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Colorectal cancer (CRC) is a major public health issue, and there are limited studies on the association between 17β-hydroxysteroid dehydrogenase type 4 (HSD17B4) polymorphism and CRC. We used two national databases from Taiwan to examine whether HSD17B4 rs721673, rs721675, and alcohol intake were independently and interactively correlated with CRC development. We linked the Taiwan Biobank (TWB) participants’ health and lifestyle information and genotypic data from 2012 to 2018 to the National Health Insurance Database (NHIRD) to confirm their medical records. We performed a genome-wide association study (GWAS) using data from 145 new incident CRC cases and matched 1316 healthy, non-CRC individuals. We calculated the odds ratios (OR) and 95% confidence intervals (CI) for CRC based on multiple logistic regression analyses. HSD17B4 rs721673 and rs721675 on chromosome 5 were significantly and positively correlated with CRC (rs721673 A > G, aOR = 2.62, p = 2.90 × 10−8; rs721675 A > T, aOR = 2.61, p = 1.01 × 10−6). Within the high-risk genotypes, significantly higher ORs were observed among the alcohol intake group. Our results demonstrated that the rs721673 and rs721675 risk genotypes of HSD17B4 might increase the risk of CRC development in Taiwanese adults, especially those with alcohol consumption habits.

This paper presents a fault location technique for homogeneous ring-topology power transmission systems using synchrophasors sensed from the instruments in the power Internet of Things (IoT), such as Global Positioning System (GPS) based Phasor Measurement Units (PMUs) or Intelligent Electronic Devices (IEDs) with embedded GPS. Moreover, with a view to reducing the influence of measurement errors on fault location estimation, minimum demands for GPS-based equipment and Capacitor Voltage Transformer (CVT)/Current Transformer (CT) transducers are also considered when deriving the proposed algorithm. A unique fault locator is thus developed to recognize the faulted line branch as well as pinpoint the fault position at the same time. Not only can the proposed method avoid iterative operations, but it is also free from the problems of multiple solutions, fault type selections, and fault-path/source impedance assumptions. Last but not the least, extensive simulations considering 161 kV overhead-line parameters of Taiwan Power Company (Taipower) and actual non-ideal sensing/measurement phenomena are conducted to demonstrate the performance and effectiveness of the suggested idea.

BACKGROUND Slow transit constipation (STC) has traditionally been considered as a functional disorder. However, evidence is accumulating that suggests that most of the motility alterations in STC might be of a neuropathic etiology. If the patient does not meet the diagnosis of pelvic outlet obstruction and poorly response to conservative treatment, surgical intervention with subtotal colectomy may be effective. The most unwanted complication of the procedure is anastomotic leakage, however, preservation of the superior rectal artery (SRA) may reduce its incidence. AIM To evaluate the preservation of the SRA in laparoscopically assisted subtotal colectomy with ileorectal anastomosis in STC patients. METHODS This was a single-center retrospective observational study. STC was diagnosed after a series of examinations which included a colonic transit test, anal manometry, a balloon expulsion test, and a barium enema. Eligible patients underwent laparoscopically assisted total colectomy with ileorectal anastomosis and were examined between January 2016 and January 2018. The operation time, blood loss, time to first flatus, length of hospital days, and incidence of minor or major complications were recorded. RESULTS A total of 32 patients (mean age, 42.6 years) who had received laparoscopic assisted subtotal colectomy with ileorectal artery anastomosis and preservation of the SRA. All patients were diagnosed with STC after a series of examinations. The mean operative time was 151 min and the mean blood loss was 119 mL. The mean day of first time to flatus was 3.0 d, and the mean hospital stay was 10.6 d. There were no any patients conversions to laparotomy. Post-operative minor complications including 1 wound infection and 1 case of ileus. There was no surgical mortality. No anastomosis leakage was noted in any of the patients. CONCLUSION Laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the SRA can significantly improve bowel function with careful patient selection. Sparing the SRA may protect against anastomosis leakage.

In a power system, the transmission network is the backbone of electricity delivery from power plants to load centers; hence, it becomes a critical issue for electrical engineers to shorten the service restoration time after a fault occurrence on the transmission line. This application paper integrates the two- and three-terminal hybrid transmission line fault location algorithms based on synchronized phasor measurements into the proposed cloud-computing-based fault location system to inspect the feasibility and practicality of our algorithms for the real transmission-line incidents. The computing results are performed via Google Map for authorized personal computers and the application for intelligent mobile devices is developed to assist engineers in acquiring the fault-event information immediately as well as in figuring out the fault position intuitively and quickly due to its visualization and navigation. Last but not the least, the suggested fault location system has already been applied to the practical 345- and 161-kV transmission networks of Taiwan Power Company for achieving the combination of theory and practice. Up to the present, the proposed system still yields excellent performance verified by realistic fault data.

