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Abstract Background Establishing an efficient multidisciplinary team for transferred postpartum haemorrhage (PPH) cases is challenging due to limited clinical exposure. We hypothesised that leveraging trauma team experience could effectively facilitate the development of such a team within a short timeframe. Methods In September 2019, a multidisciplinary team was established at our tertiary care centre to provide rapid management of critical PPH cases transferred from the obstetric clinic, prioritising immediate resuscitation and haemostatic interventions. This historical cohort study (2017–2022) compared outcomes before (2017–2018, before group [BG]) and after (2019–2022, after group [AG]) team establishment. Outcomes included process-related quality indicators, clinical measures such as length of hospital stay, intensive care unit (ICU) days, presence of the lethal triad, and hysterectomy rate. Results Of the 71 PPH patients transferred during the study period, 24 were in the BG and 47 in the AG. The AG demonstrated higher use of tranexamic acid (33.33% vs. 74.47%, P = 0.002), shorter time to the first blood transfusion (11 vs. 8 min, P = 0.029), and increased rates of arrival in the operating room within 60 min (25% vs. 80%, P = 0.014). Clinical outcomes showed reduced rates of cardiopulmonary resuscitation (16.67% vs. 0%, P = 0.011) and shorter ICU stays (4 vs. 1 day, P = 0.005) in the AG. Conclusions Leveraging trauma team expertise is an effective strategy for establishing a multidisciplinary PPH team, significantly improving outcomes for critically ill PPH patients transferred from obstetric clinics.

Multidisciplinary approaches are commonly employed in the rehabilitation of patients with locked-in syndrome (LIS); however, reports on acupuncture treatment of LIS are limited. A 56-year-old male was diagnosed with a pontine infarction, presenting with a National Institutes of Health Stroke Scale score of 23. By week 3 post-stroke, the patient showed LIS signs, as he could communicate through eye blinking while remaining quadriplegic. By week 4, the patient began receiving traditional acupuncture therapy for a total of 9 weeks. Acupuncture points used included LR3, SP3, SP4, K2, SP6, SP8, SP9, LI4, LI11, L10, GV20, EXTRA-1, and EXTRA-8. In the meantime, the patient received repetitive transcranial magnetic stimulations, regular physiotherapy, occupational therapy, and speech therapy. By week 11, the patient could voluntarily move his right fingers and toes and was successfully weaned off the tracheostomy. By week 12, he was discharged from the hospital.

Abstract Objectives Chest computed tomography (CT) can diagnose and assess the severity of pulmonary contusions. However, in cases of severe lung contusion, the total lung volume ratio may not accurately predict severity. This study investigated the association between life-threatening hemoptysis and chest CT imaging data on arrival at the emergency department in patients with pulmonary contusions or lacerations due to blunt chest injury. Methods The records of 277 patients with lung contusions or lacerations treated at a trauma center between 2018 and 2022 were retrospectively reviewed. The ratio of the local lung contusion volume to lobe volume in each lobe was calculated from chest CT images. The maximal ratio in the Hounsfield unit (HU) range was defined as the highest ratio value within the HU range among five lobes. Results The median patient age was 41 years, and 68.6% were male. Life-threatening hemoptysis occurred in 39 patients. The area under the receiver operating characteristic curve for the maximal ratio at −500 HU to 100 HU was 96.52%. The cutoff value was 45.49%. Multivariate analysis showed a high maximal chest CT ratio ≥ 45.49% at −500 HU to 100 HU (adjusted odds ratio [aOR]: 104.66, 95% confidence interval [CI]: 21.81–502.16, p

Abstract With recent proposal suggesting the multifaceted nature of impulsivity, researchers have been intrigued by the question of whether the impulsive behaviour measured in the traditionally psychological paradigms is unitary. One such paradigm, the differential reinforcement of low-rate responding (DRL), has been used to assess response inhibition, but its underlying mechanism has still been debated. In present research, we examined and differentiated the effects of both response inhibition and interval timing on a multisession DRL-10 s (DRL-10 s) in a large sample of normally developing young adults, as well as with three other measures including the stop-signal reaction task (SSRT), time production task-10 s (TPT-10 s), and the Barrett impulsivity scale-11 (BIS-11). The results showed that behavioural changes existed in DRL. As the task sessions progressed, there was an increase in both reinforcement probability and peak time, but a decrease in burst responses. Most importantly, both principal component analysis and generalized multilevel modeling yielded consistent results that as the task progressed, there was an increasing involvement of the TPT in the late sessions of DRL. However, none of the effect of SSRT was found. In sum, the differential degrees of involvement of the timing process, relative to response inhibition, were observed in DRL.

