Search

ABSTRACT All metazoans produce antimicrobial peptides (AMPs) that have both broad antimicrobial and immunomodulatory activity. Cathelicidins are AMPs that preferentially kill Gram-negative bacteria in vitro, purportedly by assembling into higher-order structures that perforate the membrane. We utilized high-resolution, single-cell fluorescence microscopy to examine their mechanism of action in real time. Engineered cathelicidins rapidly bound to Gram-negative and Gram-positive cells and penetrated the cytoplasmic membrane. Rapid failure of the peptidoglycan superstructure in regions of active turnover caused leakage of cytoplasmic contents and the formation of membrane-bound blebs. A mutation anticipated to destabilize interactions between cathelicidin subunits had no effect on bactericidal activity, suggesting that cathelicidins have activities beyond perforating the membrane. Nanomolar concentrations of cathelicidins, although not bactericidal, reduced the growth rate of Gram-negative and Gram-positive bacteria. The cells exhibited expression changes in multiple essential processes, including protein synthesis, peptidoglycan biosynthesis, respiration, and the detoxification of reactive oxygen species (ROS). Time-lapse imaging revealed that ROS accumulation preceded bleb formation, and treatments that reduced cellular ROS levels overcame these bactericidal effects. We propose that that the primary effect of cathelicidins is to induce the production of ROS that damage bacterial molecules, leading to slowed growth or cell death. Given their low circulating levels in vivo, AMPs may serve to slow bacterial population expansion so that cellular immunity systems can respond to and battle the infection. IMPORTANCE Antimicrobial peptides (AMPs) are an important part of the mammalian innate immune system in the battle against microbial infection. How AMPs function to control bacteria is not clear, as nearly all activity studies use nonphysiological levels of AMPs. We monitored peptide action in live bacterial cells over short time frames with single-cell resolution and found that the primary effect of cathelicidin peptides is to increase the production of oxidative molecules that cause cellular damage in Gram-positive and Gram-negative bacteria.

ABSTRACT The world is at the precipice of a postantibiotic era in which medical procedures and minor injuries can result in bacterial infections that are no longer effectively treated by antibiotics. Cathelicidins are peptides produced by animals to combat bacterial infections and to regulate innate immune responses. However, cathelicidins are potent activators of the inflammatory response. Cathelicidins with reduced proinflammatory activity and potent bactericidal activity in the low micromolar range against Gram-negative bacteria have been identified. Motifs in cathelicidins that impact bactericidal activity and cytotoxicity to human cells have been elucidated and used to generate peptides that have reduced activation of proinflammatory cytokine production and reduced cytotoxicity to human cells. The resultant peptides have bactericidal activities comparable to that of colistin and can kill colistin-resistant bacteria. IMPORTANCE Cathelicidins are antimicrobial peptides that can also increase inflammatory responses. This combination of activities can cause complications in the treatment of bacterial infections despite the pressing need for new antimicrobials. We have identified cathelicidins with decreased activation of inflammatory responses. The peptides kill Gram-negative bacteria at low micromolar concentrations by binding to and perturbing the integrity of the bacterial membrane. The peptides were also engineered to further decrease lysis of human red blood cells. The peptides have activities comparable to those of the polymyxins, a class of antibiotics to which plasmid-borne resistance is rapidly spreading and can kill colistin-resistant bacteria. These peptides are promising candidates for the development of novel antibacterial agents.

In the hospice ward where patients are in the terminal stages of cancer, it is common practice to give them a subcutaneous injection of pain relievers to reduce their pain and make them more comfortable. Most of these patients are elderly and have low blood pressure or poor veins, which often makes it difficult to inject them because of the calcification at previous injection sites. Thus, subcutaneous injections are a convenient way to maintain analgesia and patient comfort. Our patient, a 73-year-old aboriginal woman, was diagnosed with gastric adenocarcinoma and peritoneal carcinomatosis in March, 2004. While she was in the inpatient hospice ward, a subcutaneous injection site became infected and localized cellulitis developed. The patient’s quality of life began to decline and her hospice stay was lengthened due to these complications. This case is offered as a reference case of subcutaneous injection complications encountered by elderly patients in hospice care.

