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[[alternative]]Surrounding greenness during prenatal and early-life windows and childhood asthma and related phenotypes: Role of genome and epigenome
No full text[[abstract]]過去數十年來，全世界不論兒童或是成人，氣喘以及相關過敏免疫疾病的盛行率，均逐年增加；目前，呼吸哮鳴、氣喘、異位性皮膚炎和過敏性鼻炎也是台灣孩童臨床上最常見的疾病；本計畫預計透過一系列的分析探討，藉以釐清嬰幼兒時期環境綠蔽度暴露、嬰幼兒時期環境綠蔽度及遺傳因子之間交互作用，以及嬰幼兒時期環境綠蔽度、遺傳因子和表觀基因組三者之間的關係對兒童氣喘以及相關過敏免疫疾病的發生的機制和影響，研究結果期能對孩童在臨床上常見的氣喘以及相關過敏免疫疾病之發生以及對其相關之免疫發炎機制方面的調控，能有進一步的了解，日後並能夠將此研究結果轉譯，藉此更準確地預測及預防孩童氣喘與過敏免疫疾病的發生，及早進行預防性治療。[[note]]學術補
Mitomycin C-immobilized silver nanoparticle-loaded polycaprolactone membrane for temporary scalp expansion after decompressive craniectomy to prevent wound infection
No full text[[abstract]]Malignant cerebral edema (MCE) represents a significant medical emergency characterized by unmanageable intracranial pressure (ICP), frequently arising as a consequence of traumatic brain injury (TBI) or ischemic stroke. Decompressive craniectomy (DC) is a prevalent surgical procedure employed to mitigate elevated ICP by excising a segment of the skull to enhance intracranial volume. Nevertheless, in patients suffering from MCE, the limited capacity for expansion of the scalp subsequent to DC may lead to sustained elevated ICP and complications including wound-edge necrosis, cerebrospinal fluid leakage, and infection. This investigation seeks to formulate a biocompatible, antibacterial, and anti-adhesive membrane intended for temporary scalp expansion following DC, thereby addressing these pressing concerns. The proposed membrane comprises polycaprolactone (PCL) augmented with silver nanoparticles (AgNPs) to confer antibacterial properties and is further immobilized with Mitomycin C (MMC) to minimize tissue adhesion, thereby facilitating more straightforward removal. The selection of PCL was predicated upon its remarkable mechanical strength and ductility, which make it suitable for withstanding intracranial edema and facilitating the suturing protocol. The AgNPs were synthesized through a green synthesis methodology employing epigallocatechin gallate (EGCG) to ensure environmental sustainability and the stability of the resultant nanoparticles. MMC, known for its anti-proliferative attributes, was affixed to the PCL surface via oxygen plasma treatment, thereby enhancing the anti-adhesive properties of the membrane. This study evaluates the mechanical characteristics, antibacterial effectiveness, anti-adhesive capabilities, and biocompatibility of the PCL/AgNPs/MMC membrane, thereby demonstrating its potential to improve outcomes in DC procedures by increasing intracranial volume and reducing postoperative complications
[[alternative]]Urinary bisphenol A and its substitutes exposure increased the risk of renal tubular injury (N-acetyl-β-d-glucosaminidase) in the general Taiwanese population
No full text[[abstract]]BACKGROUND: It is uncertain if exposure to BPA and its substitutes has an impact on renal function, including N-acetyl-β-D-glucosaminidase (NAG), which is an early marker for kidney injury. We aimed to (1) Estimate the daily intakes (DIs) of BPA and its substitutes using individual urinary levels and conduct the cumulative risk assessment of bisphenols. (2) Assessed the association between exposure to BPA and its substitutes with various renal function indices using a dose-based and cumulative risk assessment approach. METHODS: We recruited 366 participants, and three bisphenols (BPA, bisphenol F, and bisphenol S) were analyzed through ultraperformance liquid chromatography-tandem mass spectrometry. DI levels were calculated for each bisphenol. Hazard index (HI) values were calculated for determining cumulative risk. Using the renal function index, we measured the serum and urinary level (e.g., microalbumin, NAG). The NAG/Creatinine ratio (> 4 IU/g creatinine) and other renal functions indexes based on clinical cut-off points to defined abnormality. RESULTS: After adjustment for covariates, increased NAG/Creatinine ratios were associated with higher DIs of BPA, showing a dose-response trend (Adjusted Odds Ratio [AOR] (tertile2): 3.58, 95% CI = 1.52-8.44; AOR (tertile3): 7.34, 95% CI = 2.26-23.81; P (trend) < 0.001). Notably, the HI of bisphenols was positively associated with NAG/Creatinine in adults (AOR (tertile2)= 2.18, 95% CI = 1.10-4.34; AOR (tertile3)= 4.27, 95% CI = 2.14-8.51) after adjusted for covariates. CONCLUSION: We found a sensitive risk factor for abnormal NAG/creatinine levels after exposure to BPA and its substitute. Further mechanistic studies are needed to clarify these associations
