Search Results (67)

Background: GLP-1 receptor agonists (GLP-1 RAs) lower glucose and reduce cardiovascular events in type 2 diabetes, with noted renal benefits. Few studies directly compare GLP-1 RAs. This study aims to compare the effects of semaglutide and dulaglutide on renal function decline and proteinuria reduction in diabetic patients. Methods: The present study was conducted at Wanfang Hospital, Taipei Medical University. Diabetic patients using either semaglutide or dulaglutide for more than 1 year in the outpatient department from 1 January 2022 to 30 September 2024 were enrolled retrospectively. The outcome events in the present study included a decline in the estimated glomerular filtration rate (eGFR), an increase in the urine albumin–creatinine ratio (UACR), and patient death. Results: A total of 268 patients on dulaglutide and 747 on semaglutide were included. Baseline eGFR levels were similar in both groups. After 12 months, eGFR levels did not significantly decline in both groups. However, the dulaglutide group showed significantly higher UACR increases than the semaglutide group (p < 0.01). More death events also occurred in the dulaglutide group (p < 0.01). Multivariate logistic regression revealed a higher risk of UACR increase with dulaglutide (p < 0.01). Subgroup analysis found dulaglutide associated with higher UACR in patients younger than 60, males, those with hypertension, without heart failure, those using angiotensin receptor blockers, biguanides, and statins, and those not using sodium-glucose cotransporter-2 inhibitors. Conclusions: Dulaglutide and semaglutide had comparable effects on slowing eGFR decline. However, dulaglutide was less effective in reducing UACR, particularly in the subgroups mentioned above. Full article

Black soybean okara is a common food byproduct in Asia. This study conducted collaborative fermentation with Rhizopus oligosporus and Yarrowia lipolytica to produce a GABA-enriched okara product. Two black soybean varieties, TN3 and TN5, were used, and optimal fermentation conditions were predicted using response surface methodology (RSM). After 24 h of Rhizopus oligosporus incubation, Yarrowia lipolytica was inoculated under 20 trial conditions with variations in temperature, incubation time, and inoculation size. The model predicted that the highest GABA content would be achieved at 34–35 °C, 47–49 h incubation, and 3–4 log CFU/mL inoculation. Under these optimal conditions, the maximum GABA yields achieved were 868.3 µg/g for TN3 and 853.1 µg/g for TN5. Fermentation conditions had minimal influence on protease activity, which may be attributed to the distinct roles of Rhizopus oligosporus and Yarrowia lipolytica in the fermentation process. The solid-state collaborative fermentation technology supports food waste recycling and enhances product functionality, contributing to the circular economy. Full article

The changes in the physicochemical properties of fermented black bean dregs (FBBD) coated with carboxymethyl cellulose (CMC) solution (0–3%) and pectin solution (0–3%) on a fluidized bed were analyzed. The Carr index of the FBBD powder decreased from 55.4 ± 0.3% to 7.5 ± 0.4% after coating with CMC solution (3%) and to 11.3 ± 1.6% after coating with pectin solution (3%) for 120 min. After coating with CMC solution (3%) for 120 min, the proportion of medium-sized particles decreased significantly with the increased duration of the coating process, whereas the proportion of large-sized particles increased. Microstructural analysis by scanning electron microscopy showed that the particle size significantly increased and the surface changed from rough to smooth. The L* and b* values of the powder samples decreased from 45.5 ± 0.1 and 17.2 ± 0.1 to 32.9 ± 0.2 and 15.3 ± 0.1, respectively, whereas the a* value increased from 7.6 ± 0.1 to 8.9 ± 0.1; thus, the sample color changed from bright to dark and tended toward bluish and reddish colors. The wettability and solubility of the powder samples increased significantly with the increased duration of the coating process, but the water-holding capacity decreased. Moreover, FBBD coated with pectin solution (3%) and CMC solution (3%) on a fluidized bed for 120 min exhibited similar physicochemical properties. Thus, FBBD powder exhibited favorable flowability, wettability, and solubility after 120 min of coating with CMC solution (3%) or pectin solution (3%). Full article

