Showing papers by "Taipei Veterans General Hospital published in 2022"
TL;DR: In this paper, generalized additive model-penalized regression splines and logistic regression models were employed to determine the risk for low birth weight (LBW) or small for gestational age (SGA) among pregnant women exposed to PAEs.
9 citations
03 Jan 2022
TL;DR: The SARS-CoV-2 vaccination was also recommended by the international society for patients with inflammatory bowel disease (IBD) as discussed by the authors , however, IBD patients were not recruited in prospective randomized clinical vaccine studies.
Abstract: In the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been effective in preventing COVID-19 infections and related mortality. The SARS-CoV-2 vaccination was also recommended by the international society for patients with inflammatory bowel disease (IBD). However, IBD patients were not recruited in prospective randomized clinical vaccine studies. To evaluate the efficacy and safety of SARS-CoV-2 vaccination in IBD patients, we conducted this systemic review and meta-analysis.We systematically searched PubMed, Medline, and the Cochrane Library for studies published between January 1, 2019, and September 9, 2021. Studies written in English reported the efficacy, seroconversion (anti-SARS-CoV-2 anti-spike (S) antibody titer beyond the threshold) rate, and adverse events after the SARS-CoV-2 vaccination in IBD patients. We extracted the author, date, study design, country, types of SARS-CoV-2 vaccination, number of IBD patients receiving SARS-CoV-2 vaccinations, and study outcomes. Published data from the enrolled studies were pooled to determine effect estimates. The study protocol was registered in PROSPERO (CRD42021264993).We analyzed findings from 27 454 IBD patients who received SARS-CoV-2 vaccinations in 11 studies that met the inclusion criteria. The post-SARS-CoV-2 vaccination COVID-19 infection rate was comparable between the IBD patients and non-IBD patients (odds ratio [OR], 1.28 [95% CI, 0.96-1.71]) and higher in nonvaccinated IBD patients compared with vaccinated IBD patients (OR, 8.63 [95% CI, 5.44-13.37]). The adverse event rate, severe adverse events, and mortality after the SARS-CoV-2 vaccination were 69%, 3%, and 0%, respectively.The SARS-CoV-2 vaccine is effective and tolerated in preventing COVID-19 infections in IBD patients. Over 98% of patients had seroconversion after receiving all doses of the SARS-CoV-2 vaccination, and the influence of biologics on vaccination was limited. The SARS-CoV-2 vaccination is recommended for IBD patients.
8 citations
09 Sep 2022
TL;DR: In this article , the effects of nerve-sparing procedures, combined with other covariate factors, on margin status were evaluated by the laterality and levels of NS techniques in site-specific prostate lobes.
Abstract: Background: Nerve-sparing (NS) techniques could potentially increase positive surgical margins after robot-assisted radical prostatectomy (RARP). Nevertheless, the available studies have revealed ambiguous results among distinct groups. This study purposed to clarify the details of NS techniques to accurately estimate their influence on margin status. Methods: We studied RARPs performed by one surgeon from 2010 to 2018. Surgical margins were evaluated by the laterality and levels of NS techniques in site-specific prostate lobes. The multivariable analysis evaluated the effects of nerve-sparing procedures, combined with other covariate factors, on margin status. Results: Overall, 419 RARPs involving 838 prostate lobes were analyzed. Notably, 181 patients (43.4%) had pT2-stage, and 236 (56.6%) had pT3-stage cancer. The PSM rates for patients who underwent unilateral, bilateral, and non NS procedures were 30.3%, 28.8%, and 50%, respectively (p = 0.233) or in stratification by pT2 (p = 0.584) and pT3 (p = 0.116) stage. The posterolateral PSM rates among site-specific prostate lobes were 10.9%, 22.4%, and 18.9% for complete, partial, and non NS techniques, respectively (p = 0.001). The partial NS group revealed a significant increase in PSM rate compared with the complete NS (OR 2.187, 95% CI: 1.19–4.03) and non NS (OR 2.237, 95% CI: 1.01–4.93) groups in site-specific prostate lobes. Conclusion: Partial NS procedures have a potential risk of increasing the positive surgical margins rate than complete and non NS procedures do. Therefore, correct case selection is required before performing partial NS techniques.
8 citations
TL;DR: In this paper, the authors explored how age and sex affect the impacts of self-rated health, self-reported physical activities, physical function, and depressive symptoms on long-term mortality among community-dwelling middle-aged and older adults using a nationally representative population-based cohort study.
8 citations
TL;DR: In this paper , the effects of FGF21 on EPCs under high oxidative stress conditions were investigated in a high-fat diet (H2 O2 )-induced oxidative stress impaired EPC function, including cell viability, migration and tube formation.