Objective: The aim of this study was to explore the association between etodolac use and acute in Taiwan. Design: We designed a case-control study using the database of Taiwan’s National Health Insurance. Subjects: In all, 7577 subjects aged 20 years or older with newly diagnosed acute pancreatitis were defined as cases, and 27032 sex-matched and age-matched subjects without acute pancreatitis were defined as controls. The period considered for this study was from 1998 to 2011. For the study, never having used etodolac is defined as a subject never receiving a prescription for etodolac. Active use of etodolac is defined as a subject receiving at least 1 prescription for etodolac within 7 days of the date of their being diagnosed with acute pancreatitis. Non-active use of etodolac is defined as a subject not receiving a prescription for etodolac within 7 days but receiving at least 1 prescription for etodolac ≥ 8 days before the date of their being diagnosed with acute pancreatitis. Main outcome measure: The association between etodolac use and acute pancreatitis was estimated by using the multivariable unconditional logistic regression model. Results: After correcting for covariates, the adjusted odds ratio of acute pancreatitis was 3.78 for subjects with active use of etodolac (95% confidence interval 1.11, 12.9), compared with subjects who never used etodolac. The adjusted odds ratio decreased to 1.18 for subjects with non-active use of etodolac (95% confidence interval 0.38, 3.67), but that was without statistical significance. Conclusion: There could be an association between active use of etodolac and acute pancreatitis. Clinicians should take into account the possibility of etodolac-associated acute pancreatitis when patients currently using etodolac present with acute pancreatitis with an unknown cause.

Abstract A cost‐effective chemical prelithiation solution, which consists of Li+, polyaromatic hydrocarbon (PAH), and solvent, is developed for a model hard carbon (HC) electrode. Naphthalene and methyl‐substituted naphthalene PAHs, namely 2‐methylnaphthalene and 1‐methylnaphthalene, are first compared. Grafting an electron‐donating methyl group onto the benzene ring can decrease electron affinity and thus reduce the redox potential, which is validated by density functional theory calculations. Ethylene glycol dimethyl ether (G1), diethylene glycol dimethyl ether, and triethylene glycol dimethyl ether solvents are then compared. The G1 solution has the highest conductivity and least steric hindrance, and thus the 1‐methylnaphthalene/G1 solution shows superior prelithiation capability. In addition, the effects of the interaction time between Li+ and 1‐methylnaphthalene in G1 solvent on the electrochemical properties of a prelithiated HC electrode are investigated. Nuclear magnetic resonance data confirm that 10‐h aging is needed to achieve a stable solution coordination state and thus optimal prelithiation efficacy. It is also found that appropriate prelithiation creates a more Li+‐conducing and robust solid‐electrolyte interphase, improving the rate capability and cycling stability of the HC electrode.

Abstract Purpose Periprosthetic joint infection (PJI) is a leading cause of joint arthroplasty failure, potentially leading to critical complications like vertebral osteomyelitis (VO). The factors contributing to VO after PJI and the outcomes for these patients are not well understood. Our study aims to (1) identify risk factors for VO following PJI and (2) assess the clinical outcomes in these cases. Methods We included PJI patients treated surgically at our centre from January 2006 to December 2020, excluding those with simultaneous VO post‐PJI. Our focus was on patients with VO occurring after PJI, monitored for at least 5 years. Analysis included patient comorbidities, PJI treatment approaches, pathogen identification and clinical outcomes. Results Of 1701 PJI cases, 21 (1.23%) developed VO. Key risk factors for VO post‐PJI were identified: systemic inflammatory response syndrome, substance misuse, polymicrobial infection and undergoing at least three stages of resection arthroplasty (odds ratios: 1.86, 54.28, 52.33 and 31.88, respectively). Adverse outcomes were noted in VO patients, with recurrent VO in 6/21 and repeated PJIs in 18/21 cases. Conclusions Patients with PJI, especially those with certain risk factors, have an increased likelihood of developing VO and encountering negative outcomes. The potential role of bacteremia in the development of VO after PJI needs further exploration. Level of Evidence Level III.

Abstract Near infrared energy remains untapped toward the maneuvering of entire solar spectrum harvesting for fulfilling the nuts and bolts of solar hydrogen production. We report the use of Au@Cu7S4 yolk@shell nanocrystals as dual-plasmonic photocatalysts to achieve remarkable hydrogen production under visible and near infrared illumination. Ultrafast spectroscopic data reveal the prevalence of long-lived charge separation states for Au@Cu7S4 under both visible and near infrared excitation. Combined with the advantageous features of yolk@shell nanostructures, Au@Cu7S4 achieves a peak quantum yield of 9.4% at 500 nm and a record-breaking quantum yield of 7.3% at 2200 nm for hydrogen production in the absence of additional co-catalysts. The design of a sustainable visible- and near infrared-responsive photocatalytic system is expected to inspire further widespread applications in solar fuel generation. In this work, the feasibility of exploiting the localized surface plasmon resonance property of self-doped, nonstoichiometric semiconductor nanocrystals for the realization of wide-spectrum-driven photocatalysis is highlighted.

