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To study the association between urinary phthalate metabolite levels, endometriosis, and their effects on human granulosa cells, we recruited patients who underwent laparoscopy to confirm endometriosis (n = 123) and control patients (n = 78). Liquid chromatography&ndash, tandem mass spectrometry was used to measure the following five urinary phthalate metabolites: mono-n-butyl phthalate (MnBP), mono(2-ethylhexyl) phthalate, monobenzyl phthalate, mono(2-ethyl-5-oxo-hexyl) phthalate, and mono(2-ethyl-5-hydroxyhexyl) phthalate. Urinary MnBP levels were higher in patients with endometriosis than in controls after multivariable logistic regression including the number of deliveries, body mass index, and use of medicine as covariables. MnBP correlates with other phthalate metabolites. Previous studies found that endometriosis was a detrimental condition for granulosa cells. In our study, we observed whether MnBP affected granulosa cells. MnBP treatment altered the gene expression of BIRC5, BUB1B, CDC20, cyclin B1, IL-1&beta, TNF-&alpha, inhibin-B, StAR, and P450ssc and attenuated the ratio of the mitochondrial membrane potential in human granulosa cells. Moreover, MnBP decreased the expression of the anti-Mullerian hormone. These findings suggest that MnBP concentration is associated with endometriosis and may affect the health and steroidogenesis of human granulosa cells.

A systematic XMCD analysis was performed to study the evolution of magnetic moments of overall Fe atoms in α′-FexN thin films. It was found that the spin and orbital moments of overall Fe 3d shell of α′-FexN increase gradually along c-axis with increasing nitrogen fraction. We showed that the magnetocrystalline anisotropy of α′-FexN compounds is associated with corresponding orbital anisotropy of Fe 3d shell. No clear p-d hybridization between Fe and N elements was discovered in the current experimental systems, suggesting that lattice expansion has a sufficient influence on magnetic performance of α′-Fe8N compounds.

Early discharge (ED) has emerged and gained popularity in spine surgery. However, the benefits of ED in lumbar fusion have not yet been validated by large cohort studies. To evaluate the effects of ED on readmissions and reoperations in lumbar fusion, this study utilized a national database to enroll patients who had undergone lumbar fusion surgery at age 50&ndash, 70 years, and grouped them into an ED group or a comparison group. In the comprehensive follow-up of 180 days post-operation, the two groups were compared. There were 18,008 patients in the cohort, including 2172 in the ED group and 15,836 in the comparison group. The ED group was slightly younger (59.9 vs. 60.7 years, p &lt, 0.001), more male predominant (44.9% vs. 36.9%, p &lt, 0.001), and had fewer medical comorbidities. The ED group had less incidences of readmission than the comparison group. (Crude hazard ratio = 0.73, and adjusted HR = 0.75, both p &lt, 0.001). Overall, the cumulative incidences of readmission in the ED group (9.5%) were lower than those in the comparison group (12.8%, p &lt, 0.001), whereas reoperations were insignificantly different (1.5% vs. 1.2%, p = 0.189). For patients aged 50&ndash, 70 years and who require lumbar fusion surgery, ED could yield a 25% reduced risk of readmission for any cause within 180 days post-operation. Since the reoperation rates remained similar, our results suggest that ED may be a promising option for elderly patients undergoing lumbar spinal fusion surgery.

The LACE index and HOSPITAL score models are the two most commonly used prediction models identifying patients at high risk of readmission with limited information for home care patients. This study compares the effectiveness of these two models in predicting 30-day readmission following acute hospitalization of such patients in Taiwan. A cohort of 57 home care patients were enrolled and followed-up for one year. We compared calibration, discrimination (area under the receiver operating curve, AUC), and net reclassification improvement (NRI) to identify patients at risk of 30-day readmission for both models. Moreover, the cost-effectiveness of the models was evaluated using microsimulation analysis. A total of 22 readmissions occurred after 87 acute hospitalizations during the study period (readmission rate = 25.2%). While the LACE score had poor discrimination (AUC = 0.598, 95% confidence interval (CI) = 0.488&ndash, 0.702), the HOSPITAL score achieved helpful discrimination (AUC = 0.691, 95% CI = 0.582&ndash, 0.785). Moreover, the HOSPITAL score had improved the risk prediction in 38.3% of the patients, compared with the LACE index (NRI = 0.383, 95% CI = 0.068&ndash, 0.697, p = 0.017). Both prediction models effectively reduced readmission rates compared to an attending physician&rsquo, s model (readmission rate reduction: LACE, 39.2%, HOSPITAL, 43.4%, physician, 10.1%, p &lt, 0.001). The HOSPITAL score provides a better prediction of readmission and has potential as a risk management tool for home care patients.

