Time-restricted eating (TRE) has gained popularity in recent years as a weight loss option. Although many studies have explored the effectiveness of fasting, few have investigated the successful ...implementation of this method. Therefore, the purpose of this study is to examine the successful and failed experiences of overweight adults who have implemented TRE for weight loss, in order to identify strategies for maintaining a favorable weight over time. The study utilized semi-structured interviews and followed Constructivist Grounded Theory to collect and analyze data. Data saturation was achieved through purposive and theoretical sampling of 30 overweight adults. The research confirms four stages in the process of weight loss using a TRE strategy, namely, preparation, adaptation, challenge, and maintenance. The findings revealed that the successful implementation of TRE and its maintenance over time require viewing TRE as a lifestyle rather than a tool for short-term weight loss, the development of specific action plans to overcome obstacles, and a positive attitude and self-belief as important sources of support. Based on the study's results, a guide has been provided for those who wish to use TRE as a dietary control method.
Summary
A growing elderly population is expected worldwide, and the burden of hip fractures on health care system will continue to increase. By 2035, there will be a 2.7-fold increase in the number ...of hip fractures in Taiwan. The study provides quantitative basis for the future distribution of medical resources.
Introduction
Hip fractures have long been recognized as a major public health concern. The study aimed to determine time trends in the incidence of hip fractures and to forecast the number of hip fractures expected in Taiwan up to 2035.
Methods
A nationwide survey was conducted using data from the Taiwan National Health Insurance Research Database from 2004 to 2011. A total of 141,397 hip fractures were identified, with a mean of 17,675 fractures/year. Annual incidences of hip fractures were calculated and tested for trends. Projections of the incidence rates of hip fractures and bed days associated with hip fractures were calculated using Poisson regression on the historical incidence rates in combination with population projections from 2012 to 2035.
Results
The incidence rates of hip fracture during 2004–2011 were 317 and 211 per 100,000 person-years among women and men, respectively. Over this 8-year period, the age-standardized incidence of hip fracture decreased by 13.4 % among women and 12.2 % among men. Despite the decline in the age-standardized incidence, the absolute number of hip fractures increased owing to the aging population. The number of hip fractures is expected to increase from 18,338 in 2010 to 50,421 in 2035—a 2.7-fold increase. The number of bed days for 2010 and 2035 was estimated at 161,248 and 501,995, respectively, representing a 3.1-fold increase.
Conclusions
The socioeconomic impact of hip fractures will be high in the near future. This study provides a quantitative basis for future policy decisions to serve this need.
The advent of computer graphic processing units, improvement in mathematical models and availability of big data has allowed artificial intelligence (AI) using machine learning (ML) and deep learning ...(DL) techniques to achieve robust performance for broad applications in social-media, the internet of things, the automotive industry and healthcare. DL systems in particular provide improved capability in image, speech and motion recognition as well as in natural language processing. In medicine, significant progress of AI and DL systems has been demonstrated in image-centric specialties such as radiology, dermatology, pathology and ophthalmology. New studies, including pre-registered prospective clinical trials, have shown DL systems are accurate and effective in detecting diabetic retinopathy (DR), glaucoma, age-related macular degeneration (AMD), retinopathy of prematurity, refractive error and in identifying cardiovascular risk factors and diseases, from digital fundus photographs. There is also increasing attention on the use of AI and DL systems in identifying disease features, progression and treatment response for retinal diseases such as neovascular AMD and diabetic macular edema using optical coherence tomography (OCT). Additionally, the application of ML to visual fields may be useful in detecting glaucoma progression. There are limited studies that incorporate clinical data including electronic health records, in AL and DL algorithms, and no prospective studies to demonstrate that AI and DL algorithms can predict the development of clinical eye disease. This article describes global eye disease burden, unmet needs and common conditions of public health importance for which AI and DL systems may be applicable. Technical and clinical aspects to build a DL system to address those needs, and the potential challenges for clinical adoption are discussed. AI, ML and DL will likely play a crucial role in clinical ophthalmology practice, with implications for screening, diagnosis and follow up of the major causes of vision impairment in the setting of ageing populations globally.
