Search

Rainfall-induced shallow landslide is a coupled hydro-mechanical behavior involving the advancement of wetting fronts during the infiltration process, resulting in reducing the soil resistance from matric suction of unsaturated soil mass. The hydrologic process and mechanical response of the soil mass are coupled via the soil water characteristic curve (SWCC), unsaturated hydraulic conductivity function (HCF), and variations of effective stress of unsaturated soils. To study the coupled behavior, Internet-of-Things (IoT) based sensing modules integrated with subsurface moisture content measurement and surface inclination were developed and deployed in a high failure potential slope. The slope failed during heavy rainfall and the modules continuously recorded the advancement of the wetting front and the development of surface inclination in real time. The results agree with the integrated analysis framework by Chang et al. (2021), in which the 1D infiltration analysis is coupled with the limit equilibrium approach for infinite slopes of unsaturated soil. The technologies of in-situ monitoring and coupled analysis prove the feasibility of physics-based warning of shallow landslides.

Purpose Emergency endotracheal intubations outside the operating room (OR) are associated with high complications. We compare the outcome of emergency endotracheal intubation in the general ward, the intensive care unit (ICU) and the emergency department (ED). Materials and methods We retrospectively analyzed adult patients requiring emergency endotracheal intubation that called for anesthesiologists at our tertiary care institution from January 1, 2015 to December 31, 2016. We evaluated the outcomes, including aspiration, hemodynamic collapse, pneumothorax, emergency tracheostomy, and survival to hospital discharge in the general ward, ICU, and ED. Results There were 416 non-OR emergency endotracheal intubation calls for the anesthesiologist. Among these areas, the ED had the highest proportion of difficult endotracheal (DET) intubation (n = 144 [80.4%]), followed by the general ward (n = 85 [66.4%]), and then the ICU (n = 65 [59.6%]). The incidence of hemodynamic collapse was higher in the general ward (n = 44 [34.4%]) than the ICU (n = 18 [16.5%]) or the ED (n = 16 [9.0%]). We reported the survival rate of the general ward (55.5%), which was lower than the ICU (63.3%) and the ED (80.4%). Among these locations, the ED had the highest rate of neurologically intact (91%) to hospital discharge, compared to the ICU (56.6%) and the general ward (55%). As for the ED, although there was no difference in survival between non-preventive and preventive intubations, preventive intubations was associated with high neurological intact with hospital discharge. Conclusion Emergency and DET intubation in the general ward and ICU resulted in a higher incidence of hemodynamic collapse and mortality than those performed in the ED. Early calls for the anesthesiologist for DET intubation without medications in the ED resulted in a higher rate of neurologically intact survival to hospital discharge.

Thermal photoluminescence (PL) quenching is fundamentally important for perovskite optoelectronic applications. Herein, we investigated PL characteristics of CsSnBr3 microsquares and micropyramids ...

The long-term outcomes of surgical ablation for atrial fibrillation (AF) during cardiac surgery remain unclear.This nationwide population-based retrospective cohort study used data from Taiwan's National Health Insurance Research Database. Overall, 11,459 patients undergoing coronary artery bypass graft, valve, or aortic surgery and diagnosed as having AF between January 1, 2001, and December 31, 2016, were included. To reduce possible selection bias, we created a propensity score-matched cohort and compared outcomes between groups. The outcomes of interest were long-term survival and late ischemic stroke.The surgical ablation group had a significantly lower risk of all-cause mortality (5.74 and 7.69 events per 100 patient-years, respectively; hazard ratio, 0.75; 95% CI, 0.69-0.81) and ischemic stroke after discharge (1.88 and 2.52 events per 100 patient-years, respectively; subdistribution hazard ratio, 0.78; 95% CI, 0.67-0.91). AF ablation performed concomitantly with coronary artery bypass graft surgery, tissue aortic valve replacement, tissue mitral valve replacement, or mitral valve repair led to significantly better long-term survival (P = .0176, P = .0001, P.0001, P.0001, respectively). The surgical ablation group also had better long-term survival than the matched general AF population (log-rank test, P.001).Concomitant AF ablation during cardiac surgery is safe, does not increase the rate of perioperative complications, and confers the benefit of long-term survival after cardiac surgery in adults. AF ablation also improved cardiac surgery patients' long-term survival compared with the matched general AF population.

