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We propose a stretchable metalens on polydimethylsiloxane (PDMS) substrate. By stretching the stretchable metalens device along x- and y-axis directions, it exhibits highly tunable focal length and achromatic characteristics. The focal length of stretchable metalens keeps as stable and shows a good relationship to the change of the period of stretchable metalens. When the incident wavelengths are 480 nm, 530 nm, 580 nm, and 660 nm, the focal lengths of stretchable metalens can be tuned in a quite linear range by stretching the period of stretchable metalens from 450 nm to 800 nm. The tuning range of focal length is over 200% for these four incident wavelengths. All the full width at half maximum (FWHM) values for different incident wavelengths are small than 2.5 µm. It means the proposed stretchable metalens possesses the stable beam shape of focus length in the whole visible spectrum. The stretchable metalens provides an effective approach in stretchable device applications and new directions for the future designs in metalens applications, such as the next generation of 3D stereo imaging and holographic projection.

Ever since the first games launched in the 1970s, the rapid growth of the video games market has successfully attracted more and more purchasers. In this study, we use Nintendo Switch as a case study to examine the extended technology acceptance model (TAM), which integrates the factors of Perceived Playfulness and Compatibility to determine their relevance in the usage behavior. A total of 266 questionnaires were obtained using snowball sampling and analyzed using the Structural Equation Modeling (SEM). The study results revealed that the expanded TAM model can be effectively used in this context and it also showed a good fit for the proposed model from the data analyzed. Attitude explained an R2 of 0.85, which indicates that 85% of the variance in user’s behavior intention is accounted by attitude. Perceived Ease of Use and Perceived Usefulness were significantly positively associated with attitude. Perceived Playfulness was significantly positively associated with Perceived Usefulness. This study also addresses the implications of the findings for researchers and the game marketing strategies practitioners.

Objectives: Atrial fibrillation (AF) is linked to an increased risk of stroke and dementia. Atrial flutter (AFL) is also linked to an increased risk of stroke but at a different level of risk as compared to AF. Little is known about the difference in the risk of dementia between AF and AFL. This study aims to investigate whether the risk of dementia is different between AF and AFL.Methods: Patients with newly diagnosed AF and AFL during 2001–2013 were retrieved from Taiwan's National Health Insurance Research Database. Patients with incomplete demographic data, aged

We present a design of MEMS-based tunable terahertz (THz) metamaterial (TTM) with polarization-dependent sensing characteristic. The MEMS-based TTM device is reconfiguration by using two electrostatic comb-drive actuators, which exhibits tunable dual-band resonances in both transverse electric (TE) mode and transverse magnetic (TM) modes. The tuning ranges of free spectra ranges are 42 GHz and 82 GHz for TE and TM modes, respectively by increasing the gap between the left and right semicircle-shaped ring resonators. The electromagnetic responses of the proposed MEMS-based TTM device can be switched between dual-resonance and triple-resonance by changing the distance between the left and right semicircle-shaped ring resonators along y-axis direction. These results indicate MEMS-based TTM device shows polarization-sensitive and switching characteristics. MEMS-based TTM device is particularly sensitive to the environmental refraction index, and there is a linear relationship between the shift of resonant frequency and the change of refraction index. The sensitivity is 0.186 THz/RIU while the maximum figure of merit and quality factor reach 208 and 248, respectively at the first TE resonance. These outstanding and unique results of MEMS-based TTM device provide an effective approach for the design of highly linear and sensitive gas and environmental applications.

Background: Patients with hyperthyroidism have higher risk of atrial fibrillation (AF). However, the risk of thromboembolic event in patients with hyperthyroidism-related AF is controversial. Objectives: The aim of the study was to examine the risk of thromboembolic events in AF patients with/without hyperthyroidism. Methods: The national retrospective cohort study enrolled AF population was derived from the Taiwan National Health Insurance Research Database. The comparison between the AF patients with clinical hyperthyroidism (HT-AF group) and AF patients without hyperthyroidism (non-thyroid AF group) was made in a propensity score matched cohort and in a real-world setting, of which, the CHA2DS2-VASc level was treated as a stratum variable. The outcomes were ischemic stroke and systemic thromboembolism. Results: There were 3,880 patients in HT AF group and 178,711 in non-thyroid AF group. After propensity score analysis, the incidence of thromboembolism event and ischemic stroke were lower in HT AF patients than non-thyroid AF patients (1.6 versus 2.2 events per 100 person-years; HR, 0.73; 95% CI, 0.64–0.82 and 1.4 versus 1.8 events per 100 person-years; HR, 0.74; 95% CI, 0.64–0.84, respectively) in the 4.3 ± 3.2 year follow up period. The differences persistently existed in those receiving anticoagulants or not. In AF patients without anticoagulants, the incidence densities of ischemic stroke/systemic thromboembolism were significantly lower in HT AF group than those in non-thyroid AF group at CHA2DS2-VASc scores ≤ 4 (HR, 0.41; 95% CI, 0.35–0.48, p < 0.001), while the differences disappeared in case of score ≥ 5 (HR, 0.80; 95% CI, 0.63–1.02, p = 0.071). Conclusion: Patients with HT AF had lower incidence of thromboembolic events as compared to non-thyroid AF patients. The threshold of CHA2DS2-VASc score for anticoagulation in AF patients with clinical hyperthyroidism should be further evaluated. Highlights The incidence of thromboembolic event was different between hyperthyroidism-related atrial fibrillation (HT-AF) and non-thyroid AF patients. Hyperthyroidism did not confer additional risk of thromboembolic event at CHA2DS2-VASc of ≤ 4. The benefit of anticoagulation strategy in patients with hyperthyroidism-related AF should be further evaluated, especially at low CHA2DS2-VASc score.

Background Benefits of patients with end‐stage renal disease and atrial fibrillation undergoing peritoneal dialysis (PD) or hemodialysis are unknown. Methods and Results Patients undergoing dialysis were retrieved from Taiwan National Health Insurance Research Database during 2001 to 2013 and separated into PD or hemodialysis. Primary outcomes were ischemic stroke/systemic embolism, major bleeding, and intracranial hemorrhage (ICH). An inverse probability of treatment weighting based on propensity score was used to reduce the confounding. The risk of outcomes between PD and hemodialysis was compared using Cox proportional hazard model for fatal outcomes or Fine and Gray subdistribution hazard model which considered death a competing risk, respectively. A total of 7916 patients with end‐stage renal disease with atrial fibrillation undergoing PD or hemodialysis during 2001 to 2013 were identified. After exclusion criteria, 363 patients receiving PD and 5302 patients receiving hemodialysis were analyzed. At 1‐year follow‐up, the risk of ICH was significantly lower in the PD group compared with the hemodialysis group (0.2% versus 0.9%; subdistribution hazard ratio [SHR], 0.31; 95% CI, 0.17–0.57). At 3‐year follow‐up, the risks of major bleeding and ICH were significantly lower in the PD group compared with the hemodialysis group (major bleeding: 1.8% versus 3.2%; SHR, 0.68; 95% CI, 0.53–0.87; ICH: 0.5% versus 2%; SHR, 0.32; 95% CI, 0.21–0.48). At 5‐year follow‐up, ischemic stroke/systemic embolism, major bleeding, and ICH were significantly lower in the PD group compared with the hemodialysis group (ischemic stroke/systemic embolism: 12.4% versus 17.7%, SHR, 0.87; 95% CI, 0.79–0.96; major bleeding: 2.6% versus 4.1%; SHR, 0.79; 95% CI, 0.64–0.97; ICH: 0.5% versus 2.6%; SHR, 0.25; 95% CI, 0.17–0.37). Conclusions In patients with end‐stage renal disease and atrial fibrillation, dialytic modalities by PD or hemodialysis impacted these patients differently. There were overall reduced ischemic stroke/systemic embolism, major bleeding, and ICH at 5‐year follow‐up in patients undergoing PD compared with hemodialysis.