The optical design and performance of the recently opened 13A biological small‐angle X‐ray scattering (SAXS) beamline at the 3.0 GeV Taiwan Photon Source of the National Synchrotron Radiation ...Research Center are reported. The beamline is designed for studies of biological structures and kinetics in a wide range of length and time scales, from angstrom to micrometre and from microsecond to minutes. A 4 m IU24 undulator of the beamline provides high‐flux X‐rays in the energy range 4.0–23.0 keV. MoB4C double‐multilayer and Si(111) double‐crystal monochromators (DMM/DCM) are combined on the same rotating platform for a smooth rotation transition from a high‐flux beam of ∼4 × 1014 photons s−1 to a high‐energy‐resolution beam of ΔE/E ≃ 1.5 × 10−4; both modes share a constant beam exit. With a set of Kirkpatrick–Baez (KB) mirrors, the X‐ray beam is focused to the farthest SAXS detector position, 52 m from the source. A downstream four‐bounce crystal collimator, comprising two sets of Si(311) double crystals arranged in a dispersive configuration, optionally collimate the DCM (vertically diffracted) beam in the horizontal direction for ultra‐SAXS with a minimum scattering vector q down to 0.0004 Å−1, which allows resolving ordered d‐spacing up to 1 µm. A microbeam, of 10–50 µm beam size, is tailored by a combined set of high‐heat‐load slits followed by micrometre‐precision slits situated at the front‐end 15.5 m position. The second set of KB mirrors then focus the beam to the 40 m sample position, with a demagnification ratio of ∼1.5. A detecting system comprising two in‐vacuum X‐ray pixel detectors is installed to perform synchronized small‐ and wide‐angle X‐ray scattering data collections. The observed beamline performance proves the feasibility of having compound features of high flux, microbeam and ultra‐SAXS in one beamline.
The optical design and performance of the BioSAXS beamline at the Taiwan Photon Source are reported
Nasopharyngeal carcinoma (NPC) is strongly associated with Epstein‐Barr virus (EBV). We reported that suberoylanilide hydroxamic acid (SAHA) induced EBV lytic cycle in EBV‐positive gastric carcinoma ...cells and mediated enhanced cell death. However, expression of EBV lytic proteins was thought to exert antiapoptotic effect in EBV‐infected cells. Here, we examined the in vitro and in vivo effects of SAHA on EBV lytic cycle induction in NPC cells and investigated the cellular consequences. Micromolar concentrations of SAHA significantly induced EBV lytic cycle in EBV‐positive NPC cells. Increased apoptosis and proteolytic cleavage of poly(ADP‐ribose) polymerase and caspase‐3, ‐7 and ‐9 in EBV‐positive versus EBV‐negative NPC cells were observed. More than 85% of NPC cells expressing immediate‐early (Zta), early (BMRF1) or late (gp350/220) lytic proteins coexpressed cleaved caspase‐3. Tracking of expression of EBV lytic proteins and cleaved caspase‐3 over time demonstrated that NPC cells proceeded to apoptosis following EBV lytic cycle induction. Inhibition of EBV DNA replication and late lytic protein expression by phosphonoformic acid did not impact on SAHA's induced cell death in NPC, indicating that early rather than late phase of EBV lytic cycle contributed to the apoptotic effect. In vivo effects of SAHA on EBV lytic cycle induction and tumor growth suppression were also observed in NPC xenografts in nude mice. Taken together, our data indicated that activation of lytic cycle from latent cycle of EBV by SAHA leads to apoptosis and tumor growth suppression of NPC thereby providing experimental evidence for virus‐targeted therapy against EBV‐positive cancer.
A Zn benzotriazolate metal–organic framework (MOF), Zn(ZnO2CCH3)4(bibta)3 (1, bibta2– = 5,5′-bibenzotriazolate), has been subjected to a mild CH3CO2 –/HCO3 – ligand exchange procedure followed by ...thermal activation to generate nucleophilic Zn–OH groups that resemble the active site of α-carbonic anhydrase. The postsynthetically modified MOF, Zn(ZnOH)4(bibta)3 (2*), exhibits excellent performance for trace CO2 capture and can be regenerated at mild temperatures. IR spectroscopic data and density functional theory (DFT) calculations reveal that intercluster hydrogen bonding interactions augment a Zn–OH/Zn–O2COH fixation mechanism.
Mitochondrial dynamics underlies malignant transformation, cancer progression, and response to treatment. Current research presents conflicting evidence for functions of mitochondrial fission and ...fusion in tumor progression. Here, we investigated how mitochondrial fission and fusion states regulate underlying processes of cancer progression and metastasis in triple-negative breast cancer (TNBC).
We enforced mitochondrial fission and fusion states through chemical or genetic approaches and measured migration and invasion of TNBC cells in 2D and 3D in vitro models. We also utilized kinase translocation reporters (KTRs) to identify single cell effects of mitochondrial state on signaling cascades, PI3K/Akt/mTOR and Ras/Raf/MEK/ERK, commonly activated in TNBC. Furthermore, we determined effects of fission and fusion states on metastasis, bone destruction, and signaling in mouse models of breast cancer.
Enforcing mitochondrial fission through chemical or genetic approaches inhibited migration, invasion, and metastasis in TNBC. Breast cancer cells with predominantly fissioned mitochondria exhibited reduced activation of Akt and ERK both in vitro and in mouse models of breast cancer. Treatment with leflunomide, a potent activator of mitochondrial fusion proteins, overcame inhibitory effects of fission on migration, signaling, and metastasis. Mining existing datasets for breast cancer revealed that increased expression of genes associated with mitochondrial fission correlated with improved survival in human breast cancer.
