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Simple Summary: We retrospectively evaluated the clinical outcomes of lung metastasectomy in 147 patients with pulmonary metastases from primary liver tumors at three medical centers. Multivariate analysis demonstrated that surgical resection as the initial primary liver tumor treatment and lower MELD-Na scores significantly correlated with better OS. These findings can guide thoracic surgeons in patient selection and predicting surgical outcomes. Oligopulmonary metastases from primary liver tumors are typically treated surgically. We evaluated the clinical outcomes after lung metastasectomy in patients with pulmonary metastases from primary liver tumors. We retrospectively enrolled 147 consecutive patients with lung metastases from liver cancer who had undergone pulmonary metastasectomies at three medical centers between February 2007 and December 2020. All patients were pathologically confirmed to have lung metastases from liver cancer. Among the 147 patients, 110, 17, and 20 initially underwent surgical resection, radiofrequency ablation, and transcatheter arterial embolization, respectively. The 5-year overall survival (OS) in the study cohort was 22%. Univariate analysis revealed four factors associated with better OS: surgical resection as the initial primary liver tumor treatment (p = 0.004), a disease-free interval exceeding 12 months after the initial liver surgery (p = 0.036), a lower Model for End-Stage Liver Disease (MELD)-Na score (≤20) for liver cirrhosis (p = 0.044), and the absence of local liver tumor recurrence at the time of pulmonary metastasectomy (p = 0.004). Multivariate analysis demonstrated that surgical resection as the initial primary liver tumor treatment and lower MELD-Na scores significantly correlated with better OS. Our findings can assist thoracic surgeons in selecting suitable patients for surgery and predicting surgical outcomes. [ABSTRACT FROM AUTHOR]

Due to strong mobility, low costs, and easy parking, the scooter has become an important mode of transportation in Taiwan. The number of traffic accidents is also increasing because of drivers' bad driving habits. For road traffic injury prevention, the government has approved the road safety policy to promote awareness of road safety. Thus, we propose an AI-based driving assistance system (AI-DAS) for scooter riders to prevent traffic accidents. In the AI-DAS, Raspberry Pi controls the camera and sensors for the scooter. The AI-DAS detects pedestrians and monitors lanes not only to warn riders and pedestrians by sound and light but also to drastically reduce accidents and traffic jams. The AI-DAS is implemented using the python programming language and is tested on the Raspberry Pi hardware platform. [ABSTRACT FROM AUTHOR]