Abstract: Circulating endothelial progenitor cells (EPCs), which function in vascular repair, are the markers of endothelial dysfunction and vascular health. Fibroblast growth factor 21 (FGF21), a liver-secreted protein, plays a crucial role in glucose homeostasis and lipid metabolism. FGF21 has been reported to attenuate the progression of atherosclerosis, but its impact on EPCs under high oxidative stress conditions remains unclear. In vitro studies showed that the β-klotho protein was expressed in cultured EPCs and that its expression was upregulated by FGF21 treatment. Hydrogen peroxide (H2 O2 )-induced oxidative stress impaired EPC function, including cell viability, migration and tube formation. Pretreatment with FGF21 restored the functions of EPCs after the exposure to H2 O2 . Administration of N(ω)-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthase, inhibited the effects of FGF21 in alleviating oxidative injury by suppressing endothelial nitric oxide synthase (eNOS). In an in vivo study, the administration of FGF21 significantly reduced total cholesterol (TC) and blood glucose levels in apolipoprotein E (ApoE)-deficient mice that were fed a high-fat diet (HFD). Endothelial function, as reflected by acetylcholine-stimulated aortic relaxation, was improved after FGF21 treatment in ApoE-deficient mice. Analysis of mRNA levels in the aorta indicated that FGF21 increased the mRNA expression of eNOS and upregulated the expression of the antioxidant genes superoxide dismutase (SOD)1 and SOD2 in ApoE-deficient mice. These data suggest that FGF21 improves EPC functions via the Akt/eNOS/nitric oxide (NO) pathway and reverses endothelial dysfunction under oxidative stress. Therefore, administration of FGF21 may ameliorate a HFD-induced vascular injury in ApoE-deficient mice.
7 citations
TL;DR: In this article, the authors investigated the BDNF polymorphism contribution to the antidepressant effect of different forms left-sided prefrontal stimulations in a randomized, sham-controlled study and found a significant interaction between group, time, and BDNF genotypes effects on %HDRS-17 changes over time.
7 citations
TL;DR: In this paper , a conserved macrodomain, ADP Ribose phosphatase (ADRP), of a critical non-structural protein (Nsp3) in all coronaviruses was probed using large-scale molecular dynamics simulations to identify novel inhibitors.
7 citations
TL;DR: In this paper , a meta-analysis of randomized controlled trials of ACNRT and WM treatments for rheumatoid arthritis patients was conducted using Comprehensive Meta-Analysis V3 software.
Abstract: One new type of acupuncture and related techniques (ACNRT) is increasingly used by rheumatoid arthritis (RA) patients to control their disease and improve their quality of life. However, the efficacy of using ACNRT in combination with western medicine (WM) for this purpose remains unknown.Randomized controlled trials of ACNRT and WM treatments for RA from January 1, 2000, to January 31, 2021, were searched for in the databases PubMed, Embase, Medline, and the Cochrane Central Register of Controlled Trials, as well as in three Chinese databases: China National Knowledge Infrastructure, Wanfang Data, and Airiti Library. The primary outcomes consisted of inflammatory markers including C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor. The secondary outcomes were clinical characteristics including pain visual analog scale (VAS) score, Disease Activity Score (DAS-28), swollen joints count (SJC), tender joints count (TJC), morning stiffness, and the results of a health assessment questionnaire. The three types of ACNRT used in the focal trials were acupuncture, moxibustion, and electro-acupuncture. Two qualified researchers extracted data from these trials' results and independently assessed their risk of bias. Statistical analyses were performed using Comprehensive Meta-Analysis V3 software.A total of 12 RCTs with 874 patients met the inclusion criteria. As compared with the patients who received WM treatment alone, those who were given integrated ACNRT/WM treatment showed greater reductions in CRP (weighted mean difference [WMD]: -6.299; 95% CI: -9.082 to -3.517), ESR (WMD: -6.563; 95% CI: -8.604 to -4.522), VAS (WMD: -1.089; 95% CI: -1.575 to -0.602), DAS-28 (WMD: -0.633; 95% CI: -1.006 to -0.259), SJC (WMD: -1.921; 95% CI: -3.635 to -0.207), and TJC (WMD: -1.491; 95% CI: -2.941 to -0.042).This meta-analysis of RA provides reliable evidence in favor of ACNRT plus WM. However, longer term, high-quality, repeatable, multicenter randomized controlled trials with larger sample sizes are needed.
7 citations
TL;DR: Wang et al. as mentioned in this paper developed a method named NN-MM to model the multiple layers of regulation from genotypes to intermediate omics features, then to phenotypes, by extending conventional linear mixed models (MM) to multilayer artificial neural networks (NN).
