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Abstract We propose a meta-emitter based on micro-electro-mechanical system (MEMS) technology. The main structure of the meta-emitter unit cell is composed of four symmetrically split crosses of Au and SiO2 bilayer cantilevers. By changing the size of the cantilevers, this MEMS-based meta-emitter can realize the tunable perfect absorption, and the absorption spectrum is within the longwave infrared (LWIR) wavelength from 8.90 to 11.90 µm. When the surface temperature of the meta-emitter rises, the electrothermal actuation mechanism is performed through the different thermal expansion coefficient (TEC) of the bilayer cantilevers. Therefore, the cantilevers will be bent downward and the bending height of the cantilevers decreases linearly. In such case, the peak value of thermal radiation power can be tuned from the wavelength of 9.52 µm to 10.48 µm when the temperature of meta-emitter is increased from 293 to 1290 K. This proposed MEMS-based meta-emitter is an excellent LWIR light source and has potential application prospects in gas sensing, infrared spectroscopy analysis, medical care and so on.

Abstract Coronary artery disease (CAD) such as acute myocardial infarction (MI) share several common risk factors with cancers, and each disease may influence the prognosis of the other. Recently, acute MI was demonstrated to accelerate the outgrowth of preexisting breast cancer cells but the risk of breast cancer after MI remains unclear. This study aimed to investigate the association between acute MI and a subsequent diagnosis of breast cancer. Female patients with and without a history of acute MI were identified from nationwide databases in Taiwan. Patients with a diagnosis of cancer, MI or CAD prior to the study period were excluded. After reducing confounding through inverse probability of treatment weighting, we compared the incidence of newly diagnosed breast cancer between patients with a history of acute MI and those without. As a result, a total of 66,445 female patients were obtained, including 15,263 patients with a history of acute MI and 51,182 patients without. The incidences of breast cancer during follow-up were 1.93 (95% confidence interval [CI] 1.78–2.09) and 1.80 (95% CI 1.67–1.93) per 1,000 person-years for patients with and without a history of acute MI, respectively. The hazard ratio (HR) was 1.05 (95% CI 0.78–1.41, P = 0.756). In subgroup analysis, breast cancer risk was significantly associated with acute MI in patients using antidiabetic drugs (HR 1.27; 95% CI 1.02–1.58) and in low to moderate urbanization levels (HR 1.28; 95% CI 1.06–1.53). In conclusion, the risk of newly diagnosed breast cancer was not increased in patients with acute MI when compared to general population without MI or CAD.

Background Herpes zoster (HZ) is the reactivation of varicella zoster virus predominantly affecting individuals aged over 50 years. Dementia is a prevalent age-related condition. The association between HZ and dementia was under dispute. Objectives The objective of this study was to evaluate the evidence on the association of HZ with dementia. Methods We conducted a systematic review and meta-analysis to evaluate the risk of dementia in individuals with a history of HZ compared to those without such a history. We searched PubMed, Embase, Medline, and Cochrane Library for studies published up to February 24, 2024. The risk of bias of studies was examined by the Newcastle–Ottawa Scale. A random effects model meta-analysis was performed to calculate the pooled hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses on Alzheimer’s disease (AD), vascular dementia (VD), and cranial nerve involvement of HZ were executed. We used the GRADE methodology to assess the certainty of evidence. Results We included seven cohorts and two case–control studies involving 3,550,251 subjects. The risk of bias of included studies was generally low. The meta-analysis found no association of HZ with dementia (pooled HR 1.00, 95% CI 0.94–1.07 for cohort studies; pooled OR 1.05, 95% CI 0.84–1.30 for case-control studies), with the certainty of evidence being very low. Subgroup analyses for AD, VD, and cranial never HZ also revealed no significant differences (pooled HR being 0.99, 95% CI 0.89–1.09; 1.04, 95% CI 0.85–1.27; and 1.36, 95% CI 0.76–2.43, respectively). Conclusion The current evidence does not support an association of HZ with dementia.

An infrared (IR) tunable perfect meta-absorber (TPM) is presented, which is configured of metal-insulator-metal (MIM) structure. The unit cell of the TPM device is composed of two opposite T-shaped and two rod-shaped Au resonators on the reflective mirror layer. The optimized feature size of TPM can achieve perfect absorption and the resonant wavelength can be tuned from blue-shift first and then red-shift by increasing the gap size between two T-shaped resonators continuously. The tuning process of red shift is linear. By changing the distance between two rod-shaped resonators, the TPM device exhibits red shift linearly. Moreover, TPM device shows polarization-dependent characteristic that the main absorption resonance can be attenuated from 100% to 0% by changing polarization angle from 0° to 90° of incident IR light. The resonance of TPM device has an excellent linear relationship with the ambient refractive index, and the sensitivity and maximum figure of merit (FOM) are calculated as 1249 nm/RIU and 21 RIU−1, respectively. These results prove that the design of the proposed TPM device is very suitable for the use of IR sensing, polarization switching, and refractive index sensing applications.

This study presents and demonstrates a design of a micro-electro-mechanical system (MEMS) reconfigurable terahertz (THz) metamaterial absorber (TMA) that shows tunable free spectra range with a maximum value as 166 GHz in transverse magnetic mode and switchable resonance from 1.24 THz to 1.53 THz. The unit structure of TMA consists of two movable rectangular resonators aside and an x-shaped resonator at the center comprising two c-shaped resonators connected upside down. The material configuration of TMA is typical of the metal–insulator-metal sandwich configuration. That is a bottom Au layer preventing the penetration of the THz wave, a dielectric SiO2 layer to accommodate and absorb the incident wave, and a patterned Au structure array to select the resonant frequency. The electromagnetic response of TMA could be flexibly modulated when the structure is reconfigured by changing the gaps between x-shaped resonators and rectangular resonators based on the MEMS platform. Meanwhile, owing to the asymmetry of resonant structure, the electromagnetic response of TMA could be tuned from single-, dual-, triple- quad-resonances by varying the polarization state of incidence. Furthermore, the sensitivity of TMA is explored and demonstrated with remarkable linearity under a variation of the surrounding environment refractive index from 1.0 to 2.0. The feasibility of TMA is validated as the experimental absorption spectra are well meet the simulation results. The above results indicate the proposed TMA possesses great potential applications in multiple resonance switches, polarization switches, and highly efficient environmental sensors.

IntroductionAtherosclerotic cardiovascular disease is associated with a high mortality rate due to vascular calcification. The role of fetuin-A in aortic arch calcification (AAC) is less well understood.MethodsAn analysis of secondary biomarkers was performed on 800 individuals from the biobank using the community database. AAC was defined by radiologists based on imaging. Multiple variables logical analysis was used for risk analysis.ResultsA total of 736 individual samples were collected based on age and gender. The average age is 65 ± 10 years, and half the population comprises men. In spite of similar body weight, renal function, and hepatic function, the AAC group had higher blood pressure and fetuin-A levels independently: systolic blood pressure (SBP) index ≥130 mmHg [adjusted odds ratio (aOR) 1.85, 95% confidence interval (CI) 1.34–2.57, p = 0.002] and fetuin-A (aOR 0.62, 95% CI 0.50–0.76, p

AbstractMicro-electro-mechanical system (MEMS) is once proposed in 1970s and evolving rapidly. Current researchers are seeking for better designs and better applications for MEMS actuators. This work presents an electrostatic driven dual-axis scanning micromirror, i.e., two-dimensional (2D) scanning micromirror with mirror size of 500 μm × 500 μm. The scanning mirror is implemented by using bulk micromachining process on silicon on insulator (SOI) substrate, which is compatible with present complementary metal oxide semiconductor (CMOS) manufacturing technology. The scanning frequency of the slow axis and the fast axis is 4.87 kHz and 31.15 kHz, respectively. The impact factors of the dimensions of comb fingers and torsion beams are analyzed and discussed in this study. Under the driving voltage difference of 100 volts and 70 volts, the deviation angle is 4.57° × 13.08°. Therefore, a simple design of a dual-axis MEMS scanning micromirror is proposed, which can be precisely controlled without additional complex sensors or circuits.