Abstract High-grade liver laceration is a common injury with bleeding as the main cause of death. Timely resuscitation and hemostasis are keys to the successful management. The impact of in-hospital trauma system on the quality of resuscitation and management in patients with traumatic high-grade liver laceration, however, was rarely reported. We retrospectively reviewed the impact of team-based approach on the quality and outcomes of high-grade traumatic liver laceration in our hospital. Patients with traumatic liver laceration between 2002 and 2020 were enrolled in this retrospective study. Inverse probability of treatment weighting (IPTW)-adjusted analysis using the propensity score were performed. Outcomes before the trauma team establishment (PTTE) and after the trauma team establishment (TTE) were compared. A total of 270 patients with liver trauma were included. After IPTW adjustment, interval between emergency department arrival and managements was shortened in the TTE group with a median of 11 min (p

Abstract Background Maxillofacial fractures can lead to massive oronasal bleeding; however, surgical hemostasis and packing procedures can be challenging owing to complex facial anatomy. Only a few studies investigated maxillofacial fractures with massive oronasal hemorrhage. However, thus far, no studies have reported a protocolized management approach for maxillofacial trauma from a single center. This study aimed to evaluate the effectiveness of protocolized management for maxillofacial fractures with oronasal bleeding. Methods Patients were identified from the National Cheng University Hospital trauma registry from 2010 to 2020. We included patients with a face Abbreviated Injury Scale (AIS) score of > 3 and active oronasal bleeding. Patients’ characteristics were compared between the angiography and non-angiography groups and between survivors and nonsurvivors. Results Forty-nine patients were included. Among them, 34 (69%) underwent angiography, of whom 21 received arterial embolization. Forty-seven patients (96%) successfully achieved hemostasis by adhering to the treatment protocol at our institution. Compared with the non-angiography group, the angiography group had significantly more patients requiring oral intubation (97% vs. 53%, P 3 (65% vs. 13%, P = 0.001), higher Injury Severity Score (ISS; 43 [33–50] vs. 22 [18–27], P 3 (92% vs. 33%; P

Abstract Delayed bleeding is a major issue in patients with high-grade splenic injuries who receive non-operative management (NOM). While only few studies addressed the clinical manifestations of delayed bleeding in these patients. We reviewed the patients with high-grade splenic injuries presented with delayed bleeding, defined as the need for salvage procedures following NOM. There were 138 patients received NOM in study period. Fourteen of 107 patients in the SAE group and 3 of 31 patients in the non-embolization group had delayed bleeding. Among the 17 delayed bleeding episodes, 6 and 11 patients were salvaged by splenectomy and SAE, respectively. Ten (58.9%, 10/17) patients experienced bleeding episodes in the intensive care unit (ICU), whereas seven (41.1%, 7/17) experienced those in the ward or at home. The clinical manifestations of delayed bleeding were a decline in haemoglobin levels (47.1%, 8/17), hypotension (35.3%, 6/17), tachycardia (47.1%, 8/17), new abdominal pain (29.4%, 5/17), and worsening abdominal pain (17.6%, 3/17). For the bleeding episodes detected in the ICU, a decline in haemoglobin (60%, 6/10) was the main manifestation. New abdominal pain (71.43%, 5/7) was the main presentation when the patients left the ICU. In conclusion, abdominal pain was the main early clinical presentation of delayed bleeding following discharge from the ICU or hospital.