Tungsten-doped TiO2 thin films were prepared by sol–gel method on fluorine-doped tin oxide-coated substrates as working electrodes of dye-sensitized solar cells. The influences of different W doping (0, 2, 4, 6, and 8 at%) on the microstructure, optical, and photovoltaic properties of the W-TiO2 thin-film DSSCs were studied by the measurement of X-ray diffraction (XRD), scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), Brunauer–Emmett–Teller (BET) analysis, and electrochemical impedance spectroscopy (EIS). An optimal DSSCs performance was observed with a 6 at% W-doped TiO2 thin film, resulting in a Voc of 0.68 V, a Jsc of 20.2 mA/cm2, an FF of 68.6%, and an efficiency (η) of 9.42%. The efficiency of DSSCs with 6 at% W-doped TiO2 photoanode improved by 75%. This is because the 6 at% W-doped TiO2 thin film increases the specific surface area and electron transfer rate.

BackgroundDisaster-related psychiatric disorders (DRPD) present a significant challenge to mental health professionals, yet there is a notable lack of emphasis on the preparedness of psychiatrists in managing these conditions within post-graduate medical education.MethodsThis study utilized a questionnaire to collect data from psychiatrists, focusing on their prior involvement in managing DRPD, perceived competence, medication preferences, and factors influencing their experiences in handling such disorders. Analysis included distribution and ranking of variables, alongside cross-analysis examining associations between demographic factors (age, gender, hospital levels, years of practice, board certification) and treatment experiences, as well as readiness for in-hospital or outside-hospital mobilization in DRPD management.ResultsOne hundred and three Taiwanese psychiatrists participated in the study, with the majority reporting involvement in managing DRPD (71.8%), particularly in post-traumatic stress disorder (PTSD) and depression. Antidepressants, specifically serotonin selective reuptake inhibitors, were commonly preferred for DRPD treatment, including PTSD and depression. Psychiatrists aged over 40, with more than 10 years of practice, and hold the board-certified status, showed greater experiences for outside- or inside- the hospital mobilization in DRPD management.ConclusionFindings suggest that within post-graduate medical education, Taiwanese psychiatrists demonstrate significant experience, willingness, and capacity to effectively manage DRPD. However, there is a need to integrate comprehensive training on disaster psychiatry into post-graduate psychiatric education programs to further enhance preparedness and optimize outcomes in managing these challenging conditions.

The fabrication of InGaN-based blue 4✕4 array micro-LEDs (μLEDs) with 40 μm ✕40 μm chip size and 2✕2 array μLEDs with 80 μm ✕80 μm chip size etching by the inductive coupled plasma reactive ion etching (ICPRIE) and defect-free neutral beam etching (NBE) processes was studied in this work. In μLEDs of this size, the influence of defects formation in the sidewalls on EQE was evaluated. There was almost no difference in EQE between μLEDs array etched by the NBE process no matter 40 μm ✕40 μm and 80 μm ✕80 μm, but the dependence was observed in the ICPRIE. Even with this size, it was found that the size effect of EQE is smaller than that in case of using ICPRIE for defect-free neutral beam etching. This impact is substantial since μLED predominantly operated at low current density, around 1–5 A/cm2. Consequently, the reduction of defect density, encompassing both internal and sidewall defects, becomes imperative even in 40–80 μm InGaN-based μLEDs. This not only improves the overall efficiency of μLEDs but also fortifies the brightness stability of μLED displays if process etching by NBE. It was also found that the etching shape had an influence on EQE. It could be attributed to fact that the etching profile angle of NBE was more vertical than that of ICPRIE. Because the different angles of the mesa resulted in different light intensity. The μLEDs emitting with a wavelength of 450 nm, the light extraction efficiency and intensity at a mesa angle 58° of NBE etching μLEDs was about 8% lower than those of an angle (38°) of ICPRIE etching μLEDs by simulation.