Abstract Background Primary Sjögren’s syndrome (pSS) is associated with dental caries. Pilocarpine, a salivary stimulant, can improve the amount and flow rate of saliva in patients with pSS. This study aimed to assess whether the risk of dental caries decreases with the use of pilocarpine in patients with pSS. Methods For this prospective cohort study, we identified pSS patients from the catastrophic illnesses registry of the National Health Insurance Research Database of Taiwan between 2009 and 2013. We divided participants into pilocarpine and non-user groups based on the pilocarpine prescriptions available during the first 3-month follow-up. The primary endpoint was dental caries. The secondary endpoints were periodontitis and oral candidiasis. We compared the risk of these oral manifestations using the Cox proportional hazard model. Results A total of 4973 patients with new-onset pSS were eligible for analysis. After propensity score matching, we included 1014 patients in the pilocarpine group and 2028 patients in the non-user group. During the mean follow-up of 2.6 years, the number of events was 487 in the pilocarpine group (48.0%) and 1047 in the non-user group (51.6%); however, the difference was not significant (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.82 to 1.06). Furthermore, there was no significant difference between groups regarding risk of periodontitis (HR 0.91, 95% CI 0.81 to 1.03) and oral candidiasis (HR 1.16, 95% CI 0.70 to 1.94). Conclusion Pilocarpine may have no protective effect on dental caries, periodontitis, or oral candidiasis in patients with pSS.

Abstract Background Studies have reported conflicting findings on the infection risk posed by intravenous iron supplementation among hemodialysis (HD) patients. We used a novel study design to assess associations between intravenous iron and infectious diseases. Methods Patients initiating HD between 1998 and 2008 were extracted from Taiwan’s National Health Insurance Research Database. Their first infectious disease in the period between 1.5 years after dialysis initiation and 2010 was identified and defined as the index date. Through the case-crossover design, the odds of exposure to intravenous iron within the 1-month period immediately preceding the index date (i.e., the case period) were compared with iron exposure in three different matched control periods for the same enrollee, thus possibly reducing some unmeasured confounders. Results A total of 1410 patients who met our enrollment criteria were extracted from incident HD patients. The odds of intravenous iron exposure during the case period versus total control periods exhibited no significant difference (odds ratio: 1.000, 95% confidence interval: 0.75–1.33). In subgroup analyses, this association remained nonsignificant across patients with diabetes mellitus, heart failure, chronic lung disease, venous catheter for HD, and higher iron load. Conclusions We found that intravenous iron supplementation did not increase short-term infection risk among HD patients.

Abstract Aims High demand right ventricular pacing may elicit left ventricular systolic dysfunction known as pacing‐induced cardiomyopathy, increasing the risks of heart failure (HF) hospitalization. Percentage of demand ventricular pacing is different between patients with sick sinus syndrome (SSS) and those with complete atrioventricular block (CAVB). This study aims to compare the incidence of HF admission and pacing‐induced cardiomyopathy between patients with SSS and CAVB. Methods and results A total of 824 patients who received single ventricular or dual‐chamber pacemaker implantation at our hospital between January 2003 and December 2012 were recruited for the study. Patients with HF, those without complete cardiac echocardiography, and those with significant coronary artery disease were excluded. Finally, 315 patients with SSS and 289 patients with CAVB were enrolled in this study. The CAVB group had a higher pacing percentage (39.37 ± 9.17% vs. 83.82 ± 33.06%; P

Abstract A tunable terahertz (THz) chain-link metamaterial (CLM) is presented, which is composed of a tailored Au layer fabricated on Si substrate. CLM exhibits bidirectional polarization-dependent characteristic by applying a direct-current (dc) bias voltage on device. This CLM device can be heated up the surrounding temperature to tune the corresponding resonance. The tuning range is 0.027 THz from 0.318 THz to 0.291 THz on the bias of 0.60 V to 1.32 V. By reconfiguring the gap between CLM, there are single-resonance with red-shift at TE mode, and multi-resonance with blue-shift and red-shift at TM mode, respectively. These characterizations of CLM are polarization-dependence and bidirectional tunability. These results show the electromagnetic responses of proposed CLM device is suitable for the uses for resonator, filter, switch, and sensor in the THz frequency range.

Separation has been a historic problem in digital light process 3D printing, which limits the capability of printing large areas. Over the years, methods for reducing separation force and improving printing quality have primarily relied on changing separation mechanisms and a constrained surface. Most methods require a pulling-up process; however, a few methods can provide the desired lifting distance by themselves. In our previous work, an in-house design named “spring-assisted mechanism” using the combination of spring with a tilting mechanism was proposed to adapt to different required separation forces. The spring compression can be used to provide an additional force for separation, which results in a shorter lifting distance when encountering different print areas. In this paper, we aim to investigate the separation performance by comparing the proposed mechanism with a conventional tilting mechanism. The Taguchi method is applied to study the importance of design features of the spring-assisted mechanism. The results indicate that the maximum separation force occurring in the spring-assisted mechanism declines significantly to 89%. An additional benefit of the proposed mechanism is that the lifting distance required for separation can be adjusted automatically to different print areas, and a sufficient separation force is very low. Consequently, this paper provides experimental evidence that the spring-assisted mechanism can be used for large-scale printing.

This study proposed a novel global minimum search method for predicting the most stable biomolecule complex, which combines the strengths of three global minimum search methods (stochastic tunnelling, basin hopping, and discrete molecular dynamics) to efficiently improve the spatial domain search ability of the stochastic tunnelling–basin hopping (STUN–BH) method from our previous study. The epithelial cell adhesion molecule (EpCAM, PDB code: 4MZV) was used as a benchmark target molecule for the EpCAM aptamer EpA (AptEpA). For the most stable AptEpA/EpCAM complex predicted by our new method, the AptEpA was attached to the entangling loop fragments of the two EpCAM molecules with the most AptEpA residues. After the AptEpA/EpCAM complex had equilibrated with the water environment through a molecular dynamics simulation at 300 K for 10 ns, stable hydrogen bonds formed between the bases of AptEpA and EpCAM residues of the secondary structures, which included the alpha helix and beta sheet becoming less stable in the water environment. Those hydrogen bonds formed between the bases of AptEpA and EpCAM loop fragment residues remained stable in the water environment.

