Search Results (467)

Tai Chi has evolved into a widely used mind–body practice increasingly incorporated into complementary therapy, rehabilitation, and public health. This study provides an updated global bibliometric overview, with VOSviewer mapping publication performance, co-authorship networks, and keyword-based thematic clusters. Articles and reviews with Tai Chi–related terms in the title were retrieved from Scopus, with no restrictions on language or publication year. A total of 2253 publications from 1978 to 2025 were analyzed, revealing steady growth, concentrated largely in the past decade. China led the publication output, while the United States had the highest number of citations, forming a dual-core pattern. The field is largely driven by a small group of authors and regional clusters, and its visibility in mainstream medical journals remains limited. Nine software-generated keyword clusters were manually synthesized into five themes: motor function (balance and fall prevention), musculoskeletal conditions (osteoarthritis, rheumatoid arthritis, fibromyalgia), chronic disease management (cardiovascular disease, stroke, COPD), psychological health (quality of life, depression, anxiety, mindfulness), and cognitive aging (dementia, mild cognitive impairment). Future progress requires greater methodological rigor, including mechanistic inquiry, long-term study designs, and community- or population-level applications, along with stronger international collaboration and deeper integration into clinical and public health practice. Full article

Background/Objectives: Liver transplantation is an effective treatment for end-stage liver disease, and patients treated by surgeons with higher service volumes have better therapeutic outcomes. However, few studies have examined the effects of cumulative service volume on the survival of liver transplant patients. The objective of this study was to investigate the effect of a surgeon’s cumulative service volume on the survival rates of liver transplant patients. Methods: The study was a retrospective and nationwide cohort study. Patients who underwent a liver transplant in 2005–2013 were identified. The data were from the Taiwan National Health Insurance Research Database. The primary outcome was the effect of surgeon service volume on 1-year survival after surgery for liver transplant patients. Results: A total of 3233 patients who underwent liver transplantation had a first-year survival rate of 85.8%. The high relative service volume group (>307 cases) had the highest patient survival rate at 1 year after operation (95.31%), while the low relative service volume group (<31 cases) had the lowest survival rate (71.39%). After relevant adjustment variables, the risk of mortality was significantly higher among patients operated on when their surgeons had accumulated fewer than 41 prior transplant cases, and the risk of mortality decreased as the cumulative service volume of surgeons rose. Conclusions: This nationwide cohort study demonstrated an association, rather than a causal relationship, between surgeon cumulative service volume and 1-year survival after liver transplantation. One-year survival reached approximately 85% once surgeons had accumulated 41–60 prior transplant cases. These findings may provide a reference for understanding the clinical learning curve in liver transplantation. Full article

Background/Objectives: Late-life depression is prevalent yet frequently underdiagnosed, underscoring the need for accessible and safe non-pharmacological approaches. Pet-assisted interventions, including live animal-assisted therapy and robotic pets, have gained attention, but their comparative effectiveness remains unclear. This study aimed to evaluate and rank different pet-assisted approaches for reducing depressive symptoms in older adults using network meta-analysis. Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library up to August 2025 for randomized controlled trials involving adults aged 60 years or older with depression. The protocol was prospectively registered on INPLASY (INPLASY2025100023). Depression severity, assessed using validated scales, was synthesized using a frequentist random-effects network meta-analysis framework. Results: Twenty trials involving 1073 participants were included. Live animal-assisted therapy produced the greatest reduction in depressive symptoms versus passive control (SMD −2.04; 95% CI −3.03 to −1.04). Combining it with gait training (structured walking-based activity conducted with the animal) was associated with a reduction in depressive symptoms (SMD −4.82; 95% CI −6.69 to −2.95). Robotic pets showed a directionally beneficial but non-significant effect (SMD −1.21; 95% CI −2.79 to 0.38). Conclusions: Pet-assisted interventions are effective in reducing depressive symptoms among older adults. Live animal-assisted therapy, particularly when delivered in structured or combined formats, shows the greater benefit. Robotic pets may serve as a practical alternative when live animals cannot be implemented. Full article

