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Kuo-Wei Cheng, Shan-hui Hsu Institute of Polymer Science and Engineering, College of Engineering, National Taiwan University, Taipei, Taiwan, Republic of China Abstract: Superparamagnetic iron oxide nanoparticles (SPIO NPs) have a wide range of biomedical applications such as in magnetic resonance imaging, targeting, and hyperthermia therapy. Aggregation of SPIO NPs can occur because of the hydrophobic surface and high surface energy of SPIO NPs. Here, we developed a facile method to encapsulate SPIO NPs in amphiphilic biodegradable polymer. Anionic biodegradable polyurethane nanoparticles (PU NPs) with ~35 nm size and different chemistry were prepared by waterborne processes. SPIO NPs were synthesized by chemical co-precipitation. SPIO NPs were then added to the aqueous dispersion of PU NPs, followed by application of high-frequency (~20 kHz) ultrasonic vibration for 3 min. This method rendered SPIO-PU hybrid NPs (size ~110 nm) suspended in water. SPIO-PU hybrid NPs contained ~50–60 wt% SPIO and retained the superparamagnetic property (evaluated by a magnetometer) as well as high contrast in magnetic resonance imaging. SPIO-PU NPs also showed the ability to provide cell hyperthermic treatment. Using the same ultrasonic method, hydrophobic drug (Vitamin K3 [VK3]) or (9-(methylaminomethyl)anthracene [MAMA]) could also be encapsulated in PU NPs. The VK3-PU or MAMA-PU hybrid NPs had ~35 nm size and different release profiles for PUs with different chemistry. The encapsulation efficiency for VK3 and MAMA was high (~95%) without burst release. The encapsulation mechanism may be attributed to the low glass transition temperature (Tg) and good mechanical compliance of PU NPs. The new encapsulation method involving waterborne biodegradable PU NPs is simple, rapid, and effective to produce multimodular NP carriers. Keywords: superparamagnetic iron oxide, polyurethane, drug release, hybrid nanoparticles

Background Little is known about the emergency department (ED) visits from drug-related injury among older adults in Taiwan. This study seeks to identify risk factors associated with adverse drug events (ADEs) leading to ED visits. Methods We prospectively conducted a case–control study of patients 65 years and older presenting to the ED. ED visits between March 1, 2009 and Feb 28, 2010 identified by investigators for suspected ADEs were further assessed by using the Naranjo Adverse Drug Reaction probability scale. For each patient with an ADE, a control was selected and time-matched from the ED population of the study hospital. The association between the risk of adverse drug events and triage, age, gender, serum alanine transaminase (ALT), serum creatinine, number of medications, and Charlson Comorbidity Index scores were analyzed using logistic regression. Results Of 20,628 visits, 295 ADEs were physician-documented in older adults. Independent risk factors for ADEs included number of medications (adjusted odds ratio [OR] = 4.1; 95% confidence interval [CI] 2.4–6.9 for 3–7 drugs; adjusted OR = 6.4; 95% CI 3.7–11.0 for 8 or more drugs) and increased concentration of serum creatinine (adjusted OR = 1.5; 95% CI 1.1–2.2). Diuretics, analgesics, cardiovascular agents, anti-diabetic agents and anticoagulants were the medications most commonly associated with an ADE leading to ED visits. Conclusions This study suggests that prevention efforts should be focused on older patients with renal insufficiency and polypharmacy who are using high risk medications such as anticoagulants, diuretics, cardiovascular agents, analgesics, and anti-diabetic agents.

Cardiac dysfunction is common in patients with severe sepsis and septic shock. We present a 71-year-old woman with Escherichia coli urosepsis and sepsis-induced myocardial injury masquerading as non-ST elevated myocardial ischemia. Spontaneous psoas hematoma requiring blood transfusion and intracranial hemorrhage developed after antiplatelet and anticoagulant therapies, even in therapeutic doses. The patient was managed conservatively and recovered well with minor residual hemiparesis. Bleeding complications are a common risk of antithrombotic therapy. It is therefore crucial to weigh the impact of efficacy against safety. Old age, female gender, renal insufficiency and sepsis character increased the risk of bleeding in this patient. A misinterpretation of elevated cardiac troponin I may give rise to a diagnostic dilemma and cause unnecessary morbidity.