Abstract Background High-dose steroids and intravenous immunoglobulin (IVIG) are controversial treatments for pediatric patients with acute myocarditis. This study aimed to investigate their efficacies in the Taiwanese pediatric population. Methods This study evaluated 5563 acute myocarditis patients from the Taiwan’s National Health Insurance Research Database and identified 1542 pediatric patients hospitalized for acute myocarditis between January 1, 2001 and December 31, 2011. The exclusion criteria were age of > 11 years, associated cardiovascular comorbidities, autoimmune disease, malignancy before the index hospitalization, extracorporeal membrane oxygenation, intra-aortic balloon pumping, and dual therapy using IVIG and high-dose steroids. Results After 2:1 propensity score matching, we identified 208 subjects without steroid therapy and 104 subjects who received high-dose steroids. The mean age in that cohort was 2.6 ± 2.9 years, and high-dose steroid therapy had no significant effects on major in-hospital complications and post-discharge outcomes. After 2:1 propensity score matching, we identified 178 subjects without IVIG therapy and 89 subjects who received IVIG. The mean age in that cohort was 2.0 ± 2.1 years, and IVIG had no significant effects on the major outcomes. Conclusions The present study revealed that high-dose steroid or IVIG therapy had no significant effects on major in-hospital complications, late heart failure hospitalization, and long-term mortality.

The maximum $k$ -plex problem is intended to relax the clique definition with maximum cardinality. It helps people understand the structures of networks by considering them a problem of graph clustering; therefore, it is a useful model for social network analysis. In this paper, we propose a swap-based heuristic algorithm for the maximum $k$ -plex problem. Starting with a randomly selected solution, we use three types of swap operators to enlarge our current solution in different situations. The results of experiments conducted on various graphs from two benchmarks demonstrated that our proposed algorithm achieved desirable performance on specific graphs compared with other algorithms.

Orf is highly contagious zoonoses which is caused by the orf virus (ORFV). In order to determine the characteristics of B2L genes between vaccine strain and wild strain of ORFV in China. In this study we choose the weak vaccine of ORFV produced in biological products (Shandong Taifeng, China) and the wild strain (FJ-PN) isolated and identified in our laboratory to amplify, clone and sequence the B2L genes, and the changes in nucleotide, amino acid and secondary and tertiary protein structure of the B2L proteins were compared and analyzed by bioinformatics software. Comparison results showed that the nucleotide sequence similarity and amino acid sequence similarity of the B2L genes of vaccine strain and wild strain were 98.6% and 98.7% respectively. There was no significant difference between the primary, secondary and tertiary structures of the B2L proteins. The results of this study provide ideas for the study on the function and molecular biological characteristics of related proteins after the ORFV is weakened.

We present two types of tunable terahertz metamaterial (TTM) resonator. They are denoted as TTM-1 and TTM-2 for TTM resonators composed of a moveable metal frame carrying with inner disc and inner ring on Si substrates, respectively. The electromagnetic responses of TTM resonators are caused by the inductance-capacitance coupling effect between the incident THz wave into TTM structure. There is a Fano-resonance with a reflection intensity of 99% excited by electromagnetic wave within TTM-1 at 2.62 THz. By actively moving the metal frame in a specific direction, it enables a modulation of resonant frequency. The tuning ranges of TTM-1 and TTM-2 are 0.19 THz and 0.79 THz, respectively. Furthermore, TTM devices have the ability of anti-inference by moving metal frame transversely. It means TTM devices exhibit stable characteristic used in dynamic motion. Such designs of TTM configurations provide a high-efficiency THz resonator in the THz-waves applications such as filtering, switching, polarizing, sensing, and imaging fields.

ObjectiveMetformin has been linked to anti-proliferative and anti-inflammatory mechanisms. In this study, we aimed to examine the long-term impact of metformin on mortality and organ damage in patients with autoimmune diseases and type 2 diabetes mellitus (T2DM).MethodsWe conducted a cohort study using the National Health Insurance Research Database in Taiwan between 1997 and 2013. Based on metformin and other anti-diabetic agent prescriptions, we categorized all patients with autoimmune diseases into either the metformin group (metformin administration for at least 28 days) or the non-metformin group. The primary outcomes were all-cause mortality and annual admission rate, while the secondary outcome was target organ damage. We followed patients from the index date to the date on which the event of interest occurred, death, or the end of this study.ResultsOur cohort study included 3,359 subjects for analysis. During a mean follow up of 5.2 ± 3.8 years, the event rate of all-cause mortality was 228 (33.6%) in the metformin group and 125 (36.9%) in the non-metformin group. The risk of both all-cause mortality and annual number of admissions for autoimmune diseases was significantly lower in the metformin group than in the non-metformin group [hazard ratio (HR) 0.77; 95% CI 0.62–0.96 and risk ratio (RR) 0.81; 95% CI 0.73–0.90, respectively].ConclusionMetformin may add benefits beyond T2DM control with regard to reducing all-cause mortality and admission rate, as well as minimizing end-organ injury in lungs and kidneys among patients with autoimmune diseases.

Background: The incidence of osteoporotic fracture increases with age, particularly in elderly populations with atrial fibrillation (AF). However, direct oral anticoagulants (DOACs) have less effect on osteoporotic fracture than vitamin K antagonists, it is unclear whether the risk of osteoporotic fracture is affected by different types and doses of DOACs in AF patients. Methods: This nationwide population-based cohort study included AF patients prescribed DOACs between 2011 and 2016 taken from the Taiwan National Health Insurance database. Adjusted hazard ratios (aHRs) for the risk of osteoporotic, hip, and spine fractures between DOAC users were compared using the Fine and Gray subdistribution hazard model to adjust for possible confounders. Results: A total of 56,795 patients who were prescribed DOACs were included in the present study. Among them, 24,597 patients received dabigatran, 26,968 received rivaroxaban, and 5230 received apixaban. After 2 years’ follow up, there was no significant difference in the incidence of osteoporotic, spine, or hip fracture among those receiving dabigatran, rivaroxaban, or apixaban. Subgroup analysis showed that patients taking dabigatran had a higher incidence of osteoporotic and hip fracture than those taking rivaroxaban and apixaban in cases with concomitant peripheral artery disease (PAD) or a history of hip fracture ( p for interaction: 0.004 and 0.030, respectively). However, dabigatran users had a lower incidence of osteoporotic fracture and spine fracture in those receiving standard-dose DOACs compared with rivaroxaban and apixaban; whereas, they had a higher incidence of hip fractures when administered at low dose. Conclusion: AF patients with different DOACs did not have different risks of osteoporotic fracture overall. However, additional concomitant morbidities, such as PAD or a history of hip fracture, and standard/low doses might be associated with different risks for different DOACs. These findings should be taken into consideration in the clinic when the DOAC is being chosen. Plain language summary Different direct oral anticoagulants had different impact on osteoporotic fracture Anticoagulation therapy is an essential therapy in atrial fibrillation (AF) patients, but osteoporotic fracture is another important issue in these patients prescribed with anticoagulants. However, no study has been conducted to evaluate the impact of different DOACs on different types of osteoporotic fractures. In our findings, although different DOACs had no significantly different impact on osteoporotic fractures, dabigatran users had a slightly higher incidence of osteoporotic and hip fractures among different DOACs, particularly in those have simultaneously had peripheral artery disease, a history of hip fracture. In addition, when AF patients taking low-dose DOACs, dabigatran users also have higher incidence of hip fracture than those taking other DOACs.

