Search Results (53)

Background/Objectives: Dementia is a growing public health issue, especially in rapidly aging societies like Taiwan, where nearly 10% of adults over 65 show signs of cognitive decline. Given that mild cognitive impairment (MCI) serves as a critical stage for early intervention, this study examined the feasibility and preliminary effectiveness of a virtual reality (VR)-based dementia prevention program, specifically designed based on self-regulated learning (SRL) principles to enhance dementia knowledge, health literacy, and self-efficacy among older adults with MCI. Methods: A pilot randomized controlled trial (RCT) was conducted with 60 older adults aged 65 and above with MCI. Participants were randomly assigned to either an experimental group, which received a VR-based dementia prevention program, or a comparison group, which received routine paper-based educational materials. Results: The experimental group demonstrated significant improvements in overall dementia knowledge and all subdomains. Significant gains were also observed in critical health literacy and self-efficacy, though no significant changes were found in overall health literacy. Conclusions: The preliminary findings suggest that the SRL-informed VR program showed initial effectiveness in enhancing dementia knowledge, critical health literacy, and self-efficacy among older adults with MCI, highlighting its potential as an innovative approach to dementia prevention education. Full article

Most countries face declining birth rates and an aging population, which makes the persistent healthcare labor shortage a pressing challenge. Introducing artificial intelligence (AI) robots into home healthcare could help address these issues. Exploring the primary considerations for integrating AI robots in home healthcare has become an urgent topic. However, previous studies have not systematically examined the factors influencing elderly individuals’ adoption of home healthcare AI robots, hindering an understanding of their acceptance and adoption. Furthermore, traditional methods overlook the relative importance of each consideration and cannot manage the ambiguity inherent in subjective human cognition, potentially leading to biased decision-making. To address these limitations, this study employs the unified theory of acceptance and use of technology (UTAUT) as a theoretical framework, integrating the modified Delphi method (MDM) and the fuzzy analytical hierarchy process (FAHP) to identify the key considerations. The research determined the order of importance of four evaluation criteria and fourteen evaluation sub-criteria, revealing that customization, accompany, and subjective norms are key factors that influence elderly individuals’ adoption of home healthcare AI robots. Full article

Bridges are widely used for train transportation. Some bridges must be constructed close to geologic faults or across them due to the constraints of travel route alignment and the geographical environment. Taiwan is located at the junction of the Eurasian Plate and the Philippine Plate, where geological joints are present and earthquakes are frequent. In Taiwan, the monitoring and early warning of structural displacements is increasingly important, especially in the mutual control and monitoring of bridges and railways. This study utilizes fiber as a continuous sensor to monitor the safety of railway bridges in a near-fault region. This research builds upon the theory of Brillouin frequency shift (BFS) and applies it to a practical scenario of a fault-crossing railway bridge. BFS is related to the strain and temperature change in a single-mode fiber. Distributed fiber optic sensing (DFOS) systems enable us to detect shifts in frequency on the sensing fiber. A systemic approach to installing DFOS systems will be discussed. Data from a DFOS system are collected, and through data processing, they are converted into strain with regard to the deformations (bending, tension, compression) of a box girder bridge. Changes in the geometric structure of the box girder bridge throughout the year are measured and processed into graphical data. This system can be effectively applied to the structural safety monitoring of railway bridges. Through this research, several functions have been achieved, including continuous displacement, automatic monitoring, and real-time automatic alarm functions, without the need for human intervention. Full article