Abstract Background Continuing education (CE) is essential for health professionals to improve competence in clinical practice, yet many medical technologists still experience barriers to learning in complex clinical settings. To better manage CE and address medical technologists’ learning needs, we developed a learner-centred electronic book (e-book) to promote self-directed learning for medical technologists. Methods A cross-sectional study was conducted to explore the acceptability and learning impacts of the e-book as CE material for medical technologists in two medical centres in Taiwan. We designed the learner-centred context in the e-book based on medical technologists’ practice requirements and learning needs. Moreover, we adopted The New World Kirkpatrick Model with four levels (reactions, learning, behaviours and results) to evaluate the e-book’s learning impacts on medical technologists. A total of 280 medical technologists were invited to complete a questionnaire and a post-test, providing learning patterns as well as their satisfaction with the e-book and their learning outcomes after using it. Results Most readers had positive learning experiences and better learning outcomes, including knowledge acquisition and behavioural change, after reading the e-book. The e-book became a new CE activity and reached medical technologists in various types of laboratories. Conclusions The low-cost and learner-centred e-book effectively overcame CE learning barriers for medical technologists. The interactivity and flexibility of e-learning particularly helped learners to engage in clinical scenarios in laboratory medicine. This study could pave the way for medical educators to build a high-quality e-learning model in CE.

Background: This study was to perform an economic evaluation to understand clinical outcomes and health resource use between hip fracture patients receiving hospital-based postfracture fracture liaison service (FLS) care and those receiving usual care (UC) in Taiwan. Methods: This cohort study included hospital-based data of 174 hip fracture patients who received FLS care (FLS group) from National Taiwan University Hospital, and 1697 propensity score-matched patients who received UC (UC group) of National Health Insurance claim-based data. Two groups had similar baseline characteristics but differed in hip fracture care after propensity score matching. Clinical outcomes included refracture-free survival (RFS), hip-refracture-free survival (HRFS), and overall survival (OS). Health resource use included inpatient, outpatient, and pharmacy costs within 2 years follow-up after the index of hip fracture. The economic evaluation of the FLS model was analyzed using the net monetary benefit regression framework based on the National Health Insurance perspective. Results: The FLS group had longer RFS than the UC group, with an adjusted difference of 44.3 days (95% confidence interval: 7.2–81.4 days). Two groups did not differ in inpatient and outpatient costs during follow-up, but the FLS group had a higher expenditure than the UC group on osteoporosis-related medication. The probability of FLS being cost-effective was >80% and of increasing RFS, HRFS, and OS was 95%, 81%, and 80%, respectively, when the willingness-to-pay threshold was >USD 65/gross domestic product per day. Conclusion: FLS care was cost-effective in reducing refracture occurrence days for patients initially diagnosed with hip fractures.

Background: Osteoporosis is a common metabolic bone disease that benefits from many newly developed anti-osteoporosis medications (AOMs). Reimbursement policies need to allocate medical budgets properly based on evidence-based data. This study aimed to investigate the 11-year secular trend, focusing on older age and males in this adjustment wave of the National Health Insurance reimbursement. Methods: We adopted a nationwide cohort from Taiwan's National Health Insurance Research Database (NHIRD). Patients undergoing newly initiated AOMs from 2008 to 2018 were included. The AOMs in this study included denosumab, zoledronate, ibandronate, alendronate, raloxifene, and risedronate. Patients

Background: The Bureau of National Health Insurance in Taiwan implemented a new reimbursement scheme incorporating bone mineral density (BMD) criteria on Jan. 1, 2011. This study aimed to investigate a real-life 11-year secular trend of adherence in new AOMs users and evaluated the change of adherence to AOMs therapy in different urbanization areas after reimbursement criteria were restrained. Methods: We used Taiwan's National Health Insurance Research Database to identify new AOMs users as our study population. The AOMs in this study included denosumab, zoledronate, ibandronate, alendronate, raloxifene, and risedronate. The first prescription date of AOMs was defined as the cohort entry date. The adherence rates within one year after initiation were assessed. Results: High adherence (≥75%) in the first year increased markedly after the new reimbursement scheme in 2011, changing from 31.8% in 2008, and 41.7% in 2011 to 54.2% in 2018. On the other hand, low adherence (

