Diet Quality and Resilience through Adulthood: A Cross-Sectional Analysis of the WELL for Life Study.

Despite evidence suggesting the importance of psychological resilience for successful aging, little is known about the relationship between diet quality and resilience at different ages. Our study aims to examine the association between diet quality and resilience across the stages of adulthood. Using Stanfords' WELL for Life (WELL) survey data, we conducted a cross-sectional study of diet quality, resilience, sociodemographic, perceived stress, lifestyle, and mental health factors among 6171 Bay Area adults. Diet quality was measured by the WELL Diet Score, which ranges from 0-120. A higher score indicates a better diet quality. Linear regression analysis was used to evaluate the association between the WELL Diet Score and overall resilience and within the following age groups: early young (18-24), late young (25-34), middle (35-49), and late adulthood (≥50). To test whether these associations varied by age groups, an age group by resilience interaction term was also examined. In the fully adjusted model, the WELL Diet Score was positively and significantly associated with overall resilience (all ages (ß = 1.2 ± sd: 0.2, p < 0.001)) and within each age group (early young (ß = 1.1 ± sd: 0.3, p < 0.001); late young (ß = 1.2 ± sd: 0.3, p < 0.001); middle (ß = 0.9 ± sd: 0.3, p < 0.001); and late adulthood (ß = 1.0 ± sd: 0.3, p < 0.001)). Young adults demonstrated the strongest associations between diet quality and resilience. However, there were no significant age-by-resilience interactions. Diet quality may be positively associated with resilience at all stages of adulthood. Further research is needed to determine whether assessing and addressing resilience could inform the development of more effective dietary interventions, particularly in young adults.

Unbiased metastatic niche-labeling identifies estrogen receptor-positive macrophages as a barrier of T cell infiltration during bone colonization.

Microenvironment niches determine cellular fates of metastatic cancer cells. However, robust and unbiased approaches to identify niche components and their molecular profiles are lacking. We established Sortase A-Based Microenvironment Niche Tagging (SAMENT), which selectively labels cells encountered by cancer cells during metastatic colonization. SAMENT was applied to multiple cancer models colonizing the same organ and the same cancer to different organs. Common metastatic niche features include macrophage enrichment and T cell depletion. Macrophage niches are phenotypically diverse between different organs. In bone, macrophages express the estrogen receptor alpha (ERα) and exhibit active ERα signaling in male and female hosts. Conditional knockout of Esr1 in macrophages significantly retarded bone colonization by allowing T cell infiltration. ERα expression was also discovered in human bone metastases of both genders. Collectively, we identified a unique population of ERα+ macrophages in the metastatic niche and functionally tied ERα signaling in macrophages to T cell exclusion during metastatic colonization. HIGHLIGHTS: SAMENT is a robust metastatic niche-labeling approach amenable to single-cell omics.Metastatic niches are typically enriched with macrophages and depleted of T cells.Direct interaction with cancer cells induces ERα expression in niche macrophages. Knockout of Esr1 in macrophages allows T cell infiltration and retards bone colonization.

Probing Surface Transformations of Lanthanum Nickelate Electrocatalysts during Oxygen Evolution Reaction.

Monitoring the spontaneous reconstruction of the surface of metal oxides under electrocatalytic reaction conditions is critical to identifying the active sites and establishing structure-activity relationships. Here, we report on a self-terminated surface reconstruction of Ruddlesden-Popper lanthanum nickel oxide (La2NiO4+δ) that occurs spontaneously during reaction with alkaline electrolyte species. Using a combination of high-resolution scanning transmission electron microscopy (HR-STEM), surface-sensitive X-ray photoelectron spectroscopy (XPS), and soft X-ray absorption spectroscopy (sXAS), as well as electrochemical techniques, we identify the structure of the reconstructed surface layer as an amorphous (oxy)hydroxide phase that features abundant under-coordinated nickel sites. No further amorphization of the crystalline oxide lattice (beyond the ∼2 nm thick layer formed) was observed during oxygen evolution reaction (OER) cycling experiments. Notably, the formation of the reconstructed surface layer increases the material's oxygen evolution reaction (OER) activity by a factor of 45 when compared to that of the pristine crystalline surface. In contrast, a related perovskite phase, i.e., LaNiO3, did not show noticeable surface reconstruction, and also no increase in its OER activity was observed. This work provides detailed insight into a surface reconstruction behavior dictated by the crystal structure of the parent oxide and highlights the importance of surface dynamics under reaction conditions.

