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Currently, the active surveillance of men with favorable intermediate-risk localized prostate cancer (PCa) is a longstanding controversy, in terms of their oncological outcomes, and radical prostatectomy would constitute a similar concern of overtreatment, regarding its functional outcomes. Thus, focal therapy could be considered in men belonging to favorable intermediate-risk group. Among all focal therapies, high-intensity focused ultrasound (HIFU) was the most studied methodology in clinical trials. Although HIFU provided better functional outcomes than radical prostatecomy, the oncological outcomes were inferior in men with intermediate-risk localized PCa. Two articles have been published discussing the feasibility and clinical outcomes of robot-assisted partial prostatectomy (RAPP), and both the functional and oncological outcomes were superior than those with HIFU. However, the rate of positive surgical margins (PSMs) was reported as high in the literature. Here, we present a case of favorable intermediate-risk localized PCa with an isolated tumor at the anterior apex. After reconstructing a personal three-dimensional (3D) image, we utilized it in a 3D image-guided precise excise, followed by intraoperative frozen specimen review. We found that this method may present a resolution to the high PSM rate documented in the current literature regarding RAPP. This method merits further study with a well-designed prospective study.

Objective There are different upper limb manual training protocols, namely constraint-induced movement therapy, modified constraint-induced movement therapy, hand–arm bimanual intensive training, hand–arm bimanual intensive training including lower extremity, action observation training, and mirror therapy, available for improving functional outcomes in children with cerebral palsy. However, the effect and priority of these strategies remain unclear. Data sources We searched the PubMed, Cochrane Library, and Embase databases for relevant articles from inception to October 12, 2022. Review methods To assess the effect and priority of different strategies of upper limb manual training protocols through a systematic review and network meta-analysis of randomized controlled trials. Results We included 22 randomized controlled trials in this network meta-analysis. The ranking probability and standard mean differences with 95% credible intervals of the comparison between placebo and other forms of upper limb manual training were as follows: mirror therapy = 2.83 (1.78, 3.88), hand–arm bimanual intensive training including the lower extremity = 0.53 (0.09, 0.96), constraint-induced movement therapy = 0.44 (0.18, 0.71), hand–arm bimanual intensive training = 0.41 (0.15, 0.67), modified constraint-induced movement therapy = 0.39 (0.03, 0.74), and action observation training = 0.18 ( − 0.29, 0.65). No significant inconsistency was noted between the results of direct and indirect comparisons. Conclusion We suggest that mirror therapy could be the upper limb manual training protocol of choice for improving functional outcomes in patients with cerebral palsy.

Context Conjugated linoleic acid (CLA) has been reported to have anti-obesity and antidiabetic effects. However, the benefits of CLA combined with exercise remain unclear, and studies report conflicting results. Objective A systematic review and meta-analysis were performed to investigate the synergistic effect of CLA and exercise on body composition, exercise-related indices, insulin resistance, and lipid profiles; and of the safety of CLA supplements. Data sources In October 2021, the PubMed, Embase, and Cochrane Library databases were searched for reports on clinical trials of the combined intervention of CLA and exercise. Data extraction A total of 18 randomized controlled trials and 2 crossover trials were included. The methodological quality assessment was performed using the revised Cochrane risk-of-bias tool. Pooled effect sizes were reported as standardized mean difference (SMD) for continuous data and risk ratio for dichotomous data with their corresponding 95% confidence intervals (CIs). Heterogeneity was tested using the I2 statistic. Data analysis The combination of CLA and exercise resulted in significantly decreased body fat (SMD, –0.42 [95%CI, –0.70, –0.14]; P = 0.003; I2 = 65) and insulin resistance (SMD, –0.25 [95%CI, –0.44, –0.06]; P = 0.01; I2 = 0) than did exercise alone. In subgroup analysis, the following factors were associated with significant outcomes: (1) body mass index ≥25 kg/m2; (2) female sex; (3) follow-up time >4 weeks; and (4) intervention duration >4 weeks. Nevertheless, supplementation with CLA during exercise programs was not effective for body-weight control, exercise performance enhancement, or lipid-profile improvement. CLA in combination with exercise did not result in a higher risk of adverse events (risk ratio, 1.32 [95%CI, 0.94–1.84]; P > 0.05; I2 = 0). Conclusion CLA combined with exercise is generally safe and can lower body fat and insulin resistance but does not reduce body weight, enhance exercise performance, or improve lipid profiles.

Background Near-infrared indocyanine green fluorescence cholangiography (NIRF) has shown promising results on delineating extra-hepatic biliary anatomy during laparoscopic cholecystectomy to avoid bile duct injury. However its routine usage remains in question. In this study, the technique was evaluated further with learning curve estimation and learning factors were observed. Methods One hundred ninety-nine cases which underwent laparoscopic cholecystectomy for acute or chronic cholecystitis within a 2-year period including 51 cases with initial use of NIRF by 2 surgeons were studied retrospectively. The learning curve was evaluated for a surgeon as primary objective. A case-matched comparison of the operative time between NIRF and conventional group, in terms of acute and chronic cholecystitis was also conducted as a secondary calculation. Results Learning curve was evaluated with 61% learning rate for NIRF experience. Cysto-biliary junction non-illuminated cases under fluorescent view, had mean operative time of 80.83 ± 22.82 min, which was shorter than the cysto-biliary junction illuminated cases. The NIRF group exhibited longer operative time compared with the conventional group with mean difference of 34.39 min (significant at P < .05). Conclusions While the initial learning phase might be affected by surgeons’ behavior and attitude, our results may provide a reference to learn at one’s own pace and to employ NIRF teaching strategies during surgical training programs to overcome the initial phase during training period itself and facilitate universal achievement.

Older adults with sarcopenic obesity have a higher risk of experiencing mobility difficulty. Additionally, sarcopenia and obesity are closely associated with knee osteoarthritis. This study investigated the associations of sarcopenia, obesity, and in combination of both with walking disability during postoperative rehabilitation in older adults with knee osteoarthritis who underwent total knee replacement.A retrospective cohort study.From a rehabilitation center database, we retrospectively selected and investigated 482 older patients with knee osteoarthritis who had undergone total knee replacement and received postoperative rehabilitation.Sarcopenia was identified in accordance with the diagnostic criteria established by the Asian Working Group for Sarcopenia and obesity was defined as body mass index ≥ 30 kg/mCompared with the reference group, the sarcopenic, obese, and sarcopenic obese groups appeared to have a higher probability of experiencing postoperative walking disability (all P.001). The sarcopenic obese group were likely to have the highest risk of experiencing postoperative walking disability (adjusted hazard ratio = 3.89).Sarcopenia or obesity alone may independently exert negative effects on postoperative gait speed. The participants with sarcopenic obesity were likely to have the highest risk of experiencing walking disability following total knee replacement. The findings may serve as a reference for clinicians developing rehabilitation strategies to optimize walking ability after total knee replacement, especially those preoperatively diagnosed as having sarcopenic obesity.

