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BackgroundThe use of prostate-specific antigen (PSA) for early detection of prostate cancer (PCa) is common but controversial. In rural areas, PSA is widely used for screening because it is convenient and early-stage PCa often shows no symptoms. Studies suggest that PSA levels are linked to factors like unhealthy lifestyles, obesity, lack of exercise, inflammation, and aging. Proper use and interpretation of PSA are crucial for healthcare providers, especially in primary care settings. This study aims to explore the prevalence and factors linked to higher PSA levels in rural men.MethodsWe conducted a community-based cross-sectional study from March to December 2023 in the western coastal region of Taiwan. Men aged 40-75 years participated, completing a lifestyle questionnaire and providing blood samples for cardiometabolic biomarkers and PSA levels. PSA levels of ≥ 4.0 ng/mL were considered elevated. We used propensity score matching (PSM) and genetic matching (GM) for analysis, followed by regression analysis.ResultsIn total, 3347 male adults with a mean age of 56.3 years (SD=11.8, range 40-75), and without cancer-related diseases, were enrolled. Findings indicated that 3.9% (n=130) of men aged 40-75 years had a PSA ≥ 4 ng/mL. and many of them did not adopt health-related behaviors, including inadequate servings of vegetables, water intake, and engaging in regular exercise. Furthermore, more than half of the participants had high blood pressure, and over one-quarter exhibited a higher waist-hip ratio and cardiometabolic diseases. After employing propensity score matching (PSM) and genetic matching (GM) with respect to age and education, the multivariate logistic regression model indicated that less water intake (p 0.95) (p

Abstract Breast cancer (BC) is the most common cancer and the leading cause of cancer-related deaths in women worldwide. The 5-year survival rate is over 90% in BC patients, but once BC cells metastasis into distal organs, it is dramatically decreasing to less than 30%. Especially, triple-negative breast cancer (TNBC) patients usually lead to poor prognosis and survival because of metastasis. Understanding the underline mechanisms of TNBC metastasis is a critical issue. Non-coding RNAs, including of lncRNAs and microRNAs, are non-protein-coding transcripts and have been reported as important regulators in TNBC metastasis. However, the underline mechanisms for non-coding RNAs regulating TNBC metastasis remain largely unclear. Here, we found that lncRNA MIR4500HG003 was highly expressed in highly metastatic MDA-MB-231 TNBC cells and overexpression of MIR4500HG003 enhanced metastasis ability in vitro and in vivo and promoted MMP9 expression. Furthermore, we found MIR4500HG003 physically interacted with miR-483-3p and reporter assay showed miR-483-3p attenuated MMP9 expression. Importantly, endogenous high expressions of MIR4500HG003 were correlated with tumor recurrence in TNBC patients with tumor metastasis. Taken together, our findings suggested that MIR4500HG003 promotes metastasis of TNBC through miR-483-3p-MMP9 signaling axis and may be used as potential prognostic marker for TNBC patients.

Abstract This study focuses on the issue of lots resubmission in inspection processes, which often arises when the initial inspection of a lot is suspected, marked as held, or not accepted. To address this problem, a novel variables sampling plan based on the coefficient of variation is proposed. The objective is to determine the sampling plan parameters that minimize the average sample number while satisfying the two-points of operating characteristic curve. Practical considerations are taken into account by providing tabulated values for the inspection sample size and acceptance criteria of the proposed plan. These tables incorporate various combinations of quality levels, considering commonly used producer's risk and consumer's risk. Furthermore, a comparative analysis between the proposed plan and a single sampling plan is conducted to highlight the advantages of the new approach. To illustrate the practical implementation of the proposed plan, an example is presented.

Abstract Background Endophytic fungi have proven to be a rich source of novel natural products with a wide-array of biological activities and higher levels of structural diversity. Results Chemical investigation on the liquid- and solid-state fermented products of Chaetomium globosum Km1226 isolated from the littoral medicinal herb Atriplex maximowicziana Makino resulted in the isolation of compounds 1–14. Their structures were determined by spectroscopic analysis as three previously undescribed C13-polyketides, namely aureonitol C (1), mollipilins G (2), and H (3), along with eleven known compounds 4–14. Among these, mollipilin A (5) exhibited significant nitric oxide production inhibitory activity in LPS-induced BV-2 microglial cells with an IC50 value of 0.7 ± 0.1 µM, and chaetoglobosin D (10) displayed potent anti-angiogenesis property in human endothelial progenitor cells (EPCs) with an IC50 value of 0.8 ± 0.3 µM. Conclusions Three previously unreported compounds 1–3 were isolated and identified. Mollipilin A (5) and chaetoglobosin D (10) could possibly be developed as anti-inflammatory and anti-angiogenic lead drugs, respectively.

Abstract Aim Diversified students in higher education and the complexity and difficulty of the evidence‐based nursing course perceived by students challenge nursing educators. Differentiated instruction can provide students with various opportunities to learn and meet the learning needs of students with different academic abilities and strengths, which may be a solution. This study aimed to apply differentiated instruction to design the undergraduate evidence‐based nursing course and evaluate the effects of differentiated instruction on students' learning outcomes and learning satisfaction. Design One‐group pretest–posttest pre‐experimental design was applied. Methods Ninety‐eight undergraduate nursing students enrolled in the evidence‐based nursing course 2020 participated in this study. Students' learning outcomes including preferred learning styles, classroom engagement, collaborative learning, attitudes towards evidence‐based nursing, learning satisfaction and evidence‐based nursing knowledge were measured using validated questionnaires. Results The differentiated instruction increased students' learning interests, promoted focused and independent thinking, and enhanced academic achievement. Students' classroom engagement, attitudes towards evidence‐based nursing, evidence‐based nursing knowledge and learning satisfaction were improved after the course. The course designed with differentiated instruction provided a supportive learning environment and furnished a vivid pedagogical way for the unique nursing profession. Patient or Public Contribution Positive results of the study support the application of differentiated instruction in the evidence‐based nursing course. The study indicates that the application of differentiated instruction in mixed‐ability classrooms in the evidence‐based nursing course improved students' learning outcomes, attitudes towards evidence‐based nursing, evidence‐based nursing knowledge and learning satisfaction. In clinical settings where nurses are even more diverse in academic education, clinical experiences and learning preferences, differentiated instruction can be a suitable application for in‐service training and education to promote nurses' enthusiasm for professional learning.

Background Domestic cats are important companion animals in modern society that live closely with their owners. Mislabeling of pet food can not only harm pets but also cause issues in areas such as religious beliefs and natural resource management. Currently, the cat food market is booming. However, despite the risk that mislabeling poses to cats and humans, few studies have focused on species misrepresentation in cat food products. Methods To address this issue, we used DNA barcoding, a highly effective identification methodology that can be applied to even highly processed products. We targeted a short segment (~85 basepairs) of the mitochondrial 16S rRNA (16S) gene as a barcode and employed Sanger or next generation sequencing (NGS) to inspect 138 canned cat food products in the Taiwanese market. Results We discovered that the majority of mislabeling incidents were related to replacement of tuna with other species. Moreover, our metabarcoding revealed that numerous undeclared ingredients were present in all examined canned products. One product contained CITES Appendix II-listed shortfin mako shark (Isurus oxyrinchus). Overall, we uncovered a mislabeling rate of at least 28.99%. To verify cases of mislabeling, an official standardized list of vernacular names, along with the corresponding scientific species names, as well as a dependable barcoding reference sequence database are necessary.

