Search Results (285)

Lactoferrin (LF), a multifunctional glycoprotein found abundantly in bovine colostrum, is known for its regenerative and anti-inflammatory properties. In this study, we investigated the wound healing and immunomodulatory effects of colostrum-derived exosome-encapsulated lactoferrin (EV-exoLF) on dermal fibroblasts. EV-exoLF was isolated and characterized via nanoparticle tracking analysis and flow cytometry. Functional assays demonstrated that EV-exoLF significantly promoted fibroblast viability and migration in both mouse NIH/3T3 and human HS-68 cell lines. Furthermore, EV-exoLF reduced the expression of pro-inflammatory cytokines (IL-1 and IL-6) and phosphorylated JNK in lipopolysaccharide (LPS)-treated fibroblasts. These findings suggest that EV-exoLF not only enhances fibroblast-mediated wound closure but also mitigates inflammation, highlighting its therapeutic potential in skin regeneration. Colostrum-derived exosomal lactoferrin may serve as a promising natural, cell-free strategy for managing inflammatory skin conditions and improving wound healing outcomes. Full article

Introduction: Total knee arthroplasty (TKA) is a treatment for knee pain, but some patients are not satisfied with their outcomes. Utilizing shared decision making (SDM) can lead to better decisions, satisfaction, and fewer regrets. However, healthcare professionals have little knowledge of risk factors for regret. The aim of this study is to evaluate decisional regret using the Decision Regret Scale (DRS) after primary TKA among patients who engaged in SDM. Method: A total of 118 patients who underwent TKA surgery between March 2020 and May 2022 participated in this study, and they were able to reflect on their outcomes. The primary outcome was decisional regret assessed using the DRS, and the secondary outcome was post-operative pain at a three-month follow-up, measured using the Lequesne Index. Result: The study found that 49% of the patients reported no regret, 25% reported mild regret, and 26% reported moderate-to-severe regret. There was a significant correlation between greater levels of decision regret and a higher three-month Lequesne Index. Post-operative pain and post-operative mobility status and the range of motion of the knee joint were also strongly correlated. Conclusion: The study found that more than half of the patients undergoing primary TKAs experienced regret even following SDM counseling. Regret levels were associated with higher post-operative pain and poorer mobility. This underscores the importance of informing patients about potential adverse effects of TKA to manage their expectations and reduce regret in future SDM interviews. Practice implications: This study incorporated patient perspectives through their direct engagement in the SDM process prior to surgery. Patients participated in the design of the SDM framework, which included educational pamphlets and structured interviews to assess their values and preferences. Their involvement ensured that the SDM procedure was tailored to patient-centered outcomes. Furthermore, the follow-up assessments were conducted with patients to evaluate decisional regret and post-operative outcomes, providing valuable insights into the effectiveness of the SDM process. By actively participating in the research through decision making and outcome reflection, the patients contributed to the understanding of factors influencing decisional regret after undergoing TKA. Full article

Background: Thermal ablation of centrally located liver tumors carries an increased risk of bile duct injury due to their proximity to the biliary tree. We aim to evaluate whether biliary cooling using a nasobiliary tube can effectively mitigate bile duct injury during the ablation process. Methods: We retrospectively analyzed the data of 322 patients who underwent thermal ablation at Dalin Tzu Chi Hospital from July 2020 to June 2023 and identified those who received prophylactic biliary cooling during thermal ablation for central liver tumors. Data including demographics, tumor characteristics, procedural details, and clinical outcomes were analyzed. Results: Among the 322 patients who underwent thermal ablation, 9 with central liver tumors received prophylactic biliary cooling. The median distance between the tumor and the central bile duct was 1 mm (range: 0–4 mm), the temperature of the cold normal saline was 4 °C, and the mean volume of normal saline infused was 150 mL (range: 100–200 mL). Complete ablation was achieved in all patients in a single session without any biliary injury. One patient developed acute cholangitis after ENBD placement, which resolved with antibiotic therapy. Conclusions: Biliary cooling with 4 °C cold saline through a nasobiliary tube can improve the safety and effectiveness of thermal ablation for central liver tumors. Full article