Quasibound states in the continuum (BIC) have earned extensive attentions due to the capability to realize extremely high quality‐factor (Q‐factor) resonance. Here, a metamaterial composed of silicon dioxide (SiO2) with low refractive index (≈1.45) on gold (Au) reflection mirror is proposed to realize narrowband perfect absorption with the assistance of quasi‐BIC and surface lattice resonance. The proposed SiO2‐Au absorber based on SiO2 metamaterial is composed of two tilted SiO2 cubes into a unit cell and periodically arranged on Au reflection mirror. By optimizing the geometry parameters, the proposed absorber presents both accidental quasi‐BIC and symmetry‐protected quasi‐BIC modes with near‐perfect absorptivity and high Q‐factor of 2330 and 1438, respectively. The Q‐factor can be further improved to 104 by increasing the thickness of SiO2 cubes to micrometer level. Meanwhile, the wavelength of absorption peak shows linear sensitivity of 16.67 and 17.88 nm per degree to incident angles as the absorptivity is higher than 92% and 75% in the spectra range of 215.0–141.0 nm, respectively. These results open the avenue for the metamaterial absorber in emitter, imaging, and biosensing applications.

Background Hypertension and hypercholesterolemia are important risk factors for cardiovascular disease, and treatment with fixed‐dose combination (FDC) regimens is recommended by current guidelines. However, the clinical outcomes of different FDC dosages remain unknown. This study aimed to examine the clinical outcomes of FDC regimens and the free combination of amlodipine and atorvastatin at different dosages. Methods and Results Patients with concurrent hypertension and hypercholesterolemia treated daily with an FDC of 5 mg amlodipine and 10 mg atorvastatin (5/10 fixed group), and FDC of 5 mg amlodipine and 20 mg atorvastatin (5/20 fixed group), or free combination of 5 mg amlodipine and 20 mg atorvastatin (5/20 free group) were identified from the National Health Insurance Research Database of Taiwan. The primary outcome was the composite cardiovascular outcomes, including cardiovascular death, acute myocardial infarction, stroke, and coronary intervention. A total of 9095 patients were eligible for inclusion. The incidence of primary outcome per 1000 person‐years was 16.6 in the 5/10 fixed group, 12.6 in the 5/20 fixed group, and 16.5 in the 5/20 free group (5/20 fixed versus 5/20 free: hazard ratio [HR], 0.76 [95% CI, 0.64–0.91]; 5/20 fixed versus 5/10 fixed: HR, 0.76 [95% CI, 0.63–0.90]). Conclusions Among patients with concomitant hypertension and hypercholesterolemia, treatment with an FDC of amlodipine and high‐dose atorvastatin led to a lower risk of a composite of cardiovascular outcomes than treatment with the free combination or a similar FDC with a lower dose of atorvastatin.

The molecular and genetic mechanisms underlying left atrial (LA) enlargement and atrial fibrosis following right ventricular (RV) dependent pacing remain unclear. Our objective was to investigate genetic expressions in the LA of pigs subjected to RV pacing for atrioventricular block (AVB), as well as to identify the differential gene expressions affected by biventricular (BiV) pacing. We established an AVB pig model and divided the subjects into three groups: a sham control group, an RV pacing group, and a BiV pacing group. Differential expression genes (DEGs) analyses conducted through next-generation sequencing (NGS) and enrichment analyses were employed to identify genes with altered expression in the LA myocardium. The RV pacing group showed a significant increase in extracellular fibrosis in the LA myocardium compared to the control group. NGS analysis revealed suppressed expression of the sirtuin signaling pathway in the RV pacing group. Among the DEGs within this pathway, GADD45G was found to be downregulated in the RV pacing group and upregulated in the BiV pacing group. Remarkably, the BiV pacing group exhibited elevated levels of GADD45G protein. In our study, we observed significant downregulation of SIRT1 and GADD45G genes, which are associated with the sirtuin signaling pathway, in the LA myocardium of the RV pacing group when compared to the control group. Moreover, these genes, which were downregulated in the RV pacing group, displayed a noteworthy upregulation in the BiV pacing group when compared to the RV pacing group.

Background Metabolic disorder is noted for pacing‐induced cardiomyopathy. The benefits of His bundle pacing over right ventricular (RV) pacing in preventing pacing‐induced cardiomyopathy from a metabolic perspective are yet to be fully understood. Method and Results Three pig groups were established for this study: sham control, RV pacing (RV pacing for 6 months), and His pacing (RV pacing for 6 months, followed by His bundle pacing for 3 months). Complete atrioventricular block was created in the last 2 groups. Left ventricular function and dyssynchrony were assessed via echocardiography, while proteins linked to metabolism, endoplasmic reticulum stress, and inflammation in left ventricular myocardium were examined. The RV pacing group had significantly more left ventricular mechanical dyssynchrony compared with the other groups. The RV pacing group exhibited triglyceride and diacylglycerol accumulation in cardiomyocytes and higher expression of binding immunoglobulin protein and tumor necrosis factor‐α than the other groups. Additionally, the expression of CD36 was activated, while the expression of hormone‐sensitive lipase was downregulated in the RV pacing group compared with the His pacing and sham control groups. Furthermore, the expressions of GLUT4 and pyruvate dehydrogenase were higher in the RV pacing group than the sham control and His pacing groups. Notably, the abnormal fatty acid and glucose metabolic pathways in the left ventricular myocardium during RV pacing could be corrected by His bundle pacing. Conclusions His bundle pacing can mitigate the abnormal metabolism disorders, endoplasmic reticulum stress, and inflammation induced during RV pacing and may contribute to the superiority of conduction system pacing over RV pacing in reducing heart failure hospitalization.

As ultrathin optical elements with subwavelength structures densely arranged, planar lens or called metalens can effectively focus incident wave. Due to the compact design and wide operating frequency of metalens, it becomes promising in applications like information encryption, imaging, and wireless communication fields. However, the fabrication of large-aperture metalens is still time-consuming and costly while the focusing performances are commonly tuned by introducing active materials requiring extra stimuli, such as laser and electrical pulses. In this study, five designs of metalenses with synthetic rectangular aperture are proposed and demonstrated with excellent focusing performances. By reconfiguring the synthetic aperture, focusing properties like focusing lengths, full width at half maximum values, and modulation transfer function can be tuned with great flexibility. With a polarization-dependent phase-shifting structure, the proposed metalens shows different focusing performances with incident wave under transverse magnetic field and transverse electric field modes. By utilizing spatial multiplexing, terahertz variable foci metalenses based on a stretchable single-, dual- and quad-axis synthetic rectangular optical sparse aperture are investigated to achieve tunable multifocal performances. These designs provide a novel strategy that can reconfigure the synthetic aperture with stretchable substrate to make metalens with multifunction and active tunability, which show promising applications in imaging, information encryption, and space telescope areas.