To inspect Denonvilliers' fascia and its relationship with neighboring oncologically and functionally important anatomic structures by laparoscopic approach.A total of 112 patients with middle or low rectal cancer were successfully treated by laparoscopic total mesorectal excision (TME). Digital versatile disk (DVD) recordings were retrieved for scrutiny of the whole dissection process of Denonvilliers' fascia and its contiguous anatomic structures.As highlighted in the attached video footage, for nearly all male patients (91%, n = 58), the boundaries of Denonvilliers' fascia could be clearly recognized by laparoscopy. Denonvilliers' fascia, varying in nature from a fragile translucent fibrous layer to a tough leathery membrane, manifests itself as a trapezoidal "apron" covering the glistening fatty tissues of the anterior mesorectum. Anterior dissection in TME can be efficiently continued downwards "in front of" Denonvilliers' fascia. When the prostate is reached, the natural surgical plane halts, and the dissection plane should be shifted to behind this fascia. In contrast, in female patients, Denonvilliers' fascia was much less obvious as a distinct fibrous layer than in male patients. The most appropriate term for the structure in between the rectum and vagina may be rectovaginal septum, in which there is no natural surgical plane, rather than Denonvilliers' fascia.By laparoscopic approach, the nature of Denonvilliers' fasciae in male and female patients can be better defined and facilitates more precise laparoscopic total mesorectal excision for rectal cancer.

Network Coding (NC) has emerged as a ubiquitous technique of communication networks and has extensive applications in both practical implementations and theoretical developments. While the Avalanche P2P file system from Microsoft, the MORE routing protocol, and the COPE coding architecture from MIT have implemented the idea of NC and exhibited promising performance improvements, a significant part of the success of NC stems from the continuing theoretic development of NC capacity, e.g., the Shannon capacity results for the single-flow multi-cast network and the packet erasure broadcast channel with feedback. However, characterizing the capacity for the practical wireless multi-flow network setting remains a challenging topic in NC. For example, the difficulties of finding the optimal NC strategy over multiple flows under varying-channel qualities and the rate adaption scenarios hinder any further advancement in this area. Despite the difficulty of characterizing the full capacity for large networks, there are evidences showing that even when using only local operations, NC can still recover substantial NC gain. We believe that a deeper understanding of multi-flow local network coding will play a key role in designing the next-generation high-throughput coding-based wireless network architecture. This thesis consists of three parts. In the first part, we characterize the full Shannon capacity region of the "COPE" principle when applied to a 2-flow wireless butterfly network with broadcast packet erasure channels. The capacity results allow for random overhearing probabilities, arbitrary scheduling policies, network-wide channel state information (CSI) feedback after each transmission, and potential use of non-linear network codes. We propose a theoretical outer bound and a new class of linear network codes, named the Space-Based Linear Network Coding (SBLNC), that achieves the capacity outer bound. Numerical experiments show that SBLNC provides close-to-optimal throughput even in the scenario with opportunistic routing. In the second part, we further consider the complete network dynamics of stochastic arrivals and queueing and study the corresponding stability region. Based on dynamic packet arrivals, the resulting solution would be one step closer to practical implementation, when compared to the previous block-code-based capacity study. For the 2-flow downlink scenario, we propose the first opportunistic INC + scheduling solution that is provably optimal for time-varying channels, i.e., the corresponding stability region matches the optimal Shannon capacity. Specifically, we first introduce a new binary INC operation, which is distinctly different from the traditional wisdom of XORing two overheard packets. We then develop a queue-length-based scheduling scheme, which, with the help of the new INC operation, can robustly and optimally adapt to time-varying channel quality. We then show that the proposed algorithm can be easily extended for rate adaptation and it again robustly achieves the optimal throughput. In the third part, we propose an 802.11-based MAC layer protocol which incorporates the rate adaption solution developed in the second part. The new MAC protocol realizes the promised intersession network coding gain for two-flow downlink traffic with short decoding delay. Furthermore, we delicately retain the CSMA-CA distributed contention mechanism with only 17 bits new header field changes, and carefully ensure the backward compatibility. In summary, the new solution demonstrates concrete throughput improvement without alternating the too much packet-by-packet traffic behavior. Such a feature is critical in practical implementation since it allows the network coding solution to be transparent to any arbitrary upper layer applications.

