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Item type:Item, Bioethanol production from acid pretreated microalgal hydrolysate using microwave-assisted heating wet torrefaction(2020-11-01) ;Yu, Kai Ling ;Chen, Wei-Hsin ;Sheen, Herng-Kuang ;Chang, Jo-ShuLin, Chih-ShengThis study focused on the bioethanol production from the co-production of solid biochar and liquid hydrolysate under microwave-assisted heating wet torrefaction towards a sustainable green technology. The two indigenous microalgal biomass undergone dilute acid pretreatment using wet torrefaction to produce microalgal hydrolysates and biochar at operating conditions of 160-170 degrees C with holding times of 5-10 min. The hydrolysates were utilized for fermentation with the yeast Saccharomyces cerevisiae at 29 degrees C in a dark condition at a non-agitation state for 120 h. The concentrations of total reducing sugar, reducing sugar by-product, and bioethanol in the hydrolysates were determined. The carbohydrate-rich microalga C. vulgaris ESP-31 showed a good performance in bioethanol production. Microalgal hydrolysate obtained after the pretreatment consisted of a total reducing sugar with the highest concentration of 98.11 g/L. The formation of by-product 5-hydroxymethyl-2-furaldehyde (5 HMF), which might act as the fermentation inhibitor that led to the low ethanol yield, was also analyzed. The highest ethanol yield achieved was 7.61% with a maximum experimental conversion probability of 95.22%. This study has demonstrated the feasible bioethanol production from microalgal hydrolysate through microwave-assisted heating wet torrefaction using dilute acids and the optimization of bioethanol production can be carried out for better performance in the future study.Item type:Item, Seizure After Percutaneous Endoscopic Surgery?Incidence, Risk Factors, Prevention, and Management(2020-06-01) ;Lin, Chia-Yu ;Chang, Chien-Chun ;Tseng, Chun ;Chen, Yen-JenTsai, Chun-HaoItem type:Item, Production of microalgal biochar and reducing sugar using wet torrefaction with microwave-assisted heating and acid hydrolysis pretreatment(2020-08-01) ;Yu, Kai Ling ;Chen, Wei-Hsin ;Sheen, Herng-Kuang ;Chang, Jo-ShuLin, Chih-ShengThis study employed the microwave-assisted acid hydrolysis pretreatment using wet torrefaction on two indigenous microalgae, Chlorella vulgaris ESP-31 and Chlorella sp. GD with different biomass composition to investigate the yields of solid biochar and total reducing sugar in the liquid hydrolysate. Operating conditions at low temperatures (160, 170 degrees C) with short holding time (5, 10 min) under several concentrations of diluted acid medium (0, 0.1 and 0.2 M) were carried out to investigate the torrefaction severity effects towards the properties of the solid and liquid products. The highest biochar yields of 54.5% and 74.6% are obtained from C. vulgaris ESP-31 and Chlorella sp. GD, respectively under the wet torrefaction conditions with an improvement in the properties for fuel and value-added environmental application. The highest total reducing sugar concentration of 98.11 g/L and 12.08 g/L are obtained in C. vulgaris ESP-31 and Chlorella sp. GD liquid hydrolysates, respectively after acid hydrolysis pretreatment. With the co-production of high total reducing sugar in the liquid hydrolysate that can be utilized for bioethanol production and solid biochar as another value-added product, the acid hydrolysis pretreatment using wet torrefaction can be one of the conversion technologies towards the application of renewable energy production. (C) 2020 Elsevier Ltd. All rights reserved.Item type:Item, 3D Real-Time Image-Guided Navigation Spine Corpectomy with Ultrasonic Bone Cutter: Technical Note(2020-03-01) ;Lin, Chung-Wei ;Chang, Chien-Chun ;Chen, Hsien-Te ;Chen, Yen-JenLin, Chih-ShengBACKGROUND: Surgical interventions for congenital scoliosis are challenging for spine surgeons. The coordination of 3-dimensional (3D), real-time, image-guided navigation with an ultrasonic bone cutter allows surgeons to localize the affected area of the spine accurately and remove the lesion without damaging soft tissue structures. The goal of this technical paper is to report a previously undescribed method of hemivertebrectomy that combines 3D, real-time, image-guided navigation and an ultrasonic bone cutter. We highlight the feasibility and safety of this method in spinal surgery. METHODS: Three patients with congenital scoliosis were treated with this technique. We present three illustrative cases comprising hemivertebrectomies for congenital scoliosis. Intraoperative photos demonstrating the technique are also provided. RESULTS: All surgeries were completed without complications. The hemivertebrae were completely removed, and