Objectives This study assessed the effectiveness, compliance, and safety of dextrose prolotherapy for patients with knee osteoarthritis. Data sources PubMed, EMBASE, the Cochrane Library Database, and the Scopus database from their inception to December 31, 2021. Methods This study was conducted in accordance with the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Randomized controlled trials regarding the effectiveness of dextrose prolotherapy in knee osteoarthritis were identified. The included trials were subjected to meta-analysis. Risk of bias was assessed using the Cochrane risk of bias tool. Subgroup and random-effects metaregression analyses were performed to explore any heterogeneity ( I2) of treatment effects across studies. Results A total of 14 trials enrolling 978 patients were included in the meta-analysis. Compared with placebo injection and noninvasive control therapy, dextrose prolotherapy had favorable effects on pain, global function, and quality of life during the overall follow-up. Dextrose prolotherapy yielded greater reductions in pain score over each follow-up duration than did the placebo. Compared with other invasive therapies, dextrose prolotherapy generally achieved comparable effects on pain and functional outcomes for each follow-up duration. Subgroup results indicated that combined intra-articular and extra-articular injection techniques may have stronger effects on pain than a single intra-articular technique. Conclusions Dextrose prolotherapy may have dose-dependent and time-dependent effects on pain reduction and function recovery, respectively, in patients with knee osteoarthritis. Due to remarkable heterogeneity and the risk of biases across the included trials, the study results should be cautiously interpreted.

To investigate the effect of hypertonic dextrose injection on pain and disability in patients with chronic supraspinatus tendinosis. The secondary aim was to evaluate its effect on the tendon range of motion (ROM) and morphology.Randomized double-blind placebo-controlled trial.Outpatient clinic.Individuals (N=57) with symptomatic chronic supraspinatus tendinosis.Participants were randomly administered ultrasound-guided injections of 20% hypertonic dextrose (study group, n=29) or 5% normal saline (control group, n=28).The primary outcome measure was visual analog scale (VAS) scores for pain and Shoulder Pain and Disability Index (SPADI) scores. Secondary outcomes included the ROM and ultrasound examination findings of the supraspinatus tendon at baseline and at 2, 6, and 12 weeks postintervention.The study group exhibited significant improvements in the VAS (mean difference [MD], -2.1; 95% confidence interval [CI], -2.7 to -1.4; P.001) and SPADI (MD, -11.6; 95% CI, -16.5 to -6.7; P.001) scores compared with baseline scores at week 2. However, the effect was not sustained to week 6. Flexion ROM increased at weeks 2 (MD, 14.1; 95% CI, 5.7-22.5; P.001) and 6 (MD, 8.9; 95% CI, 2.4-15.4; P=.003) compared with baseline. The thickness of the supraspinatus tendon improved at weeks 6 (MD, .50; 95% CI, .26-.74; P.001) and 12 (MD, .61; 95% CI, .37-.84; P.001) compared with baseline. The ratio of histograms also improved at weeks 6 (MD, .19; 95% CI, .06-.32; P=.002) and 12 (MD, .26; 95% CI, .10-.41; P.001) compared with baseline.Hypertonic dextrose injection could provide short-term pain and disability relief in patients with chronic supraspinatus tendinosis. Ultrasound imaging at week 6 revealed changed tendon morphology.

Moorthy checklist (MC) and laparoscopic skill competency assessment tool (LS-CAT) are tools commonly used to evaluate the quality of laparoscopic suturing. The current assessment model is single measurement by multiple raters. Our aim is to examine the reliability of the current assessment model and tools.With IRB approval, participants of three different backgrounds, namely medical students, trainees, and surgeons, were enrolled. The participants each accomplished a standardized laparoscopic suturing task. The performances were video-recorded and reviewed with LS-CAT and MC independently by three blinded raters. Intraclass correlation coefficients (ICC) were calculated for inter-rater and intra-rater reliability.26 participants were enrolled, comprising 10 students, 10 trainees and 6 surgeons. In regard of inter-rater reliability, ICC values (95% CI) were 0.909 (0.768-0.961) and 0.868 (0.608-0.948) in LS-CAP and MC, respectively. For students, ICC values were 0.908 (0.682-0.976) and 0.815 (0.408-0.951) in LS-CAT and MC, respectively. For trainees, ICC values were 0.812 (0.426-0.947) and 0.717 (0.102-0.925), respectively. For surgeons, ICC values were 0.720 (0.064-0.955) and 0.868 (0.608-0.948), respectively. In regard of intra-rater reliability, ICC values of the mean scores from the three raters were 0.956 (0.905-0.980) and 0.925 (0.842-0.966) in LS-CAP and MC, respectively.LS-CAT and MC are both qualified assessment tools for laparoscopic suturing. LS-CAT is more reliable particularly for medical students and trainees. The current assessment model of single measurement by multiple raters provides excellent reliability.

Osteoporosis has been demonstrated to be a risk factor for rotator cuff retears after surgery; however, no studies have directly investigated the association between osteoporosis and the development of rotator cuff tears. To investigate whether osteoporosis is associated with an increased risk of rotator cuff tears.We conducted a population-based, matched-cohort study with a 7-year follow-uTwo matched cohorts (n = 3511 with osteoporosis and 17,555 without osteoporosis) were recruited from Taiwan's Longitudinal Health Insurance Dataset. Person-year data and incidence rates were evaluated. A multivariable Cox model was used to derive an adjusted hazard ratio (aHR) after controlling for age, sex, and various prespecified comorbidities. Age and sex were added in the model to test for interaction with osteoporosis.Women constituted 88.5% of the cohorts. During follow-up of 17,067 and 100,501 person-years for the osteoporosis and nonosteoporosis cohorts, 166 and 89 rotator cuff tears occurred, respectively. The cumulative incidence of rotator cuff tears was significantly higher in the osteoporosis cohort than in the nonosteoporosis cohort (p 0.001, log-rank). The Cox model revealed a 1.79-fold increase in rotator cuff tears in the osteoporosis cohort, with an aHR of 1.79 (95% confidence interval, 1.55-2.05). Effect modification of sex and age on rotator cuff tears was not found in patients with osteoporosis.This population-based study supports the hypothesis that compared with individuals without osteoporosis, those with osteoporosis have a higher risk of developing rotator cuff tears.