Although advancements in n- and p-doping of gallium oxide (Ga2O3) are underway, the realization of functional pn diodes remains elusive. Here, we present the successful fabrication of a Ga2O3 pn diode utilizing ion implantation technology. The Ga2O3 epilayers were grown on c-plane sapphire substrates by metalorganic chemical vapor deposition (MOCVD). P-type conductivity Ga2O3 epilayer, confirmed by Hall effect analysis, was achieved by phosphorus (P) ion implantation followed with a rapid thermal annealing (RTA) process. This p-Ga2O3 epilayer reveals a significant reduction in resistivity ( 3kT/q) and remained very low at 2✕10−8 A, as the diode operated at 150oC. The behavior could be due to Ga2O3 being a wide bandgap material.

Ferroelectric HfO2 thin film has been widely explored due to its superior characteristics, such as high switching speed, scalability, and long data retention. However, it still faces challenges in achieving good stability due to the wake-up and split-up effects. In this study, the sub-cycling behavior of Hf0.5Zr0.5O2-based ferroelectric capacitors (FeCaps) with various annealing temperatures is investigated. Our results suggest that the FeCaps with higher annealing temperatures demonstrate an increased resistance to the split-up effect and exhibit less distorted hysteresis loops compared to their lower-temperature counterparts. Symmetrical sub-cycling reveals pronounced current split-up and diminished switching current peaks in the FeCaps with lower annealing temperatures, whereas those annealed at higher temperatures show minimal current split-up and enhanced performance. Asymmetrical sub-cycling shows that lower annealing temperatures cause local domain pinning, while higher temperatures result in imprint-like behavior. Synchrotron-based extended x-ray absorption fine structure and hard x-ray photoelectron spectroscopy analyses reveal the potential of nitrogen doping in HfZrOx under high-temperature annealing processes, forming the Hf–N species to mitigate the amount of charged oxygen vacancy ( V O 2 + ) in the interfacial region. This study elucidates the relationship between V O 2 + distribution and the split-up effect during sub-cycling, providing critical insights for enhancing the sub-cycling performance and stability of HfO2-based devices.

Abstract Background Diabetes mellitus (DM) has been associated with the cancer risk. This study investigated relationship between DM and esophageal cancer using Taiwan’s insurance data. Methods We identified 549 patients with esophageal cancer newly diagnosed in 2000-2009 and randomly selected 2196 controls without any cancer, frequency matched by sex, age and diagnosis year of cases. Logistic regression model estimated odds ratios (ORs) and 95% confidence intervals (CI) of esophageal cancer associated with DM, sex, age. co-morbidities and medications. Results Cases were more prevalent than controls for alcoholism and esophageal disorders and using nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 inhibitors but not DM. Esophageal cancer had no association with DM (OR 0.99, 95% CI 0.71-1.37), but significantly associated with alcoholism (OR 14.1, 95% CI 7.87-25.4), esophageal ulcer (OR 10.1, 95% CI 5.70-17.9), esophageal reflux (OR 3.47, 95% CI 2.14-5.26) and uses of NSAIDs (OR 2.73, 95% CI 1.80-4.13). An elevated risk of esophageal cancer appeared in DM patients taking insulin (OR 2.57, 95% CI 1.08-6.15) or sulfonyurea (OR 3.80, 95% CI 1.16-12.5). Conclusions Patients with DM are not at higher risk for esophagus cancer. However, esophageal disorders and anti-diabetic drugs are associated with the risk of the disease.

Abstract Background Chronic kidney disease (CKD) is more prevalent in Taiwan than in most countries. This population-based cohort study evaluated the dementia risk associated with CKD. Methods Using claims data of 1,000,000 insured residents covered in the universal health insurance of Taiwan, we selected 37049 adults with CKD newly diagnosed from 2000–2006 as the CKD cohort. We also randomly selected 74098 persons free from CKD and other kidney diseases, frequency matched with age, sex and the date of CKD diagnosed. Incidence and hazard ratios (HRs) of dementia were evaluated by the end of 2009. Results Subjects in the CKD cohort were more prevalent with comorbidities than those in the non-CKD cohort (p Conclusions Patients with CKD could have an elevated dementia risk. CKD patients with comorbidity deserve attention to prevent dementia.

