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To investigate how sodium-glucose co-transporter 2 inhibitors (SGLT2is) add-on therapy for metformin affects diabetic retinopathy (DR) progression in patients with type 2 diabetes mellitus (T2DM). This nationwide population-based study conducted from January 1, 2016, to December 31, 2018 involved 3,432,911 adults with T2DM in Taiwan. To adjust for potential confounders, data on sex, age, income, comorbidities, diabetes complication severity index score, staging of kidney disease, anti-diabetic medications, and index year were included. The outcome was DR progression, determined by procedure codes or the addition of ICD-9-CM or ICD-10-CM codes to the medical records of the patients during the study. Sensitivity analyses were performed to validate the findings. The adjusted hazard ratio (aHR) of DR progression was 0.89 for the SGLT2is add-on group, relative to the control group [95% confidence interval (CI) 0.81–0.99, P = 0.026]. The Kaplan–Meier curve of the cumulative incidence rate showed that the cumulative incidence of DR progression was considerably decreased in the SGLT2is cohort (log-rank P = 0.0261). The use of SGLT2is for less than 1 year and 1–2 years were associated with a significant increase in the risk of DR progression (aHR 1.56 and 1.88, respectively); however, the risk markedly reduced if the SGLT2is regimen was used for more than 2 years (aHR 0.41, 95% Cl 0.35–0.48; P < 0.001). The serial sensitivity analysis showed consistent findings. The aHR of DR progression was 0.82 for the SGLT2is cohort relative to the non-SGLT2is cohort based on the fundoscopy or indirect ophthalmoscopy findings within 1 year before the outcome date (95% Cl 0.71–0.95; P = 0.009). Co-administration of metformin and SGLT2is may reduce the risk of DR progression. Short-term use of SGLT2is may markedly increase the risk of DR, whereas prolonged use SGLT2is may significantly decrease it. [ABSTRACT FROM AUTHOR]

To investigate how sodium-glucose co-transporter 2 inhibitors (SGLT2is) add-on therapy for metformin affects diabetic retinopathy (DR) progression in patients with type 2 diabetes mellitus (T2DM). This nationwide population-based study conducted from January 1, 2016, to December 31, 2018 involved 3,432,911 adults with T2DM in Taiwan. To adjust for potential confounders, data on sex, age, income, comorbidities, diabetes complication severity index score, staging of kidney disease, anti-diabetic medications, and index year were included. The outcome was DR progression, determined by procedure codes or the addition of ICD-9-CM or ICD-10-CM codes to the medical records of the patients during the study. Sensitivity analyses were performed to validate the findings. The adjusted hazard ratio (aHR) of DR progression was 0.89 for the SGLT2is add-on group, relative to the control group [95% confidence interval (CI) 0.81–0.99, P = 0.026]. The Kaplan–Meier curve of the cumulative incidence rate showed that the cumulative incidence of DR progression was considerably decreased in the SGLT2is cohort (log-rank P = 0.0261). The use of SGLT2is for less than 1 year and 1–2 years were associated with a significant increase in the risk of DR progression (aHR 1.56 and 1.88, respectively); however, the risk markedly reduced if the SGLT2is regimen was used for more than 2 years (aHR 0.41, 95% Cl 0.35–0.48; P < 0.001). The serial sensitivity analysis showed consistent findings. The aHR of DR progression was 0.82 for the SGLT2is cohort relative to the non-SGLT2is cohort based on the fundoscopy or indirect ophthalmoscopy findings within 1 year before the outcome date (95% Cl 0.71–0.95; P = 0.009). Co-administration of metformin and SGLT2is may reduce the risk of DR progression. Short-term use of SGLT2is may markedly increase the risk of DR, whereas prolonged use SGLT2is may significantly decrease it. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the association of blepharitis and ischemic stroke. Methods: This nationwide retrospective cohort study used population-based data in Taiwan. Individuals aged 20 and above with diagnosis of blepharitis was included based on electrical medical records. After exclusion of ineligible cases, 424,161 patients were identified between 2008 and 2018. The blepharitis and non-blepharitis cohorts were matched based on sex, age, and comorbidities. Multivariable-adjusted Cox proportional hazards model was adopted to calculate the hazard ratio and 95% confidence interval (CI) between blepharitis and non-blepharitis cohorts. The incidence of ischemic stroke was estimated by Kaplan–Meier analysis. Results: 424,161 pairs of blepharitis cohort and non-blepharitis cohort were 1:1 propensity score matched for statistical analysis. Patients with blepharitis had significantly increased risk of ischemic stroke compared with the individuals without blepharitis (adjusted hazard ratio 1.32, 95% CI 1.29–1.34, P < 0.001). A significantly higher risk of ischemic stroke was observed in blepharitis cohort with a previous diagnosis of cancer than in those without cancer (P for interaction < 0.0001). Kaplan–Meier survival analysis revealed the cumulative incidence of ischemic stroke increased in the blepharitis cohort compared with that in the non-blepharitis cohort in 10 years (log-rank P < 0.001). The follow-up period analysis further indicated 1.41-fold adjusted hazard (95% CI 1.35−1.46, P < 0.001) of ischemic stroke within a year after blepharitis diagnosis. Conclusions: Patients with blepharitis had an elevated risk of developing ischemic stroke. Early treatment and active surveillance are suggested for patients with chronic blepharitis. Further research is required to determine the casual relationship between blepharitis and ischemic stroke, as well as the underlying mechanism. [ABSTRACT FROM AUTHOR]