Nanocomposite hydroxypropyl-beta-cyclodextrin functionalized reduced graphene oxide sheets (HpβCD@rGOs) with zinc oxide flaky structures (ZnOFs) were synthesized. The ZnOFs/HpβCD@rGOs were first characterized to examine their physicochemical characteristics. The ZnOFs exhibited a highly crystalline structure intertwined with HpβCD@rGO sheets. The electrocatalyst experienced excellent electrochemical oxidation current responses toward melatonin (MTN). The interaction between the catalyst and MTN improves electrochemical activity through a synergistic action, which can be measured by a glassy carbon electrode (GCE) modified with ZnOFs/HpβCD@rGOs. This modified electrode with the increased reactive sites and a large electrochemically active surface area allows the rapid oxidation reaction of MTN. The oxidation of MTN was detected and measured with a linearity range around 0.014–0.149 and 1.149–643.341 (µM), with a low detection limit (LOD) of around 0.0105 µM or 10.5 nM. The sensitivity was around 6.19 μA μM⁻¹ cm⁻². The constructed electrode demonstrated a notable level of selectivity to MTN when the interfering (biological) chemicals with a similar structure to MTN were introduced. The real samples were tested in order to examine whether the ZnOFs/HpβCD@rGOs/GCE can be developed for the biomedical monitoring of compounds. The results suggest that ZnOFs/HpβCD@rGOs/GCE can detect MTN in in vitro human samples. Furthermore, the cost-effectiveness, enhanced electrochemical capabilities, and easy fabrication of the electrode make the ZnOFs/HpβCD@rGOs composite a feasible solution for the future industrial development of monitoring tools as sensors. Full article

This study investigated common diagnoses from surgical biopsies of domestic rabbits (Oryctolagus cuniculi) in Taiwan and examined the role of leporipoxvirus in tumor pathogenesis. Biopsy specimens from 70 rabbits collected between 2014 and 2023 were retrospectively analyzed, yielding 85 diagnoses. Polymerase chain reaction (PCR) was performed to detect leporipoxvirus in formalin-fixed, paraffin-embedded tissues diagnosed with fibroma, fibrosarcoma, or myxosarcoma. The most commonly affected systems were the integumentary (n = 41) and reproductive (n = 36) systems. Common integumentary tumors included fibrosarcomas (n = 12), trichoblastomas (n = 8), mammary gland tumors (n = 5), and fibromas (n = 4). In the reproductive system, the most common lesions were uterine adenocarcinomas (n = 16), uterine endometrial cystic hyperplasia and hypertrophy (n = 5), and uterine adenomyosis (n = 4). The 15 cases of fibroma, fibrosarcoma, and myxosarcoma were tested for leporipoxvirus using PCR. No viral sequences were detected in these tumors. This study identified the common diagnoses from rabbit biopsy specimens and found no leporipoxvirus infection in samples of fibrosarcoma and fibroma. This is the first study on tumors in pet rabbit biopsies and the first in Taiwan to investigate leporipoxvirus infection, providing valuable insights for future diagnosis and management. Full article

Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory disorder characterized by persistent airway inflammation and progressive airflow limitation, resulting in a significant global health burden and high mortality. This narrative review synthesizes the current evidence on the roles of leukocyte subtypes—including neutrophils, monocytes, lymphocytes, eosinophils, and basophils—in the pathogenesis and clinical management of COPD. Relevant original studies and reviews are included, providing data on leukocyte functions, associated biomarkers, and therapeutic implications. Neutrophils contribute to airway damage and remodeling by releasing proteases and reactive oxygen species, particularly in response to environmental exposure such as cigarette smoke or air pollution. Lymphocytes, especially CD8⁺ T cells, drive chronic inflammation and immune dysregulation. Monocytes differentiate into macrophages that promote airway fibrosis and persistent inflammation, further impairing lung function. Eosinophils, though classically linked to asthma, are now recognized for their role in eosinophilic COPD, where they are associated with an increased exacerbation risk and corticosteroid responsiveness. Basophils, though less studied, may influence airway inflammation through interactions with eosinophils and cytokine release. Understanding these immune cell dynamics provides insights into the heterogeneity of COPD and highlights potential targets for precision therapy. Tailored interventions based on inflammatory phenotypes may improve clinical outcomes and advance personalized treatment strategies. Full article

