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An advanced dual Fe2-site catalyst (Fe2 DAC) exhibiting CO current density (jCO) of 10 mA cm−2 at an overpotential of 330 mV in a CO2-saturated 0.5 M KHCO3 electrolyte was designed and characterized by HAADF-STEM microscopy and XAS/EPR spectroscopies.

幫助員工展現出「自願學習行為」（Voluntary learning behavior），能夠讓組織在動態的複雜環境中繼續保有競爭力，鼓勵員工自願學習是一個現代化企業不可或缺的人力資源發展策略；然而，目前仍只有少數研究探討為何員工願意於職場上產生自願學習行為，且過往的研究強調組織的責任─提供良好環境以促使員工學習，但忽略個人的義務─主動積極性的學習促發因子。本研究以華人成就動機理論為基礎，提出一個以心理─社會工作依賴為前置變數、工作投入為中介變數影響自願學習行為的雙因素中介模式，解釋自願學習行為的自我內在發生機制。本研究蒐集1,314位台灣員工樣本，應用結構方程模式進行驗證。結果顯示，本研究所提出之中介模式受實徵資料所支持。本研究結果，除可增加現有理論對於員工自願學習行為的解釋外，實務面上亦可對組織提出相關建議用以促進員工的自願學習行為。 The voluntary learning behavior of employees indicates the organization may maintain its momentum and competitiveness as a human resource development strategy. Unfortunately, studies concerning voluntary learning behavior are few. Most prior research emphasize the organization’s responsibility to provide supportive environment to facilitate employee learning, yet overlook the obligation for employees to be proactive on their learning. Drawing on the Chinese achievement motivation theory, this study proposes the two-factor of psycho-social work dependency as the antecedent and work involvement as the mediator to influence voluntary learning behavior among employees. Empirical data was collected by a survey of 1,314 employees working in private enterprises in Taiwan. Structural equation modeling was used to validate the proposed model. The results show that the relationships among psycho-social work dependency, work involvement and voluntary learning behavior are validated. Theoretical contribution and practical implications are discussed. &nbsp

Living donor kidney transplantation (LDKT) is an important organ resource, especially in countries with low deceased donation rates. Strategies for expanding access to transplantation should be developed by identifying the modifiable factors. In this study, we evaluated these factors in the relatives of patients from both medical centers and dialysis clinics using questionnaires.The questionnaires were anonymous and confidential. We collected questionnaires from previous donors, relatives of patients on the waitlist in the medical center, and relatives of dialysis patients in three nephrology clinics. The study groups were divided into three categories: donor group (n = 68), willing group (n = 43), and non-donor group (n = 65).Respondents in the clinics had lower cognition and willingness towards LDKT than those in the medical center. More knowledge of LDKT, better relationship with patients, more familial support, and female gender were positively related to donation. The non-donor group tended to want to maintain an intact body for the afterlife. There was no significant difference in age, educational degree, average monthly income, and medical compliance among the three groups.More efforts need to be made in dialysis clinics, where general nephrologists are important for the outreach of information. In addition, dealing with religious ambivalence and reestablishing cultural mindsets with health education programs are important issues in a non-Christian country.

PurposeDrawing from the conservation of resource theory and the job demands-resources model, this study examines the bi-directional conflicts of work and family during COVID-19, and investigates the online teaching work-related antecedents and the mechanism shaping emotional exhaustion of teachers in Taiwan. Moreover, this study explores mindfulness in teaching as a possible moderator.Design/methodology/approachData for analysis were collected from elementary school teachers via an online survey using a questionnaire comprising well-developed scales. The hypotheses were validated using structural equation modeling.FindingsResults show that only family interfering with work conflict mediates the positive relationship of online teaching job demand with emotional exhaustion and negative relationship of online teaching job resource with emotional exhaustion. Results also evidence that mindfulness practiced by teachers can help them perceive their own feelings and thoughts non-judgmentally in face of job demands.Originality/valueWith the growing work-from-home trend, the current study revisits the impact of work demands and resources on work-family conflict, and examines whether Taiwanese teachers' perception towards online teaching would lead to different observations. The path that JD→WIF conflict→EE is well established in the literature, while COVID-19 brings to light another path JD→FIW conflict→EE, revealing insight into teachers' cognition and plight during the pandemic.

Objectives The multi-center clinical microbiological study in Taiwan aimed to evaluate the impact of childhood PCV13 immunization on pneumococcal disease, and the magnitude of serotype replacement in invasive and non-invasive pneumococcal disease among all age groups. Methods The study of culture-confirmed pneumococcal disease (CCPD) was conducted at four hospitals across Taiwan in 2015-2018. Pneumococcal pneumonia was defined as clinical diagnosis with positive sputum or bronchoalveolar lavage culture. Serotyping, multi-locus sequence typing, and antimicrobial susceptibility testing for penicillin and ceftriaxone were performed. Results A total of 1413 CCPD cases were identified. Invasive pneumococcal disease (IPD) accounted for 13.4% (190/1413) of CCPD. PCV7-type CCPD incidence declined among all age groups between 2015 and 2018. In adults aged 50-64 years, PCV7-type pneumococcal pneumonia incidence in 2018 was 72% lower than that in 2015, and all pneumococcal pneumonia incidence was 35% lower than that in 2015. In children, CCPD incidence was higher in 2018 than in 2015 (IRR 1.75 for age 5 years, IRR 1.56 for age 5-17 years). Incidence of CCPD caused by non-PCV13-types, mainly 15A and 23A, increased significantly in those younger than 50 years. Serotypes 19A and 19F constituted the largest clonal complex, CC236/320 (n = 280, 19.8%). The rates of penicillin and ceftriaxone non-susceptibility were higher in PCV13-type isolates. Conclusions Childhood PCV13 immunization exerted an indirect protection to vaccine serotype clinically defined non-bacteremic pneumococcal pneumonia among adults, especially those between 50 and 64 years of age. Emerging non-PCV13 serotypes mainly caused non-invasive mucosal disease among children.

