Tzu Chi Medical Journal最新文献

{"title":"Cell culture platform fabrication methods and applications.","authors":"Yao-Nan Wang, Ko-Tung Chang, Jui-Kai Liu, Chang-Hsien Tai","doi":"10.4103/tcmj.TCMJ-D-25-00004","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00004","url":null,"abstract":"<p><p>Cell culture technologies are fundamental tool in biological research. Traditional two-dimensional (2D) cell culture methods, despite their widespread use and simplicity, fail to accurately replicate the physiological conditions of native tissues, leading to altered cellular behavior. Recent advancements in 3D culture techniques, combined with innovative fabrication methods such as photolithography, paper-based, and 3D printing, have substantially improved the fidelity of cell culture models. In parallel, numerical simulations have become indispensable for optimizing the design and performance of these systems, offering precise control microenvironmental factors such as fluid dynamics, nutrient and oxygen gradients, and shear stress within microfluidic platforms. These approaches for integration facilitate accurate modeling of cell-to-cell and cell-to-matrix interactions essential for physiological relation. Concurrently, the integration of multimaterial fabrication techniques provides scalable and customizable solutions for developing sophisticated microfluidic and cell culture systems. This review discusses recent developments in these fabrication methods and highlights their integration with numerical simulation for optimization design, explores their collective potential to advance biomedical research and applications.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"21-30"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of functional ability in autism spectrum disorder: A scoping review.","authors":"Purboyo Solek, Eka Nurfitri, Taufan Prasetya, Anggia Farrah Rizqiamuti, Indra Sahril, Burhan, Uni Gamayani, Kusnandi Rusmil, Irvan Afriandi, Lukman Ade Chandra, Kevin Gunawan","doi":"10.4103/tcmj.tcmj_319_24","DOIUrl":"10.4103/tcmj.tcmj_319_24","url":null,"abstract":"<p><p>Autism spectrum disorder (ASD) is a group of diverse neurodevelopmental conditions characterized by deficits in social communication and interaction, as well as confined and repetitive patterns of behaviors, interests, or activities. Currently, there are no standardized techniques for predicting functional ability in children with ASD, which can lead to undetected clinical impairments and delayed targeted treatments. To address this issue, a scoping review was conducted following the preferred reporting items for systematic reviews and meta-analyses criteria. Twelve articles met the inclusion criteria for this review. This study summarized the potential tools and parameters that may benefit in predicting abilities used in the daily lives of children with ASD. The collected tools varied widely, including clinical questionnaires, physical symptoms, laboratory tests, and imaging studies. These tools provided descriptions of various functional abilities that are altered in ASD, offering insights into the diverse manifestations of the disorder and potential approaches for assessment and intervention.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"48-58"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an enhanced sensitivity method for lateral flow immunoassays: An overview of strategies.","authors":"Chung-An Chen, Chi-Hung Liu, Natalie Yi-Ju Ho, Sheng Liu, Tsung-Ting Tsai","doi":"10.4103/tcmj.TCMJ-D-25-00061","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00061","url":null,"abstract":"<p><p>Lateral flow immunoassay (LFIA) is a widely recognized point-of-care diagnostic platform for detecting various analytes. It must meet the criteria of REASSURED, but poor sensitivity and lack of precision in test results remain the main bottlenecks of LFIA. Therefore, signal enhancement methods, such as devices, nanoprobes, or detection modes, can improve this platform. In this paper, many representative studies from the past decade on LFIA sensing platforms will be discussed in detail.