BackgroundMiddle-aged adults often overlook critical modifiable risk factors that contribute to the emergence of cardiometabolic diseases (CMDs), including hypertension and diabetes. Many CMDs can be alleviated by addressing these modifiable risks. However, there has been insufficient research focused on rural adults with lower levels of health literacy in this regard. The aim of this study was to explore and develop an intuitive assessment tool for predicting cardiometabolic diseases (CMDs), which can be used for health education with adults of low health literacy.MethodsThis was a community-based, cross-sectional study. A structured questionnaire on health-promoting habits, smoking, sleep, and physiological biomarkers was obtained via community health screening in the coastal region of Yunlin County, Taiwan. Multivariate logistic regression was used to screen for significant variables in the nomogram construction. Analysis with nonlinear restricted cubic spline was performed.ResultsA total of 712 participants (60.9% females) aged 40–64 years, with middle school level or lower education, were included. The average age was 55.6 years (SD=7.3), and 220 individuals (31%) had CMDs. Multivariate logistic regression analysis revealed that age, lower scores of vegetables, fruit, water, and exercise (VFWE), smoking history, sleep deprivation, and being overweight were significantly associated with CMDs. The model incorporating these modifiable risk factors demonstrated good discriminatory ability, as indicated by an area under the receiver operating characteristic curve of 0.75 (0.73–0.76). A predictive nomogram was developed that presented modifiable risk factors in a simple graphical format to facilitate the prediction of CMDs.ConclusionsThis study highlights a high prevalence of CMDs among middle-aged adults, along with the disregard for important risk factors that could be modified. The developed nomogram could be a practical and effective tool for community health education to enhance health literacy and prevent the progression of CMDs.

Background From passive acoustic monitoring (PAM) recordings, the vocal activity rate (VAR), vocalizations per unit of time, can be calculated and is essential for assessing bird population abundance. However, VAR is subject to influences from a range of factors, including species and environmental conditions. Identifying the optimal sampling design to obtain representative acoustic data for VAR estimation is crucial for research objectives. PAM commonly uses temporal sampling strategies to decrease the volume of recordings and the resources needed for audio data management. Yet, the comprehensive impact of this sampling approach on VAR estimation remains insufficiently explored. Methods In this study, we used vocalizations extracted from recordings of 12 bird species, taken at 14 PAM stations situated in subtropical montane forests over a four-month period, to assess the impact of temporal sampling on VAR across three distinct scales: short-term periodic, diel, and hourly. For short-term periodic sampling analysis, we employed hierarchical clustering analysis (HCA) and the coefficient of variation (CV). Generalized additive models (GAMs) were utilized for diel sampling analysis, and we determined the average difference in VAR values per minute for the hourly sampling analysis. Results We identified significant day and species-specific VAR fluctuations. The survey season was divided into five segments; the earliest two showed high variability and are best avoided for surveys. Data from days with heavy rain and strong winds showed reduced VAR values and should be excluded from analysis. Continuous recordings spanning at least seven days, extending to 14 days is optimal for minimizing sampling variance. Morning chorus recordings effectively capture the majority of bird vocalizations, and hourly sampling with frequent, shorter intervals aligns closely with continuous recording outcomes. Conclusions While our findings are context-specific, they highlight the significance of strategic sampling in avian monitoring, optimizing resource utilization and enhancing the breadth of monitoring efforts.

Abstract Introduction Acute kidney injury (AKI) is occasionally detected in patients receiving anti-tuberculosis (TB) treatment. This prospective cohort study is the first to investigate the incidence, risk factors, and renal outcomes of AKI during anti-TB treatment. Methods This study was conducted from January 1, 2016, to May 31, 2018. Patients with a new diagnosis of TB and on standard anti-TB treatment were enrolled, and the patients received regular laboratory monitoring. AKI was defined according to the Kidney Disease: Improving Global Outcome (KDIGO) criteria. Urinalysis, renal ultrasonography, blood erythrocyte morphology, and fractional excretion of sodium were performed at AKI onset. The TB treatment regimen was adjusted by the primary physician if necessary. Risk factors for AKI were identified through Cox regression. Results In total, 106 patients were recruited (mean age 52.6 years, 71.7% men). Eleven (10.3%) patients experienced AKI. Increased serum uric acid and hemoglobin levels were noted at AKI onset. All patients with AKI achieved renal recovery and completed anti-TB treatment containing rifampin. Age [hazard ratio (HR) 1.06 (1.02–1.11)], a higher baseline estimated glomerular filtration rate [eGFR; HR 1.04 (1.02–1.06)], and a blood eosinophil count > 350 (109/L) [HR 10.99 (2.28–53.02)] were associated with a higher risk of AKI during TB treatment. Conclusion Regular pharmacovigilant monitoring revealed an incidence of renal impairment during anti-TB treatment that was higher than expected. AKI was more common in older patients with a higher eGFR and blood eosinophil count. However, the complications had no influence on TB treatment completion, and no permanent renal impairment occurred.

Abstract Background The study aims to clarify the association of sarcopenia with perioperative and postoperative complications in oral cavity squamous cell carcinoma (OCSCC) patients undergoing curative surgery and to understand the reasons causing the poor oncologic outcomes for OCSCC. Methods We conducted a propensity score matching study to investigate the association of perioperative and postoperative outcomes in OCSCC patients with sarcopenia and without sarcopenia. A retrospective analysis of a large national data set from the Taiwan Cancer Registry Database was conducted. At least two claims for patients with a principal diagnosis of sarcopenia within the 12‐month preoperative period were defined as the criteria for sarcopenia diagnosis (ICD‐10‐CM code M62.84). Sarcopenia was diagnosed through the measurement of low muscle strength and low muscle mass by any one of the patient's attending orthopaedic physician, rehabilitation physician, family medicine specialist or geriatrician. A multivariate logistic regression model was used to calculate the perioperative, and postoperative major complications. Results Our final cohort included 16 293 patients with OCSCC (10 862 and 5 431 in the sarcopenia and nonsarcopenia groups, respectively) who were eligible for further analysis. The sarcopenia group was 10.40% female and 89.60% male, and the nonsarcopenia group was 9.74% female and 90.26% male. The mean age ± standard deviation (SD) were 56.44 ± 11.14 and 56.22 ± 11.29 for sarcopenia and nonsarcopenia groups. OCSCC patients with sarcopenia undergoing curative surgery had a significantly higher blood transfusion rate and volume; longer intensive care unit (ICU) stay, and hospital stay; higher postoperative 30‐day mortality (adjusted odds ratio [aOR]: 1.12, 95% confidence interval [CI] [1.07, 1.56]) and rates of pneumonia (aOR: 1.34, 95% CI [1.20, 1.50]), acute renal failure (aOR: 1.45, 95% CI [1.12, 1.87]) and septicaemia (aOR: 1.29, 95% CI [1.15, 1.45]); higher postoperative first‐year mortality (aOR: 1.18, 95% CI [1.13, 1.51]) and rates of pneumonia (aOR: 1.43, 95% CI [1.30, 1.56]), acute myocardial infarction (aOR: 1.52, 95% CI [1.06, 2.18]) and septicaemia (aOR: 1.29, 95% CI [1.15, 1.45]). Conclusions OCSCC patients with sarcopenia might exhibit more perioperative and surgical complications than those without sarcopenia.

The motivation behind this study is to explore whether high oil prices, interest rate hikes, an inverted yield curve, and reduced semiconductor capital expenditures affect the PHLX Semiconductor Index in advance. The rise in inflation in 2022 is due to the supply chain tension following COVID-19, Israel-Hamas war in October of 2023, and the rise in international oil prices. Additionally, the Federal Open Market Committee decided to keep the federal benchmark interest rate unchanged at 5.00 to 5.25%. The cost of investment in turn affects the profitability and value of an enterprise. We use nonlinear autoregressive distributed lag to analyze the representation of the yield curve, the amount of shale oil production, the fab equipment spending month-on-month rate, and other independent variables for cointegration analysis of the Philadelphia Semiconductor Index. The research period spans from 1994 to 2021. The results of the study revealed that an increase in the fab equipment spending month-on-month rate, an increase in shale oil production in the short run, and the representation of the yield curve in the short run had a significant impact on the Philadelphia Semiconductor Index.

Based on limited biodiversity data collected from a line transect, what is the minimal distance to find the first individual of a new species that has not been discovered in the original sample? Resolving this puzzle can be of practical value in ecological studies, for example, an assessment of sampling intensity for the purpose of discovering new species. In this study, we develop a simple estimator to predict the minimal distance of finding a single new species. Numerical and empirical tests verified the high predictive power of the proposed estimator.

The relationships that control seed production in trees are key to understand evolutionary pressures that have shaped forests. A global synthesis of fecundity data reveals that while seed production is not constrained by a strict size-number trade-off, it is influenced by taxonomy and nutrient allocation.