Yueh-An Lu, Chao-Yu Chen, George Kuo, Chieh-Li Yen, Ya-Chung Tian, Hsiang-Hao Hsu Department of Nephrology, Kidney Research Center, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, TaiwanCorrespondence: Hsiang-Hao Hsu, Department of Nephrology, Kidney Research Center, Linkou Chang Gung Memorial Hospital, No. 5 Fu-Shin Street, Kweishan, Taoyuan, 333, Taiwan, Tel +886-3-328-1200 ext. 8181, Fax +886-3-3282173, Email hsianghao@gmail.comPurpose: The incidence of bloodstream infection among end-stage kidney disease (ESKD) patients on chronic hemodialysis (HD) was 26-fold higher than population controls, causing higher morbidity and costs. The aim of this investigation was to clarify the prognostic factors, in-hospital outcomes and recurrence of infectious spondylitis of patients with and without chronic HD.Patients and Methods: This nationwide study analyzed 2592 patients who admitted for first-time infectious spondylitis between January 1, 2003, and December 31, 2015. Patients were classified into the chronic HD or the non-HD group. The logistic regression model and the general linear model were utilized to determine the impact of chronic HD on in-hospital mortality and recurrence. The Cox proportional hazard model was used to estimate the predictive factors of in-hospital mortality and recurrence.Results: Compared to the non-HD group, patients in the chronic HD group had a higher risk of respiratory failure, sepsis, in-hospital mortality, longer hospital stay, and higher medical spending. Chronic HD was an independent risk factor for in-hospital mortality (hazard ratio 2.21, 95% confidence interval 1.34– 3.65, p=0.0019), but not for recurrence. Intravascular device implantation or revision was a prognosticator for the mortality of both groups and a predictor for recurrence of the non-HD group. Surgical treatment was associated with a decreased risk of recurrence, whereas treatment with CT-guided abscess drainage was associated with an increased risk of recurrence in both groups.Conclusion: Patients with infectious spondylitis who were receiving chronic HD had a higher in-hospital mortality compared to those without HD. Intravascular device implantations or revision within 6 months was a significant predictor of in-hospital mortality and disease recurrence. Surgical treatment of infectious spondylitis had a lower risk of recurrence than those with CT-guided abscess drainage in both patient groups.Keywords: infectious spondylitis, chronic hemodialysis, chronic kidney disease, end-stage kidney disease, outcome, recurrence, risk factor

BACKGROUND/PURPOSE Salmonella Panama was considered an invasive non-typhoidal Salmonella (iNTS) serovar. Comprehensive clinical, microbiological, and genomic studies on S. Panama are scarce. We aimed to characterize the clinical and microbiological characteristics of S. Panama infection. Virulence mechanism of S. Panama and other iNTS serovars were also examined. METHODS Based on data from the longitudinal surveillance system for Salmonella deployed in Taiwan since 2004, a case-control study was undertaken to evaluate clinical characteristics of S. Panama infection during an outbreak in 2015-2016. Cellular experiments were conducted to compare pathogenicity of S. Panama and other iNTS with S. Typhimurium. RESULTS Most patients (41/44, 93.2%) infected by S. Panama were

Background: Metabolic acidosis is a common complication in patients with chronic kidney disease (CKD). Oral sodium bicarbonate is often used to treat metabolic acidosis and prevent CKD progression. However, there is limited information about the effect of sodium bicarbonate on major adverse cardiovascular events (MACE) and mortality in patients with pre-dialysis advanced CKD.Method: 25599 patients with CKD stage V between January 1, 2001 and December 31, 2019 were identified from the Chang Gung Research Database (CGRD), a multi-institutional electronic medical record database in Taiwan. The exposure was defined as receiving sodium bicarbonate or not. Baseline characteristics were balanced using propensity score weighting between two groups. Primary outcomes were dialysis initiation, all-cause mortality, and major adverse cardiovascular events (MACE) (myocardial infarction, heart failure, stroke). The risks of dialysis, MACE, and mortality were compared between two groups using Cox proportional hazards models. In addition, we performed analyzes using Fine and Gray sub-distribution hazard models that considered death as a competing risk.Result: Among 25599 patients with CKD stage V, 5084 patients (19.9%) were sodium bicarbonate users while 20515 (80.1%) were sodium bicarbonate non-users. The groups had similar risk of dialysis initiation (hazard ratio (HR): 0.98, 95% confidence interval (CI): 0.95-1.02, p < 0.379). However, taking sodium bicarbonate was associated with a significantly lower risks of MACE (HR: 0.95, 95% CI 0.92–0.98, p < 0.001) and hospitalizations for acute pulmonary edema (HR: 0.92, 95% CI 0.88–0.96, p < 0.001) compared with non-users. The mortality risks were significantly lower in sodium bicarbonate users compared with sodium bicarbonate non-users (HR: 0.75, 95% CI 0.74–0.77, p < 0.001).Conclusion: This cohort study revealed that in real world practice, use of sodium bicarbonate was associated with similar risk of dialysis compared with non-users among patients with advanced CKD stage V. Nonetheless, use of sodium bicarbonate was associated with significantly lower rate of MACE and mortality. Findings reinforce the benefits of sodium bicarbonate therapy in the expanding CKD population. Further prospective studies are needed to confirm these findings.

