Far-Infrared Ameliorates Pb-Induced Renal Toxicity via Voltage-Gated Calcium Channel-Mediated Calcium Influx.

Far-infrared (FIR), characterized by its specific electromagnetic wavelengths, has emerged as an adjunctive therapeutic strategy for various diseases, particularly in ameliorating manifestations associated with renal disorders. Although FIR was confirmed to possess antioxidative and anti-inflammatory attributes, the intricate cellular mechanisms through which FIR mitigates lead (Pb)-induced nephrotoxicity remain enigmatic. In this study, we investigated the effects of FIR on Pb-induced renal damage using in vitro and in vivo approaches. NRK52E rat renal cells exposed to Pb were subsequently treated with ceramic-generated FIR within the 9~14 µm range. Inductively coupled plasma mass spectrometry (ICP-MS) enabled quantitative Pb concentration assessment, while proteomic profiling unraveled intricate cellular responses. In vivo investigations used Wistar rats chronically exposed to lead acetate (PbAc) at 6 g/L in their drinking water for 15 weeks, with or without a concurrent FIR intervention. Our findings showed that FIR upregulated the voltage-gated calcium channel, voltage-dependent L type, alpha 1D subunit (CaV1.3), and myristoylated alanine-rich C kinase substrate (MARCKS) (p < 0.05), resulting in increased calcium influx (p < 0.01), the promotion of mitochondrial activity, and heightened ATP production. Furthermore, the FIR intervention effectively suppressed ROS production, concurrently mitigating Pb-induced cellular death. Notably, rats subjected to FIR exhibited significantly reduced blood Pb levels (30 vs. 71 µg/mL; p < 0.01), attenuated Pb-induced glomerulosclerosis, and enhanced Pb excretion compared to the controls. Our findings suggest that FIR has the capacity to counteract Pb-induced nephrotoxicity by modulating calcium influx and optimizing mitochondrial function. Overall, our data support FIR as a novel therapeutic avenue for Pb toxicity in the kidneys.

Utilizing Design Thinking for Effective Multidisciplinary Diabetes Management.

(1) Background: Design thinking, as a human-centered design method, represents a unique framework to support the planning, testing, and evaluation of new clinical spaces for diabetic care throughout all phases of construction. This approach prioritizes the needs and experiences of diabetic patients to create innovative and effective healthcare environments. By applying design-thinking principles, healthcare facilities can optimize the design and functionality of their clinical spaces, ensuring a patient-centered approach to diabetic care. This holistic and personalized approach can ultimately enhance the overall quality of diabetic care provided to patients. (2) Methods: The study used the action research method and progressively explored diabetes patients' needs and preferences for care, subsequently developing creative solutions to achieve the goals. There were six doctors, seven nursing staffs, four case managers and three family members who participated in the design-thinking workshop. (3) Results: The participating trainees in this study developed unique and innovative solutions during the iterative process of "divergent thinking" and "focused thinking", including diabetes dietary guidelines for food ordering and delivery platforms, and the design of accompanying health-education picture books to enable patients to learn the care process and precautions before, during, and after discharge. (4) Conclusions: This continuing education model promoted sharing among participants, improved collaboration and mutual learning, and increased motivation through goal setting.

[Applying Design Thinking to the Research and Development of Innovative Nursing Devices].

Many different patient-centered care models have been promoted around the world in recent years. The goal of current nursing innovation includes simplifying nursing workflows, constructing creative care methods, developing innovative assistive devices, activating the workplace, and improving care quality. In addition to enhancing the ability of nurses to care for the sick, employ critical thinking, improve their information literacy, and deepen their research knowledge, innovative attitudes and R&D momentum represent new trends in nursing education and talent cultivation. In nursing education worldwide, including both in-school education and clinical in-service training, innovative courses, projects, and competitions as well as corresponding academic seminars have been launched with the intention to promote practical creativity and innovative solutions. The definition of design thinking is first introduced and the Stanford University`s design thinking model is next explained. The five stages of the design thinking model - empathize, define, ideate, prototype, and test - are then introduced. Finally, using the innovative nursing product as an example, the teacher-student team is proposed as the design thinking mentorship model. The authors hope that this article serves as a reference for novice educators, developers, and researchers in the field of nursing innovation.

Glibenclamide restores dopaminergic reward circuitry in obese mice through interscauplar brown adipose tissue.