Background: An extended interval between the two primary doses may reduce the risk of myocarditis/pericarditis after COVID-19 mRNA vaccination. Taiwan has implemented a two-dose regimen with a 12-week interval for adolescents. Here we present nationwide data of myocarditis/pericarditis following COVID-19 vaccinations. Methods: Data on adverse events of myocarditis/pericarditis were from the Taiwan Vaccine Adverse Events Reporting System between March 22, 2021, and February 9, 2022. The reporting rates according to sex, age, and vaccine type were calculated. We investigated the rates among young individuals under different two-dose intervals and among those who received two doses of different vaccines. Results: Among 204 cases who met the case definition of myocarditis/pericarditis, 75 cases occurred after the first dose and 129 after the second. The rate of myocarditis/pericarditis after COVID-19 vaccination varied across sex and age groups and was highest after the second dose in males aged 12–17 years (126.79 cases per million vaccinees) for the BNT162b2 vaccine and in males aged 18–24 years (93.84 cases per million vaccinees) for the mRNA-1273 vaccine. The data did not suggest an association between longer between-dose interval and lower rate of myocarditis/pericarditis among males and females aged 18–24 or 25–29 years who received two doses of the BNT162b2 or mRNA-1273 vaccine. Rates of myocarditis/pericarditis in males and females aged 18–49 years after receiving ChAdOx1-S - mRNA-1273 vaccination was significantly higher than after ChAdOx1-S - ChAdOx1-S vaccination. Conclusions: Myocarditis and pericarditis are rare following mRNA vaccination, with higher risk occurring in young males after the second dose.

Abstract Background Little research has been done on ischemic outcomes related to left ventricular ejection fraction (EF) in acute decompensated heart failure (ADHF). Methods A retrospective cohort study was conducted between 2001 and 2021 using the Chang Gung Research Database. ADHF Patients discharged from hospitals between January 1, 2005, and December 31, 2019. Cardiovascular (CV) mortality and heart failure (HF) rehospitalization are the primary outcome components, along with all-cause mortality, acute myocardial infarction (AMI) and stroke. Results A total of 12,852 ADHF patients were identified, of whom 2,222 (17.3%) had HFmrEF, the mean (SD) age was 68.5 (14.6) years, and 1,327 (59.7%) were males. In comparison with HFrEF and HFpEF patients, HFmrEF patients had a significant phenotype comorbid with diabetes, dyslipidemia, and ischemic heart disease. Patients with HFmrEF were more likely to experience renal failure, dialysis, and replacement. Both HFmrEF and HFrEF had similar rates of cardioversion and coronary interventions. There was an intermediate clinical outcome between HFpEF and HFrEF, but HFmrEF had the highest rate of AMI (HFpEF, 9.3%; HFmrEF, 13.6%; HFrEF, 9.9%). The AMI rates in HFmrEF were higher than those in HFpEF (AHR, 1.15; 95% Confidence Interval, 0.99 to 1.32) but not in HFrEF (AHR, 0.99; 95% Confidence Interval, 0.87 to 1.13). Conclusion Acute decompression in patients with HFmrEF increases the risk of myocardial infarction. The relationship between HFmrEF and ischemic cardiomyopathy, as well as optimal anti-ischemic treatment, requires further research on a large scale.

Abstract Background Acute myocardial infarction (AMI) and colon cancer share similar risk factors. Studies have suggested an association between AMI and colon cancer; however, evidence is conflicting. Whether sex disparities exist in this association in the real world remains unknown. Methods In this population‐based retrospective cohort study, 94,780 and 97,987 male patients and 38,697 and 72,007 female patients with and without new‐onset AMI, respectively, from January 1, 2001, to December 31, 2012, were enrolled from Taiwan's National Health Insurance Research Database. Inverse probability of treatment weighting (IPTW) was used to balance covariates across study groups. The primary outcome was a new diagnosis of colon cancer. Results The incidence rate of colon cancer was 1.54 (95% confidence interval [CI] = 1.46–1.62) and 1.40 (95% CI = 1.32–1.48) per 1000 person‐years in the male patients and 1.62 (95% CI = 1.50–1.74) and 1.22 (95% CI = 1.13–1.32) in the female patients, in the AMI and non‐AMI groups, respectively. AMI was associated with a significantly higher risk of colon cancer in the female patients (hazard ratio [HR] = 1.31, 95% CI = 1.06–1.61) but not in the male patients (HR = 1.09, 95% CI = 0.95–1.26). In the subgroup analysis, the association between AMI and colon cancer in the female patients was stronger in those aged ≥65 years (HR = 1.28, 95% CI = 1.13–1.44). Conclusions An increased risk of colon cancer was observed only in the female patients with AMI. The association between AMI and colon cancer in the female patients was the most evident in those aged ≥65 years.

Abstract Respiratory oscillometry is widely explored in asthma management; however, there is currently no consensus on its routine work-up in patients with difficult-to-treat asthma. We conducted a retrospective, cross-sectional study involving patients with difficult-to-treat asthma at Asia University Hospital between January 2017 and October 2020. We aimed to correlate clinical significance of respiratory oscillometry and asthma treatment outcomes including symptoms control and exacerbation in patients with difficult-to-treat asthma. Among the 69 patients enrolled in the study, a total of 26.1% of the patients experienced at least one severe or two moderate exacerbations. Patients with ACT

A tunable terahertz (THz) metamaterial (TTM) composed of double connected semicircle-shaped rings and two segregated metallic bars is presented. Through the manipulation of the radius of connected semicircle-shaped rings (R), the transverse electric (TE)-polarization resonance is red-shifted from 1.225 to 0.669 THz. The first and second transverse magnetic (TM)-polarization resonances can be systematically red-shifted from 1.225 to 0.669 THz and from 1.787 to 1.162 THz, respectively. By increasing the R value from 15.0 to 27.5 µm, the tuning trend of the free spectral range is linear over the range of 0.50 THz. Moreover, the TTM device shows polarization-dependent characteristics, which can be modulated by manipulating the distance between the semicircular-shaped ring structure and the metallic bar. The electromagnetic responses of the TTM device can be effectively tuned, enabling the possibility to switch between single-resonance in the TE mode, and dual-, triple-, and quad-resonance in the TM mode. The experiment and simulation results are agreed well. The TTM device can be employed as a sensor for evaluating the change of surrounding refractive index. The sensitivities between resonances and refractive indices are linear in the TE and TM modes. Therefore, TTM devices can be used for single-, dual-, triple-, and quad-resonance switching, polarization switching, and high-efficiency environmental sensing applications.

Abstract Background Vitamin K antagonists and different direct oral anticoagulants (DOACs) have different renal clearance rates. However, the impact of different stages of chronic renal impairment on the efficacy and safety of warfarin, dabigatran, rivaroxaban, apixaban, and edoxaban in atrial fibrillation (AF) patients remains unclear. Methods This study enrolled AF patients from the Chang Gung Research Database. The study endpoints included thromboembolic events, major/fatal bleeding, gastrointestinal (GI) bleeding and intracranial hemorrhage (ICH). The risks of time to study endpoints between groups were compared using a Cox proportional hazards regression model with adjustment. Results This study enrolled 3525 patients with moderate renal impairment (30 ≤ creatinine clearance (CrCl)