In this study, Ba0.6Sr0.4Ti1-xMnxO3 ceramics were fabricated by a novel ball milling technique followed by spin-coating to produce thin-film resistive memories. Measurements were made using field emission scanning electron microscopes, atomic force microscopes, X-ray diffractometers, and precision power meters to observe, analyze, and calculate surface microstructures, roughness, crystalline phases, half-height widths, and memory characteristics. Firstly, the effect of different sintering methods with different substitution ratios of Mn4+ for Ti4+ was studied. The surface microstructural changes of the films prepared by the one-time sintering method were compared with those of the solid-state reaction method, and the effects of substituting a small amount of Ti4+ with Mn4+ on the physical properties were analyzed. Finally, the optimal parameters obtained in the first part of the experiment were used for the fabrication of the thin-film resistive memory devices. The voltage and current characteristics, continuous operation times, conduction mechanisms, activation energies, and hopping distances of two types of thin-film resistive memory devices, BST and BSTM, were measured and studied under different compliance currents.

The current study aimed to determine the safety profile of intra-articular-injected allogeneic adipose-derived mesenchymal stem cells (ADSCs) GXCPC1 in subjects with knee osteoarthritis (OA) and its preliminary efficacy outcome. The 3 + 3 phase I study was designed with two dose-escalation cohorts: low dose (6.7 × 10 6 GXCPC1, N = 5) and high dose (4 × 10 7 GXCPC1, N = 6). The primary endpoint was safety, which was evaluated by recording adverse events throughout the trial; the secondary endpoints included total, pain, stiffness, and function subscales of the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Visual Analogue Scale (VAS) for pain, and 12-Item Short Form (SF-12) health survey questionnaire. The GXCPC1 treatment was found to be safe after 1 year of follow-up with no treatment-related severe adverse events observed. When compared to baseline, subjects in both the low- and high-dose cohorts demonstrated improving trends in pain and knee function after receiving GXCPC1 treatment. Generally, the net change in pain (95% confidence interval (CI) = −7.773 to −2.561t at 12 weeks compared to baseline) and knee function (95% CI = −24.297 to −10.036t at 12 weeks compared to baseline) was better in subjects receiving high-dose GXCPC1. Although this study included a limited number of subjects without a placebo arm, it showed that the intra-articular injection of ADSCs was safe and well-tolerated in subjects with therapeutic alternatives to treat knee OA. However, a larger scale study with an appropriate control would be necessary for clinical efficacy in the following study.

Abstract Recently, all‐solid‐state sodium batteries (Na‐ASSBs) have received increased interest owing to their high safety and potential of high energy density. The potential of Na‐ASSBs based on sodium superionic conductor (NASICON)‐structured Na3V2(PO4)3(Na3VP) cathodes have been proven by their high capacity and a long cycling stability closely related to the microstructural evolution. However, the detailed kinetics of the electrochemical processes in the cathodes is still unclear. In this work, the sodiation/desodiation process of Na3VP is first investigated using in situ high‐resolution transmission electron microscopy (HRTEM). The intermediate Na2V2(PO4)3 (Na2VP) phase with the P21/c space group, which would be inhibited by constant electron beam irradiation, is observed at the atomic scale. With the calculated volume change and the electrode–electrolyte interface after cycling, it can be concluded that the Na2VP phase reduces the lattice mismatch between Na3VP and NaV2(PO4)3 (NaVP), preventing structural collapse. Based on the density functional theory calculation (DFT), the Na+ ion migrates more rapidly in the Na2VP structure, which facilitates the desodiation and sodiation processes. The formation of Na2VP phase lowers the formation energy of NaVP. This study demonstrates the dynamic evolution of the Na3VP structure, paving the way for an in‐depth understanding of electrode materials for energy‐storage applications.

In this study, the photoelectric properties of a complete series of GaS1−xSex (0 ≤ x ≤ 1) layered crystals are investigated. The photoconductivity spectra indicate a decreasing bandgap of GaS1−xSex as the Se composition x increases. Time-resolved photocurrent measurements reveal a significant improvement in the response of GaS1−xSex to light with increasing x. Frequency-dependent photocurrent measurements demonstrate that both pure GaS crystals and GaS1−xSex ternary alloy crystals exhibit a rapid decrease in photocurrents with increasing illumination frequency. Crystals with lower x exhibit a faster decrease in photocurrent. However, pure GaSe crystal maintains its photocurrent significantly even at high frequencies. Measurements for laser-power-dependent photoresponsivity and bias-voltage-dependent photoresponsivity also indicate an increase in the photoresponsivity of GaS1−xSex as x increases. Overall, the photoresponsive performance of GaS1−xSex is enhanced with increasing x, and pure GaSe exhibits the best performance. This result contradicts the findings of previous reports. Additionally, the inverse trends between bandgap and photoresponsivity with increasing x suggest that GaS1−xSex-based photodetectors could potentially offer a high response and wavelength-selectivity for UV and visible light detection. Thus, this work provides novel insights into the photoelectric characteristics of GaS1−xSex layered crystals and highlights their potential for optoelectronic applications.

