Abstract
Wearable strain sensors that detect joint/muscle strain changes become prevalent at human–machine interfaces for full-body motion monitoring. However, most wearable devices cannot offer ...customizable opportunities to match the sensor characteristics with specific deformation ranges of joints/muscles, resulting in suboptimal performance. Adequate wearable strain sensor design is highly required to achieve user-designated working windows without sacrificing high sensitivity, accompanied with real-time data processing. Herein, wearable Ti
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MXene sensor modules are fabricated with in-sensor machine learning (ML) models, either functioning via wireless streaming or edge computing, for full-body motion classifications and avatar reconstruction. Through topographic design on piezoresistive nanolayers, the wearable strain sensor modules exhibited ultrahigh sensitivities within the working windows that meet all joint deformation ranges. By integrating the wearable sensors with a ML chip, an edge sensor module is fabricated, enabling in-sensor reconstruction of high-precision avatar animations that mimic continuous full-body motions with an average avatar determination error of 3.5 cm, without additional computing devices.
The oral absorption of a therapeutic peptide (such as exenatide; EXT) that can improve glycemic control in the treatment of type 2 diabetes is limited by multiple barriers of the intestinal ...epithelium. This work presents an oil‐structured nanoemulsion system that consists of a phase‐changeable fatty acid that allows EXT (EXT@PC/NEMs) to be delivered orally and absorbed efficiently in the small intestine. To construct an appropriate vehicle to encapsulate EXT, an oil‐in‐water single emulsion is generated at 37 °C, which is well above the melting point of the fatty acid but below the denaturation temperature of the peptide drug. The as‐prepared EXT@PC/NEMs are physically stable when stored at 4 °C, as they form a solid core, which prevents drug leakage. Upon their oral delivery at body temperature, the deformable liquid EXT@PC/NEMs may undergo effective cellular uptake, enhancing their permeability across the intestinal epithelium. The orally administered PC/NEMs significantly improve the bioavailability of EXT via intestinal lymphatic transport, ultimately accumulating in the pancreas, suggesting the possibility of orally delivering labile peptide drugs. The delivered EXT may act on pancreatic β‐ and α‐cells to stimulate insulin release and suppress glucagon secretion, respectively, reducing the blood glucose level, eventually having antidiabetic effects.
Phase‐changeable nanoemulsions are used to encapsulate a peptide drug during emulsification at 37 °C and are physically stable when stored at 4 °C. Upon oral ingestion at body temperature, the deformable liquid nanoemulsions undergo effective cellular uptake, enhancing their permeability across the intestinal epithelium, ultimately accumulating in the pancreas via lymphatic transport to exert their beneficial antidiabetic effects.
Mass screening with abdominal ultrasonography (AUS) has been suggested as a tool to control adult hepatocellular carcinoma (HCC) in individuals, but its efficacy in reducing HCC mortality has never ...been demonstrated. This study aimed to assess the effectiveness of reducing HCC mortality by mass AUS screening for HCC based on a program designed and implemented in the Changhua Community‐based Integrated Screening (CHCIS) program with an efficient invitation scheme guided by the risk score. We invited 11,114 (27.0%) of 41,219 eligible Taiwanese subjects between 45 and 69 years of age who resided in an HCC high‐incidence area to attend a risk score‐guided mass AUS screening between 2008 and 2010. The efficacy of reducing HCC mortality was estimated. Of the 8,962 AUS screening attendees (with an 80.6% attendance rate), a total of 16 confirmed HCC cases were identified through community‐based ultrasonography screening. Among the 16 screen‐detected HCC cases, only two died from HCC, indicating a favorable survival. The cumulative mortality due to HCC (per 100,000) was considerably lower in the invited AUS group (17.26) compared with the uninvited AUS group (42.87) and the historical control group (47.51), yielding age‐ and gender‐adjusted relative mortality rates of 0.69 (95% confidence interval CI: 0.56‐0.84) and 0.63 (95% CI: 0.52‐0.77), respectively. Conclusion: The residents invited to community‐based AUS screening for HCC, compared with those who were not invited, showed a reduction in HCC mortality by ∼31% among subjects aged 45‐69 years who had not been included in the nationwide vaccination program against hepatitis B virus infection. (Hepatology 2014;59:1840–1849)
Exercise improves health, but illnesses can cause changes in exercise behavior, including starting or stopping. This study investigated the effects of chronic disease screening on inactive ...individuals' exercise behavior and analyzed the impact of age and chronic disease history on this relationship using stratified analysis.