BACKGROUND: Obesity, a critical feature in metabolic disorders, is associated with medical depression. Recent evidence reveals that brown adipose tissue (BAT) activity may contribute to mood disorders, Adenosine triphosphate (ATP)-sensitive K+ (KATP) channels regulate BAT sympathetic nerve activity. However, the mechanism through which BAT activity affects mood control remains unknown. We hypothesized the BAT is involved in depressive-like symptoms regulation by trafficking KATP channels. METHODS: Eight-week-old male B6 mice fed with a high-fat diet (HFD) for 12 weeks exhibited characteristics of metabolic disorders, including hyperglycemia, hyperinsulinemia, and hyperlipidemia, as well as depressive symptoms. In this study, we surgically removed interscapular BAT in mice, and these mice exhibited immobility in the forced swim test and less preference for sugar water compared with other mice. To delineate the role of KATP channels in BAT activity regulation, we implanted a miniosmotic pump containing glibenclamide (GB), a KATP channel blocker, into the interscapular BAT of HFD-fed mice. RESULTS: GB infusion improved glucose homeostasis, insulin sensitivity, and depressive-like symptoms. KATP channel expression was lower in HFD-fed mice than in chow-fed mice. Notably, GB infusion in HFD-fed mice restored KATP channel expression. CONCLUSION: KATP channels are functionally expressed in BAT, and inhibiting BAT-KATP channels improves metabolic syndromes and reduces depressive symptoms through beta-3-adrenergic receptor-mediated protein kinase A signaling.

Chronic exposure to high fat diet triggers myelin disruption and interleukin-33 upregulation in hypothalamus.

BACKGROUND: Hypothalamic inflammation including astrogliosis and microglia activation occurs after intake of high fat diet (HFD) in rodent models or in obese individuals. However, the effect of chronic HFD feeding on oligodendrocytes (OLGs), a myelin-producing glial population in the central nervous system (CNS), remains unclear. In this study, we used 8-week old male C57BL/6 mice fed by HFD for 3-6 months to induce chronic obesity. RESULTS: The transmission electron microscopy imaging analysis showed that the integrity of hypothalamic myelin was disrupted after HFD feeding for 4 and 6 months. Moreover, the accumulation of Iba1+-microglia with an amoeboid hypertrophic form was continually observed in arcuate nucleus of HFD-fed mice during the entire feeding time period. Interleukin-33 (IL-33), a tissue alarmin upon injury to the CNS, was detected with an increased level in hypothalamus after HFD feeding for 3 and 4 months. Furthermore, the in vitro study indicated that exposure of mature OLGs to IL-33 impaired OLG cell structure along with a decline in the expression of myelin basic protein. CONCLUSIONS: Altogether, our findings demonstrate that chronic HFD feeding triggers hypothalamic myelin disruption in accompany with IL-33 upregulation and prolonged microglial activation in hypothalamus. Given that the addition of exogenous IL-33 was harmful for the maturation of OLGs, an increase in IL-33 by chronic HFD feeding might contribute to the induction of hypothalamic myelin disruption.

Functional Studies of Anodic Oxidized ß-Ti-28Nb-11Ta-8Zr Alloy for Mechanical, In-vitro and Antibacterial Capability.

We developed an osseocompatible ß-type Ti-28Nb-11Ta-8Zr (TNTZ) alloy that displays the excellent elastic modulus, cellular response, corrosion resistance and antibacterial capability demanded for bone-mimetic materials. The TNTZ alloy exhibited an elastic modulus of 49 GPa, which approximates that of human bones and prevent stress shielding effects. A further anodic oxidation and subsequent post-annealing modification formed a crystalline nanoporous TNTZ oxide layer (NPTNTZO(c)) on the alloy surface, potentially promoting interlocking with the extracellular matrix of bone cells and cell proliferation. Osteoblast viability tests also verified that NPTNTZO(c) enhanced cell growth more significantly than that of flat TNTZ. In addition, potentiodynamic polarization tests in Hanks' balanced salt solution (HBSS) revealed that both TNTZ and NPTNTZO(c) exhibited better corrosion resistance than commercial pure titanium. Finally, NPTNTZO(c) reinforced with silver nanoparticles (NPTNTZO

An Exploration of Intent to Use Telehealth at Home for Patients with Chronic Diseases.

Telecare is defined as care practiced at a distance. It is an effective strategy for improving the self-health care management of home-patients with chronic diseases. The purpose of this study was to explore the intent to use of telehealth patients. The correlation between the self-care behaviors, the intent to use of telehealth, and the effects on physiological indicators of patients with chronic disease at home were studied. A cross-sectional study design employing purposive sampling was selected. The structured questionnaire 'Telecare Usage Intention Scale and Self-Care Behavior Scale' were used, 'HbA1c, glucose levels and monthly blood pressure measurements' were analyzed in this thirteen month study. The self-care behaviors of the participants were positively correlated with their intent to use telehealth (p < 0.01). The results also indicated that HbA1c, glucose levels and frequency BP measurement of the participants improved significantly after using telecare (p < 0.005). The results indicated a strong intent to use telehealth and positive perception of telecare services by in-home patients with a chronic disease. Telehealth improves the self-care behavior of in-home chronic disease patients and enhances medical professionals' ability to deliver quality and effective healthcare.

