Si-Meng Chang

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This study applies LoRA — a technique originally developed to efficiently fine-tune large language models — to the problem of detecting structural damage in buildings using vibration measurements and finite element models. Because damage is typically localized, the change in a structure's stiffness matrix is inherently low-rank, and exploiting this reduces the number of unknowns and provides built-in noise resistance. In tests on beam and plate structures, the method localized damage correctly in 100% of cases even at moderate noise levels where standard approaches failed.

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Three patients developed persistent skin rashes near their orthopedic fracture repair hardware made from titanium alloy, with no signs of infection and confirmed bone healing. Two patients had positive patch tests or biopsy findings consistent with hypersensitivity, and all three improved significantly after the hardware was surgically removed. The cases highlight that titanium allergy, while uncommon, is real and should be considered when patients have unexplained persistent dermatitis after orthopedic surgery.

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Four large language models were tested on 1,715 questions from Taiwan's neurology board exams spanning 2018-2024. GPT-o1 performed best at 83.86% accuracy overall and handled image-based questions well, while DeepSeek-V3 scored lowest at 65.62% with high variability. All models performed worse on 2024 questions as exam design shifted, and DeepSeek-R1 lost points due to refusing to answer certain questions.

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Nine children with high-risk neuroblastoma in Hong Kong were treated with a modified chemotherapy regimen combined with dinutuximab beta, an antibody targeting a cancer surface molecule, given during the induction phase. At the end of induction, 78% showed a response at the primary tumor site and 100% responded at metastatic sites. While 8 of 9 patients experienced serious side effects, all were manageable, supporting the feasibility of this combined approach.

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Ten ICU patients with myositis-associated interstitial lung disease meeting the new global ARDS definition were studied retrospectively. All had myositis-specific antibodies, with anti-MDA-5 being most common. Despite aggressive treatment with high-dose steroids and immunosuppression, six patients died during hospitalization — underscoring the severity of this presentation and the need for early recognition of myositis in unexplained ARDS.

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A case-control study at a Shanghai hospital found that patients taking GLP-1 receptor agonists — drugs used for diabetes and obesity — had 13-fold higher odds of having excess stomach contents at the time of upper endoscopy, even when they had completed standard bowel preparation for concurrent colonoscopy. Among GLP-1 RA users undergoing combined procedures, 86% had increased residual gastric content. The findings support enhanced pre-procedure assessment and individualized fasting protocols for patients on these drugs.

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A case-control study of 375 bladder cancer patients and 375 controls in Taiwan found that a specific genetic variant in the MMP-2 gene (rs2285053) was significantly associated with bladder cancer risk. Among smokers and younger patients, certain variant combinations carried substantially higher risk and were also linked to more aggressive, muscle-invasive disease. These MMP-2 variants may serve as genetic risk markers for bladder cancer screening.

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A two-stage AI system — combining YOLOv9 for detecting wound locations and DenseNet161 for classifying injury severity — was trained and tested on 1,807 pressure injury images. On the independent test set, it achieved 77.5% overall accuracy and 95.5% specificity, with performance comparable to or better than prior reported approaches. The system reduces subjectivity in wound staging and could be integrated into nursing workflows to standardize clinical documentation.

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Researchers developed a novel method to decellularize rat salivary glands through the duct and blood vessel systems, preserving the three-dimensional scaffold structure while removing all cells. They then repopulated the scaffolds with different cell sources, including fat-derived stem cells that were pre-converted toward a salivary gland identity, and showed that all cell types formed gland-like structures in lab culture and retained partial function for up to 5 days after transplantation. Insufficient blood vessel growth limited longer-term survival, but the work establishes a promising foundation for engineering replacement salivary glands.

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Enzymatic digests of a marine species' meat were tested in UV-irradiated nude mice as a treatment for sun-damaged skin. The treatment reduced thickening of the outer skin layer, restored collagen levels, suppressed enzymes that break down collagen, and shifted gut bacteria and blood metabolites toward a healthier profile. The results support the meat hydrolysates as a candidate functional food ingredient for reducing skin photoaging.