Background This study compared the efficacy and safety between catheter‐directed thrombolysis (CDT) and systemic thrombolysis for patients with acute pulmonary embolism (PE) with midterm follow‐up. Methods and Results We conducted a prospective open cohort study by using data from the Taiwan National Health Insurance Research Database for 2001 to 2013. Patients who were first admitted for PE and were treated by either systemic thrombolysis or CDT were included and compared. Inverse probability of treatment weighting, based on the propensity score, was used to mitigate possible selection bias. A total of 145 CDT‐treated and 1158 systemic thrombolysis–treated patients with PE were included. The in‐hospital mortality rate was significantly lower in the CDT group (12.7% versus 21.4%; odds ratio, 0.49; 95% CI, 0.36–0.67) after inverse probability of treatment weighting. No significant differences between the groups were observed for the safety (bleeding) outcomes. In patients who survived the index PE admission, the 1‐year all‐cause mortality rate was significantly lower in the CDT group after inverse probability of treatment weighting (12.2% versus 13.2%; hazard ratio [HR], 0.73; 95% CI, 0.56–0.94). Treatment with CDT was also associated with lower risks of recurrent PE (9.3% versus 17.5%; subdistribution HR, 0.52; 95% CI, 0.41–0.66). The difference remained through the last follow‐up. Conclusions Among patients with PE requiring reperfusion therapy, those accepting CDT had lower all‐cause mortality and recurrent PE over both short‐term and midterm follow‐up periods than those receiving systemic thrombolysis. The bleeding risk was similar for both groups. These findings should be cautiously validated in future randomized trials.

A tunable perfect meta‐absorber (PMA) composed of an electric split‐ring resonator (eSRR) and a cross‐shaped nanostructure is proposed. Owing to the electromagnetic coupling effect generated between dipole and inductive–capacitive (LC) resonances, the PMA exhibits perfect absorption, tunable resonance, variable optical attenuation, and switchable polarization‐dependence/independence characteristics. Furthermore, the PMA is demonstrated to be feasible for sensing applications. The PMA exhibits high sensing performance with a sensitivity of 1200 nm/RIU. Such results indicate that the proposed PMA can be used in variable optical attenuators, polarization switches, tunable absorbers, and sensors applications.

This research is aimed at exploring the influencing factors of users’ behavioral intention toward the Nike Training Club (NTC) app, using the decomposed theory of planned behavior as the main research framework. In this study, users of the NTC app were the research objects. A total of 300 questionnaires were distributed on the Internet by the purposive sampling method. After excluding invalid questionnaires, a total of 280 copies were obtained. The effective questionnaire recovery rate was 93.33%. All data were verified by descriptive statistics and multiple regression analysis. The results of this study were as follows. First, the NTC app users were mostly female, aged between 19 and 25 years, were students, had a monthly income below 20,000, and exercised one to two times a week. Second, the application of the decomposed theory of planned behavior found the following: perceived usefulness and perceived ease of use had positive effects on attitude; interpersonal influence and electronic word of mouth had a positive influence on subjective norms; self-efficacy and technology facilitation had positive effects on perceptual behavior control; and attitude, subjective norms, and perceptual behavior control all had a positive impact on behavioral intention. The NTC app users thought that the program interface was easy to use and that the app could help them effectively achieve the effect of exercise and fitness, which increased the benefits of continuously using the program.

A design of electrostatically tunable metamaterial is proposed in the terahertz (THz) frequency range using electric split-ring resonators (eSRR), which shows polarization-dependent and switching characteristics. The eSRR is composed of anchored rectangular split-ring resonators and a movable middle I-shaped metal bar. By exploiting electrostatic force to change the gap within eSRR and the distance of middle I-shaped metal bar, the electromagnetic characteristics of eSRR can be controlled. The electromagnetic response of eSRR shows a single-resonance in transverse electric (TE) mode and keeps as quite stable. In transverse magnetic (TM) mode, the electromagnetic response of eSRR shows dual- and triple-resonance. Such eSRR design is able to be used in lots of applications, such as polarizers, actively tunable filters, frequency-selective detectors, tunable high-efficiency sensors, and multi-functional switches in the THz optoelectronic devices.

This paper proposed implementing a water and air monitoring system using sensor development and a LoRa Network. To transmit data, a self-made PCB board integrates the terminal sensors with Renesas RX64M MCU and LoRa. There are 16 monitoring point stations for the media experiment. The sensors were used to measure the water and air parameters such as PM2.5, CO2, DO concentration, pH level, temperature, and humidity. In addition, the Grafana system was implemented to present the status and variation in the monitoring parameters in the environmental area. To evaluate the monitoring system, we also collected public information provided by the environmental protection department of the Taiwan government at the same monitoring point for comparison.

We present a design of programmable terahertz (THz) metamaterial (PTM) with multiple logic characteristics. The proposed PTM device is composed of a cut-wire resonator (CWR) sandwiched two face-to-face split-ring resonators (SRRs). By moving CWR along z-axis direction to change vertical distance between CWR and substrate, the programmable coding digits could be switched from four digits to five digits by alternating the polarization of incident THz wave. The electromagnetic responses of PTM device are stable in TE mode and can be tuned by moving vertical distance of CWR in TM mode. These results indicate the potential possibilities of PTM to be used as a stable polarization switch and an effective programmable metamaterial in the THz frequency range.