Urine test paper is a standard, noninvasive detection method for direct bilirubin, but this method can only achieve qualitative analysis and cannot achieve quantitative analysis. This study used Mini-LEDs as the light source, and direct bilirubin was oxidized to biliverdin by an enzymatic method with ferric chloride (FeCl3) for labeling. Images were captured with a smartphone and evaluated for red (R), green (G), and blue (B) colors to analyze the linear relationship between the spectral change of the test paper image and the direct bilirubin concentration. This method achieved noninvasive detection of bilirubin. The experimental results demonstrated that Mini-LEDs can be used as the light source to analyze the grayscale value of the image RGB. For the direct bilirubin concentration range of 0.1–2 mg/dL, the green channel had the highest coefficient of determination coefficient (R2) of 0.9313 and a limit of detection of 0.56 mg/dL. With this method, direct bilirubin concentrations higher than 1.86 mg/dL can be quantitatively analyzed with the advantage of rapid and noninvasive detection.

Objective To investigate the effectiveness of functional electrical stimulation of the legs in patients with heart failure. Methods Data were obtained from PubMed, Cochrane Library, and Embase databases until August 12, 2021. We included randomized controlled trials that evaluated the effects of functional electrical stimulation applied to the legs of patients with heart failure, namely changes in cardiopulmonary function, muscle strength, and quality of life. Results In total, 14 randomized controlled trials (consisting of 518 patients) were included in our article. Pooled estimates demonstrated that functional electrical stimulation significantly improved peak oxygen consumption (peak VO2; standardized mean difference = 0.33, 95% confidence interval = 0.07–0.59, eight randomized controlled trials, n = 321), 6-min walking distance (mean difference = 48.03 m, 95% confidence interval = 28.50–67.57 m, 10 randomized controlled trials, n = 380), and Minnesota Living with Heart Failure Questionnaire quality of life score (mean difference = − 8.23, 95% confidence interval = − 12.64 to − 3.83, nine randomized controlled trials, n = 383). Muscle strength of lower extremities was not significantly improved in the functional electrical stimulation group compared with that in the control group (standardized mean difference = 0.26, 95% confidence interval = − 0.18 to 0.71, five randomized controlled trials, n = 218). Furthermore, the subgroup analysis revealed that functional electrical stimulation significantly improved peak VO2, 6-min walking distance, and Minnesota Living with Heart Failure Questionnaire quality of life score in the heart failure with reduced ejection fraction and heart failure with preserved ejection fraction subgroups. Conclusion Functional electrical stimulation can effectively improve the cardiopulmonary function and quality of life in patients with heart failure. However, functional electrical stimulation did not significantly improve muscle strength in the legs.

Background Robot-assisted gait training (RAGT) is a practical treatment that can complement conventional rehabilitation by providing high-intensity repetitive training for patients with stroke. RAGT systems are usually either of the end-effector or exoskeleton types. We developed a novel hybrid RAGT system that leverages the advantages of both types. Objective This single-blind randomized controlled trial evaluated the beneficial effects of the novel RAGT system both immediately after the intervention and at the 3-month follow-up in nonambulatory patients with subacute stroke. Methods We recruited 40 patients with subacute stroke who were equally randomized to receive conventional rehabilitation either alone or with the addition of 15 RAGT sessions. We assessed lower-extremity motor function, balance, and gait performance by using the following tools: active range of motion (AROM), manual muscle test (MMT), the Fugl–Meyer Assessment (FMA) lower-extremity subscale (FMA-LE) and total (FMA-total), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), Tinetti Performance-Oriented Mobility Assessment (POMA) balance and gait subscores, and the 3-m and 6-m walking speed and Timed Up and Go (TUG) tests. These measurements were performed before and after the intervention and at the 3-month follow-up. Results Both groups demonstrated significant within-group changes in the AROM, MMT, FMA-LE, FMA-total, PASS, BBS, POMA, TUG, and 3-m and 6-m walking speed tests before and after intervention and at the 3-month follow-up (p p = 0.014) and total (p = 0.002) assessments. Conclusion Although the novel hybrid RAGT is effective, strong evidence supporting its clinical effectiveness relative to controls in those with substantial leg dysfunction after stroke remains elusive. Trial registration The study was registered with an International Standard Randomized Controlled Trial Number, ISRCTN, ISRCTN15088682. Registered retrospectively on September 16, 2016, at https://www.isrctn.com/ISRCTN15088682

Background: High-definition transcranial electrical theta burst superimposing direct current stimulation (HD-tDCS-eTBS) not only incorporates the therapeutic advantages of tDCS and TBS but enhances stimulation focality and practicality. However, the applicability of this innovative neuromodulatory device in post-stroke rehabilitation remains uncertain. Objective: This study aimed to assess the efficacy and safety of the HD-tDCS-eTBS on upper extremity (UE) motor function in patients with chronic stroke. Methods: A patient-blinded, randomized controlled study was conducted. Twenty-four participants were randomly assigned into either the active HD-tDCS-eTBS group or sham HD-tDCS-eTBS group. Both groups received 20 minutes of active/sham HD-tDCS-eTBS combined with 30 minutes of conventional UE rehabilitation each time, 3 times a week for 4 weeks. Outcome measures including the Fugl-Meyer Assessment of Upper Extremity, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Finger-Nose Test, and Modified Ashworth Scale were assessed before and immediately after the intervention period. Results: Spasticity of shoulder adductor ( P = .05), elbow extensor ( P = .04), and thumb flexor ( P p2 = 0.06–0.16). No severe adverse events except for slight skin redness under the stimulus electrode was detected after the HD-tDCS-eTBS. Conclusions: Our findings support that HD-tDCS-eTBS is safe and has therapeutic potential for post-stroke UE motor rehabilitation. Trial registration: ClinicalTrials.gov (ID: NCT04278105).

Background Problematic internet use, especially in people with substance use disorder, may negatively affect their quality of life (QoL). However, it is unclear whether sleep quality is a key mediator in the association between problematic internet use and QoL among people with substance use disorder. Aims This study aimed to investigate the relationship between problematic internet use and QoL and how sleep quality may mediate the association between these two variables. Method Overall, 319 people (85% male) with substance use disorder (mean age 42.2 years, s.d. 8.9) participated in a cross-sectional study in Taiwan. The Smartphone Application-Based Addiction Scale, Bergan Social Media Addiction Scale, Internet Gaming Disorder-Short Form, Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Questionnaire Brief Version were used. Results The prevalence of sleep problems was 56%. There were significant and direct associations between sleep quality and two types of problematic internet use, and between sleep quality and different dimensions of QoL. All types of problematic internet use were significantly and negatively correlated with QoL. Mediated effects of sleep quality in relationships between the different types of problematic internet use and all dimensions of QoL were significant, except for problematic use of social media. Conclusions Different types of problematic internet use in people with substance use disorder may be directly associated with reduced QoL. Sleep quality as a significant mediator in this association may be an underlying mechanism to explain pathways between problematic internet use and QoL in this population.