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Men with Klinefelter syndrome — a chromosomal condition associated with low testosterone — showed higher levels of proteins in the contact activation system, a clotting and inflammation pathway, compared to healthy controls. Testosterone replacement therapy reduced levels of key contact activation proteins, while body fat levels correlated with other markers in the pathway. The findings suggest this inflammation-coagulation system is dysregulated in Klinefelter syndrome and contributes to the elevated blood clot risk seen in these patients.

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A self-supervised deep learning framework was developed to enhance the resolution of expansion microscopy images — a technique that physically inflates tissue for nanoscale imaging — without requiring ground-truth high-resolution training data. The system compresses image data by up to 128-fold while enabling up to 8-fold improvement in axial resolution, yielding roughly 1000-fold storage savings compared to storing full-resolution volumes. This makes large-scale, whole-organ nanoscale imaging practically feasible for the first time.

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A Phase 2 trial of once-weekly oral islatravir plus lenacapavir in 52 virologically suppressed HIV-positive adults maintained 94.2% viral suppression at 48 weeks. Resistance analysis found no patients developed drug resistance, even those with pre-existing mutations that could have compromised treatment. The results support continued evaluation of this convenient weekly oral regimen as a long-term HIV treatment option.

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A scoping review of 24 machine learning studies predicting drug-induced acute kidney injury found all achieved good discrimination (AUROC above 0.75), with neural networks showing the highest median performance. However, two-thirds of studies had high risk of bias due to small sample sizes, inadequate performance evaluation, and lack of external validation. Standardizing methods and ensuring external validation are needed before these models can be trusted in clinical practice.

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A deep learning framework called TANZANITE was developed to harmonize CT scan images acquired at different x-ray voltages by translating between virtual monoenergetic image energy levels. Applied to patient CT data, it reduced measurement differences across acquisition settings and improved radiomic feature reproducibility from an average correlation of 0.30-0.63 to above 0.97 across all tested tissues. The method works without raw projection data or scanner-specific retraining, making it broadly deployable for multi-site studies.

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Men with Klinefelter syndrome showed significantly higher activity of the lectin complement pathway — an immune activation route — compared to age-matched controls, along with elevated levels of the lectin pathway regulator MAP-1. Increased expression of the gene encoding MAP-1 was found in skeletal muscle tissue from Klinefelter patients. These findings suggest that immune dysregulation through the lectin complement pathway is a biological feature of Klinefelter syndrome that may contribute to its associated health complications.

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This trial-in-progress paper describes an ongoing phase I dose de-escalation study testing a combination of aerosolized chemotherapy delivered directly into the abdomen (PIPAC) with systemic chemotherapy in recurrent ovarian cancer patients with abdominal spread. The study evaluates safety of combining PIPAC nab-paclitaxel and cisplatin with intravenous nab-paclitaxel across three cycles. Primary endpoints are dose-limiting toxicities and adverse events, with response and survival as secondary endpoints.

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A multi-decadal analysis of U.S. wildfire activity found that climate-driven wildfires have increased substantially in the western U.S., particularly in the northwest, driven by warming temperatures and drier conditions. These fires are contributing an increasing share of reactive nitrogen emissions and deposition — up to 20-40% more in the western U.S. — which can damage ecosystems by exceeding their capacity to absorb nitrogen. Smaller increases in nitrogen deposition were also found in the eastern U.S. from prescribed burns.

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Researchers generated single-nucleus genomic data from over 3.3 million brain cells across five regions in 80 Parkinson's disease patients and 21 healthy controls, paired with whole-genome sequencing. Using this data, they trained machine learning models to predict how rare genetic variants affect gene regulation and identified specific rare noncoding variants statistically associated with sporadic Parkinson's disease. The work provides a roadmap for uncovering the genetic underpinnings of complex diseases beyond what standard genetic studies can find.

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A model-based meta-analysis of quality-of-life data from 27 immune checkpoint inhibitor trials found that while raw quality-of-life scores often showed no difference between treatment and control groups, the modeling approach revealed that checkpoint inhibitors actually improved quality of life faster than controls — they just had similar short-term toxicity. Baseline quality of life, early toxicity, and the rate of improvement were all independently linked to overall survival. The analysis shows that standard single-timepoint quality-of-life comparisons can miss meaningful patient benefits.