Metal-organic framework (MOF) membranes are potentially useful in gas separation applications. Conventional methods of MOF membrane preparation require multiple steps and high-pressure conditions. In this study, a reliable one-step interfacial synthesis method under atmospheric pressure has been developed to prepare zeolitic imidazolate framework-8 (ZIF-8) membranes supported on porous α-Al2O3 disks. To obtain optimal ZIF-8 membranes, three reaction parameters were investigated, namely, reaction temperature, reaction time, and concentration of the organic linker (i.e., 2-methylimidazole). The growth of ZIF-8 membranes under various parameters was evaluated by field-emission scanning electron microscopy, and the optimal synthesis conditions were determined (i.e., 80 °C for 12 h in 50 mM of 2-methylimidazole). The as-synthesized ZIF-8 membranes were then applied to CO2/N2 gas separation, which exhibited a maximum separation factor of 5.49 and CO2 gas permeance of 0.47 × 10−7 mol·m−2·s−1·Pa−1.

Abstract Background The purpose was to examine the effect of negative lymph nodes (NLN) number on survival in stage III colon cancer. To reduce the interference of acute inflammation, we included patients with stage III colon cancer who had undergone elective surgery and excluded those who had tumor perforation, obstruction, ischemia, or massive tumor bleeding. Methods This retrospective cohort study included 2244 patients with stage III colon cancer between 1995 and 2016 at a single center. The effect of NLN on 5-year relapse-free survival (RFS), 5-year overall survival (OS), and comparison of multivariate factors was assessed according to tumor locations. Results The two optimal cutoff values of NLN for proximal and distal colon, namely 27 and 12, were determined by plotting the time-dependent receiver operating characteristic curve. Overall, 499 of 891 and 1020 of 1353 patients with right-side and left-side colon cancer, respectively, had high NLN. In right-side colon cancer, patients with high NLN (≥ 27) had superior OS (74.9% vs. 62.7%, P

BackgroundSerum carcinoembryonic antigen (CEA) is a biomarker commonly used to detect colorectal cancer. CEA levels are affected by many factors, including cardiometabolic diseases, such as cardiovascular diseases (CVDs) and diabetes. Cardiometabolic diseases and cancer share a similar pathological inflammatory pathway, which correlates with an unhealthy lifestyle. Hence, establishing an adequate CEA cut-off value might be a valuable reference for developing precision healthcare programs for cardiometabolic disease prevention. This study aimed to investigate the association between cardiometabolic risks and serum CEA and the underlying factors.MethodsA community-based, cross-sectional study was conducted between March and December 2021 on the western coast of Taiwan. Lifestyle data were assessed using a structured questionnaire. The cardiometabolic biomarkers, serum CEA, urine malondialdehyde, and 1-hydroxypyrene were quantified by the central laboratory of the collaborating hospital. Chi-square and binary multivariable logistic regression implemented in R version 4.0.2 were used to identify factors defining the risk of high serum CEA levels.ResultsA total of 6,295 adult residents without cancer-related diseases completed the study. The mean age was 48.6 (SD = 16.4) years, 56% were female, 32% had metabolic syndrome, and 23% and 10% had CVDs and diabetes, respectively. Multivariate logistic regression showed that age ≥ 65 years, male sex, alcohol consumption, smoking, infrequent use of dental floss, fewer remaining teeth, CVDs, diabetes, and oxidative stress were significantly associated with serum CEA ≥ 3 ng/mL. The discriminatory performance of the area under the receiver operating characteristic curve was 0.75 (0.73–0.76), showing that this model was suitable for distinguishing high CEA levels.ConclusionOur findings highlight the importance of understanding cardiometabolic diseases, unhealthy lifestyles, and oxidative stress, which contribute to high serum CEA. This study demonstrates that CEA, a well-known tumor marker, can help the early detection and prevention of cardiometabolic diseases via personalized lifestyle modification.

Metal artifacts present a major challenge to computed tomography (CT) because they reduce the image quality in medical diagnosis and treatment. Several metal artifact reduction (MAR) methods have been proposed to address this issue in previous studies. This study aimed to synthesize a virtual monochromatic image for MAR in CT images using projection-based material decomposition (MD) algorithms. We developed a spectral micro-CT prototype system equipped with a photon-counting detector (PCD) and PCD-CT imaging simulator to assess the performances of different MAR methods. Two projection-based MD algorithms were implemented and evaluated for their MAR performances in CT images and compared with conventional sinogram inpainting MAR methods. Different parts of digital 4D-extended cardiac torso (XCAT) phantoms with metal implants were designed to simulate various real scenarios. A homemade metal artifact evaluation (MAE) phantom was used to evaluate the MAR performance in experiments. The simulated results of the XCAT phantom indicated that the projection-based virtual monochromatic CT (VMCT) images provided better image quality than the conventional MAR images without blurring the normal tissues at the position of the metal artifacts. Various quantitative indicators support this conclusion. Additionally, the experimental results of the MAE phantom reveal that projection-based VMCT images can avoid image distortion caused by metal artifacts, unlike conventional MAR methods. In regards to the projection-based VMCT images, the simulated and experimental results demonstrated that using the linear maximum likelihood estimators with an error correction look-up table algorithm yielded better MAR performance compared to that obtained using a polynomial algorithm. Furthermore, projection-based VMCT images can not only reduce metal artifacts effectively but also simultaneously prevents object blurring at the metal artifact position and image distortion of the metal implants. Hence, the CT image quality can be further improved to increase the abilities for both preoperative and postoperative assessment of metal implants.

When Carnot and Stirling initially conceptualized heat engines, temperature unambiguously represented our everyday perception of cold and hot. However, as this energy scale is expanded to measure the strength of noise in general nonequilibrium heat baths, such as those consisting of bacteria or active particles, it takes on different definitions and connotations. This raises a fundamental question of whether and how thermodynamic conclusions beyond a unique definition of temperature would deviate from our conventional understanding. To address this inquiry, we investigate a colloidal Stirling engine governed by a large number of stochastic dynamical systems. Within experimentally accessible parameter values, we discover certain exceptional active engines that can outperform their passive counterpart, as notably claimed in a recent experiment involving a bacterial bath. Our analysis shows that such heightened performance can be attributed to either a restoring effect in noise or a significant dissipation kernel. The revealed influence of active baths on Stirling efficiency provides further insights into their impact on maximum power output, Carnot efficiency, and Curzon-Alhborn efficiency. The finding elucidates the origins of exceptional performance in stochastic heat engines, offers strategies for harvesting energies from active noises, and sheds light on the effects of nonequilibrium temperature in stochastic thermodynamics.

A recent experiment demonstrated that a colloidal heat engine immersed in an active bath can outperform those subject to equilibrium or passive baths. Although it has motivated several theoretical studies to clarify the possible origins of such high efficiency, the discussed noise effects are often intertwined and hard to distinguish in nature. In this paper, we used the optical feedback trap to mimic a colloidal heat engine in various active baths in a precisely controllable setting to analyze the impacts of individual noise properties in real systems. Our experiment, together with theoretical calculations, show that the efficiency of the active engine can be greatly increased when the magnitude of the active-bath noise with a nonzero correlation time is modulated according to the variation of the confining potential in the quasistatic limit. This result reveals how to tune the noise properties of an active bath to enhance the efficiency of a microscopic machine, which could be used to manipulate the functions of stochastic systems under complex active backgrounds.

The relationship of mycorrhizal associations with latitudinal gradients in tree beta-diversity is unexplored. Using a global dataset approach, this study examines how trees with arbuscular mycorrhizal and ectomycorrhizal associations contribute to latitudinal beta-diversity patterns and the environmental controls of these patterns.

The main purpose of this article was to define a model that could defeat the online bookmakers’ odds, where the betting item considered was the first five innings of major league baseball (MLB) matches. The betting odds of online bookmakers have two purposes: first, they are used to quantify the amount of profit made by the bettors; second, they are regarded as a market equilibrium point between multiple bookmakers and bettors. If the bettors have a more accurate prediction model than the system used to produce betting odds, it will create a positive expected return for the bettors. In this article, we used the Markov process method and the runner advancement model to estimate the expected runs in an MLB match for the teams based on the batting lineup and the pitcher.

