The prevalence, clinical reasoning and impact of non-standard anti-tuberculosis regimens at the initial prescription.

Regarding clinically-concerning non-standard initial anti-tuberculous (TB) regimens, few studies have examined their prevalence, risk factors and impacts. We recruited patients with drug susceptible TB and non-standard initial anti-TB regimens (NSTB group) and matched them with patients with standard initial regimens (STB group) in a 1:1 ratio. The risk factors and outcomes were analyzed. During the 11-year study period, we analyzed 50 (3.7%) patients with NSTB from a total set of 1337 patients with drug-susceptible TB. Pyrazinamide (60%) was the drug most commonly not prescribed in the NSTB group, followed by ethambutol (34%). Multivariable logistic regression identified independent risk factors as underlying eye disease (adjusted odds ratio [aOR]: 8.869; 95% CI 2.542-30.949; p = 0.001), gout/hyperuricemia (aOR: 4.012 [1.196-13.425]; p = 0.024), and liver disease (aOR: 12.790 [3.981-41.089]; p < 0.001). The NSTB group had longer treatment durations (281 ± 121 vs. 223 ± 63 days; p = 0.003) and more occurrences of treatment interruption (26% vs. 8%; p = 0.021) than the STB group. In conclusion, NSTB occurs in around 3.7% of patients and is associated with longer treatment and more treatment interruption. The risk factors might include underlying liver and eye diseases, and gout. Further studies to improve non-standard initial regimens and prevent negative outcomes are warranted.

Regulatory T cells in inflamed liver are dysfunctional in murine primary biliary cholangitis.

Primary biliary cholangitis (PBC) is a chronic autoimmune disease characterized by immune-mediated destruction of intrahepatic small bile ducts. CD8 T cells play a critical role in biliary destruction. However, regulatory T cells (Tregs) have also been identified in the portal tracts of PBC patients. This study tested the hypothesis that hepatic Tregs in PBC were dysfunctional in suppressing immune responses in disease by using our human PBC-like autoimmune cholangitis (AIC) mouse model induced by 2-octynoic acid-conjugated ovalbumin (2-OA-OVA). Our results showed that female and male mice immunized with 2-OA-OVA developed AIC; however, female AIC mice had more severe liver inflammation and fibrosis than male AIC mice. Levels of functional effector CD8 T cells and their chemoattractants, CXCL9 and CXCL10, in the liver were markedly elevated in female AIC mice than in male AIC mice. These results reinforce that CD8 T cells are the primary effector cells in PBC. The number of hepatic Tregs in AIC mice was also higher than in saline-treated mice, but there was no difference between male and female AIC mice. The suppressive function of AIC Tregs was evident despite a discrepancy in the changes in their co-inhibitory receptors and inhibitory cytokines. However, the expansion of hepatic Tregs by low-dose IL-2 treatment did not reduce immune responses to AIC, which may be due to the dysfunction of Tregs in inhibiting T cells. In conclusion, the function of Tregs in the inflamed liver of PBC was insufficient, and low-dose IL-2 treatment could not restore their function to suppress pathological immune responses. Transferring normal Tregs or directly targeting effector CD8 T cells may be beneficial for treating PBC.

Reconstructing missing time-varying land subsidence data using back propagation neural network with principal component analysis.

Land subsidence, a complex geophysical phenomenon, necessitates comprehensive time-varying data to understand regional subsidence patterns over time. This article focuses on the crucial task of reconstructing missing time-varying land subsidence data in the Choshui Delta, Taiwan. We propose a novel algorithm that leverages a multi-factorial perspective to accurately reconstruct the missing time-varying land subsidence data. By considering eight influential factors, our method seeks to capture the intricate interplay among these variables in the land subsidence process. Utilizing Principal Component Analysis (PCA), we ascertain the significance of these influencing factors and their principal components in relation to land subsidence. To reconstruct the absent time-dependent land subsidence data using PCA-derived principal components, we employ the backpropagation neural network. We illustrate the approach using data from three multi-layer compaction monitoring wells from 2008 to 2021 in a highly subsiding region within the study area. The proposed model is validated, and the resulting network is used to reconstruct the missing time-varying subsidence data. The accuracy of the reconstructed data is evaluated using metrics such as root mean square error and coefficient of determination. The results demonstrate the high accuracy of the proposed neural network model, which obviates the need for a sophisticated hydrogeological numerical model involving corresponding soil compaction parameters.

Modeling of land subsidence using GIS-based artificial neural network in Yunlin County, Taiwan.