The advent of the digital era has catalyzed transformative shifts in educational paradigms, seamlessly integrating sustainable education with innovative pedagogical approaches that cater to a broader spectrum of learners and educators. As the academic landscape evolves into an information-dense environment, traditional models of one-on-one feedback often fall short, resulting in delays and a lack of diverse intellectual engagement. This shift underscores the growing importance of peer feedback and asynchronous post-lesson feedback mechanisms, which have emerged as vital, process-oriented educational activities. Such mechanisms not only address the immediacy and diversity of feedback but also foster a sustainable, collaborative, and engaging learning environment that bolsters student autonomy and interaction. This study conducts a mapping review and synthesis of the literature on peer interaction, assessment, and participatory innovations in online and mobile learning within higher education, covering the period from 1993 to 2022. By employing topic modeling techniques to analyze a corpus of 485 articles, the literature was initially segmented into 19 distinct issues. These were subsequently consolidated into three major thematic models, thereby highlighting significant themes, research focal points, and prospective trends. This analytical process not only enriches the understanding of peer dynamics in digital learning settings but also integrates sustainable educational practices by promoting resource efficiency and inclusivity. The findings serve as a robust reference for future researchers aiming to explore the intersections of technology, peer interaction, and sustainability in educational settings. Full article

Colon cancer has a poor clinical response to anti-PD1 therapy. This study aimed to evaluate the effect of cordycepin on the efficacy of anti-PD1 treatment in colon cancer. The viability of CT26 mouse colon carcinoma cells, cell-cycle progression, morphology, and the expression of mRNA and protein were assessed. A syngeneic animal model was established by implanting CT26 cells into BALB/c mice for in vivo experiments. Multi-parameter flow cytometry was used to analyze the splenic cell lineages and tumor microenvironment (TME). The in vitro data revealed that cordycepin, but not adenosine, inhibited CT26 cell viability. The protein, but not mRNA, expression levels of A2AR and A2BR were suppressed by cordycepin but not by adenosine in CT26 cells. The combination of cordycepin, but not adenosine, with anti-PD1 exhibited a greater tumor-inhibitory effect than anti-PD1 alone as well as inhibited the expression of A2AR and A2BR in splenic macrophages. In the TME, the combination of cordycepin and anti-PD1 increased the number of CD3+ T cells and neutrophils and decreased the number of natural killer (NK) cells. Overall, cordycepin augmented the antitumor effects of anti-PD1 against mouse colon carcinoma cells and inhibited the expression of the adenosine receptors A2AR and A2BR in splenic macrophages and intratumoral NK cells. Full article

Objective: Chronic kidney disease (CKD) is one of the most common diseases worldwide. The increasing prevalence and incidence of CKD have contributed to the critical problem of high medical costs. Due to stressful environments, aircrew members may have a high risk of renal dysfunction. A better strategy to prevent CKD progression in Air Force personnel would be to diagnosis CKD at an early stage. Since few studies have been conducted in Taiwan to examine the long-term trends in early CKD in Air Force aircrew members, this study is highly important. We investigated the prevalence of CKD and established a predictive model of disease variation among aircrew members. Materials and Methods: In this retrospective study, we included all subjects who had received physical examinations at a military hospital from 2004 to 2010 and who could be tracked for four years. The Abbreviated Modification of Diet in Renal Disease Formula (aMDRD) was used to estimate the glomerular filtration rate (GFR) and was combined with the National Kidney Foundation/ Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) to identify CKD patients. Results: A total of 212 aircrew members were assessed. The results showed that the prevalence of CKD was 3.8%, 9.4%, 9.0%, and 9.4% in each of the four years. According to the logistic regression analysis, abnormal urobilinogen levels, ketones, and white blood cell (WBC) counts in urine and a positive urine occult blood test increased the risk of CKD. A positive urine occult blood test can be used to predict the future risk of CKD. Moreover, the generalized estimating equation (GEE) model showed that a greater risk of CKD with increased examination time, age and seniority had a negative effect. In conclusion, abnormal urobilinogen levels, ketones, and urine WBC counts in urine as well as a positive urine occult blood test might serve as independent predictors for CKD. Conclusion: In the future, we can focus not only on annual physical examinations but also on simple and accurate examinations, such as urine occult blood testing, to determine the risk of CKD and prevent its progression in our aircrew members. Full article

