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Vitamin D deficiency has been associated with various diseases and adverse health outcomes, including diabetes, cardiovascular diseases, and cancer. Currently, the majority of vitamin D testing is conducted in large-scale laboratories upon the request of a physician as part of an annual panel of blood tests. In this paper, we present a novel paper-based microfluidic system that enables the rapid quantification of vitamin D levels on a portable platform. The system comprises a smartphone accessory, an app, and a test strip that allows for the colorimetric detection of 25-hydroxyvitamin D3 using a gold-nanoparticle-based immunoassay. We demonstrate that the system can accurately measure the physiological levels of 25-hydroxyvitamin D with an accuracy higher than 25 nM and a precision of 10 nM. We compared our system with the well-established ELISA test kits for serum samples of unknown concentration and demonstrated the equivalency of the obtained results. [ABSTRACT FROM AUTHOR]

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 <50 years was 1.46 times higher than those without AF (p = 0.207). Ischemic stroke incidence was over 1.47% even in those with a low CHA₂DS₂-VASc score (0–1) with or without anticoagulant therapy. Conclusions: During the 12-year follow-up, ACHDs with AF were found to have an increased risk of ischemic stroke. The ischemic stroke incidence was high, even in those with a low CHA₂DS₂-VASc score (0–1). [ABSTRACT FROM AUTHOR]

Team-based learning (TBL) has been increasingly applied in engineering and science education over the past decade. This study explores a particular TBL approach used in a mechanical engineering module for second-year undergraduates in Taiwan. The results of a survey on these students’ learner autonomy (LA), perceptions of TBL, engagement with TBL, self-reported contributions and concerns about TBL activities were analyzed along with their academic performance. The results suggested that LA played a crucial role in TBL, especially contribution to group work, and that classroom implementationsshould therefore make it a priority to boost LA. In addition, positive reciprocity was found to be operating during group work. Group differences were found in issues the students expressed concern about. Students who cared about fairness had higher LA and were more likely to contribute to team tasks whilst some students could have been less engaged in group activities due to poor Yu-Hsuan Lin Corresponding author. 43 Jibong-ro, Bucheon-si, Gyeonggi-do, (14662), Republic of Korea. yuhsuan.lin@catholic.ac.kr organizational structure. Several challenges were also observed in thisstudy. They included passive learners, classroom-management problems, free-riding, and limited resources. Based on our findings, we recommend that engineering instructors encourage student-teacher communication by using bonus-point incentives, student experts, peer evaluation and group competitions. [ABSTRACT FROM AUTHOR]

Background: The 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. Methods: We 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. Results: Altogether, 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 < 0.001], ALT/AST ratio >1 (OR 2.63, 95% CI 2.15-3.21, p < 0.001), education (OR 0.96, 95% CI 0.94-0.98, p < 0.001), and HBV seropositivity (OR 0.70, 95% CI 0.52-0.95, p = 0.021) were associated with the risk of MetS. The area under the curve of the ALT/AST ratio was 0.62 (95% CI 0.60-0.64, p < 0.001), and the cutoff value was >0.852 for the Youden index. Conclusion: An 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. [ABSTRACT FROM AUTHOR]

We study the XAI (explainable AI) on the face recognition task, particularly the face verification. Face verification has become a crucial task in recent days and it has been deployed to plenty of applications, such as access control, surveillance, and automatic personal log-on for mobile devices. With the increasing amount of data, deep convolutional neural networks can achieve very high accuracy for the face verification task. Beyond exceptional performances, deep face verification models need more interpretability so that we can trust the results they generate. In this article, we propose a novel similarity metric, called explainable cosine (xCos), that comes with a learnable module that can be plugged into most of the verification models to provide meaningful explanations. With the help of xCos, we can see which parts of the two input faces are similar, where the model pays its attention to, and how the local similarities are weighted to form the output xCos score. We demonstrate the effectiveness of our proposed method on LFW and various competitive benchmarks, not only resulting in providing novel and desirable model interpretability for face verification but also ensuring the accuracy as plugging into existing face recognition models. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore the relevance between the fitness club brand image and the willingness of members to purchase, and verify that whether the fitness coach's personal brand has an intermediary effect between the two. The members of the fitness clubs were selected as the research objects, a total of 363 questionnaires were distributed on the Internet by purposive sampling. The data were analyzed through the descriptive statistics, the confirmatory factor analysis and the structural equation model. The results of this study found that there is a significant positive impact between the fitness club brand image, the fitness coach's personal brand and the willingness of member to purchase; In addition, the fitness coach's personal brand plays a full intermediary role in the fitness club brand image and the willingness of member's to purchase. Conclusion: The main factor for the fitness club members to purchase courses in the future is impact by the fitness coach. Besides that, the good brand image can help to shape the coach's distinctive and professional knowledge to enhance the willingness of members continue to purchase courses. [ABSTRACT FROM AUTHOR]