A Study of Personal Health Record User's Behavioral Model Based on the PMT and UTAUT Integrative Perspective.

The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management.

The effect of telehealth systems and satisfaction with health expenditure among patients with metabolic syndrome.

Telehealth cost analysis has become a crucial issue for governments in recent years. In this study, we examined cases of metabolic syndrome in Hualien County, Taiwan. This research adopted the framework proposed by Marchand to establish a study process. In addition, descriptive statistics, a t test, analysis of variance, and regression analysis were employed to analyze 100 questionnaires. The results of the t$ test revealed significant differences in medical health expenditure, number of clinical visits for medical treatment, average amount of time spent commuting to clinics, amount of time spent undergoing medical treatment, and average number of people accompanying patients to medical care facilities or assisting with other tasks in the past one month, indicating that offering telehealth care services can reduce health expenditure. The statistical analysis results revealed that customer satisfaction has a positive effect on reducing health expenditure. Therefore, this study proves that telehealth care systems can effectively reduce health expenditure and directly improve customer satisfaction with medical treatment.

Structural Factors Affecting Health Examination Behavioral Intention.

Disease screening instruments used for secondary prevention can facilitate early determination and treatment of pathogenic factors, effectively reducing disease incidence, mortality rates, and health complications. Therefore, people should be encouraged to receive health examinations for discovering potential pathogenic factors before symptoms occur. Here, we used the health belief model as a foundation and integrated social psychological factors and investigated the factors influencing health examination behavioral intention among the public in Taiwan. In total, 388 effective questionnaires were analyzed through structural model analysis. Consequently, this study yielded four crucial findings: (1) The established extended health belief model could effectively predict health examination behavioral intention; (2) Self-efficacy was the factor that most strongly influenced health examination behavioral intention, followed by health knowledge; (3) Self-efficacy substantially influenced perceived benefits and perceived barriers; (4) Health knowledge and social support indirectly influenced health examination behavioral intention. The preceding results can effectively increase the acceptance and use of health examination services among the public, thereby facilitating early diagnosis and treatment and ultimately reducing disease and mortality rates.

Telecare Services for Elderly: Predictive Factors of Continued Use Intention.

BACKGROUND: Several countries have recently attempted to implement telecare information technology to provide health care to older adults. This study applied self-determination theory (autonomy, relatedness, and competence) and the theory of planned behavior (subjective norm, perceived behavioral control, and attitudes toward using tools) to investigate a theoretical model for explaining the predictive factors influencing the intention of elderly patients to continue using telecare services. METHODS: Elderly patients in Taiwan (N = 160) who used telecare systems and fall-detection systems completed a questionnaire. Hierarchical multiple regression analysis was applied to test hypotheses. RESULTS: The results revealed that the main effects related to identification supported the notion that autonomy, relatedness, subjective norm, and attitudes toward using tools positively affect elderly patients' intention to continue using telecare services. But, perceived competence and perceived behavioral control cannot be used as a predictor of intention to adopt telecare services. CONCLUSION: For an aging society, to provide appropriate ways to enhance elderly patients' willingness to use telecare services is important. Our findings indicate that elderly patients' perceived relatedness and subjective norm are both crucial predictors in intention to adopt telecare services. And it means that social influence may play a critical role in elderly patients' intention to adopt telecare services; therefore, researchers can investigate social influence mechanisms in depth and examine them more closely in future research.

Influences of satisfaction with telecare and family trust in older Taiwanese people.

The level of trust given towards telecare by the family members of older people using the service is extremely important. Family trust may be an influential factor in deciding whether to use such services. This study focuses on older people's satisfaction with telecare and examines their family's trust in telecare services. Influences on intention to continue using telecare services are also explored. A questionnaire-based survey on 60 communities dwelling older people who had been receiving telecare services in the past two years was employed. This study developed a satisfaction and trust scale based on previous studies. Our results show that older people's satisfaction with telecare services and families' trust were influential in decided whether to continue to use of telecare services. These findings can help medical institutions to better insight into the user experience of telecare to help them provide future services that better comply with clients' desires and requirements.

Greenhouse gas and air pollutant emission reduction potentials of renewable energy--case studies on photovoltaic and wind power introduction considering interactions among technologies in Taiwan.