Background: Invasive coronary angiography is the gold standard for assessing in-stent restenosis (ISR) in patients with coronary artery disease. However, the predictive value of non-invasive Tissue Doppler Imaging (TDI) to evaluate patients with ISR has not been studied extensively. Methods: A total of 41 patients (19 with acute myocardial infarction and 22 with stable angina pectoris) who received percutaneous coronary intervention (PCI) were enrolled in the study. Time-to-peak velocities (TpV) of 12 non-apical segments of the left ventricle, by pulse wave TDI echocardiography, were obtained within two days prior to the PCI and six months later. Results: A 12-segmental mean TpV ≥ 279.6 ms at six months after PCI was able to detect ISR (odds ratio: 2.09, 95% CI 1.004–4.352, p = 0.049). Moreover, a significant decrease in the standard deviation of TpV was demonstrated in patients without ISR (85.8 ± 44.8 vs. 60.3 ± 31.7 ms, p = 0.001), but not in patients with ISR (97.7 ± 53.3 vs. 91.2 ± 52.6 ms, p = 0.57). Conclusions: Pulse-wave TDI echocardiography is a promising tool in the detection of ISR six months after PCI in patients with coronary artery disease. Full article

This study conducted field measurements to explore the effects of street spatial structure on micrometeorological condition and air quality on both hot and cool days in Taipei City. Six street canyons with an aspect ratio of one, but varied in street orientation, street width, sky view factor, and number of planting strips, were selected for observations. In this case study, it was observed that, as well as the meso-scale phenomena, the local and micro-scale (street canyon structure) had influences on street air temperature, mean radiant temperature, and wind velocity. However, the local and micro-scales only had minor effects on relative humidity for both hot and cool days. Shade effect on temperature by street trees was observed; this effect could cause 2 degrees drop on mean radiant temperature and about 0.5 degree drop on air temperature. Our analyses and field measurements also revealed that, in some cases, concentrations of PM_2.5 and PM₁₀ were found to be correlated with local street canopy structure; however, in some cases, the meso-scale process was found to be the dominant factor. We also found that concentrations of CO and O₃ were inversely correlated in the street canyon. The findings of this study provide introductory scientific data and guidelines for urban street designers to improve thermal comfort and air quality. Full article

Background and Objectives: Chronic kidney disease (CKD) poses a significant global health challenge, necessitating effective renal replacement therapies. Peritoneal dialysis (PD) offers a patient-friendly, home-based alternative to hemodialysis. The Stepwise Initiation of Peritoneal Dialysis (SIPD) method, used in the SPD group and involving a gradual introduction of PD, presents a potential advantage over traditional protocols, yet the scientific literature on its efficacy and safety is limited. Materials and Methods: We conducted a retrospective analysis of 39 end-stage renal disease patients undergoing SIPD and 78 patients receiving conventional PD (CPD) at a single center from 1 January 2010 to 31 December 2023. Patients were matched for age and sex. Surgical techniques, early and late complications, infection rates, and catheter survival were evaluated. Data were analyzed using statistical methods, including the chi-square test, t-test, and negative binomial regression. Results: The mean break-in period was significantly more extended for the SPD group (176.05 ± 154.39 days) compared to the CPD group (26.87 ± 58.45 days). Early complications were similar between groups, but late complications, including peritonitis, were significantly higher in the CPD group. The SPD group experienced fewer infection events (28 vs. 80, p = 0.043). Median catheter survival times were 1486 days for SPD and 1774 days for CPD, with no statistical difference. Age was a significant factor in peritonitis incidence, increasing with age in both groups. Conclusions: Our study suggests that SPD may reduce the incidence of catheter-related infections and peritonitis compared to CPD. The extended break-in period in SPD could enhance tissue healing and reduce biofilm formation, thereby contributing to fewer infectious complications. Despite these findings, no significant difference in overall catheter survival was observed. Further multi-center studies with larger sample sizes are recommended to confirm these results and explore the economic impact of SPD vs. CPD. Full article