Abstract Aims Ivabradine is indicated for heart failure (HF) patients with reduced ejection fraction (HFrEF), but limited data are available with regards to the use of ivabradine in those with a history of paroxysmal atrial fibrillation (AF). To assess the effect of ivabradine in HFrEF patients with paroxysmal AF, we analysed heart failure (HF) hospitalization and mortality from multiple‐centre registry database. Methods and results We conducted a multicentre observational matched cohort study, and this study enrolled patient with symptomatic HFrEF from 1 January 2015 to 31 December 2018 who had a history of paroxysmal AF in Chang Gung Memorial Hospital medical database in Taiwan. A total of 2042 patients were eligible for the study, of whom 887 were prescribed with ivabradine and 1115 were not. The primary outcome, including HF hospitalization and cardiovascular death, and individual outcome during the 12 month observation period were analysed after inverse probability of treatment weighting. The ivabradine group had significantly lower mean heart rate after 12 months follow‐up than the non‐ivabradine group (P

Abnormal DRP1 expression has been identified in a variety of human cancers. However, the prognostic potential and mechanistic role of DRP1 in head and neck cancer (HNC) are currently poorly understood. Here, we demonstrated a significant upregulation of DRP1 in HNC tissues, and that DRP1 expression correlates with poor survival of HNC patients. Diminished DRP1 expression suppressed tumor growth and metastasis in both in vitro and in vivo models. DRP1 expression was positively correlated with FOXM1 and MMP12 expression in HNC patient samples, suggesting pathological relevance in the context of HNC development. Moreover, DRP1 depletion affected aerobic glycolysis through the downregulation of glycolytic genes, and overexpression of MMP12 in DRP1‐depleted cells could help restore glucose consumption and lactate production. Using ChIP‐qPCR, we showed that DRP1 modulates FOXM1 expression, which can enhance MMP12 transcription by binding to its promoter. We also showed that miR‐575 could target 3’UTR of DRP1 mRNA and suppress DRP1 expression. Collectively, our study provides mechanistic insights into the role of DRP1 in HNC and highlights the potential of targeting the miR‐575/DRP1/FOXM1/MMP12 axis as a novel therapy for the prevention of HNC progression.

Highlights Among patients with acute myocardial infarction (AMI), women were older, had more comorbid conditions, and were less likely to be discharged with optimal medical therapy than their male counterparts. In-hospital and long-term outcomes were worse among women compared to men, particularly in those who received percutaneous coronary intervention (PCI) as the mode of revascularization for AMI. Despite worse in-hospital survival, women were less likely to receive mechanical cardiac support. After propensity score matching between women and men for baseline characteristics, the incidence of hospitalization for heart failure was higher among women during long-term follow-up, especially among patients who had undergone PCI. Contrarily, the incidence of repeat revascularization procedures was lower in women in the long term. Mechanisms underlying cardiac ischemia likely differ between women and men, and socioeconomic inequalities that influence treatment of female patients are also possible.

Background: The global rise in nosocomial infections associated with gram-negative bacteria and the spread of multi-drug resistant Acinetobacter baumannii (MDR-AB) pose public health concerns. This study investigates the inhibitory effects and possible inhibitory mechanism of Pseudomonas aeruginosa (PA) on selected clinical strains of A. baumannii (AB) isolated from Taiwanese patients. Methods: Four and eight clinical strains of AB and PA, respectively, were randomly selected from the bacterial collection of Feng-Yuan Hospital, Taiwan. Antimicrobial-susceptibility was performed on the AB strains. Inhibition potential of the PA strains against AB was assessed by measuring the inhibition zones. In vitro analysis using phenazine-1-carboxamide (PCN) was conducted to assess the possible inhibitory mechanism of PA, which was later confirmed in the clinical isolates by liquid chromatography-mass spectrometry. Results: All the clinical AB strains showed resistance to the eleven antibiotics and were classified as MDR-AB. The nine PA strains exert either a high (PA3596, PA3681, PA3772, and ATCC27853) or a low (PA3613, PA3625, PA3712, PA3715, and PA3744) degree of inhibition against AB strains. 0.25 mg/ml PCN had a clearer inhibition zone than 0.05 mg/ml PCN, suggesting a dose-dependent inhibition of PCN on the AB strains. The four PA strains that demonstrated a high degree of inhibition had a relatively high amount of PCN. Conclusion: Selected strains of PA exert inhibitory actions on MDR-AB with PCN being a possible inhibitory agent. This finding raises the possibility of developing effective therapeutic antibiotics and disinfectant from specific components of PA for the treatment and control of Acinetobacter-associated infections in hospital settings.

This paper proposes a mini-light-emitting diode (mini-LED) driving circuit that is driven by pulse width modulation (PWM) for the backlights of active-matrix (AM) liquid crystal displays (LCDs). The proposed circuit compensates for threshold voltage (VTH) variations of low-temperature poly-crystalline silicon thin-film transistors (LTPS TFTs) and the current-resistance (I-R) rise in VSS lines to supply a stable driving current. Operating the mini-LED at the high luminous efficacy by the PWM driving method and setting only the driving TFT on the path of the driving current reduce the power consumption of the backlight. Based on a 2.89-inch LCD panel with an AMLED $48\times48$ backlit module, the TFTs are fabricated, measured, and fitted. Simulation results show that the relative current error rates are all below 4.67% when the VTH of the driving TFT varies by ±0.3 V and the VSS rises by 0.5 V. The voltage across VDD and VSS of the proposed circuit is 4.5 V lower than that of the 6T1C compensating driving circuit, so the power consumption of the circuit is at least 27.05% lower. Therefore, the proposed driving circuit is well suitable to use in mini-LED backlit LCDs.

In recent years, the problem of potential-induced degradation (PID) phenomenon has been deeply associated with solar power issues because it causes serious power attenuation of solar panels and results in lowering its power generation efficiency. Thus, effectively identifying the PID problem from insights of industry data analysis to reduce production costs and increase the performance of power generation is an interesting and important subject for the solar power industry. Moreover, by the traditional standard rule (IEC62804) and the condition of a 96 h testing time, the costs of testing time and assembling materials against PID are very high and must be improved. Given the above reasons, this study proposes a hybrid procedure to organizes four mathematical methods: the mini-module testing, solar cell testing, a settling time, and a neural network, which are named as Method-1–Method-4, respectively, to efficiently solve the PID problem. Consequently, there are four key outcomes from the empirical results for solar power application: (1) In Method-1 with a 96 h testing time, it was found that the large module with higher costs and the mini module with lower costs have a positive correlation; thus, we can replace the large-module testing by the effective mini module for lower cost on module materials. (2) In Method-2 with a 24 h testing time, it was also found that the mini module and the solar cell are positively correlated; this result provides evidence that we can conduct the PID test by the easier solar cell to lower the costs. (3) In Method-3, the settling time achieves an average accuracy of 94% for PID prediction with a 14 h testing time. (4) In Method-4, the experimental result provides an accuracy of 80% when identifying the PID problem with the mathematical neural network model and are obtained within a 2 h testing time. From the above results, these methods succeed in reducing cost of materials and testing time during the manufacturing process; thus, this study has an industrial application value. Concurrently, Method-3 and Method-4 are rarely seen in the limited literature review for identifying PID problem; therefore, this study also offers a novel contribution for technical application innovation.