This work examines the coupling effect in concentric double split-ring-resonator devices in terahertz (THz) range when the inner ring changes its relative orientation to the outer ring. Through detailed analysis on the simulation results of surface current and electrical field distributions, we look into the changes of inductance and capacitance in the system caused by structural layouts, and present a set of coherent theory that is solely rooted in the inductance-capacitance circuit analogy to systematically account for the resonance change. Such coupling effect combined with polarization of the incident wave is further explored to demonstrate continuous modulation of THz resonances. A variation range of transmission intensity from 20% to 80% has been successfully achieved. These experimental results demonstrate the promise of realizing future tunable THz filters by means of rotating sub-structures of the device only. [ABSTRACT FROM AUTHOR]

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 < 0.001). NAMPT-rs61330082 TT genotype was independently associated with incident cardiovascular events (95% CI hazard ratio (HR): 1.88-10.37; HR: 4.415); no eNAMPT profiles were associated with incident malignancies. Of CHC patients, hepatic vascular endothelial cells and baseline peripheral leukocytes expressed higher eNAMPT levels than controls, and peripheral eNAMPT-positive leukocyte proportions decreased after SVR. During HCV infection, eNAMPT involvement in glucose metabolism was modulated by HCV RNA linked to lipid metabolism and NAMPT-associated SNPs. Hepatic endothelial cells and peripheral leukocytes potentially secrete eNAMPT. Caution is required for incident cardiovascular events in SVR patients with NAMPT-rs61330082 TT genotype. [ABSTRACT FROM AUTHOR]

A 77 GHz quadrature frequency multiplier-by-nine is demonstrated using the 90 nm CMOS process. The implemented multiplier-by-nine is composed of a high conversion gain quadrature frequency tripler with coupled lines as the buffer stage to reduce power consumption and increase power output. This frequency multiplier-by-nine achieves good suppression for the fundamental, second, and other harmonics. The conversion loss is â?'33 dB at 77 GHz. The DC power consumption is only 5.2 mW. The chip area is 0.46 mm². This device can help to improve the performance of high-frequency radar sensors. [ABSTRACT FROM AUTHOR]

Even though the prison population in Taiwan are not as high as 10 years ago, prison population is about the same as that of countries with much bigger overall populations such as Japan, France, Germany or the United Kingdom. Moreover, the recidivism rates were increased over the past few decades. Most criminological research indicated a strong inverse relationship between employment and crime, suggesting that ex-prisoners with stable employments were less likely to reoffend than their counterpart without employment. However, ex-offenders face significant barriers to employment after release from prison, such as employer attitudes toward individuals with criminal records, legal barriers, educational and financial obstacles, substance abuse and health issues, and lack of stable housing. This study discussed the applications of self-stigma by analyzed the sources of job search, employment status, type of job, causes of unemployment, and salary expectations. The results indicated that given up played an important role in ex-prisoners' job searching. [ABSTRACT FROM AUTHOR]

Objectives This study determined the recurrence and complication rates after radiofrequency catheter ablation (RFCA) for those with paroxysmal supraventricular tachycardia (PSVT), Wolff-Parkinson-White syndrome (WPW), atrial flutter (AFL), atrial fibrillation (AF) and ventricular tachycardia (VT). Study design and setting This retrospective study included RFCAs for 2001-2010 in the Taiwan National Health Insurance Research Database. Primary outcomes included perioperative complications (pericardial effusion and new-onset stroke), RFCA recurrence and long-term outcomes (high-grade atrioventricular block (AVB) and pacemaker implantation). Results Of 19,475 patients who underwent RFCA, prevalence rates were 56.7% for PSVT, 13.5% for WPW, 9.5% for AFL, 5.1% for AF and 2.7% for VT. Prevalence rates increased in AF, AFL and VT over the study years. During an average follow-up period of 4.3 years (SD: 2.8 years), recurrence rates for PSVT, WPW, VT, AFL and AF were 2.0%, 4.9%, 5.7%, 5.8% and 16.1%, respectively. Compared with the PSVT group, the WPW and AF groups had significantly higher risk of pericardial effusion during admission (adjusted OR (aOR) 2.98, 95% CI (CI) 1.24 to 7.15; aOR 4.09, 95% CI 1.90 to 8.79, respectively); the AFL group had a higher risk of new-onset stroke during admission (aOR 4.07, 95% CI 1.39 to 11.91); the WPW group had a lower risk of high-grade AVB during follow-up (adjusted HR (aHR) 0.37, 95% CI 0.19 to 0.71) while the AFL group had a greater risk (aHR 1.74, 95% CI 1.17 to 2.60); and the AFL group had a higher risk of permanent pacemaker (aHR 2.14, 95% CI 1.27 to 3.62). Conclusions The RFCA rate increased rapidly during 2001-2010 for AF, AFL and VT. Recurrence was associated with congenital heart disease in PSVT and WPW, and with age in AF and AFL. AFL had a higher risk of permanent pacemaker implantation and new stroke. AF had a higher risk of life-threatening pericardial effusion. [ABSTRACT FROM AUTHOR]