Polyvinylidene fluoride (PVDF)/ZnO nanowire arrays were prepared on polydimethylsiloxane (PDMS) substrates for piezoelectric pressure sensor applications by the chemical bath deposition method. The effects of three different catalysts, namely, NaOH, NH4OH, and C6H12N4 (HMT), on the crystal structure, surface structure, and optical characteristics of ZnO nanowires have been studied. The piezoelectric sensing properties of pressure sensors formed by coating PVDF on ZnO nanowires were also studied under different forces. The results showed that the ZnO nanowires obtained with HMT have a hexagonal wurtzite crystal structure with a good c-axis (002) preferred orientation, as well as the largest length of 5800 nm and a length-to-width ratio of 72.5. The maximum sensitivity of the sensor with the ZnO nanowire length of 5800 nm is 61.1 mV/N. In addition, the sensor exhibits an optimized linear response within the applied pressure range of 0.1-1.2 N. [ABSTRACT FROM AUTHOR]

Microelectronics play a crucial role in medical settings by monitoring physiological signals, treating illnesses, and enhancing human well-being. For implanted and wearable devices, a reliable and continuous energy source is essential. While conventional energy systems rely on batteries and external power connections, their drawbacks, including the need for frequent charging, limited battery lifespan, and the potential for reoperation, restrict their utility. This has spurred the exploration of self-sustaining, long-lasting power solutions. The ultrasound-driven nanogenerator, a promising energy source, harnesses biomechanical energy from activities like muscle movement, heartbeat, respiration, and gastric peristalsis. It converts this energy into electrical signals, enabling the detection of physiological and pathological markers, cardiac pacing, nerve stimulation, tissue repair, and weight management. In this review, we provide an overview of triboelectric (TENG) and piezoelectric (PENG) nanogenerator design with ultrasound and its applications in biomedicine, offering insights for the advancement of self-powered medical devices in the future. These devices hold potential for diverse applications, including wound treatment, nerve stimulation and regeneration, as well as charging batteries in implanted devices.

Objective Surgical treatment of severe infectious spondylodiskitis remains challenging. Although minimally invasive percutaneous endoscopic drainage and debridement (PEDD) may yield good results in complicated cases, outcomes of patients with extensive structural damage and mechanical instability may be unsatisfactory. To address severe infectious spondylodiskitis, we have developed a surgical technique called percutaneous endoscopic interbody debridement and fusion (PEIDF), which comprises endoscopic debridement, bonegraft interbody fusion, and percutaneous posterior instrumentation. Methods Outcomes of PEIDF in 12 patients and PEDD in 15 patients with infectious spondylodiskitis from April 2014 to July 2018 were reviewed retrospectively. Outcome were compared between 2 kinds of surgical procedures. Results Patients in PEIDF group had significantly lower rate of revision surgery (8.3% vs. 58.3%), better kyphosis angle (-5.73°±8.74 vs. 1.07°±2.70 in postoperative; 7.09°±7.23 vs. 0.79°±4.08 in kyphosis correction at 1 year), and higher fusion rate (83.3% vs. 46.7%) than those who received PEDD. Conclusion PEIDF is an effective approach for treating infectious spondylodiskitis, especially in patients with spinal instability and multiple medical comorbidities.

Copper-doped zinc oxide films (Zn1−xCuxO) (x = 0, 2%, 4%, 6%) were fabricated on conductive substrates using the sol-gel process. The crystal structure, optical and resistive switching properties of Zn1−xCuxO films are studied and discussed. RRAM is made using Zn1−xCuxO as the resistive layer. The results show that the (002) peak intensity and grain size of Zn1−xCuxOfilms increase from 0 to 6%. In addition, PL spectroscopy shows that the oxygen vacancy defect density of Zn1−xCuxO films also increases with the increase in Cu. The improved resistive switching performance of the RRAM device can be attributed to the formation of conductive filaments and the destruction of more oxygen vacancies in the Zn1−xCuxO film. Consequently, the RRAM device exhibits a higher low resistance state to high resistance state ratio and an HRS state of higher resistance value.