Abstract: Abstract With the growing amount and diversity of intermediate omics data complementary to genomics (e.g. DNA methylation, gene expression, and protein abundance), there is a need to develop methods to incorporate intermediate omics data into conventional genomic evaluation. The omics data help decode the multiple layers of regulation from genotypes to phenotypes, thus forms a connected multilayer network naturally. We developed a new method named NN-MM to model the multiple layers of regulation from genotypes to intermediate omics features, then to phenotypes, by extending conventional linear mixed models (“MM”) to multilayer artificial neural networks (“NN”). NN-MM incorporates intermediate omics features by adding middle layers between genotypes and phenotypes. Linear mixed models (e.g. pedigree-based BLUP, GBLUP, Bayesian Alphabet, single-step GBLUP, or single-step Bayesian Alphabet) can be used to sample marker effects or genetic values on intermediate omics features, and activation functions in neural networks are used to capture the nonlinear relationships between intermediate omics features and phenotypes. NN-MM had significantly better prediction performance than the recently proposed single-step approach for genomic prediction with intermediate omics data. Compared to the single-step approach, NN-MM can handle various patterns of missing omics measures and allows nonlinear relationships between intermediate omics features and phenotypes. NN-MM has been implemented in an open-source package called “JWAS”.
6 citations
TL;DR: In this paper, a quantized distributed model-free adaptive iterative learning bipartite consensus control (QDMFAILBC) approach is proposed based on the dynamic linearization technology, algebraic graph theory, and sector-bound methods.
6 citations
TL;DR: In this paper , targeted therapy EGFR-tyrosine kinase inhibitors (TKIs) have been considered as primary option of NSCLC patients with activation EGFR mutation.
Abstract: Lung carcinoma (LC) is the third most common cancer diagnosis and accounted for the most cancer-related mortality worldwide in 2018. Based on the type of cells from which it originates, LC is commonly classified into non-small cell lung cancers (NSCLC) and small cell lung cancers (SCLC). NSCLC account for the majority of LC and can be further categories into adenocarcinoma, large cell carcinoma, and squamous cell carcinoma. Accurate classification of LC is critical for its adequate treatment and therapeutic outcome. Since NSCLC express more epidermal growth factor receptor (EGFR) with activation mutations, targeted therapy EGFR-tyrosine kinase inhibitors (TKIs) have been considered as primary option of NSCLC patients with activation EGFR mutation. In this review, we present the genetic alterations, reported mutations in EGFR, and TKIs treatment in NSCLC patients with an emphasis on the downstream signaling pathways in NSCLC progression. Among the signaling pathways identified, mitogen activation protein kinase (MAPK), known also as extracellular signal-regulated protein kinase (Erk) pathway, is the most investigated among the related pathways. EGFR activation leads to the autophosphorylation of its kinase domain and subsequent activation of Ras, phosphorylation of Raf and MEK1/2, and the activation of ERK1/2. Phosphatidylinositol 3-kinase (PI3K)/Akt is another signal pathway that regulates cell cycle and has been linked to NSCLC progression. Currently, three generations of EGFR TKIs have been developed as a first-line treatment of NSCLC patients with EGFR activation and mutation in which these treatment options will be further discussed in this review. The Supplementary Appendix for this article is available at http://links.lww.com/JCMA/A138.
TL;DR: In this paper , the authors summarized the most recent evidence supporting the beneficial effects of exercise on TBI outcomes, focusing on the efficacy of exercise for cognitive recovery after injury and its potential mechanisms.
17 Oct 2022
TL;DR: Wang et al. as mentioned in this paper found that inappropriate use of antibiotics may be associated with an increased risk of necrotizing enterocolitis (NEC) or bronchopulmonary dysplasia (BPD).
Abstract: Dear Editor, Premature preterm birth (PPB) is still a biggest challenge not only for obstetricians but also for pediatricians, because it dramatically increases the perinatal morbidity and mortality and also results in a heavy economic-social burden.1–3 Therefore, any information addressing the care of PPB-related premature preterm infants, especially for those with very low birth weight (VLBW) is welcome. We have read an article published in in the September issue of the Journal of the Chinese Medical Association with interest.4 The authors found that inappropriate use of antibiotics may be associated with an increased risk of necrotizing enterocolitis (NEC) or bronchopulmonary dysplasia (BPD).4 The authors attempted to explore the role of the using antibiotics, and the impact of antibiotic exposure duration on the occurrence of NEC and BPD.4 However, we found that the enrolled subjects were different in theory. Based on their description, the use of antibiotics included a combination of ampicillin and cefotaxime and a combination of teicoplanin and meropenem.3 The authors have explained that the different regimen was based on the different clinical presentation (infants with supposed early-onset sepsis and infant with ill-appearing clinical presentation). It implied that the study group consisting of some infants treated with empirical antibiotics and some infants treated with disease-related antibiotics. Moreover, we did not know what percentage of these two different groups of infants accounts for. Like cancer treatment, we would like to explore the role of adjuvant therapy on the outcome of the patients. If we put all stage of patients into analysis, the results may lead to misinterpretation. Since stage is the most important and independent prognostic factors, regardless of use of adjuvant therapy. For example, all the stage I patients do not need adjuvant therapy, but the outcome is good.5 By contrast, stage IV patients have worst outcomes compared to the stage I patients, even though they are rescued by the adjuvant therapy. If the stage IV patients are the main components of our proposed study, we think that results may demonstrate a positive correlation between adjuvant therapy and worse outcome,6 but is it real? We hope to see the kind response by authors.