Reliability of the Montreal Cognitive Assessment in people with stroke.

This study examined the relative and absolute reliability of the Taiwanese version of the MoCA (MoCA-T) in people with stroke. The study recruited 114 individuals who were at least 3 months after the onset of a first-ever unilateral stroke. The MoCA-T was administered twice, at a 6-week interval, to all participants. The relative reliability was assessed using the intraclass correlation coefficient (ICC), and the absolute reliability was assessed using standard error of measurement (SEM), the smallest real difference (SRD), the SRD percentage, and the Bland-Altman method. The ICC analysis showed the MoCA-T was highly reliable (ICC = 0.85). The absolute reliability was between an acceptable and excellent level, where the SEM and the SRD at the 95% confidence interval were 1.38 and 3.83, respectively. The Bland-Altman analyses showed no systematic bias between repeated measurements. The range of the 95% limits of agreement was narrow, indicating a high level of stability over time. These findings suggest that the MoCA-T has high agreement between repeated measurements without systematic bias. The threshold to detect real change stands between an acceptable and excellent level. The MoCA-T is a reliable tool for cognitive screening in stroke rehabilitation.

Development of a Dyad-Focused Intervention for Stroke Survivors and Their Family Caregivers: A Feasibility Study.

IMPORTANCE: Transitioning from the hospital to the community poses significant challenges for stroke survivors and their caregivers. OBJECTIVE: To examine the feasibility and preliminary effects of a dyad-focused strategy training intervention. DESIGN: Single-arm trial with data collection at baseline, postintervention, and 3-mo follow-up. SETTING: Rehabilitation settings in Taiwan. PARTICIPANTS: Sixteen stroke survivor-caregiver dyads. INTERVENTIONS: Dyad-focused strategy training was provided to stroke survivor-caregiver dyads twice a week over 6 wk. The training included shared decision-making, goal setting, performance evaluation, strategy development and implementation, and therapeutic guided discovery. OUTCOMES AND MEASURES: Feasibility indicators were Goal Attainment Scaling, Dyadic Relationship Scale, Participation Measure-3 Domains, 4 Dimensions, Activity Measure for Post-Acute Care, Montreal Cognitive Assessment, Trail Making Test, Stroop Color and Word Test, Preparedness for Caregiving Scale, and Zarit Burden Interview. RESULTS: In total, 15 dyads completed all intervention sessions with full attendance. Both stroke survivors and their caregivers demonstrated high engagement and comprehension and reported moderate to high satisfaction with the intervention. From baseline to postintervention, the effects on goal attainment, frequency and perceived difficulty of community participation, executive function, mobility function, and caregiver preparedness were significant and positive. CONCLUSIONS AND RELEVANCE: Our study supports the feasibility and preliminary efficacy of dyad-focused strategy training for stroke survivor-caregiver dyads transitioning from the hospital to the community in Taiwan. Our preliminary evidence indicates that dyads who receive strategy training exhibit advancement toward their goals and experience considerable enhancements in their individual outcomes. Plain-Language Summary: This study addresses the scarcity of interventions catering to both stroke survivors and their caregivers. By demonstrating the feasibility of our dyad-focused intervention, the research offers preliminary evidence that supports the potential advantages of involving both stroke survivors and their caregivers in the intervention process.

Siglec-15/sialic acid axis as a central glyco-immune checkpoint in breast cancer bone metastasis.

Immunotherapy is a promising approach for treating metastatic breast cancer (MBC), offering new possibilities for therapy. While checkpoint inhibitors have shown great progress in the treatment of metastatic breast cancer, their effectiveness in patients with bone metastases has been disappointing. This lack of efficacy seems to be specific to the bone environment, which exhibits immunosuppressive features. In this study, we elucidate the multiple roles of the sialic acid-binding Ig-like lectin (Siglec)-15/sialic acid glyco-immune checkpoint axis in the bone metastatic niche and explore potential therapeutic strategies targeting this glyco-immune checkpoint. Our research reveals that elevated levels of Siglec-15 in the bone metastatic niche can promote tumor-induced osteoclastogenesis as well as suppress antigen-specific T cell responses. Next, we demonstrate that antibody blockade of the Siglec-15/sialic acid glyco-immune checkpoint axis can act as a potential treatment for breast cancer bone metastasis. By targeting this pathway, we not only aim to treat bone metastasis but also inhibit the spread of metastatic cancer cells from bone lesions to other organs.