Response surface models (RSMs) are a new trend in modern anesthesia. RSMs have demonstrated significant applicability in the field of anesthesia. However, the comparative analysis between RSMs and logistic regression (LR) in different surgeries remains relatively limited in the current literature. We hypothesized that using a total intravenous anesthesia (TIVA) technique with the response surface model (RSM) and logistic regression (LR) would predict the emergence from anesthesia in patients undergoing video-assisted thoracotomy surgery (VATS). This study aimed to prove that LR, like the RSM, can be used to improve patient safety and achieve enhanced recovery after surgery (ERAS). This was a prospective, observational study with data reanalysis. Twenty-nine patients (American Society of Anesthesiologists (ASA) class II and III) who underwent VATS for elective pulmonary or mediastinal surgery under TIVA were enrolled. We monitored the emergence from anesthesia, and the precise time point of regained response (RR) was noted. The influence of varying concentrations was examined and incorporated into both the RSM and LR. The receiver operating characteristic (ROC) curve area for Greco and LR models was 0.979 (confidence interval: 0.987 to 0.990) and 0.989 (confidence interval: 0.989 to 0.990), respectively. The two models had no significant differences in predicting the probability of regaining response. In conclusion, the LR model was effective and can be applied to patients undergoing VATS or other procedures of similar modalities. Furthermore, the RSM is significantly more sophisticated and has an accuracy similar to that of the LR model; however, the LR model is more accessible. Therefore, the LR model is a simpler tool for predicting arousal in patients undergoing VATS under TIVA with Remifentanil and Propofol. Full article

The propagation of earthquake energy occurs primarily through elastic waves. If the seismic force input to a structure can be directly reduced from the source, then the structure can be protected from seismic wave energy. Seismic metamaterials, regarded as periodic structures with properties different from conventional materials, use wave propagation characteristics and bandgaps to dissipate seismic wave energy. When the seismic wave is located in the bandgap, the transmission of seismic wave energy is effectively reduced, which protects the structure from the damage caused by seismic disturbance. In practical application, locating seismic frequencies below ten Hz is a challenge for seismic metamaterials. In the commonly used method, high-mass materials are employed to induce the effect of local resonance, which is not economically feasible. In this study, a lightweight design using auxetic geometry is proposed to facilitate the practical feasibility of seismic metamaterials. The benefits of this design are proven by comparing conventional seismic metamaterials with metamaterials of auxetic geometry. Different geometric parameters are defined using auxetic geometry to determine the structure with the best bandgap performance. Finite element simulations are conducted to evaluate the vibration reduction benefits of auxetic seismic metamaterials in time and frequency domains. Additionally, the relationship between the mass and stiffness of the unit structure is derived from the analytical solution of one-dimensional periodic structures, and modal analysis results of auxetic metamaterials are verified. This study provides seismic metamaterials that are lightweight, small in volume, and possess low-frequency bandgaps for practical applications. Full article

According to numerous studies, various parts processed by machine tools usually have multiple-quality characteristics at the same time. Moreover, the process capability index is a handy and useful tool for assessing various quality characteristics. In order to assist downstream customers in evaluating their process capabilities, achieve the effect of integrating the production data of the machine tool industry chain, advance the process quality of products, and reduce rework and scrap, we constructed a shared decision-making model of production data management for multi-quality characteristic products on the cloud platform in consideration of Industry 4.0. This model not only can help downstream customers improve the process for quality characteristics with insufficient process precision or accuracy to figure out the optimum machine parameter setting but also can build a better system of repairs and maintenance. At the same time, all downstream customers’ improvement experiences can be gathered to form a knowledge database for improvements and provided to the machine tool industry to set up a complete mechanism of supplier selection, or they can be regarded as a reference for designing superior key components of machine tools, thereby enhancing the product value and industrial competitiveness of machine tools. Full article