Microwave-assisted induction heating (MAIH) is a composite microwave and induction heating to supply rapid and uniform heating of food. A recent study showed that the optimum MAIH heating condition for barramundi meat was 90 °C/110 s or 70 °C/130 s. This study examines whether the microwave-assisted induction heating (MAIH) technology (at 70 °C for 130 s or 90 °C for 110 s) can more effectively slow down the quality loss of barramundi meat during cold storage than the traditional boiling method (at 90 °C for 150 s). The results show that no microbial growth was observed in the three groups of heated barramundi meat samples during the 60 days of cold storage. However, the MAIH technology slowed down the increase in the total volatile basic nitrogen (TVBN) content more significantly than the boiling method. As the cold storage time increased, though, the L* (lightness), a* (redness), and W (whiteness) values decreased, while the b* (yellowness) and color difference (ΔE) values increased in the three treatment groups. However, the MAIH technology slowed down the decrease in the L*, a*, and W values more significantly, and produced a ΔE value smaller than the boiling method. Moreover, the MAIH technology ensured higher hardness and chewiness of the barramundi meat than the boiling method. Overall, the MAIH technology slowed down the quality loss of the barramundi meat and maintained better color and texture during cold storage.

Activation energy, bipolar resistance switching behavior, and the electrical conduction transport properties of ITOX:SiO2 thin film resistive random access memory (RRAM) devices were observed and discussed. The ITOX:SiO2 thin films were prepared using a co-sputtering deposition method on the TiN/Si substrate. For the RRAM device structure fabrication, an Al/ITOX:SiO2/TiN/Si structure was prepared by using aluminum for the top electrode and a TiN material for the bottom electrode. In addition, grain growth, defect reduction, and RRAM device performance of the ITOX:SiO2 thin film for the various oxygen gas flow conditions were observed and described. Based on the I-V curve measurements of the RRAM devices, the turn on-off ratio and the bipolar resistance switching properties of the Al/ITOX:SiO2/TiN/Si RRAM devices in the set and reset states were also obtained. At low operating voltages and high resistance values, the conductance mechanism exhibits hopping conduction mechanisms for set states. Moreover, at high operating voltages, the conductance mechanism behaves as an ohmic conduction current mechanism. Finally, the Al/ITOX:SiO2/TiN/Si RRAM devices demonstrated memory window properties, bipolar resistance switching behavior, and nonvolatile characteristics for next-generation nonvolatile memory applications.

Coastal forests can increase the resilience of seaside communities against natural disasters. These forests also provide other benefits, including food and an avenue for economic growth. The Dakenggu community in Suao, Yilan (Taiwan), is adjacent to a coastal forest with an area of nearly 114,000 m2. Artificial plantation has been performed locally in this area since 1977 to prevent the loss of beaches. The coastal forest area was estimated through drone aerial photography combined with a geographic information system. We found that Pandanus tectorius (11.5%), Casuarina equisetifolia (30.8%), Cerbera manghas (4.07%), Hibiscus tiliaceus (5.2%), and grass (23.52%) are the dominant species in the plant community of Dakenngu coastal forest, which together accounted for 75.1% of the total land area. The area covered by different species in the coastal forest was examined and estimated as well. The height and diameter at breast height (DBH) of the main tree species in five transects were surveyed, and we also found some significant differences among transects that correspond to cohorts planted at different times by the Forestry Bureau. We also performed a survey of land crabs in the same transects over five months to infer any differences in land crab species among the transects. We found that the transect dominated by H. tiliaceus had a larger population of land crabs than others. We revealed that the mudflat crab Chiromantes haematocheir prefers to live under H. tiliaceus. Finally, we propose recommendations for improving the biodiversity of the Dakenggu coastal forest so that it can become a sustainable resource for its residents.

Background and Objectives: An elevated heart rate is an independent risk factor for cardiovascular disease; however, the relationship between heart rate control and the long-term outcomes of patients with heart failure with reduced ejection fraction (HFrEF) remains unclear. This study explored the long-term prognostic importance of heart rate control in patients hospitalized with HFrEF. Materials and Methods: We retrieved the records of patients admitted for decompensated heart failure with a left ventricular ejection fraction (LVEF) of ≤40%, from 1 January 2005 to 31 December 2019. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure (HHF) during follow-up. We analyzed the outcomes using Cox proportional hazard ratios calculated using the patients’ heart rates, as measured at baseline and approximately 3 months later. The mean follow-up duration was 49.0 ± 38.1 months. Results: We identified 5236 eligible patients, and divided them into five groups on the basis of changes in their heart rates. The mean LVEFs of the groups ranged from 29.1% to 30.6%. After adjustment for all covariates, the results demonstrated that lesser heart rate reductions at the 3-month screening period were associated with long-term cardiovascular death, HHF, and all-cause mortality (p for linear trend = 0.033, 0.042, and 0.003, respectively). The restricted cubic spline model revealed a linear relationship between reduction in heart rate and risk of outcomes (p for nonlinearity > 0.2). Conclusions: Greater reductions in heart rate were associated with a lower risk of long-term cardiovascular death, HHF, and all-cause mortality among patients discharged after hospitalization for decompensated HFrEF.