Background: Hepatocellular carcinoma (HCC) remains a significant concern for patients with chronic hepatitis C (HCV), even after achieving a sustained virological response (SVR) with direct-acting antivirals (DAAs) or interferon (IFN)-based therapies. This study compared the risk of HCC in patients with HCV who achieved SVR through the DAA versus IFN regimens. Methods: A retrospective analysis was conducted on 4806 HCV patients, without coinfection nor prior HCC history, treated at the Chang Gung Memorial Hospital, Taiwan (DAA: 2825, IFN: 1981). Kaplan–Meier and Cox regression analyses with propensity score matching (PSM) were used to adjust for baseline differences. Results: DAA-treated patients exhibited a higher incidence of HCC than IFN-treated patients before and after PSM (after PSM: annual: 1% vs. 0.5%; 6-year: 6% vs. 3%, p = 0.01). Both DAA and IFN patients had a decreased HCC incidence during follow-up (>3 vs. <3 years from the end of treatment: DAA: 1.43% vs. 1.00% per year; IFN: 0.47% vs. 0.36% per year, both p < 0.05). HCC incidence was higher in the first three years post-SVR in DAA-treated ACLD patients and then decreased (3.26% vs. 1.39% per year, p < 0.01). In contrast, HCC incidence remained constant in the non-ACLD and IFN-treated groups. Multivariate Cox regression identified age ≥ 60, male sex, BMI, AFP ≥ 6 ng/mL, FIB-4, and ACLD status as independent risk factors for HCC, but antiviral regimens were not an independent factor for HCC. Conclusion: DAA treatment significantly affects HCC risk primarily within three years post-treatment, especially in younger HCV patients with ACLD. HCC incidence was reduced after three years in ACLD patients treated by DAA, but continued surveillance was still necessary. However, patients under 60 without advanced liver disease may require less intensive follow-up. Full article

Background: Post-acute sequelae of SARS-CoV-2 infection (PASC) affects patients after recovering from acute coronavirus disease 2019 (COVID-19). This study investigates the impact of SARS-CoV-2 vaccination on PASC symptoms in children in Taiwan during the Omicron pandemic. Methods: We enrolled children under 18 years with PASC symptoms persisting for more than 4 weeks. Data collected included demographics, clinical information, vaccination status, and symptom persistence. We used logistic regression models to compare symptoms in the acute and post-COVID-19 phases and to assess the association between vaccination and these symptoms. Results: Among 500 PASC children, 292 (58.4%) were vaccinated, 282 (52.8%) were male, and the mean (SD) age was 7.6 (4.6) years. Vaccinated individuals exhibited higher odds of experiencing symptoms in the previous acute phase, such as cough (adjusted odds ratio [AOR] = 1.57; 95% confidence interval [CI]: 1.02–2.42), rhinorrhea/nasal congestion (AOR = 1.74; 95% CI: 1.13–2.67), sneezing (AOR = 1.68; 95% CI: 1.02–2.76), sputum production (AOR = 1.91; 95% CI: 1.15–3.19), headache/dizziness (AOR = 1.73; 95% CI: 1.04–2.87), and muscle soreness (AOR = 2.33; 95% CI: 1.13–4.80). In contrast, there were lower odds of experiencing abdominal pain (AOR = 0.49; 95% CI: 0.25–0.94) and diarrhea (AOR = 0.37; 95% CI: 0.17–0.78) in children who had received vaccination during the post-COVID-19 phase. Conclusions: This study revealed clinical features and vaccination effects in PASC children in Taiwan. Vaccination may reduce some gastrointestinal symptoms in the post-COVID-19 phase. Full article

Background: Heart failure (HF) remains a leading cause of morbidity and mortality globally, necessitating the identification of reliable prognostic biomarkers to guide therapeutic interventions. Recent clinical observations have underscored phenylalanine (PHE) as a prognostic marker in HF, although the mechanisms involving inter-organ crosstalk remain understood. Methods: This study adopted a dull approach, with a retrospective analysis of 550 HF patients to establish the prognostic value of pre-discharge PHE levels and a study on the inter-organ crosstalk of PHE among 24 patients. We analyzed the correlations between PHE concentrations and clinical outcomes, alongside a comprehensive examination of PHE metabolism across the skeletal muscle, liver, heart, kidney, and lung. Results: In the clinical prognostic analysis of 550 patients hospitalized for acute decompensated HF, elevated PHE levels (≥65.6 μM) were significantly and independently associated with increased all-cause mortality during a median follow-up of 4.5 years (log rank = 36.7, p < 0.001), underscoring its value as a prognostic marker in HF. The inter-organic crosstalk study elucidated the mechanism associated with PHE elevation in patients with HF, characterized by an increase in PHE output in skeletal muscle and a decrease in hepatic and cardiac PHE uptakes. Notably, PHE concentration gradients across these organs were correlated with HF severity, such as the NYHA functional class, B-type natriuretic peptide levels, and the presence of acute HF. Conclusions: Our findings confirm the prognostic significance of PHE in patients with HF and unveil the complex metabolic interplay among key organs that contribute to PHE dysregulation. These insights not only reinforce the importance of metabolic monitoring in HF management but also open avenues for therapeutic targets. Full article