Hamiltonian cycle problems play a central role in graph theory and have wide-ranging applications in network-on-chip architectures, interconnection networks, and large-scale parallel systems. When a network contains faulty nodes or faulty links, the feasibility of certain paths becomes restricted, making the construction of Hamiltonian cycles substantially more difficult and increasingly important for ensuring reliable communication. A dimension-balanced Hamiltonian cycle is a special type of cycle that maintains an even distribution of edges across multiple dimensions of a network. Its directed counterpart extends this idea to symmetric directed networks by balancing the number of edges used in each positive and negative direction. Such cycles are desirable because they support uniform traffic distribution and reduce communication contention in practical systems. Previous research has examined the existence of directed dimension-balanced Hamiltonian cycles in directed toroidal mesh networks and has shown that some configurations permit directed dimension-balanced Hamiltonian cycles while others do not. Building on this foundation, this paper investigates the fault-tolerant properties of such networks by analyzing whether directed dimension-balanced Hamiltonian cycles still exist when a single vertex (node) or a single edge (link) is faulty. Our results extend the current understanding of Hamiltonian robustness in symmetric directed networks. Full article

Oral health is a critical factor in maintaining overall health, and its association with systemic diseases, including cardiovascular disease and diabetes mellitus, has been extensively investigated. Effective plaque removal through proper toothbrushing techniques is fundamental for preventing dental caries and periodontal diseases. Despite standardized guidelines, many individuals fail to adhere to correct brushing techniques, thereby increasing the risk of oral diseases. To address this issue, this study proposes a fine-grained toothbrushing region recognition approach incorporating six machine learning classifiers and two inertial measurement units (IMUs), which are embedded in the toothbrush holder and mounted on the right wrist of the participant, respectively. By analyzing the continuous motion signals, the proposed hierarchical approach is capable of identifying brushing and transition activities and subsequently recognizing specific toothbrushing regions based on the predicted brushing activities. To further improve recognition reliability, post-processing strategies such as contextual smoothing and majority voting are applied. Experimental results demonstrate that random forest achieves the highest recognition accuracy of 96.13%, sensitivity of 96.10%, precision of 95.51%, and F1-score of 95.60%. The results indicate that the proposed approach is both effective and feasible for providing fine-grained toothbrushing region recognition in toothbrushing monitoring. Full article

Background/Objectives: Hesperetin (HSP) is a bioactive flavonoid known for its strong antioxidant and anti-inflammatory properties. However, its low water solubility (1.36 ± 0.30 μg/mL) and poor oral bioavailability (~20%) greatly hinder its potential in nutraceutical applications. Methods: Using the solvent dispersion method, nanoparticles composed of HSP, hydroxypropyl-β-cyclodextrin (HPBCD), and polyvinylpyrrolidone K30 (PVPK30) were prepared and collectively termed HHPNP. Characterization involved particle size measurement, FTIR, XRD, SEM, and TEM. Antioxidant activity was evaluated using DPPH and ABTS⁺ radical scavenging assays. In vitro dissolution testing was performed at pH 1.2 and pH 6.8 to compare HHPNP with physical mixtures, and release behavior was assessed using both gelatin (non-vegetarian) and HPMC (vegetarian) capsules. Results: The optimal formulation (1:15:12) produced uniformly distributed spherical nanoparticles with a mean size of 14.87 ± 0.49 nm and achieved an 827-fold increase in water solubility compared with raw HSP. FTIR analysis indicated hydrogen bond formation, and XRD confirmed a complete transition from a crystalline to an amorphous state. In aqueous environments, HHPNP demonstrated markedly improved antioxidant activity, with DPPH and ABTS⁺ radical scavenging comparable to HSP solutions prepared in methanol. In vitro dissolution testing revealed rapid release at both pH 1.2 (>65% in 10 min) and at pH 6.8 (70% in 5 min). In contrast, physical mixtures only released 10–30% over two hours. T50% values at pH 1.2 were 17.8 min (gelatin) and 16.8 min (HPMC). At pH 6.8, T50% values were 17.6 min (gelatin) and 7.5 min (HPMC). Both capsule types matched the HHPNP in release at 120 min, and these comparable profiles indicate the formulation’s stability and adaptability across capsule variants. Conclusions: This nanoparticle-based delivery system, leveraging molecular inclusion and amorphization, significantly enhanced the solubility, bioactivity, and release efficiency of HSP, offering a potent platform for oral flavonoid-based dietary supplements. Full article