Using a community-based prospective observational cohort design and data from the Changhua Community-Based Integrated Screening (CHCIS) dataset from 2005 to 2020, we examined 12,038 people who were screened at least twice and self-reported having never exercised at their first screening. Changes in exercise behavior were classified as “initiating exercise” and “remaining inactive.” We obtained chronic disease screening results from CHCIS records, which included measurements of waist circumference, blood glucose, blood pressure, triglycerides, and high-density lipoproteins. SAS version 9.4 was used for COX proportional hazards regression.
The findings indicated that abnormal waist circumference and blood pressure increased the likelihood of initiating exercise compared to normal results. Age stratification showed that those aged 40–49 with abnormal results were more likely to start exercising than normal participants, but not those under 40 or over 65. When stratified by chronic disease history, abnormal screening results correlated with exercise initiation only in groups without chronic disease history, except for those with a history of hyperlipidemia.
This is the first study to demonstrate that abnormal screening results may influence exercise initiation in individuals who have never exercised, and this association varies by screening item, age, and disease history.
•Abnormal screening results can motivate non-exercisers to start exercising.•Abnormal waist and blood pressure are associated with initiation of exercise.•The link between screening results and exercise varies by age and disease history.
This study evaluated short-term (1-month) and long-term (1-year) mortality risks associated with the glomerular filtration rate (eGFR) on admission for patients with intracerebral hemorrhage.
From ...the Taiwan Stroke Registry data from April 2006 to December 2016, we identified and stratified patients with intracerebral hemorrhage into five subgroups by the eGFR level on admission: ≥90, 60-89, 30-59, 15-29, and <15 mL/min/1.73 m2 or on dialysis. Risks for 1-month and 1-year mortality after intracerebral hemorrhage were compared by the eGFR levels.
Both the 1-month and 1-year mortality rates progressively increased with the decrease in eGFR levels. The 1-month mortality rate in patients with eGFR < 15 mL/min/1.73 m2 or on dialysis was approximately 5.5-fold greater than that in patients with eGFR ≥ 90 mL/min/1.73 m2 (8.31 versus 1.50 per 1000 person-days), with an adjusted hazard ratio (HR) of 4.59 95% confidence interval (CI) = 2.71-7.78. Similarly, the 1-year mortality in patients with eGFR < 15 mL/min/1.73 m2 or on dialysis was 7.5 times that in patients with eGFR ≥ 90 mL/min/1.73 m2 (2.34 versus 0.31 per 1000 person-days), with an adjusted HR of 4.54 (95% CI 2.95-6.98).
Impairment of renal function is an independent risk factor for mortality in patients with intracerebral hemorrhage in a gradual way. The eGFR level is a prognostic indicator for patients with intracerebral hemorrhage.
For its second decade, Taiwan's National 10‐Year Long‐Term Care Plan launched a policy of reinforcing home‐ and community‐based services (HCBSs) with a focus on reablement. This study aimed to (1) ...identify the distinct service use patterns of reablement‐embedded HCBS and (2) examine the effects of these service patterns on functional improvements among older care recipients, including among groups with different levels of care needs. We collected 2018 data from the Long‐Term Care Service Management System for care recipients in one county located in central Taiwan (N = 4735). Three recipient groups were assigned based on level of care needs. We included data on use of the following services: reablement, home care, respite care, applications for assistive devices and home environmental modifications, transportation to medical appointments and community‐based services. Outcome variables were measured by change scores between successive assessments of activities of daily living (ADL) and instrumental activities of daily living (IADL). Latent class analysis and multivariate linear regression analyses were used to analyse relationships between use patterns, participant subgroups and outcomes. Four subgroups of HCBS use patterns were found. Care recipients with low care needs had greater potential to improve their physical function in ADL through reablement‐embedded HCBS. Care recipients in the groups with low and high care needs showed overall benefits in functional improvements in ADL and IADL from personal care–based HCBS. Care recipients in the community‐based and multiple services–based use pattern subgroups showed the least improvement in physical function. Our study indicates that the effects of reablement‐embedded HCBS use strategies may vary among older adults with different levels of care needs. We recommend further research to examine how to design HCBS with a reablement focus to better fit the needs of those with moderate and high levels of care needs.
liu c.‐c., chen y.‐c., yeh y.‐p. & hsieh y.‐s.
(2011) Effects of maternal confidence and competence on maternal parenting stress in newborn care. Journal of Advanced Nursing 68(4), 908–918.
Aim. ...This paper is a report of a correlational study of the relations of maternal confidence and maternal competence to maternal parenting stress during newborn care.
Background. Maternal role development is a cognitive and social process influenced by cultural and family contexts and mother and child characteristics. Most knowledge about maternal role development comes from western society. However, perceptions of the maternal role in contemporary Taiwanese society may be affected by contextual and environmental factors.
