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BackgroundThe COVID-19 pandemic prompted social distancing policies and caused misinformation that hindered in-person HIV screening for high-risk groups. Social media platforms provide additional options for voluntary counseling and testing (VCT) for HIV, overcoming these limitations. However, there is a lack of data on HIV testing recruitment through social media platforms and its outcomes during the pandemic. ObjectiveThis study aimed to measure the rate of face-to-face mobile and video VCT conducted after recruitment through social media platforms and friend referrals during the pandemic and compare the geographic distribution, risk feature targeting, testing outcome, and cost between the 2 models. MethodsData were collected from March 3 to December 31, 2021, during the COVID-19 outbreak in Taiwan. Participants engaging in unprotected sex were recruited. After one-on-one message discussions through the platforms, the well-trained research assistants provided mobile or video VCT based on the participants’ availability. Primary outcomes were completion rate, testing results, and CD4 count. Secondary outcomes included demographic and HIV risk-taking and protective features from a questionnaire. Selection bias was controlled by adjusting for the testing site (Taipei vs non-Taipei) using univariable multinomial logistic regression. ResultsThis study gathered 5142 responses on the social media platforms, recruiting 1187 participants. Video VCT had a completion rate of 31.8% (207/651), higher than mobile VCT’s 21.8% (980/4491). Both rates were higher than those before the COVID-19 pandemic. Recruitment through friend referrals, instant messaging apps (eg, Line [LY Corporation]), and geosocial dating apps (eg, Hornet [Queer Networks Inc], Grindr [Grindr LLC], and Gsland [Tien-Hao Tsai]) resulted in higher acceptance and completion rates than social networks (eg, Facebook [Meta], X [formerly Twitter], and Instagram [Meta]). Mobile VCT had higher recruitment among urban residents and screening density, while video VCT reached a broader geographic area. The mobile group was more likely to have had more than 10 sexual partners (odds ratio [OR] 1.92, 95% CI 1.05-3.50; P=.03), history of sex work (OR 4.19, 95% CI 1.68-10.43; P=.002), and sexually transmitted diseases (OR 2.23, 95% CI 1.18-4.23; P=.01) within the past 3 months. The video group was more likely to meet sexual partners through social media. The HIV-positive rate in the mobile group was 0.7% (7/973) with an average CD4 count of 460/μL, while in the video group, it was 1% (2/205) with an average CD4 count of 347/μL, indicating a later diagnosis. Both positivity rates were higher than those before the COVID-19 pandemic, with no significant difference between the groups. The video group cost US $54.68 per participant, slightly higher than the US $50.36 for the mobile group. ConclusionsRecruiting through social media platforms that facilitate one-on-one message discussions can effectively target high-risk groups for mobile and video VCT. This approach should be integrated into the current screening model to enhance HIV case finding.

Abstract Herein, this work aims to develop a facile method for the fabrication of metallic mechanical metamaterial with a well-ordered diamond structure from a bottom-up approach using a self-assembled block copolymer for templated electrochemical deposition. By controlling the effective volume fraction of PDMS in PS-b-PDMS via solvent annealing followed by HF etching of PDMS, it is feasible to obtain nanoporous PS with diamond-structured nanochannels and used it as a template for templated electrochemical deposition. Subsequently, well-ordered nanonetwork gold (Au) can be fabricated. As evidenced by nanoindentation and micro-compression tests, the mechanical properties of the diamond-structured Au after removal of PS give the combination of lightweight and mechanically robust characteristics with an exceptionally high reduced elastic modulus of 11.9 ± 0.6 GPa and yield strength of 193 ± 11 MPa above the Hashin-Shtrikman upper bound of 72 MPa with a bending-dominated structure at equivalent density. The corresponding deformation mechanism can be elucidated by morphological observations experimentally and finite element analysis (FEA) numerically. This work demonstrates the bottom-up approach to fabricating metallic monolith with diamond structure in the nanoscale, giving a superior performance as mechanical metamaterials.