Background Disturbances are crucial in determining forest biodiversity, dynamics, and ecosystem functions. Surface fire is a significant disturbance in tropical forests, but research on the effect of surface fire on structuring species and functional composition in a community through time remains scarce. Using a 20-year dataset of tree demography in a seasonal evergreen tropical forest in Thailand, we specifically addressed two essential questions: (1) What is the pattern of temporal turnover in species and functional composition in a community with frequent fire disturbance? (2) How did the temporal turnover vary with tree size? Methods We analyzed species compositional and functional temporal turnovers in four different tree size classes among five tree censuses. We quantified species turnover by calculating Bray-Curtis dissimilarity, and investigated its underlying mechanisms by comparing pairwise dissimilarity of functional traits with simulations from null models. If fire disturbances contribute more to a stochastic process, the functional composition would display a random pattern. However, if they contribute more towards a deterministic process, the functional composition should reveal a non-random pattern. Results Over 20 years (1994–2014), we observed changes in species composition, whereas functional composition remained relatively stable. The temporal turnover patterns of species and functional compositions varied with tree sizes. In particular, temporal functional turnover shifted very little for large trees, suggesting that changes in species composition of larger trees are contributed by species with similar functional traits through time. The temporal functional composition turnovers of smaller trees (DBH ≤ 5 cm) were mostly at random. We detected a higher functional turnover than expected by null models in some quadrats throughout the 50-ha study plot, and their observed turnover varied with diameter classes. Conclusions Species compositional changes were caused by changes in the abundance of species with similar functional traits through time. Temporal functional turnover in small trees was random in most quadrats, suggesting that the recruits came from the equal proportions of surviving trees and new individuals of fast-growing species, which increased rapidly after fires. On the other hand, functional composition in big trees was more likely determined by surviving trees which maintained higher functional similarities than small trees through time. Fire disturbance is important for ecosystem functions, as changing forest fire frequency may alter forest turnover, particularly in functional composition in the new recruits of this forest.

The milkfish, Chanos chanos, is an important aquaculture species that can be cultured in freshwater (FW) and seawater (SW) ponds because of its high euryhalinity. In winter, cold snap leading to high mortality of this tropical species is a critical issue for the aquaculture industry in Taiwan. Under hypothermal stress, however, changes in energy supply for osmoregulation of this euryhaline species is intriguing. In this study, we used an antibody against glycogen phosphorylase (GP) to identify glycogen-rich (GR) cells distributed adjacent to the mitochondria-rich (MR) ionocytes in milkfish gills. Glucose transporter 1 (GLUT1), which plays a major role in energy supply, was also identified and localized in GR cells. Moreover, the expression of indicators of aerobic metabolism and energy production, citrate synthase (CS) and cytochrome c oxidase (COX), were analyzed in gills of FW- and SW-acclimated milkfish to reveal different strategies of energy utilization under hypothermal stress. When exposed to a low-temperature environment, SW individuals used branchial glycogen and lactate to match the energy demands of aerobic metabolism in ionocytes, and elevated aerobic capacity to support and maintain normal functions in gills. However, branchial glycogen mainly localized in the GR cells of FW milkfish was not utilized under hypothermal stress. Meanwhile, a similar level of branchial COX activity and COXIV protein abundance at low temperatures between FW and SW milkfish indicated similar energy requirements in gills. This suggested that another source, but not branchial glycogen, maintained the energy demand in FW milkfish. The present study illustrated differential energy supply strategies in gills between SW- and FW-acclimated milkfish for osmoregulation under low temperatures.

Introduction Dual antiplatelet therapy and high-intensity statins are the mainstay treatment in patients with acute stage, symptomatic intracranial atherosclerotic stenosis (ICAS). Alirocumab is a monoclonal antibody that can inhibit proprotein convertase subtilisin–kexin type 9 and effectively lower low-density lipoprotein cholesterol levels with less side effects than statins. We hypothesise that alirocumab treatment in addition to statin therapy could stabilise intracranial plaque and reduce arterial stenosis.Methods and analysis In this prospective, randomised, open-label, blinded end-point study, we will use high-resolution vessel-wall MRI to evaluate the efficacy and safety of alirocumab in patients who had an acute ischaemic stroke from ICAS. We will recruit 66 patients who had an acute ischaemic stroke within 7 days of symptom onset, who had symptomatic intracranial artery stenosis (>30%) at the middle cerebral artery, basilar artery or intracranial internal carotid artery. Among them, 22 patients will be randomised to the intervention group to receive treatment with 75 mg alirocumab subcutaneously every 2 weeks for a total of 26 weeks, while those in the control group will not. All patients in both groups will receive antiplatelet agents and high-intensity statins, including 20 mg rosuvastatin or 40–80 mg atorvastatin or at the maximum tolerated dose. All of them will undergo MRI at recruitment and after 26 weeks. The primary outcomes are changes in intracranial atherosclerotic plaques in the MRI before and after 6 months treatment. This trial is being conducted at Chang Gung Memorial Hospital at Chiayi, Taiwan.Ethics and dissemination This trial has been approved by the Institutional Review Board of Chang Gung Memorial Hospital (approval no. 202 002 482A3). Written informed consent will be obtained from all research participants. Study results will be published as peer-reviewed articles.Trial registration number ClinicalTrials.gov, Identifier: NCT05001984; Pre-results.

In this work, we propose an image denoising approach, specifically for “salt-and-pepper noise,” based on the optimized sparse approximation for restoring images contaminated by high-density impulse noise. The proposed method first uses the inverse-distance weighting-based prediction to estimate noise-recovered pixels. It then utilizes DCT-based sparse approximation to further refine the denoised results with the ant colony optimization. Experiments on an image benchmark dataset demonstrate that the proposed method yields better results compared to the state-of-the-art image noise removal methods.

Background: This study explored the outcome of older adults with severe head injury after 1-year follow-up. Materials and Methods: Data were collected from the hospital medical information system. The patients who suffered from severe head injury met with the disease classification system, traumatic statistics, with or without brain surgery, and patient medical records of a regional teaching hospital were included in the study. Patients were followed with telephone contact 1 year after discharge. The Glasgow Outcome Scale and the Functional Independence Measure were used as tools for prognostic evaluation. This study protocol was approved by the institutional review board of the hospital. Results: Patients who were 65 years of age and older diagnosed with severe head injury (Injury Severity Score [ISS] ≥16) were included. Between January 2009 and September 2015, a total of 142 patients were collected with 88 men (62%) and 54 women (38%). The mean age was 76.6 ± 6.6 years. Head injury was caused by traffic accidents for 73 patients (51.4%) and by falls for 69 patients (48.6%). There were 122 patients with subdural hemorrhage, 82 with intracerebral hemorrhage, 71 with subarachnoid hemorrhage, and 11 with epidural hemorrhage. Forty-one patients (28.9%) had simple head injury and 101 patients had multiple head injuries. The mean Glasgow Coma Scale was 5.4 ± 1.9, and the mean ISS was 24.3 ± 9.2. Thirty-eight patients (26.8%) refused surgery and 104 patients (73.2%) underwent brain surgery. Among 142 patients, 70 (49.3%) died and 72 (50.7%) survived, with 16 patients (11.3%) classified as good condition and 126 (88.7%) as poor condition. After 1 year, those who underwent brain surgery had a better prognosis than those who refused surgery (P = 0.01). Conclusion: Older adults with severe head injuries often face disability, a vegetative state, or death. In this study, those who underwent brain surgery had better survival, and 27.6% (16/58) of those who survived were able to live independently after 1 year.