With the increasing use of open educational resources (OERs) in higher education, and the potential of OERs to enhance student learning, this study investigated minority students’ perceptions of using OERs in learning computer programming. The influence of minority students’ OER perceptions on their learning outcomes, as well as the relationships of the perception variables were explored. The participants were minority students from an HBCU institution in the southeastern United States. Quantitative approaches were used to analyze the collected data. The results indicated that the minority students’ perceptions of using OERs had a significant influence on their perceived learning outcomes in learning computer programming. OER self-efficacy did not influence the minority students’ perceived learning for programming. Understanding of OERs, OER interest, and OER self-efficacy significantly predicted the minority students’ perceived value/usefulness of OERs in learning coding. Full article

Background/Objectives: Patients with inflammatory bowel disease (IBD) are at a higher risk of developing bone disorders. Awareness and understanding of the disease are crucial for prevention and early diagnosis. Currently, there is no research on the risk factors and knowledge of bone fragility in the population with IBD in Taiwan. This study aimed to evaluate the risk factors and self-assessed knowledge levels of bone health among patients with IBD in Taiwan. Methods: This single-center cross-sectional study included 59 adult patients. Clinical data, blood tests, bone mineral density (BMD), T-score, Z-score, and questionnaires covering self-assessed knowledge, fracture risks, and physical activity were assessed. The patients were divided into normal and low BMD groups. Results: Of all participants, eighteen (30.5%) had low BMD: six (10.2%) had BMD below the expected range, ten (16.9%) had osteopenia, and two (3.4%) had osteoporosis. Vitamin D insufficiency and deficiency were observed in 26.3% and 66.6% of the patients, respectively. According to multivariate analysis, age and sex hormone deficiency are strongly associated with low BMD. Educational interventions significantly improved the patients’ self-assessed knowledge levels. Conclusions: Age and sex hormone deficiency are significant factors contributing to low BMD in IBD patients. Not only women but also men with IBD who had symptoms of hypogonadism are at high risk for low BMD. Educational interventions improve self-assessment knowledge regarding the relationship between IBD and bone health. Full article

Titanium alloys are widely used in the aerospace, automotive, chemical, and biomedical industries due to their excellent corrosion resistance, mechanical properties, and biocompatibility. However, the surface properties of titanium alloys are often insufficient to meet the increasingly complex requirements of certain applications. Therefore, enhancing the surface performance of titanium alloys in physiological environments has become a key focus of research. In this study, a porous oxide layer was generated on the surface of a titanium substrate through micro-arc oxidation (MAO). This layer served as an intermediate layer for a subsequently deposited polyurethane (PU) coating, providing a strong foundation for adhesion. The high porosity of the MAO layer not only facilitated the adhesion of the PU coating but also protected the titanium alloy, further enhancing its corrosion resistance. The surface microstructure after MAO treatment and the morphological changes after application of the PU coating were characterized using scanning electron microscopy. The PU layer uniformly covered the surface of the MAO layer, significantly improving the smoothness and uniformity of the surface. The increase in surface smoothness due to the PU coating on top of the MAO layer was verified through white light interferometry. Additionally, surface hydrophobicity was assessed through water contact angle measurements. The PU layer over the MAO coating significantly enhanced the hydrophobicity of the titanium alloy’s surface, which is crucial for reducing biofouling and improving the effectiveness of biomedical implants. Finally, electrochemical analysis was conducted to study the corrosion resistance of the titanium alloy after MAO and PU treatment. The titanium alloy with an MAO–PU composite coating exhibited the highest corrosion resistance. The findings revealed that the combination of the MAO layer and PU coating provides an excellent multifunctional protective layer for titanium alloys, not only enhancing their durability but also their ability to adapt to physiological and harsh environments. Full article