Background: The population of adults with congenital heart diseases (ACHDs) is expanding, and atrial fibrillation (AF) emerges as a crucial risk factor for ischemic stroke. However, the evidence regarding the impact of AF on the incidence of ischemic stroke in ACHDs remains limited. In this study, we aimed to investigate the prevalence and effect of AF among ACHDs and assess the suitability of the traditional CHA₂DS₂-VASc score in this specific population. Methods: Data of ACHDs from 2000 to 2010 were retrospectively collected from the Taiwan National Health Insurance Research Database. We divided ACHDs into those with and without AF, and ischemic stroke incidence was studied among ACHD subtypes and those who received anticoagulant therapy with warfarin or not according to CHA₂DS₂-VASc score. Results: 36,530 ACHDs were retrieved from the database. ACHDs had a 4.7–15.3 times higher AF risk than did the general population, which varied based on the age group. ACHDs with AF had 1.45 times higher ischemic stroke risk than those without AF (p = 0.009). Ischemic stroke incidence among ACHDs with AF aged

With the motivation of long-term care 2.0 plans, forecasting models to identify potential customers of long-term care insurance (LTCI) are an important and interesting issue. From the limited literature, most past researchers emphasize traditional statistics techniques to address this issue; however, these are lacking in some areas. For example, intelligent hybrid models for LTCI are lacking, performance measurement of components for hybrid models is lacking, and research results for interpretative capacities are lacking, resulting in a black box scenario and difficulty in making decisions, and the gap between identifying potential customers and constructing hybrid models is unbridged. To solve the shortcomings mentioned above, this study proposes some advanced intelligent single and hybrid models; the study object is LTCI customers. The proposed hybrid models were used on the experimental dataset collected from real insurance data and possess the following advantages: (1) The feature selection technique was used to simplify variables for the purpose of improving model performance. (2) The performance of hybrid models was evaluated against some machine learning methods, including rough set theory, decision trees, multilayer perceptron, support vector machine, genetic algorithm, random forest, logistic regression, and naive Bayes, and sensitivity analysis was performed in terms of accuracy, coverage, rules number, and standard deviation. (3) We used the C4.5 algorithm of decision trees and the LEM2 algorithm of rough sets to extract and provide valuably comprehensible decisional rules as decision-making references for the interested parties for their varied benefits. (4) We used post hoc testing to verify the significant difference in groups. Conclusively, this study effectively identifies potential customers for their key attributes and creates a decision rule set of knowledge for use as a reference when solving practical problems by forming a structured solution. This study is a new trial in the LTCI application field and realizes novel creative application values. Such a hybrid model is rarely seen in identifying LTCI potential customers; thus, the study has sufficient application contribution and managerial benefits to attract much concern from the interested parties.

Abstract Objective Long-term oral anticoagulant should be considered or recommended in patients with atrial fibrillation (AF) and CHA2DS2VASc score ≥ 1 for stroke prevention. Warfarin and different direct oral anticoagulants (DOACs) are metabolized differently by the kidney. The impact on renal function after long-term use of anticoagulants in the patients with AF remains unclear. This study aimed to compare DOACs and warfarin’s impact on the decline in renal function from a large cohort with AF. Methods This study included patients with nonvalvular AF from 2000 to 2018, mainly through the medical history (ICD code) of the Chang Gung Research Database. Baseline estimated glomerular filtration rate (eGFR), follow-up eGFR and the change in eGFR between 2-year eGFR and baseline eGFR were compared between different DOACs and warfarin after propensity score matching. The primary study endpoint was acute kidney injury (AKI). Results 3657 patients were enrolled in this study and the mean observation time was 3.3 ± 0.9 years. During the observation period, there was a significantly higher incidence of AKI during follow-up in the warfarin group than in the different DOAC groups before and after propensity score matching (before: warfarin vs. DOAC: 9.2% vs. 5.2%, p

Involvement of extracellular nicotinamide phosphoribosyltransferase (eNAMPT, i.e., visfatin or pre-B-cell colony-enhancing factor), a cancer metabokine, in chronically hepatitis C virus (HCV)-infected (CHC) patients with sustained virological responses (SVRs) remains elusive. This 8-year prospective cohort study evaluated eNAMPT profiles of 842 consecutive CHC patients, including 519 who had completed an anti-HCV therapy course and pre-therapy and 24-week post-therapy surveys. For 842 patients, pre-therapy associations were HCV RNA, homeostatic model assessment for insulin resistance (HOMA-IR) index, and body mass index with eNAMPT levels, and NAMPT-rs61330082 T allele with total cholesterol levels. NAMPT-rs10953502, NAMPT-rs2058539, and NAMPT-rs61330082 were in a linkage disequilibrium block, which was associated with total cholesterol levels. Compared to pre-therapy levels, at 24 weeks post-therapy, decreased eNAMPT and increased lipid levels were observed in SVR patients (n = 427). Among SVR patients, higher cumulative incidences of cardiovascular events occurred in those with a NAMPT-rs61330082 TT genotype than those with non-TT genotypes (28.2% vs. 8.4%, p

Abstract Objective This study assesses the mortality outcomes of non‐vitamin K antagonist oral anticoagulants (NOACs) in cancer patients with venous thromboembolism (VTE) and atrial fibrillation (AF). Methods Medical records of cancer patients receiving NOACs for VTE or AF between January 1, 2011, and December 31, 2016, were retrieved from Taiwan's National Health Institute Research Database. NOACs were compared using the inverse probability of treatment weighting (IPTW) method. The primary outcome was cancer‐related death. Secondary outcomes were all‐cause mortality, major bleeding, and gastrointestinal (GI) bleeding. Results Among 202,754 patients who received anticoagulants, 3591 patients (dabigatran: 907; rivaroxaban: 2684) with active cancers were studied. Patients who received dabigatran were associated with lower risks of cancer‐related death at one year (HR = 0.71, 95% CI = 0.54–0.93) and at the end of follow‐ups (HR = 0.79, 95% CI = 0.64–0.98) compared with rivaroxaban. Patients who received dabigatran were also associated with lower risks of all‐cause mortality (HR = 0.81, 95% CI = 0.67–0.97), major bleeding (HR = 0.64, 95% CI = 0.47–0.88), and GI bleeding (HR = 0.57, 95% CI = 0.39–0.84) at the end of follow‐ups compared with rivaroxaban. Conclusion Compared with rivaroxaban, the use of dabigatran may be associated with a lower risk of cancer‐related death and all‐cause mortality.

In this study, two kinds of nanostructured metasurfaces are presented and compared to exhibit ultrahigh color purity and selectivity in the visible wavelength range. The proposed nanostructured metasurfaces are composed of all-dielectric materials, which are Si3N4 fabricated on quartz substrates to form one-dimensional (1D) and two-dimensional (2D) nanogratings (NGs). These nanostructured metasurfaces exhibit over 98 % reflection intensity with ultra-narrow bandwidths less than 20 nm to perform vivid red, green, and blue colors, implying the potentials in high-saturation display. Among nanostructured metasurfaces, 2D-NGs allow a wider range of incident angle than 1D-NGs and show polarization-independent characteristic owing to the symmetric arrangement in nanoscale in the incident plane. Furthermore, the numerical simulation results prove that 1D-NGs and 2D-NGs exhibit single- and dual-resonance when exposed on the ambient environment with different refractive indexes. Such excellent optical performances verify their potentials not only in high-resolution display but also in chemical sensing applications.