Abstract Background Undertriage of major trauma patients is unavoidable, especially in the trauma system of rural areas. Timely stabilization and transfer of critical trauma patients remains a great challenge for hospitals with limited resources. No definitive measure has been proven to improve the outcomes of patients transferred with major trauma. The current study hypothesized that regular feedback on inter-hospital transfer of patients with major trauma can improve quality of care and clinical outcomes. Method This retrospective cohort study retrieved data of transferred major trauma patients with an injury severity score (ISS) > 15 between January 2010 and December 2018 from the trauma registry databank of a tertiary medical center. Regular monthly feedback on inter-hospital transfers was initiated in 2014. The patients were divided into a without-feedback group and a with-feedback group. Demographic data, management before transfer, and outcomes after transfer were collected and analyzed. Results A total of 178 patients were included: 69 patients in the without-feedback group and 109 in the with-feedback group. The with-feedback group had a higher ISS (25 vs. 27; p = 0.049), more patients requiring massive transfusion (14.49% vs. 29.36%, p = 0.036), and less patients with Glasgow Coma Scale ≤8 (30.43% vs. 23.85%, p

Abstract Background The impact of associated chest wall injuries (CWI) on the complications of clavicle fracture repair is unclear to date. This study aimed to investigate the complications after surgical clavicle fracture fixation in patients with and without different degrees of associated CWI. Methods A retrospective review over a four-year period of patients who underwent clavicle fracture repair was conducted. A CWI and no-CWI group were distinguished, and the CWI group was subdivided into the minor-CWI (three or fewer rib fractures without flail chest) and complex-CWI (flail chest, four or more rib fractures) subgroup. Demographic data, classification of the clavicle fracture, number of rib fractures, and associated injuries were recorded. Overall complications included surgery-related complications and unplanned hospital readmissions. Univariate analysis and stepwise backward multivariate logistic regression were used to identify potential risk factors for complications. Results A total of 314 patients undergoing 316 clavicle fracture operations were studied; 28.7% of patients (90/314) occurred with associated CWI. Patients with associated CWI showed a significantly higher age, body mass index, and number of rib fractures. The overall and surgical-related complication rate were similar between groups. Unplanned 30-day hospital readmission rates were significantly higher in the complex-CWI group (p = 0.02). Complex CWI and number of rib fractures were both independent factor for 30-day unplanned hospital readmission (OR 1.59, 95% CI: 1.00–2.54 and OR 1.33, 95% CI: 1.06–1.68, respectively). Conclusion CWI did not affect surgery-related complications after clavicle fracture repair. However, complex-CWI may increase 30-day unplanned hospital readmission rates.

Objective To investigate the incidence and risk factors of bone cement implantation syndrome (BCIS) in bone tumor surgeries. Methods This was a retrospective observational study. We investigated patients who underwent bone tumor surgeries requiring cementation as part of the surgery between March 2016 and January 2018. We reviewed medical records, including formal anesthesia records and operation notes. Patients with complete data files were included. To investigate the general incidence of BCIS in tumor surgeries, patients of all ages, genders and tumor types were included. Vital signs, including oxygen saturation, blood pressure, heart rate, and respiratory rate, were checked and recorded once every 1–2 min after cementation. Accurate time points of cementation were recorded on formal anesthesia record sheets by the anesthesiologists. The definition and severity of BCIS were based on the classification system proposed in previous studies: grade I, moderate hypoxia (SpO2 20%); grade II, severe hypoxia (SpO2 40%) or unexpected loss of consciousness; and grade III, cardiovascular collapse requiring cardiopulmonary resuscitation. We also compared the incidence of BCIS between those patients with and without possible risk factors, including intraoperative blood loss, arthroplasty, use of an intramedullary device, patient age, gender, tumor location, and preexisting lung cancer or lung metastasis. Results A total of 88 patients were included. BCIS occurred in 23 patients, with an incidence of 26.1%. Among them, 19 had grade I and 4 had grade II BCIS. There was no patients with grade III BCIS. The lowest blood pressure occurred within 10 min in 21 (87.5%) patients and within 20 min for all patients. A total of 9 grade I BCIS were self‐limiting. The other 10 grade I hypotension cases and all grade II hypotension cases recovered after administration of a vasoconstrictor medication. Preexisting lung cancer or lung metastasis was the risk factor for BCIS; 40.0% of patients (16 in 40 patients) with preexisting lung cancer or metastasis had BCIS, whereas only 14.6% of patients (7 in 48 patients) without lung lesions had BCIS. There was no risk difference in terms of arthroplasty, old age, and increased blood loss. Apart from grades I and II bone cement implantation syndrome, there were no other major complications, including death, cardiovascular events, or cerebrovascular events. Conclusion Bone cement implantation syndrome is not unusual in bone tumor surgeries, and preexisting lung cancer or lung metastasis is a risk factor.