INTRODUCTION: The animal studies raise concerns about the possible ototoxicity of phenolic chemicals. Therefore, we conducted an epidemiologic study to examine the associations of phenols and parabens with hearing impairment. MATERIALS AND METHODS: Bisphenol A (BPA), benzophenone-3 (BP-3), and triclosan (TCS) were measured in urine samples in the National Health and Nutrition Examination Survey (NHANES) 2003–06 and 2009–12. Methyl paraben (MPB) and propyl paraben (PPB) were measured in urine samples in NHANES 2005–06 and 2009–12. Hearing impairment was defined as a hearing threshold of more than 25 dB at each hearing frequency in the better ear. Tests for linear trend were conducted using the median concentrations of urinary phenols or parabens in each quartile as a continuous variable. RESULTS: A total of 1809 participants (women = 52.0%) aged 20 and above were included in the final analysis (For MPB and PPB, the sample size was 1188). After adjusting for potential confounders, we found positive associations between BPA and hearing impairment at 3 K (p-trend = 0.04); between TCS and hearing impairment at 6 K (p-trend = 0.03); However, the odds ratio (OR) for the highest compared with the lowest quartile of both BPA and TCS did not reach statistical significance. In contrast, we found unexpected negative associations between BP-3 and hearing impairment at 0.5 K (p-trend = 0.04), 1 K (p-trend = 0.02), 2 K (p-trend

The aim of the present study is to examine whether overweight or obese people in Taiwan have an inadequate intake of selected micronutrients. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013–2016. We evaluated fourteen nutrient intakes using the 24 h dietary recall method. The dietary reference intake (DRI) adherence was estimated by the prevalence of participants whose intake was lower than the recommended dietary allowance (RDA) or adequate intakes (AIs) for selected micronutrients. Body mass index (BMI) ≥ 27 kg/m2 and waist circumference (WC), with men having WC ≥ 90 cm or women having WC ≥ 80 cm, were defined as obesity. A total of 3075 participants aged 19 years and above were included. After adjusting for confounders, we found that obese women have a lower DRI adherence of vitamin C (odds ratio (OR) 0⋅73, 95 % confidence interval (CI) 0⋅56, 0⋅95) and magnesium (OR 0⋅72, 95 % CI 0⋅54, 0⋅95), compared with normal-weight women. Obese men have a higher DRI adherence of vitamin B3 (OR 1⋅70, 95 % CI 1⋅29, 2⋅23), iron (OR 1⋅46, 95 % CI 1⋅06, 2⋅00) and zinc (OR 1⋅41, 95 % CI 1⋅07, 1⋅85), compared with normal-weight men. Similar findings were found using WC to define obesity. We conclude that obese women may have insufficient intakes of vitamin A, vitamin C and magnesium.

Backgrounds Neutrophil-to-lymphocyte ratio (NLR), a surrogate marker of systemic response to physiological stress, is used for prognosis prediction in many diseases. However, the usefulness of this marker for predicting acute kidney injury (AKI) progression is unclear. Methods This retrospective study was based on the Chang Gung Research Database. Patients admitted to the intensive care unit with a diagnosis of stage 1 or 2 AKI were identified. The primary outcome was a composite of progression to stage 3 AKI, requirement of renal replacement therapy, or 14-day in-hospital mortality. The association between NLR and the primary outcome was examined using a logistic regression model and multivariable analysis. The nonlinearity and cutoff points of this relationship were determined using a restricted cubic spline model. Results A total of 10,441 patients were enrolled. NLR level at the time of stage 1–2 AKI diagnosis was a marker of adverse outcomes. After adjustment for confounders, NLR was independently associated with the composite outcome of AKI progression, renal replacement therapy, or mortality. The restricted cubic spline model revealed a J-shaped curve, with the lowest odds ratio for an NLR between 7 and 38. Subgroup analysis revealed linear and J-shaped relationships between NLR and the primary outcome in patients admitted to the intensive care unit for medical reasons and for cardiovascular surgery, respectively. Conclusions NLR is an independent marker of AKI progression and in-hospital mortality. Because it is readily available in daily practice, it might be used for risk stratification in the AKI population. Graphic abstract Supplementary Information The online version contains supplementary material available at 10.1007/s40620-021-01162-3.