Objective To compare two Nutrition and Health Surveys in Taiwan (NAHSITs) 15-18 years apart to evaluate secular changes in ultra-processed food (UPF) consumption and expenditure among Taiwanese adolescents aged 16-18 years and the influences of such changes on dietary quality. Design This cross-sectional study was based on two representative surveys (NAHSIT 1993-1996, n = 788; NAHSIT 2011, n = 1,274) of senior high school students. Dietary information and food expenditure were based on 24-h dietary recall. All food items were classified into original foods, processed culinary ingredients, processed foods, and UPFs based on NOVA criteria. Dietary quality was categorized as poor or good based on the mean of the Youth Healthy Eating Index-Taiwan Revised. Results Compared to 1993-1996, adolescents consumed less energy from original foods (55 vs. 39%) but more from processed foods (12 vs. 18%) and UPFs (21 vs. 25%) in 2011, with no apparent gender differences. Those who consumed more UPFs had the lowest proportions of protein energy intake in both surveys (13.7 and 13.1%). Those who consumed more UPFs had higher levels of saturated fat and lower levels of monounsaturated and polyunsaturated fat, dietary fiber, and micronutrient intakes. The participants who consumed more UPFs and fewer original foods exhibited poorer dietary quality. Boys and girls exhibited equal UPF expenditure in both surveys despite an increase in UPF energy consumption. The adjusted odds ratios (95% confidence interval) were 1.33 (1.16-1.52) and 1.36 (1.10-1.69) for the risk of poor dietary quality with 10% increases in UPF energy intake and expenditure, respectively, in 2011. Conclusions UPF energy consumption among Taiwanese adolescents increased between 1993-1996 and 2011. Observed trends in expenditure suggest that lower UPF costs influenced food choices during this period. Increasing UPF intake and expenditure was associated with poor dietary quality.

In this article, based on the reference configuration of combustion chamber of scramjet, the influence of design point parameters of the two-stage combustion chamber geometry configuration and fuel distribution ratio on engine performance is studied, and thrust and specific impulse are used as the overall performance evaluation parameters, the comparison and evaluation of the mobility and economy of the engine provide certain references for the selection of design point parameters of the combustion chamber geometry configuration and fuel distribution ratio. The results show that increasing the area of the thermal throat of the combustion chamber by increasing the two-stage expansion ratio of the combustion chamber can increase the thrust at low speed and enhance the mobility of the aircraft; when it does not cause thermal choke and does not affect the start-up of the inlet, increasing the fuel distribution ratio in the first stage of the combustion chamber can increase the engine’s specific impulse, thereby improve the economy of the aircraft.

For a reusable hypersonic cruise vehicle with the ability of horizontal take-off and landing, triple combined cycle engine is a suitable choice in a short term. The triple combined cycle engine in this paper is a combination of turbine engine, ramjet engine and DMSJ (dual mode scramjet) engine. It can operate at three modes. The transition of the three modes is crucial to the performance of the engine. This paper establishes the performance calculation model of the triple combined cycle engine. Providing the control schedule of the engine, the engine performance during mode transition is studied. The design of the turbine-to-ramjet mode transition zone and the performance during of the ramjet-to-DMSJ mode transition are analyzed. The principle of turbine-to-ramjet mode transition is that the increase of airflow rate caused by ram duct air supply and the decrease of installation loss can compensate the loss of specific thrust. Therefore, it can be assured that the thrust can transit smoothly and is higher. Performance simulations show that the influence between the two flow paths is small, thus the thrust transition is stable during the ramjet-to-DMSJ mode transition.

This paper establishes performance calculation models of variable cycle engine (VCE) of single bypass mode and double bypass mode, and studies the cruising characteristics of VCE in two modes. The results of the research show that, in subsonic cruise flight conditions, the VCE operates in double bypass mode has better SFC (specific fuel consumption) performance and in supersonic cruise flight conditions, the VCE operates in single bypass mode can generate greater thrust.

In the variable-cycle engine performance calculation model which is established based on the component method, the acquisition of variable compression component parameters is one of the keys to iterative calculation. In this paper, a new interpolation method is proposed and verified for the characteristics of variable compressors with adjustable first-stage vanes and adjustable two-stage vanes. Using the proposed two interpolation methods, the steady-state throttling performance of a turbine engine with variable compressor was calculated.

Based on the component maps based gas turbine engine starting simulation model, the power extraction method is used to establish the design method of the turbine engine starting control law and build a starter demand power calculation model under different external conditions, which treats fast start as the target, turbine inlet total temperature, fan/compressor surge margin and the main combustion chamber FAR(fuel air ratio) as the constraints, the main combustion chamber fuel supply as the moderator variables. Besides, starting control law design, starter demand power calculation and starting process simulation for the F119 engine are completed. The calculation results show that the starting control law can ensure turbine inlet total temperature, the fan/compressor surge margin and the FAR of the main combustion chamber under the limitation in the starting process of engine. All this study shows that the starting calculation model and design method of the starting control law developed in this paper have practical value in engineering.

