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Type II diabetes is the most important health issue in the whole world. Besides the use of prescribed drugs to control blood glucose level, recently, the development of health supplements is being actively explored. Owing to its high nutritional value, Momordica cochinchinensis Spreng. (Gac) is potentially a good source for developing this supplement. In recent years, the aril of Gac has been utilized as a substrate for developing various forms of supplements, but the pulp has been neglected as a byproduct. However, the pulp contains lots of phytochemicals that could provide health benefits, and the investigation using lactobacilli to ferment the pulp juices to lower blood glucose is not yet to be explored. Therefore, we set out to investigate the potential to develop the pulp-based juices for controlling blood glucose level by selecting an optimal strain of lactobacillus to ferment the pulp juice and measuring the inhibitory action of the fermented juice on α-glucosidase. This enzyme is crucial for controlling postprandial glucose absorbed into the bloodstream because it is the enzyme that hydrolyzes the carbohydrates to release glucose. First, we have successfully isolated a strain of lactobacillus which was capable of fermenting the pulp to produce α-glucosidase-inhibitory activity. Through a 16S rRNA sequence, this lactobacillus was named Lactiplantibacillus plantarum GBI 001. The optimal conditions for its growth in commercial culture medium were found to be 35 °C for 16 h to produce the highest α-glucosidase activity (72.03%). The optimal conditions for the strain to grow in Gac pulp juice were: 20% pulp juices as substrate with an initial pH adjusted to 4.0, growing at 35 °C for 16 h. Under these conditions, the fermented juice exhibited α-glucosidase activity of 24.36%, which is a 2.17-fold increase over the control group (11.23%). From its increase in α-glucosidase potency, using L. plantarum GBI 001 to ferment the pulp juices of Gac as soft drinks has great potential to develop a helpful drink as a food supplement to control postprandial blood glucose in patients with diabetes.

In the present work, nanostructured hydroxyapatite (HA)-containing coating was prepared on a Ti surface by ultrasonic mechanical coating and armoring (UMCA). A Ti plate was pre-coated with HA slurry, followed by UMCA, which was achieved by high-frequency ZrO2 ball bombardment. The UMCA process comprised several cycles of pre-coating and ball bombardment, providing high amounts of HA and good coating adhesion. The coating mainly consisted of nano-HA particles (less than 10 nm) and a small amount of Ti. Furthermore, the deformation structures of the Ti surface region were characterized in a nanocrystalline layer with a grain size of 50–200 nm. Additionally, the coating exhibited improved bioactivity and corrosion resistance in Hanks’ balanced salt solution than the Ti surface. Furthermore, the in vitro cytotoxicity test assessed that the HA-containing coating was non-cytotoxic.

Thermoprotective carrier agents increase bacterial viability during the drying process. We investigated the ability of various carriers, including skim milk powder, casein, and whey protein, to improve the survival rate of Lactobacillus brevis RK03 under gastrointestinal tract conditions. Employing optimized top fluid bed drying (TFBD) conditions (40 min at 50 °C), the highest bacterial survival rate (95 %) was achieved using casein and whey protein as carriers for RK03. Additionally, whey protein-microencapsulated RK03 displayed the highest survival rates in gastric juice at pH 3.0 (96 %) and 2.0 (75 %). Further, whey protein-microencapsulated RK03 exhibited better dispersibility and solubility than RK03 microencapsulated with other carriers, displayed a slower degradation rate at 50 °C and 60 °C, and had the lowest activation energy (30.27 J/mol). These results indicate that the use of whey protein as a carrier during TFBD is suitable for the production of RK03 probiotic powder.