Vertical GaN Schottky barrier diodes (SBDs) with floating metal rings (FMRs) as edge termination structures have been fabricated on bulk GaN substrates. Devices with different FMR geometries were investigated including various numbers of rings and various spacings between rings. These devices have a low Ron of 1.16~1.59 mΩ·cm2, a turn-on voltage of 0.96~ 0.94 V, a high on-off ratio of 109, a nearly ideal ideality factor of 1.03~1.09, and a Schottky barrier height of 1.11~1.18 eV at room temperature. These devices have similar forward electrical characteristics, indicating that FMRs don't degrade the device rectifying performance. The ideality factor decreased and the Schottky barrier height increased with increasing temperature from 300 K to 420 K, where the temperature dependencies of the two parameters indicate the inhomogeneity of the metal/semiconductor Schottky interface. In addition, FMRs can improve device breakdown voltages. As the number of FMRs increased from 0 to 20, the reverse breakdown voltage increased from 223 to 289 V. As the spacing between the FMRs increased from 1.5 to 3 μm, the reverse breakdown voltage increased from 233 to 290 V, respectively. These results indicate multiple FMRs with proper spacings can effectively improve breakdown performance without degrading the device forward characteristics. This work represents a useful reference for the FMR termination design for GaN power devices.

Vertical GaN-on-GaN Schottky barrier diodes based on as-grown and regrown samples were fabricated to investigate the effects of the etch-then-regrow process on device performance. The surface roughness increased slightly after dry etching and decreased after regrowth. According to X-ray diffraction results, the etch-then-regrow process caused a slight increase of defect density due to increased edge dislocations. Schottky parameters extracted from forward current-voltage curves, such as turn-on voltages of 0.74 V and 0.72 V, ideality factors of 1.07 and 1.10, and barrier heights of 1.07 eV and 1.05 eV, were obtained for diodes based on the regrown and as-grown samples, respectively. The breakdown voltage of the regrown sample was much lower than the as-grown sample. The regrowth interface can be regarded as a n-doping GaN layer due to the high interface charge density after the etch-then-regrown process. This equivalent ${n}$ -doping GaN layer reduced the effective thickness of the UID-GaN under the Schottky contact thus causing lower breakdown voltage for the regrown sample. Poole-Frenkel emission and trap-assisted tunneling processes were responsible for the leakage of both as-grown and regrown samples according to the temperature dependence of the reverse currents.

Background: The outcomes for patients with NASH-related HCC after curative resection have not been clarified. This study compared the overall survival (OS), time-to-tumor recurrence (TTR), and recurrence-free survival (RFS) associated with NASH-related HCC and virus-related HCC after resection. Methods: Patients with HCC who underwent curative resection were retrospectively enrolled. Baseline characteristics, including disease etiologies and clinical and tumor features, were reviewed. The primary outcomes were OS, TTR, and RFS. Results: Two hundred and six patients were enrolled (HBV: n = 121, HCV: n = 54, NASH: n = 31). Of those with virus-related HCC, 84.0% achieved viral suppression. In both the overall and propensity-score-matched cohorts, those with NASH-related HCC experienced recurrence significantly earlier than those with virus-related HCC (median TTR: 1108 days vs. non-reached; p = 0.03). Through multivariate analysis, NASH-related HCC (hazard ratio (HR), 2.27; 95% confidence interval (CI), 1.25–4.12) was independently associated with early recurrence. The unadjusted RFS rate of the NASH-related HCC group was lower than the virus-related HCC group. There was no difference in the OS between the two groups. Conclusions: NASH-related HCC was associated with earlier tumor recurrence following curative resection compared to virus-related HCC. Post-surgical surveillance is crucial for detecting early recurrence in patients with NASH-related HCC.