Background Depression is a mental health problem and substance use concerns are socially unacceptable behaviors. While depression and substance use may individually impact self-concept and social relationships, their co-occurrence can increase the risk of self-stigmatization. However, there is no evidence regarding how depression and self-stigma may influence each other over time. The aim of the current study was to evaluate the cross-sectional and longitudinal relationships between features of depression and self-stigma in people with substance use disorders. Methods Overall, 319 individuals with substance use disorders (273 males) with a mean (± SD) age of 42.2 (± 8.9) years were recruited from a psychiatric center in Taiwan by convenience sampling. They were assessed for features of depression and self-stigma at four times over a period of nine months using the depression subscale of the Depression Anxiety Stress Scales (DASS-21) and Self-Stigma Scale-Short S (SSS-S), respectively. Repeated-measures analyses of variance, Pearson correlations and cross-lagged models using structural equation modeling examined cross-sectional and temporal associations between depression and self-stigma. Results Positive cross-sectional associations were found between depressive features and all assessed forms of self-stigma over time (0.13 0.98). The direction of associations between depressive features towards self-stigma was stronger than the opposite direction. Conclusion Positive associations between depressive features and self-stigma were found in people with substance use disorders. Although these associations may be bidirectional longitudinally, the directions from depressive features to self-stigma may be stronger than the reverse directions, suggesting treatment of depression in earlier stages may prevent self-stigmatization and subsequent poor outcomes in people with substance use disorders.

Knee osteoarthritis (KOA) is closely associated with sarcopenia, sharing the common characteristics of muscle weakness and low physical performance. Resistance exercise training (RET), protein supplementation (PS), and PS+RET have promise as treatments for both sarcopenia and KOA. However, whether PS+RET exerts any effect on time to recovery to normal walking speed (WS) in older adults with sarcopenia and KOA remains unclear. This study investigated the treatment efficiency of PS+RET on WS recovery among individuals with KOA and sarcopenia. A total of 108 older adults aged ≥ 60 years who had a diagnosis of radiographic KOA and sarcopenia were enrolled in this prospective cohort study. Sarcopenia was defined on the basis of the cutoff values of the appendicular skeletal muscle mass index for Asian people and a slow WS less than 1.0 m/s. The patients were equally distributed to three groups: PS+RET, RET alone, and usual care. The weekly assessment was performed during a 12-week intervention and a subsequent 36-week follow-up period. A cutoff of 1.0 m/s was used to identify successful recovery to normal WS. Kaplan–Meier analysis was performed to measure the survival time to normal WS among the study groups. Multivariate Cox proportional-hazards regression (CPHR) models were established to calculate the hazard ratios (HRs) of successful WS recovery and determine its potential moderators. After the 3-month intervention, PS+RET as well as RET obtained greater changes in WS by an adjusted mean difference of 0.18 m/s (p < 0.0001) and 0.08 (p < 0.05) m/s, respectively, compared to usual care. Kaplan–Meier analysis results showed both RET and PS+RET interventions yielded high probabilities of achieving normal WS over the 12-month follow-up period. Multivariate CPHR results revealed that PS+RET (adjusted HR = 5.48; p < 0.001), as well as RET (adjusted HR = 2.21; p < 0.05), independently exerted significant effects on WS recovery. PS+RET may accelerate normal WS recovery by approximately 3 months compared with RET. Sex and initial WS may influence the treatment efficiency. For patients with KOA who suffer sarcopenia, 12-week RET alone exerts significant effects on WS recovery, whereas additional PS further augments the treatment effects of RET by speeding up the recovery time of WS toward a level ≥ 1.0 m/s, which facilitates the patients to diminish the disease severity or even free from sarcopenia.

In this study, the adsorption material is fabricated from the aluminum residues using inductively coupled plasma (ICP) technique and applied as a raw material to manufacture porous solid desiccant wheel. An ICP system is developed to refine aluminum hydroxide extracted from aluminum residues into activated alumina by utilizing its high energy densities. A six-turn induction coil is suitable for our match box to produce alternating electromagnetic field, to sustain space discharge, and to have well reaction zone. The ICP generator power is set at 800 W, and the batch of aluminum residues is purified to generate activated alumina with a BET surface area of 122 m2/g. The porous desiccant wheel is manufactured using activated alumina with a 3-D random porous structure and applied to adsorb moisture from the air. The equilibrium time for the solid desiccant wheel and humidity are determined by observed kinetics in the adsorption experiment. The adsorption equilibrium time of the desiccant wheel (60 pores per inch) with 15-cm diameter and 5-cm thickness is 12 minutes. The maximum adsorption capacity is 51.4 g (at 12 min) and per gram of the desiccant wheel can adsorb 0.184-g water.

Background: Both corticosteroids and hypertonic dextrose injections are commonly used for chronic supraspinatus tendinopathy. Purpose: To compare the supraspinatus echogenicity and clinical effects of echo-guided hypertonic dextrose versus corticosteroid injection for treating chronic supraspinatus tendinopathy. Study Design: Cohort study; Level of evidence, 3. Methods: The authors performed a secondary data analysis of a previous clinical trial including patients who received normal saline versus hypertonic dextrose injection; patients who received corticosteroid injection were recruited between August 2017 and July 2021. Baseline patient data were matched among these 3 groups at a 1:1:1 ratio. At baseline and 2, 6, and 12 weeks after the intervention, the authors compared morphological changes (supraspinatus thickness and echogenicity) and clinical parameters (visual analog scale [VAS] for pain, Shoulder Pain and Disability Index [SPADI], and range of motion [ROM]). Analysis of variance was used to compare mean changes from baseline among the groups. Results: A total of 75 patients (25 in each group) were included. At 2-week follow-up, both the dextrose and the steroid groups exhibited improvement in VAS scores (mean difference [MD] from baseline: –2.0 in dextrose group; –3.3 in steroid group (P < .001)), SPADI scores (MD from baseline: –10.6 in dextrose group; –24.6 in steroid group (P < .001)), and flexion ROM (MD from baseline: 13.6° in dextrose group; 21.1° in steroid group) ( P =.001). At 6 weeks after injection, the hypertonic dextrose group exhibited more favorable echogenic improvement in supraspinatus tendon morphology compared with the other 2 groups ( P < .001). However, the steroid group showed significantly more improvement in clinical parameters compared with the other 2 groups at both week 6 (MD from baseline: VAS, –3.2; SPADI, –26.6; flexion ROM, 21.5°) and week 12 (MD from baseline: VAS, –2.5; SPADI, –20.4; flexion ROM, 15.2°) ( P < .001 for all). Conclusion: Hypertonic dextrose injection improved supraspinatus echogenicity after 6 weeks but provided short-term symptomatic relief in the patients with chronic supraspinatus tendinopathy when compared with corticosteroid or saline injections. Steroid injection exerted a more favorable clinical effect at weeks 6 and 12 but demonstrated a negative effect on the supraspinatus.