BackgroundMobile voluntary counseling and testing (VCT) for HIV has been carried out to improve the targeting of at-risk populations and HIV case detection for men who have sex with men (MSM). However, the HIV-positive detection rate using this screening strategy has declined in recent years. This may imply unknown changes in risk-taking and protective features jointly influencing the testing results. These changing patterns in this key population remain unexplored. ObjectiveThe aim of this study was to identify the nuanced group classification of MSM who underwent mobile VCT using latent class analysis (LCA), and to compare the difference in characteristics and testing results between subgroups. MethodsA cross-sectional research design and purposive sampling were applied between May 21, 2019, and December 31, 2019. Participants were recruited by a well-trained research assistant through social networking platforms, including the most popular instant messenger app Line, geosocial network apps dedicated to MSM, and online communities. Mobile VCT was provided to participants at an assigned time and place. Demographic characteristics and risk-taking and protective features of the MSM were collected via online questionnaires. LCA was used to identify discrete subgroups based on four risk-taking indicators—multiple sexual partners (MSP), unprotected anal intercourse (UAI), recreational drug use within the past 3 months, and history of sexually transmitted diseases—and three protective indicators—experience of postexposure prophylaxis, preexposure prophylaxis use, and regular HIV testing. ResultsOverall, 1018 participants (mean age 30.17, SD 7.29 years) were included. A three-class model provided the best fit. Classes 1, 2, and 3 corresponded to the highest risk (n=175, 17.19%), highest protection (n=121, 11.89%), and low risk and low protection (n=722, 70.92%), respectively. Compared to those of class 3, class 1 participants were more likely to have MSP and UAI within the past 3 months, to be ≥40 years of age (odds ratio [OR] 2.197, 95% CI 1.357-3.558; P=.001), to have HIV-positive results (OR 6.47, 95% CI 2.272-18.482; P

Skin-inspired flexible tactile sensors, with interfacial microstructure, are developed on cellulose fiber substrates for subtle pressure applications. Our device is made of two cellulose fiber substrates with conductive microscale structures, which emulate the randomly distributed spinosum in between the dermis and epidermis layers of the human skin. The microstructures not only permit a higher stress concentration at the tips but also generate electrical contact points and change contact resistance between the top and bottom substrates when the pressure is applied. Meanwhile, cellulose fibers possessing viscoelastic and biocompatible properties are utilized as substrates to mimic the dermis and epidermis layers of the skin. The electrical contact resistances (ECR) are then measured to quantify the tactile information. The microstructures and the substrate properties are studied to enhance the sensors’ sensitivity. A very high sensitivity (14.4 kPa−1) and fast recovery time (approx. 2.5 ms) are achieved in the subtle pressure range (approx. 0–0.05 kPa). The device can detect subtle pressures from the human body due to breathing patterns and voice activity showing its potential for healthcare. Further, the guitar strumming and chord progression of the players with different skill levels are assessed to monitor the muscle strain during guitar playing, showing its potential for posture feedback in playing guitar or another musical instrument.

Curriculum Guidelines of 12-Year Basic Education aims to encourage students to become spontaneous and motivated learners and develop them with excellent social adaptability, emphasizing taking the initiative, engaging in interaction, and seeking the common good ultimately achieve the goal of lifelong learning. The goals of the Curriculum Guidelines and character education are interweaved. However, teachers always ignore the importance of character education due to its absence in curriculum. This research was initiated by the teacher community, hoping to engage students in good morals. Based on the concept of philosophy for children, teachers designed curriculum and implemented in seventh and eighth grade students, trying to transfer good characters from cognitive understanding to practical actions. Observation data, teacher's journal, and student worksheets were collected; besides, teachers and students were interviewed. The results discussed from three aspects, "the awareness of teachers' teaching", " the process of students' learning " and " the change of school's atmosphere ". Finally, suggestions for future researches were provided. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic that swept the world in 2020 has highlighted the dangers and challenges posed by infectious diseases and encouraged healthcare providers to further re-think the stigma of epidemic and pandemic diseases. HIV infection was reclassified as a chronic disease in Taiwan after highly active antiretroviral therapy was introduced in the country. Because HIV infection is related to behavior, people living with HIV are often affected by a negative social image that is influenced by multiple stereotypes and the general stigma toward AIDS. In Taiwan, this stigma is deeply influenced by Eastern philosophy and Confucian culture, making the context and effect of stigma different from Western countries. The current "U=U" concept of HIV treatment holds that someone under treatment for HIV with an undetectable HIV viral load cannot sexually transmit the virus to others. Therefore, in the post-pandemic era, HIV medical care personnel should apply evidence-based-care thinking. This article describes HIV stigma in the context of Confucianism, U=U as the leading concept of HIV treatment, and the recommended approach to care for HIV healthcare practitioners in the post-COVID-19 era. Reducing HIV stigma will enable Taiwan to achieve the 'Three Zeros' of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Program on HIV/AIDS for ending the AIDS epidemic by 2030. [ABSTRACT FROM AUTHOR]