Purpose This large-scale nationwide population-based study aimed to determine the recurrence rate and risk factors for recurrence after video-assisted thoracoscopic surgery (VATS) for primary spontaneous pneumothorax (PSP). Methods This retrospective study used data from the Taiwan National Health Insurance Database to identify individuals who underwent VATS for PSP from 2007 to 2014. All patients were followed up until December 31, 2017. Study variables included demographic characteristics, intensive care unit admission, lung resection status, use of non-steroidal anti-inflammatory drugs (NSAIDs), and hospital level. The primary outcome was 1-year recurrence, and the secondary outcomes were the 1-year rate of reintervention for recurrence and overall recurrence rate. Results During the study period, 6654 patients underwent VATS for PSP (average age: 23.2 years, 89.1% male), including 910 patients (13.7%) who experienced recurrence within 1 year and 531 patients (8.0%) who required reintervention within 1 year. The overall recurrence rate was 24.8%, with an average follow-up time of 6.7 years. Age ≤18 years and the use of NSAIDs, especially ketorolac, were significant risk factors for 1-year recurrence and overall recurrence. Younger age was a risk factor for 1-year reintervention. In subgroup analysis, NSAID use was a significant risk factor for 1-year recurrence, 1-year reintervention, and overall recurrence in pediatric patients but not in adult patients. Conclusions In Taiwan, the 1-year recurrence rate was 13.7% after VATS for PSP. Younger age and the use of NSAIDs, especially ketorolac, were significant risk factors for short- and long-term recurrence after VATS for PSP.

AJCC TNM stage and WHO grade (G) are two widely used staging systems to guide clinical management for pancreatic neuroendocrine neoplasms (panNENs), based on clinical staging and pathological grading information, respectively. We proposed to integrate TNM stage and G grade into one staging system (TNMG) and to evaluate its clinical application as a prognostic indicator for panNENs. Accordingly, 5254 patients diagnosed with panNENs were used to evaluate and to validate the applicability of TNMG to panNENs. The predictive accuracy of TNMG system was compared with that of each separate staging/grading system. We found that TNM stage and G grade were independent risk factors for survival in both the Surveillance, Epidemiology, and End Result (SEER) and multicenter series. The interaction effect between TNM stage and G grade was significant. Twelve subgroups combining the TNM stage and G grade were proposed in the TNMG stage, which were classified into five stages TNMG. According to the TNMG staging classification in the SEER series, the estimated median survival for stages I, II, III, IV, and V were 203, 174, 112, 61, and 8 months, respectively. The predictive accuracy of TNMG stage was higher than that of TNM stage and G grade used independently. The TNMG stage classification was more accurate in predicting panNEN patient's prognosis than either the TNM stage or G grade.

Background An individual’s genetics play a role in how RNA transcripts are generated from DNA and consequently in their translation into protein. Transcriptional and translational profiling of patients furnishes the information that a specific marker is present; however, it fails to provide evidence whether the marker correlates with response to a therapeutic agent. A comparative analysis of the frequency of genetic variants, such as single nucleotide polymorphisms (SNPs), in diseased and general populations can identify pathogenic variants in individual patients. This is in part because SNPs have considerable effects on protein function and gene expression when they occur in coding regions and regulatory sequences, respectively. Therefore, a tool that can help users to obtain the allele frequency for a corresponding transcript is the need of the day. Several annotation tools such as SNPnexus and VariED are publicly available; however, none of them can use transcript IDs as input and provide the corresponding genomic positions of variants. Results In this study, we developed an R package, called transcript annotation tool (TransAT), that provides (i) SNP ID and genomic position for a user-provided transcript ID from patients, and (ii) allele frequencies for the SNPs from publicly available global populations. All data elements are extracted, collected, and displayed in an easily downloadable format in two simple command lines. TransAT is available on Windows/Linux/MacOS and is operative for R version 4.0.4 or later. It is available at https://github.com/ShihChingYu/TransAT and can be downloaded and installed using devtools::install_github("ShihChingYu/TransAT", force=T) on the R execution page. Thereafter, all functions can be executed by loading the package into R with library(TransAT). Conclusions TransAT is a novel tool that seamlessly provides genetic annotations for queried transcripts. Such easily obtainable information would be greatly advantageous for physicians, assisting them to make individualized decisions about specific drug treatments. Moreover, allele frequencies from user-chosen global ethnic populations will highlight the importance of ethnicity and its effect on patient pathogenicity.