Objectives: Target populations with persistent polypharmacy should be identified prior to implementing strategies against inappropriate medication use, yet limited information regarding such populations is available. The main objectives were to explore the trends of excessive polypharmacy, whether transient or persistent, at the individual level. The secondary objectives were to identify the factors associated with persistently excessive polypharmacy and to estimate the probabilities for repeatedly excessive polypharmacy.Methods: Retrospective cohort analyses of excessive polypharmacy, defined as prescription of ≥ 10 medicines at an ambulatory visit, from 2001 to 2013 were conducted using a nationally representative claims database in Taiwan. Survival analyses with log-rank test of adult patients with first-time excessive polypharmacy were conducted to predict the probabilities, stratified by age and sex, of having repeatedly excessive polypharmacy.Results: During the study period, excessive polypharmacy occurred in 5.4% of patients for the first time. Among them, 63.9% had repeatedly excessive polypharmacy and the probabilities were higher in men and old people. Men versus women, and old versus middle-aged and young people had shorter median excessive polypharmacy-free times (9.4 vs. 5.5 months, 5.3 vs. 10.1 and 35.0 months, both p < 0.001). Overall, the probabilities of having no repeatedly excessive polypharmacy within 3 months, 6 months, and 1 year were 59.9, 53.6, and 48.1%, respectively.Conclusion: Although male and old patients were more likely to have persistently excessive polypharmacy, most cases of excessive polypharmacy were transient or did not re-appear in the short run. Systemic deprescribing measures should be tailored to at-risk groups.

Osteoarthritis (OA), one of the most common joint disease, affects more than 80% of the population aged 70 or over. Mesenchymal stem cells (MSCs) show multi-potent differentiation and self-renewal capability, and, after exposure to an inflammatory environment, also exhibit immunosuppressive properties. In this study, we have used a model of lipopolysaccharide (LPS)-stimulated chondrocytes to evaluate MSC anti-inflammatory efficacy. The anti-inflammatory mechanism was tested in two cell-contained culture systems: (i) MSC-chondrocyte indirect contact system and (ii) MSC-chondrocyte direct contact system, and one cytokine-only culture system: MSC-conditioned medium (CM) system. Results showed that MSCs reduced chondrocyte inflammation through both paracrine secretion and cell-to-cell contact. The inflammation-associated, and free-radical-related genes were down-regulated significantly in the direct contact system on 24 h, however, the TNF-α. IL-6 were upregulated and aggrecan, COLII were downregulated on 72 h in direct contact system. Moreover, we found CM produced by MSC possess well therapeutic effect on inflammatory chondorcyte, and the 10-fold concentrated MSC-conditioned medium could down-regulated chondorcyte synthesis inflammation-associated, and free-radical-related genes, such as TNF-α, IL-1β, IL-6 and iNOS even treated for 72 h. In conclusion, MSC-CM showed great potential for MSC-based therapy for OA.

The aim of this study was to evaluate the antibacterial properties of oyster, hard clam, and sea urchin shell powders as a result of calcination. After subjection to calcination at 1050 °C for 2 h, and as identified by FTIR and XRD spectra, the structures of oyster, hard clam, and sea urchin shell powders were mainly transformed into calcium oxide, with slight amounts of calcium hydroxide. Metal content testing revealed no detectable harmful heavy metals, and showed rich content of trace elements including Ba, Sr, Mg, and Mn. To evaluate their antibacterial properties, activity against five foodborne microorganisms was assessed using the disk diffusion method, which indicated the presence of antibacterial activity in these products at a concentration of 1 %. These results indicate antibacterial potential for oyster, hard clam, and sea urchin shell powders after subjection to calcination.

The disabling pathophysiologic effects of lipid and neuroprotective effects of statins have recently been demonstrated for acute spinal cord injuries in animal models. This large scale population-based study aimed to investigate the effect hyperlipidemia and the use of statins in patients with lumbar spine injury. The National Health Insurance Research Database of Taiwan was used to identify patients with lumbar spine injury. A total of 2844 patients were grouped into three: no hyperlipidemia, hyperlipidemia using low-dose of statins (≤90 of the defined daily dosage (DDD)), and severe hyperlipidemia using high-dose of statins (&gt, 90 DDD). A Cox multiple regression model was used to compare the incidence rates of disability among the three groups. The results showed that patients with hyperlipidemia appeared a higher risk of permanent disability (adjusted HR = 1.38, p = 0.28). In subgroup analysis, patients with severe hyperlipidemia had a higher risk of disability (adjusted HR = 3.1, p &lt, 0.004), whereas hyperlipidemia using low-dose statins had a similar risk of permanently disability (adjusted HR = 0.83, p = 0.661). Hyperlipidemia adversely affected the neurological outcomes of lumbar spinal injury. Statins may have the potential to reverse this higher risk of disability. However, this beneficiary effect of statins only existed in patients using a lower dose (≤90 DDD).