marked correction of congenital scoliosis was noted. CONCLUSIONS: We believe that the combination of 3D, real-time image navigation and an ultrasonic bone cutter improves hemivertebrectomy by increasing accuracy and avoiding dura laceration, major organ damage, or potential vessel damage.Item type:Item, Stimulants associated with reduced risk of hospitalization for motor vehicle accident injury in patients with obstructive sleep apnea-a nationwide cohort study(2020-02-03) ;Lin, Yi-Chang ;Chen, Tien-Yu ;Chien, Wu-Chien ;Chung, Chi-HsiangChang, Hsin-AnBackground The risk of injury directly related to hospitalization for motor vehicle accidents (MVAs) in the obstructive sleep apnea (OSA) patients has not been thoroughly understood. Our study aimed to examine the association between the OSA and the hospitalization for an MVA injury. Methods This retrospective cohort study used Taiwan's National Health Insurance Research Database (NHIRD) between 2000 and 2015. The OSA patients aged >= 20 years by age, sex, and index-year matched by non-OSA controls were enrolled (1:3). We used the Cox proportional regression model to evaluate the association between the OSA and the hospitalization for an MVA injury. Results The incidence rate of hospitalization for an MVA injury was higher in the OSA cohort (N = 3025) when compared with the non-OSA controls (N = 9075), as 575.3 and 372.0 per 100,000 person-years, respectively (p < 0.001). The Kaplan-Meier analysis showed that the OSA cohort had a significantly higher incidence of hospitalization for the MVA injury (log-rank test, p < 0.001). After adjusting for the covariates, the risk of hospitalization for the MVA injury among the OSA was significantly higher (hazard ratio [HR] =2.18; 95% confidence interval [CI] = 1.79-2.64; p < 0.001). Stimulants usage was associated with a nearly 20% decrease in the risk of an overall hospitalization for an MVA injury in the OSA patients. Conclusions This study provides evidence that patients with OSA are at a two-fold higher risk of developing hospitalization for an MVA injury, and the usage of modafinil and methylphenidate was associated with a lower risk of an overall hospitalization for the MVA injury.Item type:Item, Transplant Recipients Using Tacrolimus Had Higher Utilization of Healthcare Services Than Those Receiving Cyclosporine in Taiwan(2019-09-19) ;Lin, Yi-Chang ;Tsai, Chien-Sung ;Li, I-Hsun ;Tsai, Yi-TingHuang, Tien-YuTo date, population-based studies on the healthcare service utilization among stable heart, kidney, and liver transplant recipients with different calcineurin inhibitors are still scarce. Therefore, we used the Taiwan National Health Insurance Research Database to conduct a nationwide cross-sectional study to estimate the healthcare utilization of stable transplant recipients with tacrolimus or cyclosporine (n = 3,482). The sampled patients in this study comprised 377 heart, 1,693 kidney, and 1,412 liver transplant recipients between 1 January 2011 and 31 December 2011. Each subject was followed for a 1-year period to evaluate his/her healthcare service utilization. Outcome variables of the healthcare service utilization were stated as below: numbers of outpatient visits, outpatient costs, numbers of inpatient days, inpatients costs, and total costs of all healthcare services. As for all healthcare service utilization, stable transplant recipients on tacrolimus had significantly more outpatient visits (40.7 vs. 38.6), outpatient costs (US$10,383 vs. US$8,155), and total costs (US$12,516 vs. US$10,372) of all healthcare services than those on cyclosporine during the 1-year follow-up period. Additionally, further analysis showed that heart transplant recipients receiving tacrolimus incurred 1.7-fold higher inpatient costs compared to patients receiving cyclosporine. We concluded that transplant recipients using tacrolimus had significantly higher utilization of all healthcare services than those receiving cyclosporine as immunosuppressive therapy.Item type:Item, Simultaneous Colorimetric Detection of a Variety of Salmonella spp. in Food and Environmental Samples by Optical Biosensing Using Oligonucleotide-Gold Nanoparticles(2019-05-31) ;Quintela, Irwin A. ;de los Reyes, Benildo G. ;Lin, Chih-Sheng ;Wu, Vivian C. H.