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare with low-grade malignancy and unclarified clinicopathological features. This study aimed to examine their characteristics and re-evaluate current treatments.Databases from three sources were screened for patients with SPNs. We compared the perioperative variables, clinical data, overall survival (OS), and prognostic factors for recurrence among the three corresponding cohorts.We identified 286 patients diagnosed with SPNs between 1988 and 2020. Patients were mostly women (81%; median age: 38 years), and peak incidence was observed in women of 20-29 years of age. SPNs had a peak incidence in Asian men at 50-59 years of age (p = 0.002) and a delayed peak incidence in Asian women at 30-39 years of age (p 0.001). Treatment strategies differed significantly across the institutions and included variations in the number of harvested lymph nodes and rates of vascular resection. Lymph node positivity was the only predictor of postoperative recurrence (odds ratio, 2.2; 95% confidence interval, 1.38-2.99; p = 0.007). Higher rates of lymphovascular invasion (p = 0.02), perineural invasion (p 0.001), and R1 margin involvement (p 0.001), as seen in one institution, did not result in poorer long-term survival in terms of the overall (p = 0.43), SPN-specific (p = 0.69), and recurrence-free survivals (p = 0.067).In contrast to previous findings that SPNs are prevalent in young women, a racial predilection for middle-aged Asian men and a delayed female peak incidence were noted. Parenchyma-preserving pancreatectomy may be an acceptable treatment. Non-radical surgery may be appropriate in patients with multiple comorbidities.

To analyze the effect of preoperative body composition on survival in patients with pancreatic cancer following pancreaticoduodenectomy (PD). Between October 2005 and August 2018, 116 patients (68 men, 48 women, mean age 66.2 ± 11.9 years) diagnosed with pancreatic adenocarcinoma following PD were retrospectively enrolled. The preoperative CT on vertebral level L3 was assessed for total abdominal muscle area (TAMA), visceral adipose tissue area (VAT), subcutaneous adipose tissue area (SAT), and mean skeletal muscle attenuation (SMD). The clinical data and pathological findings of tumors were collected. The impact of these factors on disease-free survival (DFS) and overall survival (OS) was evaluated by the Kaplan–Meier method and by univariable and multivariable Cox proportional hazards models. The 3-year DFS and OS rates were 8% and 25%, respectively. Of 116 patients, 20 (17.2%), 3 (2.6%), and 46 (39.7%) patients were classified as having sarcopenia, sarcopenic obesity, and myosteatosis, respectively. The VAT–TAMA ratio (1.2 ± 0.7 vs 0.9 ± 0.5, p = 0.01) and the visceral to subcutaneous adipose tissue area ratio (1.3 ± 0.7 vs 0.9 ± 0.5, p = 0.04) were higher in sarcopenic patients than in the nonsarcopenic group. Preoperative sarcopenia and sarcopenic obesity were associated with shorter OS (p = 0.012 and p = 0.041, respectively), but not shorter DFS. Myosteatosis was neither associated with DFS nor OS. On multivariable analysis, sarcopenia was the only significant prognostic factor for OS (p = 0.039). Preoperative sarcopenia assessed by CT is a poor prognostic factor for OS in pancreatic cancer patients after PD. • Sarcopenia and sarcopenic obesity can be evaluated by abdominal CT on L3 level. • Patients with diabetes mellitus (DM) had lower sex-standardized subcutaneous adipose tissue area index and skeletal muscle density and higher visceral to subcutaneous adipose tissue area ratio than did those without DM. • Preoperative sarcopenia, sarcopenic obesity, and new-onset diabetes mellitus may predict poor overall survival in pancreatic cancer patients following pancreaticoduodenectomy.

Background The centralization of pancreatoduodenectomy (PD) has been shown to improve patient outcomes. The scheduling of two PDs in one day is one option to shorten the waiting time for patients referred to high volume centers. The effect on the surgical team or patient outcomes of such an approach have not previously been explored. This study aimed to investigate the effect of scheduling two PDs in one day on the surgeon's workload and patient outcomes. Methods A retrospective review of patients undergoing PD by a single surgeon between 2007 and 2018 was performed. Patients were allocated into: first PD (FIRSTPD group) or second PD (SECONDPD group) according to the position on the surgical operating list. The intraoperative, postoperative outcomes, and workload (the Surgery Task Load Index; SURG-TLX) were assessed between two groups. Results A total of 967 (91%) and 101 (9%) patients were included in the FIRSTPD and SECONDPD group, respectively. There were no differences in the duration of surgery (coefficient = −9.65; 95% confidence interval: −29.26 to 9.94; P = 0.334), incidence of major complications (odds ratio = 1.08; 95% confidence interval: 0.67–1.73; P = 0.739), or 90-day mortality (odds ratio = 1.03; 95% confidence interval: 0.12–8.53; P = 0.978) for those patients in the SECONDPD group as compared to the FIRSTPD group. The mean scores of two (physical and temporal demand) of the six SURG-TLX subscales of surgical workload were recorded as significantly higher by surgeons following two PD's as compared to one PD. Conclusions Although scheduling a second PD in one day shows no association with adverse patient outcomes, there is an increase in the physical and temporal subscales of surgical workload and consideration should be given to how this could be minimized.