Atopic dermatitis is a prevalent dermatologic disease in children. Corticosteroid is an important treatment but side effects caused by long-term and excessive use heavily concern patients. Traditional Chinese medicine (TCM) is potentially an alternative treatment and might cause less adverse effects. This nationwide retrospective cohort study aimed to examine the hypothesis that TCM use is associated with lower exposure to corticosteroid.Children under 12 years of age with ICD-9 codes 691.8 and 692.x were identified as atopic dermatitis patients from 2007/1/1 to 2007/12/31. Corticosteroid use was compared between TCM users and non-users for one-year follow-up by using a general estimation equation model with propensity-score matching.A total of 9012 TCM users were identified and the use of corticosteroid after treatment was compared with matched TCM non-users. Use of TCM significantly reduced exposure to corticosteroids after 1-year follow-up. Among TCM users, the exposure to any corticosteroids was lower (42.1% reduction in TCM users versus 34.5% increase in TCM non-users, relative risk: 0.36; p-Value0.001), the duration was shorter (relative risk for using corticosteroid more than 14 days: 0.37; p-Value0.001), and the rate of frequent visits with steroid prescription was also lower. CHM was the most commonly used TCM modality (98.5% of all visits) and Xiao-Feng-San was the most commonly used CHM (33% of all prescriptions) with extensive coverage for pathogenesis of atopic dermatitis.Lower use rate of corticosteroid can be found after TCM treatment, which can be considered as an integrative therapy for atopic dermatitis. Further studies are warranted on the basis of this study.

Eczema is a highly prevalent dermatological disease that can severely affect the patient’s quality of life. Chinese herbal medicine (CHM) is commonly used in combination for eczema due to the complicated pathogenesis. This study aimed to identify a CHM network for the treatment of eczema by using a nationwide database. During 2011, 381,282 CHM prescriptions made for eczema (ICD-9-CM 692.x) were obtained from the National Health Insurance Research Database (NHIRD) in Taiwan and analyzed by using association rule mining and social network analysis. Among 661 available CHMs, 44 important combinations were identified. Among the CHM networks, seven clusters with the predominant traditional Chinese medicine (TCM) pattern were recognized. The largest CHM cluster was used to treat the wind-dampness-heat pattern, and Xiao-Feng-San (24.1% of all prescriptions) was the core of this cluster with anti-inflammation, antioxidation, and antiallergic effects.Lonicera japonica(11.0% of all prescriptions) withForsythia suspense(17.0% of all prescriptions) was the most commonly used CHM combination and was also the core treatment for treating the heat pattern, in which an antimicrobial effect is found. CHM network analysis is helpful for TCM doctors or researchers to choose candidates for clinical practice or further studies.

article i nfo Purpose: The aim of this study is to examine the relationship between physician case volume and the outcomes of critically ill children with pneumonia. Materials and methods: This is a population-based cohort study analyzed data provided from by the National Health Insurance Research Database of Taiwan, 2006-2009. Children (aged 3 months to 17 years) having records of intensive care unit (ICU) admission and a diagnosis of pneumonia were included. A total of 9754 critically ill children and 1042 attending physicians were enrolled. The children were assigned to 1 of 4 groups based on the physician's pneumonia case volume. Results: The patients in the very high case volume group had a significantly lower length of hospital stay, in- hospital mortality rate, and hospitalization expenses, and a significantly higher ratio of ICU to hospital stays than the other 3 groups (P b .001). The probability of death tended to be lower when the physician's case volume was higher. The risk-adjusted odds ratio for in-hospital mortality of very-high case volume group was 0.48 (95% confidence interval, 0.35-0.65; P b .001) compared to low case volume group. Conclusions: A higher physician's pneumonia case volume is associated with a lower length of hospital stay, lower in-hospital mortality rate, and lower hospitalization expenses among critically ill children with pneumonia.

Laryngeal microsurgery is performed to assess disorders of the larynx. Parecoxib is the only parenterally administered selective cyclooxygenase (COX)-2 inhibitor widely used in acute pain control. The purpose of this study is to assess the analgesic effects of parecoxib compared with morphine for postoperative sore throat in patients undergoing laryngeal microsurgery. Fifty patients were randomly allocated to receive either parecoxib 0.5 mg/kg or morphine 50 μg/kg prior to anesthesia induction. General anesthesia was maintained with sevoflurane 2–4%. Postoperative sore throat and other outcomes were measured at a postanesthesia care unit (PACU) 4 hours and 24 hours postoperatively. The severity of postoperative sore throat was assessed by sore throat score as follows: none (0) = no pharyngeal or laryngeal discomfort; mild (1) = no pain at rest, but swallowing induced mild pain or discomfort; moderate (2) = constant pain without swallowing exacerbation; and severe (3) = constant pain with swallowing or respiratory exacerbation. The incidences of postoperative side effects (nausea, vomiting, itching, dizziness, and somnolence) were also recorded. Demographic data from the parecoxib (n = 25) and morphine (n = 25) groups did not differ significantly. The parecoxib group depicted similar sore throat scores as the morphine group at three measured postoperative time points. Patients requiring postoperative analgesics were comparable between the parecoxib group and morphine group (2/25, 8% vs. 3/25, 12%, p = 0.64). Overall postoperative adverse events were fewer in the parecoxib group than the morphine group (3/25, 12% vs. 9/25, 36%, p = 0.047). Both parecoxib and morphine are effective to attenuate postoperative sore throat after laryngeal microsurgery. Parecoxib may be an effective and well-tolerated injectable analgesic to manage postoperative sore throat after laryngeal microsurgery.