Background: Statins are associated with improved survival outcomes in patients receiving immune checkpoint inhibitors (ICIs), but the impact of lipophilic and hydrophilic statin properties on patient outcomes is unknown. Objectives: We aim to investigate if statins with lipophilic properties are associated with clinical outcomes in patients receiving ICIs. Method: We conducted a retrospective cohort study at two tertiary referral centers in Taiwan comprising patients receiving ICIs between January 2015 and December 2021. We compared the comparative effect of lipophilic and hydrophilic statins on patient outcomes. The primary outcome was overall survival (OS) and the secondary outcome was progression-free survival (PFS). Results: Among 734 patients receiving ICIs, there were 51 lipophilic statin users, 25 hydrophilic statin users, and 658 nonusers. Lipophilic statin users had a longer median OS (38.0 [IQR, 16.7–not reached] vs. 15.2 [IQR, 8.2–not reached] months vs. 18.9 [IQR, 5.4 51.6] months) and PFS (13.0 [IQR, 4.7–41.5] vs. 8.2 [IQR, 2.2–14.7] months vs. 5.6 [2.3–18.7] months) than hydrophilic statin users and non-statin users. In Cox proportional hazard analyses, the use of lipophilic statins was associated with a 40–50% lower risk of mortality and disease progression compared with hydrophilic statin or non-statin users. Conclusions: The use of lipophilic statins seems to be associated with survival benefits in patients undergoing immunotherapy. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors have transformed the treatment landscape of cancer treatment, but only a fraction of patients responds to treatment, leading to an increasing effort to repurpose clinically approved medications to augment ICI therapy. Metformin has been associated with improved survival outcomes in patients undergoing conventional chemotherapy. However, whether metformin provides survival benefits in patients receiving immune checkpoint inhibitors (ICIs) is unknown. Methods: We performed a retrospective cohort study at two tertiary referral centers in Taiwan. All adult diabetes mellitus patients who were treated with ICIs between January 2015 and December 2021 were included. The primary and secondary outcomes were overall survival (OS) and progression-free survival (PFS), respectively. Results: In total, 878 patients were enrolled in our study, of which 86 patients used metformin and 78 patients used non-metformin diabetes medications. Compared with non-users, metformin users had a longer median OS (15.4 [IQR 5.6–not reached] vs. 6.1 [IQR, 0.8–21.0] months, P = 0.003) and PFS (5.1 [IQR 2.0—14.3] vs. 1.9 [IQR 0.7—8.6] months, P = 0.041). In a univariate Cox proportional hazard analysis, the use of metformin was associated with a reduction in the risk of mortality (HR: 0.53 [95% confidence interval: 0.35—0.81], P = 0.004) and disease progression (HR: 0.69 [95% CI 0.49—0.99], P = 0.042). The use of metformin remained associated with a lower risk of mortality after adjusting for baseline variables such as age, cancer stage, and underlying comorbidities (OS, HR: 0.55 [95% CI 0.34–0.87], P = 0.011). Similarly, the use of metformin was associated with a lower risk of disease progression. Importantly, the use of metformin before ICI initiation was not associated with a reduction in mortality (HR: 0.61 [95% CI 0.27—1.42], P = 0.25) or disease progression (HR: 0.69 [95% CI 0.33—1.43], P = 0.32). Conclusion: The use of metformin is associated with survival benefits in patients undergoing immunotherapy. Prospective clinical trials are warranted to define the role of metformin in augmenting immunotherapy. [ABSTRACT FROM AUTHOR]

The monitoring of droughts is practically important yet challenging due to the complexity of the phenomena. The occurrence of drought involves changes in meteorological conditions, vegetation coverage and soil moisture. To advance the techniques for detecting and monitoring droughts, this study explores the usage of a suite of vegetation and water indices derived from high-resolution images produced by geostationary satellite Himawari-8. The technique is tested on the detection of the drought event in Spring 2021 across Taiwan due to deficit of precipitation in that season. It is found that the time series analysis of green chlorophyll index (CIgreen) and normalized difference vegetation index (NDVI) helps detect the initiation of drought before its severity intensifies. The vegetation condition index (VCI) and vegetation health index (VHI) derived from GIgreen and NDVI are similarly useful for the early warning of a drought event. In addition to vegetation indices, the normalized difference water index (NDWI) is adopted for quantifying the deficit in precipitation. It is found that NDWI provides a better early warning system of drought compared to the vegetation indices. Combining the vegetation and water indices allows a more complete description of the evolution of drought for the Spring 2021 event. The potential for using the new framework for the early warning of future drought events is discussed. [ABSTRACT FROM AUTHOR]

This study uses the research structure of the experimental design, taking Taiwan specialty coffee beans as an example, and selects four aspects which are a coffee grind, brewing water temperature, coffee blooming, and coffee water powder ratio that is most likely to affect the coffee extraction rate and coffee concentration. Brewing with hand brewing equipment which is easier to buy in daily life, and obtain data analysis, and then conduct experiments and comparisons with coffee beans from other countries. The results of this study found that coffee beans from different producing areas can be slightly adjusted for different brewing techniques to reduce the consumption of coffee beans and reduce costs, to provide consumers and subsequent researchers with references and suggestions. [ABSTRACT FROM AUTHOR]