BackgroundHeart rate (HR) control is important in heart failure (HF) patients with reduced ejection fraction, and ivabradine is indicated for patients with chronic HF and sinus rhythm. However, ivabradine is limited in initiation of ivabradine at acute stage of HF.Materials and methodsThis multi-institutional retrospective study enrolled 30,639 patients who were admitted for HF from January 01, 2013 to December 31, 2018 at Chang Gung Memorial Hospitals. After applying selection criteria, the eligible patients were divided into ivabradine and non-ivabradine groups according to the initiation of ivabradine at the index hospitalization. HR, clinical outcomes including HF hospitalization, all-cause hospitalization, mortality, the composite of cardiovascular (CV) death or HF hospitalization and newly developed atrial fibrillation, and left ventricular ejection fraction (LVEF) and left atrium size were compared between the ivabradine and non-ivabradine groups after inverse probability of treatment weighting (IPTW) analysis after 12 months.ResultsThe HR at admission in the ivabradine group (n = 433) was 99.04 ± 20.69/min, compared to 86.99 ± 20.34/min in the non-ivabradine group (n = 9,601). After IPTW, HR was lower in the ivabradine group than that in the non-ivabradine group after 12 months (74.14 ± 8.53 vs. 81.23 ± 16.79 bpm, p = 0.079). However, there were no significant differences in HF hospitalization (HR = 1.02; 95% CI, 0.38–2.79), all-cause hospitalization (HR = 0.95; 95% CI, 0.54–1.68), mortality (HR = 0.87; 95% CI, 0.69–1.08), the composite of CV death or HF hospitalization (HR = 0.87; 95% CI, 0.69–1.08) and newly developed AF between the two groups. In addition, LVEF increased with time in both groups, but there were no significant differences during the observation period.ConclusionIvabradine was beneficial in controlling HR when initiated in patients with acute stage of HF, but it did not seem to provide any benefits in reducing HF hospitalization, all-cause hospitalization, and mortality in 1 year after discharge.

Abstract Mycoplasma capricolum subsp.subsp. capripneumonia (Mccp) and Mycoplasma mycoides subsp.sbusp. capri (Mmc) cause caprine pleuropneumonia (CCPP) and mycoplasmal pneumonia in goats and sheep (MPGS), respectively. These diseases cannot be identified on clinical symptoms alone and it is laborious to distinguish them using biochemical methods. It is therefore important to establish a simple, rapid identification method for Mccp and Mmc. Here, we report a high-resolution melting (HRM) curve analysis using specific primers based on the Mmc 95010 strain MLC_0560 and Mccp F38 strain MCCPF38_00984 gene sequences. The method was highly specific with intra- and inter-batch coefficients of variation

BackgroundThe serum aminotransferase elevation in metabolic syndrome (MetS) reflected hepatosteatosis, but there is a conflict with the coexistence of viral hepatitis, especially for the hepatitis B virus (HBV). Thus, this study aimed to investigate the relationship between the alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio, MetS, and HBV infection in a rural Taiwanese population.MethodsWe conducted a cross-sectional analysis in southern Taiwan between March and December 2019. Multivariable logistic regression analyses adjusted for demographics, education, dietary behaviors, irregular exercise, substance use, and viral markers were performed to investigate the association between the ALT/AST ratio and MetS.ResultsAltogether, 2,416 participants (891 men and 1,525 women; mean age, 64.1 ± 14.9 years) were enrolled. Of the participants, 22.7% (n = 519) were seropositive for viral hepatitis. In the multivariable analysis, age [odds ratio (OR) 1.02, 95% CI 1.01–1.03, p 1 (OR 2.63, 95% CI 2.15–3.21, p 0.852 for the Youden index.ConclusionAn ALT/AST ratio >1 could be a simple index for MetS prediction during community checkups. In contrast to age and betel nut chewing, HBV seropositivity and higher education might be inversely associated with MetS. Aggressive health promotion for MetS prevention has emerged as essential in participants without HBV and with lower education levels. Further large-scale, longitudinal studies are needed to unlink these correlations.

Intelligent machinery fault diagnosis is one of the key technologies for the transformation and competitiveness of traditional factories. Complex production environments make it difficult to maintain good prediction performance using traditional methods. This paper proposes a deep convolutional neural network combined with an adaptive environmental noise method to achieve robust fault classification. The proposed method uses six-dimensional physical signals for data fusion and feature fusion, extracts obvious features and enhances subtle features, and uses continuous wavelets and Gramian angular fields to transform signals with different physical and frequency characteristics into time–frequency maps and two-dimensional images. The fusion technology of different signals can provide comprehensive features for fault prediction, improving upon the blind spots of traditional methods to extract features, and then perform prediction and classification through deep convolutional neural networks. In the experiment, the tool failure classification of the dental milling machine is used as a verification case. The results show that the prediction accuracy of the proposed method is nearly 100%, much better than other comparison methods. In addition, white noise was added in the experiment to verify the noise immunity of the model. The results show that the accuracy of the proposed method is 99%, which is better than other comparison methods in terms of accuracy and robustness, proving the effectiveness of the proposed method for fault diagnosis and classification.

Abstract The incidence of herpes zoster in psoriasis patients is higher than in the general population. However, the association between herpes zoster risk and different systemic therapies, especially biologic agents, remains controversial. This study investigated the association between herpes zoster risk and several systemic antipsoriasis therapies. This prospective open cohort study was conducted using retrospectively collected data from the Taiwan National Health Insurance Research Database. We included 92,374 patients with newly diagnosed psoriasis between January 1, 2001, and December 31, 2013. The exposure of interest was the “on-treatment” effect of systemic antipsoriasis therapies documented by each person-quarter. The outcome was the occurrence of newly diagnosed herpes zoster. During a mean follow-up of 6.8 years, 4834 (5.2%) patients were diagnosed with herpes zoster after the index date. Among the systemic antipsoriasis therapies, etanercept (hazard ratio [HR] 4.78, 95% confidence interval [CI] 1.51–15.17), adalimumab (HR 5.52, 95% CI 1.72–17.71), and methotrexate plus azathioprine (HR 4.17, 95% CI 1.78–9.82) were significantly associated with an increased risk of herpes zoster. By contrast, phototherapy (HR 0.76, 95% CI 0.60–0.96) and acitretin (HR 0.39, 95% CI 0.24–0.64) were associated with a reduced risk of herpes zoster. Overall, this study identified an association of both etanercept and adalimumab with an increased risk of herpes zoster among psoriasis patients. Acitretin and phototherapy were associated with a reduced risk.

Abstract The stochastic tunnelling-basin hopping-discrete molecular dynamics (STUN-BH-DMD) method was applied to the search for the most stable biomolecular complexes in water by using the MARTINI coarse-grained (CG) model. The epithelial cell adhesion molecule (EpCAM, PDB code: 4MZV) was used as an EpCAM adaptor for an EpA (AptEpA) benchmark target molecule. The effects of two adsorption positions on the EpCAM were analysed, and it is found that the AptEpA adsorption configuration located within the EpCAM pocket-like structure is more stable and the energy barrier is lower due to the interaction with water. By the root mean square deviation (RMSD), the configuration of EpCAM in water is more conservative when the AptEpA binds to EpCAM by attaching to the pocket space of the EpCAM dimer. For AptEpA, the root mean square fluctuation (RMSF) analysis result indicates Nucleobase 1 and Nucleobase 2 display higher flexibility during the CGMD simulation. Finally, from the binding energy contour maps and histogram plots of EpCAM and each AptEpA nucleobase, it is clear that the binding energy adsorbed to the pocket-like structure is more continuous than that energy not adsorbed to the pocket-like structure. This study has proposed a new numerical process for applying the STUN-BH-DMD with the CG model, which can reduce computational details and directly find a more stable AptEpA/EpCAM complex in water.