TL;DR: The most common reason for discontinuing 1L sunitinib was disease progression (88.9% of patients) as discussed by the authors . But, the most common 2L targeted therapy, in 23 patients (85.2%), was the most commonly used 2L axitib (14.8%), and the median duration of 2L therapy was 4.0 (0.1-30.8) months.
Abstract: There are limited real-world data to guide the sequencing of targeted therapies in patients with metastatic renal cell carcinoma (mRCC). The objective of this study was to characterize real-world treatment patterns (primarily second line [2L]) after prior vascular endothelial growth factor (VEGF) targeted therapy in an unselected mRCC population from Taiwan between 2013 and 2017. Treatment-related adverse events (TRAEs) and their management were also evaluated (NCT03633579).This retrospective cohort study included patients who had received prior VEGF-targeted therapy and were treated at the National Taiwan University Hospital or the Taipei Veterans General Hospital between June 2013 and December 2017. Outcomes were characterized using descriptive statistics.Overall, 27 patients were included: 22 (81.5%) male; mean standard deviation (SD) age, 63.1 (11.1) years; 18 (66.7%) initiated targeted therapy during the year immediately following mRCC diagnosis. All patients received sunitinib as their first-line (1L) targeted therapy, with a median (range) treatment duration of 10 (1.8-65.8) months. The most common reason for discontinuing 1L sunitinib was disease progression (88.9% of patients). Everolimus was the most common 2L targeted therapy, in 23 patients (85.2%); 4 patients (14.8%) received 2L axitinib. Median (range) duration of 2L therapy was 4.0 (0.1-30.5) months for everolimus and 4.2 (0.5-9.2) months for axitinib. Ten TRAEs were reported among seven patients receiving 2L everolimus: hypertension (n = 5), hand-foot syndrome (n = 2), hyperglycemia (n = 1), renal failure (n = 1), and interstitial pneumonitis (n = 1). The majority (80%) of TRAEs were managed in the outpatient setting. No TRAEs were reported in the axitinib group.Real-world management of patients with mRCC in Taiwan broadly aligned with clinical guidelines and national reimbursement policy at the time of the study. These findings may be a useful reference for assessing the implications of evolving mRCC management approaches in Taiwan.
20 Jun 2022
TL;DR: In this paper , the authors compared the efficacy of two statin treatments (simvastatin vs rosuvastat) in achieving the combined goal of low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/L and non-high-density LDL-C <3.4 mmol/l in patients with type 2 diabetes and dyslipidemia.
Abstract: This study compared the efficacy of two statin treatments (simvastatin vs rosuvastatin) in achieving the combined goal of low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/L and non-high-density lipoprotein cholesterol (non-HDL-C) <3.4 mmol/L in patients with type 2 diabetes and dyslipidemia.After a 5-week run-in, 89 patients with type 2 diabetes having fasting triglyceride (TG) levels of 1.7 to 5.7 mmol/L or non-HDL-C levels of 3.4 to 5.2 mmol/L were randomized to receive simvastatin 20 mg daily for 4 weeks followed by 40 mg for 8 weeks or rosuvastatin 10 mg for 4 weeks followed by 20 mg for 8 weeks. The primary end-point was the percentage of patients achieving the combined goal at week 12.Although significant between-group differences were observed in changes in LDL-C and non-HDL-C levels, both study treatments were sufficiently intensive for a 40% to 55% LDL-C reduction. At the end of the study, the two groups had similar percentages of patients who achieved the combined lipid goal (84% vs 89%, p = 0.66). All patients who attained the combined lipid goal also met the apolipoprotein B (Apo-B) target of <0.9 g/L. No between-group differences were noted in changes in HDL-C and TG levels at week 12. The patients tolerated both treatments well.In our study, ≈85% of patients with type 2 diabetes and dyslipidemia could achieve the combined lipid goal with statin monotherapy. The two statin treatments could sufficiently control diabetic dyslipidemia (NCT00506961).
TL;DR: In this paper , suicidal ideation and different mood states of bipolar I disorder (BD) have been associated with dysregulated proinflammatory cytokines, including soluble interleukin-6 receptor (sIL-6R), soluble tumor necrosis factor-α receptor type 1 (sTNF-αR1), and C-reactive protein (CRP), and cognitive function was assessed using 2-back task and Go/No-Go task.
TL;DR: In this paper , a quantized distributed model-free adaptive iterative learning bipartite consensus control (QDMFAILBC) approach is proposed based on the dynamic linearization technology, algebraic graph theory, and sector-bound methods.