This paper reports on the development of a quadrupedal crawling-rolling hybrid robot that can switch motions under various circumstances. Through mechanical design, we reduced the number of motors used without sacrificing fluency of motion. The robot was empirically built and tested to performed the designate crawling and rolling behaviors.

This work proposes a systematic design approach to perform minimum and second minimum fast-searching in 2-dimensional xy-planes. This fast-searching approach can extremely improve the calculating timing in LDPC decoder architecture, especially for high row weights defined in IEEE 802.11n/ac/ax SPEC. In a design example with row weight of 22, our developed approach only requires about 42.9% of critical-path timing under 12.2% hardware overhead with respect to often-used binary-tree approach. This approach also extends to other various high row weights for enhancing critical-path timing performance.

Background Although dysphagia is often self-limiting after anterior cervical discectomy and fusion (ACDF), its incidence, risks, and long-term outcomes remain unclear. The present study aimed to analyze dysphagia up to 5 years post-ACDF using a nation-scaled cohort. Methods Incidences of permanent dysphagia requiring nasogastric-tube feeding after ACDF were analyzed using three million-sample cohorts derived from the National Health Insurance Research Database of Taiwan. All identified subjects were stratified into four groups (40's, 50's, 60's, and >70) according to their age at operation, and were subsequently followed up for 5 years. The risks of dysphagia were compared between the groups using Kaplan-Meier analysis and Cox regression hazard ratio model. Results A total of 2723 patients (>40 years old) who received first-time ACDF surgery were identified from a cohort of three million and followed up for a maximum of 5 years post-operation. The 5-year incidence rates of persistent dysphagia (requiring use of a nasogastric tube) were 6.1, 4.0, 12.0, and 22.8 per 1000 person-years for each age group (40's, 50's, 60's, and 70+ years old, respectively). The overall incidence rate of dysphagia after ACDF was 18.4, 10.9, and 8.9 per 1000 person-years at 3 months, 1 year, and 5 years follow-up, respectively. The incidence rates of dysphagia and use of home care services were highest at 3 months postoperatively in all age groups, but dropped to a stable level after one year post-operation. The risks of dysphagia and the necessity of using home care services were higher (hazard ratio= 2.69 and 4.96) in the elderly group (aged 70 years and over) at all follow-up time points. Conclusions The elderly patients had higher risks of short- and long-term severe dysphagia after ACDF. Therefore, although the incidence rates were still low (approximately 2.3%), older patients (aged 70 years and over) should be cautioned for dysphagia requiring a nasogastric tube and home care services if they undergo ACDF.

Long-term morbidities can develop after traumatic brain injury (TBI). Some studies have suggested that the risk of stroke is higher after TBI, but the association between concussion and stroke remains unclear. Using a national cohort, the authors analyzed the incidence of both hemorrhagic and ischemic strokes in patients with previous concussion. A representative cohort of approximately one million people was followed up for four years. Patients with new-onset concussion were identified (n = 13,652) as the concussion group. Subsequently, the incidence rates of later stroke events in the concussion group were compared to a sex-, age- and propensity score–matched comparison group (n = 13,652). The overall incidence rate of stroke in the concussion group was higher than that of the comparison group (9.63 versus 6.52 per 1000 person-years, p < 0.001). Significantly higher stroke risk was observed in the concussion group than in the comparison group (crude hazard ratio 1.48, p < 0.001; adjusted HR 1.65, p < 0.001). In the concussion group, the cumulative incidence rates of both ischemic stroke and hemorrhagic stroke were higher than those of the comparison group (8.9% vs. 5.8% and 2.7% vs. 1.6%, respectively, both p < 0.001). Concussion is an independent risk factor for both ischemic and hemorrhagic strokes. Prevention and monitoring strategies of stroke are therefore suggested for patients who have experienced concussion.

Background. Endometriosis is a common but bothersome gynecological disease, and Chinese herbal medicine (CHM) is used for treating endometriosis. The aim of this study is to explore CHM network and core treatments for endometriosis by analyzing nationwide CHM prescription database. Methods. From 1998 to 2013, the CHM prescriptions made primarily for endometriosis among women diagnosed with endometriosis (ICD-9-CM code: 671) by gynecologists during their reproductive age were collected. CHM network analysis was then carried out by using association rule mining and social network analysis. Results. A total of 12,986 CHM prescriptions made for endometriosis were analyzed. There were 556 kinds of CHM ever used, and, in average, each prescription was composed of 6.2 CHMs. Gui-Zhi-Fu-Ling-Wan (GZFLW) was used most frequently, followed by Cyperus rotundus (28.1% and 18.8% of all prescriptions, resp.). Additionally, the combination of Cyperus rotundus with GZFLW (8.0%) was the most frequently used combination of two CHMs. CHM network showed that GZFLW was the core CHM for endometriosis and graphically demonstrated the extensive coverage of TCM syndromes and pathogenesis of endometriosis. Conclusions. CHM network provides graphical demonstration and summary of commonly used CHMs for endometriosis, and further studies are warranted based on these findings.