[[alternative]]在宅醫療的新篇章：高價值基礎支付的在宅住院模式
No full text[[abstract]]The aging of populations is expected to drive an increased demand for acute hospitalization. For hospitals facing limited resource growth and capacity, hospitalization can be substituted with a hospital-at-home (HaH) model. Recent reforms to health-care systems have focused on designing value-based care models. High-value care models should be cost-effective, patient-centered, and integrated and should ensure intervention efficacy. The current review introduces HaH models in different countries and outlines their value-based payment designs. These models are then compared with the HaH model under Taiwan’s National Health Insurance scheme (the "Acute Care at Home" model). The HaH model in Taiwan is subject to six key challenges: 1) uncertainty regarding actual HaH care costs, 2) difficulty in quantifying nonclinical efficacy, 3) geographic variation in care effectiveness, 4) incomplete integration of essential professions within the current bundled payment design, 5) complexities in information system integration, and 6) challenges in integrating HaH with long-term care services. To ensure high-value, holistic care under Taiwan’s HaH model, health-care providers can leverage existing home-based care infrastructure. HaH care should be integrated with long-term care, care teams should be expanded to encompass a wider range of professions, and robust information technology solutions should be implemented
Primers, snp markers and method for genotyping mycobacterium tuberculosis
No full text[[abstract]]The present application provides a primer set for genotyping M. tuberculosis selected from the group consisting of primer sets 1-25 (SEQ ID Nos. 1-50), and also provides an extension primer for genotyping M. tuberculosis selected from one of the group consisting of SEQ ID Nos. 51-75. The present application provides a combination of single-nucleotide polymorphism markers of M. tuberculosis. Further, the present application provides a method and a kit for genotyping M. tuberculosis
Primers, snp markers and method for genotyping mycobacterium tuberculosis
No full text[[abstract]]The present application provides a method for genotyping M. tuberculosis, comprising obtaining amplifying and obtaining a first DNA fragment from a DNA sample by using one or more primer sets selected from the group consisting of primer sets 1 to 25 (SEQ ID Nos. 1 to 50); amplifying and obtaining a second DNA fragment from the obtained first DNA fragment by using one or more extension primers selected from the group consisting of SEQ ID Nos. 51 to 75; and detecting the second DNA fragment by using mass spectrometry, particularly by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS)
Methods of obtaining immunosuppressive cells
No full text[[abstract]]This invention relates to an immunosuppressive cell, and methods of obtaining the cell and using the cell. The immunosuppressive cell is obtained by culturing a precursor cell in a medium that contains a GRO chemokine
Microfluidic dual-well device for highthroughput single-cell capture and culture
No full text[[abstract]]A microfluidic dual-well device is disclosed. The device comprises: (a) a first substrate having a first end, a second end, and a culture microwell forming portion; (b) a plurality of culture microwells; (c) a second substrate having a first end, a second end, and a capture microwell forming portion, the two ends of the second substrate being respectively bounded to the two ends of the first substrate; (d) a plurality of capture microwells; (e) a microfluidic channel; (f) a microfluidic inlet port; and (g) a microfluidic outlet port; wherein the microfluidic channel is in fluidic connections with the culture microwells, the capture microwells, and the inlet and outlet ports. Methods of capturing and transferring a single cell or a single cell colony for culture, and method of transferring a target cell from a polydimethylsiloxane (PDMS) structure of culture microwells to a culture plate for culture are also disclosed
TCOG T3221 study: The registry of genetic alterations of Taiwan biliary tract cancer