Background: Substance use is an important issue worldwide and people with substance use disorders (SUDs) have been reported to have high levels of psychological distress and self-stigma. Therefore, psychological distress and self-stigma in people with SUDs are considerable. Objective: The present study used a longitudinal design to examine whether treatment-as-usual approaches in Taiwan improve psychological distress and self-stigma among people with three types of SUDs (heroin, amphetamine, and alcohol use disorders). Design: A 9-month longitudinal design involving four assessments spaced 3 months apart. Methods: Convenience sampling was used to recruit people with heroin ( n = 112), amphetamine ( n = 151), and alcohol ( n = 56) use disorders from outpatient psychiatric center in Southern Taiwan. Psychological distress was assessed using the Depression, Anxiety, Stress Scale (DASS-21), and self-stigma was assessed using the Self-Stigma Scale–Short (SSS-S). Generalized estimating equation (GEE) models were constructed to understand between-group differences in psychological distress and self-stigma over time. Results: Patients with heroin and amphetamine use disorders had lower levels of psychological distress as compared with those with alcohol use disorder. Levels of psychological distress were lower at Time 2 to Time 4 as compared with Time 1. Patients with heroin and amphetamine use disorders had higher levels of self-stigma as compared with those with alcohol use disorder. Self-stigma levels remained stable over time. The dropout rate of receiving treatment-as-usual approach in the 9-month study was 60%. Conclusion: Treatment as usual for SUDs among outpatients in Taiwan may decrease psychological distress but not self-stigma. However, such effects need to be further examined given the high drop-out rates and absence of a control condition. The findings suggest that self-stigma may warrant additional treatment for patients with SUDs.

Self-stigma is a common experience for people with substance use disorders (SUDs). Understanding factors associated with self-stigma may aid in intervention development. This study investigated the reciprocal relationship between three types of problematic use of the internet [PUI; i.e. problematic use of social media (PUSM), problematic smartphone use (PSPU), and problematic gaming (PG)] and self-stigma among people with SUDs. This longitudinal study involved five waves of a survey given to individuals with SUDs in Taiwan. A total of 319 participants (85% male), with a mean age of 42.2 years (SD = 8.9), were recruited. The Smartphone Application-Based Addiction Scale, Bergen Social Media Addiction Scale, Internet Gaming Disorder-Short Form, and Self-Stigma Scale-Short Form were used. No significant associations between PUI and self-stigma were found in early waves (i.e., Waves 1 and 2). The earliest significant finding was identified between Wave 2 PSPU (smartphone) and Wave 3 self-stigma. Additionally, Wave 3 PSPU (smartphone) and PG (gaming) were associated with Wave 4 self-stigma, and Wave 4 PSPU (smartphone), PG (gaming), and PUSM (social media) were associated with Wave 5 self-stigma. Therefore, all three types of PUI (internet) may elevate self-stigma at different time points for individuals with SUDs. However, the reciprocal effects between self-stigma and PUI (internet) only occurred in PUSM (social media) at a later stage (i.e., from Wave 4 to Wave 5). In conclusion, people with SUDs who have PUI (internet) are at increased likelihood of developing more self-stigma, which may then increase subsequent PUSM (social media), forming a vicious cycle.

To compare and cluster the health status and disability restrictions associated with eight major physiological functions of body systems, using functioning domains of WHO Disability Assessment Schedule 2.0.Retrospective analyses of a nation-wide disability database.Population-based study.Records from patients18 years of age with disability were obtained from the Taiwan Data Bank of Persons with Disability (July 2012-November 2017). Disability functioning profile of the following diagnosis were analyzed: stroke, schizophrenia, hearing loss, liver cirrhosis, chronic kidney disease, congestive heart failure, burn, head and neck cancer.Not applicable.Demographic data, severity of impairment, and Disability Assessment Scale scores were obtained and analyzed. Radar charts were constructed using the WHO Disability Assessment Schedule 2.0. functioning domain score. Degree of similarity between any two given diagnosis was assessed by cluster analysis, comparing the Euclidean distances between radar chart data points among the six domains.Based on cluster analysis of similarities between functioning domain profiles, the eight diagnoses were grouped into different disability clusters. Four clusters of disability were named according to the type restriction patterns: global-impact cluster (stroke); interaction-restriction cluster (schizophrenia, hearing loss); physical-limitation cluster, (liver cirrhosis, CKD, and congestive heart failure); and specific-impact cluster (burn, head and neck cancer). The rates of institutionalization and unemployment differed between the four clusters.We converted WHO Disability Assessment Schedule 2.0. functioning domain scores into six-dimensioned radar chart, and demonstrate disability restrictions can be further categorized into clusters according to similarity of functioning impairment. Understanding of disease-related disabilities provides an important basis for designing rehabilitation programs and policies on social welfare and health that reflect the daily-living needs of people according to diagnosis.Implication for RehabilitationThe use of radar charts provided a direct visualization of the scope and severity of disabilities associated with specific diagnoses.Diagnosis-related disabilities can be organized into clusters based on similarities in WHODAS 2.0 disability domain profiles.Knowledge of the characteristics of disability clusters is important to understand disease-related disabilities and provide a basis for designing rehabilitation.

The current work reports the formation of triangular pyramidal pattern on c-plane sapphire substrate by the sulfuric-acid wet etching process. The corner-up Al2(SO4)3 wet-etching reaction product f...

BACKGROUND/AIM The aim of the study was to compare the outcomes of anatomical resection (AR) versus non-anatomical resection (NAR) for Japanese and Taiwanese patients with single, resectable hepatocellular carcinoma (HCC). PATIENTS AND METHODS A propensity score matched (PSM) analysis was performed to compare the outcomes of the AR group to those of the NAR group. Tumor size

The enteric viruses, including adenovirus (AdVs) and norovirus (NoVs), in shellfish is a significant food safety risk. This study investigated the prevalence, seasonal occurrence, genetic diversity, and quantification of AdVs and NoVs in the water and cultured shellfish samples at the four major coastal oyster breeding farms (COBF), five major fishing ports (FP), and their markets in Taiwan. The AdVs/NoVs in the water and shellfish samples were isolated by the membrane filtration and direct elution methods. The RNA of NoVs was reverse-transcribed into complementary DNA through reverse transcription reaction. Further NoVs and AdVs were detected using nested PCR. A higher detection rate was recorded in the low-temperature period than high-temperature. Detection difference was noted between nested PCR and qPCR outcomes for AdVs. The total detection rate of AdVs was higher in the water samples (COBF-40.6%, FP 20%) than the shellfish samples (COBF-11.7% and FP 6.3%). The AdVs load in the water and shellfish samples ranged from 1.23 × 103 to 1.00 × 106 copies/L and 3.57 × 103 to 4.27 × 104 copies/100g, respectively. The total detection of NoVs was highest in the water samples of the FP and their market shellfish samples (11.1% and 3.2%, respectively). Genotyping and phylogenetic analysis were identified as the prevalent AdVs and NoVs genotypes in the water and shellfish samples: A species HAdVs serotype 12; F species HAdVs serotype 41; and C species PAdVs serotype 5 (NoVs GI.2, GI.3 and GII.2). No significant differences were observed between the presence of AdVs, and all of the water quality parameters evaluated (heterotrophic plate count, water temperature, turbidity, pH, salinity, and dissolved oxygen). The virus contamination occurs mainly due to the direct discharge of domestic sewage, livestock farm, and fishing market wastewater into the coastal environment. Thus, this study suggested framing better estuarine management to prevent AdVs/NoVs transmission in water and cultured/distributed shellfish.