Present study focused on optimizing bioprocess condition for microalgal lutein production. From previous baseline yields of biomass (3.46 g/L) and lutein (13.7 mg/g), this study examined few key parameters. The 3X:3X ratio macro- and micronutrients was the most affecting parameter with highest biomass and lutein yields of 4.61 g/L and 14.3 mg/g. Temperature 30 °C enhanced the lutein up to 17.3 mg/g but reduced the biomass to 3 g/L. The light effects study showed 10k lux was most effective for lutein up to 14 mg/g, and effect of increasing salinity (25-75%) was detrimental. All the above parameters' optimization resulted in a lipid content of 22.5-26.5%. A maximum lutein productivity and yield of 0.451 mg/L/d and 65.74 mg/L with a 3X:3X macro- and micronutrient ratio was achieved. The Chlorella sorokiniana Kh12 strain exhibited one of the highest yields among recent reports; hence it could be a source for commercial lutein production.

BackgroundPancreatic head ductal adenocarcinoma (PHDAC) patients with the same tumor-node-metastasis (TNM) stage may share different outcomes after pancreaticoduodenectomy (PD). Therefore, a novel method to identify patients with poor prognosis after PD is urgently needed. We aimed to develop a nomogram to estimate survival in PHDAC after PD.MethodsTo estimate survival after PD, a nomogram was developed using the Tongji Pancreatic cancer cohort comprising 355 PHDAC patients who underwent PD. The nomogram was validated under the same conditions in another cohort (N = 161) from the National Taiwan University Hospital. Prognostic factors were assessed using LASSO and multivariate Cox regression models. The nomogram was internally validated using bootstrap resampling and then externally validated. Performance was assessed using concordance index (c-index) and calibration curve. Clinical utility was evaluated using decision curve analysis (DCA), X-tile program, and Kaplan–Meier curve in both training and validation cohorts.ResultsOverall, the median follow-up duration was 32.17 months, with 199 deaths (64.82%) in the training cohort. Variables included in the nomogram were age, preoperative CA 19-9 levels, adjuvant chemotherapy, Tongji classification, T stage, N stage, and differentiation degree. Harrell’s c-indices in the internal and external validation cohorts were 0.79 (95% confidence interval [CI], 0.76–0.82) and 0.83 (95% CI, 0.78–0.87), respectively, which were higher than those in other staging systems. DCA showed better clinical utility.ConclusionThe nomogram was better than TNM stage and Tongji classification in predicting PHDAC patients’ prognosis and may improve prognosis-based selection of patients who would benefit from PD.

In this study, a Ti nitride/Ni metal-based composite was fabricated by the carbothermal reduction reaction during the sintering process. After cold isostatic pressing, green compacts consisting of 50 wt% Ti and 50 wt% Ni were soaked in a water-based hot forging lubricant followed by sintering in air at 850, 950, and 1050 °C. The effects of the sintering temperature on the wear resistance and the compressive strength of the composites were investigated. During sintering, Ti particles were transformed to Ti nitride as TiN0.3 at 850 °C, and then gradually transformed to TiN0.3 and TiN at 950 °C accompanied by TiO2 formation. The Ti oxide layer surrounding the outer surface of the Ti nitride particles has a hardness of 327.5 HV, which is lower than that of the Ti nitride particles (1224.0 HV) and higher than that of the Ni matrix (77.2 HV). The oxide layer is regarded as a buffer layer which can improve the adhesion of the Ti nitride particles and the Ni matrix. The compact sintered at 950 °C had the highest wear resistance and compressive strength among all the compacts due to its low porosity and thick oxide layer. The compact sintered at 850 °C had the lowest wear resistance, and the main fracture mechanism realizes due to the detachment of the Ti nitride particles from the Ni matrix. The wear fracture mechanism of the compact sintered at 1050 °C explained by the enlargement of the pores in the Ti nitride particle by abrasion.