Background: Previous clinical trials showed a significant difference in efficacy and safety among antiplatelets in acute ischemic stroke (IS). The present study wished to compare the efficacy and safety head-to-head between cilostazol and clopidogrel in chronic IS. Methods: This open prospective cohort study recruited chronic IS patients with an index hospitalization between 2001 and 2013 from Taiwan National Health Insurance Research Database. In the 504,191 hospitalized patients, patients who had missing information and history of atrial fibrillation or rheumatic heart disease, received mechanical valve replacement or anticoagulants, expired during the index hospitalization, received follow-up ⩽6 months, or had recurrent stroke within 6 months after index stroke were excluded. Results: Among the 15,968 eligible patients, 502 patients who consistently received either cilostazol or clopidogrel from the 7th month after the index stroke were included for analysis after propensity score matching. The 3-year primary outcomes showed similar frequency of recurrent IS, all-cause mortality, and acute myocardial infarction (AMI), and similar frequency of intracerebral hemorrhage, gastrointestinal bleeding, and major bleeding between the cilostazol and clopidogrel groups. Subgroup analysis revealed that patients with a history of hypertension or gastrointestinal bleeding had a trend of having lower frequency of recurrent IS or major bleeding, respectively, in the cilostazol group. Conclusion: The present real-world study demonstrated no significant difference in efficacy and safety between cilostazol and clopidogrel in chronic IS. However, cilostazol might be better than clopidogrel in patients with a history of hypertension or gastrointestinal bleeding.

Objective Cephalic arch stenosis (CAS) causes repeated dysfunction and failure of arteriovenous access. Percutaneous transluminal angioplasty is the standard initial treatment for CAS, but its outcome is unsatisfactory. This study aimed to evaluate the outcome of stent graft placement for CAS in patients on hemodialysis. Methods A retrospective chart review from a tertiary medical center was performed in patients receiving stent graft placement for CAS between January 2012 and 2016. Patency was analyzed using the Kaplan–Meier method. Results Twenty-one patients received stent graft placement for CAS. Technical and clinical success rates were 100%. Primary target lesion patency was 95% (95% confidence interval [CI], 86%–100%), 76% (95% CI, 58%–94%), and 43% (95% CI, 22%–64%) at 3, 6, and 12 months, respectively. No significant difference in patency was observed between the arteriovenous fistula and arteriovenous graft groups. Assisted primary patency was 95% (95% CI, 86%–100%), 71% (95% CI, 52%–91%), and 57% (95% CI, 36%–78%) at 3, 6, and 12 months, respectively. Secondary patency was 100% at 3, 6, and 12 months. Conclusions After repeated failed angioplasty for cephalic arch stenosis, patients on hemodialysis who receive stent graft placement have effective and durable outcomes.

To date, organic–inorganic metal halide perovskite material has become an emerging research topic for scientists to alternate the semiconductor material in the optoelectronic applications. However, the photoluminescence (PL) efficiency of perovskite material is quite low, which impacts the performance of perovskite-based optoelectronic devices. Here, we propose and demonstrate an effective approach to enhance the PL efficiency of perovskite material. We utilize the metal nanostructures fabricated on the perovskite surface. Metal nanostructures possess extraordinary electromagnetic properties, e.g., easily controlled the amplitude, phase, and polarization of the incident light, which can be utilized to enhance the PL performance of the perovskite material. The intensity and spectral bandwidth of the PL spectrum could be enhanced significantly via metal nanostructures. The full width at half maximum of PL spectral bandwidth could be narrowed to several nanometers. This nanostructure-enhanced PL characterization of the perovskite material exhibits better monochromaticity and provides the simple, cost-effective, and potentially scalable method for the development of high-efficiency light emitting diodes, solar cells, photodetectors, etc.

Three designs of tunable broadband resonators using three-dimensional pyramid metamaterials (3DPMs) are presented. They are pyramid-shaped absorbers with nine taper steps from bottom to top. Each step of three 3DPMs is composed of a metal–insulator–metal (MIM) layer, a metal–insulator–metal–insulator–metal (MIMIM) layer, and a metal–insulator–metal–insulator–metal–insulator–metal (MIMIMIM) layer denoted as 3DPM-1, 3DPM-2, and 3DPM-3, respectively. 3DPMs exhibit ultra-broad bandwidths of 9.56 µm spanning the wavelength of 8.88 µm–18.44 µm. Within the whole absorption bandwidth, there are near-perfect absorptions of 96.57%, 97.61%, and 99.15% for 3DPM-1, 3DPM-2, and 3DPM-3, respectively, at the strongest resonant wavelength. The average absorption intensities are 84.86%, 83.92%, and 87.47%, respectively, calculated at the whole absorption bandwidths. To enhance the flexibility of the proposed 3DPMs, we choose 3DPM-1 as an example to design a slot gap between 3DPM-1. By changing this gap from 0 nm to 250 nm, the absorption spectra could be tuned from the bandwidth of 9.56 µm to 3.56 µm. The absorption intensity can be kept as high as 80%. These superior electromagnetic characteristics provide the proposed 3DPMs to be used for sensor, detector, energy harvesting, and imaging applications with polarization-dependence, tunable bandwidth, broad absorption bandwidth, and high interference resistance characterizations.

We present two types of tunable terahertz (THz) metamaterials (TTM-1 and TTM-2) to explore their extraordinary optical properties. The proposed TTMs are composed of Au layers with 300 nm in thickness on Si substrates. The designs of TTMs exhibit superior properties in adjustability for high-efficiency THz switching characteristic. By changing the geometrical dimensions of TTMs, the corresponding electromagnetic responses could be tuned and switched between single-band and dual-band resonances. TTM-1 exhibits three switching windows with higher switching ratios by embedding different materials into the cavity underneath the complementary metamaterial. TTM-2 can be tuned to have two resonances and then merge into one resonance by increasing the height between the inner and outer rings. The transmission intensity of TTM-2 can be tuned from 0 to 0.7 at 0.57 THz by changing the sizes of inner and outer rings. TTM-2 exhibits tunable filter, single-/dual-band switch, tunable free spectrum range, and tunable bandwidth characteristics by varying the radius of the inner and outer rings. This study paves a way to the possibility of tunable high-efficiency switch, filter, polarizer, and other THz applications.

We present three tunable multi-resonance of terahertz (THz) metamaterials. They are composed of single-, dual-, and triple-split-disk resonators (SDRs) on Si substrates, which are denoted as SDR-1, SDR-2, and SDR-3, respectively. They exhibit extraordinary electromagnetic characteristics. SDR-1 exhibits polarization-dependence owing to the asymmetrical SDR structure. To increase the flexibility and applicability of SDR configuration, SDR-2 and SDR-3 are presented to modify the distances between the SDR layers. By moving the top SDR layer of SDR-2, a controllable resonance with a 0.32 THz shifting and tunable free spectrum range (FSR) of 0.15 THz at transverse magnetic mode is achieved, while an electromagnetically induced transparency-like effect appears at the transverse electric mode. The spectral bandwidth of SDR-3 can be tuned to 0.10 THz, and the resonant intensity becomes controllable by moving the middle SDR layer of SDR-3. Furthermore, by moving the top SDR layer of SDR-3, the tuning ranges of resonance, FSR, and bandwidth of SDR-3 are 0.23 THz, 0.20 THz, and 0.08 THz, respectively. Such designs of SDR configurations provide a high-efficient THz resonator in the THz-wave applications such as filters, switches, polarizers, sensors, imaging, and so on.