生物科技學系Optical biosensors for rapid detection of significant foodborne pathogens are steadily gaining popularity due to its simplicity and sensitivity. While nanomaterials such as gold nanoparticles (AuNPs) are commonly used as signal amplifiers for optical biosensors, AuNPs can also be utilized as a robust biosensing platform. Many reported optical biosensors were designed for individual pathogen detection in a single assay and have high detection limit (DL). Salmonella spp. is one of the major causative agents of foodborne sickness, hospitalization and deaths. Unfortunately, there are around 2,000 serotypes of Salmonella worldwide, and rapid and simultaneous detection of multiple strains in a single assay is lacking. In this study, a comprehensive and highly sensitive simultaneous colorimetric detection of nineteen (19) environmental and outbreak Salmonella spp. strains was achieved by a novel optical biosensing platform using oligonucleotide-functionalized AuNPs. A pair of newly designed single stranded oligonucleotides (30-mer) was displayed onto the surface of AuNPs (13 nm) as detection probes to hybridize with a conserved genomic region (192-bases) of ttrRSBCA found on a broad range of Salmonella spp. strains. The sandwich hybridization (30 min, 55 degrees C) resulted in a structural formation of highly stable oligonucleotide/AuNPs-DNA complexes which remained undisturbed even after subjecting to an increased salt concentration (2 M, final), thus allowing a direct discrimination via color change of target (red color) from non-target (purplish-blue color) reaction mixtures by direct observation using the naked eye. In food matrices (blueberries and chicken meat), nineteen different Salmonella spp. strains were concentrated using immunomagnetic separation and then simultaneously detected in a 96-well microplate by oligonucleotide-functionalized AuNPs after DNA preparation. Successful oligonucleotide/AuNPs-DNA hybridization was confirmed by gel electrophoresis while AuNPs aggregation in non-target and control reaction mixtures was verified by both spectrophotometric analysis and TEM images. Results showed that the optical AuNP biosensing platform can simultaneously screen nineteen (19) viable Salmonella spp. strains tested with 100% specificity and a superior detection limit of <10 CFU/mL or g for both pure culture and complex matrices setups. The highly sensitive colorimetric detection system can significantly improve the screening and detection of viable Salmonella spp. strains present in complex food and environmental matrices, therefore reducing the risks of contamination and incidence of foodborne diseases.Item type:Item, New Strategy for Minimally Invasive Endoscopic Surgery to Treat Infectious Spondylodiscitis in the Thoracolumbar Spine(2019-05-01) ;Lin, Chia-Yu ;Chang, Chien-Chun ;Chen, Yen-Jen ;Tsai, Chun-HaoTsou, Hsi-KaiBackground: Eradicating infection, protecting neurologic function, and maintaining structural alignment are the 3 objectives of treatment for infectious spondylodiscitis. For some patients, surgery may be necessary to achieve these goals; however, open surgeries are associated with high morbidity and mortality in elderly patients and those with multiple comorbidities. Endoscopic surgery provides a minimally invasive surgical option for obtaining a culture sample to aid identification of pathogens, while also providing a route for adequate decompression and drainage. The clinical results of this study were analyzed. Objectives: To evaluate the efficacy and safety of spinal endoscopic surgery, the basic characteristics of patients analyzed and their inflammatory markers, pain levels, and local kyphotic angles were recorded before surgery and at regular intervals after surgery. The patients' cultured pathogens and previous antibiotic treatments were also recorded and analyzed. Study Design: Retrospective observational study (institutional review board: CMUH 105-REC2-101). Setting: Inpatient surgery center. Methods: From October 2006 to March 2017, of 508 patients who received spinal endoscopic surgery, 60 with infectious spondylodiscitis were treated using this new strategy. All 60 patients underwent plain film radiography and enhanced magnetic resonance imaging of the affected region to obtain evidence of infectious spondylodiscitis. The role of a computed tomography-guided biopsy and some indications for open surgery were replaced with endoscopic surgery. Results: All the patients reported rapid pain relief after endoscopic surgery and antibiotic treatment. No significant changes in sagittal alignment were observed in final follow-up radiography images. Causative pathogens were identified in 34 patients (culture rate: 77.27%) without previous antibiotic treatment. The patients' erythrocyte sedimentation rates and C-reactive protein levels had decreased significantly 3 months after endoscopic surgery. Two patients (3.3%) experienced infection relapse following initial endoscopic surgery; both of them were efficiently resolved through a second round of endoscopic surgery. No surgery-related complications were observed and no open spinal surgery was required during the follow-up period. Limitations: This was a retrospective study; bias