Although the hypoglycemic potential of brewer’s yeast extract has been reported, there is limited information pertaining to the hypoglycemic ingredients of Saccharomyces pastorianus extract and their mechanisms of action available. This study aimed to investigate the in vivo and in vitro hypoglycemic effect of S. pastorianus extract and to elucidate its molecular mechanisms. S. pastorianus extract was mainly composed of proteins followed by carbohydrates. In diabetic rats, oral administration of S. pastorianus extract significantly reduced the levels of plasma glucose and enhanced the activity of hepatic glucose-6-phosphatase dehydrogenase. Treatment with S. pastorianus extract increased the localization of type 4 glucose transporter (GLUT4), PTP, and insulin receptor at 3T3-L1 cell membranes and raised the levels of P38 MAPK, PI3K, and AKT in the cytosol. In agreement with these results, pretreatment of 3T3-L1 cells with inhibitors of PTP, PI3K, Akt/PKB, and p38 MAPK inhibited glucose uptake induced by application of S. pastorianus extract. Most importantly, a 54 kDa protein with hypoglycemic activity was identified and suggested as the major ingredient contributing to the hypoglycemic activity of S. pastorianus extract. In summary, these results clearly confirm the hypoglycemic activity of S. pastorianus extract and provide critical insights into the underlying molecular mechanisms.

The pre-experiment of the present study revealed that polyurethane (PU) synthesized using poly (hexamethylene carbonate) glycol (PHC) has high melt viscosity and is difficult to process. Therefore, poly (trimethylene carbonate) glycol (PTC) was employed to synthesize a PU product with low melt viscosity. First, four types of thermoplastic polyurethane (TPU) were formed through one-step solvent-free synthesis. TPU is presented in the format “TPU-X-Y,” with X representing the polyol (PTC or PHC, around 1000 molecular weight) and Y the chain extender (1,3-propane diol [PDO] or 1,4-butane diol [BDO]) used. The TPU was synthesized using a fixed molar ratio of (isocyanate):(polyol):(chain extender) = 2:1:1 and compared. The results indicated that chain entanglement often occurred among the long carbon chains of PHC. The synthesized TPU employed a property of PTC, namely converting polarity into reverse polarity in high temperatures, to resolve the high melt viscosity of TPU of the PHC series, which causes processing difficulties. The synthesized TPU-PTC-PDO exhibited favorable molecular arrangements. Given its polarity, TPU-PTC-PDO has outstanding tensile properties (strength at break: 41.10 ± 10.78 MPa, 100% modulus = 6.73 ± 0.12 MPa), making processing at lower temperatures (180 or 190 °C) feasible. With the inclusion of PTC, the synthesized polycarbonate TPU exhibits the advantages of polycarbonate and is suitable for a wide range of applications.

Purpose Pancreatic cancer is one of the most malignant cancers with poor survival. The latest edition of the American Joint Committee on Cancer (AJCC) staging system classifies the majority of operable pancreatic cancer patients as stage-III, while dramatic heterogeneity is observed among these patients. Therefore, subgrouping is required to accurately predict their prognosis and define a treatment plan. This study conducts a cohort study to provide a more precise classification system for stage-III pancreatic cancer patients by utilizing clinical variables. Methods We analyzed survival using log-rank tests, univariate Cox-regression models, and Kaplan-Meier survival curves for stage-III pancreatic ductal adenocarcinoma (PDAC) patients from the Taiwan Cancer Registry (TCR). Patients were further divided into subgroups using classification and regression tree (CART) algorithm. All results were validated using the SEER database. Results Among stage-III PDAC patients, lymph node and tumor grade showed significant association with survival. Patients with N2 stage had higher mortality risks (hazard ratio [HR] = 2.30, 95% confidence interval [CI] 1.71–3.08, p p p Conclusions Lymph node involvement and tumor grade are predictive factors for survival in stage-III PDAC patients. This new precise classification system can be used to guide treatment planning in advanced-stage pancreatic cancer.