Background Graphene and its derivatives have recently gained popularity in the biomedical field. Previous studies have confirmed that both the mechanical strength and wear resistance of graphene-containing polyethylene have been greatly improved. Therefore, it is being considered as an alternative for artificial joint replacement liners. Based on the literature, the wear debris generated from the traditional polymers used for orthopedic liners could lead to particle-induced osteolysis and, consequently, failure of joint replacement. However, the biological response of this novel graphene-based polymer is still unclear. Therefore, the current study aimed to investigate the in vitro and in vivo biological effects of graphene and graphene oxide (GO) particles on bone. Materials and methods The biological responses of graphene and GO particles were tested via in vitro and murine calvarial in vivo models. In the in vitro model, murine macrophage cells were mixed with particles and hydrogel and printed into two differently designed scaffolds; the induced proinflammatory cytokines were then tested. In the murine in vivo model, the particle size distribution was measured via SEM, and these particles were then administrated in the calvarial area, referring to our established model. A micro-CT and histological analysis were performed to examine the biological effects of the particles on bone health. The data were analyzed via the one-way analysis of variance to determine the differences between the groups. Results Both graphene and GO induced significantly higher TNF-α and IL-6 secretion compared with the control in the three-dimensional in vitro model. In the murine calvarial in vivo test, the graphene and GO particles increased the bone mass compared with the sham groups in the micro-CT analysis. Bone formation was also observed in the histological analysis. Conclusion In these in vivo and in vitro studies, the graphene and GO wear debris did not seem to induce harmful biological response effect to bone. Bone formation around the skull was observed in the calvarial model instead. Graphene-containing biomaterials could be a suitable new material for application in orthopedic prostheses due to their benefit of eliminating the risk of particle-induce osteolysis.

Graphene is a novel material which has recently been gaining great interest in the biomedical fields. Our previous study observed that graphene-derived particles help induce bone formation in a murine calvarial model. Here, we further developed a blended graphene-contained polycaprolactone (PCL/G) filament for application in a 3D-printed bone scaffold. Since implants are expected to be for long-term usage

Graphene is a novel material which has recently been gaining great interest in the biomedical fields. Our previous study observed that graphene-derived particles help induce bone formation in a murine calvarial model. Here, we further developed a blended graphene-contained polycaprolactone (PCL/G) filament for application in a 3D-printed bone scaffold. Since implants are expected to be for long-term usage, in vitro cell culture and in vivo scaffold implants were evaluated in a critical-size bone defect calvarial model for over 60 weeks. Graphene greatly improved the mechanical strength by 30.2% compared to pure PCL. The fabricated PCL/G scaffolds also showed fine cell viability. In animal model, an abnormal electroencephalogram power spectrum and early signs of aging, such as hair graying and hair loss, were found in the group with a PCL/G scaffold compared to pure PCL scaffold. Neither of the abnormal symptoms caused death of all animals in both groups. The long-term use of graphene-derived biomaterials for in-vivo implants seems to be safe. But the comprehensive biosafety still needs further evaluation.

This paper presents an innovative fault location method for multi-terminal nonhomogeneous transmission lines by using synchronized voltage and current phasors acquired from phasor measurement units or intelligent electronic devices. We extend the previously published two-terminal and three-terminal nonhomogeneous transmission line fault location techniques developed in our lab to multi-terminal nonhomogeneous transmission lines. Specifically, a graph theory based indices and an optimal calculation data window is applied to identify the faulty line branch and to mitigate the undesirable influence caused by dc decay and the arc phenomenon of circuit breaker. The high performance of the proposed fault location method is validated by simulation results and real world utility fault data.

Introduction: Sleep disorders, depression, and cancer have become increasingly prevalent worldwide. However, it is unknown whether coexistence of sleep disorders and depression influences the risk of cancer development. Therefore, we conducted a nationwide population-based study to examine this association among patients in Taiwan. Materials and Methods: A total of 105,071 individuals diagnosed with cancer and 420,284 age- and sex-matched patients without a diagnosis of cancer between 2000 and 2015 were identified from Taiwan’s National Health Insurance Research Database. The underlying chronic diseases of patients that may developed cancer were gathered and studied as the predictor. A multivariate Cox proportional odds model was used to estimate the crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) to estimate the interaction effect between sleep disorders and depression on the risk of cancer. Results: After adjusting for age, sex, comorbidities, and other covariates, the cancer group was associated with increased exposure to sleep disorders than the non-cancer group (aOR = 1.440, 95% CI = 1.392–1.489, p < 0.001). In addition, patients with both sleep disorders and depression were at an even higher risk for cancer than the general population (aOR = 6.857, p < 0.001). Conclusions: This retrospective cohort study shows that patients with both sleep disorders and depression are at a higher risk of cancer. Clinically, a meticulous cancer risk evaluation is recommended for patients with both sleep disorders and depression.