Background Recent population-based studies have revealed that the use of fluoroquinolones (FQs) is associated with an increased risk of aortic dissection (AD) and aneurysm (AA). However, no evidence is available on whether FQs increase adverse events in patients who had been diagnosed with AD or AA. Objectives This study investigated whether the use of FQs increases the risk of aortic-related adverse events and death in this high-risk population. Methods A retrospective cohort study was conducted by using the Taiwan National Health Insurance Research Database. A total of 31,570 adult patients who survived after admission for AD or AA between 2001 and 2013 were identified. We divided each calendar year into 6 data units (2 months) for each patient and each year during follow-up. Covariates and exposure of interest (FQs) were reassessed every 2 months. We used another common antibiotic, amoxicillin, as a negative control exposure. Results Exposure to FQs was associated with a higher risk of all-cause death (adjusted hazard ratio: 1.61; 95% confidence interval: 1.50 to 1.73), aortic death (adjusted hazard ratio: 1.80; 95% confidence interval: 1.50 to 2.15), and later aortic surgery. However, amoxicillin exposure was not significantly associated with risk of any of the outcomes. A subgroup analysis revealed that the effect of FQs was not significantly different between the AD and AA groups. Conclusions Relative to amoxicillin use, FQ exposure in patients with AD or AA was associated with a higher risk of adverse outcomes. FQs should not be used by high-risk patients unless no other treatment options are available.

Controlling matter-light interactions with cavities is of fundamental importance in modern science and technology. It is exemplified in the strong-coupling regime, where matter-light hybrid modes form, with properties controllable via the photon component on the optical-wavelength scale. In contrast, matter excitations on the nanometer scale are harder to access. In two-dimensional van der Waals heterostructures, a tunable moir\'e lattice potential for electronic excitations may form, enabling correlated electron gases in lattice potentials. Excitons confined in moir\'e lattices have also been reported, but cooperative effects have been elusive and interactions with light have remained perturbative. Here, integrating MoSe$_{2}$-WS$_{2}$ heterobilayers in a microcavity, we establish cooperative coupling between moir\'e-lattice excitons and microcavity photons up to liquid-nitrogen temperature, thereby integrating into one platform versatile control over both matter and light. The density dependence of the moir\'e polaritons reveals strong nonlinearity due to exciton blockade, suppressed exciton energy shift, and suppressed excitation-induced dephasing, all of which are consistent with the quantum-confined nature of the moir\'e excitons. Such a moir\'e polariton system combines strong nonlinearity and microscopic-scale tuning of matter excitations with the power of cavity engineering and long range coherence of light, providing a new platform for collective phenomena from tunable arrays of quantum emitters.

The fall armyworm (FAW), Spodoptera frugiperda (Smith), is a major pest native to the Americas. A recent invasion of FAWs from Africa eastward to South Asia, the Indochina Peninsula, and mainland China has received much attention due to the considerable economic losses in agriculture. FAWs can rapidly colonise a new area, likely due to the wide range of host plants, good flying capability, and high egg production. Therefore, a convenient, quick, and accurate tool for FAW identification is urgently required to establish a FAW invasion management strategy. In this study, FAW-specific primers were designed to recognise FAWs on the basis of internal transcribed spacer 1 (ITS1). The results revealed the accurate FAW recognition of the three congeneric species and eight common corn lepidopteran pests, especially at their larval stage. Furthermore, species-specific primers have confirmed their efficacy by using 69 FAW specimens from Taiwan, Thailand, and the United States, with a 96% success rate, excluding 3 decayed specimens. By using the simple, reliable, and convenient FAW-specific primers, a pest management programme can be developed not only to reduce sequencing costs and experimental time from 2 days to 4 h, but eradicate the FAW as soon as it enters a new area.

Background Aortic dissection (AD) is a life-threatening emergency. However, the heritability and association of family history with late outcomes are unclear. Objectives The purpose of this study was to evaluate the effect of family history of AD on the incidence and prognosis of AD and estimate the heritability and environmental contribution in AD in Taiwan. Methods Both cross-sectional and cohort studies were conducted using Taiwan National Health Insurance database. A registry parent–offspring relationship algorithm was used to reconstruct the genealogy of this population for heritability estimation. The cross-sectional study included 23,868 patients with a diagnosis of AD in 2015. The prevalence and adjusted relative risks (RRs) were evaluated, and the liability threshold model was used to examine the effects of heritability and environmental factors. Furthermore, a 1:10 propensity score–matched cohort comprising AD patients with or without a family history of AD was included to compare late outcomes in the cohort study. Results A family history of AD in first-degree relatives was associated with an RR of 6.82 (95% confidence interval [CI]: 5.12 to 9.07). The heritability of AD was estimated to be 57.0% for genetic factors, and 3.1% and 40.0% for shared and nonshared environmental factors, respectively. After excluding individuals with Marfan syndrome or bicuspid aortic valve, a family history of AD was associated with an RR of 6.56 (95% CI: 4.92 to 8.77) for AD. Furthermore, patients with AD and a family history of AD had a higher risk of later aortic surgery than those with AD without a family history (subdistribution hazard ratio: 1.40; 95% CI: 1.12 to 1.76). Conclusions A family history of AD was a strong risk factor for AD. Furthermore, patients with AD with a family history of AD had a higher risk of later aortic surgery than those with no family history of AD.