TL;DR: In this article , the authors used the levofloxacin-loaded chitosan/gelatin/β-glycerophosphate hydrogel sustained releasing system with good in vitro anti-bacterial efficacy and biocompatibility for ex vivo keratitis model to test the preclinical drug efficacy and to determine drug level in the anterior chamber of the eye.
TL;DR: In this article , the authors investigated the effect of mangrove restoration on the anti-scouribility of sediment sediments. And they found evidence for a link between restoration and increased extracellular polymeric substance (EPS) secretion.
TL;DR: In this article , the authors applied the Theory of Planned Behavior to predict exercise behaviors and intentions of teenagers and analyzed sex differences, finding that 22.1% of all students and more male students than female students exercised for ≥ 30 min/day on 5 or more days/week.
TL;DR: The Pediatric Orthopaedic Society of North America (POSNA) membership directory was searched for the presence of social media as mentioned in this paper , and a review of all Instagram and TikTok posts made by the POSNA members were reviewed.
Abstract: Social media has grown significantly and its application in health care has been dramatically accentuated by the COVID-19 pandemic. It is often considered as a "new dimension" of health care, particularly in its ability to provide health information. In 2017, the top social media sites utilized by pediatric orthopaedic surgeons included Facebook, LinkedIn, and Twitter. In our study, we analyze the current social media usage, trends in Instagram and TikTok content, and the perceptions on social media usage among pediatric orthopaedic surgeons.The Pediatric Orthopaedic Society of North America (POSNA) membership directory was searched for the presence of social media. A review of all Instagram and TikTok posts made by the POSNA members were reviewed. A survey regarding the perception of social media networks and content was distributed to all POSNA members.A total of 1231 POSNA members actively practicing in the United States were included in our study. In all, 327 (26.6%) had a LinkedIn profile, 34 (2.8%) had a professional Facebook profile, 15 (1.2%) had a public Instagram account, 0 (0%) had TikTok, and 72 (5.8%) had a professional Twitter account. Fifteen POSNA members with public Instagram accounts had 10,878 followers. A total of 907 Instagram posts were made, 134 (14.8%) of which were education and 462 (50.9%) of which were personal or political. The perception of various social media networks such as Instagram (3.02), Facebook (3.16), and LinkedIn (3.51) were positive on a 5-point Likert scale, while perceptions of TikTok (2.36) and Twitter (2.99) were negative. Educational posts on Instagram (3.19) and Facebook (3.37) were positive.We provide an update to the utilization of social media by pediatric orthopaedists. Use of Instagram and TikTok accounts remain rare. Educational posts, when hosted on an appropriate social media platform, are perceived positively among pediatric orthopaedists.Level IV.
TL;DR: Li et al. as mentioned in this paper evaluated the concordance of interpretation of intrapartum cardiotocography between physicians and AI-based FCNs of deep learning, and they found the sensitivity of nonreassuring fetal status evaluation by the AI model is better than with clinical practice, although the false-positive rate was higher in the FA model than in the clinical practice.
Abstract: A big congratulation is given to Dr. Li-Chun Liu as the 2021 Journal of the Chinese Medical Association Outstanding Research Paper Award winner who is selected from all authors having contributed their research works to the Journal of the Chinese Medical Association (JCMA) last year.1–6 This year's award, sponsored by the Chinese Medical Association-Taipei (CMA-Taipei), is granted to researchers who demonstrate their excellent performance and great contribution to enhanced better patients’ care. Dr. Liu won this credit at the Annual Meeting of the CMA-Taipei on July 16, 2022, held at Taipei, Taiwan, and the meeting is still affected apparently by the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) pandemic.7–9 Therefore, the annual conference is still held in the hybrid form, including virtual and physical meetings. Dr. Liu and her colleagues attempted to use a novel artificial intelligence (AI) tool, such as fully convolutional networks (FCNs) and deep learning to resolve the limits of physicians who are unable to monitor immediate and complicated physical changes of human beings at every moment. The intrapartum cardiotocography, one of the best examples and also a target of Dr. Liu’s work, is successfully applied to simultaneously monitor fetal well-being (fetal heart rate) and adequate uterine contraction during labor in a long-term period.6,9 With the assistance of intrapartum cardiotocography, many ominous signs, such as uterine hyperstimulation and abnormal fetal heartbeats, could be detected if the appropriate interpretation is given.6,9,10 However, as shown by Dr. Liu, visual interpretation of cardiotocography may be delayed and has a discrepancy between observers, resulting in different decision-making.6 With the implication of AI-aided analysis of cardiotocography by standard criteria, the discrepancy may be minimized.6 In Dr. Liu’s study design, nonreassuring fetal status may be at higher risk of the development of large discrepancy between the different observers. Therefore, the authors evaluated the concordance of interpretation of cardiotocography between physicians and AI-based FCNs of deep learning. The