Satellite remote sensing sea surface temperature (SST) data are lost due to cloud cover. Missing data often cause inconvenience in subsequent applications and thus need to be reconstructed. In this study, the Data Interpolating Empirical Orthogonal Function (DINEOF) method was used to reconstruct the hourly SST data missing from the Himawari-8 satellite in the waters near Taiwan. The SST characteristics in the waters around Taiwan are quite complex, with high SST at Kuroshio in the east of Taiwan and great variation in the SST west of Taiwan due to the influence of tides. Therefore, the analysis with DINEOF was conducted using 25-h data to match the tidal cycle. The influence of SST characteristics on the accuracy of SST reconstruction is also discussed. The results show that in the western sea area where the variation of SST is large, the average root-mean-square error of SST between the original SST and the reconstructed SST is the lowest and the average coefficient of determination is the highest. The accuracy of the reconstructed SST is positively correlated with the SST variation. Furthermore, the statistical results also show that the DINEOF method can effectively reconstruct the SST regardless of the missing data rate. [ABSTRACT FROM AUTHOR]

Immune thrombocytopenia (ITP) is a condition that is distinct from thrombosis with thrombocytopenia syndrome (TTS) that may also occur after coronavirus disease 2019 (COVID-19) vaccinations. Previous reports revealed an increased ITP incidence after ChAdOx1, a vaccine for COVID-19. Our study aimed to highlight the key features of ITP after COVID-19 vaccination. From April to October 2021, we collected data on 23 patients, including nine men and 14 women, with ITP from five hospitals across Taiwan who received either the ChAdOx1 or mRNA-1273 vaccine before development or exacerbation of ITP. Our findings revealed that both ChAdOx1 and mRNA-1273 vaccines were associated with ITP. Many patients responded well to steroids and immune suppressants, which may also suggest that the nature of thrombocytopenia is more like ITP rather than TTS. Lack of thrombosis, low D-dimer level, and negative anti-PF4 result could help to exclude TTS, which is also a rare but a far more lethal condition. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the annual effective dose per capita attributed to computed tomography (CT) examinations in 2013 and to predict the population effective dose from 2000 to 2013 in Taiwan. Methods: A CT examination database collected from 30 hospitals was divided into 22 procedures and classified into six regions: head, neck, chest, abdomen, pelvis, and other, respectively. The effective doses in different regions were evaluated by dose-length product (DLP) multiplied by conversion factors. Results: The CT scan dose parameters were collected from 4,407 patients. For the six scanned regions, the percentages of patients scanned were: head (39.8%), neck (3.9%), chest (23.3%), abdomen (26.7%), pelvis (4.8%), and other (1.6%), respectively. The DLPs per patient (mGy·cm/patient) were head (1,071±225), neck (1,103±615), chest (724±509), abdomen (1,315±550), pelvis (1,231±620) and other (1,407±937), respectively. The number of CT examinations increased rapidly, with an average annual growth rate of 7.6%. The number of CT examinations in 2013 was 2.6 times that in 2000. The population effective dose was 0.30 mSv per capita in 2000 and increased to 0.74 mSv per capita in 2013, with an annual growth rate of 7.2%. The growth trend indicates that the effective dose will continue to rise in Taiwan. Conclusion: Some strategies should be applied to cope with this growth. Defining the CT dose reference level stipulated in official recommendations and encouraging the use of iterative reconstruction imaging instead of filtered back-projection imaging could be a useful method for optimizing the effective dose and image quality. [ABSTRACT FROM AUTHOR]