Background/Objectives: Chronic hepatitis C virus (HCV) remains a major public health concern in Taiwan, particularly in southern regions with high endemicity. While HCV elimination is a national priority, resources are often limited. Relying solely on broad, township-level prevalence rates is inefficient, as the true disease burden can vary dramatically at the village level. Therefore, identifying local hotspots through fine-scale mapping is critical for efficient resource allocation and targeted intervention. This study aimed to validate village-level prevalence estimates and evaluate the efficiency of a community-based, targeted screening approach utilizing this detailed prevalence data in Chiayi County. Methods: We integrated data from the Chiayi Health Bureau and Chiayi Chang Gung Memorial Hospital (2000–2015) to generate village-level risk maps for five townships: Lioujiao (LJ), Yijhu (YH), Dongshih (DS), Taibao (TB), and Lucao (LC). Between 2018 and 2021, we conducted door-to-door community screening using anti-HCV testing with reflex HCV antigen (Ag) testing. Anti-HCV/HCV Ag prevalence, number needed to test (NNT), and linkage-to-care rates were calculated to validate prevalence estimates and assess screening efficiency. Results: Among 3910 participants, anti-HCV prevalence ranged from 5.4% (TB) to 8.7% (DS). Estimated and observed village-level prevalence showed moderate-to-strong correlation (r = 0.696–0.830, p < 0.001). Screening efficiency was highest in DS (NNT = 21) and lowest in TB (NNT = 42). Of 132 antigen-positive individuals, 131 (99.2%) initiated direct-acting antiviral therapy. Conclusions: The village-level risk maps accurately predicted local HCV burden, enabling targeted screening with high diagnostic yield and near-complete treatment uptake. This approach maximizes resource efficiency and may serve as a scalable model for advancing Taiwan and the WHO’s 2030 HCV elimination goals. Full article