Background: Osteolysis is one of the most prevalent clinical complications of total joint replacement (TJR). Wedelolactone (WDL) is a coumestan compound derived from the Wedelia chinensis plant and has been demonstrated to exhibit anti-inflammatory properties. This study aimed to investigate the use of WDL as a potential treatment for reducing the risk of particle-induced osteolysis using a well-established particle-induced mice calvarial disease model. Methods: Thirty-two C57BL/6J mice were randomized into four groups: sham, polystyrene particles (PS), PS particles with WDL treatment for 4 weeks (WDL 4w) and PS particles with WDL treatment for 8 weeks (WDL 8w). Micro-CT was used to quantitatively analyze the bone mass. Osteoclast numbers were also measured from histological analysis. Results: The results showed that bone mineral density was significantly higher in the WDL 8w group than in the PS group (p < 0.05), and both the WDL 4 and WDL 8w groups had lower osteoclast numbers (p < 0.05). No significant difference in osteoclast number was found between the WDL 4w and WDL 8w groups. Conclusions: These results support the use of WDL as a herbal medicine for reducing the severity of particle-induced osteolysis after TJR.

Introduction: Enterocutaneous fistulas (ECFs) can be caused by abscess formation at the site of anastomotic leakage (AL) after surgery. Rectocutaneous fistula following low anterior resection (LAR) is rare, and medical management of ECFs is usually the initial treatment. We report a case of rectocutaneous fistula after laparoscopic LAR, which was successfully treated, for the first time, with a transanal endoscopic operation (TEO). Case Presentation: A 58-year-old man presented with a history of hypertension, benign prostatic hyperplasia, peptic ulcer, and recent diagnosis of rectal cancer. The patient underwent laparoscopic LAR with coloanal anastomosis complicated with AL. He then underwent transanal repair of the anastomosis site and laparoscopy with ileostomy. Six months later, he complained of a painful mass lesion over the right buttock that relieved after passing purulent fluid and feces. Colonoscopy and imaging revealed a fistula for which he received antibiotics and wound incision and drainage. He also underwent TEO repair of the rectal fistula, recovered well, and was discharged from hospital. On follow-up 7 months later, there was no recurrence or sign of localized infection. Conclusion: TEO repair may be an effective method for managing rectocutaneous fistula after LAR complicated with AL instead of a major operation.

BACKGROUND: Sex differences in heart failure mortality might be affected by age, race, and treatment response. Many large studies in Western countries have shown conflicting results, however few studies have been conducted in Asian patients. OBJECTIVES: We prospectively investigated the mortality risk in a multicenter cohort of 1,093 male and 416 female heart failure patients with reduced ejection fraction (HFrEF) hospitalized for worsening symptoms in Taiwan between 2013 and 2015. METHODS: Kaplan-Meier curve and Cox proportional regression analyses were used to determine the one-year mortality risk by sex. RESULTS: There were no significant differences in major adverse cardiovascular events, re-admission rate, and mortality between sexes in the overall cohort and the young subgroup during one-year of follow-up. In the elderly subgroup, the overall and cardiac mortality rate of the male patients were higher than those of the female patients (p = 0.035, p = 0.049, respectively). We found that the prognostic effect of old age on overall mortality rate appeared to be stronger in the male patients (p < 0.0001) than in the female patients (p = 0.69) in Cox regression analysis and Kaplan-Meier survival curves. Male sex was a risk factor for all-cause mortality in the elderly (hazard ratio: 1.50, 95% confidence interval 1.02-2.25) independently of systolic blood pressure, diabetes mellitus, hemoglobin concentration, kidney function, and medications. CONCLUSIONS: In the Taiwan HFrEF registry, the highest mortality risk was observed in male patients aged 65 years or more. Clinicians need to pay more attention to these patients.