Background Restless legs syndrome (RLS) is common among patients with end-stage kidney disease (ESKD) and is associated with poor outcomes. Several recently published studies had focused on pharmacological and non-pharmacological treatments of RLS, but an updated meta-analysis has not been conducted. Methods The study population was adult ESKD patients on dialysis with RLS. Randomized controlled trials (RCTs) were selected. The primary outcome was reduction in RLS severity. The secondary outcomes were improvement in sleep quality and treatment-related adverse events. Frequentist standard network meta-analysis (NMA) and additive component NMA were performed. The evidence certainty was assessed using the Confidence in NMA (CINeMA) framework. Results A total of 24 RCTs with 1252 participants were enrolled and 14 interventions were compared. Cool dialysate produced the largest RLS severity score reduction {mean difference [MD] 16.82 [95% confidence interval (CI) 10.635–23.02]} and a high level of confidence. Other potential non-pharmacological interventions include intradialytic stretching exercise [MD 12.00 (95% CI 7.04–16.97)] and aromatherapy massage [MD 10.91 (95% CI 6.96–14.85)], but all with limited confidence of evidence. Among the pharmacological interventions, gabapentin was the most effective [MD 8.95 (95% CI 1.95–15.85)], which also improved sleep quality [standardized MD 2.00 (95% CI 0.47–3.53)]. No statically significant adverse events were detected. Conclusions The NMA supports that cool dialysate is appropriate to treat patients with ESKD and RLS. Gabapentin is the most effective pharmacological intervention and also might improve sleep quality. Further parallel RCTs with sufficient sample sizes are required to evaluate these potential interventions and long-term effects.

This study investigates an abnormal degradation induced in a moist environment. Although devices maintain optimal performance under bias stress operation in a vacuum, an abnormal hump is observed in capacitance–voltage ( ${C}$ – ${V}$ ) electrical characteristics under negative bias stress (NBS) operation in a moist environment. Electrolysis of the H2O model is proposed to explain the degradation. An asymmetric stress condition, with ${V} _{\text {GD}} = {0}$ V, is designed to confirm that a vertical electric field causes the electrolysis of H2O, which is the reason for the hump phenomenon in the ${C}$ – ${V}$ curve. Moreover, COMSOL simulation and ${C}$ – ${V}$ measurement of the source and drain parasitic capacitances are utilized to clarify the precise degradation position and support the mechanism. The results from electrical measurement suggest that a vertical electric field can cause instability in a moist environment.

BackgroundAlthough a recent study reported that fibrates are associated with a low risk of cardiovascular (CV) death and can postpone the need for long-term hemodialysis in patients with advanced chronic kidney disease (CKD), little is known regarding whether the CV protective effects of fibrates extend to patients with end-stage renal disease (ESRD). The present study compared CV outcomes and mortality among patients with ESRD treated with fibrates, statins, neither, or their combination.MethodsThis cohort study extracted data from Taiwan's National Health Insurance Research Database (NHIRD). Adult patients with ESRD and hyperlipidemia were identified and categorized into four groups (fibrate, statin, combination, and non-user groups) according to their use of different lipid-lowering therapies within 3 months prior to the commencement of permanent dialysis. Inverse probability of treatment weighting was used to balance the baseline characteristics of the groups. The follow-up outcomes were all-cause mortality, CV death, and major adverse cardiac and cerebrovascular events (MACCEs).ResultsCompared with the non-user and statin groups, the fibrate group did not exhibit significantly lower risks of all-cause mortality [fibrate vs. non-user: hazard ratio (HR), 0.97; 95% confidence interval (CI), 0.92–1.03; statin vs. fibrate: HR, 0.95; 95% CI, 0.90–1.01], CV death (fibrate vs. non-user: HR, 0.97; 95% CI, 0.90–1.05; statin vs. fibrate: HR, 0.97; 95% CI, 0.90–1.06), and MACCEs (fibrate vs. non-user: HR, 1.03; 95% CI, 0.96–1.10; statin vs. fibrate: HR, 0.94; 95% CI, 0.87–1.004). The combination of fibrates and statins (specifically moderate- to high-potency statins) did not result in lower risks of all-cause mortality, CV death, or MACCEs compared with statins alone.ConclusionIn patients with ESRD, the use of fibrates might be not associated with reduced mortality or CV risks, regardless of whether they are used alone or in combination with statins.

Background The benefit of low‐density lipoprotein cholesterol (LDL‐C) levels in chronic kidney disease populations remains unclear. This study evaluated the cardiovascular and renal outcomes in patients with stage 3 chronic kidney disease with different LDL‐C levels during statin treatment. Methods and Results There were 8500 patients newly diagnosed as having stage 3 chronic kidney disease under statin treatment who were identified from the Chang Gung Research Database and divided into 3 groups according to their first LDL‐C level after the index date: 100 mg/dL. Inverse probability of treatment weighting was performed to balance baseline characteristics. Compared with the LDL‐C ≥100 mg/dL group, the 70≤LDL‐C Conclusions Among patients with stage 3 chronic kidney disease, statin users with 70≤LDL‐C100 mg/dL. Moreover, the 70≤LDL‐C