Yiguan Dao's similarity to Buddhism is often considered the reason for its expansion in Thailand and its attraction of not only ethnic Chinese members, but also Thai members. However, the teachings, practices, and networks of female Yiguan Dao members in Thailand are exemplary of Yiguan Dao's discontinuities with established Buddhism in Thailand. In Thai Theravada Buddhism, women's full ordination as bhikkhunıs is not recognized by the authorities and much of the public, and women are considered subordinate to men in the religious dimension. Although certain ideas and practices regarding the reform of women's status in Thai Buddhism have made advances, most reforms continue to face difficulties under the restrictions of the Thai Buddhist establishment. Although some sexist elements exist in its teachings, Yiguan Dao, a new religious movement in modern Thailand existing outside the framework of Buddhism, offers its female members a competitive alternative to women's religious equality and geographic mobility in the pluralistic Thai religious marketplace. [ABSTRACT FROM AUTHOR]

Background: The use of an implantable cardioverter-defibrillator (ICD) has been established as an effective secondary prevention strategy for ventricular tachycardia (VT)/ventricular fibrillation (VF). However, few reports discuss the difference in clinical predictors for recurrent VT/VF between patients with ischemic cardiomyopathy (ICM) and patients with dilated cardiomyopathy (DCM). Methods: From May 2004 to December 2015, 132 consecutive patients who had ICM (n = 94) or DCM (n = 38) and had received ICD implantation for secondary prevention were enrolled in this study. All anti-tachycardia events during follow-up were validated. The clinical characteristics and echocardiographic parameters were obtained for comparison. The incidence of recurrence of VT/VF, cardiovascular mortality, all-cause mortality, the change of left ventricular ejection fraction (LVEF) and LV volume were analyzed. Results: At a mean follow-up of 3.62 ± 2.93 years, 34 patients (36.2%) in the ICM group and 22 patients (57.9%) in the DCM group had a recurrence of VT/VF episodes (p = 0.032). The DCM group had a lower LVEF (p = 0.019), a larger LV end-diastolic volume (LVEDV) (p = 0.001), a higher prevalence of LVEDV >158 mL (p = 0.010), and a larger LV end-systolic volume (p = 0.010) than the ICM group. LVEDV >158 mL and no use of angiotensin-converting-enzyme inhibitor/angiotensin receptor blocker were independent predictors of recurrences of VT/VF in ICM patients but not in DCM patients. There were no difference in cardiovascular mortality and all-cause mortality between the ICM and DCM patients. Conclusion: The DCM patients had a higher recurrence rate of VT/VF than did the ICM patients during long-term follow-up. An enlarged LV is an independent predictor of the recurrence of VT/VF in ICM patients receiving ICD for secondary prevention. [ABSTRACT FROM AUTHOR]

This paper presents a comprehensive analysis of a current-mode-logic frequency divider (CML FD) and the theoretical locking range of CML FD. The locking range of the CML divider is proportional to the injection ratio. By adding a resistive load, the locking range of the CML divider is not limited by the Q value of the LC resonant circuit. The minimum input power to drive the divider is achieved when the output frequency is equal to the self-oscillation frequency. To verify the properties of wideband and multi-phase outputs, the ÷4 octet-phase frequency divider based on a two-stage CML FD was implemented using a 0.18 µm CMOS process. It has a locking range of 1GHz to 8GHz with a 12.6mW dc power consumption, and the phase deviation between the octet output signals is less than 4.7°. With an ultra-wide frequency bandwidth and accurate octet outputs, the proposed divider is suitable for multi-phase generator applications. [ABSTRACT FROM AUTHOR]