Abstract Little is known about the association between deep vein thrombosis (DVT) and arterial complications in patients with type 2 diabetes (T2DM). The aim of this retrospective cohort study was to assess the influence of prior DVT on major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) in T2DM. A total of 1,628,675 patients with T2DM with or without a history of DVT from 2001 to 2013 were identified in the National Health Insurance Research Database of Taiwan. Before matching, the patients in the DVT group (n = 2020) were older than the control group (66.3 vs. 58.3 years). Patients in the DVT group were more likely to be female than the control group (54.3% vs. 47.5%). Before matching, the DVT group had higher prevalence of most comorbidities, more prescription of antiplatelet, antihypertensive agents and insulins, but less prescription of metformin and sulfonylurea. During a mean follow-up of 5.2 years (standard deviation: 3.9 years), the matched DVT group (n = 2017) have a significantly increased risk of MALE (8.4% vs. 5.2%; subdistribution hazard ratio [SHR] 1.60, 95% CI 1.34–1.90), foot ulcer (5.2% vs. 2.6%, SHR 1.96, 95% CI 1.57–2.45), gangrene (3.4% vs. 2.3%, SHR 1.44, 95% CI 1.10–1.90) and amputation (2.5% vs. 1.7%; SHR 1.42, 95% CI 1.03–1.95) than the 10,085 matched controls without DVT. They also tended to have a greater risk of all-cause mortality (38.1% vs. 33.1%; hazard ratio [HR] 1.18, 95% CI 1.09–1.27) and systemic thromboembolism (4.2% vs. 2.6%; SHR 1.56, 95% CI 1.22–1.99), respectively. We showed the presence of DVT may be associated with an increased risk of MALEs, major amputation, and thromboembolism, contributing to a higher mortality rate in T2DM.

The present research aimed to explore the effect of dietary ferrous glycine chelate supplementation on performance, serum immune-antioxidant parameters, fecal volatile fatty acids, and microbiota in weaned piglets. A total of 80 healthy piglets (weaned at 28 day with an initial weight of 7.43 ± 1.51 kg) were separated into two treatments with five replicates of eight pigs each following a completely randomized block design. The diet was a corn-soybean basal diet with 2,000 mg/kg ferrous glycine chelates (FGC) or not (Ctrl). The serum and fecal samples were collected on days 14 and 28 of the experiment. The results indicated that dietary FGC supplementation improved (p < 0.05) the average daily gain and average daily feed intake overall, alleviated (p < 0.05) the diarrhea rate of piglets at the early stage, enhanced (p < 0.05) the levels of superoxide dismutase and catalase on day 14 and lowered (p < 0.05) the MDA level overall. Similarly, the levels of growth hormone and serum iron were increased (p < 0.05) in the FGC group. Moreover, dietary FGC supplementation was capable of modulating the microbial community structure of piglets in the early period, increasing (p < 0.05) the abundance of short-chain fatty acid-producing bacteria Tezzerella, decreasing (p < 0.05) the abundance of potentially pathogenic bacteria Slackia, Olsenella, and Prevotella as well as stimulating (p < 0.05) the propanoate and butanoate metabolisms. Briefly, dietary supplemented FGC ameliorates the performance and alleviated the diarrhea of piglets by enhancing antioxidant properties, improving iron transport, up-regulating the growth hormone, modulating the fecal microbiota, and increasing the metabolism function. Therefore, FGC is effective for early iron supplementation and growth of piglets and may be more effective in neonatal piglets.

Summary: We propose and demonstrate a metamaterial design by integrating a microelectromechanical system (MEMS) electrothermal actuator (ETA) platform and a cross-shaped metamaterial (CSM) to perform opto-logic function characteristics. Reconfigurable and stretchable mechanisms of CSM are achieved by driving different DC bias voltages on ETA to improve the limitations induced by the conventional use of the flexible substrate. The optical responses of CSM are tunable by the electrical signals inputs. By driving a DC bias voltage of 0.20 V, a tuning range of CSM is 0.54 THz is obtained and it and provides perfect zero-transmission characteristics. In addition, the “XNOR” logic gate function of CSM is realized at 1.20 THz, which plays a key role in the all opto-logic network communication system. The proposed MEMS-based CSM exhibits potential applications in logical operation, signal modulation, optical switching, THz imaging, and so on.

Abstract Atorvastatin 40 mg (ATOR 40) and ezetimibe 10 mg/simvastatin 20 mg (EZ-SIM 20) have similar reductions of low-density lipoprotein cholesterol (LDL-C) but cardiovascular (CV) outcomes between these two therapies are unclear. Our real-world cohort study is to test the hypothesis of pleiotropic effects of purely higher dose statin on CV outcomes beyond similar reductions of LDL-C, especially for extremely CV risk patients. Between January 1, 2007 and December 31, 2013, a total of 3,372 patients with type 2 diabetes mellitus (T2DM) admitted due to acute coronary syndrome (ACS) or acute ischemic stroke (AIS) were selected as the study cohort from the Taiwan National Health Insurance Research Database. Clinical outcomes were evaluated by ATOR 40 group (n = 1686) matched with EZ-SIM 20 group (n = 1686). Primary composite outcome includes CV death, non-fatal myocardial infarction, and non-fatal stroke. Secondary composite outcome includes hospitalization for unstable angina (HUA), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). With a mean follow-up of 2.4 years, no significant difference of primary composite outcome was observed between ATOR 40 and EZ-SIM 20 groups (subdistribution hazard ratio [SHR], 1.09; 95% confidence interval [CI], 0.95–1.25). Nevertheless, ATOR 40 group had lower risks of HUA (SHR, 0.50; 95% CI, 0.35–0.72), PCI (SHR, 0.82; 95% CI, 0.69–0.97) and CABG (SHR, 0.62; 95% CI, 0.40–0.97) than EZ-SIM 20 group. For T2DM patients after ACS or AIS, ATOR 40 and EZ-SIM 20 had similar major CV outcomes, which still supported the main driver for CV risk reductions is LDL-C lowering.

In this study, a tunable terahertz (THz) metamaterial using the micro-electro-mechanical system (MEMS) technique is proposed to demonstrate pressure sensing application. This MEMS-based tunable metamaterial (MTM) structure is composed of gold (Au) split-ring resonators (SRRs) on patterned silicon (Si) substrate with through Si via (TSV). SRR is designed as a cantilever on the TSV structure. When the airflow passes through the TSV from bottom to up and then bends the SRR cantilever, the SRR cantilever will bend upward. The electromagnetic responses of MTM show the tunability and polarization-dependent characteristics by bending the SRR cantilever. The resonances can both be blue-shifted from 0.721 THz to 0.796 THz with a tuning range of 0.075 THz in transverse magnetic (TM) mode and from 0.805 THz to 0.945 THz with a tuning range of 0.140 THz in transverse electric (TE) mode by changing the angle of SRR cantilever from 10° to 45°. These results provide the potential applications and possibilities of MTM design for use in pressure and flow rate sensors.

To further enhance the color conversion from a quantum-well (QW) structure into a color-converting colloidal quantum dot (QD) through Förster resonance energy transfer (FRET), we designed and implemented a device structure with QDs inserted into a GaN nano-porous structure near the QWs to gain the advantageous nanoscale-cavity effect. Additionally, surface Ag nanoparticles were deposited for inducing surface plasmon (SP) coupling with the QW structure. Based on the measurements of time-resolved and continuous-wave photoluminescence spectroscopies, the FRET efficiency from QW into QD is enhanced through the SP coupling. In particular, performance in the polarization perpendicular to the essentially extended direction of the fabricated pores in the nano-porous structure is more strongly enhanced when compared with the other linear polarization. A numerical simulation study was undertaken, and showed consistent results with the experimental observations.