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"11-20"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing self-care implementation and reducing marker detachment rates in cancer radiotherapy patients through diverse nursing care strategies.","authors":"Huei-Fang Yang, Hsueh-Ya Tsai, Ying-Hsiang Chou, Yu-Chen Hsieh, Shao-Ti Li, Hsiao-Ju Huang, Ya-Fang Ke, Pei-Fang Tsai, Hsiu-Man Chan, Yueh-Chun Lee","doi":"10.4103/tcmj.tcmj_121_25","DOIUrl":"10.4103/tcmj.tcmj_121_25","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;During radiation therapy, clear and stable body-surface markers are essential for accurate patient positioning. Peer benchmarking across four Taiwanese tertiary centers (January 2023-Mar 2024) revealed marker detachment rates of 0.8%-10.7%, whereas our in-house audit documented 15%, underscoring a significant quality gap (unpublished institutional quality assurance data). Marker detachment or fading commonly occurs due to daily activities, hygiene routines, and patient-specific factors, adversely affecting treatment accuracy, prolonging treatment duration, and increasing patient anxiety and medical costs. This study aimed to reduce the rate of marker detachment in radiotherapy patients from the previous level of approximately 15% to below 5%, thereby decreasing repositioning time, treatment delays, patient anxiety, family inconvenience, and hospital resource expenditure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This was a single-center pre-post comparative study conducted from January to June 2023. Two hundred cancer patients undergoing radiation therapy participated in this study. Patients were classified using an in-house-developed red-green light marking system based on body mass index (BMI &gt;25 or ≤25), educational level (high school or below and above high school), and presence of a specific caregiver. Patients with higher risk (BMI &gt;25, education level ≤ high school, and no specific caregiver) received weekly education sessions emphasizing marker maintenance, whereas lower-risk patients received sessions at the beginning, middle, and near the end of treatment. Interventions included personalized educational pamphlets, hypoallergenic adhesive patches, standardized marker pen replacements, and systematic tracking using the MOSAIQ® Radiation Oncology Management System (Elekta AB, Sweden). Data on marker detachment rates, repositioning times, and patient anxiety (Beck Anxiety Inventory) were collected before and after implementation. Statistical analyses, including paired &lt;i&gt;t&lt;/i&gt;-tests, were conducted to assess the significance of observed changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After the implementation of interventions, marker repositioning incidents significantly decreased from 82 instances (average 102.5 min/month) to 7 instances (average 23.4 min/month) (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). The marker detachment rate was effectively reduced from approximately 15% to 3.5%, achieving the targeted goal. In addition, patient anxiety scores significantly decreased from an average of 5 points to 3 points (&lt;i&gt;P&lt;/i&gt; &lt; 0.001), reflecting clinically meaningful improvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The implementation of a structured nursing intervention program, featuring a red-green light marking system, personalized education, and systematic management, effectively decreased marker detachment rates, repositioning times, and patient anxiety. These improvements highlight the feasibility and effectiveness of integrating su","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"117-122"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum adipocyte fatty acid-binding protein is associated with impaired endothelial function in nondialysis chronic kidney disease.","authors":"Teoh Ling Lun, Yu-Li Lin, Chih-Hsien Wang, Yu-Hsien Lai, Chiu-Huang Kuo, Chi-Chong Tang, Bang-Gee Hsu","doi":"10.4103/tcmj.tcmj_173_25","DOIUrl":"10.4103/tcmj.tcmj_173_25","url":null,"abstract":"<p><strong>Objectives: </strong>Adipocyte fatty acid-binding protein (A-FABP) has been implicated in atherosclerosis, and endothelial dysfunction is a critical contributor to cardiovascular outcomes in chronic kidney disease (CKD). This study evaluated links between serum A-FABP and endothelial function among patients with CKD who were not on dialysis.</p><p><strong>Materials and methods: </strong>Fasting serum from 151 adults with CKD not on dialysis was analyzed for A-FABP using enzyme immunoassay. Endothelial function was measured noninvasively through digital thermal monitoring (DTM), yielding vascular reactivity index (VRI) scores categorized as poor (<1.0), intermediate (1.0-1.99), or good (≥2.0) vascular reactivity.