Background: Comprehensive rehabilitation programs are recommended for patients with prolonged mechanical ventilation (PMV) to facilitate functional recovery and ventilator weaning, but whether the functional status after rehabilitation influences outcome has not been clearly evaluated. This study aimed to investigate the association between post-rehabilitation functional status and weaning and survival outcome in PMV patients.Methods: We retrospectively enrolled PMV patients admitted to the respiratory care center (RCC), a post-ICU weaning facility with protocolized rehabilitation program, from January 2016 through December 2017. Functional status was measured by the de Morton Mobility Index (DEMMI), with a cut-off value set at 20 points. The primary outcomes were the weaning status at RCC discharge and hospital survival. The secondary outcomes were overall survival and survival at 3 months after RCC discharge. We followed patients until 3 months after RCC discharge or death. Logistic and Cox regressions were performed to identify significant parameters associated with weaning success and survival.Results: In total, 320 patients were enrolled. The weaning success rate was 71.6%. The survival rate at RCC discharge, hospital discharge, and 3 months after RCC discharge was 89.1, 77.5, and 66.6%, respectively. Post-rehabilitation DEMMI ≥ 20 (odds ratio [OR], 3.514; 95% confidence interval [CI], 1.436–8.598; P = 0.006) was the most significantly associated with weaning success. The weaning success and higher post-rehabilitation DEMMI were the two most significant independent factors associated with both hospital survival (weaning success, OR, 12.272; 95% CI, 5.281–28.517; P < 0.001; post-rehabilitation DEMMI ≥ 20, OR, 6.298; 95% CI, 1.302–30.477; P = 0.022) and survival at 3 months after RCC discharge (weaning success, OR, 38.788; 95% CI, 11.505–130.762; P < 0.001; post-rehabilitation DEMMI ≥ 20, OR, 4.830; 95% CI, 1.072–21.756; P = 0.040). Post-rehabilitation DEMMI ≥ 20 remained significantly association with overall survival at 3 months after RCC discharge (hazard ratio, 0.237; 95% CI, 0.072–0.785; P = 0.018).Conclusions: Post-rehabilitation functional status of PMV patients was independently associated with weaning success, as well as hospital and 3-month overall survival after RCC discharge. Post-rehabilitation, but not pre-rehabilitation, functional status was a significant parameter associated with weaning success and survival in patients requiring PMV.

When Darwin visited the Galapagos archipelago, he observed that, in spite of the islands' physical similarity, members of species that had dispersed to them recently were beginning to diverge from each other. He postulated that these divergences must have resulted primarily from interactions with sets of other species that had also diverged across these otherwise similar islands. By extrapolation, if Darwin is correct, such complex interactions must be driving species divergences across all ecosystems. However, many current general ecological theories that predict observed distributions of species in ecosystems do not take the details of between-species interactions into account. Here we quantify, in sixteen forest diversity plots (FDPs) worldwide, highly significant negative density-dependent (NDD) components of both conspecific and heterospecific between-tree interactions that affect the trees' distributions, growth, recruitment, and mortality. These interactions decline smoothly in significance with increasing physical distance between trees. They also tend to decline in significance with increasing phylogenetic distance between the trees, but each FDP exhibits its own unique pattern of exceptions to this overall decline. Unique patterns of between-species interactions in ecosystems, of the general type that Darwin postulated, are likely to have contributed to the exceptions. We test the power of our null-model method by using a deliberately modified data set, and show that the method easily identifies the modifications. We examine how some of the exceptions, at the Wind River (USA) FDP, reveal new details of a known allelopathic effect of one of the Wind River gymnosperm species. Finally, we explore how similar analyses can be used to investigate details of many types of interactions in these complex ecosystems, and can provide clues to the evolution of these interactions.

ObjectivesLarge-scale, population-based real-world studies on the treatment outcomes of first-line tyrosine kinase inhibitors (TKIs) and subsequent systemic chemotherapy agents for lung adenocarcinoma (with activating epidermal growth factor receptor [EGFR] mutations) remain limited.Materials and MethodsFrom March 2014 to December 2016, patients with advanced lung adenocarcinoma, identified from the Taiwan Cancer Registry were included in this study if they received any of the three TKIs as first-line treatment. The primary outcome was overall survival (OS). The secondary outcome was time-to-treatment discontinuation (TTD).ResultsA total of 4,889 patients (median age: 67 years and two-thirds with distant metastasis) were recruited (1,778 gefitinib, 1,599 erlotinib, and 1,512 afatinib users). A 1:1 propensity score (PS)-matched cohorts of 1,228 afatinib/erlotinib and 1054 afatinib/gefitinib was created. After PS matching, it was found that afatinib was not associated with better OS (afatinib vs. erlotinib, HR: 0.96, 95% CI: 0.86–1.07; afatinib vs. gefitinib, HR: 0.91, 95% CI: 0.81–1.02). In the subgroup analysis, afatinib demonstrated a survival benefit in patients with active smoking (afatinib vs. erlotinib, HR: 0.69, 95% CI: 0.51–0.93; afatinib vs. gefitinib, HR: 0.67, 95% CI: 0.48–0.94) and ECOG > 1 (afatinib vs. erlotinib, HR: 0.79, 95% CI: 0.63–0.99; afatinib vs. gefitinib, HR: 0.78, 95% CI: 0.62–0.98). A total of 41.1% (n = 1992) of first-line TKI users received subsequent chemotherapy. Among the three TKI groups, pemetrexed usage was associated with better OS compared with other chemotherapy agents, with the exception of gemcitabine in the afatinib and gefitinib groups. Pemetrexed and gemcitabine had the longest TTD of 3–4 months.ConclusionsAmong patients with EGFR mutant lung adenocarcinoma, afatinib use may not provide longer OS compared with first-generation TKIs. Afatinib may be preferably considered among patients with active smoking and should not be withheld among those with worse performance status. With 40% of patients receiving subsequent chemotherapy, pemetrexed may be the preferred agent, while gemcitabine can be a reasonable alternative.

BackgroundThrough activation of adrenergic receptors, chronic stress can trigger the secretion of neurotransmitters and hormones that enhance tumor growth, increase angiogenesis, and promote drug resistance. This study aimed to evaluate the effect of β-blockers in patients receiving first-line epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for lung adenocarcinoma.MethodsThis retrospective cohort study enrolled patients with advanced lung adenocarcinoma under first-line EGFR-TKIs between 2011 and 2014 in the National Health Insurance Research Database of Taiwan. The effects of β-blockers use, defined as ≥60 defined daily doses within 180 days before initiation of EGFR-TKI therapy, on the 2-year time-to-discontinuation (TTD) of EGFR-TKIs and 4-year overall survival (OS) were investigated using Cox regression analyses with inverse propensity score weighting and sensitivity analysis in subgroup with either hypertension or ischemic heart diseases.ResultsAmong 4988 enrolled patients, 552 (11.1%) were in the β-blocker group. Patients in the β-blocker group were more likely to be older than 75 and had diabetes mellitus and cardiovascular comorbidities. In Cox regression analysis, β-blocker usage was associated with a longer TTD (hazard ratio, HR: 0.91 [0.86–0.96]) and OS (HR: 0.68 [0.64–0.72]). The results also favored β-blocker group in sensitivity analysis.ConclusionsIn treatment-naïve patients with advanced lung adenocarcinoma under first-line EGFR-TKIs, prior use of β-blocker was associated with a better outcome. The findings encourage further prospective clinical study to validate the possibility of β-blockers as adjuvant anticancer therapy.

In this paper, a multiple dependent state repetitive (MDSR) sampling plan based on the lifetime performance index CL is proposed for lifetime data with type II censoring when the lifetime of a product follows the exponential distribution or Weibull distribution. The optimal parameters of the proposed plan are determined by minimizing the average sample number while satisfying the producer's risk and consumer's risk at corresponding quality levels. Besides, the performance of the proposed plan is compared with that of the existing lifetime sampling plan in terms of the average sample number and operating characteristic curve. Two illustrative examples are given for the demonstration of the proposed plan.

Abstract Background Traditional Chinese medicine (TCM) has been used by Chinese patients and in many other countries worldwide. However, epidemiological reports and prescription patterns on children are few. Methods A cohort of 178,617 children aged 18 and under from one million randomly sampled cases of the National Health Insurance Research Database was analyzed for TCM prescription patterns. SAS 9.1 was applied and descriptive medicine utilization patterns were presented. Results The cohort included 112,889 children treated by TCM, with adolescents (12- to 18-year-olds) as the largest group. In the children’s TCM outpatient visits, Chinese herbal remedies were the main treatment. The top three categories of diseases treated with Chinese herbal remedies were respiratory system; symptoms, signs, and ill-defined conditions; and digestive system. The top three categories using acupuncture were: injury and poisoning, diseases of the musculoskeletal system and connective tissue, and diseases of the respiratory system. Of the top ten herbal medicines prescribed by TCM physicians, the top nine herbal formulae and the top ten single herbs were associated with diseases of the respiratory system. Conclusion This study identified patterns of TCM prescriptions for children and common disease categories treated with TCM. The results provide a useful reference for health policy makers and for those who consider the usage of TCM for children.