We present a facile low-cost method to produce nitrogen-doped holey graphene (N-HGE) and its application to supercapacitors. A composite of N-HGE and activated carbon (AC) was used as the electrode active material in organic-electrolyte supercapacitors, and the performances were evaluated. Melamine was mixed into graphite oxide (GO) as the N source, and an ultra-rapid heating method was used to create numerous holes during the reduction process of GO. X-ray photoelectron spectra confirmed the successful doping with 2.9–4.5 at.% of nitrogen on all samples. Scanning electron micrographs and Raman spectra revealed that a higher heating rate resulted in more holes and defects on the reduced graphene sheets. An extra annealing step at 1000 °C for 1 h was carried out to further eliminate residual oxygen functional groups, which are undesirable in the organic electrolyte system. Compared to the low-heating-rate counterpart (N-GE-15), N-HGE boosted the specific capacity of the supercapacitor by 42 and 22% at current densities of 0.5 and 20 A/g, respectively. The effects of annealing time (0.5, 1, and 2 h) at 1000 °C were also studied. Longer annealing time resulted in higher capacitance values at all current densities due to the minimized oxygen content. Volumetric specific capacitances of 49 and 24 F/cm³ were achieved at current densities of 0.5 and 20 A/g, respectively. For the high-power-density operation at 31,000 W/kg (or 10,000 W/L), an energy density as high as 11 Wh/kg (or 3.5 Wh/L) was achieved. The results indicated that N-HGE not only improved the conductivity of the composite supercapacitors but also accelerated ion transport by way of shortened diffusion paths through the numerous holes all over the graphene sheets. Full article

Background: The association between perioperative blood transfusion and cancer prognosis in patients with head and neck cancer (HNC) receiving surgery remains controversial. Methods: We designed a retrospective observational study of patients with HNC undergoing tumor resection surgery from 2014 to 2017 and followed them up until June 2020. An inverse probability of treatment weighting (IPTW) was applied to balance baseline patient characteristics in the exposed and unexposed groups. COX regression was used for the evaluation of tumor recurrence and overall survival. Results: A total of 683 patients were included; 192 of them (28.1%) received perioperative packed RBC transfusion. Perioperative blood transfusion was significantly associated with HNC recurrence (IPTW adjusted HR: 1.37, 95% CI: 1.1–1.7, p = 0.006) and all-cause mortality (IPTW adjusted HR: 1.37, 95% CI: 1.07–1.74, p = 0.011). Otherwise, there was an increased association with cancer recurrence in a dose-dependent manner. Conclusion: Perioperative transfusion was associated with cancer recurrence and mortality after HNC tumor surgery. Full article

The objective of the proposed human–machine cooperation (HMC) workstation is to both rapidly detect calcium-based fish bones in masses of minced fish floss and visually guide operators in approaching and removing the detected fish bones by hand based on the detection of fingernails or plastic-based gloves. Because vibration is a separation mechanism that can prevent absorption or scattering in thick fish floss for UV fluorescence detection, the design of the HMC workstation included a vibration unit together with an optical box and display screens. The system was tested with commonly used fish (swordfish, salmon, tuna, and cod) representing various cooking conditions (raw meat, steam-cooked meat, and fish floss), their bones, and contaminating materials such as derived from gloves made of various types of plastic (polyvinylchloride, emulsion, and rubber) commonly used in the removal of fish bones. These aspects were each investigated using the spectrum analyzer and the optical box to obtain and analyze the fluorescence spectra and images. The filter was mounted on a charge-coupled device, and its transmission-wavelength window was based on the characteristic band for fish bones observed in the spectra. Gray-level AI algorithm was utilized to generate white marker rectangles. The vibration unit supports two mechanisms of air and downstream separation to improve the imaging screening of fish bones inside the considerable flow of fish floss. Notably, under 310 nm ultraviolet B (UVB) excitation, the fluorescence peaks of the raw fillets, steam-cooked meat, and fish floss were observed at for bands at longer wavelengths (500–600 nm), whereas those of the calcium and plastic materials occurred in shorter wavelength bands (400–500 nm). Perfect accuracy of 100% was achieved with the detection of 20 fish bones in 2 kg of fish floss, and the long test time of around 10–12 min results from the manual removal of these fish bones. Full article