Methods. A prospective correlational design was used to recruit 372 postpartum Taiwanese women and their infants from well‐child clinics at 16 health centres in central Taiwan. Inclusion criteria for mothers were gestational age >37 weeks, ≥18 years old, and healthy, with infants <4 months old. Data were collected between August 2007 and January 2008 using a self‐report questionnaire on mothers’ and infants’ demographic variables, maternal confidence, maternal competence and self‐perceived maternal parenting stress.
Results. After controlling for maternal parity and infant temperament, high maternal confidence and competence were associated with low maternal parenting stress. Maternal confidence influenced maternal parenting stress both directly and indirectly via maternal competence.
Conclusion. To assist postpartum women in infant care programmes achieve positive outcomes, nurses should evaluate and bolster mothers’ belief in their own abilities. Likewise, nurses should not only consider mothers’ infant care skills, but also mothers’ parity and infant temperament. Finally, it is crucial for nurses and researchers to recognize that infant care programmes should be tailored to mothers’ specific maternal characteristics.
Sugar-sweetened beverages (SSBs) are linked to increased metabolic risk. However, the sex differences in the relationship between SSB intake and adverse health effects remain unclear. Therefore, the ...present study examined the association between SSB consumption and metabolic risks among working-age males and females from Taiwanese communities.
A community-based study utilized data from a comprehensive health screening project conducted by the Public Health Bureau in Changhua County, Taiwan. Metabolic risks included waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL), and fasting glucose level using serum tests.
Participants were recruited in Changhua County, Taiwan.
Between 2005 and 2014, 92,724 citizens participated in the health screening; our data analysis included 75,278 respondents between 30 and 64.
The results showed that the frequency of SSB consumption was associated with abnormal waist circumference and elevated total cholesterol, triglycerides, LDL, and glucose in both men and women. Increased SSB consumption frequency was associated with elevated glucose and hypertension in women. Even a slight increase in SSB intake frequency was related to raising the metabolic risks. Similar patterns were evident when models included body mass index (BMI); however, the associations were attenuated. In the BMI-stratified subgroup analysis, the relationship between SSB consumption and metabolic risks was more pronounced in participants without obesity.
The present study suggests that SSB consumption carries metabolic risk among working-age Taiwanese, particularly women and those without obesity. Health promotion programs should raise awareness of the health hazards associated with SSBs.
We reported two cases with community-acquired pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who returned from Wuhan, China in January, 2020. The reported cases ...highlight non-specific clinical presentations of 2019 novel coronavirus disease (COVID-19) as well as the importance of rapid laboratory-based diagnosis.
Background
We investigated the uses and frequency of self‐monitoring of blood glucose (SMBG) with glycemic control and hypoglycemia in two groups of type 2 diabetes (T2D) (recently diagnosed and ...long‐term follow‐up) using real‐world data in Taiwan (the Taiwan Diabetes Registry).
Methods
Patients with T2D recently diagnosed within 6 months (n = 3297, mean age 54.4 ± 13.9 years) and T2D patients with long‐term follow‐up (n = 1201, mean age 65.5 ± 12.1 years, mean diabetes duration 14.3 ± 7.8 years) from the Taiwan Diabetes Registry were analysed. All patients were interviewed by certified diabetes educators. Information about SMBG and hypoglycemia was recorded. Demography, personal history, and laboratory data were obtained from electronic medical records. Logistic regression analyses were used to examine the associations of SMBG with glycated haemoglobin (HbA1c) <7% and hypoglycemia.
Results
Mean HbA1c values were 8.4 ± 2.5 and 7.6 ± 1.4%, respectively, in the recently diagnosed and long‐term follow‐up T2D groups. The self‐reported rates of hypoglycemic events within 3 months were 10.5% and 19.0%, respectively. SMBG was associated with higher odds of HbA1c <7% (OR 1.21, 95% CI 1.01‐1.44) in patients with recently diagnosed T2D, but with lower odds of HbA1c <7% in T2D patients with long‐term follow‐up (OR 0.60, 95% CI 0.44‐0.82). In both study populations, SMBG was independently associated with hypoglycemia (OR 3.90 95% CI 2.99‐5.08 and OR 3.93 95% CI 2.73‐5.66, respectively). The aforementioned findings were consistent across the strata of SMBG frequency.
Conclusion
We reported different associations between SMBG and glycemic control in patients recently diagnosed with T2D and in T2D patients with long‐term follow‐up. SMBG was associated with higher detection of hypoglycemic episodes in both study populations.
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