Abstract Background Tuberculosis (TB) remains one of the major infectious diseases worldwide. Adverse reactions are common during TB treatment. Few reports, however, are available on treatment-related acute biliary events (ABEs), such as cholelithiasis, biliary obstruction, acute cholecystitis, and cholangitis. Methods We first report four pulmonary TB patients who developed ABEs during anti-TB treatment. Abdominal sonography revealed multiple gall stones with dilated intrahepatic ducts in three patients and cholecystitis in one patient. To investigate the incidence of and risk factors for ABEs during anti-TB treatment, we subsequently conducted a nationwide cohort study using the National Health Insurance Research Database of Taiwan. Results A total of 159,566 pulmonary TB patients were identified from the database between 1996 and 2010, and among them, 195 (0.12%) developed ABEs within 180 days after beginning anti-TB treatment. Logistic regression analysis revealed that the risk factors associated with ABEs are older age (relative risk [RR]: 1.32 [1.21–1.44] per 10-year increment) and diabetes mellitus (RR: 1.59 [1.19–2.13]). Conclusions Although infrequently encountered, ABEs should be considered among patients with TB who experience abdominal discomfort with hyperbilirubinemia, especially patients who have older age or diabetes.

Fish of the tribe Thunnini represent a significant proportion of the stock caught by the fishing industry, with many of these fishes being collectively called tuna. However, only certain species can be used legally as an ingredient in canned tuna products, depending on regional food regulations. In Taiwan, only Thunnus species or Katsuwonus pelamis can be used as canned tuna. Here, we authenticated 90 canned tuna products, including 25 cat food samples, by sequencing two mitochondrial regions, 16S rRNA (16S) and the control region (CR). BLAST analysis revealed that Sarda orientalis, Euthynnus affinis, Auxis rochei, and Auxis thazard are all used as substitutes for legitimate tuna products. We found that 63.33% of investigated samples are true canned tuna, i.e., contain Thunnus species or skipjack tuna. We advocate that the Taiwanese government publishes an official standardized list of fishes, especially so that scientific, Chinese and vernacular names can be assigned unambiguously based on a “one species-one name policy”, thereby clarifying which species can be used in seafood products such as tuna. Furthermore, we feel that the large-scale and long-term monitoring of canned tuna products is warranted to fully assess the extent of tuna product adulteration in Taiwan.

To convert external light into internal neural signal, vertebrates rely on a special group of proteins, the visual opsins. Four of the five types of visual opsins-short-wavelength sensitive 1 (Sws1), short-wavelength sensitive 2 (Sws2), medium-wavelength sensitive (Rh2), and long-wavelength sensitive (Lws)-are expressed in cone cells for scotopic vision, with the fifth, rhodopsin (Rh1), being expressed in rod cells for photopic vision. Fish often display differing ontogenetic cone opsin expression profiles, which may be related to dietary and/or habitat ontogenetic shift. The western mosquitofish (Gambusia affinis) is an aggressive invader that has successfully colonized every continent except Antarctica. The strong invasiveness of this species may be linked to its visual acuity since it can inhabit turbid waters better than other fishes. By genome screening and transcriptome analysis, we identify seven cone opsin genes in the western mosquitofish, including one sws1, two sws2, one rh2, and three lws. The predicted maximal absorbance wavelength (λmax) values of the respective proteins are 353 nm for Sws1, 449 nm for Sws2a, 408 nm for Sws2b, 516 nm for Rh2-1, 571 nm for Lws-1, and 519 nm for Lws-3. Retention of an intron in the lws-r transcript likely renders this visual opsin gene non-functional. Our real-time quantitative PCR demonstrates that adult male and female western mosquitofish do not differ in their cone opsin expression profiles, but we do reveal an ontogenetic shift in cone opsin expression. Compared to adults, larvae express proportionally more sws1 and less lws-1, suggesting that the western mosquitofish is more sensitive to shorter wavelengths in the larval stage, but becomes more sensitive to longer wavelengths in adulthood.

Obesity and regional adiposity are important risk factors for cardiometabolic disorders. The aim of this study is to compare 7-site skinfold (SF) measurement to dual-energy x-ray absorptiometry (DXA) as the reference method for estimating body fat percentage (BF%) and regional adiposity in diabetic outpatients. A total of 59 diabetic patients (36 females and 23 males) aged 28.5-78 years (median 67.7 years) with BMI 18.8-40.6 kg/m2 (median: 25.5 kg/m2) were enrolled. 7-site skinfold measurement and DXA were performed at the same visit day and biochemistry data were collected. Our results demonstrate the BF% calculated via Jackson & Pollock 7-site skinfold equation presents a strong correlation (r = 0.672, p < 0.001 in females; r = 0.885, p < 0.001 in males) with that measured by DXA, but the means of BF% between these two methods are significantly different in both sexes (paired t-test, p < 0.001). The Bland-Altman analysis showed the mean differences (DXA-SF) of BF% were positive for female (8.74%) and male (7.22%), suggesting Jackson & Pollock 7-site skinfold equation tends to underestimate the BF%. Besides, regional SF thicknesses of 7-site skinfold measurement were significantly correlated with the matched regional adiposity quantified by DXA. Furthermore, truncal and android SF thicknesses were notably positively correlated with several cardiometabolic risk factors in gender-specific manner. Our data indicate the 7-site skinfold measurement is not an interchangeable method for precisely measuring BF%, but might be practical for evaluating the cardiometabolic risks in Taiwanese diabetic outpatients.

Patients on maintenance hemodialysis are at high risk for cardiovascular morbidity and mortality. Fluid overload is generally regarded as the main cause of cardiovascular death among them. Cardiothoracic ratio (CTR) by chest plain film is routinely performed to evaluate their volumetric states and cardiac conditions. We recently reported that salivary conductivity is a reliable marker for assessing fluid status in healthy adults. This cross-sectional study aims to explore the association between salivary conductivity and CTR. Cardiomegaly is defined as a CTR greater than 0.5. A total of 129 hemodialysis patients were enrolled, 42 of whom (32.6%) had cardiomegaly. Patients with cardiomegaly had significantly lower serum osmolality, lower serum sodium, and lower salivary conductivity, but a higher percentage of underlying atrial fibrillation. In the multiple linear regression analysis, CTR was negatively associated with salivary conductivity or to the serum sodium level and positively correlated with older age. We further divided patients into low, medium, and high salivary conductivity groups according to the tertials of conductivity levels. There was a significant trend for the increment of cardiomegaly from high to low salivary conductivity groups (p for trend: 0.021). The receiver operating characteristic curves for the diagnostic ability of salivary conductivity on cardiomegaly reported the area under the curve equal to 0.626 (95% CI: 0.521–0.730, p = 0.02). Moreover, older age and higher serum osmolality were independent determinants for salivary conductivity by multiple linear regression analysis. This work has presented that salivary conductivity is a novel approach to uncover fluid overload and cardiomegaly among chronic hemodialysis patients.