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Transfer factors — immune signaling proteins extracted from spleens of immunized animals — were tested in chickens for their ability to fight reticuloendotheliosis virus. Transfer factors from virus-infected spleens were most effective, activating specific cellular immune pathways and significantly reducing viral replication, while those from vaccinated or uninfected spleens had little effect. The findings reveal the molecular mechanisms behind transfer factor specificity and support their development as targeted antiviral agents.

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This American College of Radiology guideline provides evidence-based imaging recommendations for staging and monitoring adrenal cancer, including adrenocortical carcinoma and pheochromocytoma. For adrenocortical carcinoma, MRI or CT of the abdomen and pelvis plus chest CT and FDG-PET/CT are recommended. For pheochromocytoma, DOTATATE PET/CT is preferred, with MIBG scanning as an acceptable alternative particularly when radioiodine therapy eligibility is being assessed.

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A prospective study of 128 patients with white matter lesions of presumed vascular origin used advanced MRI blood flow imaging to find that more severe white matter damage was associated with higher — not lower — blood flow in certain brain regions, suggesting compensatory blood flow through alternative pathways. This elevated blood flow in areas like the lenticular nucleus and thalamus correlated negatively with cognitive test scores. The findings suggest that collateral circulation in more advanced white matter disease may paradoxically increase perfusion in some areas while still contributing to cognitive decline.

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A global analysis using 7,562 field measurements and machine learning estimated total terrestrial carbon release at 96.52 billion tons of carbon per year, incorporating previously omitted sources including carbon released from dissolving soil minerals and agricultural lime application. These overlooked sources added a small but real amount to total carbon efflux estimates, and structural equation modeling identified the main drivers of variation. The study highlights soil acidification as a dual problem affecting both crop production and greenhouse gas budgets.

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A novel synbiotic combining five human milk oligosaccharides, a probiotic strain, whey protein hydrolysate, and tryptophan was tested in a mouse model of food allergy and significantly reduced allergic symptoms, lowered allergy-associated antibody levels, and restored immune balance. The synbiotic enriched beneficial gut bacteria and elevated intestinal levels of indole-3-lactic acid, a metabolite known to regulate immune tolerance. The findings support targeted design of synbiotics to produce specific immune-modulating compounds.

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A proteomics and metabolomics study of 25 lupus patients treated with telitacicept — a drug targeting B cell survival factors — identified protein and metabolite signatures that distinguished responders from non-responders. Key biomarkers included six proteins related to RNA processing and metabolism, with pyruvate as a metabolic marker for responders and GABA for non-responders. Both pyruvate and one of the protein biomarkers converge on the citric acid cycle, suggesting metabolic reprogramming may determine treatment response.

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A randomized controlled trial in Australia is testing whether modifying invitation materials sent to people who have ignored at least three national bowel cancer screening kits can increase screening participation. Two intervention arms — one with a modified pre-invitation letter highlighting missed screening and one with a kit packaged with revised materials emphasizing personal risk — will be compared to the standard kit. The trial will enroll participants over 5 weeks and track kit return rates over 6 months.

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Taiwan's national Hospital-at-Home program, which provides acute hospital-level care in patients' homes, enrolled 2,160 patients over 9 months at 184 institutions. The average care duration was 6.7 days versus about 12 days for conventional hospitalization, at roughly half the cost, with a 90% treatment completion rate and in-home mortality of only 2%. The program demonstrates that hospital-at-home care is safe, effective, and cost-efficient at national scale for an aging population.

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A deep learning model called DIAMOND was trained to convert standard CT scan images into virtual high-energy monoenergetic images, which reduce blooming artifacts from calcified plaques in coronary arteries. In 23 patients, DIAMOND reduced estimated coronary artery stenosis from 35.7% to 25.2%, closely matching results from more expensive photon-counting CT scanners, and reclassified lesion severity in 42% of plaques. The model runs in about 0.21 seconds per image slice, making it practical for routine clinical use without hardware upgrades.

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A multicenter study of 280 patients with spinal hemangioblastomas compared laminectomy — removing the full back of a vertebra — with hemilaminectomy — removing only half — and found comparable complete resection rates (86% vs. 90%) and similar functional outcomes at 12 months. Postoperative bleeding risk was higher with tumors spanning multiple spinal segments but did not differ by surgical approach. Surgeons can choose the approach based on patient anatomy and their own experience without sacrificing outcomes.