BACKGROUND:It has been unclear whether diabetes mellitus (DM) is positively associated with a risk of venous thromboembolism (VTE). In addition, whether the risk of VTE is altered in patients with type 1 diabetes (T1DM) has rarely been explored. AIM:We investigated whether patients with T1DM are at a relatively high risk of VTE development. METHODS:We retrieved data from the National Health Insurance Research Database of Taiwan to conduct this retrospective cohort study. The T1DM group consisted of 4967 patients diagnosed as having T1DM before 2003. The non-T1DM group comprised 19 868 age- and sex-matched enrollees without T1DM. Cox proportional hazard regression analysis was used to investigate the hazard ratio of VTE in patients with T1DM relative to those without T1DM. RESULTS:During a mean follow-up period of 8.61 years, the risk of VTE in the T1DM group was 5.33-fold higher than in the non-T1DM group after adjusting for dyslipidemia, hypertension, stroke, lower leg fracture or surgery, and obesity. Further stratified analysis revealed that the risk of VTE was significantly high in both sexes and in all age groups below the age of 60. CONCLUSION:T1DM appears to be an independent risk factor for VTE development.

BackgroundUremic pruritus (UP) is a multifactorial problem that contributes to low quality of life in dialysis patients. The long-term influences of UP on dialysis patients are still poorly understood. This study aims to elucidate the contribution of UP to long-term outcomes.Materials and methodWe used the Taiwan National Health Insurance Research Database to conduct this study. Patients on chronic dialysis were included and divided into UP and non-UP groups according to the long-term prescription of antihistamine in the absence of other indications. The outcomes include infection-related hospitalization, catheter-related infection, major adverse cardiac and cerebrovascular events (MACCE) and parathyroidectomy.ResultsAfter propensity score matching, 14,760 patients with UP and 29,520 patients without UP were eligible for analysis. After a mean follow-up of 5 years, we found that infection-related hospitalization, MACCE, catheter-related infection, heart failure and parathyroidectomy were all slightly higher in the UP than non-UP group (hazard ratio: 1.18 [1.16-1.21], 1.05 [1.01-1.09], 1.16 [1.12-1.21], 1.08 [1.01-1.16] and 1.10 [1.01-1.20], respectively). Subgroup analysis revealed that the increased risk of adverse events by UP was generally more apparent in younger patients and patients who underwent peritoneal dialysis.ConclusionUP may be significantly associated with an increased risk of long-term morbidities.

Silicone printing can enable a lot more accessibility and customizability towards utilizing silicone in different applications, including medicine for its biocompatibility. However, challenges existed for printing in specific geometries due to the lack of guidelines and studies on the mechanical properties. To support the understanding of printing three-dimensional silicone structure having different infill patterns and gel-like material, this paper conducted a parametric study for the specimens printed using a Bowden-type silicone printer and measurements of the tensile properties. Four printing parameters of print speed, infill density, flow rate, and infill pattern, are categorized following the Taguchi L9 method, and arranged into the four-parameter-three-level orthogonal array. The signal-to-noise (S/N) ratio was calculated based on the principle of the-larger-the-better, and analysis of variance (ANOVA) was also obtained. Tensile performance was further discussed with the characterization of internal structure, using the cross-sections of the printed specimens. It was found that the change of flow rate is the most significant to the tensile stress; and for the tensile strain, infill pattern was found to be the most significant parameter. The Line infill pattern consistently presented the highest tensile stress. Agglomeration can be seen inside the printed structure, hence optimal printing parameters play an important role for complicated geometry, while ensuring the flow rate and infill density do not exceed a reasonable value. This study would serve as the guideline for printing three-dimensional silicone structures.

We present terahertz (THz) metamaterial with multi-configurations, which are composed of H-shaped, II-shaped, and IHI-shaped configurations, respectively. By changing the geometrical dimension of H-shaped metamaterial, the electromagnetic response exhibits switch and bandwidth modulation characteristics between 0.20 THz and 0.30 THz. For II-shaped metamaterial, the electromagnetic response shows the single-resonance and dual-resonance switching and tunable free spectrum range (FSR) characteristics. The superimposed structures of H- and II-shaped metamaterials to form IHI-shaped metamaterial, which exhibits the combinations of H- and II-shaped metamaterials characterizations. The resonances could be switched at 0.25 THz, 0.55 THz, and 0.95 THz depending on the metamaterial pattern. To increase the flexibility of proposed device, there are composed of dual-layer IHI-shaped metamaterial on Si substrate. The FSR could be tuned from 0.16 THz to 0.05 THz by changing the height of top IHI-shaped metamaterial. These optical properties of IHI-shaped metamaterial open an avenue to be used in widespread applications with high portability, flexibility, and compatibility. Keywords: Metamaterial, Terahertz, Resonator, Modulator, Multi-functionality

We present four designs of actively switchable terahertz metamaterials (ASTMs) to explore their extraordinary optical characteristics. They are denoted as ASTM_1, ASTM_2, ASTM_3, and ASTM_4, respectively. ASTM_1 and ASTM_2 are composed of asymmetrically single-layer L-shaped metamaterial and asymmetrically dual-layer L-shaped metamaterial with rotated 0° on Si substrate, respectively. ASTM_3 and ASTM_4 are composed of asymmetrically dual-layer L-shaped metamaterial with rotated 90° and asymmetrically connected L-shaped metamaterial on Si substrate, respectively. ASTM_1 shows three resonances at 0.19 THz, 0.33 THz, and 0.49 THz. The tuning range of first resonance is 0.06 THz by changing the gap between the L-shaped metamaterial. While ASTM_2 shows three resonances at 0.15 THz, 0.28 THz, and 0.42 THz. The tuning range of first resonance is 0.05 THz by changing the height between top and bottom L-shaped metamaterials. By changing the gap and height of L-shaped metamaterials, ASTM_3 and ASTM_4 exhibit the optical switching characteristic. The transmission spectra of four ASTMs show the polarization-independent characteristic. Such optical properties of ASTM designs provide the possibilities of THz metamaterial to be used in active switching optoelectronics applications, such as sensors, logic devices, programmable devices, and so on. Keywords: Metamaterial, Terahertz, Modulator, Resonator, Switch