Background The association between elevated serum uric acid (UA) levels and the risk of developing colonic diverticulosis has not yet been investigated. Thus, this cross-sectional study aimed to examine this correlation in individuals from Taiwan. Methods From Jan. 1, 2010, to Dec. 31, 2016., approximately 5,605 patients (aged >20 years) from Tri-Service General Hospital who met the inclusion criteria according to colonoscopy and laboratory test findings were included in this research. The correlation between serum UA levels and colonic diverticulosis was investigated via regression analyses. Results Participants with elevated serum UA levels were at a higher risk of colonic diverticulosis. The area under the curve for serum UA levels was significantly higher in women than in men (0.651 [95% confidence interval: 0.596–0.707] vs. 0.55 [0.507–0.593]). There were specific trends in female-specific indicators for colonic diverticulosis across increasing quartiles of serum UA levels. Conclusions Patients with elevated serum UA levels should be cautious regarding the development of colonic diverticulosis disorder in female. Moreover, prospective studies may provide additional information on the relationship between elevated serum UA levels and colonic diverticulosis.

With the rapid development of wireless communication systems and various emerging applications, software implementations could not satisfy the real-time applications of location-based services (LBS). This article presents a three-dimensional (3D) localization algorithms based on positioning and tracking approaches. The proposed real-time positioning and tracking approaches are implemented with field programmable gate arrays (FPGAs). The hardware implementation of the FPGA-based algorithms can improve the traditional matrix operation approaches, and it has advantages of high portability, low cost, and low executing time for LBS applications.

Background Colorectal cancer (CRC) is regarded as a multifactorial disease and shares many risk factors with alcoholism. However, the association between alcoholism and CRC remains controversial. Objectives In this study, we aimed to evaluate the association between alcoholism and risk of CRC. Methods We performed a large-scale, population-based nested case-control study using the Longitudinal Health Insurance Database 2013, derived from Taiwan’s National Health Insurance Research Database, and collected data from 2000 to 2013. There were 49,095 diagnosed cases of CRC defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification. Each case was matched with three controls by sex, age, index date of CRC, and annual medical visits; a total of 147,285 controls were identified. Multiple risk factors of CRC in alcoholism cases were investigated using unconditional multiple logistic regression analysis. Results Among 49,095 cases of CRC, alcoholism was associated with a significantly higher risk of CRC (adjusted odds ratio (OR), 1.631; 95% CI, 1.565–1.699) in multivariate logistic regression, after adjusting other CRC risk factors, and in stratified analysis with multivariate logistic regression. In addition, there was a time-dependent relationship between alcoholism duration and CRC risk in >1 year, > 2 years, >5 years, and > 11 years groups (adjusted ORs, 1.875, 2.050, 2.662 and 2.670; 95% CI, 1.788–1.967, 1.948–2.158, 2.498–2.835, and 2.511–2.989 respectively). Conclusion An association between alcoholism and risk of CRC was found in this study. Furthermore, patients with longer alcoholism history showed higher likelihood of developing CRC, which indicates a time-dependent relationship between alcoholism exposure and CRC. Further research on colorectal tumorigenesis is needed.

BACKGROUND Particulate anorganic bovine bone matrix (ABBM) is extensively used for alveolar ridge preservation (ARP). This study evaluates the potential of ABBM/gelatin cryogel scaffold of regular (250 to 1,000 μm) and small (50 to 100 μm) particles for ARP. METHODS ABBM was either condensed in a gypsum ring to simulate filling of ABBM in a defect or incorporated into a gelatin cryogel scaffold to disperse ABBM. Condensed regular-sized or small-sized ABBM (rABBM or sABBM) (± bone morphogenetic protein [BMP]-2) were subcutaneously implanted in rats to evaluate biocompatibility and osteogenic potential. Experimental extraction sockets were surgically created on the maxillary ridges of rats and were unfilled (control), filled with rABBM/gelatin, or sABBM/gelatin cryogel scaffold. The socket fill and dimensional changes of the ridge were evaluated by microcomputed tomography imaging and histology. RESULTS Condensed sABBM showed acceptable biocompatibility but significantly lower interparticle distance (IPD) and porosity (P

This letter presents a fault location technique for three-terminal hybrid AC transmission lines with one off-service line branch by using synchrophasor data obtained from buses which are connected to in-service line branches. The proposed method adopts the two-terminal fault location technique to identify the faulted line branch and locate the fault point when a fault exists on the in-service line branch. Contrarily, if a fault exists on the off-service line branch, the apparent reactance that is obtained from synchronized voltage and current phasor sets of the junction point P, and sequence networks are both chosen to calculate the exact fault point. The performance evaluation shows that the proposed idea has high accuracy under different fault types and resistance.