Ming-Chieh Li1,2 1Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan; 2Department of Public Health, College of Public Health, China Medical University, Taichung, TaiwanCorrespondence: Ming-Chieh Li, Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei, 106, Taiwan, Tel +886277491698, Email mingchiehli@ntnu.edu.twIntroduction: We conducted a study to examine whether adherence to the Taiwan Daily Food Guide was associated with bone mineral density (BMD).Methods: A population-based cross-sectional study was conducted utilizing data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013– 2016. A total of seven BMD sites were evaluated, including the head, arms, legs, trunk, ribs, pelvis, and spine BMD. Besides, we further examined the association between the Daily Food Guide adherence score and osteoporosis (T-score of ≤ − 2.5 standard deviation (SD) of a measured total BMD). A validated food-frequency questionnaire (FFQ) was used for dietary assessment.Results: We included a total of 555 participants with osteoporosis and 1977 without osteoporosis in the final analysis. We found negative associations between levels of adherence to the Daily Food Guide and the risk of osteoporosis. The odds ratio (OR) for participants in the highest quartile of the adherence level was 0.61 (95% CI = 0.42– 0.88), compared with those in the lowest quartile. When participants had total servings of six food groups higher than the recommendation, the protective effect still existed (OR = 0.59, 95% CI = 0.42– 0.84).Conclusion: Better adherence to the Taiwan Daily Food Guide is associated with a lower risk of osteoporosis.Keywords: bone health, osteoporosis, Daily Food Guide, diet, vegetables

This article contextualises Xing Danwen’s role in creating the posed photography of Ma Liuming from 1993 to 1995, the canon of East Village performance art in China, and how this experience prompte...

In this article, we introduce a fractional-N all-digital phase-locked loop (ADPLL) architecture based on a single LC-tank, featuring an ultra-wide tuning range (TR) and optimized for ultra-low area in 10-nm FinFET CMOS. Underpinned by excellent switches in the FinFET technology, a high turn-on/off capacitance ratio of LC-tank switched capacitors, in addition to an adjustable magnetic coupling technique, yields almost an octave TR from 10.8 to 19.3GHz. A new method to compensate for the tracking-bank resolution can maintain its quantization noise level over this wide TR. A new scheme is adopted to overcome the metastability resolution problem in a fractional-N ADPLL operation. A low-complexity TDC gain estimator reduces the digital core area by progressive averaging and time-division multiplexing. Among the published fractional-N PLLs with an area smaller than 0.1mm2, this work achieves an rms jitter of 725fs in an internal fractional-N mode of ADPLL's phase detector (2.7-4.825GHz) yielding the best overall jitter figure-of-merit (FOM) of -232dB. This topology features small area (0.034mm2), wide TR (56.5%) and good supply noise rejection (1.8%/V), resulting in FOMs with normalized TR (FOMT) of -247dB, and normalized TR and area (FOMTA) of -262dB.

In this article, a quadtree element-free Galerkin method (QEFGM) is proposed for automatically configuring background cells. The QEFGM is then employed in the fracture analysis of a piezoelectric elliptical tube subjected to internal pressure and thermal loading. The stress intensity factor (SIF) is calculated by the QEFGM and the traditional element-free Galerkin method (EFGM). By investigating an internally cracked piezoelectric plate subjected to lateral tension, the error of SIF for the EFGM is 5.17%, and the QEFGM is 1.28% at the crack-to-length ratio ( $$c/W = 0.25$$ ). The results show that the error of QEFGM is one-fourth of EFGM, which demonstrates the correctness and superiority of the approach. The QEFGM was then employed in an examination of the system geometry on the SIF in a fractured piezoelectric tube. Fracture analysis was carried out for four ellipses with different axial ratios and three super-ellipses of different powers. The SIF increased with the axial ratio for the ellipses, and increased with the powers for the super-ellipses. In this paper, various physical characteristics analyses of fracture piezoelectric material were carried out under different structure geometries. The presented result is beneficial to the prediction of material life.

We show that for a quadratic polynomial $$f(x)=x^2-c$$ , where $$c=(8k+2)(8k+3)$$ or $$c=(4k+1)(4k+2)+1$$ with $$k\in {\mathbb {N}}\cup \{0\}$$ , the Galois group of the splitting field of each iterate $$f^n$$ of f is isomorphic to the automorphism group of a complete binary rooted tree of height n.

Growing research suggests that a social-emotional learning (SEL) curriculum in school has a positive impact on students’ emotional and academic learning. However, schools in Pakistan face multiple ...

Context Fenofibrate provides limited cardiovascular (CV) benefits in the general population; however, little is known about its benefit among advanced chronic kidney disease (CKD) patients. Objective This study compared outcomes among advanced CKD patients treated with fenofibrate, statins, a combination of both, and none of these. Methods This national cohort study was based on Taiwan’s National Health Insurance Research Database. Patients younger than 20 years with advanced CKD were identified and further divided into 4 groups according to treatment. The inverse probability of treatment weighting was used to balance baseline characteristics. Patients received fenofibrate, statins, a combination of fenofibrate and statins, or none of these in the 3 months preceding the advanced CKD date. Main outcome measures included all-cause mortality, CV death, and incidence of permanent dialysis. Results The fenofibrate and statin groups exhibited a lower risk of CV death (fenofibrate vs nonuser: hazard ratio [HR]: 0.84; 95% CI, 0.75-0.94; statins vs nonuser: HR: 0.94; 95% CI, 0.90-0.97) compared with the nonuser group. The fenofibrate group further exhibited the lowest incidence of permanent dialysis (fenofibrate vs nonuser: subdistribution HR [SHR]: 0.78; 95% CI, 0.77-0.80; statins vs fenofibrate: SHR: 1.27; 95% CI, 1.26-1.29; combination vs fenofibrate: SHR: 1.15; 95% CI, 1.13-1.17). Furthermore, the combined administration of fenofibrate and high-intensity statins exhibited a lower risk of major adverse cardiac and cerebrovascular events. Conclusion For patients with advanced CKD, continuing fenofibrate may provide a protective effect on CV outcomes equal to that of statins, and it may further delay the need for permanent dialysis. The combination of fenofibrate and high-intensity statins may have additional benefits.