We propose two designs of plasmonic metamaterial mid-infrared (MIR) sensors, which are composed of metallic nanograting on SiO2 layer with a bottom mirror to form metal–insulator-metal (MIM) configurations. These MIM configurations are denoted as MIM-S and MIM-D to represent MIM composed of single metal nanograting and double metal nanogratings, respectively. The electromagnetic responses of MIM-S and MIM-D are investigated and compared with and without embedded a SiO2 layer between top nanograting and bottom mirror layer. By changing the height of insulator layer, the absorption spectra of MIM-S can be tuned with a linearly wavelength tuning range of 2.4 μm. Furthermore, MIM-D exhibits not only tunable resonance by changing the gap between top and bottom nanogratings, but also switch characteristics by changing the horizontal shift of top nanograting. For the environment sensor application, MIM-S and MIM-D exhibit the sensitive/insensitive to refraction index and tunable FSR characteristics by changing ambient refraction index. Such results provide the MIM devices can be used as multifunctional sensors. This study proposes an implementation strategy of actively tunable filter, switch, and high-sensitive refraction index sensor in the MIR wavelength range. Keywords: Plasmonic metamaterial, Metal-insulator-metal structure, Infrared sensor, Nanograting

Abstract The on-chip perfect meta-absorber (PMA) is an important optical and thermal energy component in photovoltaics, thermal emitters, and energy harvesting applications. However, most reported PMAs rely on the complicated lithography techniques, which imposed a serious cost barrier on the development of practical applications, especially in the visible to near-infrared (NIR) wavelength range and at very large scales. Importantly, it is hard to realize PMA in the UV wavelength range by using current lithography techniques. In this article, we develop an ultra-broadband PMA by using natural lithography (NL) technique. The morphology of proposed PMA is randomly distributed pod-like nanostructures composed of a nanocomposite (Au/SiO2) covered a gold layer. It can be formed easily on Si substrate to function as an ultra-broadband, omnidirectional, and polarization-independent PMA by controlling the conditions of sputtering deposition and thermal annealing treatment. We experimentally realized an on-chip ultra-broadband PMA with almost 100% absorption spanned from UV-visible to NIR wavelength ranges. This cost-effective and high-efficiency approach would release the manufacturing barrier for previously reported PMAs and therefore open an avenue to the development of effectively energy harvesting, energy recycling, and heat liberation applications.

Background: It is generally understood that cancer patients are at an increased risk for osteoporosis. Additionally, recent studies have suggested a shared pathophysiological mechanism between the development of cancer and osteoporosis. The purpose of this investigation was to investigate whether low bone mineral density is associated with cancer risk. Methods: We enrolled 8780 subjects who underwent dual-energy X-ray absorptiometry (DXA) and cancer screening from January 1, 2008–December 31, 2012 from a cohort selected from Chang Gung Health Care Center in Taiwan. The study end point was a definite pathological diagnosis of cancer or admission for cancer treatment. Results: During a mean follow-up of 6.6 ± 1.5 years, 110 incident cases of cancer occurred. The overall incidence of cancer was significantly higher in those patients with a low BMD (1.3%) than in those with a normal BMD (1.0%). Multivariate Cox regression analysis showed that older age, smoking, and low BMD (hazard ratio: 1.5; 95% confidence interval: 1.0–2.3) were significant independent risk factors for cancer. Conclusion: Our investigation suggested that subjects with a low BMD may have a higher long-term risk of cancer compared with subjects with a normal BMD. Keywords: Bone mineral density, Cancer

This paper presents a new driving scheme for active-matrix organic light-emitting diode displays. A pixel circuit based on this driving scheme was developed to compensate for the threshold voltage and mobility variations of low-temperature polycrystalline-silicon thin-film transistors (TFTs), eliminate image flickering and current-resistance voltage drops, and suit ultrahigh-definition (UHD) resolution applications. A new gate driver with a concise 6T1C structure is also proposed to realize the driving scheme in practice. Fabricated TFTs and OLEDs were measured to establish models. Simulations using these models demonstrate that the proposed pixel circuit achieves uniform OLED current regardless of undesirable influences at UHD resolution.

A new capacitive coupling method to enhance the driving performance of hydrogenated amorphous silicon thin-film transistors (a-Si:H TFTs) in high-resolution applications is presented. The gate voltage can be enlarged by the entirely transmitted high voltage of a global direct current power source line (VDD). Established models that are based on the measured electrical characteristics of fabricated a-Si:H TFTs with different aspect ratios are used to evaluate the feasibility of this proposed method in the gate driver. The maximum voltage of the gate voltage can be increased from 37.3 V to 47.6 V when VDD is set to 20 V, improving the driving capability of the gate driver by more than 17%, based on the specifications of a 5.99 inch HD + (720 × 1440) panel at a frame rate of 120 Hz.

The most common ventricular premature contractions (VPCs) originate from the right ventricular outflow tract (RVOT), but the molecular mechanisms of altered cytoskeletons of VPC-induced cardiomyopathy remain unexplored. We created a RVOT bigeminy VPC pig model (n = 6 in each group). Echocardiography was performed. The histopathological alternations in the LV myocardium were analyzed, and next generation sequencing (NGS) and functional enrichment analyses were employed to identify the differentially expressed genes (DEGs) responsible for the histopathological alternations. Finally, a cell silencing model was used to confirm the key regulatory gene and pathway. VPC pigs had increased LV diameters in the 6-month follow-up period. A histological study showed more actin cytoskeleton disorganization and actin accumulation over intercalated disc, Z-line arrangement disarray, increased β-catenin expression, and cardiomyocyte enlargement in the LV myocardium of the VPC pigs compared to the control pigs. The NGS study showed actin cytoskeleton signaling, RhoGDI signaling, and signaling by Rho Family GTPases and ILK Signaling presented z-scores with same activation states. The expressions of Rac family small GTPase 2 (Rac2), the p-cofilin/cofilin ratio, and the F-actin/G-actin ratio were downregulated in the VPC group compared to the control group. Moreover, the intensity and number of actin filaments per cardiomyocyte were significantly decreased by Rac2 siRNA in the cell silencing model. Therefore, the Rac2/cofilin pathway was found to play a crucial role in the sarcomere morphology and Z-line arrangement disarray induced by RVOT bigeminy VPCs.

Dihydrosinularin (DHS) is an analog of soft coral-derived sinularin; however, the anticancer effects and mechanisms of DHS have seldom been reported. This investigation examined the antiproliferation ability and mechanisms of DHS on oral cancer cells. In a cell viability assay, DHS showed growth inhibition against several types of oral cancer cell lines (Ca9-22, SCC-9, OECM-1, CAL 27, OC-2, and HSC-3) with no cytotoxic side effects on non-malignant oral cells (HGF-1). Ca9-22 and SCC-9 cell lines showing high susceptibility to DHS were selected to explore the antiproliferation mechanisms of DHS. DHS also causes apoptosis as detected by annexin V, pancaspase, and caspase 3 activation. DHS induces oxidative stress, leading to the generation of reactive oxygen species (ROS)/mitochondrial superoxide (MitoSOX) and mitochondrial membrane potential (MitoMP) depletion. DHS also induced DNA damage by probing γH2AX phosphorylation. Pretreatment with the ROS scavenger N-acetylcysteine (NAC) can partly counter these DHS-induced changes. We report that the marine natural product DHS can inhibit the cell growth of oral cancer cells. Exploring the mechanisms of this cancer cell growth inhibition, we demonstrate the prominent role DHS plays in oxidative stress.