Abstract Background Sodium-glucose co-transporter 2 inhibitors (SGLT2i) has shown evidence of cardiovascular benefit in patients with type 2 diabetes mellitus (T2DM). Currently metformin is the guideline-recommended first-line treatment. We aimed to investigate the benefit of SGLT2i vs metformin as first-line therapy. Methods Electronic medical records from Chang Gung Research Database during 2016–2019 were retrieved for patients with T2DM. Patients aged

A tunable liquid metamaterial (TLM) is proposed and demonstrated to possess phase tunability. TLM is composed of SiO2 nanopillars encapsulated with silicone oil. The phase of incident wavelength of 660 nm can be tuned 2π by elevating the height of SiO2 nanopillars to 1.65 μm. TLM shows high transmission intensity of 0.9. The phase manipulation is based on the liquid morphology, which is different from that by temperature and electrical methods. Herein, a TLM design is proposed to exhibit an actively tunable phase metamaterial and promote its application prospect. It provides the potential possibility of holography with high transmission intensity and shows actively tunable transmission phase to realize the tunable deflection angle, variable image, and varifocal metalens applications. This TLM design, an innovative idea for one kind of liquid metamaterial, is desirable to bring more possibilities to the tunable phase metamaterial. The adoptable electromagnetic spectrum of this design can also extend to the entire electromagnetic spectrum, such as microwave, terahertz (THz), infrared (IR), etc. The proposed TLM design provides an effective approach in tunable optoelectronics applications and a new direction for the future 3D stereoimaging and holographic projection applications.

Abstract Background We aimed to assess the impact of systemic lupus erythematosus (SLE) on the risk of infection after total hip arthroplasty (THA). Methods We identified patients undergoing primary THA (1996–2013) in Taiwan National Health Insurance Research Database (NHIRD). Patients were then divided into the SLE and control groups according to the diagnosis of SLE. We used 1:1 propensity score to match the control to the SLE group by age, sex, and comorbidities. The primary outcome was infection, including early and late superficial wound infection and periprosthetic joint infection (PJI). The secondary outcome was in-hospital complications. Results We enrolled 325 patients in each group. In the primary outcome, the incidence of early superficial wound infection and PJI was comparable between the SLE and matched-control group. However, the incidence of late superficial wound infection and PJI in the SLE group was higher than that in matched-control group (11.4% vs. 5.5%, P = 0.01; 5.2% vs 2.2%, P = 0.04, respectively). Furthermore, the SLE group had a higher risk for late superficial wound infection and PJI (hazard ratio = 2.37, 95% confidence interval (CI) 1.35–4.16; HR = 2.74, 95% CI 1.14–6.64, respectively) than the matched-control. Complications other than infection and in-hospital mortality cannot be compared because of very low incidence. Conclusions SLE is a risk factor for developing late superficial wound infection and PJI, but not for early postoperative complications following THA. Clinical presentations should be monitored to avoid misdiagnosis of PJI in SLE patients after THA.

Abstract Two designs of metasurface color filters (MCFs) using aluminum and lithium niobate (LN) configurations are proposed and numerically studied. They are denoted as tunable aluminum metasurface (TAM) and tunable LN metasurface (TLNM), respectively. The configurations of MCFs are composed of suspended metasurfaces above aluminum mirror layers to form a Fabry-Perot (F-P) resonator. The resonances of TAM and TLNM are red-shifted with tuning ranges of 100 nm and 111 nm, respectively, by changing the gap between the bottom mirror layer and top metasurface. Furthermore, the proposed devices exhibit perfect absorption with ultra-narrow bandwidth spanning the whole visible spectral range by composing the corresponding geometrical parameters. To increase the flexibility and applicability of proposed devices, TAM exhibits high sensitivity of 481.5 nm/RIU and TLNM exhibits high figure-of-merit (FOM) of 97.5 when the devices are exposed in surrounding environment with different refraction indexes. The adoption of LN-based metasurface can enhance FWHM and FOM values as 10-fold and 7-fold compared to those of Al-based metasurface, which greatly improves the optical performance and exhibits great potential in sensing applications. These proposed designs provide an effective approach for tunable high-efficiency color filters and sensors by using LN-based metamaterial.

Abstract Background and aim Peroxisome proliferator-activated receptor-γ (PPAR-γ) modulating treatment may have cardiovascular benefits in type 2 diabetes mellitus (T2DM) patients after ischemic stroke (IS). However, whether there are additional benefits from intensive PPAR-γ modulating treatments in Asian patients with T2DM and hypertension (HTN) after IS remains unknown. Methods Between 2001 and 2013, patients admitted due to IS were identified from the National Health Insurance Research Database of Taiwan. Patients with T2DM and HTN using angiotensin receptor blockers were further included. Eligible patients were divided into two groups: (1) pioglitazone and (2) non-pioglitazone oral anti-diabetic agent groups. Propensity score matching (1:2) was used to balance the distribution of baseline characteristics, stroke severity and medications. The primary outcome was recurrent IS. Subgroup analysis for recurrent IS in pioglitazone and/or telmisartan users, the trend of IS risks across different PPAR-γ intensity treatments, and dose-dependent outcomes across different pioglitazone possession ratios were further studied. Statistical significance was set at p

In recent years, electromagnetic characteristics of metamaterials has aroused great interest because of innovative fundamental understanding as well as promising potential applications in optics, semiconductors, imaging, and sensing. We survey the state-of-the-art of spatially reconfigurable metamaterials in which electromagnetic Lorentz, Coulomb, and Ampere forces, as well as optical signals and thermal stimulation can be dynamically changed their optical properties. Electro-mechanical and optical inputs change the amplitude, phase, polarization of incident electromagnetic wave, and optical response within these metamaterials, which can be driven by electric or optical signals. Based on a solid theoretical foundation, we review the most recent experimental works on reconfigurable metamaterials endowed with an active tuning characteristic. Additionally, we review the potential metamaterial applications that may inspire new research works and offer a comparison to other optoelectronic fields.

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

Objective: Atrial fibrillation (AF) and venous thromboembolism (VTE) share several risk factors related to arterial thromboembolism. No study has reported the differential contribution to arterial thromboembolic events and mortality between these two conditions in the same population. We therefore assessed the differential arterial thromboembolic events between AF and VTE.Methods: We included AF and VTE national cohorts derived from Taiwan National Health Insurance Research Database between 2001 and 2013. The eligible population was 314,861 patients in the AF cohort and 41,102 patients in the VTE cohort. The primary outcome was arterial thromboembolic events, including ischemic stroke, extracranial arterial thromboembolism (ECATE) and myocardial infarction (MI). Secondary outcomes were all-cause mortality and cardiovascular death.Results: After a 1:1 propensity matching, 32,688 patients in either group were analyzed. The risk of arterial thromboembolic events was lower in the VTE cohort than that in the AF cohort (subdistribution hazard ratio [SHR], 0.60; 95% confidence interval [CI], 0.57–0.62). The risk of ischemic stroke (SHR, 0.44; 95% CI, 0.42–0.46) and MI (SHR, 0.80; 95% CI, 0.72–0.89) were lower in the VTE cohort, while the risk of ECATE (SHR, 1.23; 95% CI, 1.14–1.33; particularly lower extremities) was higher in the VTE cohort. All-cause mortality rate was higher in the VTE cohort (HR, 1.18; 95% CI, 1.15–1.21) while the risk of cardiovascular death was lower in the VTE cohort (HR, 0.96; 95% CI, 0.93–0.995).Conclusions: Patients with AF had higher risks of arterial thromboembolic events compared to patients with VTE, despite having risk factors in common. The VTE cohort had higher risks of all-cause mortality and ECATE, particularly lower extremity events, compared to AF patients. The differential manifestations of thromboembolism sequelae and mortality between AF and VTE patients merit further investigation.