In this work, a wave run-up monitoring system and a model for forecasting the wave run-up height on a seawall were developed. Electrical conductivity sensors were installed on the seaward slopes of seawalls to measure the wave run-up heights. The general packet radio service protocol was used to transmit the measured data in real time to the desired remote location. The Princeton Ocean Model and WAVEWATCH III were used to predict the water levels and ocean waves, respectively, by using the available wind fields. The empirical formulas recommended in the Coastal Engineering Manual (2011) and EurOtop (2018) were adopted to estimate the run-up height. The wave run-up heights were forecasted 72 h in advance and were renewed at 6-h intervals as new wind fields became available. The developed monitoring system and forecasting model were combined for operational monitoring and forecasting of wave run-up on seawalls. The wave run-up monitoring system was set up at three seawalls along the southwestern coast of Taiwan from 2013 to 2016. Consistency between the forecasted and measured wave run-up heights during typhoon periods demonstrated the feasibility of using the proposed method for monitoring and forecasting wave run-up heights. Furthermore, the multi-model ensemble approach was adopted to improve the unsatisfactory run-up forecasting performance during typhoon periods, and the forecasted run-up heights were eventually presented as a band with upper and lower limits as opposed to single values. The forecast results can be used to provide advance warning of possible wave overtopping and associated coastal flooding during typhoon periods. • Electrical conductivity sensors on the seawall were used to establish an operational wave run-up monitoring system. • Operational run-up forecasting system was established based on the POM, WAVEWATCH III, and empirical formulas for run-up. • Combined wave run-up systems were operated on seawalls along the coast of Taiwan during typhoon periods. • Consistency between the forecasted and measured run-up heights during typhoon periods has been demonstrated. [ABSTRACT FROM AUTHOR]

• Iron-based oxygen carriers were pneumatically circulated and reacted in a 30-kW th moving bed chemical looping system. • The concentration of CO 2 produced in the reducer was 95%, and H 2 produced in the oxidizer reached 90%. • Oxygen carriers were nearly completely oxidized by air in the combustor resulting in temperature increase. • Parts of the oxygen carriers in the reducer were reduced to Fe, showing the integrating conversion rate of 61.5%. • In the oxidizer, the oxygen carrier contained Fe 3 O 4 , and the integrating conversion rate was 22.2%. A 30-kW th moving-bed chemical looping system has been developed at the Industrial Technology Research Institute of Taiwan. In this system, methane is supplied as a fuel to a reducer, and steam enters an oxidizer to produce hydrogen under ambient pressure. An iron-based oxygen carrier is used and pneumatically transported in the system. In this study, a hydrogen production test was performed on the system, while the methane flow rate was 40 L/min according to the capacity requirement of a 30-kW th system, and the oxygen carrier circulation rate was 2100 g/min for 40-wt% Fe 2 O 3 content. The concentration of carbon dioxide produced in the reducer was 95 %, and the concentration of hydrogen produced in the oxidizer reached 90 %. Partially oxidized oxygen carriers then reacted with air in the combustor, leading to a temperature increase of approximately 120°C. The oxygen carriers in the reducer were reduced to Fe, and the integrating conversion rate was 61.5 %. In the oxidizer, the oxygen carrier contained Fe 3 O 4 , and the integrated conversion rate was 22.2 %. 75 % of the oxygen carriers in the combustor exhibited a conversion rate of 5.3 %, indicating a nearly complete oxidation state. By conducting the hydrogen production test while effectively removing small particles of worn oxygen carriers from the system, the moving-bed chemical looping system was evaluated for the circulation and reaction of oxygen carriers. The system development experience will be used for system scale-up design. [ABSTRACT FROM AUTHOR]