The production and use of antibiotics increased significantly after the Second World War due to their effectiveness against bacterial infections. However, bacterial resistance also emerged and has now become an important global issue. Those most in need are typically high-risk and include individuals who experience burns and other wounds, as well as those with pulmonary infections caused by antibiotic-resistant bacteria, such as Pseudomonas aeruginosa, Acinetobacter sp, and Staphylococci. With investment to develop new antibiotics waning, finding and developing alternative therapeutic strategies to tackle this issue is imperative. One option remerging in popularity is bacteriophage (phage) therapy. This review focuses on Staphylococcus aureus and how it has developed resistance to antibiotics. It also discusses the potential of phage therapy in this setting and its appropriateness in high-risk people, such as those with cystic fibrosis, where it typically forms a biofilm.

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease that mainly affects the axial bones, and dementia is characterized by a decline in cognitive function, leading to dependence in everyday activity. Although the association between dementia and ankylosing spondylitis has been investigated, the influence of axSpA medication on dementia risk is unclear. The aim of this study was to investigate the risk of dementia among axSpA patients and if the conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) can reduce the risk of dementia. Patients with axSpA whose data were recorded during 2004–2008 and who were followed up until the end of 2010 were recruited. A control cohort was matched by age and sex. A Cox multivariate proportional hazards model was applied to analyze the risk factors for dementia. The hazard ratio (HR) and adjusted HR (aHR) were estimated between the study and control cohorts. The effects of csDMARDs and steroid use on the risk of different types of dementia were also analyzed. In total, 2341 and 11,705 patients constituted the axSpA and control cohort, respectively. The axSpA cohort had a greater risk of vascular dementia (aHR = 2.09 (1.36–3.20). The risk of dementia (aHR = 1.01 (0.55–1.85) did not significantly differ between patients with axSpA who received csDMARDs. In conclusion, patients with axSpA are at a risk of vascular dementia, which could be reduced by csDMARDs.

Purpose The minimally invasive surgery (MIS) has shown advantages when compared to traditional surgery. However, there are two major challenges in the MIS technique: the limited field of view (FOV) and the lack of depth perception provided by the standard monocular endoscope. Therefore, in this study, we proposed a New Endoscope for Panoramic-View with Focus-Area 3D-Vision (3DMISPE) in order to provide surgeons with a broad view field and 3D images in the surgical area for real-time display. Method The proposed system consisted of two endoscopic cameras fixed to each other. Compared to our previous study, the proposed algorithm for the stitching videos was novel. This proposed stitching algorithm was based on the stereo vision synthesis theory. Thus, this new method can support 3D reconstruction and image stitching at the same time. Moreover, our approach employed the same functions on reconstructing 3D surface images by calculating the overlap region’s disparity and performing image stitching with the two-view images from both the cameras. Results The experimental results demonstrated that the proposed method can combine two endoscope’s FOV into one wider FOV. In addition, the part in the overlap region could also be synthesized for a 3D display to provide more information about depth and distance, with an error of about 1 mm. In the proposed system, the performance could achieve a frame rate of up to 11.3 fps on a single Intel i5-4590 CPU computer and 17.6 fps on a computer with an additional GTX1060 Nvidia GeForce GPU. Furthermore, the proposed stitching method in this study could be made 1.4 times after when compared to that in our previous report. Besides, our method also improved stitched image quality by significantly reducing the alignment errors or “ghosting” when compared to the SURF-based stitching method employed in our previous study. Conclusion The proposed system can provide a more efficient way for the doctors with a broad area of view while still providing a 3D surface image in real-time applications. Our system give promises to improve existing limitations in laparoscopic surgery such as the limited FOV and the lack of depth perception.

Extracorporeal shockwave therapy (ESWT) has been recommended for managing pain in patients with knee osteoarthritis (KOA). The difference in therapeutic effects between radial shockwave characteristics (RaSW) and focused shockwave characteristics (FoSW) with different energy levels for KOA remains controversial. The purpose of this network meta-analysis (NMA) was to identify the effects relative to the different ESWT regime and combination treatments on pain and functional outcomes in individuals with KOA. The randomized controlled trials (RCTs) which investigated the efficacy of RaSW, FoSW, and combination treatments in patients with KOA were identified by searches of electronic databases. The included RCTs were analyzed through NMA and risk-of-bias assessment. We analyzed 69 RCTs with a total of 21 treatment arms in the NMA. Medium-energy FoSW plus physical therapy, medium-energy acupoint RaSW plus Chinese medicine, and high-energy FoSW alone were the most effective treatments for reducing pain [standard mean difference (SMD) = −4.51], restoring function (SMD = 4.97), and decreasing joint inflammation (SMD = −5.01). Population area and study quality influenced the treatment outcomes, particularly pain. Our findings indicate that medium-energy ESWT combined with physical therapy or Chinese medicine is beneficial for treating pain and increasing function in adults with KOA.

STUDY DESIGN Retrospective longitudinal cohort study. OBJECTIVE To investigate the incidence and risk of axial spondyloarthritis (axSpA) in patients with scoliosis in Taiwan. SUMMARY OF BACKGROUND DATA Scoliosis and axSpA causes back pain which reduces quality of life in many patients. Both scoliosis and axSpA had attracted numerous research attention, but the association between the two was hardly known. METHODS In this retrospective study, the data of 25,566 patients were obtained from Taiwan's National Health Insurance Research Database. We identified patients diagnosed with scoliosis and included them in the study cohort. We included age- and sex-matched patients without scoliosis in the control cohort. The total follow-up period was 7 years. Cox proportional hazards models were used to analyze the retrieved data. Hazard ratios (HRs) and adjusted HRs were calculated. RESULTS The study and control cohorts included 4261 and 21,305 patients, respectively. The incidences of axSpA were 141 and 46 per 100,000 person-years in the study and control cohorts, respectively. The crude HRs and adjusted HRs for patients with scoliosis were 2.98 (95% confidence interval, 1.87-4.73; P