In TNBC, mitochondrial fission inhibits cellular processes and signaling pathways associated with cancer progression and metastasis. These data suggest that therapies driving mitochondrial fission may benefit patients with breast cancer.
•A novel semi-empirical method measuring local effective thermal conductivity of VC is devised.•VC thickness between 0.3 and 0.5 mm exhibits noticeable thermal impacts.•Condenser effective thermal ...conductivity becomes less than copper at sub-cooling condition.•Effective thermal conductivity is correlated into functions of heat flux and VC orientation.
Present study proposes a semi-empirical method to measure the effective thermal conductivities (keff) of a thin vapor chamber (VC). With the liquid-vapor phase change processes as the dominant heat transfer mechanisms in a VC, the keff measurements are expressed as the functions of heat flux and VC orientation. Thermal performance tests measuring the thermal resistances and keff at horizontal and vertical orientations are carried out using three thin VCs of the identical capillary structure with the total thickness of 0.3 mm, 0.4 mm, and 0.5 mm. With the augmented counteracting vapor-liquid flows in these thin VCs, the thermal resistances are raised from a conventional VC. But the thermal spreading performances indexed by keff over the evaporator region remain compatible with the conventional VCs. The sub-cooling effect significantly undermines the thermal spreading performance over the condenser region. When the interior copper pillars are immerged within the excess liquid in condenser, the condenser keff can be less than the thermal conductivity of copper, which phenomenon requires design precautions. While the VC thickness exhibits the noticeable impacts on the thermal performances of the thin VCs, their thermal resistances and evaporator keff are less affected by VC orientation to confirm the anti-gravity properties. A set of empirical correlations evaluating the thermal resistance of these thin VCs are devised for design applications.
A combination of a three-dimensional Eulerian ocean circulation model (Princeton ocean model, POM) and a Lagrangian particle-tracking model (Surface-Trapped River Plume Evolution, STRiPE) is used to ...study the fate of fine river sediments discharged by the Peinan River at the southeastern coast of the island of Taiwan. The composite model is verified against in situ measurements and applied to simulate primary sediment deposition under freshet and typhoon discharge conditions of the Peinan River. It is shown that local wind plays a crucial role in sediment transport and settling in the coastal area through its influence on the river plume dynamics and turbulent mixing in the upper layer. Wind forcing conditions generally determine the location of the sediment deposit area, while its final pattern is defined by coastal circulation as modulated by the geometry of the coast and local bathymetry. In the study, region river-borne sediments are deposited to the sea floor, mainly in the shallow shelf areas. A significant portion of discharged fine sediments is moved offshore to the deeper ocean where it is further advected and dispersed by strong coastal circulation, mainly governed by the Kuroshio Current.The performed numerical experiments showed that sediment accumulation rate under typhoon conditions is about 2 orders of magnitude greater compared to freshet conditions. Based on the simulation results, we identified areas of continental shelf and continental slope adjacent to the Peinan River estuary which exhibit a high risk of formation of submarine landslides during and shortly after the typhoon events.
Background
The transvaginal natural orifice specimen extraction (NOSE) approach for right-side colon surgery has been proven to exhibit favorable short-term outcomes. However, thus far, no study has ...reported the advantages of transrectal NOSE for right-side colon surgery. The aim of this study was to compare the technical feasibility, safety, and short-term outcomes of minimally invasive right hemicolectomy using the transrectal NOSE method and those of conventional mini-laparotomy specimen extraction.
Methods
A study was conducted on consecutive patients who had minimally invasive right hemicolectomy either for malignancy or benign disease at Chang Gung Memorial Hospital, Linkou, Taiwan, between January 2017 and December 2018. The patients were divided into two groups: conventional surgery with specimen extraction using mini-laparotomy and NOSE surgery. Surgical outcomes, including complications, postoperative short-term recovery, and pain intensity, were analyzed.
Results
We enrolled 297 patients (151 males, mean age 64.9 ± 12.8 years) who had minimally invasive right hemicolectomy. Of these 297 patients, 272 patients had conventional surgery with specimen extraction through mini-laparotomy and 25 patients had NOSE surgery (23 transrectal, 2 transvaginal). The diagnosis of colon disease did not differ significantly between the conventional and NOSE groups. Postoperative morbidity and mortality rates were comparable. The postoperative hospital stay was significantly (
p
= 0.004) shorter in the NOSE group (median 5 days, range 3–17 days) than in the conventional group (median 7 days, range 3–45 days). Postoperative pain was significantly (
p
= 0.026 on postoperative day 1 and
p
= 0.002 on postoperative day 2) greater in the conventional group than in the NOSE group.
Conclusions
NOSE was associated with acceptable short-term surgical outcomes that were comparable to those of conventional surgery. NOSE results in less postoperative wound pain and a shorter hospital stay than conventional surgery. Larger studies are needed
PDF