No full text[[abstract]]Background :Recent advances in oncology drug development and next-generation sequencing (NGS)-based genomic profiling have greatly improved treatment precision for advanced biliary tract cancer (BTC). The current registration study (NCT05036486) was initiated to evaluate targetable genetic alterations in specific BTC groups in Taiwan. Methods: A total of 264 tumor tissues from 194 adenocarcinoma or adenosquamous carcinoma of intrahepatic cholangiocarcinoma (ICC), 38 extrahepatic cholangiocarcinoma (ECC), and 32 gallbladder cancer (GBC) were sequenced with a clinical-graded panel ACTOnco®+ encompassing 440 cancer-related genes. Therapeutic evidence of predictive biomarkers was categorized into levels 1-4 using the Memorial Sloan Kettering Precision Oncology Knowledge Base classification. Baseline characteristics, previous history, and subsequent treatment and outcomes were collected at six-month intervals until either expiration or five years following enrollment. Results: The most commonly altered genes in the entire cohort were TP53 (45%), KRAS (23%), CDKN2A (14%), ARID1A (13%), ERBB2(HER2, 11%), and BAP1 (7%). Therapeutic biomarkers with evidence levels 1-4 were identified in 58%, 58%, and 56% of patients with ICC, ECC, and GBC, respectively. Among the ICC group, 28.5% harbored level 1 biomarkers, including the IDH1R132C mutation (11.3%), FGFR2 fusions (10.5%), tumor mutation burden-high (TMB H, 5.7%), RET fusion (0.5%), and BRAFV600E mutation (0.5%), which occurred mutually exclusively. While level 1 therapeutic biomarkers are rarely found in non-ICC patients, such as 1 (2.6%) IDH1R132C mutation in ECC and 1 (3.1%) TMB-H in GBC, there is a notably higher prevalence of targetable HER2 alterations, including gene mutations and amplifications, in GBC (28.1%) compared to ICC (10.5%) and ECC (7.7%). Conclusions: Resutls from the extensive multi-center study in Taiwan on tissue NGS for specific BTC populations could become a benchmark for reimbursed diagnostic tests
Longitudinal transition of osteoporosis status among middle-aged and older adults in a Taiwanese longitudinal study
No full text[[abstract]]Objectives: This study aims to predict the longitudinal transition of osteoporosis status among adults aged 55 years and older. Material and Methods: Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry at baseline and a follow-up visit in the Healthy Aging Longitudinal Study in Taiwan (HALST). Osteoporosis status was categorized based on the lower BMD T-score between lumbar spine (L1 – L4) and femur neck as severe osteoporosis (T-score ≤ -3), osteoporosis (-3 < T-score ≤ -2.5), osteopenia (-2.5 < T-score <-1), or normal status (T-score ≥ -1). Baseline characteristics included sex, age, body mass index, education level, smoking and drinking status, frailty status, and serum vitamin D concentration. A four-state semi-Markov model was employed to predict longitudinal tran- sitions of osteoporosis status for participants by their osteoporosis status at baseline. Re- sults: Among the 3,681 participants with one BMD measurement at baseline, 51.4% were women (n=1,893). Moreover, 49.9% of women (n=945) had osteopenia, 11.4% (n=215) had osteoporosis, and 16.0% (n=302) had severe osteoporosis. Correspondingly, among men (n=1,788), 38.3% (n=684) had osteopenia, 4.2% (n=75) had osteoporosis, and 2.6% (n=47) had severe osteoporosis. After an average of 6 years of follow-up, a notable proportion of participants experienced transitions in osteoporosis status. Among women (n=767), 12.1% (n=44) progressed from osteopenia to osteoporosis, 2.2% (n=8) from osteopenia to severe osteoporosis, and 38.2% (n=29) from osteoporosis to severe osteoporosis. Corresponding- ly, among men (n=728), 7.4% (n=20) transitioned from osteopenia to osteoporosis, 1.1% (n=3) from osteopenia to severe osteoporosis, and 30.4% (n=7) from osteoporosis to se- vere osteoporosis. Adjusting for various factors, women participants over 75 years old, frail women, and those with insufficient vitamin D levels revealed higher transition probabilities to severe status (osteopenia, osteoporosis, or severe osteoporosis) (Figure). Conclusions: In middle-aged and older Taiwanese adults, transition probabilities between different osteoporosis statuses varied by sex, age group, frailty status, and serum vitamin D concentration. These findings suggest the potential for targeted health promotion strategies based on current osteoporosis status and individualized risk factors, particularly, among women, older adults, frail individuals, and people with insufficient vitamin D levels