BackgroundMental health has become a public health concern worldwide, and the number of affected individuals is rising. Therefore, further research must be conducted to identify potential risk factors to develop optimal prevention strategies to mitigate mental health disorders.MethodsUsing Taiwanese Nutrition and Health Survey data collected from 2013–2016, we conducted a cross-sectional study to examine whether adherence to the Taiwan Daily Food Guide affects mental health conditions. Study participants were adults aged ≥19 years. The dietary assessment was conducted using a validated food frequency questionnaire. The presence of psychiatric morbidity was defined as a five-item Brief Symptom Rating Scale (BSRS-5) score of ≥10. Logistic regression models were used to determine whether Taiwan Daily Food Guide adherence was related to the presence of psychiatric morbidity.ResultsAfter adjusting for potential confounders, we observed protective associations between adherence to the Taiwan Daily Food Guide and psychiatric morbidity risk.ConclusionThe Taiwan Daily Food Guide might reduce the risk associated with psychiatric morbidity and could be a reference for developing a national food guide for mental health.

This paper analyses how time-based media practices in Taiwan and Hong Kong initially emerged to preserve traces of the disappearing and the already invisible. This phenomenon is intrinsically relat...

In this brief, we introduce a 3.2–4 GHz three-winding transformer-based class-F digitally controlled oscillator (DCO) with a DC-DC booster for energy harvesting applications. A $\pi $ -model is adopted for this multi-turn transformer to analyze its impedance transformation and overall loop gain. The trifilar coil generates large passive voltage loop gain, allowing the DCO supply voltage of 0.2 V to be even lower than the threshold voltage of transistors without any performance degradation. Due to the gate/drain isolation as well as smaller voltage-dependent capacitance in advanced FinFET technology, this brief achieves very low supply frequency pushing of 38 MHz/V. The switched capacitor placed at the tertiary winding can reach very fine resolution of 1.3 kHz due to the impedance transformations and source degeneration. The bias and control voltages of nearly zero power are generated with a switched-capacitor based DC-DC converter and a ring-based non-overlapped clock generator.

Virtual vehicles (e.g., driving video games) can give rise to visually induced motion sickness. Typically, people drive virtual vehicles. In the present study, we investigated motion sickness among participants who were exposed to virtual vehicles as passengers; that is, they observed vehicle motion, but did not control it. We also asked how motion sickness and the postural precursors of motion sickness might be influenced by participants' previous experience of driving physical vehicles. Participants viewed a recording of a virtual automobile in a driving video game. Drivers were young adults with several years of experience driving physical automobiles, while non-drivers were individuals in the same age group who did not have a driver's license and had never driven an automobile. During exposure to the virtual vehicle, we monitored movement of the head and torso. The independent measures included the incidence and severity of motion sickness. After exposure to the virtual vehicle, the incidence and severity of motion sickness did not differ between Drivers and Non-Drivers. By contrast, postural movement differed between participants who later became motion sick and those who did not. In addition, during exposure to the virtual vehicle, physical driving experience was related to patterns of postural activity that preceded motion sickness. The results are consistent with the postural instability theory of motion sickness, and illuminate relations between the control of physical and virtual vehicles.

Because depression is highly prevalent among Chinese undergraduates, it is crucial to develop an approach for early intervention and prevention. Cognitive bias modification of interpretation (CBM-I) has been shown to be an effective approach to alleviate anxiety. However, its utility in improving depression needs further verification. The current study sought to evaluate the efficacy of a four-session CBM-I program of depression prevention for Chinese undergraduates. Forty Chinese participants with depressive symptoms (Self-Rating Depression Scale, SDS ≥ 50) were randomly assigned to receive either a CBM-I training or a waitlist control condition. Test results of Ambiguous Scenarios Test for Depression-Related Bias and SDS indicate that the CBM-I training group have more positive interpretations and fewer symptoms of depression after the training compared to the control group. In addition, significant correlation was found between changes in depressive symptoms and changes in interpretation bias. The effect of the CBM-I on depressive symptoms was partially mediated by the change in interpretation bias. The study findings highlight the potential of CBM-I protocol as a brief, simple, and accessible approach for preventing depression.

In recent years, the explosion of social media platforms and the public collection of social data has brought forth a growing desire and need for research capabilities in the realm of social media and social data analytics. Research on this scale, however, requires a high level of computational and data-science expertise, limiting the researchers who are capable of undertaking social media data-driven research to those with significant computational expertise or those who have access to such experts as part of their research team. The Social Media Macroscope (SMM) is a science gateway with the goal of removing that limitation and making social media data, analytics, and visualization tools accessible to researchers and students of all levels of expertise. The SMM provides a single point of access to a suite of intuitive web interfaces for performing social media data collection, analysis, and visualization via for open-source and commercial tools. Within the SMM social scientists are able to process and store large datasets and collaborate with other researchers by sharing ideas, data, and methods. This document functions as a brief primer on the initial build of the SMM and we end this paper discussing future directions for the SMM.