Objective: Acupuncture, a widely employed traditional therapeutic modality known for its efficacy in pain alleviation and diverse condition management, may inadvertently result in mechanical nerve injury due to its invasive nature. This research aimed to ascertain the incidence of nerve injuries post-acupuncture, identify associated risk factors, and map the distribution of nerve injury sites. Methods: A case-control study nested in the National Health Insurance Research Database (NHIRD) 2000–2018 two million cohort was conducted. Patients previously diagnosed with nerve injury, surgery, or degeneration before acupuncture were excluded. Cases were defined as patients receiving acupuncture and seeking medical attention for nerve injury (ICD9-CM code 950–957) within 14 days post-procedure, while control groups comprised patients undergoing acupuncture without subsequent adverse events. Invasive treatments prior to adverse events and adverse events occurring more than 14 days post-acupuncture were excluded. To ensure case-control comparability, factors such as age, gender, socioeconomic status, and medical facility environment were controlled using propensity score matching. Results: The study encompassed 14,507,847 acupuncture treatments administered to 886,753 patients, with 8361 instances of post-acupuncture nerve injury identified, representing an incidence rate of approximately 5.76 per 10,000 procedures. Age emerged as a significant risk factor, with the adjusted odds ratios escalating with age. Several comorbidities including diabetes, hypothyroidism, liver cirrhosis, chronic kidney disease, herpes zoster, hepatitis virus, rheumatoid arthritis, systemic lupus erythematosus, dementia, and cerebrovascular accidents were associated with an elevated risk of nerve injury post-acupuncture. Conclusion: This study underscores the importance of meticulous patient profiling and cautious therapeutic approach in acupuncture, considering the evident influence of various demographic, systemic, and treatment-related factors on the incidence of nerve injuries.

Objectives: Normal-pressure hydrocephalus is a clinical syndrome consisting of dilated cerebral ventricles with the clinical triad of gait disturbance, cognitive impairment and/or urinary dysfunction. Lumbar-peritoneal (LP) shunt could improve idiopathic normal pressure hydrocephalus (iNPH) while its effectiveness on secondary NPH (sNPH) is elusive. We compared the clinical results of the patients who received LP shunt surgery between iNPH and sNPH. Materials and Methods: We retrospectively analyzed the patients who received LP shunt surgery in a single center from January 1, 2017, to June 30, 2017. Patients selected for LP shunt placement had at least two of three cardinal symptoms of iNPH. The symptoms should persist for more than 3 months with compatible brain magnetic resonance imaging findings. All patients were followed up with iNPH grading scale (iNPHGS) and Modified Rankin Scale (MRS) for evaluation. Results: Thirty-three patients (23 male and 10 female patients) with mean age 76-year-old completed follow-up in this study, and 17 patients received lumbar drainage tests and intracranial pressure measurements. Both iNPH (n = 22) and sNPH (n = 11) groups did not have major complications such as infection, nerve root injury, or shunt failure. Both groups have significant improvement in iNPHGS and MRS. Interestingly, we found the correlation between both opening intracranial pressure and pressure gradient difference to the improvement percentage from LP shunt. Conclusion: The safety and effectiveness for sNPH patients who received LP shunt placement are equivalent to the iNPH patients. Lumbar drainage test provides prerequisite outcome prediction and should be considered to identify NPH patients planned to receive LP shunt.

Objectives: The main aim of this study was to examine the association of sarcopenia and subjective memory complaints with the incidence of dementia in a population-based cohort of cognitively unimpaired older adults., Design: Three-year longitudinal study., Settings and Participants: A total of 2163 community-dwelling persons aged 65 years or older who participated in the National Health Interview Survey in Taiwan, 2017., Measurements: Sarcopenia was determined based on SARC-F, a self-reported symptom-based questionnaire that includes five components: strength, assistance walking, rise from a chair, climb stairs, and falls. Two questions ("Do you have difficulties with your memory or attention?" and "Do you have difficulties with your memory only or attention only or both?") were used to screen for subjective memory complaints (SMCs). The incidence of dementia was determined by data linkage to the Taiwan National Health Insurance claims database from 2018 to 2020., Results: Among the 2163 participants without dementia at baseline, 135 had incident dementia during the 3-year follow-up, giving a crude incidence rate of 6.2% (135/2163). Compared to participants free from sarcopenia and SMCs, the adjusted hazard ratio for incident dementia was 1.83 (95% confidence interval [CI]: 1.23-2.72) for SMCs alone, 2.40 (95% CI: 1.17-4.93) for sarcopenia alone, and 2.49 (95% CI: 1.21-5.11) for coexisting SMCs and sarcopenia., Conclusions: Our results indicate that sarcopenia screened with SARC-F and SMCs independently predict the cognitively unimpaired older adults at risk of incident dementia. Our findings highlight the importance of screening not only for cognitive but also muscle deficits to identify those at increased risk of incident dementia., Competing Interests: The authors have no conflicts of interest to declare