Anemia defined as reduced hemoglobin levels of red blood cells may carry less oxygen to skeletal muscle and impair physical performance. Previous studies have shown that exercise intolerance was related to moderate or severe anemia, however, the relationship to mild anemia was unknown. We investigated the cross-sectional association of mild anemia defined as a hemoglobin level of 10.0–13.9 g/dL with physical fitness in 3,666 military young males in Taiwan in 2014. Aerobic fitness was evaluated by 3000-meter run test, and anaerobic fitness was evaluated by 2-minute sit-ups and 2-minute push-ups, respectively. Multiple logistic regressions for the best 10% and the worst 10% performers were used to determine the relationship. There were 343 mild anemic males in whom 47.8% were microcytic anemia and 3,323 non-anemic males for the analysis. The multiple logistic regression shows that as compared with non-anemic males, mild anemic males were more likely to be the worst 10% performers in the 3000-meter run test (odds ratios (OR) and 95% confidence intervals: 1.47, 1.01–2.14) after adjusting for age, service specialty, body mass index, waist size, mean blood pressure, unhealthy behaviors, lipid profiles, and exercise frequency. On the contrary, mild anemic males had higher possibility to be the best 10% performers in the 2-minute push-ups test (OR: 1.48, 1.08–2.04). However, there was no association between mild anemia and 2-minute sit-ups. Our findings suggest that unspecified mild anemia might be associated with lower cardiorespiratory fitness but not with anaerobic fitness in physically active military males.

Invasive protozoan infection with ameboma formation is relatively rare in advanced-modern countries and can be mistakenly diagnosed as a neoplasm, which constitutes the majority of conditions in medical centers. The treatment between rectal ameboma and carcinoma is different, in which the former can be treated by effective medication, and the latter may sustain invasively inconvertible surgical intervention. Herein, we present a case of a 66-year-old man with a travel history to Japan who presented with anal pain and diarrhea secondary to ulcerative rectal mass detected by colonoscopy, which resembled colorectal carcinoma. The mass lesion was later determined histopathologically to be amebic infection caused by invasive Entamoeba histolytica, which had remarkable regression after metronidazole therapy. This case highlights the necessity of complete recognition of ulcerative rectal mass before definitive treatment and inadvertent clues from travel history to achieve a good outcome.

This paper presents a three-terminal fault location algorithm based on the unsynchronized voltage and current phasors acquired from the digital relays or the Intelligent Electronic Devices (IEDs) installed in three terminals. The idea is to extend a two-terminal fault location scheme using synchrophasors to an approach regarding the three-terminal line structure with unsynchronized sampling. Firstly, a Voltage Comparison Scheme (VCS) is proposed to simultaneously identify a faulted line branch and derive the synchronization angle between the ends of the remaining two healthy branches. Subsequently, the Modified Secant-based Algorithm (MSA) is suggested to synchronize the measurements of the faulted-branch end as well as locate a fault at the same time. The effectiveness and the performance of the proposed idea have been validated by an extensive series of simulations under various fault conditions with the use of the 161 kV overhead transmission-line parameters of the Taiwan Power Company (Taipower).

In this paper, a new algorithm based on cyclic prefix (CP) is proposed for blind carrier frequency offset (CFO) estimation in orthogonal frequency division multiplexing (OFDM) transmission over multipath channels. Like other CP-based methods, the proposed method enjoys low complexity. The proposed method is very robust to the symbol timing synchronization error. Closed-form formulas for CFO estimates are derived. In addition, we also carry out the theoretical mean-square-error analysis and derive the Cramer-Rao bound. Simulation results show that the proposed method performs very well.

Epidemiological studies on the obstructive sleep apnea (OSA) and cancer relationship in humans are inconsistent. Furthermore, there are limited prospective studies on the association between OSA and the risk of colorectal cancer (CRC). This retrospective cohort study examined the longitudinal relationship between OSA and CRC in a nationwide population-based cohort.We identified 4180 individuals newly diagnosed with OSA (the exposed cohort) and randomly selected 16,720 age- and sex-matched subjects without OSA (the nonexposed cohort) between 2000 and 2008 from Taiwan's National Health Insurance Research Database (NHIRD). The Kaplan-Meier method was used for calculating the cumulative incidence of CRC in each cohort. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and the accompanying 95% confidence intervals (CIs) for the association between OSA and CRC.After adjusting for potential confounders, patients with OSA were associated with a significantly higher risk of CRC than those without OSA (adjusted HR, 1.80; 95% CI, 1.28-2.52). The cumulative incidence of CRC was significantly higher in the OSA cohort than in the comparison cohort (log-rank test, p 0.001). Furthermore, the association between OSA and CRC appeared to be enhanced with increasing frequency of OSA medical visits (adjusted HR [95% CI] was 1.61 [0.97-2.66] and 1.86 [1.26-2.75] for one visit and two or more visits, respectively).This population-based cohort study demonstrated that OSA was associated with an increased risk of CRC. Further large-scale prospective studies are needed to confirm our results.