Physical review / B 95(2), 024413(2017). doi:10.1103/PhysRevB.95.024413, We have performed first-order reversal curve (FORC) measurements to investigate the irreversible magnetization processes in the low-temperature phase of MnBi. Using temperature-dependent FORC analysis, we are able to provide a clear insight into the effects of microstructural parameters such as grain diameter, shape, and surface composition on the coercivity of nucleation hardened permanent magnet MnBi. FORC diagrams of MnBi show a unique broadening and narrowing of the coercive field distribution with increasing temperature. We were able to microscopically identify the reason for this behavior, based on the shift in the single domain critical diameter from nearly 1 to 2 μm, thereby changing the dependence of coercivity with particle size. This is based on a strong increase in the uniaxial anisotropy constant with increasing temperature. Furthermore, the results also give an additional confirmation that the magnetic hardening in low-temperature phase MnBi occurs due to nucleation mechanisms. In our case, we show that temperature-dependent FORC measurements provide a powerful tool for the microscopic understanding of high-performance permanent magnet systems., Published by Inst., Woodbury, NY

While molting occurs in the development of many animals especially in arthropods, post-maturity molting (PMM, organisms continue to molt after sexual maturity) has received little attention. Mechanism of molting has been studied intensively, however, the mechanism of PMM remains unknown although it is suggested to be crucial for the development of body size. In this study, we investigated factors that potentially induce PMM in the golden orb-web spider Nephila pilipes, which has the greatest degree of sexual dimorphism among terrestrial animals. We manipulated the mating history and the nutrient consumption of the females to examine whether they can affect PMM. The results showed that female spiders under low nutrition were more likely to molt as adults, and mating had no significant influence to the occurrence rate of PMM. Moreover, spiders that experienced PMM lived longer than those without and their body sizes were significantly increased. Therefore, we concluded that it is the nutritional condition rather than the mating history that has affected PMM.

This study was performed to compare the various bioactivities of water-soluble, polar, and nonpolar extracts from the edible part (gonad) and waste (body wall) of the sea urchin Tripneustes gratilla. During antioxidant activity screening, these three extracts from both gonad and body wall showed various antioxidant activities in different tests. During human skin fibroblast (CCD966SK) viability and collagen screening, only water-soluble and polar extracts from gonad and body wall were observed to promote cell viability, while the water-soluble gonad extract promoted the collagen-generating activity of CCD966SK cells. The water-soluble and polar extracts from gonad and body wall showed proliferative activity towards different cell types. In contrast, the nonpolar extracts of gonad and body wall exerted antiproliferative effects on most tumor cells. These results indicate that the bioactivities of sea urchin extracts depend on the part of the urchin that the extract was taken from as well as the extraction method used.

In this paper, amorphous InGaZnO 4 thin-film transistors with an asymmetric structure exhibit ultraviolet (UV) light sensing property. At the offset region near the drain electrode, the extended active layer plays the role of a resistor. However, the ON-state current is obviously reduced with increasing offset length at the offset region near the source electrode and the characteristics cannot be turned ON when offset length is over 4 μm. After exposure to UV light, photogenerated holes-induce source barrier lowering and then amplifying the photocurrent response. Therefore, the devices in this paper reach a high-ON/OFF ratio of UV sensitivity to 10 6 .

Asthma and atrial fibrillation (AF) have been reported to be related to an increased risk of cardiovascular events. However, the relationship between asthma and AF has not been fully elucidated. The purpose of this study was to examine the association between asthma and AF risk.We conducted a population-based nested case-control study including a total of 7439 newly-diagnosed adult patients with AF and 10,075 age-, gender-, comorbidity-, and cohort entry date-matched subjects without AF from the Taiwan National Health Insurance database. Exposure to asthma as well as medications including bronchodilators and corticosteroid before the index date was evaluated to investigate the association between AF and asthma as well as concurrent medications.AF patients were 1.2 times (adjusted OR 1.2, 95% CI 1.109-1.298) more likely to be associated with a future occurrence of asthma independent of comorbidities and treatment with corticosteroids and bronchodilator. In addition, the risks of new-onset AF were significantly higher among current users of inhaled corticosteroid, oral corticosteroids, and bronchodilators. Newly users (within 6 months) have the highest risk (inhaled corticosteroid: OR, 2.13; 95% CI, 1.226-3.701, P=0.007; oral corticosteroid: OR, 1.932; 95% CI, 1.66-2.25, P0.001; non-steroid bronchodilator: OR, 2.849; 95% CI, 2.48-3.273, P0.001). A graded association with AF risk was also observed among subjects treated with corticosteroid (inhaled and systemic administration) and bronchodilators. New users (within 6 months) of these medications had the highest risk of AF (ICS: OR, 2.13; 95% CI, 1.226-3.701, P=0.007; oral corticosteroid: OR, 1.932; 95% CI, 1.66-2.25, P0.001; non-steroid bronchodilator: OR, 2.849; 95% CI, 2.48-3.273, P0.001). A graded association with AF risk was also observed among subjects treated with ICS or bronchodilator.Asthma was associated with an increased risk of developing future AF.