Background: Cognitive and physical deficits are core features of schizophrenia. Although Baduanjin and brisk walking (BW) have shown promise as intervention strategies, comparative evidence with follow-up and considering maintenance is limited. Objective: This study compared the effects of Baduanjin, BW, and health education (HE) on cognitive and physical outcomes in schizophrenia and examined whether a maintenance program could sustain these effects. Methods: In this single-blind three-arm randomized controlled trial, 60 patients with schizophrenia were assigned to Baduanjin (n = 20), BW (n = 20), or HE (n = 20). Interventions were conducted three times weekly for 12 weeks, each lasting 60 min, followed by a four-week home-based maintenance program with brochures and short message reminders. Cognitive outcomes were assessed using the Brief Assessment of Cognition in Schizophrenia, and physical outcomes included the Six-Minute Walk Test (6MWT), 30-Second Chair Stand Test (30CST), Timed Up-and-Go (TUG), motor dual-task TUG (TUGmanual), and cognitive dual-task TUG (TUGcognitive). Results: Baduanjin produced larger improvements than HE in verbal memory, attention and processing speed, executive function, and global cognition. BW significantly enhanced the working memory and global cognition versus HE, with additional improvements in attention and processing speed at follow-up. Both Baduanjin and BW improved the walking distance and lower-limb strength compared with HE, while Baduanjin outperformed BW and HE in balance and dual-task outcomes. Conclusions: Baduanjin and BW improved cognitive and physical functions in individuals with schizophrenia. Maintenance programs with short message reminders may help sustain these benefits. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent worldwide and represents a growing healthcare challenge due to its risk of progression and association with metabolic comorbidities. Extracellular vesicles (EVs), nanosized membrane-bound particles mediating intercellular communication, have emerged as candidate biomarkers in multiple diseases. This study aimed to characterize serum EV profiles in MASLD patients, stratified into obese and lean groups using a body mass index cutoff of 23 for Asians. Methods: We enrolled 170 MASLD patients, 83 obese (median age 50, range 20–80) and 87 lean (median age 50, range 20–87), along with 57 non-MASLD controls (median age 44, range 21–86). Serum EV concentrations and particle sizes were quantified using nanoparticle tracking analysis and correlated with clinical and laboratory parameters. EV cargo proteins, including tetraspanins (CD9, CD63) and lipid droplet-associated perilipins (PLIN2, PLIN3), were assessed by Western blotting. Results: Obese MASLD patients displayed marked biochemical abnormalities, whereas lean MASLD patients showed levels comparable to non-MASLD controls. Nevertheless, serum EV concentrations were elevated in both the obese and lean MASLD groups. Importantly, in lean MASLD, EV levels correlated strongly with disruptions in lipid and glycemic homeostasis. Furthermore, a reduction in the PLIN3/CD63 ratio was observed in EVs isolated from lean MASLD patients. Conclusions: Circulating EVs are elevated in both obese and lean MASLD, but lean patients demonstrate a distinctive decrease in the EV PLIN3/CD63 ratio. These findings highlight the potential of EV profiling to uncover disease heterogeneity and to inform risk stratification in MASLD. Full article

Background/Objectives: Endometrial cancer (EC), a malignancy arising from the uterine lining, is a leading gynecological cancer in developed countries. Syringic acid (SA), a naturally occurring phenolic compound, possesses various bioactivities including antioxidant, anti-inflammatory, chemoprotective, and anti-angiogenic properties. This study aimed to investigate the effects of SA on the proliferation and migration of RL95-2 EC cells, its protective role in normal endometrial stromal cells (HESCs), and the underlying molecular mechanisms. Furthermore, the potential synergistic anticancer effects of SA in combination with chemotherapeutic agents against EC were evaluated. Methods: Cell viability was assessed using nuclear fluorescence staining, the MTT assay, and clonogenic survival assay. Cell migration was evaluated through wound closure and Transwell migration assays. Gene expression levels were analyzed by the RT-PCR method. Results: SA significantly inhibited the proliferation of RL95-2 EC cells, with an IC₅₀ value of 27.22 μM. Co-treatment with SA and the chemotherapeutic agent doxorubicin (Dox) demonstrated an additive inhibitory effect. Mechanistically, both SA and the SA-Dox combination induced apoptosis by upregulating the expression of caspases-3, -8, and -9, increasing the expression of pro-apoptotic genes (Bax and Bad), and downregulating anti-apoptotic genes (Bcl-XL and Bcl-2). Cell cycle analysis revealed the downregulation of cyclin D and the upregulation of tumor suppressors p21 and p27, contributing to growth arrest. In addition, both SA and the combination treatment effectively suppressed cell migration by downregulating matrix metalloproteinases (MMPs) and β-catenin. SA treatment also induced the expression of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) and activated NF-κB signaling, leading to an elevated expression of inflammatory mediators such as COX-2 and iNOS. Furthermore, SA promoted oxidative stress in RL95-2 cells by inhibiting the Nrf2 pathway and reducing the expression and activities of antioxidant enzymes including catalase, glutathione peroxidase, and superoxide dismutase, thereby enhancing reactive oxygen species (ROS) accumulation. In contrast, in lipopolysaccharide-stimulated HESC cells, SA attenuated inflammation and ROS generation, indicating its selective cytoprotective role in normal endometrial cells. Conclusions: SA may serve as a promising adjuvant candidate to enhance chemotherapeutic efficacy while protecting normal cells by mitigating inflammation and oxidative stress. Full article