The IBIS algorithmic modeling interface (IBIS-AMI) has become the standard methodology to model Serializer/Deserializer (SerDes) behavior for end-to-end high-speed serial link simulations. Meanwhile, machine learning (ML) techniques can mimic a black-box system behavior. This article proposes the self-evolution cascade deep learning (SCDL) model to show a parallel approach to effectively modeling adaptive SerDes behavior. Specifically, the proposed self-guide learning methodology uses its own failure experiences to optimize its future solution search according to the prediction of the receiver equalization adaptation trend. The proposed SCDL model can provide the high-correlation adaptation results, while the adaptation simulation time is much faster than conventional IBIS-AMI models.

OBJECTIVES Extracorporeal membrane oxygenation (ECMO) is used for life support in patients with liver cirrhosis (LC). However, there have been no studies evaluating the outcome of ECMO support in patients with LC. METHODS Using Taiwan’s National Health Insurance (NHI) database, we retrospectively evaluated patients with LC who received veno-venous or veno-arterial ECMO between 1 January 2000 and 31 December 2013. The outcomes included ECMO-related complications, in-hospital mortality, all-cause mortality and long-term outcomes in patients with and without LC. RESULTS A total of 7003 patients who received ECMO, of whom 233 (3.3%) had LC, were eligible for analysis. The LC patients who received ECMO support had a significantly higher risk of in-hospital mortality than the non-LC group (76.4% vs 60.7%; odds ratio 1.97; 95% confidence interval 1.44–2.70). The LC group also had a higher risk of complications, including de novo dialysis and massive blood transfusion with >10 units of red blood cells. Patients ≥65 years of age, patients with respiratory disease, patients with hypoalbuminaemia and liver transplant patients had higher in-hospital and 1-year mortality. The mortality rates for patients with 2 or more risk factors were 90.3% and 95.8%, respectively. LC was associated with a higher incidence of all-cause mortality and liver-related outcomes during follow-up. CONCLUSIONS Our findings raise questions regarding the utility of ECMO for LC patients, especially when >2 risk factors have been identified. ECMO support for LC patients should be used with caution and with careful patient selection.

This prospective study investigated the preventive effect of transcutaneous electrical nerve stimulation (TENS) for postoperative thirst.This experimental study was conducted with the CONSORT checklist.A total of 105 surgical patients who received general anesthesia were recruited from a medical center. Each patient was randomly assigned to the experimental group (n = 53; 20 min of TENS) or the control group (n = 52; routine care). In each group, oral moisture wetness was measured at 1 min, 20 min, and 50 min post-surgery. Descriptive and inferential statistics (Chi-square test, t test, one-way ANOVA, and generalized estimating equation (GEE) regression analysis) were performed to assess the proposed relationships.The two groups showed similar characteristics at baseline. The oral moisture wetness was significantly higher in the experimental group than the control group at each post-surgery assessment time (all P.001). The GEE results showed that patients in the experimental group reported more oral moisture wetness than patients in the control group.This study demonstrated that TENS can reduce thirst reported by patients after general anesthesia. Thus, this method may have clinical applications for managing postoperative thirst.

Background The sutureless valve has gained popularity for degenerative aortic valve stenosis but not congenital bicuspid aortic valve (BAV) due to anatomical challenges. We reviewed our modified implant techniques for patients with BAV. Methods From June 2015 to June 2019, 66 patients with aortic valve stenosis were treated with the Perceval sutureless valve, 20 of whom had BAV. The demographics, type of BAV (the Sievers classification), and associated pathologies, surgical outcomes, and midterm hemodynamics were recorded. Results The median age was 64 (range: 49–81) years and the Society of Thoracic Surgeons score was 2.186 (range: 0.407–6.384). Annular plication was performed in 9 (75%) of 12 type 0 and 3 (37.5%) of 8 type I, with implanted valve sizes of M, L, and XL in 6, 10, 4 cases, respectively. Three patients, all type 0 in the initial learning periods, required intraoperative redeployment due to malposition of the valve. The final implant was successful in all without conversion to traditional prosthesis. The median extubation time was 4 hours and the durations of intensive care unit and hospital stay were 1 and 6 days. At a median follow-up of 46 (23–72) months, there was one late mortality due to hemorrhagic stroke sequel. The last echo revealed none had more than mild paravalvular leakage and the mean transvalvular pressure gradient remained stable at 9.70 (range: 6.94–15.0) mm Hg. Conclusions The sutureless valve can achieve satisfactory outcomes in BAV without paravalvular leakage and excellent hemodynamics. It may serve as the benchmark for transcatheter aortic valve implantation in this unique population.