</p><p><strong>Results: </strong>Vascular reactivity categorized by DTM-derived VRI was poor in 17.9% (<i>n</i> = 27), intermediate in 30.5% (n = 46), and good in 51.6% (<i>n</i> = 78). Poor reactivity correlated with older age (P = 0.013), higher blood urea nitrogen (<i>P</i> = 0.007), creatinine (<i>P</i> = 0.009), urinary protein-to-creatinine ratio, <i>P</i> = 0.010, higher serum A-FABP (<i>P</i> < 0.001), and lower estimated glomerular filtration rate, <i>P</i> = 0.007. In adjusted multivariable linear models, age (<i>P</i> = 0.044), log-transformed (log-glucose, <i>P</i> = 0.045), and serum A-FABP (<i>P</i> < 0.001) were negatively associated with VRI.</p><p><strong>Conclusion: </strong>Higher serum A-FABP independently correlated with reduced VRI, consistent with a potential modulatory role and supporting its use as a biomarker of endothelial dysfunction in nondialysis CKD patients.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"203-209"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of platelet-rich plasma injection versus corticosteroid injection for the treatment of frozen shoulder in Asia: A systematic review and meta-analysis of randomized controlled trials.","authors":"Hendrawan Chandra Kusuma, Mario Daniel Simatupang, Jesica Ery, Sabrina Danica, Billy Leoprayogo, Woo-Yong Lee","doi":"10.4103/tcmj.TCMJ-D-25-00008","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00008","url":null,"abstract":"<p><p>This study investigates the therapeutic performance of intra-articular platelet-rich plasma (PRP) versus intra-articular corticosteroid injections, specifically evaluating outcomes within Asian demographic groups. This review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement. We assessed study quality with the Cochrane Risk of Bias 2 (RoB2) tool, Review Manager (RevMan) 5.4 for the meta-analysis, and GRADE analysis to assess the certainty of evidence. Our review includes 14 studies, with 11 analyzed through meta-analysis, involving 1295 patients. However, the included studies were limited to populations from India and Pakistan. In the short term, there were no significant differences between the PRP and corticosteroid groups in pain and disability scores. However, the PRP group showed significantly greater improvements in some aspects of range of motion (ROM). In the mid-term, the PRP group had significantly lower Visual Analog Scale (VAS) (mean difference [MD]: -9.67; 95% confidence interval [CI]: -19.36, -0.08), Disabilities of the Arm, Shoulder and Hand (DASH) (MD: -10.47, 95% CI: -20.82, -0.13), and Shoulder Pain and Disability Index (SPADI) scores (MD: -17.92, 95% CI: -28.14, -7.69) compared to corticosteroids, as well as greater ROM improvements across multiple measures (all <i>P</i> < 0.05). In the mid-long term, pooled analysis indicated that VAS (MD: -21.13, 95% CI: -33.35, -8.91), DASH (MD: -10.25, 95% CI: -16.87, -3.64), and SPADI scores (MD: -17.81, 95% CI: -30.89, -4.73) were significantly lower in the PRP group than in corticosteroids. Although PRP shows no immediate advantage over corticosteroids in pain and disability, it improves short-term ROM and provides superior mid- to mid-long-term outcomes. However, results should be interpreted cautiously due to high heterogeneity, varying RoB, and moderate to very low GRADE certainty.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"164-173"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood-based predictive biomarkers for preterm birth: Redefining risk stratification in modern perinatal care.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Julian Dewantiningrum, Mochammad Besari Adi Pramono, I Nyoman Hariyasa Sanjaya, Ernawati Darmawan, Dudy Aldiansyah, Milan Stanojevic, Asim Kurjak","doi":"10.4103/tcmj.TCMJ-D-25-00042","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00042","url":null,"abstract":"<p><p>Spontaneous preterm birth (sPTB) remains a leading cause of neonatal morbidity and mortality worldwide, with current screening tools - such as cervical length measurement and fetal fibronectin - showing limited predictive value, particularly in asymptomatic women. Recent advances in molecular diagnostics have identified blood-based biomarkers that capture transcriptomic, proteomic, and metabolomic changes preceding labor. This systematic review synthesizes recent high-quality studies published between 2018 and 2025, selected through a Preferred Reporting Items for Systematic Reviews and Meta-analyses-guided search and appraised using AMSTAR-2 and the Newcastle-Ottawa Scale. Transcriptomic signatures, including cell-free RNA profiles, demonstrate area-under-the-curve (AUC) values up to 0.94 when measured in early gestation (10-20 weeks). Proteomic panels targeting inflammatory mediators and matrix-remodeling proteins achieve AUCs of 0.80-0.89, while metabolomic assays identify arginine