Maltooligosyltrehalose synthase (MTSase) is a key enzyme in the synthesis of trehalose. Computer simulations using AutoDock and NAMD were employed to assess the substrate-binding and selectivity-related residues of MTSase. We introduced mutations at residues D411, D610, and R614 to determine the substrate-binding residues of Sulfolobus solfataricus ATCC 35092 MTSase, and introduced mutations at residues P402, A406, and V426 to investigate the enzyme's selectivity-related residues. Kinetic studies of D411A, D610A, and R614A MTSases reveal significant reductions in catalytic efficiency and cause increase in the transition-state energy of mutant MTSases, indicating that residues D411, D610, and R614 form hydrogen bonds to the substrate. Compared with wild-type MTSase, the hydrolysis: transglycosylation selectivity ratio was significantly decreased for P402Q and significantly increased for A406S MTSases, while the ratio for V426T MTSase showed little change. The results suggest that P402 and A406 residues are selectivity-related.

ESRD in the young represents a heavy burden to patients, families, and health care systems. This nationwide retrospective study characterized the incidence of ESRD and analyzed diagnoses associated with renal survival in the young population in Taiwan.Through use of Taiwan's National Health Insurance Research Database, the population of young patients (age30 years, including children and young adults) with ESRD between January 1998 and December 2009 were enrolled. The medical claims were used to derive the date when the cause of ESRD was first determined. The medical data were reviewed and the renal survival time (time from first diagnosis of the cause to the start of ESRD) was calculated by experts, including clinical physicians and a large-database specialist.The incidence rate of ESRD in the young population was high compared with the worldwide rate at 21.1 per million person-years, whereas the incidence in the pediatric group was still similar to that in other countries at 10.3 per million person-years. A total of 2304 patients with new-onset ESRD and identified renal diseases during the study period were enrolled. All preschool-age patients (100%) began receiving peritoneal dialysis as their initial treatment for ESRD. The leading causes, which varied by sex and onset age, were glomerulonephropathy followed by hypertension for the young adult group and glomerulonephropathy followed by congenital anomalies of the kidney and urinary tract (CAKUT) for the pediatric group. Renal survival was cause-dependent. The median overall renal survival duration was 0.8 year (interquartile range [IQR], 0.7-3.5 years). CAKUT-related ESRD had the longest progression time (median renal survival, 16.0 years; IQR, 10.7-23.5 years); glomerulonephropathy progressed more rapidly into ESRD and had the shortest median renal survival of 0.5 year (IQR, 0.1-2.7 years).The incidence and causes of ESRD greatly differ between pediatric patients and young adults. Moreover, renal survival in the young population markedly varies depending on the cause of renal disease.

The nano-sized V/TiO2 prepared by a sol-gel method calcined at 500°C for 3 h was characterized in this study. The synthesized photo-catalysts were used for the photo-degradation of 1, 2-dichloroethane (1, 2-DCE). From X-ray powder diffraction data, the crystal phase presents the mixture of anatase and rutile phases with anatase the dominant phase. From TEM images, the crystallites of photo-catalysts are spherical particles with a crystallite size about 10–20 nm. UV-Visible absorption spectra of V/TiO2 show a slightly increase in absorbance in the visible light region with the increasing vanadium ion doping concentration. The X-ray photoelectron spectroscopy results indicate that the doped vanadium ions exist in the form of V (IV). The V (IV) may alleviate the surface poison phenomenon and act as both h + /e – traps to reduce the recombination rate of h + /e – pairs, and the optimum vanadium doping amount is 0.01 mol%. The products and byproducts of 1, 2-DCE photo-degradation include H2O, CO, CO2, C2H5Cl, CH2Cl2, and HCl.

A new strategy for cyclopenta[b]furan synthesis mediated by hypervalent iodine(III) has been described. The approach employs diacetoxyiodobenzene-induced initial dehydrogenation to a putative trienone intermediate and triggered sequential cycloisomerization to form the cyclo-penta[b]furan targets.

While molting occurs in the development of many animals, especially arthropods, post-maturity molting (PMM, organisms continue to molt after sexual maturity) has received little attention. The mechanism of molting has been studied intensively; however, the mechanism of PMM remains unknown although it is suggested to be crucial for the development of body size. In this study, we investigated factors that potentially induce PMM in the golden orb-web spider

BACKGROUND This study aimed to investigate the medical expenses and outcomes of central cord syndrome (CCS), comparing patients who received surgical and non-surgical management. METHODS Using a 14-year nationwide database in Taiwan, this study followed-up all patients of CCS at least 5 years. The incidence rates, medical expenses, permanently disabled spinal cord injury (SCI), and mortality rates were compared for patients who underwent surgery and those who were managed conservatively. All CCS patients were further stratified by the level of injury (C1-4 vs. C5-7) in the cost analysis. RESULTS A total of 1,753 patients with CCS were followed and the incidence of CCS was the highest among males aged between 60 and 70 years, at 42.4 per 1,000,000 person-years. The total medical expenses were higher in the surgery than the non-surgery group (46,586.9 vs. 28,472.4, P