We treated dry black bean dreg fermentation products with radio-frequency (RF) waves. With RF treatment (RF output power of 3 kW and electrode gap of 12 cm), a sample was dried within 1 h, which would take 10 h to dry via hot-air drying at 60 °C (sample weight reduction from 100 to 28.2 g). RF treatment thus accelerated fermented black bean dreg drying approximately 10-fold. The fermented black bean dregs were dried for 60 min at a fixed RF output power of 3 kW with different electrode gaps (12, 16, and 20 cm). Samples treated with electrode gaps of 12 and 16 cm were completely dried. When the fermented black bean dregs were dried for 60 min with an RF output power of 3 kW with a 16 cm electrode gap, their water activity decreased from 0.98 to 0.65. Colorimetric analysis showed that the sample color darkened significantly (ΔE = 5.73 ± 2.71), whereas its solubility (28.8 ± 0.1%) and antioxidant capacity (EC₅₀ = 51.7 ± 0.7 mg/mL) increased. In addition, deglycosylated isoflavone daidzein content significantly increased, whereas that of the glycosylated isoflavone genistin decreased. These results reveal that RF application can efficiently dry fermented black bean dregs. Full article

Calcium titanium oxide has emerged as a highly promising material for optoelectronic devices, with recent studies suggesting its potential for favorable thermoelectric properties. However, current experimental observations indicate a low thermoelectric performance, with a significant gap between these observations and theoretical predictions. Therefore, this study employs a combined approach of experiments and simulations to thoroughly investigate the impact of structural and directional differences on the thermoelectric properties of two-dimensional (2D) and three-dimensional (3D) metal halide perovskites. Two-dimensional (2D) and three-dimensional (3D) metal halide perovskites constitute the focus of examination in this study, where an in-depth exploration of their thermoelectric properties is conducted via a comprehensive methodology incorporating simulations and experimental analyses. The non-equilibrium molecular dynamics simulation (NEMD) was utilized to calculate the thermal conductivity of the perovskite material. Thermal conductivities along both in-plane and out-plane directions of 2D perovskite were computed. The NEMD simulation results show that the thermal conductivity of the 3D perovskite is approximately 0.443 W/mK, while the thermal conductivities of the parallel and vertical oriented 2D perovskites increase with n and range from 0.158 W/mK to 0.215 W/mK and 0.289 W/mK to 0.309 W/mK, respectively. Hence, the thermal conductivity of the 2D perovskites is noticeably lower than the 3D ones. Furthermore, the parallel oriented 2D perovskites exhibit more effective blocking of heat transfer behavior than the perpendicular oriented ones. The experimental results reveal that the Seebeck coefficient of the 2D perovskites reaches 3.79 × 10² µV/K. However, the electrical conductivity of the 2D perovskites is only 4.55 × 10⁻⁵ S/cm, which is one order of magnitude lower than that of the 3D perovskites. Consequently, the calculated thermoelectric figure of merit for the 2D perovskites is approximately 1.41 × 10⁻⁷, slightly lower than that of the 3D perovskites. Full article