Alzheimer’s disease (AD) remains a significant public health challenge, with current treatments limited partly due to the difficulty of delivering therapeutics across the blood–brain barrier (BBB). The nose-to-brain (N-2-B) pathway offers a promising alternative to circumvent the BBB, but no drugs have yet been clinically applied via this route for AD. Mild stress is thought to activate intrinsic protective mechanisms against neurodegeneration, but traditional methods lack specificity and practicality. To address this, we propose the inhalation of mildly heated air as thermal stimulation, which utilizes the N-2-B pathway to induce mild stress and stimulate cerebral activity. This study employs thermal cycling-hyperthermia (TC-HT) in developing thermal cycling-stimulation via nasal inhalation (TCSNI), providing cyclic stimulation to maintain pathway activity while minimizing thermal injury. In C57BL/6 mice, TCSNI showed no adverse olfactory effects. In β-amyloid (Aβ)-treated mice, TCSNI significantly enhanced cognitive performance in Y-maze and novel object recognition (NOR) assessments, suggesting cognitive improvement. Mice hippocampal protein analyses indicated a reduction in Aβ accumulation, alongside increased expression of heat shock protein 70 (HSP70), insulin-degrading enzyme (IDE), and phosphorylated Akt (p-Akt). These results suggest that N-2-B-delivered TCSNI effectively modulates protein expression and enhances cognitive function, highlighting its potential for further exploration in AD treatment. Full article

Knee osteoarthritis (OA) is a prevalent condition in older adults that often results in impaired gait and balance, increased risk of falls, and reduced quality of life. Conventional clinical assessments may not adequately capture these deficiencies. This study investigated the gait and balance of elderly individuals with knee OA using wearable inertial measurement units (IMUs). Forty-four participants with Kellgren–Lawrence grade 2–3 knee OA (71.23 ± 5.75 years) and forty-five age-matched controls (70.87 ± 4.30 years) completed dynamic balance (balance board), static balance (single-leg stance), ‘timed up and go’ (TUG), and normal walking tasks. Between 2 and 8 IMUs, depending on the task, were placed on the head, chest, waist, knees, ankles, soles, and balance board to record kinematic data. Balance was quantified using absolute angular velocity and linear acceleration, with group differences analyzed by MANOVA and Bonferroni-adjusted univariate tests. The participants with knee OA exhibited greater gait asymmetry, although the difference was not significant. However, they consistently demonstrated higher absolute angular velocities than controls across most body segments during static and dynamic tasks, indicating reduced postural stability. No group differences were observed in TUG performance. These findings suggest that IMU-based measures, particularly angular velocity, are sensitive to balance impairment detection in knee OA. Incorporating IMU technology into clinical assessments may facilitate early identification of instability and guide targeted interventions to reduce fall risk. Full article

Tooth whitening is increasingly sought in both clinical and home settings, raising concerns about the efficacy and safety of various whitening agents and their delivery systems. This narrative review compares the whitening performance and biocompatibility of active ingredients, including hydrogen peroxide, carbamide peroxide, activated charcoal, sodium bicarbonate, fluoride compounds, and blue covarine, with particular emphasis on the role of polymer-based carriers in formulation strategies. Hydrogen peroxide and carbamide peroxide remain the most effective agents for intrinsic whitening, but are associated with risks of enamel surface alterations, microhardness reduction, and potential cytotoxicity, particularly at higher concentrations. Sodium bicarbonate provides moderate whitening effects through extrinsic stain removal, while fluoride compounds play a supportive role by reducing demineralization and tooth sensitivity, thereby preserving enamel integrity. These properties make them valuable adjuncts or alternatives for patients with high sensitivity risks. Blue covarine offers immediate optical effects without inducing intrinsic color changes, whereas activated charcoal poses risks of enamel abrasion and surface roughness with limited long-term efficacy. Polymer-based carriers such as Carbopol gels, polyvinylpyrrolidone, and hydroxypropyl methylcellulose are incorporated into whitening formulations to improve viscosity, adhesion, and modulate the release of active ingredients. These polymers might help minimize diffusion of bleaching agents into deeper dental tissues, potentially reducing cytotoxic effects, and may improve handling characteristics. However, dedicated studies evaluating the unique advantages of polymers in different whitening systems remain limited. A comprehensive understanding of both the active ingredients and delivery technologies is critical to balancing esthetic outcomes with long-term oral health. From a clinical perspective, polymer-based carriers might contribute to reducing whitening-related tooth sensitivity, improving patient comfort, and providing more predictable treatment outcomes. Continued research is needed to clarify optimal formulations and application protocols, ensuring safer and more effective tooth-whitening practices in both clinical and home-use scenarios. Full article