Implementing strategy training in Taiwan: perspectives of individuals with Acquired brain injury.

PURPOSE: Strategy training is a rehabilitation intervention that aims to enhance problem-solving skills with respect to daily activity-related challenges and has achieved favorable results in Western countries. This study explored the perspectives of individuals with acquired brain injury (ABI) in Taiwan who received strategy training. MATERIALS AND METHODS: Semi-structured interviews with community-dwelling adults with ABI were conducted, and reflective memos made by research team members were recorded. Interviews and memos were analyzed through thematic analysis. RESULTS: This study included 55 participants. The analysis of the participants' interview responses and memos yielded nine themes under three categories: 1) expectations regarding strategy training, 2) perceived benefits of strategy training, and 3) barriers affecting the process and outcomes of strategy training. CONCLUSIONS: All the participants endorsed strategy training through different gains. Most participants' expectations before the intervention were uncertain. Including family members into the strategy training is of key importance for a successfulness of their goals. The participants' experiences about strategy training were affected by various barriers (i.e., health and medical problems, the physical environment, and natural events). Clinicians and researchers should consider these expectations, benefits, and barriers when studying and implementing strategy training in non-Western contexts.IMPLICATIONS FOR REHABILITATIONStrategy training provides clients the opportunity to actively engage in their own goal setting and decision making.Strategy training increases the client's confidence in their ability to participate in the community, communicate, and perform daily living and physical activities.Therapists should consider the health conditions and physical environment of clients when helping them set goals and before facilitating their engagement in the community.Taiwanese family members play a crucial role in supporting acquired brain injury survivors in strategy training.

Of Glasses and Crystals: Mitigating the Deactivation of CaO-Based CO2 Sorbents through Calcium Aluminosilicates.

CaO-based sorbents are cost-efficient materials for high-temperature CO2 capture, yet they rapidly deactivate over carbonation-regeneration cycles due to sintering, hindering their utilization at the industrial scale. Morphological stabilizers such as Al2O3 or SiO2 (e.g., introduced via impregnation) can improve sintering resistance, but the sorbents still deactivate through the formation of mixed oxide phases and phase segregation, rendering the stabilization inefficient. Here, we introduce a strategy to mitigate these deactivation mechanisms by applying (Al,Si)Ox overcoats via atomic layer deposition onto CaCO3 nanoparticles and benchmark the CO2 uptake of the resulting sorbent after 10 carbonation-regeneration cycles against sorbents with optimized overcoats of only alumina/silica (+25%) and unstabilized CaCO3 nanoparticles (+55%). 27Al and 29Si NMR studies reveal that the improved CO2 uptake and structural stability of sorbents with (Al,Si)Ox overcoats is linked to the formation of glassy calcium aluminosilicate phases (Ca,Al,Si)Ox that prevent sintering and phase segregation, probably due to a slower self-diffusion of cations in the glassy phases, reducing in turn the formation of CO2 capture-inactive Ca-containing mixed oxides. This strategy provides a roadmap for the design of more efficient CaO-based sorbents using glassy stabilizers.

Effects of Redox Homeostasis and Mitochondrial Damage on Alzheimer's Disease.

Bioenergetic mitochondrial dysfunction is a common feature of several diseases, including Alzheimer's disease (AD), where redox imbalance also plays an important role in terms of disease development. AD is an age-related disease and begins many years before the appearance of neurodegenerative symptoms. Intracellular tau aggregation, extracellular ß-amyloid (Aß) deposition in the brain, and even the APOE4 genotype contribute to the process of AD by impairing redox homeostasis and mitochondrial dysfunction. This review summarizes the evidence for the redox imbalance and mitochondrial dysfunction in AD and demonstrates the current therapeutic strategies related to mitochondrial maintenance.

Associations amongst genes, molecules, cells, and organs in breast cancer metastasis.

This paper is a cross fertilization of ideas about the importance of molecular aspects of breast cancer metastasis by basic scientists, a pathologist, and clinical oncologists at the Henry Ford Health symposium. We address four major topics: (i) the complex roles of lymphatic endothelial cells and the molecules that stimulate them to enhance lymph node and systemic metastasis and influence the anti-tumor immunity that might inhibit metastasis; (ii) the interaction of molecules and cells when breast cancer spreads to bone, and how bone metastases may themselves spread to internal viscera; (iii) how molecular expression and morphologic subtypes of breast cancer assist clinicians in determining which patients to treat with more or less aggressive therapies; (iv) how the outcomes of patients with oligometastases in breast cancer are different from those with multiple metastases and how that could justify the aggressive treatment of these patients with the hope of cure.