Write-once-read-many-times (WORM) characteristics of sol-gel InZnO (IZO) thin films are investigated in this paper. The Ag/IZO/n+-Si WORM memory exhibits a poor read disturb immunity. Although a postannealing process is capable of improving the performance due to formation of a thin interfacial AgxO layer, the memory window is only 5 x 10² and the resistance in high resistance state degrades dramatically during read disturb testing. By replacing the Ag electrode with an Al electrode, without the postannealing process, the Al/IZO/n+-Si WORM memory shows a superior read disturb immunity and a large memory window of 4 x 10³. The read endurance is over 104 cycles. X-ray diffraction, X-ray photoelectron spectroscopy, transmission electron microscopy, and energy dispersive spectroscopy were utilized to investigate the physical mechanisms of the WORM characteristics. The carrier conduction mechanisms were also explored. [ABSTRACT FROM AUTHOR]

Background: To compare the long-term clinical outcomes of different antihypertensive drugs in stable patients after acute hemorrhagic stroke (HS). Methods: From January 2001 to December 2013, patients with first-ever primary HS were identified in the National Health Insurance Research Database, Taiwan. Patients with traumatic intracerebral hemorrhage and secondary HS were excluded. Those with first-ever HS were recruited and classified into three groups: (1) angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB); (2) calcium channel blocker (CCB); and (3) other antihypertensive drugs (comparison) groups. Propensity score matching was used to balance the distribution of baseline characteristics, stroke severity, and medications between any two of the three groups. A validation study was performed using the databank of the Stroke Registry in Chang-Gung Healthcare System to reduce the bias. Primary outcomes were recurrent HS, ischemic stroke, any stroke, and all-cause mortality. Results: Compared to the comparison group, the ACEI/ARB group [35.4% versus 39.3%; hazard ratio (HR), 0.84; 95% confidence interval (CI), 0.74–0.95] and CCB group (33.0% versus 41.9%; HR, 0.72; 95% CI, 0.64–0.81) had a lower risk of all-cause mortality during long-term follow up. The CCB group had a similar risk of all-cause mortality to the ACEI/ARB group. Risks of recurrent HS, ischemic stroke, or any stroke were not different between the study groups. Conclusions: Antihypertensive drug class could be important to long-term outcomes in HS patients in addition to the target control of blood pressure. Both ACEIs/ARBs and CCBs are associated with lower risks of all-cause mortality. Our results may be applied to inform future research on hypertensive control in HS patients. [ABSTRACT FROM AUTHOR]

Objectives. The incidence of thromboembolism in patients with SLE is higher than that in the general population. HCQ, widely used to treat lupus, may have vascular protective effects. The aim of this study was to determine whether long-term HCQ exposure is associated with decreased thromboembolism risk in SLE. Methods. We designed a prospective cohort study within an SLE population based on the National Health Insurance Research Database in Taiwan. We divided participants into HCQ and control groups according to HCQ prescription during the first year. These groups were defined by medication possession ratio (MPR) ≥80% and MPR= 0%, respectively. Patients with an MPR between 0 and 80% were excluded. The primary outcome was a composite vascular event, including acute coronary syndrome, ischaemic stroke, pulmonary embolism, deep vein thrombosis and peripheral arterial disease 1 year after inclusion. We excluded patients from the cohort if they had outcomes within the first year. Results. A total of 8397 patients were eligible for analysis. After propensity-score matching, we included 1946 patients in each group. During a mean follow-up of 7.4 years, the number of events was 139 in the HCQ group (7.1%) and 149 in the control group (7.7%). The risk of vascular events in the HCQ group was similar to that in the control group (hazard ratio = 0.91; 95% CI: 0.72, 1.15). Further subgroup analyses confirmed no statistically significant differences between the groups. Conclusion. Long-term HCQ appears to have no vascular protective effect in patients with SLE. [ABSTRACT FROM AUTHOR]