The microbial communities inhabiting mud volcanoes have received more attention due to their noteworthy impact on the global methane cycle. However, the impact of temporal effects of volcanic eruptions on the microbial community’s diversity and functions remain poorly characterized. This study aimed to underpin the temporal variations in the bacterial community’s diversity and PICRUSt-predicted functional profile changes of mud volcanic sites located in southern Taiwan using 16S rRNA gene sequencing. The physicochemical analysis showed that the samples were slightly alkaline and had elevated levels of Na+, Cl−, and SO42−. Comparatively, the major and trace element contents were distinctly higher, and tended to be increased in the long-period samples. Alpha diversity metrics revealed that the bacterial diversity and abundance were lesser in the initial period, but increased over time. Instead, day 96 and 418 samples showed reduced bacterial abundance, which may have been due to the dry spell that occurred before each sampling. The initial-period samples were significantly abundant in haloalkaliphilic marine-inhabiting, hydrocarbon-degrading bacterial genera such as Marinobacter, Halomonas, Marinobacterium, and Oceanimonas. Sulfur-reducing bacteria such as Desulfurispirillum and Desulfofarcimen were found dominant in the mid-period samples, whereas the methanogenic archaeon Methanosarcina was abundant in the long-period samples. Unfortunately, heavy precipitation encountered during the mid and long periods may have polluted the volcanic site with animal pathogens such as Desulfofarcimen and Erysipelothrix. The functional prediction results showed that lipid biosynthesis and ubiquinol pathways were significantly abundant in the initial days, and the super pathway of glucose and xylose degradation was rich in the long-period samples. The findings of this study highlighted that the temporal effects of a mud volcanic eruption highly influenced the bacterial diversity, abundance, and functional profiles in our study site.

This study investigated the effect of environmental physical factors on the relative abundance of bacteria and the consequential landscape evolution in karst topography, focusing mainly on the effects of ureolytic microbial CaCO3 precipitation. The narrow-sky located in the upper part of Tangshan is a small gulch of Pleistocene coralline limestone formation in southern Taiwan. A 16S-metagenomic approach was used to determine the relationship of microbial community structures on the landscapes in various habitats. Our results showed that the biomass of habitats in the opening of the gulch was two times higher than the inside where light penetration was lower. We also found that speleothems only occurred at the inner wall inside the gulch, where the environment exhibited water drips running through the surface of speleothems and less light penetration. The sequence reads of operational taxonomic units relative to urease-producing bacteria and weathering-associated bacteria from each habitat were determined by NCBI database. Our data revealed that the 16S-metagenomics of the inner wall and water samples exhibited more sequences that were similar to those of urease-producing bacteria, whereas the outer wall showed more sequences that were similar to those of weathering-associated bacteria, suggesting that bacteria facilitated the formation of limestone weathering and calcite precipitation for various habitats. The semi-quantitative PCR for determining bacterial urease gene (ureC) levels confirmed that the inner limestone habitat had higher ureC gene levels than the outer limestone habitat. This study revealed the pivotal role of microorganisms in governing the geological evolution in the lightless limestone landscape.

Prolonged mechanical ventilation (PMV) is associated with poor outcomes and a high economic cost. The association between protein intake and PMV has rarely been investigated in previous studies. This study aimed to investigate the impact of protein intake on weaning from mechanical ventilation. Patients with the PMV (mechanical ventilation ≥6 h/day for ≥21 days) at our hospital between December 2020 and April 2022 were included in this study. Demographic data, nutrition records, laboratory data, weaning conditions, and survival data were retrieved from the patient’s electronic medical records. A total of 172 patients were eligible for analysis. The patients were divided into two groups: weaning success (n = 109) and weaning failure (n = 63). Patients with daily protein intake greater than 1.2 g/kg/day had significant shorter median days of ventilator use than those with less daily protein intake (36.5 vs. 114 days, respectively, p < 0.0001). Daily protein intake ≥1.065 g/kg/day (odds ratio: 4.97, p = 0.033), daily protein intake ≥1.2 g/kg/day (odds ratio: 89.07, p = 0.001), improvement of serum albumin (odds ratio: 3.68, p = 0.027), and BMI (odds ratio: 1.235, p = 0.014) were independent predictor for successful weaning. The serum creatinine level in the 4th week remained similar in patients with daily protein intake either >1.065 g/kg/day or >1.2 g/kg/day (p = 0.5219 and p = 0.7796, respectively). Higher protein intake may have benefits in weaning in patients with PMV and had no negative impact on renal function.

Objective: Rheumatoid arthritis and age are associated with high sarcopenia risk. Exercise is an effective treatment for preventing muscle mass loss in older adult populations. It remains unclear whether exercise affects muscle mass in people with rheumatoid arthritis. Thus, this meta-analysis investigated the effect of exercise on muscle mass gain in patients with rheumatoid arthritis. Data sources: PubMed, EMBASE, the Cochrane Library, the Physiotherapy Evidence Database (PEDro), the China Knowledge Resource Integrated Database, and Google Scholar were systematically searched until June 2021. Methods: The present study was conducted according to the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Randomized controlled trials (RCTs) that reported the effects of exercise on muscle mass for rheumatoid arthritis were identified. The included RCTs were subject to meta-analysis and risk of bias assessment. Subgroup and random-effects meta-regression analyses were performed to identify any heterogeneity ( I2) of treatment effects across studies. Results: We included nine RCTs with a median PEDro score of 6/10 (range: 4/10–8/10). The weighted mean effect size for muscle mass was 0.77 (95% CI: 0.30–1.24; P = 0.001; I2 = 77%). Meta-regression analyses indicated that the disease duration significantly explained variance of treatment effects across studies (β = −0.006, R2 = 69.7%, P = 0.005). Conclusions: Exercise therapy effectively increased muscle mass in patients with rheumatoid arthritis. Treatment effects may be attenuated in those who have had rheumatoid arthritis for a relatively long time.

Background: Patients with cervical radiculopathy typically present with shoulder pain and weakness; these symptoms are similar to those of rotator cuff disease. Studies investigating cervical spine pathology (CSP) as an independent risk factor for rotator cuff tear (RCT) are lacking in the literature. Purpose: To investigate the risk of RCT among patients with CSP who have undergone cervical diskectomy (CD) and to determine whether CD reduces this risk. Study Design: Cohort study; Level of evidence, 3. Methods: The authors queried the Taiwan National Health Insurance Research Database for patients diagnosed with CSP between 2004 and 2008 and followed up until the end of 2010. A control cohort comprised patients without CSP who were age- and sex-matched in a 4-to-1 ratio with patients with CSP through propensity score matching. A Cox multivariate proportional hazards model was applied to analyze the risk factors for RCT. After adjustment for confounders, the authors calculated the hazard ratio (HR) and adjusted HR (aHR) between the study and control cohorts. The effects of CD on the risk of RCT were also analyzed. Results: The study included 3245 patients and 12,980 matched controls. A higher RCT incidence rate was found in the CSP cohort, with an aHR of 1.52 (95% CI, 1.22-1.89; P < .001). Patients with CSP who underwent CD had a risk of RCT similar to that of the controls, with an aHR of 1.65 (95% CI, 0.90-3.03; P > .05). Conclusion: Patients with CSP had a 1.52-fold higher risk of RCT than healthy controls. Patients with CSP with CD did not have a high risk of RCT, possibly indicating a protective effect of diskectomy against RCT.