We present and demonstrate a MEMS-based tunable terahertz metamaterial (TTM) composed of inner triadius and outer electric split-ring resonator (eSRR) structures. With the aim to explore the electromagnetic responses of TTM device, different geometrical parameters are compared and discussed to optimize the suitable TTM design, including the length, radius, and height of TTM device. The height of triadius structure could be changed by using MEMS technique to perform active tunability. TTM shows the polarization-dependent and electromagnetic induced transparency (EIT) characteristics owing to the eSRR configuration. The electromagnetic responses of TTM exhibit tunable characteristics in resonance, polarization-dependent, and electromagnetically induced transparency (EIT). By properly tailoring the length and height of the inner triadius structure and the radius of the outer eSRR structure, the corresponding resonance tuning range reaches 0.32 THz. In addition to the above optical characteristics of TTM, we further investigate its potential application in a refraction index sensor. TTM is exposed on the surrounding ambient with different refraction indexes. The corresponding key sensing performances, such as figure of merit (FOM), sensitivity (S), and quality factor (Q-factor) values, are calculated and discussed, respectively. The calculated sensitivity of TTM is 0.379 THz/RIU, while the average values of Q-factor and FOM are 66.01 and 63.83, respectively. These characteristics indicate that the presented MEMS-based TTM device could be widely used in tunable filters, perfect absorbers, high-efficient environmental sensors, and optical switches applications for THz-wave optoelectronics.

We present two types of refractive index sensors by using tunable terahertz (THz) metamaterial (TTM) based on two concentric split-ring resonators (SRRs) with different splits. By modifying the distance between SRRs and substrate, TTM shows tunable single- and dual-resonance characteristic. The maximum tuning range of resonance is 0.432 THz from 0.958 THz to 1.390 THz. To demonstrate a great flexibility of TTM in real application, TTM device is exposed on the surrounding ambient with different refractive index (n). The sensitivity of TTM can be enhanced by increasing SRR height, which is increased from 0.18 THz/RIU to 1.12 THz/RIU under the condition of n = 1.1. These results provide a strategy to improve the sensing performance of the metamaterial-based sensing device by properly arranging the geometric position of meta-atoms. The proposed TTM device can be used for tunable filters, frequency-selective detectors, and tunable high-efficiency sensors in the THz frequency range.

Abstract Background Evidences support the benefits of moderate- to high-intensity statins for patients with acute myocardial infarction (AMI) except for those with type 2 diabetes mellitus (T2DM) on dialysis after AMI. This study was aimed to investigate the safety and efficacy of secondary prevention of cardiovascular diseases using moderate- to high-intensity statins in T2DM patients on dialysis after AMI. Methods A simulated prospective cohort study was conducted between January 1st, 2001 and December 31st, 2013 utilizing data from the Taiwan National Health Insurance Research Database. A total of 882 patients with T2DM on dialysis after AMI were selected as the study cohort. Cardiovascular efficacy and safety of moderate- to high-intensity statins were evaluated by comparing outcomes of 441 subjects receiving statins after AMI to 441 matched subjects not receiving statins after AMI. The primary composite outcome included cardiovascular death, non-fatal myocardial infarction and non-fatal ischemic stroke. Results The Kaplan–Meier event rate for the primary composite outcomes at 8 years was 30.2% (133 patients) in the statin group compared with 25.2% (111 patients) in the non-statin group (hazard ratio [HR], .98; 95% confidence interval [CI] .76–1.27). Significantly lower risks of non-fatal ischemic stroke (HR, .58; 95% CI .35–.98) and all-cause mortality (HR, .70; 95% CI .59–.84) were found in the statin group. Conclusions In T2DM patients on dialysis after AMI, the use of moderate- to high-intensity statins has neutral effects on composite cardiovascular events but may reduce risks of non-fatal ischemic stroke and all-cause mortality.

Abstract Background Hepatitis C virus (HCV)-infected patients with chronic kidney disease (CKD) have rarely been studied because they rarely accept interferon-based therapy (IBT) and have been difficult to follow up. We investigated long-term outcomes of IBT on the population. Methods This population-based cohort study used the Taiwan National Health Insurance Research Database as its data source. HCV patients diagnosed with CKD between Jan. 1, 2003, and Dec. 31, 2013, were selected. They were then divided into two groups based on whether they had undergone IBT. All-cause mortality, acute myocardial infarction (AMI), ischemic stroke (IS), hemorrhagic stroke, and new-onset dialysis were evaluated using a Cox proportional hazard regression analysis after propensity score matching. Results We enrolled 9872 HCV patients with CKD: 1684 patients in the treated cohort and 8188 patients in the untreated cohort. The annual incidence of all-cause mortality (19.00 vs. 42.89 events per 1000 person-years; p

Abstract Circulating tumor cells (CTCs) detection, enumeration and characterization with microfluidic chips has critical significance in cancer prognosis offering a non-invasive “liquid biopsy”. Based on physical differences of size and deformability, we explore micro-ellipse filters consisting of microfuidic slits in series gradually narrowed. Slender tunnels sensitively capture tumor cells with slim chance to escape. Tumor cells could reside at capture sites organized by arrays of micro-ellipse microposts enduring less stress. Circular elliptical microstructures produce smooth flow minimally reducing any damage. “Air Suction” could extremely shorten capture. Capture efficiency comes out to be a robust yield of 90% and percentage obeys Gaussian distribution at various stages. With rare number accurately enumerated, micro-Ellipse filters have been tested high efficiently capturing tumor cells in both whole and lysed blood. To clinically validate the device, the microfluidic chip was utilized to identify and capture CTCs from metastatic breast, colon and non-small-cell lung (NSCLC) cancer patients. CTCs were detected positive in all samples with 4 patients having more than 20 CTCs. Those sensitive results are consistent with theoretical expectation. Efficient micro-ellipse filters enable clinical enumeration of metastasis, on-chip anti-cancer drug responses and biological molecular analysis.

The Q-switched and mode-locked (QML) pulses of an all normal dispersion Yb3+-doped fiber laser (YDFL) using the nonlinear polarization rotation technique with symmetric and asymmetric Q-switched envelopes were investigated. For QML pulses with a symmetric shape, the width of envelope decreases as the pump power increases, achieving a shortest duration of ~1.4 μs. An alternate QML state of the YDFL exhibited an asymmetric envelope with a broad spectrum bandwidth, and whose short duration mode-locked pulses could be used as a light source for the cascaded Raman scattering generation through the injection of these high intensity QML pulses into an amplifier, using Yb3+-doped germano-zirconia silica (YD-GZS) glass based fiber as the gain fiber. In addition, the generation of a relatively broad spectrum near the IR range and the observation of some emission bands in the visible and UV range have been demonstrated at high pump power.