Microbubble disease observed in cellulose acetate microfilm is accompanied by the production of vinegar syndrome, which affects the image integrity. In the present study, samples of cellulose acetate microfilm with microbubble disease were selected to investigate potential treatment methods. Samples were sourced from the Republic of China (AD 1912–1949) microfilm collections held in the Second Historical Archives of China. A combination of optical microscopy and a stainless-steel needle was used to remove plasticizer exudation within microbubbles. The plasticizer was effectively removed by infiltrating butan-1-ol into the microbubble from a small hole made by the stainless-steel needle. SEM and confocal microscopy were used to study the morphology and roughness of the internal surface of the microbubbles. It was found that the blurry image could be attributed to light scattering from the rough surface. Ethyl cellulose was used to fill the interior of the microbubble to obtain a clearer image. To determine the protective potential of this filling material, the chemical and mechanical properties of coated film after dry heat, hygrothermal and UV accelerated ageing were measured. Based on the above-mentioned results, it is encouraging that a new microrepair method and its corresponding method are offered in film treatment work. [ABSTRACT FROM AUTHOR]

Continuous improvement and innovation are solid foundations for the company to maintain excellent performance and competitive advantage. As the limited resources possessed by companies generally result in the incapability of implementing several improving plans simultaneously, researchers advocate that companies should evaluate the influential relationships among key success factors (KSFs) to explore the more dominant determinants for designing improving actions. This study focused on the auto lighting aftermarket (AM) industry in which the KSFs have not yet been adequately performed to explore the decisive criteria of an improvement strategy. After a literature review and a survey of experts, a preliminary list of suitable evaluation criteria was derived. Consequently, the fuzzy and decision-making trial and evaluation laboratory (DEMATEL) method were employed to analyze and establish the causal relationship among criteria. This study contributes to the auto lighting AM industry by using a novel approach for identifying and prioritizing the KSFs. The result indicates that product integrity was the "cause" construct on the constructs of operating cost, quality and brand, technology development, and customer satisfaction. These findings contribute to help practitioners better design effective improvement strategies. [ABSTRACT FROM AUTHOR]

An incident of sartan medicine contamination was notified by Europe in June 2018. The contaminant was identified as a probable carcinogenic nitrosamine and the recalls of sartan medicines were soon made. Since then, more nitrosamine contaminants in sartan medicines were reported. To broaden the applicability and variety in nitrosamine determination, a multi-analyte method is required. In this study, a feasible and sensitive multi-analyte LC-MS/MS method for determination of 12 nitrosamines in sartans was established, where the active pharmaceutical ingredients and final products merchandised in Taiwan were also examined. Chromatographic separation was achieved on an Xselect® HSS T3 column (15 cm x 3 mm i.d., 3.5 mm) with gradient elution using mobile phase A consisting of 0.1% formic acid in water and mobile phase B consisting of 0.1% formic acid in acetonitrile/methanol (2:8). Validation of the proposed method was also carried out. The limit of detection and limit of quantification for 12 nitrosamines were 20 ng/g and 50 ng/g, respectively. The intra-day and inter-day recoveries of nitrosamines were among 80e120% with precision of 20% for most nitrosamines within sartans matrices. The method was successfully established and applied to authentic samples which a total of 98 positive samples containing 5 distinct nitrosamines, including N-nitrosodiethylamine, N-nitrosodimethylamine, N-nitroso-N-methyl-4-aminobutyric acid, N-nitrosomorpholine and Nnitrosopiperidine, were detected from 557 authentic samples. [ABSTRACT FROM AUTHOR]

The white spots known as microbubbles that are formed in cellulose acetate film, significantly affects the texture of the image. However, the formation of microbubbles and their corresponding microstructure are poorly understood. In this paper, cellulose acetate microfilm from the Republic of China (AD 1912–1949) collected in the Second Historical Archives of China was chosen as a prototype to investigate the causes of microbubble disease for the first time. A comparative study was conducted between the film samples with and without microbubbles. Herein, the microstructural analyses including optical and SEM microscopy were conducted. The crystals in the microbubbles proved to be triphenyl phosphate as identified by NMR spectroscopy and SEM–EDX. Comparative properties of the film substrate with and without microbubbles were measured by TG, XRD and FT-IR spectroscopy. The results show that formation of microbubbles was generally accompanied with the vinegar syndrome and was produced between the protective and emulsion layers with the different types of shapes along the closed structure (the diameter of ~ 0.1–2 mm). The formed microbubble was filled with plasticizer. Based on the above-mentioned results, the possible formation process of microbubble was proposed in the present study. The results can provide support for the cause of microbubbles and basis for the conservation of photographic films. [ABSTRACT FROM AUTHOR]