Background: Evidences support the benefits of moderate- to high-intensity statins for patients with acute myocardial infarction (AMI) except for those with type 2 diabetes mellitus (T2DM) on dialysis after AMI. This study was aimed to investigate the safety and efficacy of secondary prevention of cardiovascular diseases using moderate- to highintensity statins in T2DM patients on dialysis after AMI. Methods: A simulated prospective cohort study was conducted between January 1st, 2001 and December 31st, 2013 utilizing data from the Taiwan National Health Insurance Research Database. A total of 882 patients with T2DM on dialysis after AMI were selected as the study cohort. Cardiovascular efficacy and safety of moderate- to high-intensity statins were evaluated by comparing outcomes of 441 subjects receiving statins after AMI to 441 matched subjects not receiving statins after AMI. The primary composite outcome included cardiovascular death, non-fatal myocardial infarction and non-fatal ischemic stroke. Results: The Kaplan-Meier event rate for the primary composite outcomes at 8 years was 30.2% (133 patients) in the statin group compared with 25.2% (111 patients) in the non-statin group (hazard ratio [HR], .98; 95% confidence interval [CI] .76-1.27). Significantly lower risks of non-fatal ischemic stroke (HR, .58; 95% CI .35-.98) and all-cause mortality (HR, .70; 95% CI .59-.84) were found in the statin group. Conclusions: In T2DM patients on dialysis after AMI, the use of moderate- to high-intensity statins has neutral effects on composite cardiovascular events but may reduce risks of non-fatal ischemic stroke and all-cause mortality. [ABSTRACT FROM AUTHOR]

BACKGROUND: A biodegradable porous particle for the controlled biofactor delivery which assembly of pores in scaffolds can improve the permeation and diffusion of drugs or growth factors. OBJECTIVE: Porous-spheres in millimeter scale were prepared by mixing sodium alginate and gelatin interpenetrating networks with cross-linkers; interconnected open pores were fabricated through solvent casting and particulate leaching. METHODS: Morphological characteristics, degradation, and bovine serum albumin (BSA) release rates of the porous-spheres immersed in three different solutions, namely, deionized distilled water, simulated body fluid (SBF), and phosphate-buffered saline (PBS), were detected. RESULTS: Porous-spheres with a large amount of gelatin exhibited an increase in water absorption rates without affecting scaffold strength and no cytotoxicity was elicited. Highly interconnected pores with a diameter of 100-200 µm were uniformly distributed in scaffolds. The weight loss in PBS was faster than that in other solutions; the highest release rate of BSA in SBF was observed for 2 h. The release rates also exhibited linear patterns from 2 h to 24 h in all of the groups. CONCLUSIONS: After 1 d of immersion in solutions, BSA release rates in scaffolds logarithmically decreased for 14 d. The degradation of porous-spheres also showed an inverse pattern. [ABSTRACT FROM AUTHOR]

Objectives. Immunosuppressive therapy is necessary to alter the natural course of SLE. However, immunosuppressant-related cancer risk is a major concern. The aim of this study was to determine whether immunosuppressant use is associated with cancer risk in SLE. Methods. We designed a retrospective nested case-control study within an SLE population based on the National Health Insurance Research Database in Taiwan. We screened 14 842 patients with SLE from 2001 to 2013 and compared patients with SLE complicated by later cancer with patients with SLE but without cancer. The cumulative dose of immunosuppressants was calculated from the SLE diagnosis date to the occurrence of cancer. The immunosuppressants of interest were AZA, CYC, MTX, HCQ and systemic glucocorticoids. Adjusted odds ratios (ORs) for cancer were calculated in conditional Cox regression models after propensity score matching. Results. The top five types of cancers were breast (16.9%), haematological (11.7%), colorectal (11.0%), lung (10.6%) and hepatobiliary (10.4%) cancers. After matching, this study included 330 cancer patients and 1320 matched cancer-free patients. The adjusted analyses showed an association of a higher cumulative CYC dose (OR = 1.09, 95% CI: 1.04, 1.13) and lower HCQ dose (OR = 0.93, 95% CI: 0.90, 0.97) with cancer risk in comparison with the controls. Conclusion. Diverse cancer risks are associated with different immunosuppressants in patients with SLE. CYC increases the risk of cancer, and HCQ decreases this risk in SLE patients, both in a dose-dependent manner. [ABSTRACT FROM AUTHOR]