For materials where spin-orbit coupling is competitive with electronic correlations, the spatially anisotropic spin-orbital wave functions can stabilize degenerate states that lead to many and diverse quantum phases of matter. Here we find evidence for a dynamical spin-orbital state preceding a T^{*} = 50 K order-disorder spin-orbital ordering transition in the j=3/2 lacunar spinel GaTa_{4}Se_{8}. Above T^{*}, GaTa_{4}Se_{8} has an average cubic crystal structure, but total scattering measurements indicate local noncubic distortions of Ta_{4} tetrahedral clusters for all measured temperatures 2

BackgroundIdentification of vertebral fractures (VFs) is critical for effective secondary fracture prevention owing to their association with the increasing risks of future fractures. Plain abdominal frontal radiographs (PARs) are a common investigation method performed for a variety of clinical indications and provide an ideal platform for the opportunistic identification of VF. This study uses a deep convolutional neural network (DCNN) to identify the feasibility for the screening, detection, and localization of VFs using PARs.MethodsA DCNN was pretrained using ImageNet and retrained with 1306 images from the PARs database obtained between August 2015 and December 2018. The accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were evaluated. The visualization algorithm gradient-weighted class activation mapping (Grad-CAM) was used for model interpretation.ResultsOnly 46.6% (204/438) of the VFs were diagnosed in the original PARs reports. The algorithm achieved 73.59% accuracy, 73.81% sensitivity, 73.02% specificity, and an AUC of 0.72 in the VF identification.ConclusionComputer driven solutions integrated with the DCNN have the potential to identify VFs with good accuracy when used opportunistically on PARs taken for a variety of clinical purposes. The proposed model can help clinicians become more efficient and economical in the current clinical pathway of fragile fracture treatment.

Potholes, one of the major types of distress on pavement surfaces, damage vehicles and are a safety hazard for the travelling public. In order to mitigate the effect of potholes, cold-mix asphalt (CMA) patching materials are commonly used for urgent repair of pavement surfaces before resurfacing can be undertaken. Therefore, the short-term (initial stability) and long-term (in-service durability) performance evaluation of CMA patching materials is necessary. This study conducted several curing conditions in the laboratory to investigate short-term, long-term, and moisture effects on pavement surfaces. Moreover, this study compared the Marshall stability of samples prepared under various compaction conditions. Marshall stability, Cantabro abrasion, and UK wheel tracking tests were conducted to evaluate the performance of CMA patching materials. The results indicated that the Marshall stability of dense-gradation (DG) CMA patching materials was higher than that of open-graded (OG) CMA patching materials and the Marshall stability of OG CMA patching materials was highly influenced by the coarse aggregate proportion. The DG and OG CMA patching materials exhibited comparable abrasion resistance, and the Cantabro abrasion ratio was highly correlated to the estimated asphalt film thickness for the OG CMA patching materials. A moisture indicator (MI) was proposed, and the effect of moisture damage on Marshall stability and Cantabro abrasion ratio was related to the proposed MI. The rutting resistance of the DG CMA patching materials was higher than that of the OG CMA patching materials, which is consistent with the Marshall stability result.

Background: Antimicrobial resistance of Streptococcus agalactiae (Group B Streptococcus, GBS) has been emerging worldwide. We aimed to examine the correlation of drug-resistant genes with serotypes and with the mutations of the quinolone resistance-determining region (QRDR) in GBS isolates. Methods: A total of 323 human GBS isolates were collected from a hospital in southern Taiwan. Laboratory investigation included serotyping by a multiplex polymerase chain reaction (PCR) method, antimicrobial susceptibility testing by a disc diffusion method, and mechanism analysis of the resistance to macrolides and fluoroquinolones by PCR and sequencing methods. Results: Multiplex PCR showed that the most prevalent serotypes were Ib, III, V, and VI, mostly isolated from urine. The ermB gene was highly prevalent in serotypes Ib and V and was associated with clindamycin and macrolide resistance. GBS with a serine-to-leucine mutation at codon 81 in GyrA and with a serine-to-phenylalanine or -tyrosine mutation at codon 79 in ParC had a higher minimum inhibitory concentration of levofloxacin than isolates with only an aspartic acid-to-tyrosine mutation at codon 83 (>32 μg/ml vs. 16 μg/ml) in GyrA. Conclusions: The most prevalent GBS serotypes were Ib, III, V, and VI. The ermB and mefE genes carried in serotypes Ib and V were highly associated with the resistance to macrolides and clindamycin. Mutations at codon 79 and codon 83 of ParC were the major determining factors for high-level fluoroquinolone resistance.