The associations between sialylated anti-cyclic citrullinated peptide (anti-CCP) antibodies bearing α-2,6-sialic acid (SIA), ST6Gal1 and Neu1 enzymes, and clinical disease activity measures such as disease activity score 28 (DAS28), the Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) are unknown in rheumatoid arthritis (RA). To address this gap, this study included 97 patients with RA evaluated at baseline (month 0) and at 6 and 12 months. At each visit, blood cells were analyzed for B-cell ST6Gal1 and Neu1 expressions, and plasma samples were assessed for ST6Gal1 and Neu1 levels. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), monocyte chemotactic protein-1 (MCP-1), and IgG anti-CCP with its α-2,6-SIA modification were measured. Disease activity measures, namely DAS28-ESR, DAS28-CRP, DAS28-MCP-1, SDAI, and CDAI, were calculated. Correlations and Receiver Operating Characteristics among ST6Gal, Neu1, SIA/anti-CCP ratios, and disease activity measures were assessed. Multivariate regression analyses were performed to reveal confounding factors in such correlations. The total SIA content of anti-CCP antibodies was inversely correlated with B-cell Neu1 levels (ρ = −0.317 with p = 0.013. Plasma (free-form) Neu1 levels were inversely correlated with SIA/IgG anti-CCP ratios (ρ = −0.361, p = 0.001) in the DAS28-MCP-1 < 2.2 (remission) subgroup. No such correlation was observed for the DAS28-ESR, DAS28-CRP, SDAI, or CDAI subgroups. B-cell ST6Gal1 levels correlated inversely with SDAI ≤ 11 and DAS28-MCP-1 ≤ 3.6 combined remission and low-disease-activity subgroups (ρ = −0.315 with p = 0.001 and ρ = −0.237 with p = 0.008, respectively). The same was observed for B-cell ST6Gal1/Neu1 ratios correlating with the SDAI ≤ 11 subgroup (ρ = −0.261, p = 0.009). Nevertheless, B-cell ST6Gal1/Neu1 ratios against SDAI ≤ 11 and DAS28-MCP-1 ≤ 3.6 subgroups produced significant area-under-curve (AUC) values of 0.616 and 0.600, respectively (asymptotic p-Values 0.004 and 0.018, respectively). Through multivariate regression analyses, we found that biologics (a confounding factor) interfered with p-Values related to the B-cell ST6Gal1 enzyme but did not interfere with p-Values related to the pure B-cell Neu1 enzyme. In addition, disease duration interfered with p-Values related to the pure Neu1 enzyme on B-cells or in plasma. Moreover, plasma ST6Gal1/Neu1 ratios against the DAS28-MCP-1 < 2.2 remission subgroup produced an AUC of 0.628 and asymptotic p = 0.003. Therefore, it is suggested that B-cell ST6Gal1/Neu1 ratios can be used as clinical indicators for the combined remission and low-disease-activity subgroup of SDAI and DAS28-MCP-1 formulae. Plasma ST6Gal1/Neu1 ratios are also good indicators of DAS28-MCP-1 remission. Full article