To achieve higher energy security and lower emission of greenhouse gases (GHGs) and pollutants, the development of renewable energy has attracted much attention in Taiwan. In addition to its contribution to the enhancement of reliable indigenous resources, the introduction of renewable energy such as photovoltaic (PV) and wind power systems reduces the emission of GHGs and air pollutants by substituting a part of the carbon- and pollutant-intensive power with power generated by methods that are cleaner and less carbon-intensive. To evaluate the reduction potentials, consequential changes in the operation of different types of existing power plants have to be taken into account. In this study, a linear mathematical programming model is constructed to simulate a power mix for a given power demand in a power market sharing a cost-minimization objective. By applying the model, the emission reduction potentials of capacity extension case studies, including the enhancement of PV and wind power introduction at different scales, were assessed. In particular, the consequences of power mix changes in carbon dioxide, nitrogen oxides, sulfur oxides, and particulates were discussed. Seasonally varying power demand levels, solar irradiation, and wind strength were taken into account. In this study, we have found that the synergetic reduction of carbon dioxide emission induced by PV and wind power introduction occurs under a certain level of additional installed capacity. Investigation of a greater variety of case studies on scenario development with emerging power sources becomes possible by applying the model developed in this study.

Identification of transcripts related to high egg production in the chicken hypothalamus and pituitary gland.

To identify transcripts related to high egg production expressed specifically in the hypothalamus and pituitary gland of the chicken, two subtracted cDNA libraries were constructed. Two divergently selected strains of Taiwan Country Chickens (TCCs), B (sire line) and L2 (dam line) were used; they had originated from a single population and were further subjected (since 1982) to selection for egg production to 40 wk of age and body weight/comb size, respectively. A total of 324 and 370 clones were identified from the L2-B (L2-subtract-B) and the B-L2 subtracted cDNA libraries, respectively. After sequencing and annotation, 175 and 136 transcripts that represented 53 known and 65 unknown non-redundant sequences were characterized in the L2-B subtracted cDNA library. Quantitative reverse-transcription (RT)-PCR was used to screen the mRNA expression levels of 32 randomly selected transcripts in another 78 laying hens from five different strains. These strains included the two original strains (B and L2) used to construct the subtracted cDNA libraries and an additional three commercial strains, i.e., Black- and Red-feather TCCs and Single-Comb White Leghorn (WL) layer. The mRNA expression levels of 16 transcripts were significantly higher in the L2 than in the B strain, whereas the mRNA expression levels of nine transcripts, BDH, NCAM1, PCDHA@, PGDS, PLAG1, PRL, SAR1A, SCG2 and STMN2, were significantly higher in two high egg production strains, L2 and Single-Comb WL; this indicated their usefulness as molecular markers of high egg production.

The in vivo effect of Cordyceps sinensis mycelium on plasma corticosterone level in male mouse.

Cordyceps sinensis (CS), an Ascomycetes fungus parasitic to Lepidoptera larvae, has been traditionally used as nutritious food for the enhancement in immuno-modulation in Chinese society for a long time. Previous report has demonstrated the CS water extract stimulates in vitro corticosterone production in rat primary adrenal cells. In the present studies, we determined the in vivo effects of CS and its fractions on plasma corticosterone production in mouse. Different concentrations of CS and CS fractions dissolved in water (0.02 and 0.2 mg/g body weight) were fed to immature and mature mice from 1, 3 or 7 d. The plasma levels of corticosterone were determined by radioimmunoassay (RIA), and the weight of adrenal gland and body weight were also evaluated. Results illustrated that plasma corticosterone levels were significantly induced by F2 at 0.02 mg/g body weight with 7 d feeding in immature mice, and by CS at 0.02 mg/g body weight with 3 d feeding and F3 at 0.02 mg/g body weight for 7 d feeding in mature mice, respectively (p < 0.05). There were no differences of adrenal gland weight except there was significant stimulation by CS at 0.2 mg/g body weight with 3 d feeding in mature mice (p < 0.05) and there were significant inhibitions by both dosages of F3 for 3 d feeding in immature mice and F2 for 7 d feeding in mature mice (p < 0.05), respectively. Concerning body weight, the stimulatory effects were observed with CS feeding at 0.2 mg/g body weight for 7 d and F3 feeding at 0.02 mg/g body weight for 3 and 7 d in mature mice. Whereas, the inhibitory effect were observed in F2 feeding at 0.2 mg/g body weight for 7 d in immature mice and at both dosages for 7 d in mature mice, respectively. Taken together, these studies illustrate that CS and its fractions stimulated mouse in vivo corticosterone production. However, CS and its fractions didn't have constant stimulatory or inhibitory effects on the weights of body and adrenal glands.