The formosan land-locked salmon is one of the representative but endangered species in Taiwan and the first-order stream of Yushen Creek in Chichiawan Watershed, Taiwan is the major habitat for the salmons. Unfortunately, the intensive water exchanges beneath the streambed caused the creek to cease flow, and the fragmented creek could not provide a sustainable environment for the rehabilitation and the population of salmon was significantly reduced. To comprehensively understand the mechanisms of surface water and groundwater interaction and mitigate the effect of fragmentation on the salmon habitat, the tracer tests and numerical models were conducted to characteristic hyporheic flux exchanges beneath the stream. Seven observation wells and seven piezometers along the stream were installed to provide long-term water levels, temperatures, and electrical conductivities of surface water and groundwater. Five tracer tests from April, 2017 to May, 2018 were conducted at different sections of reach to delineate the horizontal and vertical hyporheic flow paths and seepage flow directions through the breakthrough curves. OTIS and VS2DT were selected to simulate the concentration variations in the stream and streambed, respectively and quantify the hydraulic characteristics of hyporheic zone. The estimated storage zones and exchange coefficients by the OTIS model were used to mimic the hyporheic cells and fed into the VS2DT model to identify the hyporheic and seepage flows. The simulated results revealed that the first-order stream has frequent flux exchanges beneath a high porosity gravel streambed but this intensive interaction reduces with the existence of confluences and the high level of baseflow. The results also demonstrated the effect of topography on the flow path that water flows out of the upstream wetted channel and back into downstream wetted channel to avoid the areas of step-riffle. Finally, the hydraulic characteristics of streambed, streamflow, and morphology of stream should be considered to mitigate the fragmentation when conducting the river restoration of the first-order stream in the alpine watershed. [ABSTRACT FROM AUTHOR]

Cationic amphiphilic antihistamines have been shown to improve patient outcomes in immunogenic tumours, but whether they can augment and improve response to immunotherapy is unknown. We aim to evaluate the effect of cationic amphiphilic antihistamines in patients receiving immune checkpoint inhibitors (ICIs). We conducted a retrospective propensity score-matched cohort study at two tertiary referral centres in Taiwan between January 2015 and December 2021. Patients who received desloratadine, cyproheptadine, and ebastine were classified as cationic amphiphilic antihistamine users. The primary outcome was overall survival, and the secondary outcomes were progression-free survival and clinical benefit rate. Patients treated with cationic amphiphilic antihistamines were matched to patients who received non-cationic amphiphilic antihistamines based on variables including age, cancer type, stage, and history of allergic diseases. A total of 734 ICI-treated patients were included. After matching, 68 cationic amphiphilic antihistamine and non-cationic amphiphilic antihistamine users remained for analysis. Compared with non-cationic amphiphilic antihistamine users, patients who received cationic amphiphilic antihistamines had a significantly longer median overall survival (24.8 versus 10.4 months; Log-rank, p = 0.018) and progression-free survival (10.6 versus 4.93 months; Log-rank, p = 0.004). The use of cationic amphiphilic antihistamines was associated with an approximately 50% lower risk of all-cause mortality (HR, 0.55 [95% CI: 0.34–0.91]). Survival benefits were not seen in patients who received cationic amphiphilic antihistamines before immune checkpoint blockade. These survival benefits were observed regardless of the generation of cationic amphiphilic antihistamines. The use of cationic amphiphilic antihistamines was associated with improved survival among patients treated with immunotherapy. • Study evaluating the effects of cationic amphiphilic antihistamines on immune checkpoint inhibitor therapy. • Cationic amphiphilic antihistamines were associated with survival benefits. • Effects not seen in patients who took cationic amphiphilic antihistamines before immune checkpoint inhibitor. • Benefits observed regardless of the generation of cationic amphiphilic antihistamines. [ABSTRACT FROM AUTHOR]

Objective: Statins have been demonstrated to improve outcomes in patients receiving immune checkpoint blockade (ICB). This study aimed to investigate whether the timing of statin administration influences the outcomes of patients receiving ICB., Methods: We conducted a retrospective cohort study utilizing electronic health records from two tertiary referral centers in Taiwan. We compared the overall survival (OS) and progression-free survival (PFS) of patients who received statins before and after ICB initiation., Results: We included 734 patients who received ICB. Among them, 606 were non-statin users, 76 started statins after ICB initiation, and 52 started statins before ICB initiation. Post-ICB statin users demonstrated significantly prolonged OS (median 37.6 versus 10.3 versus 11.3 months, p  = 0.009) and PFS (median 10.5 versus 6.3 versus 5.6 months, p  = 0.024) compared to pre-ICB statin and non-statin users. Statin use after ICB initiation had a reduced risk of all-cause mortality (HR, 0.65 [95% CI: 0.45-0.94], p  = 0.022) and progressive disease (HR, 0.71 [95% CI: 0.53-0.95], p  = 0.021) by approximately 30-35%, compared to non-statin users. However, statin use prior to ICB initiation did not affect the risk of all-cause mortality or progressive disease. Similar results were observed after controlling for potential cofounders such as age, sex, cancer stage, and cancer type., Conclusions: These findings suggest that initiating statin therapy after the initiation of ICB, regardless of indication, is associated with improved patient prognosis.