Background/Objectives: Porcine reproductive and respiratory syndrome virus (PRRSV) has a major impact on swine productivity. Modified-live vaccines (MLVs) are used to aid in control. We investigated the cross-protection provided by a lineage 7 PRRSV MLV against a lineage 1 isolate under laboratory conditions and a lineage 3 challenge under field conditions in Taiwan. Methods: In the first study, thirty PRRS antibody-negative conventional piglets were vaccinated via the intramuscular (IM) or the intradermal (ID) route, with the control group receiving a placebo. Four weeks after immunization, all groups were challenged with a Taiwanese lineage 1 strain. The standard protocol for detection of reversion to virulence was applied to the vaccine strain in the second study, using sixteen specific pathogen-free piglets. In the third study, on an infected pig farm in Taiwan (lineage 3 strain), three hundred piglets were randomly selected and divided into three groups, each injected with either the PrimePac^® PRRS vaccine via the IM or the ID route, or a placebo. Results: In the first study, both vaccinated groups demonstrated reduced viraemia compared to the control group. The second study demonstrated that the MLV strain was stable. In the third study, piglet mortality, average daily weight gain, and pig stunting rate were significantly improved in the vaccinated groups compared to the control group. Conclusions: PrimePac^® PRRS is safe to use in the field in the face of a heterologous challenge, successfully providing cross-protection against contemporary lineage 1 and lineage 3 PRRSV strains from Taiwan. Full article

5G technology and IoT devices are improving efficiency and quality of life across many sectors. IoT devices are often used in open environments where they handle sensitive data. This makes them vulnerable to side-channel attacks (SCAs), where attackers can intercept and analyze the electromagnetic signals emitted by microcontroller units (MCUs) to expose encryption keys and compromise sensitive data. To address this critical vulnerability, this study proposes a novel dynamic key replacement mechanism specifically designed for lightweight IoT microcontrollers. The mechanism integrates Moving Target Defense (MTD) with a lightweight Diffie–Hellman (D-H) key exchange protocol and AES-128 encryption to provide robust protection against SCAs. Unlike traditional approaches, the proposed mechanism dynamically updates encryption keys during each cryptographic cycle, effectively mitigating the risk of key reuse—a primary vulnerability exploited in SCAs. The lightweight D-H key exchange ensures that even resource-constrained IoT devices can securely perform key exchanges without significant computational overhead. Experimental results demonstrate the practicality and security of the proposed mechanism, achieving key updates with minimal time overhead, ranging from 12 to 50 milliseconds per encryption transmission. Moreover, the approach shows strong resilience against template attacks, with only two out of sixteen AES-128 subkeys compromised after 20,000 attack attempts—a notable improvement over existing countermeasures. The key innovation of this study lies in the seamless integration of MTD with lightweight cryptographic protocols, striking a balance between security and performance. This dynamic key replacement mechanism offers an effective, scalable, and resource-efficient solution for IoT applications, particularly in scenarios that demand robust protection against SCAs and low-latency performance. Full article

Background/Objectives: Mechanical power (MP) refers to ventilator-delivered energy to the lungs, which may induce lung injury. We examined the relationship between MP and mortality in patients with acute respiratory distress syndrome (ARDS) who underwent prone positioning. Methods: This multicenter retrospective study included data on all patients admitted to the intensive care units of eight referral hospitals in Taiwan from October 2015 to March 2016, and in Chang Gung Memorial Hospital Linkou branch from January 2017 to October 2023. The data were obtained from the electronic medical records of each hospital by using a standard case report form. MP was calculated as follows: MP (J/min) = 0.098 × VT × RR × (Ppeak − 1/2 × ΔP). Results: We included 135 patients who underwent prone positioning. Among them, 28-day survivors had significantly lower MP (22.6 ± 6.5 vs. 25.3 ± 6.2 J/min, p = 0.024), MP/predicted body weight (PBW) (396.9 ± 118.9 vs. 449.3 ± 118.8 10⁻³ J/min/kg, p = 0.018), MP/compliance values (0.8 ± 0.3 vs. 1.1 ± 0.4 J/min/mL/cmH₂O, p = 0.048) after prone positioning, and significantly lower changes in MP, MP/PBW, and MP/compliance (−0.6 ± 5.7 vs. 2.5 ± 7.4 J/min, p = 0.007; −9.2 ± 97.5 vs. 42.1 ± 127.9 10⁻³ J/min/kg, p = 0.010; −0.1 ± 0.3 vs. 0.2 ± 0.3 J/min/mL/cmH₂O, p < 0.001, respectively). Multivariate Cox regression revealed that the change in MP/compliance (HR: 7.972, p < 0.001) was an independent predictive factor for 28-day mortality. Conclusions: In ARDS patients treated with prone positioning, MP/compliance, and change in MP, MP/PBW, and MP/compliance after prone positioning differed significantly between 28-day survivors and nonsurvivors. Further randomized controlled research is required to elucidate the potential causality of decreased MP and improved clinical outcomes. Full article