Polar Codes become a new channel coding, which will be common to apply for next-generation wireless MIMO communication systems. In this work, we propose LEGO-based VLSI hardware design and implementation of the Polar encoder using radix-2 processing engines, which features low area cost, low power dissipation, high speed, and high throughput via serial computation. Under TSMC 90nm CMOS technology, the 16384-point LEGO-based radix-2 Polar encoder chip (LB-R2-PE) is designed and synthesized with total area of 0.244mm2 and power dissipation of 366.6mW, operating at maximum frequency of 2.0GHz. In the APR chip implementation point-of-view, the 16384-point LB-R2-PE chip only occupies 0.305mm2 and consumes 357.8mW with maximum operating frequency of 1.61GHz, delivering total throughput of 1.61Gbps.

Polar Codes applied for next-generation MIMO systems is an emerging research topic. In this work, we propose an efficient VLSI hardware architecture of the Polar encoder using radix-k processing engines. Under TSMC 90nm CMOS technology, the 16384-point radix-2 based Polar encoder design is synthesized with 0.244mm2 under maximum clock frequency of 2.0GHz. In the similar manner, the VLSI hardware can be extended to radix-k based design. In the chip implementation with APR results, the radix-2 based Polar encoder only occupies 0.305mm2 and dissipates 357.8mW with maximum clock frequency of 1.61GHz, delivering total throughput of 1.61Gbps.

An increasing number of emergency department (ED) visits have posed a challenge to health systems in many countries, but an understanding of non-emergent ED visits has remained limited and contentious. This retrospective study analyzed ED visits using three representative cohorts from routine data to explore the profiles and longitudinal pattern changes of non-emergent ED visits in Taiwan. Systematic-, personal-, and ED visit-level data were analyzed using a logistic regression model. Average marginal effects were calculated to compare the effects of each factor. The annual ED visit rate increased up to 261.3 per 1000 population in 2010, and a significant one-third of visits were considered as non-emergent. The rapidly growing utilization of ED visits underwent a watershed change after cost-sharing payments between patients and medical institutions were increased in 2005. In addition to cohort effects resulting from cost-sharing payment changes, all factors were significantly associated with non-emergent ED visits with different levels of impact. We concluded that non-emergent ED visits were associated with multifaceted factors, but the change to cost-sharing payment, being female, younger age, and geographical residence were the most predictive factors. This information would enhance the implementation of evidence-based strategies to optimize ED use.

The objective of the study is to understand the therapeutic effects of lipophilic (simvastatin) and hydrophilic statins (pravastatin) combined with/without hyaluronic acid for osteoarthritis by an in vitro LPS-induced inflammatory model of articular chondrocytes. HA in combination with different doses of simvastatin or pravastatin were used. Beside cytotoxicity, the influence of statins on NO production, pro-inflammatory cytokine, inflammatory mediators, and NF-κB p50 protein were analyzed. Finally, TUNEL assay was performed to detect DNA strand breakage. Two statins were less able to lower NF-κB activity when they were administrated along without HA. The gene expression demonstrates that simvastatin and pravastatin had the ability to decrease pro-inflammatory and inflammatory mediator levels. High dose simvastatin with or without HA down regulated inflammatory cytokines, but resulted in higher cytotoxicity. TUNEL assay confirms the regulatory effect of statins with or without HA over the apoptosis of chondrocytes, especially in hydrophilic statins. The significant down-regulation of inflammatory mediators suggests that intra-articular injection of HA in combination with statins might feasibly slow the progress of osteoarthritis. Administration of simvastatin or pravastatin with hyaluronic acid may produce beneficial effects for OA treatment, but with better results when hydrophilic statin was used.

Summary Periodicity and trend are features describing an observed sequence, and extracting these features is an important issue in many scientific fields. However, it is not an easy task for existing methods to analyse simultaneously the trend and dynamics of the periodicity such as time varying frequency and amplitude, and the adaptivity of the analysis to such dynamics and robustness to heteroscedastic dependent errors are not guaranteed. These tasks become even more challenging when there are multiple periodic components. We propose a non-parametric model to describe the dynamics of multicomponent periodicity and investigate the recently developed synchro-squeezing transform in extracting these features in the presence of a trend and heteroscedastic dependent errors. The identifiability problem of the non-parametric periodicity model is studied, and the adaptivity and robustness properties of the synchro-squeezing transform are theoretically justified in both discrete and continuous time settings. Consequently we have a new technique for decoupling the trend, periodicity and heteroscedastic, dependent error process in a general non-parametric set-up. Results of a series of simulations are provided, and the incidence time series of varicella and herpes zoster in Taiwan and respiratory signals observed from a sleep study are analysed.