Many banks are eager to adopt technology solutions to enhance operational efficiency in managing supply chain finance, which involves various participants and complex financial activities. Previous research either focuses on the technology aspect or the optimization of a supply chain; there is little specific guidance on how banks can form a holistic model to evaluate their Fintech strategy for supply chain finance. By using an integrated approach, this study adopted the decision- making trial and evaluation laboratory (DEMATEL) and several analytical methods to construct a hybrid decision model for banks. We concluded four plausible Fintech strategies from previous research and highlighted the advantages of the blockchain-based strategy. We used a domestic bank in Taiwan as a case study during the evaluation phase and implemented crisp and confidence-based fuzzy assessments. The result indicates that the blockchain-based leading strategy would be ideal for this bank. The hybrid decision model also unveils the complicated relationships among those evaluation factors, which sheds light on banks pursuing their innovation in financial services. The findings contribute to banks developing their Fintech-based supply chain financing business, and the supply chain participants may also benefit from securing efficient loans to expedite their operations.

Background: Postoperative immunosuppression is associated with blood loss and surgical trauma during surgery and subsequently predisposes patients to increased morbidity. Spine endoscopic surgery has been accepted as an effective surgical technique with less surgical trauma and less blood loss for the complication of infectious spondylodiscitis. Therefore, the aim of this study was to investigate whether PEIDF could reduce the morbidity rates for patients with infectious spondylodiscitis. Methods: We launched a retrospective cohort study on the comparison of the perioperative prognosis between PEIDF and conventional open surgery for single-level lumbar infectious spondylodiscitis in patients with poor physical health (ASA ≥ 4) from 2014 to 2019. Results: Forty-four patients were included in this study. Fifteen of them underwent PEIDF, and the rest of the 29 patients were treated with open surgery. Less surgical blood loss (p < 0.001) and intraoperative transfusions (p < 0.001) with a better decline of CRP (p = 0.017) were statistically significant in patients receiving PEIDF. Patients undergoing conventional open surgery encountered more postoperative sepsis (p = 0.030), a higher qSOFA score (p = 0.044), and prolonged-time for CRP normalization (p = 0.001). Conclusions: PEIDF minimizes a poor postoperative outcome due to less surgical trauma, intraoperative blood loss, and the need for a blood transfusion.

For the safety of tunnel excavation, the observation of tunnel convergence not only provides a technique for assessing the stability of the surrounding ground, but also provides an estimate of the constitutive parameters of geological materials. This estimation method belongs to an inverse algorithm process called the inverse calculation method (ICM), which utilizes the incremental concept in the convergence-confinement method (CCM) to solve the support-ground interaction of circular tunnel excavation. The method is to determine the mathematical solution of the intersection of the two nonlinear curves, the support confining curve (SCC) and the ground reaction curve (GRC) in the CCM by using Newton’s recursive method and inversely calculating the unknown parameters. To verify the validity of the developed inverse algorithm process, this study compares the results of the ICM with those of the published articles. In addition, the modulus of rock mass and unsupported span are inversely deduced using the values of convergence difference measured in the practical case of railway tunnels.

A direct algorithmic process can deal with the solution of the support–ground interaction in a circular tunnel excavation through the convergence-confinement method (CCM) with the concept of increment. This process is the so-called direct calculation method (DCM) that can find solutions, the mobilized support pressure and the convergence, in the analysis of CCM. To achieve the solution, using two linear equations in the elastic region and Newton’s recursive method to find the roots in the plastic region are proposed and realized by a calculated spreadsheet. The validity of the algorithmic process for the analytical solutions was investigated and verified by the finite element computation, and compared with the published results, Rocksupport (2004), Oreste (2009), and Gschwandtner-Galler (2012). The results obtained between DCM and related studies show no significant differences.