Background:There is no widely-accepted staging system for pancreatic neuroendocrine tumors (pNETs). The aim of this study was to validate the American Joint Committee on Cancer (AJCC) 8th edition staging system for well-differentiated (G1/G2) pNETs.Methods:A multicenter dataset (n=1086) was used to evaluate the application of the AJCC 7th and 8th, the European Neuroendocrine Tumor Society (ENETS), and the modified ENETS (mENETS) staging systems for well-differentiated pNETs.Results:The proportion of patients with stage III tumors was extremely low (1.1%) according to the AJCC 7th staging system. For the ENETS staging system, patients with stage IIIA disease had worse estimated mean survival than patients with stage IIIB disease (78.9 vs. 107.3 months). When comparing with patients in stage I, the AJCC 7th, ENETS, and mENETS staging systems showed good performance in discriminating between stages; however, there was no significant difference in some stages when the reference was defined as the earlier stage. When the reference was defined as stage I or the earlier stage, there was a significant inter-stage difference in the AJCC 8th staging system.Conclusions:The AJCC 8th staging system is more suitable for pNETs than other TNM staging systems and may be adopted in clinical practice.

A biocomposite coating comprising chitosan and ZnO deposited on a porous Ti oxide is developed to avoid orthopedic and dental implant-related infections. The coating comprised of an inner layer of nanoporous TiO2 and the outer layer of the chitosan matrix with ZnO nanoparticles. Microbiological tests show that chitosan coating is effective against Escherichia coli (E. coli), however, its ability to inhibit bacterial adhesion is very limited. A 1.2-fold increase in the antibacterial activity of chitosan/ZnO coating against E. coli was detected as compared to the chitosan coating alone, and the chitosan/ZnO efficiently inhibited biofilm formation. In addition, the chitosan/ZnO coating exhibited improved bioactivity compared to the chitosan coating. The improvement in antibacterial properties and bioactivity of the chitosan/ZnO coating is attributed to the release of Zn2+ ions. The critical force of scratching the chitosan/ZnO coating was approximately twice that of the chitosan coating. The potentiodynamic polarization results confirmed that the corrosion resistance of the implant with ZnO/chitosan/Ti structure was improved. In addition, cytocompatibility evaluation indicated that the chitosan/ZnO coating has good cytocompatibility in MG-63 cells as compared to pure Ti.

Patients with periampullary cancer frequently suffer obstructive jaundice and commonly require preoperative biliary drainage (PBD) for relief and to avoid related complications. Although research has established a correlation between PBD and surgical wound infection, the impact of PBD on major infectious complications (intra-abdominal abscess [IAA]) and overall mortality remains debatable. We hypothesized that PBD could lead to IAA and mortality, and evaluated their correlation in patients undergoing pancreaticoduodenectomy (PD). We enrolled patients undergoing PD at an Asian academic medical center between 2007 and 2016. The types of PBD included endoscopic retrograde biliary drainage (ERBD) and percutaneous transhepatic cholangiography and drainage (PTCD). The primary outcome was IAA, defined as the presence of pus or infected fluid inside the abdominal cavity and with documented infectious pathogens. There was one (0.1%) 30-day mortality and eight (0.9%) 90-day mortalities among 899 consecutive patients examined. More than one-quarter of patients had PBD (n = 237, 26.4%; 165 ERBD, 72 PTCD). In the ERBD, PTCD, and non-PBD groups, the IAA rates were 37.0%, 16.7%, and 10.6%, respectively. On multivariate analysis, ERBD (odds ratio 3.67; 95% confidence interval 2.22–6.06; p

Photoluminescent nanomaterials have immense potential for use in biological systems due to their excellent fluorescent properties and small size. Traditional semiconductor quantum dots are heavy-metal-based and can be highly toxic to living organisms, besides their poor photostability and low biocompatibility. Nano-sized carbon quantum dots and their surface-modified counterparts have shown improved characteristics for imaging purposes. We used 1,3, 6-trinitropyrene (TNP) and polyethylene glycol6000 (PEG6000) in a hydrothermal method to prepare functional polyethylene glycol6000/carbon nanodots (PEG6000/CDs) and analyzed their potential in fluorescent staining of different types of bacteria. Our results demonstrated that PEG6000/CDs stained the cell pole and septa of gram-positive bacteria B. Subtilis and B. thuringiensis but not those of gram‐negative bacteria. The optimal concentration of these composite nanodots was approximately 100 ppm and exposure times varied across different bacteria. The PEG6000/CD composite had better photostability and higher resistance to photobleaching than the commercially available FM4-64. They could emit two wavelengths (red and green) when exposed to two different wavelengths. Therefore, they may be applicable as bioimaging molecules. They can also be used for differentiating different types of bacteria owing to their ability to differentially stain gram-positive and gram-negative bacteria.