Prussian blue analog with separated active sites to catalyze water driven enhanced catalytic treatments.

Chemodynamic therapy (CDT) uses the Fenton or Fenton-like reaction to yield toxic ‧OH following H2O2 → ‧OH for tumoral therapy. Unfortunately, H2O2 is often taken from the limited endogenous supply of H2O2 in cancer cells. A water oxidation CoFe Prussian blue (CFPB) nanoframes is presented to provide sustained, external energy-free self-supply of ‧OH from H2O to process CDT and/or photothermal therapy (PTT). Unexpectedly, the as-prepared CFPB nanocubes with no near-infrared (NIR) absorption is transformed into CFPB nanoframes with NIR absorption due to the increased Fe3+-N ≡ C-Fe2+ composition through the proposed proton-induced metal replacement reactions. Surprisingly, both the CFPB nanocubes and nanoframes provide for the self-supply of O2, H2O2, and ‧OH from H2O, with the nanoframe outperforming in the production of ‧OH. Simulation analysis indicates separated active sites in catalyzation of water oxidation, oxygen reduction, and Fenton-like reactions from CFPB. The liposome-covered CFPB nanoframes prepared for controllable water-driven CDT for male tumoral mice treatments.

The impact of secondhand smoke on the development of kidney stone disease is not inferior to that of smoking: a longitudinal cohort study.

BACKGROUND: Tobacco use and secondhand smoke (SHS) are risk factors of kidney stone disease (KSD). The hypothesis is that tobacco produces chemicals that increase oxidative stress and vasopressin, which leads to decreased urine output, and contributes to stone formation. The aim of this study was to examine the effects of smoking and SHS on the development of KSD. MATERIALS AND METHODS: We analyzed a total of 25,256 volunteers with no history of KSD participated in the Taiwan Biobank. The presence of underlying and follow-up KSD was surveyed by a self-administrated questionnaire. They were classified into three groups on the basis of smoking and SHS exposure, accessed with survey questionnaires; never-smokers with no SHS exposure, never-smokers with SHS exposure and ever-smokers groups. RESULTS: KSD was noted in 352 (2.0%), 50 (3.3%) and 240 (4.1%) subjects in the never-smokers with no SHS exposure, never-smokers with SHS exposure and ever-smokers groups, respectively, with a mean follow-up of 4 years. The odds ratio (OR) of KSD was higher in the never-smokers with SHS exposure (OR, 1.622; 95% confidence interval [95% CI], 1.225 to 2.255) and ever-smokers groups (OR, 1.282; 95% CI, 1.044 to 1.574) than in the never-smokers with no SHS exposure group after adjustment of confounders. In addition, never-smokers with SHS exposure had similar effects on the development of KSD than ever-smokers (OR, 1.223; 95% CI, 0.852 to 1.756). CONCLUSION: Our study suggests that both smoking and SHS are a risk factor for developing KSD and that the impact of SHS is not inferior to that of smoking. TRIAL REGISTRATION: The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-E(I)-20,210,058).

Cardiac myofibrillogenesis is spatiotemporally modulated by the molecular chaperone UNC45B.

Sarcomeres are fundamental to cardiac muscle contraction. Their impairment can elicit cardiomyopathies, leading causes of death worldwide. However, the molecular mechanism underlying sarcomere assembly remains obscure. We used human embryonic stem cell (hESC)-derived cardiomyocytes (CMs) to reveal stepwise spatiotemporal regulation of core cardiac myofibrillogenesis-associated proteins. We found that the molecular chaperone UNC45B is highly co-expressed with KINDLIN2 (KIND2), a marker of protocostameres, and later its distribution overlaps with that of muscle myosin MYH6. UNC45B-knockout CMs display essentially no contractility. Our phenotypic analyses further reveal that (1) binding of Z line anchor protein ACTN2 to protocostameres is perturbed because of impaired protocostamere formation, resulting in ACTN2 accumulation; (2) F-ACTIN polymerization is suppressed; and (3) MYH6 becomes degraded, so it cannot replace non-muscle myosin MYH10. Our mechanistic study demonstrates that UNC45B mediates protocostamere formation by regulating KIND2 expression. Thus, we show that UNC45B modulates cardiac myofibrillogenesis by interacting spatiotemporally with various proteins.