Background: Anti-tuberculous (TB) medications are common causes of drug-induced liver injury (DILI). Limited data are available on systemic inflammatory mediators as biomarkers for predicting DILI before treatment. We aimed to select predictive markers among potential candidates and to formulate a predictive model of DILI for TB patients. Methods: Adult active TB patients from a prospective cohort were enrolled, and all participants received standard anti-tuberculous treatment. Development of DILI, defined as ≥5× ULN for alanine transaminase or ≥2.6× ULN of total bilirubin with causality assessment (RUCAM, Roussel Uclaf causality assessment method), was regularly monitored. Pre-treatment plasma was assayed for 15 candidates, and a set of risk prediction scores was established using Cox regression and receiver-operating characteristic analyses. Results: A total of 19 (7.9%) in 240 patients developed DILI (including six carriers of hepatitis B virus) following anti-TB treatment. Interleukin (IL)-22 binding protein (BP), interferon gamma-induced protein 1 (IP-10), soluble CD163 (sCD163), IL-6, and CD206 were significant univariable factors associated with DILI development, and the former three were backward selected as multivariable factors, with adjusted hazards of 0.20 (0.07–0.58), 3.71 (1.35–10.21), and 3.28 (1.07–10.06), respectively. A score set composed of IL-22BP, IP-10, and sCD163 had an improved area under the curve of 0.744 (p < 0.001). Conclusions: Pre-treatment IL-22BP was a protective biomarker against DILI development under anti-TB treatment, and a score set by additional risk factors of IP-10 and sCD163 employed an adequate DILI prediction.

Background: The aim of this prospective study was to investigate the relationship between lifestyle factors including nutrition intake and the incidence of fall-related fragility fractures in postmenopausal women. Methods: A total of 1169 female volunteers were recruited from participants at the morning health examinations held at each local public health center in the West Chiayi County of Taiwan at the beginning of the study. Laboratory examinations, anthropometric measurements, and questionnaire interviews inquiring about lifestyle factors, including weekly nutrition intake, were performed. Subsequently, four follow-up telephone interviews at intervals of about 6–12 months were performed to inquire about instances of falls and fractures. Results: Nine hundred and fifty-three subjects responded at least once to the four telephone interviews, and there were 183 postmenopausal women, with a mean age of 68.8 ± 8.3 (49–87) years, reporting falls. Of the 183 women, 25 had incurred new fractures from low-energy impacts. Statistical analysis revealed that older age and hypertension were associated with increased risks of falling. Intake of other deep-colored (nondark-green) vegetables and light-colored vegetables as well as total vegetable intake were associated with reduced risk of fall-related fragility fracture. Conclusion: Among postmenopausal women, older age and the presence of hypertension were associated with increased risks of falls. Increased vegetable intake might be helpful to reduce the incidence of fall-related fragility fractures.

The aim of this study was to develop a geometric calibration method capable of eliminating the reconstruction artifacts of geometric misalignments in a tomosynthesis prototype with dual-axis scanning geometry. The potential scenarios of geometric misalignments were demonstrated, and their effects on reconstructed images were also evaluated. This method was a phantom-based approach with iterative optimization, and the calibration phantom was designed for specific tomosynthesis scanning geometry. The phantom was used to calculate a set of geometric parameters from each projection, and these parameters were then used to evaluate the geometric misalignments of the dual-axis scanning-geometry prototype. The simulated results revealed that the extracted geometric parameters were similar to the input values and that the artifacts of reconstructed images were minimized due to geometric calibration. Additionally, experimental chest phantom imaging results also indicated that the artifacts of the reconstructed images were suppressed and that object structures were preserved through calibration. And the quantitative analysis result also indicated that the MTF can be further improved with the geometric calibration. All the simulated and experimental results demonstrated that this method is effective for tomosynthesis with dual-axis scanning geometry. Furthermore, this geometric calibration method can also be applied to other tomography imaging systems to reduce geometric misalignments and be used for different geometric calibration phantom configurations.

Vision is very important to fish as it is required for foraging food, fighting competitors, fleeing from predators, and finding potential mates. Vertebrates express opsin genes in photoreceptor cells to receive visual signals, and the variety of light levels in aquatic habits has driven fish to evolve multiple opsin genes with expression profiles that are highly plastic. In this study, red shiners (Cyprinella lutrensis) were exposed to four water turbidity treatments and their opsin genes were cloned to elucidate how opsin gene expression could be modulated by ambient light conditions. Opsin gene cloning revealed that these fish have single RH1, SWS1, SWS2 and LWS genes and two RH2 genes. Phylogenetic analysis also indicated that these two RH2 opsin genes-RH2A and RH2B -are in-paralogous. Using quantitative PCR, we found evidence that opsin expression is plastic in adults. Elevated proportional expression of LWS in the cone under ambient light and turbid treatment indicated that the red shiner's visual spectrum displays a red shift in response to increased turbidity.

Swordfish, Xiphias gladius (Linnaeus, 1758), is a commercially important species that is widely distributed throughout three oceans. This species inhabits oceanic waters with preferred environmental ranges and migrates vertically to the surface layer for feeding. However, the spatial distribution pattern and habitat preferences of swordfish have been rarely studied in the Pacific Ocean due to the wide geographic range of this species. This study examined the spatial distribution and preferred ranges of environmental variables for swordfish using two approaches, generalized additive models and habitat suitability index methods, with different spatio-temporal data resolution scales. Results indicated that sea surface temperature is the most important factor determining swordfish spatial distribution. Habitat spatial pattern and preferred environmental ranges, estimated using various modeling approaches, were robust relative to the spatio-temporal data resolution scales. The models were validated by examining the consistency between predictions and untrained actual observations, which all predicted a high relative density of swordfish in the tropical waters of the central Pacific Ocean, with no obvious seasonal movement. Results from this study, based on fishery and remote sensing data with wide spatial coverage, could benefit the conservation and management of fisheries for highly migratory species such as swordfish and tuna.

The Notch signaling pathway is a highly evolutionarily-conserved cell-cell signaling pathway that regulates many events during development. It plays a pivotal role in the regulation of fundamental cellular processes, such as cell proliferation, stem cell maintenance, and differentiation during embryonic and adult development. However, functions of Notch signaling in Aedes aegypti, the major mosquito vector for dengue, are largely unknown. In this study, we identified a unique feature of A. aegypti Notch (AaNotch) in the control of the sterile-like phenotype in female mosquitoes. Silencing AaNotch with a reverse genetic approach significantly reduced the fecundity and fertility of the mosquito. Silencing AaNotch also resulted in the prevention of micropyle formation, which led to impaired fertilization. In addition, JNK phosphorylation (a signaling molecule in the non-canonical Notch signaling pathway) was inhibited in the absence of AaNotch. Furthermore, treatment with a JNK inhibitor in the mosquito resulted in impaired fecundity and fertility. Taken together, our results demonstrate that non-canonical Notch signaling is essential for controlling fertility in the A. aegypti mosquito.

The fluctuation of temperature affects many physiological responses in ectothermic organisms, including feed intake, growth, reproduction, and behavior. Changes in environmental temperatures affect the acquisition of energy, whereas hepatic glycogen plays a central role in energy supply for the homeostasis of the entire body. Glycogen phosphorylase (GP), which catalyzes the rate-limiting step in glycogenolysis, is also an indicator of environmental stress. Here, we examined the effects of salinity on glycogen metabolism in milkfish livers under cold stress. A reduction of feed intake was observed in both freshwater (FW) and seawater (SW) milkfish under cold adaptation. At normal temperature (28°C), compared to the FW milkfish, the SW milkfish exhibited greater mRNA abundance of the liver isoform of GP (Ccpygl), higher GP activity, and less glycogen content in the livers. Upon hypothermal (18°C) stress, hepatic Ccpygl mRNA expression of FW milkfish surged at 3 h, declined at 6 and 12 h, increased again at 24 h, and increased significantly after 96 h. Increases in GP protein, GP activity, and the phosphorylation state and the breakdown of glycogen were also found in FW milkfish livers after 12 h of exposure at 18°C. Conversely, the Ccpygl transcript levels in SW milkfish were downregulated after 1 h of exposure at 18°C, whereas the protein abundance of GP, GP activity, and glycogen content were not significantly altered. Taken together, under 18°C cold stress, FW milkfish exhibited an acute response with the breakdown of hepatic glycogen for maintaining energy homeostasis of the entire body, whereas no change was observed in the hepatic glycogen content and GP activity of SW milkfish because of their greater tolerance to cold conditions.