was unavoidable because of the single-center nature of the study design. Conclusions: Regarding the culture rate, recurrence rate, kyphotic change, and surgery-related complications, this new strategy for endoscopic surgery is safe and effective for treating infectious spondylodiscitis in the thoracic or lumbar spine and may be considered a new trend in treating diseases of this type.Item type:Item, Alternative Roles of STAT3 and MAPK Signaling Pathways in the MMPs Activation and Progression of Lung Injury Induced by Cigarette Smoke Exposure in ACE2 Knockout Mice(2016-01-01) ;Hung, Yi-Han ;Hsieh, Wen-Yeh ;Hsieh, Jih-Sheng ;Liu, Fon-ChangTsai, Chin-HungInflammation-mediated abnormalities in the renin-angiotensin system (RAS) and expression of matrix metalloproteinases (MMPs) are implicated in the pathogenesis of lung injury. Angiotensin converting enzyme II (ACE2), an angiotensin converting enzyme (ACE) homologue that displays antagonist effects on ACE/angiotensin II (Ang II) axis, could also play a protective role against lung diseases. However, the relationship between ACE2 and MMPs activation in lung injury is still largely unclear. The purpose of this study is to investigate whether MMPs activity could be affected by ACE2 and which ACE2 derived signaling pathways could be also involved via using a mouse model with lung injury induced by cigarette smoke (CS) exposure for 1 to 3 weeks. Wild-type (WT; C57BL/6) and ACE2 KO mice (ACE2(-/-)) were utilized to study CS-induced lung injury. Increases in the resting respiratory rate (RRR), pulmonary immunokines, leukocyte infiltration and bronchial hyperplasia were observed in the CS-exposed mice. Compared to WT mice, more serious physiopathological changes were found in ACE2(-/-) mice in the first week of CS exposure. CS exposure increased pulmonary ACE and ACE2 activities in WT mice, and significantly increased ACE in ACE2(-/-) mice. Furthermore, the activity of pulmonary MMPs was decreased in CS-exposed WT mice, whereas this activity was increased in ACE2(-/-) mice. CS exposure increased the pulmonary p-p38, p-JNK and p-ERK1/2 level in all mice. In ACE2(-/-) mice, a significant increase p-STAT3 signaling was detected; however, no effect was observed on the p-STAT3 level in WT mice. Our results support the hypothesis that ACE2 deficiency influences MMPs activation and STAT3 phosphorylation signaling to promote more pulmonary inflammation in the development of lung injury.Item type:Item, Serum Iron Concentration, but Not Hemoglobin, Correlates with TIMI Risk Score and 6-Month Left Ventricular Performance after Primary Angioplasty for Acute Myocardial Infarction(2014-08-06) ;Huang, Ching-Hui ;Chang, Chia-Chu ;Kuo, Chen-Ling ;Huang, Ching-ShanChiu, Tzai-WenObjective: Anemia is associated with high mortality and poor prognosis after acute coronary syndrome (A(S). Increased red cell distribution width (RDW) is a strong independent predictor for adverse outcomes in ACS. The common underlying mechanism for anemia and increased RDW value is iron deficiency. It is not clear whether serum iron deficiency without anemia affects left ventricular (LV) performance after primary angioplasty for acute myocardial infarction (AMI). We investigated the prognostic value of serum iron concentration on LV ejection fraction (EF) at 6 months and its relationship to thrombolysis in myocardial infarction (TIMI) risk score in post MI patients. Methods: We recruited 55 patients who were scheduled to undergo primary coronary balloon angioplasty after AM I and 54 age- and sex-matched volunteers. Serum iron concentration and interleukin-6 levels were measured before primary angioplasty. LVEF was measured by echocardiography at baseline and after 6 months. TIMI risk score was calculated for risk stratification. Results: Serum iron concentration was significantly lower in those in whom LVEF had not improved >= 10% from baseline (52.7 +/- 24.1 versus 80.8 +/- 50.8 mu g/dl, P = 0.016) regardless of hemoglobin level, and was significantly lower in the AMI group than in the control group (62.5 +/- 37.7 versus 103.0 +/- 38.1 mu g/dl, P<0.001). Trend analysis revealed that serum iron concentration decreased as TIMI risk score increased (P = 0.002). In addition, lower serum iron concentrations were associated with higher levels of inflammatory markers. Multiple linear regression showed that baseline serum iron concentration can predict LV systolic function 6 months after primary angioplasty for AMI even after adjusting for traditional prognostic factors. Conclusion: Hypoferremia is not only a marker of inflammation but also a potential prognostic factor for LV systolic function after revascularization therapy for AMI, and may be a novel biomarker for therapeutic intervention.