Trails are important recreation settings; determining an appropriate trail usage amount to avoid unacceptable ecological impacts is important for protected areas. However, there is a lack of studies examining trail usage’s direct and indirect relationships and the influence of landscape-level conditions to evaluate ecological carrying capacity. This study integrated a path analysis model and stakeholder assessment to estimate the ecological carrying capacity of trails in a protected area. This study surveyed the biophysical environment along the trails and conducted a path analysis to establish the use–impact model for the trails in the study area. Based on the use–impact model, this study developed four-level usage scenarios and collected the stakeholders’ acceptance evaluation to determine the ecological carrying capacity range. The results showed that the weekly usage of the trails directly affected the soil hardness and plant coverage of the trail. The trail’s soil hardness directly affected the surrounding soil hardness, decreasing its plant coverage, while the vegetation type and slope also affected its plant cover. The stakeholders of the Mt. Xiaoguanyin Area reached a consensus on the ecological carrying capacity range, which was 288 to 404 total weekly hikers. The study results revealed the effect paths of the landscape-level conditions and usage impacts and provided managers with an implementable ecological carrying capacity. The estimation framework could be a reference for determining ecological carrying capacity in other protected areas. Full article

Ground heat flux may play an important role in surface energy balance. In this study we evaluate the performance of the objective hysteresis model (OHM) for estimating ground heat flux from net radiation and compare it with the linear regression model. The experimental sites include residential roofs (concrete), campus grassland, agricultural grassland, and peat bog. Our field measurements show that the mean partition coefficient from net radiation to ground heat flux varied from 0.47 (concrete roof) to 0.079 (agricultural grassland). The mean hysteresis (lag) factors for residential roof, campus grassland, and peat bog were 0.55, 0.26, and −0.11 h, respectively; and the hysteresis factor at the agricultural site was only 0.032 h. However, the partition and hysteresis coefficients in the OHM were found to vary with time for the same surface. Our measurements and analysis show that when the hysteresis factor is larger than 0.11 h, ground heat flux estimates from net radiation can be improved (17–37% reduction in the root mean square error) by using OHM instead of a simple linear regression model. Full article

Canopy resistance is a key parameter in the Penman–Monteith (P–M) equation for calculating evapotranspiration (ET). In this study, we compared a machine learning algorithm–support vector machine (SVM) and an analytical solution (Todorovic, 1999) for estimating canopy resistances. Then, these estimated canopy resistances were applied to the P–M equation for estimating ET; as a benchmark, a constant (fixed) canopy resistance was also adopted for ET estimations. ET data were measured using the eddy-covariance method above three sites: a grassland (south Ireland), Cypress forest (north Taiwan), and Cryptomeria forest (central Taiwan) were used to test the accuracy of the above two methods. The observed canopy resistance was derived from rearranging the P–M equation. From the measurements, the average canopy resistances for the grassland, Cypress forest, and Cryptomeria forest were 163, 346, and 321 (s/m), respectively. Our results show that both methods tend to reproduce canopy resistances within a certain range of intervals. In general, the SVM model performs better, and the analytical solution systematically underestimates the canopy resistances and leads to an overestimation of evapotranspiration. It is found that the analytical solution is only suitable for low canopy resistance (less than 100 s/m) conditions. Full article

The effects of transglutaminase (TGase), reductant, and thermal treatment on the cross-linking of white proteins in soft-shell turtle eggs were investigated. Egg white proteins were denatured by reductant (0.83% 2-mercaptoethanol, 2-ME) pretreatment and thermal pretreatment (95 °C and 5 min), and the denatured proteins were then catalyzed by TGase (1.0 unit/mL). SDS–PAGE showed that without any pretreatments, three major egg white proteins (210 kDa, 115 kDa, and 76 kDa proteins) were inferior substrates for TGase. Only portions of the 210 kDa protein (7.9%), 115 kDa protein (11.4%), and 76 kDa protein (42.9%) were polymerized by TGase into high-molecular-weight (MW) protein polymers (>180 kDa) after incubation for 3 h at 40 °C. However, the combined use of TGase with 0.83% 2-ME and thermal pretreatment led to a significant increase (p < 0.05) in the rate of white protein polymerization after 3 h: 210 kDa protein (90.8%), 115 kDa protein (69.5%), and 76 kDa protein (72.2%). Particle size analysis indicated that these cross-linked high-MW protein polymers were 2000–10,000 nm in size. Based on the experimental results, egg white proteins denatured by 2-ME and heat pretreatment are more prone to TGase-induced cross-linking. Full article