In this study, the land subsidence in Yunlin County, Taiwan, was modeled using an artificial neural network (ANN). Maps of the fine-grained soil percentage, average maximum drainage path length, agricultural land use percentage, electricity consumption of wells, and accumulated land subsidence depth were produced through geographic information system spatial analysis for 5607 cells in the study area. An ANN model based on a backpropagation neural network was developed to predict the accumulated land subsidence depth. A comparison of the model predictions with ground-truth leveling survey data indicated that the developed model had high accuracy. Moreover, the developed model was used to investigate the relationship of electricity consumption reduction with reductions in the total area of land with severe subsidence (> 4 cm per year); the relationship was approximately linear. In particular, the optimal results were obtained when decreasing the electricity consumption from 80 to 70% of the current value, with the area of severe land subsidence decreasing by 13.66%.

A comprehensive series of Irx cluster mutants reveals diverse roles in facial cartilage development.

Proper function of the vertebrate skeleton requires the development of distinct articulating embryonic cartilages. Irx transcription factors are arranged in co-regulated clusters that are expressed in the developing skeletons of the face and appendages. IrxB cluster genes are required for the separation of toes in mice and formation of the hyoid joint in zebrafish, yet whether Irx genes have broader roles in skeletal development remains unclear. Here, we perform a comprehensive loss-of-function analysis of all 11 Irx genes in zebrafish. We uncover conserved requirements for IrxB genes in formation of the fish and mouse scapula. In the face, we find a requirement for IrxAb genes and irx7 in formation of anterior neural crest precursors of the jaw, and for IrxBa genes in formation of endodermal pouches and gill cartilages. We also observe extensive joint loss and cartilage fusions in animals with combinatorial losses of Irx clusters, with in vivo imaging revealing that at least some of these fusions arise through inappropriate chondrogenesis. Our analysis reveals diverse roles for Irx genes in the formation and later segmentation of the facial skeleton.

A GIS-Based Artificial Neural Network Model for Flood Susceptibility Assessment.

This article presents a geographic information system (GIS)-based artificial neural network (GANN) model for flood susceptibility assessment of Keelung City, Taiwan. Various factors, including elevation, slope angle, slope aspect, flow accumulation, flow direction, topographic wetness index (TWI), drainage density, rainfall, and normalized difference vegetation index, were generated using a digital elevation model and LANDSAT 8 imagery. Historical flood data from 2015 to 2019, including 307 flood events, were adopted for a comparison of flood susceptibility. Using these factors, the GANN model, based on the back-propagation neural network (BPNN), was employed to provide flood susceptibility. The validation results indicate that a satisfactory result, with a correlation coefficient of 0.814, was obtained. A comparison of the GANN model with those from the SOBEK model was conducted. The comparative results demonstrated that the proposed method can provide good accuracy in predicting flood susceptibility. The results of flood susceptibility are categorized into five classes: Very low, low, moderate, high, and very high, with coverage areas of 60.5%, 27.4%, 8.6%, 2.5%, and 1%, respectively. The results demonstrate that nearly 3.5% of the study area, including the core district of the city and an exceedingly populated area including the financial center of the city, can be categorized as high to very high flood susceptibility zones.

Video-based gait analysis for functional evaluation of healing achilles tendon in rats.

Video-based walking track systems have been developed for gait analysis in rat models. However, there is no previous study using video-based tracking systems to address the gait parameters to evaluate the recovery of Achilles tendon rupture models. This study conducted a comprehensive gait analysis using a video-based image processing system. Eighteen Sprague-Dawley rats were randomly assigned to one of three interventional conditions: sham surgery, Achilles tendon repair, and Achilles tendon defect. After surgery, all animals were evaluated using a video-based walking track system. The gait parameters and the Achilles functional index (AFI) were further analyzed. The ankle joint angles of the injury side at mid-stance and pre-swing were highly correlated with the AFI. However, lack of sensitivity was found for the AFI. Increased measurement sensitivity of the Achilles tendon healing condition was found in the ankle joint angle of the involved side at the pre-swing and the level of asymmetry of the hindlimb joint position and stance/swing time. The overall sensitivity of the ankle motion analysis was significantly higher than that of AFI. We conclude that the ankle motion analysis is a reliable, reproducible, and sensitive tool for Achilles tendon analysis in rats.

Factors affecting caregivers' perceptions of residents' oral health in long-term care facilities in Taiwan.

The purpose of this study was to investigate the differences between resident oral care policies provided by 2 types of long-term care (LTC) institutions. The study also investigated factors affecting LTC institutional caregivers' perceptions of the residents' oral health. Overall, 103 completed questionnaires were returned. Of these, 44 were from senior citizen welfare institutions, and 59 were from nursing homes. The variables affecting these perceptions included institution type and whether the residents attended hospital dental clinics or consulted a hospital doctor regarding oral health problems. The research results showed that institution type and whether an oral care-related professional was available in an institution were correlated with an increase in institutional caregivers' perceptions of oral care.