Multicellular tumor spheroids and tumoroids are considered ideal in vitro models that reflect the features of the tumor microenvironment. Biomimetic components resembling the extracellular matrix form scaffolds to provide structure to 3-dimensional (3D) culture systems, supporting the growth of both spheroids and tumoroids. Although Matrigel has long been used to support 3D culture systems, batch variations, component complexity, and the use of components derived from tumors are complicating factors. To address these issues, we developed the ACD 3D culture system to provide better control and consistency. We evaluated spheroid and tumoroid formation using the ACD 3D culture system, including the assessment of cell viability and cancer marker expression. Under ACD 3D culture conditions, spheroids derived from cancer cell lines exhibited cancer stem cell characteristics, including a sphere-forming size and the expression of stem cell marker genes. The ACD 3D culture system was also able to support patient-derived primary cells and organoid cell cultures, displaying adequate cell growth, appropriate morphology, and resistance to oxaliplatin treatment. These spheroids could also be used for drug screening purposes. In conclusion, the ACD 3D culture system represents an efficient tool for basic cancer research and therapeutic development. Full article

Aging and muscle disorders frequently cause a decrease in myoblast migration and differentiation, leading to losses in skeletal muscle function and regeneration. Several studies have reported that natural flavonoids can stimulate muscle development. Quercetin, one such flavonoid found in many vegetables and fruits, has been used to promote muscle development. In this study, we investigated the effect of quercetin on migration and differentiation, two processes critical to muscle regeneration. We found that quercetin induced the migration and differentiation of mouse C2C12 cells. These results indicated quercetin could induce myogenic differentiation at the early stage through activated p-IGF-1R. The molecular mechanisms of quercetin include the promotion of myogenic differentiation via activated transcription factors STAT3 and the AKT signaling pathway. In addition, we demonstrated that AKT activation is required for quercetin induction of myogenic differentiation to occur. In addition, quercetin was found to promote myoblast migration by regulating the ITGB1 signaling pathway and activating phosphorylation of FAK and paxillin. In conclusion, quercetin can potentially be used to induce migration and differentiation and thus improve muscle regeneration. Full article

An extrahepatic manifestation of nephropathies can be a feature of the chronic hepatitis C virus (HCV) infection. Albuminuria is a major risk factor for nephropathies and chronic kidney disease (CKD). The correlation between HCV genotypes and albuminuria is still unclear. In this study, investigations have been done for the biomedical tools and methodologies used in the National Health and Nutrition Examination Survey (NHANES) public database. We searched the 2007–2016 NHANES public database to retrieve data regarding the different HCV genotypes and clinical scenarios. This study attempted to investigate the impacts of HCV genetic diversity, associated comorbidities, and racial differences on albuminuria. The urine albumin/creatinine ratio (ACR) was the primary endpoint. Among 40,856 participants, 336 participants with positive and 237 with negative HCV RNA tests were analyzed, excluding 14,454 participants with negative HCV antibodies and 25,828 which were missed. After controlling for sex, race, education level, smoking, diabetes mellitus, hepatitis B, alcohol use, and body mass index (BMI) with a generalized linear equation, HCV genotype 2 was more likely than any other genotype to cause albuminuria based on the urine ACR (p < 0.001). The generalized linear equation also demonstrated a significantly higher urine ACR, including hepatitis B (p < 0.001), diabetes mellitus (p < 0.001), and smoking (p = 0.026). In summary, the patients with HCV genotype 2 presented with increased albuminuria in comparison with other HCV genotypes in this 10-year retrospective analysis. HCV infection could be a risk factor of CKD; early diagnosis and appropriate treatment may improve clinical outcomes. Full article