Human studies on the use of metformin as host-directed therapy (HDT) for tuberculosis (TB) are rare. We performed a nationwide cohort study to evaluate the effect of metformin on mitigating the risk of active TB among patients with diabetes mellitus (DM). Among newly diagnosed DM patients identified in the Taiwan National Health Insurance Research Database, metformin users, defined on the basis of >90 cumulative defined daily doses within 1 year, and propensity-score-matched metformin nonusers were selected. The primary outcome was incident TB, identified using diagnostic criteria validated by real patient data at a medical center. Independent predictors were investigated using Cox regression analysis. Similar analysis was performed in a subpopulation without a history of hypertensive nephropathy and renal replacement therapy. A total of 88,866 metformin users and 88,866 propensity-score-matched nonusers were selected. Validation results showed that the TB diagnostic criteria had a sensitivity of 99.13% and specificity of 99.90%. During follow-up, 707 metformin users and 807 nonusers developed active TB. Metformin use was independently associated with a lower risk of incident TB (hazard ratio [HR]: 0.84 [0.74-0.96]). TB risk was lower in high-dose metformin users than in low-dose users (HR: 0.83 [0.72-0.97]). The effect of metformin remained when analysis was restricted in the subpopulation without renal function impairment. Newly diagnosed diabetic patients without contraindication should receive metformin as an anti-diabetic medication, with potential additional benefit against TB.

Objective To investigate the risk factors for osteoporosis in male Taiwanese patients with chronic obstructive pulmonary disease (COPD). Methods This cross-sectional study evaluated male COPD outpatients and age-matched male subjects at a regional teaching hospital. The following data were obtained and analyzed: bone mineral density of the lumbar spine and hip on dual-energy X-ray absorptiometry, demographic characteristics, questionnaire interview results, pulmonary function test results, chest posterior–anterior radiographic findings, and biochemical and high-sensitivity C-reactive protein (hs-CRP) levels. Results Fifty-nine male COPD patients and 36 age-matched male subjects were enrolled. COPD patients had lower body mass index (BMI) (23.6 ± 4.1 vs. 25.2 ± 3.0 kg/m2) and higher total prevalence for osteoporosis and osteopenia than controls. Among COPD patients, patients with osteoporosis had lower BMI, body weight, waist circumference, and triglyceride level but higher hs-CRP level, and tended to have lower creatinine level. Binary logistic regression analysis for factors including age, BMI, creatinine, hs-CRP, smoking, steroid use, and forced expiratory volume in one second (FEV1) revealed that an hs-CRP level ≥5 and decreased creatinine level were independent risk factors for osteoporosis in COPD patients. Lower BMI tended to be associated with osteoporosis development, although it did not reach statistical significance, and hs-CRP was associated with COPD severity and steroid use history. Conclusion The total prevalence of osteoporosis and osteopenia in male Taiwanese COPD patients is higher than that in age-matched male subjects and systemic inflammation is an independent risk factors for osteoporosis. Low creatinine level in COPD patients should raise the suspicion of sarcopenia and associated increased risk of osteoporosis.

Image analysis techniques have been applied to measure the displacements, strain field, and crack distribution of structures in the laboratory environment, and present strong potential for use in structural health monitoring applications. Compared with accelerometers, image analysis is good at monitoring area-based responses, such as crack patterns at critical regions of reinforced concrete (RC) structures. While the quantitative relationship between cracks and structural damage depends on many factors, cracks need to be detected and quantified in an automatic manner for further investigation into structural health monitoring. This work proposes a damage-indexing method by integrating an image-based crack measurement method and a crack quantification method. The image-based crack measurement method identifies cracks locations, opening widths, and orientations. Fractal dimension analysis gives the flexural cracks and shear cracks an overall damage index ranging between 0 and 1. According to the orientations of the cracks analyzed by image analysis, the cracks can be classified as either shear or flexural, and the overall damage index can be separated into shear and flexural damage indices. These damage indices not only quantify the damage of an RC structure, but also the contents of shear and flexural failures. While the engineering significance of the damage indices is structure dependent, when the damage indexing method is used for structural health monitoring, the damage indices safety thresholds can further be defined based on the structure type under consideration. Finally, this paper demonstrates this method by using the results of two experiments on RC tubular containment vessel structures.

A chip-level optical interconnect module combined with a vertical-cavity surface-emitting laser (VCSEL) chip, a photodetector (PD) chip, a driver integrated circuit (IC), and an amplifier IC on a silicon-on-insulator (SOI) substrate with 3-D guided-wave paths is experimentally demonstrated. Such an optical interconnect is developed for the signal connection in multicore processors or memory-to-processor interfaces. The 3-D guided-wave path, consisting of silicon-based 45° microreflectors and trapezoidal waveguides, is used to connect the optical signal between transmitter and receiver. In this paper, the VCSEL and PIN PD chips are flip-chip integrated on a SOI substrate to achieve complete chip-level optical interconnects. Due to the unique 3-D guided-wave path design, a higher laser-to-PD optical coupling efficiency of -2.19 dB and a larger alignment tolerance of ±10μm for the VCSEL/PD assembly are achieved. The measured laser-to-PD optical transmission efficiency can reach -2.19 dB, and the maximum optical power and threshold current of VCSEL is 3.27 mW and 1 mA, respectively. To verify the data transmission, the commercial driver IC and amplifier IC are assembled upon the silicon chip, and the error-free data transmission of 10 Gbps can be achieved when the VCSEL is operated at the driving current of 9 mA.

Background: Osteoporosis-related fragility fracture is a major health issue in older adults. This study has been developed to investigate the relationship of lifestyle factors with fragility fracture prevalence in postmenopausal Taiwanese women. Methods: A total of 1050 postmenopausal women with a mean age of 66.7±8.6 years who lived in the community in western Chiayi County in Taiwan was interviewed with a structured questionnaire collected personal data, lifestyle information and fracture history. Laboratory examinations provided biochemistry data. Fragility fractures were defined as those resulting from low energy impact. The relationship between fragility fracture prevalence and other variables was analyzed. Results: The overall prevalence of fractures of all etiologies and fragility fracture were 18.7% and 9.7%, respectively. Wrist was the most common site of fragility fracture (48 cases). Fragility fracture prevalence in participants who rarely or did not consume deep-colored vegetables was significantly higher than that of those who often consumed deep-colored vegetables: 17.6% versus 9.0%, with an odds ratio of 1.96 (95% confidence interval: 1.05–3.68) by multivariate logistic regression analysis. Conclusion: Insufficient intake of deep-colored vegetables is associated with increased risk of fragility fracture.

A tropical species, the euryhaline milkfish (Chanos chanos), is a crucial economic species in Southeast Asia and is intolerant of water temperature below 12°C. Large numbers of milkfish die during cold periods in winter. Hypothermal environments usually increase oxidative stress in teleosts, and the liver is the major organ for anti-oxidative responses in the body. Peroxiredoxin-6 (Prdx6) in mammals is a multi-functional enzyme and acts as both glutathione peroxidase, phospholipase A2 and acyl-transferase for maintenance of redox status and prevention of cell membrane peroxidation. Prdx6 can protect cells from oxidant-induced membrane damage by translocating the Prdx6 protein from the cytosol to the membrane. Upon cold stress, Ccprdx6 transcript levels were up-regulated after 24 h and 96 h in livers of fresh water (FW)- and seawater (SW)-acclimated milkfish, respectively. In the hypothermal FW group, the Prdx6 protein was up-regulated in the cytosol of hepatocytes with a similar role as glutathione peroxidase to reduce oxidative stress upon hypothermal challenge. Conversely, in hypothermal SW milkfish, total Prdx6 protein was down-regulated. However, cytosolic Prdx6 protein was translocated to the membrane, using the ability of phospholipase A2 to stabilize the membrane redox state. Moreover, H2O2 content was increased in FW-acclimated milkfish livers upon hypothermal challenge. Ex vivo H2O2 treatment of milkfish livers also induced Ccprdx6 transcriptional expression, which provided more evidence of the antioxidant role of milkfish Prdx6. Taken together, upon hypothermal challenge, greater oxidative stress in livers of FW-acclimated milkfish rather than SW-acclimated individuals led to different profiles of hepatic CcPrdx6 expression between the FW and SW group. The results indicated that CcPrdx6 played the role of antioxidant with different mechanisms, i.e., binding to reactive oxygen species and stabilizing membrane fluidity, in livers of hypothermal FW and SW milkfish, respectively.