derivatives and lipid shifts with AUCs of 0.78-0.84. Multiomic models integrating these molecular layers with machine-learning algorithms further improve prediction, reaching AUCs above 0.93 across diverse cohorts. Optimal sampling windows range from 10 to 24 weeks, with the strongest evidence for use in high-risk women or as part of universal mid-trimester screening. Emerging clinical pathways outline how these assays could integrate into prenatal care to enable timely interventions such as progesterone therapy, cervical cerclage, or intensified monitoring. Key barriers to implementation include assay standardization, cost, regulatory approval, and ethical considerations in patient counseling. Standardized protocols, multicenter validation, and equitable deployment strategies will be critical to translating these promising technologies into practice. If successfully implemented, blood-based predictive models could help shift obstetric care toward more personalized and preventive management of sPTB.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"181-189"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant chemotherapy for resectable biliary tract cancers: Current evidence and future directions - A systematic review and network meta-analysis.","authors":"Yu-Ying Huang, An-Jan Wu, Ta-Wei Wu, Tai-Yung Yi","doi":"10.4103/tcmj.tcmj_327_24","DOIUrl":"10.4103/tcmj.tcmj_327_24","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aims to address the uncertainty regarding the optimal adjuvant chemotherapy regimen for resectable biliary tract cancers (BTCs), which remain challenging to treat due to high recurrence rates, especially in patients with high-risk features such as R1 resection or lymph node positivity. By conducting a network meta-analysis (NMA), we evaluate the efficacy of various adjuvant chemotherapy regimens in improving overall survival (OS) and relapse-free survival (RFS) to provide evidence-based insights for clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A NMA was conducted by systematically searching PubMed, Cochrane Library, and Embase on November 18, 2024, to evaluate the efficacy of adjuvant chemotherapy regimens for resectable BTCs. A comprehensive search identified randomized controlled trials (RCTs) reporting OS and RFS. Hazard ratios (HRs) were estimated using random-effects models under a frequentist framework. Heterogeneity was assessed through τ&lt;sup&gt;2&lt;/sup&gt; and &lt;i&gt;I&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt;, and inconsistency was evaluated using the netsplit method. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The NMA included 5 RCT studies with 10 treatment arms, including 1449 patients, were analyzed. No regimen demonstrated statistically significant OS or RFS benefits compared to observation. Gemcitabine showed the most favorable trends for OS (HR: 0.72, 95% confidence interval [CI]: 0.27-1.97) and RFS (HR: 0.79, 95% CI: 0.47-1.31), while capecitabine demonstrated comparable trends for OS (HR: 0.84, 95% CI: 0.26-2.72) and RFS (HR: 0.81, 95% CI: 0.47-1.39). S-1 exhibited region-specific efficacy, particularly in Asian populations, with an OS HR of 0.96 (95% CI: 0.35-2.61). Gemcitabine and oxaliplatin (GEMOX) did not show notable benefits for OS (HR: 1.08, 95% CI: 0.32-3.69). Substantial heterogeneity (&lt;i&gt;I&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 82.3% for OS) and the absence of individual patient data restricted subgroup analyses. Based on &lt;i&gt;P&lt;/i&gt;-score rankings, gemcitabine ranked highest for OS (0.68) and RFS (0.67), while GEMOX ranked last for OS (0.40) and observation ranked last for RFS (0.28).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study underscores the challenges of optimizing adjuvant chemotherapy for resectable BTCs, with no regimen demonstrating statistically significant survival benefits compared to observation. Gemcitabine and capecitabine showed comparable trends toward improved overall and RFS, while S-1 exhibited region-specific efficacy, particularly in Asian populations. These findings highlight substantial heterogeneity across studies and the need for large-scale, harmonized RCTs to evaluate high-risk subgroups (e.g., R1 resections and lymph node-positive patients), incorporate molecular stratification, and address quality-of-life and toxicity outcomes. By providing a comprehensive synthesis of the available evidence, this study advances the und","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"233-241"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic body radiotherapy for inoperable primary and recurrent cholangiocarcinoma: A single-institution retrospective analysis.","authors":"Atsuto Katano","doi":"10.4103/tcmj.TCMJ-D-25-00067","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00067","url":null,"abstract":"<p><strong>Objectives: </strong>Cholangiocarcinoma is a rare and aggressive malignancy with a poor prognosis, particularly in patients who are not candidates for surgical resection. Stereotactic body radiotherapy (SBRT) combines high-dose radiation delivery with meticulous spatial accuracy, allowing for effective local control in a variety of solid tumors. However, clinical data supporting the use of SBRT in cholangiocarcinoma are limited, and this study aimed to investigate the feasibility, safety, and oncologic outcomes of SBRT.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 21 consecutive patients with unresectable cholangiocarcinoma who received SBRT between May 2012 and February 2024 at our institution. Eligible patients had no prior liver- or biliary-directed radiotherapy and no distant metastases. Target delineation was performed using four-dimensional computed tomography or breath-hold techniques. SBRT doses ranged from 50 to 60 Gy in 7-10 fractions.</p><p><strong>Results: </strong>The cohort included 16 men and 5 women with a median age of 76 years (range: 58-86). Thirteen patients (62%) had previously undergone surgery and were treated for recurrent disease. At a median follow-up of 9.5 months, the 1-year local control rate was 77.2%. For the entire cohort, the 1-year overall survival and progression-free survival rates were 47.5% (95% confidence interval [CI]: 24.5%-67.4%) and 32.4% (95% CI: 13.4%-53.2%), respectively. Three patients (14.2%) experienced Grade 3 or higher adverse events, consisting of one gastric ulcer and two instances of biliary stricture.</p><p><strong>Conclusion: </strong>SBRT may represent a feasible treatment approach for patients with inoperable cholangiocarcinoma, showing encouraging local control with acceptable toxicity in this small cohort. However, given the study's limitations, these findings should be regarded as exploratory.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"227-232"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy and its associated factors among older adults in Taiwan: The role of media use and healthcare experience.","authors":"Jyh-Gang Hsieh, Mi-Hsiu Wei, Ying-Wei Wang, Jui-Hung Yu, Shiao-Chi Wu, Mei-Chuan Chang","doi":"10.4103/tcmj.tcmj_217_25","DOIUrl":"10.4103/tcmj.tcmj_217_25","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the level of health literacy among older adults in Taiwan and to examine the predictive roles of media use, perceived healthcare experiences, and social support.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted with 335 adults aged 65 years and older between July 2016 and December 2016. Data were collected through structured face-to-face interviews using the validated instruments. Health literacy was assessed using the Mandarin Multidimensional Health Literacy Questionnaire; media use was measured by the frequency of traditional (e.g., TV and newspapers) and digital (e.g., Internet and social media) health information access; healthcare experiences were evaluated based on perceptions of organizational health literacy; and health-related social support was measured via perceived support from family and friends. Data were analyzed using descriptive statistics and hierarchical multiple regression analysis.</p><p><strong>Results: </strong>Overall, 69.3% of participants exhibited limited health literacy, with the appraisal domain being the weakest (66.3% limited). Significant differences in health literacy were observed by gender, educational attainment, traditional and digital media use, and perceived healthcare experience (all <i>P</i> < 0.001). Hierarchical regression analysis identified traditional media use (β = 0.333), digital media use (β = 0.215), and perceived healthcare experience (β = 0.165) as significant predictors, increasing the explained variance from 12.1% to 35.3%. Social support was not a significant predictor.</p><p><strong>Conclusion: </strong>Media use and favorable healthcare experiences were positively associated with health literacy in older adults. Future interventions should improve access to traditional and digital media and foster health-literate environments to mitigate disparities in aging populations.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 3","pages":"415-422"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}