In this article, an n-type double-gate low-temperature polysilicon (LTPS) TFT is investigated. Previous work has confirmed that the hot-carrier effect will cause impact ionization. Here we observed that, after hot-carrier stress (HCS), the transfer curve in the saturation region has a negative $\text{V}_{\mathrm {th}}$ shift, and a hump is also observed. The reverse output characteristic shows that gate induced drain leakage (GIDL) of the transistor gradually increases and the subthreshold swing (S.S.) has a tendency to collapse. In structures with longer lightly doped drain (LDD) lengths, the electric field at both source/drain side can be effectively dispersed. Thereby, an extended LDD can reduce the overall degradation, and a physical model of explanation is proposed. By using the energy band diagram, we clarify how the additional electron hole pairs affect the output property. Next, Silvaco TCAD simulation is utilized to illustrate the electric field distribution and validate the physical model.

The goal of the study is to identify and track the dissemination patterns of true and false information about Human Papillomavirus (HPV) vaccines on twitter from 2013 to 2017. We applied a patient-driven HPV-vaccine risk lexicon combining with natural language processing (NLP) models and network analyses to explore the spread of verified true and false HPV-vaccine information. The explorative analyses showed different dissemination patterns of the most popular verified true and false messages about HPV vaccines, which false messages went viral than the true messages. Implications on detecting false HPV-vaccine related information were also discussed.

While the virality of misinformation has been recognized as one of the significant global issues in the modern societies, few studies had examined the computational approaches to represent and identify false information in health domains. The current study aimed at using both psycholinguistic and natural language processing models to represent verified true and false texts about human papillomavirus (HPV) vaccines. Compared to the conventional word-embedding models representing texts in the levels of words, sentences or documents, results showed that introducing the embedding in the levels of propositions best differentiated the semantic representations in true and false texts. The study would advance our understandings in representing health texts and have implications on detecting false health information.

Cognitive bias modification-interpretation (CBM-I) is a promising treatment modality for emotional disorders. But the moderate effect sizes emphasize the need to explore the potential mechanism of the CBM-I. Recent research has identified intolerance of uncertainty (IU) as a possible a trans-diagnostic risk and maintaining factor emotional disorders. The current study investigated the impact of a four-session IU-focused CBM-I on reduction of anxiety and determined whether IU mediated the relationship between IU interpretation bias and anxiety. 40 participants selected based on a high IU interpretation bias (IU-IB) were randomly assigned to an active (IU CBM-I) condition and a control CBM-I condition. By longitudinal design, anxiety and uncertainty questionnaires were administered before, after and one month after the intervention. Multilayer linear model analysis indicated that the active IU CBM-I was significantly associated with changes in anxiety from pre-to-post intervention as well as reductions in IU at post-intervention and month-one follow-up. The results also found that IU mediated the relationship between IU interpretation bias and anxiety.

Background: The epidemiology of nontyphoidal Salmonella (NTS) resistant to ciprofloxacin or ceftriaxone and its impact on patients’ clinical course are rarely reported. Methods: Children with culture-proven salmonellosis treated in a medical center in northern Taiwan in 2017 were enrolled. To trace the source of Salmonella, Salmonella isolated from food samples were collected from markets. Antimicrobial susceptibility and serotypes were determined. Results: Among the 453 isolates, 122 (26.9%) were highly antimicrobial-resistant, as defined by resistance to ciprofloxacin or ceftriaxone or both. The most prevalent highly resistant serotype was S. Anatum (66, 54.1%). Salmonella was detected in 94.1%, 66.7%, and 8.6% of examined pork, chicken, and vegetables examined, respectively. S. Anatum (6, 21.4%) and S. Derby (6, 21.4%) were the major serotypes isolated. Majority of the S. Anatum (5, 83.3%) were highly antimicrobial-resistant. More patients infected by highly resistant Salmonella required carbapenem treatment (OR = 23.5, 95% confidence interval [CI] 2.8–192.7, P

Research reveals that selective attentional bias to socially negative information is a reliable characteristic of individuals with high-trait anxiety (HTA). However, for selective attentional bias across sensory channels (visual and auditory), the interaction between attentional bias type and negative face type remains unclear. In this study, we recruited 30 individuals with high- and low-trait anxiety (LTA) (15 in each group), and measured their engagement and disengagement bias indices using the cross-modal attentional-probe paradigm, and measured the occipital P1 component using a 64-channel electroencephalography system. The results showed that under the engagement condition in the HTA group, the occipital P1 amplitude of an angry face was smaller than that of a neutral face, and there also exhibited smaller attentional bias indices of angry faces in the HTA group than that of the LTA group. For the presence of disgusted faces, the attentional bias indices of the HTA group were smaller than that of the LTA group under the disengagement condition. These findings demonstrate that the selective attentional bias occurs both in the engagement and the disengagement facets within the cross modal. There is a feature of facilitated attentional engagement bias for an angry face, and a feature of promoted attentional disengagement bias for a disgusted face in HTA individuals.