The effect of a harmonic scalpel on postoperative pancreatic fistula (POPF) has not been addressed. This study assessed the effect of pancreatic neck transection using a harmonic scalpel on rate and severity of POPF after pancreaticoduodenectomy (PD).This retrospective analysis included patients who underwent PD at National Taiwan University Hospital between July 2015 and March 2019. We compared rate and severity of POPF between patients who underwent pancreatic neck transection using a harmonic scalpel versus electrosurgical unit.Of 422 consecutive PDs, the pancreatic neck was transected using a harmonic scalpel or electrosurgical unit in 144 and 278 patients, respectively. Use of a harmonic scalpel significantly increased risk of biochemical leak (25.7% versus [vs] 10.8%; P 0.05) but not clinically relevant POPF (CR-POPF; 30.2% vs 26.4%; P = 0.41). Harmonic transection was an independent predictor of biochemical leak (odds ratio [OR] = 2.93; P 0.05) but not CR-POPF (OR = 0.83; P = 0.41) or other major complications (OR = 0.72; P = 0.27). There was no significant intergroup difference in postoperative hospital stay.Pancreatic neck transection using a harmonic scalpel increased risk of biochemical leak but not CR-POPF or other major complications.

Chitosan is produced by thermochemical alkaline deacetylation of chitin, but the process is usually environmentally problematic. In the present study, Illex argentinus squid pen chitin, after de-proteinization and demineralization, was pretreated with a compressional-puffing (CP) process under various puffing pressures. The CP process facilitated the increase of the crystalline index and degree of deacetylation of chitins. The CP-treated chitins were subjected to further extraction of chitosan, and four chitosan isolates (CI1-CI4) were obtained. The CP process was found to have beneficial effects in terms of increased extraction yield and increased antibacterial activity of the extracted chitosans. Moreover, the antibacterial property of the extracted chitosans seemed to be negatively related to their molecular weight (MW). Our findings showed that CI4 exhibited the highest extraction yield and the greatest antibacterial activity, and thus we recommend it as a safe and potent antibacterial agent for food, biomedicine, and other industrial usages.

Background The rate of preoperative biliary drainage for pancreaticoduodenectomy has been increasing despite most recent evidence that favors avoiding it. Only a few studies have focused on late surgical complications - biliary stricture after pancreaticoduodenectomy and have produced only inconclusive results. We evaluate the role of preoperative biliary drainage in the formation of biliary stricture after pancreaticoduodenectomy. Methods The Taiwan National Health Insurance Program is a mandatory health care plan that covers nearly the entire population of 23 million in this country. A retrospective study was conducted to analyze the database compiled by the Taiwan National Health Insurance between January 2000 and December 2011. We included only patients with at least 2 years of follow-up. A cohort of 2,087 patients with preoperative diagnosis of biliary obstruction that underwent pancreaticoduodenectomy was evaluated. Results A total of 212 (10.1%) of the 2,087 studied patients needed intervention for biliary stricture after pancreaticoduodenectomy. The median time to biliary stricture formation was 15.2 months (range: 1.2-89.7 months). The cumulative biliary stricture rate was 6.9% (1 year), 15.8% (5 years), and 18.5% (10 year). Multivariate analysis showed preoperative biliary drainage (hazard ratio 1.78, 95% CI 1.27-2.50, P = 0.001) associated with biliary stricture after pancreaticoduodenectomy. Conclusions Preoperative biliary drainage increases biliary stricture rate after pancreaticoduodenectomy.

During the processing of mango, a huge amount of peel is generated, which is environmentally problematic. In the present study, a compressional-puffing process was adopted to pretreat the peels of various mango cultivars, and then the bioactive compounds of mango peels were extracted by water or ethanol. The phenolic compound compositions as well as the free radical-scavenging, anti-inflammatory, and antibacterial activities of water extract (WE) and ethanol extract (EE) from nonpuffed (NP) and compressional-puffed (CP) mango peels were further evaluated. It was found that compressional-puffing could increase the yield of extracts obtained from most mango varieties and could augment the polyphenol content of extracts from Jinhwang and Tainoung number 1 (TN1) cultivars. The WE and EE from TN1 exhibited the highest polyphenol content and the greatest free radical-scavenging activities among the mango cultivars tested. Seven phenolic compounds (gallic acid, pyrogallol, chlorogenic acid, p-hydroxybenzoic acid, p-coumaric acid, ECG, and CG) were detected in CPWE (compressional-puffed water extract) and CPEE (compressional-puffed ethanol extract) from TN1, and antioxidant stability of both CPWE and CPEE was higher than that of vitamin C. Further biological experiments revealed that CPEE from TN1 possessed the strongest anti-inflammatory and antibacterial activities, and thus it is recommended as a multibioactive agent, which may have applications in the food, cosmetic, and nutraceutical industries.