Deciphering the structural dynamics in molten salt-promoted MgO-based CO2 sorbents and their role in the CO2 uptake.

The development of effective CO2 sorbents is vital to achieving net-zero CO2 emission targets. MgO promoted with molten salts is an emerging class of CO2 sorbents. However, the structural features that govern their performance remain elusive. Using in situ time-resolved powder x-ray diffraction, we follow the structural dynamics of a model NaNO3-promoted, MgO-based CO2 sorbent. During the first few cycles of CO2 capture and release, the sorbent deactivates owing to an increase in the sizes of the MgO crystallites, reducing in turn the abundance of available nucleation points, i.e., MgO surface defects, for MgCO3 growth. After the third cycle, the sorbent shows a continuous reactivation, which is linked to the in situ formation of Na2Mg(CO3)2 crystallites that act effectively as seeds for MgCO3 nucleation and growth. Na2Mg(CO3)2 forms due to the partial decomposition of NaNO3 during regeneration at T ≥ 450°C followed by carbonation in CO2.

Osteoprogenitor-GMP crosstalk underpins solid tumor-induced systemic immunosuppression and persists after tumor removal.

Remote tumors disrupt the bone marrow (BM) ecosystem (BME), eliciting the overproduction of BM-derived immunosuppressive cells. However, the underlying mechanisms remain poorly understood. Herein, we characterized breast and lung cancer-induced BME shifts pre- and post-tumor removal. Remote tumors progressively lead to osteoprogenitor (OP) expansion, hematopoietic stem cell dislocation, and CD41- granulocyte-monocyte progenitor (GMP) aggregation. The tumor-entrained BME is characterized by co-localization between CD41- GMPs and OPs. OP ablation abolishes this effect and diminishes abnormal myeloid overproduction. Mechanistically, HTRA1 carried by tumor-derived small extracellular vesicles upregulates MMP-13 in OPs, which in turn induces the alterations in the hematopoietic program. Importantly, these effects persist post-surgery and continue to impair anti-tumor immunity. Conditional knockout or inhibition of MMP-13 accelerates immune reinstatement and restores the efficacies of immunotherapies. Therefore, tumor-induced systemic effects are initiated by OP-GMP crosstalk that outlasts tumor burden, and additional treatment is required to reverse these effects for optimal therapeutic efficacy.

Activation in the rate of oxygen release of Sr0.8Ca0.2FeO3-δ through removal of secondary surface species with thermal treatment in a CO2-free atmosphere.

We elucidate the underlying cause of a commonly observed increase in the rate of oxygen release of an oxygen carrier with redox cycling (here specifically for the perovskite Sr0.8Ca0.2FeO3-δ ) in chemical looping applications. This phenomenon is often referred to as activation. To this end we probe the evolution of the structure and surface elemental composition of the oxygen carrier with redox cycling by both textural and morphological characterization techniques (N2 physisorption, microscopy, X-ray powder diffraction and X-ray absorption spectroscopy). We observe no appreciable changes in the surface area, pore volume and morphology of the sample during the activation period. X-ray powder diffraction and X-ray absorption spectroscopy analysis (at the Fe and Sr K-edges) of the material before and after redox cycles do not show significant differences, implying that the bulk (average and local) structure of the perovskite is largely unaltered upon cycling. The analysis of the surface of the perovskite via X-ray photoelectron and in situ Raman spectroscopy indicates the presence of surface carbonate species in the as-synthesized sample (due to its exposure to air). Yet, such surface carbonates are absent in the activated material, pointing to the removal of carbonates during cycling (in a CO2-free atmosphere) as the underlying cause behind activation. Importantly, after activation and a re-exposure to CO2, surface carbonates re-form and yield a deactivation of the perovskite oxygen carrier, which is often overlooked when using such materials at relatively low temperature (≤500 °C) in chemical looping.

Nonalcoholic fatty liver disease (NAFLD) detection and deep learning in a Chinese community-based population.