We present a dual-chiplet interposer-based system-in-package (SiP) octo-core processor using Chip-on-Wafer-on-Substrate (CoWoS) technology. Each of the two identical chiplets is implemented in 7-nm CMOS with 15 metal layers and has four Arm Cortex-A72 processor cores operating at 4.0 GHz. A bidirectional mesh bus with 2-mm flop-to-flop distance is distributed throughout the chiplet for high-speed on-die data transport above 4.0 GHz. The chiplets communicate with each other through ultrashort reach (0.5 mm long) interposer channels using a Low-voltage-In-Package-INterCONnect (LIPINCON) clock-forwarded parallel interface. The scalable link module offers 320 GB/s of aggregate bandwidth, operating at 8.0 Gb/s/pin and 0.3-V transmitter swing without receiver termination to achieve 0.56-pJ/bit energy efficiency and 1.6-Tb/s/mm2 bandwidth density. Measurements of the fabricated SiP validate the functionality and performance of the cores, on-die data bus, and inter-chiplet link. The built-in LIPINCON eye-scan feature validates inter-chiplet connectivity at 8.0 Gb/s with an eye opening of 244 mV and 0.69 UI.

A serial of carbon modified Ag/TiO2 photocatalysts have been synthesized with different carbon content by a simple co-impregnation method. Here, 1-pentanol was used as carbon precursor. The carbon modified Ag/TiO2 nanocomposites were characterized by X-ray diffraction, raman spectroscopy, thermal gravity analysis, UV–vis diffuse reflectance spectra, photoluminescence, and X-ray photoelectron spectroscopy. The photocatalytic removal of nitrogen oxides was carried out under both UV light and visible light irradiation. Our results revealed that carbon and silver species showed strong synergistic effect which significantly enhance the photocatalytic NOx removal on TiO2 photocatalyst under visible light irradiation.

Dialysis-requiring acute kidney injury (AKI) is increasingly common in intensive care units (ICUs) and is associated with poor outcomes. Few studies have explored the temporal trends in severity of acute illness at dialysis initiation, indications for dialysis, and their association with patient outcomes.Multicenter retrospective cohort study.9,535 adult patients admitted to the ICU and received their first dialysis treatment from Chang Gung Memorial Hospital system in Taiwan between 2009 and 2018.Calendar year.ICU mortality and dialysis dependence among hospital survivors.The temporal trends over the study period were investigated using test statistics suited for continuous or categorical data. The association between the study year and the risk of mortality was analyzed using multivariable Cox regression with adjustment for relevant clinical variables, including the severity of acute illness, defined by the Sequential Organ Failure Assessment (SOFA) score.The mean SOFA score at dialysis initiation declined slightly from 14.0 in 2009 to 13.6 in 2018. There was no significant trend in the number of dialysis criteria that were fulfilled over time. Observed ICU mortality declined over time and appeared to be reverse J-shaped, with a substantial decline from 56.1% in 2009 to 46.3% in 2015 and a slight increase afterward. The risk of mortality was significantly reduced from 2013 to 2018 compared with 2009 in adjusted models. The declining trend in ICU mortality over time remained significant. Dialysis dependence among survivors increased, mainly in patients with CKD, from 36.8% in 2009 to 43.9% in 2018.Residual confounding from unmeasured factors over time such as severity of comorbidities, detailed medication interventions, and delivered dialysis dose.We observed reductions in mortality among ICU patients with dialysis-requiring AKI between 2009 and 2018, even after adjusting for dialysis indication and severity of illness at dialysis initiation. However, dialysis dependence among survivors has increased over time, mainly in patients with pre-existing CKD.

This study aims to examine whether adherence to the Taiwan Daily Food Guide relates to the risk of type 2 diabetes. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013–2016. Dietary intakes were assessed using a validated food-frequency questionnaire. Type 2 diabetes was defined as a fasting serum HbA1c level of 6.5% or higher or participants who have received treatment for type 2 diabetes or have reported a physician diagnosis of type 2 diabetes. A total of 2534 Taiwanese adults aged 19 and above were included. We found that the Daily Food Guide adherence was negatively associated with the prevalence of type 2 diabetes. The odds ratios (ORs) for those in the fourth quartile of the recommended total servings was 0.67 (95% confidence interval (CI) = 0.45–0.99) compared with those in the first quartile. In addition, those who were men (OR = 1.46, 95% CI = 1.07–1.98), aged more than 50 to 65 (OR = 6.48, 95% CI = 2.57–16.35), or more than 65 (OR = 6.81, 95% CI = 2.56–18.08), with body mass index (BMI) of 24 to less than 27 (OR = 2.08, 95% CI = 1.55–2.79), had BMI of more than 27 (OR = 3.63, 95% CI = 2.73–4.83), had an education level of junior high and high school (OR = 1.68, 95% CI = 1.03–2.74), were divorced, separated, widowed, or refused to answer (OR = 1.39, 95% CI = 1.03–1.88) were associated with an increased prevalence of type 2 diabetes. In conclusion, people who adhere better to the Taiwan Daily Food Guide were found to have a reduced risk of type 2 diabetes.