Chitosan/drug (cefazolin) coatings were synthesized on alkali-treated Ti surfaces via electrophoretic deposition to improve the antibacterial activities and corrosion resistances of the surfaces. The coatings exhibited desirable adhesion to the alkali-treated Ti due to the penetration of chitosan and drug into the pores of the substrates. The chitosan were cationic molecules which carried drug and both of them migrated toward the cathode during electrophoretic deposition. At a low potential, the drug dissolved in the chitosan film, whereas at a high potential, the drug aggregated into sheets on the surface of chitosan. The high potential provided the coating with high drug loading and releasing capacity. The total drug release of chitosan/drug coatings with 4.3 and 6.9 μm thickness in Hank's balanced salt solution (HBSS) was about 3 and more than 14 days, respectively. The coatings exhibited increased corrosion resistance than the Ti in HBSS evaluated via potentiostat. Additionally, the coating with high drug loading demonstrated approximate 100% antibacterial activities against Escherichia coli; thus, the proposed coatings can be used as promising Ti coatings to limit bacterial adhesion and proliferation.

Waste biomass of Lactobacillus brevis obtained from in vivo γ-aminobutyric acid (GABA) production was used for value-addition. This study aims to extract glutamate decarboxylase (GAD) and characterize it for in vitro GABA production. Extracted GAD showed an excellent activity for in vitro GABA production. 52 W ultrasonic output was best in crude GAD extraction which was purified by Q HP anion-exchange column followed by Superdex-200 colloid separation column. The molecular weight of the purified GAD was determined to be ~53 kDa, and the Km value for L-glutamic acid was calculated ~7.65 mM. Pyridoxal 5′-phosphate (PLP) acted as the best cofactor for GAD. Optimum temperature and PLP dosing were deferring for crude and purified enzyme forms which respectively exhibited at 45°C, 55°C, 200 µmol and 20 µmol whereas optimum pH was the same at 4.5. GAD finds applications in food industries hence its detailed characterization would be promising for commercial exploitations.

This paper proposes a revised Glosten-Jagnnathan-Runkle (GJR) model for estimating hedge ratios. The model can take into account three important characteristics in the return behavior, i.e., fat-tailed distribution, leverage effect, and spot-futures spread. Hedge performance in terms of the White's (2000) reality check is conducted. Our results demonstrate that the generalized autoregressive conditional heteroskedasticity (GARCH) model that considers both fat-tailed distribution and asymmetric effects of the spread provides the best hedging effectiveness for longer horizons.

We evaluated γ-aminobutyric acid (GABA) production by Lactobacillus brevis RK03 immobilized fermentation using three types of porous ceramic materials, All Clean (AC), Ocean Free (OF), and Power Material (PM). Almost same surface areas of the three porous ceramic materials were used to perform batch cultures with a modified GM broth and 500 mM monosodium glutamate (MSG). PM produced the highest GABA production after 96 h with an MSG conversion rate of 96.5% at pH 4.5 and 10% bacterial inoculum growing in a 500 mL flask. We then developed a semi-continuous GABA fermentation system by culturing 10% cells in the 500 mL flask comprising AC, OF, and PM carriers with similar surface areas and 500 mM MSG, for 288 h and five cycles at 30 °C. PM produced the highest GABA yield with a 86% conversion rate after five cycles. Semi-continuous fermentation was performed in a 10 L fermenter; MSG conversion rates still reached 97.3% or more following 25 consecutive fermentations, resulting in a maximum GABA yield, which was high for five cycles. Therefore, PM was the best carrier for continuous fermentation of GABA after 25 cycles and 1200 h. PM can be applied to industrial mass production of GABA.