This work reports on a comprehensive examination of the electrical and thermal properties of vertical Schottky diodes fabricated on (201)- and (001)-oriented samples of β-Ga2O3. The temperature-dependent current--voltage (I-V) and capacitance--voltage (C-V) data were gathered and analyzed down to 60 K. Deep level transient spectroscopy (DLTS) was used to study bulk and interface defects in the two materials from approx. 325 K down to 60 K. In the bulk (201) material, an electron trap was observed at EC-0.46 eV, with a capture cross section of 1.6 x 10-14 cm² and a lambda-corrected maximum trap density of 9.08 x 1015 cm-3. These results and others indicate that the electron trap is a strong candidate for the well-known E1 defect in β-Ga2O3 based on recent investigations. Additionally, in the (201) material, the smooth modulation typical of interface states is evident at temperatures below 275 K. The (001) samples manifested what is likely the E2* electron trap at EC-0.68 eV, with a capture cross section of 1.64 x 10-15 cm² and a lambda-corrected maximum trap density of 8.85 x 1015 cm-3. The presence of the E2* defect, in particular, is a contrast to the findings of recent DLTS investigations on β-Ga2O3, which report that E2* emerged only after low-energy proton irradiation. These results help to further map out the defect signatures found in β-Ga2O3 materials, which are of vital importance in the design and fabrication of future β-Ga2O3 devices. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the clinical and microbiological features of recurrent group B streptococcal (GBS) diseases among non-pregnant adults. Methods: All hospitalized non-pregnant adults who had culture-proven GBS infections between January 2008 and December 2010 were enrolled in this retrospective study. Bacterial isolates were examined for their serotypes, genotypes, and antimicrobial resistance. Results: The recurrence rate of GBS infection in Taiwan was found to be 9.3%. Of the 70 recurrent episodes in 32 patients, infections of the urinary tract (U) were diagnosed clinically in 55.7%, infections of the soft tissue (S) in 31.4%, and infections of the bloodstream (B) in 12.9%. The initial/recurrent episodes in 25 patients were mainly U/U (40.6%), followed by S/S (18.8%) and B/B (6.2%). The serotypes/serogroups identified were serotypes V (34.3%), Ib (22.9%), VI (17.1%), III (12.9%), IV (7.1%), and Ia (5.7%). Recurrent strains showed less resistance to erythromycin or clindamycin than non-recurrent strains. Six distinct genotypes were identified in 12 serotype VI isolates derived from seven patients; five of these isolate pairs had identical genotypes. Conclusions: Recurrent GBS diseases were found to occur considerably more often than previously thought, mainly in adults with a high comorbid index. Relapse, not new acquisition, was found to be more common.

This study investigated the anti-obesity effect of a polysaccharide-rich red algae Gelidium amansii hot-water extract (GHE) in high-fat (HF) diet-induced obese hamsters. GHE contained 68.54% water-soluble indigestible carbohydrate polymers. Hamsters were fed with a HF diet for 5 weeks to induce obesity, and then randomly divided into: HF group, HF with 3% guar gum diet group, HF with 3% GHE diet group, and HF with orlistat (200 mg/kg diet) group for 9 weeks. The increased weights of body, liver, and adipose in the HF group were significantly reversed by GHE supplementation. Lower plasma leptin, tumor necrosis factor-α, and interleukin-6 levels were observed in the GHE+HF group compared to the HF group. GHE also increased the lipolysis rate and decreased the lipoprotein lipase activity in adipose tissues. GHE induced an increase in the phosphorylation of AMP-activated protein kinase (AMPK) and the protein expressions of peroxisome proliferator-activated receptor alpha (PPARα) and uncoupling protein (UCP)-2 in the livers. The decreased triglyceride and total cholesterol in the plasma and liver were also observed in obese hamsters fed a diet with GHE. These results suggest that GHE exerts a down-regulation effect on hepatic lipid metabolism through AMPK phosphorylation and up-regulation of PPARα and UCP-2 in HF-induced obese hamsters.