results showed a significant match between physicians and AI model to identify the six fetal heart rate classes, suggesting that the AI-based FCNs of deep learning is feasible for monitoring intrapartum fetal heartbeats. Additionally, there is a greatest accuracy to recognize fetal heart rate acceleration on electronic fetal monitoring, although there is less accuracy to identify variable deceleration of fetal heart rate on electronic fetal monitoring. Finally, they found the sensitivity of nonreassuring fetal status evaluation by the AI model is better than with clinical practice, although the false-positive rate was higher in the AI model than in the clinical practice,6 suggesting that the AI model has a competitive ability to identify fetal heart rate patterns but to evaluate the nonreassuring fetal status is still unsatisfactory. However, their effort is worthy of big applause, since it is a milestone. It is well known that the shortage of manpower and care providers in the rural area is still the biggest challenge in Taiwan.11 Therefore, it is an urgent need to provide more effective equipment to give more precise interpretation in taking care of pregnant women during labor. Furthermore, of the most critical point, a continuous work without interruption or any need for rest is also the strength of AI mode compared to physicians. It is worthy of our efforts to provide newborns or pregnant women away from dangers and to further decrease intrapartum-related morbidities and mortalities during labor. AI, although not new, may provide a better chance to achieve the aforementioned goal,12–15 based on their uncanny ability to learn about what’s in a signal or photograph, the meaning of spoken language and much more, just through exposure.12 However, there is no doubt that AI-assisting interpretation of intrapartum cardiotocography is still far from perfect and may lead to some errors, such as overdiagnosis resulting in overtreatment, which has been demonstrated in Dr. Liu’ study.6 Moreover, deep learning needs much data access and considers personal privacy. Sometimes, it is hard to convince the public to overcome this limitation; therefore, we don’t think that the AI-assistance system can totally replace traditional approaches or standard care yet.15 By contrast, AI-assistance systems may provide a rapid, prompt, immediate, uninterrupted, and possibly cost-effective supplement that may be most useful in crisis setting or in contexts where the traditional medical care system is out of date, or when there is shortage of medical care providers.11,15 All suggest that there is still a long way to go. We congratulate Dr. Liu to win the 2021 Journal of the Chinese Medical Association Outstanding Research Paper Award again, and welcome more and more excellent articles to be published in the Journal of the Chinese Medical Association.16 According to Dr. Savage’s recommendation, understanding why a system made a certain diagnosis can help to convince all physicians that it is legitimate in a medical setting.12 Finally, we appreciate all support to the JCMA, which obtains a new impact factor of 3.396 in 2021. We encourage researchers to use this platform to publish their excellent works, since with inspiration and effort by readers, authors, reviewers, and editors, the evolution of medical sciences toward better care for patients can be easily achieved. ACKNOWLEDGMENTS This article was supported by grants from the Taiwan Ministry of Science and Technology, Executive Yuan, Taiwan (MOST 110-2314-B-075-016-MY3 and MOST 111-2314-B-075-045), and Taipei Veterans General Hospital (V110C-082, and VGH111C-103). The authors appreciate the support from Female Cancer Foundation, Taipei, Taiwan.
TL;DR: In this paper , the authors investigated the anti-hypertensive effect of renal FXR on high-fructose-induced salt-sensitive hypertension and underlying mechanism and found that FXR inhibited Dynamin 3 (DNM3), a binding protein with nNOS in the renal medulla, and its deficiency elevated NO production in mIMCD-K2 cells.
Abstract: Farnesoid X Receptor (FXR) is highly expressed in renal tubules, activation of which attenuates renal injury by suppressing inflammation and fibrosis. However, whether renal FXR contributes to the regulation of blood pressure (BP) is poorly understood. This study aimed to investigate the anti-hypertensive effect of renal FXR on high-fructose-induced salt-sensitive hypertension and underlying mechanism.Hypertension was induced in male C57BL/6 mice by 20% fructose in drinking water with 4% sodium chloride in diet (HFS) for 8 weeks. The effects of FXR on NO production were estimated in vitro and in vivo .Compared with control, HFS intake elevated BP, enhanced renal injury and reduced renal NO levels as well as FXR expression in the kidney of mice. In the mouse renal collecting duct cells mIMCD-K2, FXR agonists promoted NO production by enhancing the expression of neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS), whereas this effect was diminished by fxr knockdown. We further found that Dynamin 3 (DNM3), a binding protein with nNOS in the renal medulla, was inhibited by FXR and its deficiency elevated NO production in mIMCD-K2 cells. In HFS-fed mice, renal fxr overexpression significantly attenuated hypertension and renal fibrosis, regulated the expression of DNM3/nNOS/iNOS, and increased renal NO levels.Our results demonstrated that renal FXR prevents HFS-induced hypertension by inhibiting DNM3 to promote NO production. These findings provide insights into the role and potential mechanism of renal FXR for the treatment of hypertension.