This study explores the toxic effect of TCE at different depths of sub-surface soil and underpins microbial community-level suitable carbon (C)-sources that provided directionality to the in situ biostimulation effort via augmentation strategy for effective TCE remediation in soil. The impacts on resident microbial communities and their functional profiles that govern the TCE biodegradation process were identified. Highly contaminated PW01 soil (9 m depth) had severely limited microbial diversity and was enriched in Proteobacteria and Firmicutes. The abundance of TCE degradation-associated genera was observed in all contaminated samples, and the abundance of TCE-degradation-related taxa were positively correlated with soil TCE contamination levels. Community-level metabolic activity associated with the utilization of diverse external C-sources was directly influenced by TCE concentration and soil depth. Multivariate data analysis revealed that the functional genus, TCE concentration, and selected available C substrate uptake capacity correlated in soil samples. Pearson’s correlation tests revealed that C sources such as L -arginine, phenylethylamine and γ-hydroxybutyric acid utilization trait exhibited significant positive correlations with chloroalkane and chloroalkene degradation pathway abundance. Ultimately, depth and TCE contamination level-associated soil microbiota and their most preferred C-source understanding could add to facilitate effective biostimulation via external nutrient amendment for efficient in situ TCE degradation.

Objective: The aim of this study is to investigate the effectiveness of electrical stimulation in arm function recovery after stroke. Methods: Data were obtained from the PubMed, Cochrane Library, Embase, and Scopus databases from their inception until 12 January 2019. Only randomized controlled trials (RCTs) reporting the effects of electrical stimulation on the recovery of arm function after stroke were selected. Results: Forty-eight RCTs with a total of 1712 patients were included in the analysis. The body function assessment, Upper-Extremity Fugl-Meyer Assessment, indicated more favorable outcomes in the electrical stimulation group than in the placebo group immediately after treatment (23 RCTs ( n = 794): standard mean difference (SMD) = 0.67, 95% confidence interval (CI) = 0.51–0.84) and at follow-up (12 RCTs ( n = 391): SMD = 0.66, 95% CI = 0.35–0.97). The activity assessment, Action Research Arm Test, revealed superior outcomes in the electrical stimulation group than those in the placebo group immediately after treatment (10 RCTs ( n = 411): SMD = 0.70, 95% CI = 0.39–1.02) and at follow-up (8 RCTs ( n = 289): SMD = 0.93, 95% CI = 0.34–1.52). Other activity assessments, including Wolf Motor Function Test, Box and Block Test, and Motor Activity Log, also revealed superior outcomes in the electrical stimulation group than those in the placebo group. Comparisons between three types of electrical stimulation (sensory, cyclic, and electromyography-triggered electrical stimulation) groups revealed no significant differences in the body function and activity. Conclusion: Electrical stimulation therapy can effectively improve the arm function in stroke patients.

Purpose: Patients with traumatic brain injury often experience cognition-related problems and difficulty in returning to work. This study analyzed the accuracy of a modified version of World Health...

Tricalcium silicate (C3S) and hydroxyapatite (HAp) composites were fabricated through the sol-gel process. The aim of this research is to improve the biocompatibility of C3S through HAp addition and study the potential of using this as coating materials. The composites (HAp/C3S) were characterised by Fourier transform infrared spectrometry, thermal gravity-differential thermal analysis and X-ray diffraction. The working and setting times of cement pastes were tested using Gillmore needle. Mechanical properties were examined by nanoindentation and material testing system. In vitro biocompatibility of the materials were studied by cell attachment and viability of L929 and MG-63 cells. HAp/C3S as a coating material on gelatin film were measured with the surface roughness and imaged by scanning electron microscope. With the addition of HAp, no undesirable free CaO was detected with the synthesis by the sol-gel preparation. The pH values of HAp added groups were between 7.54 and 8.76, which were much lower than pure C3S group (pH = 11.75). For in vitro studies, the presence of HAp could effectively enhance the cell attachment and viability of both L929 and MG-63 cells grown in the extract or directly on the composites. However, the mechanical properties of the composites were impaired as compared to pure C3S. Lastly, HAp/C3S cement could be evenly coated on gelatin film. HAp is successfully demonstrated to improve C3S biocompatibility with this new composites HAp/C3S. C-75 (75% C3S and 25% HAp), in particular, has good biocompatibility, relatively high compressive strength and can be uniformly coated onto gelatin film. Thus, C-75 is a promising material for further investigation as a coating on other biopolymers.

We performed first-principles calculations to study the adsorption of the CO molecules on both clean and Pd-doped ZnGa2O4(111) surfaces. The adsorption reaction and work function of the CO adsorption models were examined. The CO molecules on the clean and Pd-doped ZnGa2O4(111) surfaces exhibit maximum work function changes of −0.55 eV and −0.79 eV, respectively. The work function change of Pd-doped ZnGa2O4(111) for detecting CO is 1.43 times higher than that of the clean ZnGa2O4(111). In addition, the adsorption energy is also significantly reduced from −1.88 eV to −3.36 eV without and with Pd atoms, respectively. The results demonstrate ZnGa2O4-based gas sensors doped by palladium can improve the sensitivity of detecting CO molecules.

This study evaluated the clinical efficacy of continuous passive motion (CPM) following knee arthroplasty and determined the predictors of effect sizes of range of motion (ROM) and functional outcomes in patients with knee arthritis. A comprehensive electronic database search was performed for randomized controlled trials (RCTs), without publication year or language restrictions. The included RCTs were analyzed through meta-analysis and risk of bias assessment. Study methodological quality (MQ) was assessed using the Physiotherapy Evidence Database (PEDro) scale. Inverse-variance weighted univariate and multivariate metaregression analyses were performed to determine the predictors of treatment outcomes. A total of 77 RCTs with PEDro scores ranging from 6/10 to 8/10 were included. Meta-analyses revealed an overall significant favorable effect of CPM on treatment success rates [odds ratio: 3.64, 95% confidence interval (CI) 2.21–6.00]. Significant immediate [postoperative day 14; standard mean difference (SMD): 1.06; 95% CI 0.61–1.51] and short-term (3-month follow-up; SMD: 0.80; 95% CI 0.45–1.15) effects on knee ROM and a long-term effect on function (12-month follow-up; SMD: 1.08; 95% CI 0.28–1.89) were observed. The preoperative ROM, postoperative day of CPM initiation, daily ROM increment, and total application days were significant independent predictors of CPM efficacy. Early CPM initiation with rapid progress over a long duration of CPM application predicts higher treatment effect on knee ROM and function. The results were based on a moderate level of evidence, with good MQ and potential blinding biases in the included RCTs. An aggressive protocol of CPM has clinically relevant beneficial short-term and long-term effects on postoperative outcomes. II.