Purpose: Adenocarcinoma is the most dominant type of lung cancer in never-smoker patients. The risk alleles from genome-wide association studies have small odds ratios and unclear biologic roles. Here we have taken an approach featuring suitable medical actionability to identify alleles with low population frequency but high disease-causing potential., Patients and Methods: Whole-genome sequencing was performed for a family with an unusually high density of lung adenocarcinoma with available DNA from the affected mother, four affected daughters, and one nonaffected son. Candidate risk alleles were confirmed by matrix-assisted laser desorption ionization time of flight mass spectroscopy. Validation was conducted in an external cohort of 1,135 participants without cancer and 1,312 patients with lung adenocarcinoma. Family follow-ups were performed by genotyping the relatives of the original proband and the relatives of the identified risk-allele carriers. Low-dose computed tomography scans of the chest were evaluated for lung abnormalities., Results: YAP1 R331W missense mutation from the original family was identified and validated in the external controls and the cohort with lung adenocarcinoma. The YAP1 mutant-allele carrier frequency was 1.1% in patients with lung adenocarcinoma compared with 0.18% in controls (P = .0095), yielding an odds ratio (adjusted for age, sex, and smoking status) of 5.9. Among the relatives, YAP1-mutant carriers have overwhelmingly higher frequencies of developing lung adenocarcinoma or ground-glass opacity lung lesions than those who do not carry the mutation (10:0 v 1:7; P < .001). YAP1 mutation was shown to increase the colony formation ability and invasion potential of lung cancer cells., Conclusion: These results implicated YAP1 R331W as an allele predisposed for lung adenocarcinoma with high familial penetrance. Low-dose computed tomography scans may be recommended to this subpopulation, which is at high risk for lung cancer, for personalized prevention and health management., (© 2015 by American Society of Clinical Oncology.)

Background: GP.Mur (Mi.III) is a glycophorin B-A-B hybrid sialoglycoprotein expressing several potent immunogens, including Mi(a), Mur, and Hil. GP.Mur is considered one of the most important red blood cell (RBC) phenotypes in blood banking in Southeast Asia. However, there are no antibodies commercially available for the screening of GP.Mur RBCs., Study Design and Methods: To develop a direct blood polymerase chain reaction (PCR) approach for the screening of GP.Mur cells, we first confirmed the genomic sequence differences among four GP.Mur and three Mi(a-) samples by sequencing their GYP.Mur and GYPB genes. With these data, we designed PCR primers that best discriminate GYPB and GYP.Mur. Our primer design also allows the detection of other Hil+ glycophorin variants. We also constructed two plasmids--pGBi2i3 and pMiIIIi2i3--which serve as the negative and positive control DNA, respectively, for the PCR procedure. Additionally, we designed a control PCR to be run side by side with the typing PCR., Results: Because of the high specificity of our primers, we found it unnecessary to extract DNA from blood samples for PCR. We have tested this PCR method on 379 fresh and frozen blood samples. The results were further validated by serology and DNA sequencing and were shown to be completely accurate in our hand. We also found that the rapid genotyping method--high-resolution melting--can be a timesaving alternative for DNA sequencing., Conclusion: This direct blood PCR approach for determination of GP.Mur and related Hil+ phenotypes is reliable and economical and is expected to be useful for blood banking in Southeast Asia., (© 2012 American Association of Blood Banks.)