OBJECTIVES: We aimed to develop and validate a deep learning system (DLS) by using an auxiliary section that extracts and outputs specific ultrasound diagnostic features to improve the explainable, clinical relevant utility of using DLS for detecting NAFLD. METHODS: In a community-based study of 4144 participants with abdominal ultrasound scan in Hangzhou, China, we sampled 928 (617 [66.5%] females, mean age: 56 years ± 13 [standard deviation]) participants (2 images per participant) to develop and validate DLS, a two-section neural network (2S-NNet). Radiologists' consensus diagnosis classified hepatic steatosis as none steatosis, mild, moderate, and severe. We also explored the NAFLD detection performance of six one-section neural network models and five fatty liver indices on our data set. We further evaluated the influence of participants' characteristics on the correctness of 2S-NNet by logistic regression. RESULTS: Area under the curve (AUROC) of 2S-NNet for hepatic steatosis was 0.90 for ≥ mild, 0.85 for ≥ moderate, and 0.93 for severe steatosis, and was 0.90 for NAFLD presence, 0.84 for moderate to severe NAFLD, and 0.93 for severe NAFLD. The AUROC of NAFLD severity was 0.88 for 2S-NNet, and 0.79-0.86 for one-section models. The AUROC of NAFLD presence was 0.90 for 2S-NNet, and 0.54-0.82 for fatty liver indices. Age, sex, body mass index, diabetes, fibrosis-4 index, android fat ratio, and skeletal muscle via dual-energy X-ray absorptiometry had no significant impact on the correctness of 2S-NNet (p > 0.05). CONCLUSIONS: By using two-section design, 2S-NNet had improved the performance for detecting NAFLD with more explainable, clinical relevant utility than using one-section design. KEY POINTS: • Based on the consensus review derived from radiologists, our DLS (2S-NNet) had an AUROC of 0.88 by using two-section design and yielded better performance for detecting NAFLD than using one-section design with more explainable, clinical relevant utility. • The 2S-NNet outperformed five fatty liver indices with the highest AUROCs (0.84-0.93 vs. 0.54-0.82) for different NAFLD severity screening, indicating screening utility of deep learning-based radiology may perform better than blood biomarker panels in epidemiology. • The correctness of 2S-NNet was not significantly influenced by individual's characteristics, including age, sex, body mass index, diabetes, fibrosis-4 index, android fat ratio, and skeletal muscle via dual-energy X-ray absorptiometry.

High Entropy Oxide (CrMnFeNiMg)3 O4 with Large Compositional Space Shows Long-Term Stability as Cathode in Lithium-Sulfur Batteries.

The repeated formation and irreversible diffusion of liquid-state lithium polysulfides (LiPSs) are the primary challenges in the development of high-energy-density lithium-sulfur battery (LSB). An effective strategy to alleviate the resulting polysulfide loss is critical for the stability of LSBs. In this regard, high entropy oxides (HEOs) appear as a promising additive for the adsorption and conversion of LiPSs owing to the diverse active sites, offering unparalleled synergistic effects. Herein, we have developed a (CrMnFeNiMg)3 O4 HEO as a functional polysulfide trapper in LSB cathode. The adsorption of LiPSs by the metal species (i. e., Cr, Mn, Fe, Ni, and Mg) in the HEO takes place through two different paths and leads to enhanced electrochemical stability. We demonstrate that the optimal sulfur cathode with the (CrMnFeNiMg)3 O4 HEO attains a high peak and reversible discharge capacities of 857 mAh g-1 and 552 mAh g-1 , respectively, at a cycling rate of C/10, a long cycle life of 300 cycles, and a high rate performance at the cycling rates from C/10 to C/2.

Robust PPG-Based Mental Workload Assessment System Using Wearable Devices.

Heart rate variability (HRV) has been used in assessing mental workload (MW) level. Compared with ECG, photoplethysmogram (PPG) provides convenient in assessing MW with wearable devices, which is more suitable for daily usage. However, PPG collected by smartwatches are prone to suffer from artifacts. Those signal corruptions cause invalid Inter-beat Intervals (IBI), making it challenging to evaluate the HRV feature. Hence, the PPG-based MW assessment system is difficult to obtain a sustainable and reliable assessment of MW. In this paper, we propose a pre- and post- processing technique, called outlier removal and uncertainty estimation, respectively, to reduce the negative influences of invalid IBIs. The proposed method helps to acquire accurate HRV features and evaluate the reliability of incoming IBIs, rejecting possibly misclassified data. We verified our approach in two open datasets, which are CLAS and MAUS. Experiment results show proposed method achieved higher accuracy (66.7% v.s. 74.2%) and lower variance (11.3% v.s. 10.8%) among users, which has comparable performance to an ECG-based MW system.