TL;DR: In this article , the authors examined whether increased excess pressure is associated with cognitive function impairment in community adults and found that higher excess pressure, derived from the arterial reservoir-excess pressure analysis, may integrate the pulsatile load of the proximal aorta.
Abstract: Carotid-femoral pulse wave velocity (cf-PWV), an index of mainly distal aortic stiffness, has been inconsistently associated with cognitive function. Excess pressure, derived from the arterial reservoir-excess pressure analysis, may integrate the pulsatile load of the proximal aorta. The present study examined whether increased excess pressure is associated with cognitive function impairment in community adults.A total of 992 community participants (69.5% females; mean age: 67.3 years; education 13.6 years) without cerebrovascular disease or dementia received the Montreal Cognitive Assessment (MoCA) to evaluate global cognition. Arterial reservoir and excess pressure, arterial stiffness, and wave reflections were assessed, using carotid tonometry and aortic Doppler flowmetry.Excess pressure integral (XSPI), percentage XSPI, cf-PWV, characteristic impedance (Zc), and forward and backward pressure amplitude (Pf, Pb, respectively) were significantly higher in 197 participants (19.9%) with a low MoCA score (<26 or <25, depending on level of education). In multivariable analyses, XSPI (standardized odds ratio, 95% confidence interval, 1.30, 1.06-1.59), and percentage XSPI (1.27, 1.06-1.52) but not cf-PWV (1.04, 0.85-1.26) were significantly associated with a low MoCA. Further analysis revealed that Pf and Zc were the major determinants of XSPI (partial R2: Pf = 0.656, Zc = 0.467) and percentage XSPI (Pf = 0.459, Zc = 0.371). In contrast, age, instead of Pf and Zc, was the major determinant of cf-PWV (partial R2: age = 0.187).Excess pressure (XSPI/percentage XSPI), mainly determined by the pulsatile hemodynamics of the proximal aorta, was significantly associated with cognitive function impairment in middle-aged and elderly community adults.
TL;DR: In this paper , the authors analyzed the bioactive functions of four kinds of dietary phospholipids in skeletal muscle and compared their composition differences using UPLC-Q-TOF-MS.
Abstract: Phospholipids have been recognized as significant functional lipids related to nutrition, while they were complex and multiple, and their sources were various. Bioactive functions of phospholipids in skeletal muscle were given serious attention; however, studies on dietary phospholipid profiles with functions on skeletal muscle were rarely reported. Here, we analyzed phospholipid profiles of four kinds of dietary phospholipids (including yolk phospholipid, soybean phospholipid, perilla seed phospholipid and krill oil phospholipid) and compared their composition differences using UPLC-Q-TOF-MS. Lipidomics emphasized significant differences in compositions. Krill oil phospholipid rich in ω-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFAs) showed the most excellent effect in skeletal muscle protection. Compared with triglyceride-type lipid (fish oil), phospholipids had higher bioavailability. Besides, as for a higher degree of unsaturation of phospholipid, they did not always perform better effects, which might be related to being more susceptible to suffering from oxidative stress. Overall, four representative phospholipids were analyzed and compared for their bioactive function in skeletal muscle, providing a reference for better understanding relationships between structures and functional applications of phospholipids. • The phospholipid profiles of four kinds of dietary phospholipids were analyzed. • The skeletal muscle injury model of zebrafish was established. • Phospholipids can protect against skeletal muscle injury, especially for krill oil phospholipids.
12 May 2022
TL;DR: In this article , the authors collected 54 surgically resected primary intestinal T-cell lymphoma (PITL) from Taiwan, with 80% presenting with bowel perforation.
Abstract: Primary intestinal T-cell lymphoma (PITL) is highly aggressive and includes celiac disease–related enteropathy-associated T-cell lymphoma (EATL), monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), and primary intestinal peripheral T-cell lymphoma, not otherwise specified (ITCL-NOS). MEITL is the most common PITL in Asia, comprising of monomorphic medium-sized cells typically expressing CD8, CD56, and cytotoxic granules. Occasional cases with intermediate features between MEITL and ITCL-NOS are difficult to be classified and warrant further investigation. We collected 54 surgically resected PITLs from Taiwan, with 80% presenting with bowel perforation. The overall outcome was poor with a median survival of 7 months. Based on histopathology (monomorphic vs. pleomorphic) and immunophenotype, we classified these cases into 4 groups: MEITL with typical immunophenotype (n=34), MEITL with atypical immunophenotype (n=5), pleomorphic PITL with MEITL-like immunophenotype (n=6), and ITCL-NOS (n=9). There was no EATL in our cohort. Targeted next-generation sequencing of the first 3 groups showed highly prevalent loss-of-function mutations for SETD2 (85%, 80%, and 83%, respectively) and frequent activating mutations for STAT5B (64%, 60%, and 50%, respectively) and JAK3 (38%, 20%, and 50%, respectively). In contrast, ITCL-NOS cases had less frequent mutations of SETD2 (56%) and STAT5B (11%) and rare JAK3 mutations (11%). Our results suggest that there is a wider morphologic and immunophenotypic spectrum of MEITL as currently defined in the 2017 WHO classification. MEITL with atypical immunophenotype and PITL with MEITL-like immunophenotype shared clinicopathologic and molecular features similar to MEITL but distinct from ITCL-NOS, indicating that such cases may be considered as immunophenotypic or histopathologic variants of MEITL.