A 39-year-old woman with recurrent left otitis media presented with the sensation of fluid flowing in the head, headache, mild dyslexia, and disequilibrium for 2 weeks. She reported no head trauma and had a normal neurologic examination. Head CT (figure, A) showed intraventricular pneumocephalus and a focal low-density lesion with air-fluid level in the left posterior temporal region. Brain MRI showed minimal enhancement and no restriction of diffusion, and thus did not suggest an abscess (figure, B). CT of petrous pyramids demonstrated a small bone defect at the left posterior temporal bone, which was considered a possible point of entry for air (figure, C).1 CSF culture was negative. Lumbar puncture to release intracranial pressure and antibiotic therapy resulted in full recovery without surgical intervention.

This paper presents a high frame rate linear scan CMOS image sensor (CIS) with time-delay integration (TDI) technique and interlaced super-resolution (ISR) pixel to increase signal-to-noise ratio (SNR) and horizontal resolution. An adjacent pixel signal transfer (APST) methodology is adopted for efficient wire routing and reducing pixel complexity. 4T-APS is applied in pixel to achieve the snapshot function. A 128×8×2 interlaced super-resolution pixel array with a pitch of 6×6 um2, a fill factor of 26.99%, and 3.3V operation has been designed and fabricated in 0.18-um TSMC 1P6M CIS technology. Two 128×8 linear array are placed in an interlaced form with a half-pixel-pitch shift to achieve the super-resolution output. The measurement results of proposed linear scan sensor with 8 TDI stages and ISR technique demonstrate a SNR improvement of 10.3 dB, double horizontal resolution, and a power dissipation of 4.114uW per column at 1.6kfps.

This paper presents a time delay and integration (TDI) structure for CMOS image sensor (CIS) with adjacent pixel signal transfer (APST). The CCD-like TDI function is achieved in CIS by proposed APST without additional in-pixel device and minimum routing effort. The in-pixel integrated signal is transferred to adjacent pixel and summed up by an off-pixel column-shared unity-gain buffer. A 128×6 pixel array with 6×6µm2 pixel size has been designed and fabricated in TSMC0.18µm 1P6M CIS technology providing 6 TDI stages with fill factor of 23.1%. It achieves a signal to noise ratio (SNR) improvement of 13dB, a transfer efficiency of 99.6%, and a total power dissipation of 4.43 µW per column at 1.6K fps.

This study aimed to evaluate the technical feasibility of laparoscopic total mesorectal excision (TME) for the treatment of low rectal cancer after concurrent chemoradiation therapy (CCRT) with bevacizumab and FOLFOX. Patients with clinical T3, T4, or N1-2 rectal cancer were subjected to a preoperative CCRT protocol with FOLFOX and bevacizumab (5 mg/kg) biweekly for 6 cycles followed by a standardized laparoscopic TME procedure, as detailed in the attached video. The treatment protocol was completed by 28 patients. Scrutiny of the video indicated that the dissection plane was a little blurred due to preoperative CCRT, but this did not significantly increase the technical difficulties. Laparoscopic TME was efficiently performed with acceptable operation time (214.4 ± 44.4 min). However, the median blood loss (420 ml; range, 120–1,200 ml) in this series was significantly greater than in the historic series without bevacizumab therapy. Bevacizumab seems not to increase the severity of FOLFOX-related liver steatosis and sinusoidal dilation. One operative mortality (3.6%) occurred. Six patients (21.4%) presented with postoperative complications including upper gastrointestinal bleeding, deep vein thrombosis, pelvic abscess, wound infection, enterocutaneous fistula, and perineal fistula. The patients presented with mild postoperative pain and had a quick convalescence. The addition of bevacizumab to FOLFOX achieved a superior pathologic response for 78.3% of the patients, whose residual tumor cells were very few (