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A Malaysian case report describes a man who presented with painless upper eyelid swelling that was initially thought to be a blood clot after trauma but was found after surgery to be a lobulated mass. Pathology identified it as chronic lymphocytic leukemia/small lymphocytic lymphoma — a rare form of eye-region lymphoma. The case illustrates the importance of multidisciplinary management and pathological analysis for unusual orbital swellings.

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This review summarizes how transition-metal hydride catalysis can be combined with nitrogen-transfer chemistry to form carbon-nitrogen bonds in organic synthesis. The key insight is that the order in which steps occur — whether the metal binds the alkene first or activates the nitrogen source first — determines which position on the molecule gets the nitrogen group. By deliberately choosing the step order, chemists can achieve selectivity patterns that would otherwise be inaccessible.

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An automated system using a local large language model analyzed nearly 64,000 pathology and imaging reports for 3,053 colorectal cancer patients to identify cancer recurrences without exposing data to external servers. After applying clinical validation rules, the system achieved 90.7% accuracy — on par with the standard cancer registry process — while substantially reducing manual labor. The tool offers a privacy-preserving, explainable alternative to traditional cancer registry data entry.

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Penicillide, a fungal-derived compound, killed six types of human cancer cells by triggering pyroptosis — an inflammatory form of cell death — rather than ordinary apoptosis. It does so by generating reactive oxygen species that activate the NLRP3 inflammasome and cause gasdermin D to punch holes in the cell membrane. Mice vaccinated with penicillide-treated cancer cells developed immune responses that delayed tumor growth, positioning penicillide as a potential immunogenic cell death inducer for cancer therapy.

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Researchers identified two new bacterial enzymes capable of synthesizing beta-(1,3;1,4)-mixed linkage glucan polymers — carbohydrates with potential prebiotic and industrial uses — and showed that a specific structural domain (the PilZ domain) regulates how much polymer the enzyme produces. Mutations in this domain altered production levels, revealing a molecular control point. The findings expand the known diversity of these glucan-making enzymes and provide insights for optimizing microbial production.

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Butterfly pea anthocyanins — a natural plant pigment used in food — were covalently attached to silk fabric using a laccase enzyme, creating a wearable sensor that changes color across a wide pH range (2-12). The sensor reliably distinguished the pH of simulated sweat, urine, and vaginal secretions by color, maintained performance through 10 wash cycles, and resisted degradation. Computational modeling explained why the color changes are stable, providing a validated design for health-monitoring smart textiles.

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This review covers how plants detect airborne chemical signals from other plants and the environment, including what receptor proteins are involved. A small number of distinct receptor families handles a wide diversity of volatile compounds, and the KAI2 receptor pathway has recently emerged as a possible sensor for volatile molecules beyond its known role in smoke detection. The review synthesizes current knowledge and identifies major open questions in plant volatile perception.

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A retrospective study of 24 patients with refractory Takayasu arteritis — a chronic inflammatory disease of large blood vessels — treated with tofacitinib plus leflunomide found 87.5% remission at 6 months and 79.2% at 12 months. Steroid doses were successfully reduced, inflammatory markers declined significantly, and imaging showed stability or improvement in most patients with vascular imaging follow-up. The combination was well-tolerated and is proposed as a new therapeutic option for this difficult-to-treat condition.

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A peptide derived from the C-terminal end of occludin — a protein that forms the tight junctions sealing airway cells together — was tested in cell culture and a mouse model of lung inflammation induced by bacterial toxin. The peptide reduced inflammatory signaling, preserved the airway barrier, protected mitochondria from oxidative damage, and improved survival in mice while lowering levels of multiple inflammatory proteins. The occludin-derived peptide is presented as a candidate treatment for inflammatory lung diseases.

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A large population study using Taiwan Biobank data found that regular tea consumption was associated with a 26% lower prevalence of self-reported lifetime history of depression, but only for semi-fermented and non-fermented teas — not fully fermented tea. The benefit was strongest for people drinking one to two cups daily every day, and was not observed in older adults, smokers, people with diabetes, or alcohol drinkers. While intriguing, the authors note these are observational findings that require confirmation.