Transarterial microembolization (TAME) is an innovative approach to treating chronic musculoskeletal pain. During the procedure, intraprocedural vasospasm, presenting juxta-catheter stenosis, and poor distal artery perfusion and flow through the anastomosis commonly pose challenges. Difficulty of the catheter reaching the target vessel and restricted drug delivery are possible consequences. To address these issues, transcatheter nitroglycerin (NTG) infusion at the extremity’s small-sized artery has been introduced. We investigated patients who underwent the TAME procedure wherein NTG was employed and sourced from two institutional settings. Transcatheter NTG infusion was administered in seven instances of chronic musculoskeletal pain manifesting with intraprocedural vasospasm during TAME procedures. Patient profiles, preprocedural imaging, fluoroscopic findings, adverse events, and Numerical Rating Scale (NRS) scores were evaluated. As a result, all seven cases experiencing intraprocedural vasospasm exhibited rapid responses to transcatheter NTG infusion. Angiography conducted pre- and post-infusion demonstrated increased vessel size, resolved proximal catheter stenosis, and improved distal perfusion. One case presented an adverse effect of self-limited transient hypotension. The NRS scores decreased following the procedure. Transcatheter NTG infusion at the extremity’s small-sized muscular artery can be an effective technique for resolving intraprocedural vasospasm in TAME procedures, irrespective of the target diseases and approach vessels. Full article

Unsupervised domain adaptation (UDA) focuses on transferring knowledge from the labeled source domain to the unlabeled target domain, reducing the costs of manual data labeling. The main challenge in UDA is bridging the substantial feature distribution gap between the source and target domains. To address this, we propose Polarized Attention Network Domain Adaptation (PANDA), a novel approach that leverages Polarized Self-Attention (PSA) to capture the intricate relationships between the source and target domains, effectively mitigating domain discrepancies. PANDA integrates both channel and spatial information, allowing it to capture detailed features and overall structures simultaneously. Our proposed method significantly outperforms current state-of-the-art unsupervised domain adaptation (UDA) techniques for semantic segmentation tasks. Specifically, it achieves a notable improvement in mean intersection over union (mIoU), with a 0.2% increase for the GTA→Cityscapes benchmark and a substantial 1.4% gain for the SYNTHIA→Cityscapes benchmark. As a result, our method attains mIoU scores of 76.1% and 68.7%, respectively, which reflect meaningful advancements in model accuracy and domain adaptation performance. Full article

A portion of individuals diagnosed with primary central nervous system lymphomas (PCNSL) may experience early relapse or refractory (R/R) disease following treatment. This research explored the potential of MRI-based radiomics in forecasting R/R cases in PCNSL. Forty-six patients with pathologically confirmed PCNSL diagnosed between January 2008 and December 2020 were included in this study. Only patients who underwent pretreatment brain MRIs and complete postoperative follow-up MRIs were included. Pretreatment contrast-enhanced T1WI, T2WI, and T2 FLAIR imaging were analyzed. A total of 107 radiomic features, including 14 shape-based, 18 first-order statistical, and 75 texture features, were extracted from each sequence. Predictive models were then built using five different machine learning algorithms to predict R/R in PCNSL. Of the included 46 PCNSL patients, 20 (20/46, 43.5%) patients were found to have R/R. In the R/R group, the median scores in predictive models such as support vector machine, k-nearest neighbors, linear discriminant analysis, naïve Bayes, and decision trees were significantly higher, while the apparent diffusion coefficient values were notably lower compared to those without R/R (p < 0.05). The support vector machine model exhibited the highest performance, achieving an overall prediction accuracy of 83%, a precision rate of 80%, and an AUC of 0.78. Additionally, when analyzing tumor progression, patients with elevated support vector machine and naïve Bayes scores demonstrated a significantly reduced progression-free survival (p < 0.05). These findings suggest that preoperative MRI-based radiomics may provide critical insights for treatment strategies in PCNSL. Full article