schizophrenic patient.

Intracranial aspergillosis of the lateral ventricle is a rare condition and has not been reported in a schizophrenic patient. We report a 39-year-old male patient with underlying schizophrenia and a rapid deterioration of consciousness. Initial cranial computed tomographic images revealed focal dilatation of the posterior part of the right lateral ventricle with a severe mass effect and midline shift. The patient received an emergency endoscopic ventriculostomy, and the resected mass was proven to be aspergillus. The patient was postoperatively treated by prolonged external ventricular drainage and antifungal medication, with no recurrence of aspergillosis at the 12-month follow-up.

Jejunojejunal intussusception following jejunostomy.

Jejunojejunal intussusception is a rare complication of jejunostomy, and its preoperative diagnosis and surgical treatment have not been reported. A 78-year-old man suffered from vomiting off and on after emergency exploratory laparotomy with omentoplasty for perforated duodenal ulcer. He also received Witzel jejunostomy for early feeding. Ileus developed postoperatively and plain X-ray of the abdomen showed distended small bowel loop with scanty colon gas. Small bowel series performed with water-soluble contrast medium revealed substantial fluid retention in the stomach, duodenum and proximal jejunum. Infusion of contrast medium into the feeding tube revealed normal caliber of the distal small bowel. Abdominal sonogram revealed target sign as well as the feeding tube in a dilated jejunum. Abdominal computed tomography confirmed the sonographic impression of jejunojejunal intussusception. Reduction of intussusception was done during exploratory laparotomy. The jejunostomy feeding was continued and the postoperative course was uneventful.