TL;DR: In this article , the safety and efficacy profiles of mRNA vaccines (BNT162b2 and mRNA-1273) have been evaluated in clinical trials or observed in the real world.
Abstract: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants of concern can infect people of all ages and can cause severe diseases in children, such as encephalitis, which require intensive care. Therefore, vaccines are urgently required to prevent severe disease in all age groups. We reviewed the safety and efficacy profiles of mRNA vaccines—BNT162b2 and mRNA-1273—demonstrated by clinical trials or observed in the real world. mRNA-1273 is effective in preventing SARS-CoV-2 infection in preschool children (6 months-6 years old). Both BNT162b2 and mRNA-1273 are effective in preventing SARS-CoV-2 infection in school-aged children and adolescents, thereby preventing post-coronavirus disease (COVID) conditions. The common side effects of vaccination are pain at the injection site, fatigue, and headache. Myocarditis and pericarditis are uncommon. Monitoring post-vaccination troponin levels may help prevent severe cardiac events. The SARS-CoV-2 coronavirus mutates its genome to overcome the herd immunity provided by mass vaccinations; therefore, we may need to develop new generations of vaccines, such as those using viral nucleocapsid proteins as antigens. In conclusion, the mRNA vaccines are generally safe and effective in preventing severe diseases and hospitalization among children and adolescents.
TL;DR: Lee et al. as mentioned in this paper found that the extraglycemic benefits of oral antidiabetic drugs, including dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with Type 2 diabetes mellitus (T2DM), are different between the male and female populations.
Abstract: DEAR EDITOR, Many patients with type 2 diabetes mellitus (T2DM) need oral antidiabetic drug treatment for blood sugar control and to avoid or delay the T2DM-related complications that could damage the microvascular and macrovascular circulatory systems and subsequently develop various kinds of morbidities and eventually mortality.1 We read Dr. Chang’s study,2 editorial comments by Dr. Lee et al,3 and a letter to Editors by Dr. Lee et al4 to discuss the extraglycemic benefits of oral antidiabetic drugs, including dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with T2DM. We found with interest that all patients with T2DM treated with DPP-4i took advantage of the lowering risk of the development of osteoporosis, as shown by the authors, but it is important to note that the advantages of decreasing the risk of osteoporosis are different between the male and female populations. Males had an adjusted hazard ratio (HR) of 0.562 (95% confidence interval [CI]: 0.322–0.878), and the females had an adjusted HR of 0.638 (95% CI: 0.364–0.980),2 suggesting that the extraglycemic benefits of DPP-4i may be more apparent in the male population. A recent meta-analysis enrolling 82 randomized controlled trials with 104,833 participants showed DPP-4i was significantly associated with an increased risk of the composite of gallbladder or biliary diseases with an odds ratio (OR) of 1.22 (95% CI: 1.04–1.43) compared with placebo or nonincretin drugs.5 Additionally, compared with sodium-glucose cotransporter-2 inhibitors, DPP-4i also increased the risk of the composite of gallbladder and biliary diseases, as well as cholecystitis.5 The prevalence and incidence of gallbladder or biliary tract diseases differ between male and female populations. The male population may have a higher risk of developing gallbladder or biliary tract diseases than the female population.6 Moreover, the male population is also strongly associated with a higher mortality rate compared with the female population,6 contributing to the concern about using DPP-4i as an antidiabetic agent in the T2DM male population. Since the extraglycemic benefits, such as the prevention of osteoporosis, are claimed by the authors, we comment that different genders may have a different impact on using DPP-4i as a choice in the management of patients with T2DM. We wonder about the authors’ opinions. ACKNOWLEDGMENTS This study was supported by grants from Taipei Veterans General Hospital (V111A-009).
TL;DR: In this paper , the safety, efficacy, and adverse events of the new mini-adjustable sling system "I-stop-mini" with transobturator midurethral slings "Obtryx" (Boston Scientific, Marlborough, MA) in women with stress urinary incontinence were compared.
TL;DR: In this paper, the effect of ET-1 on lipolysis and the underlying mechanisms were investigated in 3T3-L1 adipocytes, and it was shown that ET stimulates extracellular Ca2+ entry and activates the intracellular PLC/IP3/Ca2+ pathway through a cGMP-dependent pathway.