Purpose: We assessed the lower urinary tract symptoms (LUTSs) and clinical outcomes between diabetes mellitus (DM) patients and non-diabetic (non-DM) patients receiving transurethral resection of prostate (TUR-P). Methods: This analysis was a retrospective cohort study using 13 years (2000-2012) of claims data from Taiwan's National Health Insurance Research Database (NHIRD). A total of 4,887 patients who had persistent LUTSs and underwent TUR-P for prostate enlargement (benign prostate enlargement [BPE]) were enrolled and divided into two groups: DM and non-DM groups. The patients' characteristics, postoperative clinical outcomes, and the medication records after TUR-P were compared. Chi-square test was used for categorical variables and independent samples t-test for continuous variables. Multivariable logistic regression analysis was used to compare the risk of postoperative outcomes. Finally, we estimated the medicationfree survival rate after TUR-P using Kaplan-Meier method and compared it between study groups using log-rank test. Results: DM group patients had a higher prevalence of comorbidities. Postoperatively, the DM group had lower rates of urinary tract infection (UTI; odds ratio [OR], 0.78; P=0.009) and higher rates of urinary retention requiring catheterization (OR, 1.35; P=0.01) within 1 month after TUR-P. A higher proportion of patients with DM took anti-muscarinics (OR, 1.23; P=0.032) within the first 3 months and α-blockers (OR, 1.18; P=0.049) during 3-12 months after receiving TUR-P. Overall, the DM group patients had a worse postoperative medicationfree survival compared to that of non-DM group patients (95% confidence interval [95% CI], 1.14; P=0.005). Conclusion: DM patients require higher rates of continuing medication after TUR-P, especially anti-muscarinics in 3 months postoperatively and alpha-blocker after 3 months postoperatively. DM patients also had higher incidence of urine retention after surgery. DM patients had relatively poor treatment outcomes compared to DM-free patients. [ABSTRACT FROM AUTHOR]

Background: Implantable cardioverter defibrillator (ICD) is an effective treatment for secondary prevention of ventricular tachycardia/ventricular fibrillation (VT/VF). Left ventricular (LV) remodeling may develop before ICD implant and over time. However, it remains unclear how LV remodeling affects subsequent risk for recurrence VT/VF in ICD recipients under optimal medical therapy. Methods: From May of 2004 to June of 2015, 144 patients received ICD implantation for secondary prevention were enrolled in this study. All information interrogated from ICD devices during follow-up or ICD therapy history (antitachycardia pacing and shock therapy) were reviewed and validated the occurrences of VT/VF. Results: At a mean follow-up of 1110.5 ± 860.6 days, 53 patients (36.8%) had recurrence of VT/VF episodes and 91 patients had no recurrence of VT/VF episode after ICD implant. Left ventricular end-diastolic volume (LVEDV) > 163.5 mL had significant predictive value for VT/VF recurrence (area under the curve: 0.602, p = 0.041). Moreover, the percentage of patients with LVEDV >163.5 mL was significantly higher in patients with recurrent VT/VF than patients without recurrent VT/VF (62.3 vs 40.0%, p = 0.010). Left ventricular ejection fraction ≤ 30% (p = 0.031), LVEDV > 163.5 mL (p = 0.012) and QRS width > 125 msec (p = 0.049) were significant predictors for VT/VF recurrence by univariate Cox regression analysis. However, only LVEDV > 163.5 mL (hazard ratio: 2.549, 95% confidence interval: 1.249 ~ 5.201, p = 0.010) and QRS width > 125 msec (hazard ratio: 2.173, 95% confidence interval: 1.030 ~ 4.586, p = 0.042) were independent predictors for recurrence of VT/VF after multivariable adjustment. Conclusion: LV remodeling and QRS width > 125 msec were independent predictors for VT/VF recurrence in secondary prevention ICD recipients under optimal medical therapy, independent of LV ejection fraction. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the efficacy of bundled skin antiseptic preparation to prevent cardiac implantable electronic device (CIED) infections.Methods and Results: From January 2010 to November 2013, 665 consecutive patients were divided into two groups according to the strategy of skin preparation. In Period 1 (January 2010 to June 2012), 395 patients received the standard skin antiseptic preparation. In Period 2 (July 2012 to November 2013), 270 patients received a triple-step skin antiseptic preparation, 'bundled skin antiseptic preparation', consisting of applying 75% alcohol over anterior chest on the night before the index day, povidone-iodine 10 min before operation, and the standard skin antiseptic preparation before incision. During follow-up, the occurrence of CIED infection was recorded. Multiple logistic regression analysis was used to determinate the risk factors of CIED infection. During a mean follow-up of 26.9 ± 16.2 months, 20 episodes of CIED infection developed in 19 patients (2.9%), and the incidence of minor and major infection episodes was 2.2% and 0.8%, respectively. Patients with the bundled skin antiseptic preparation had a significantly lower incidence of CIED infection, compared with patients with the standard preparation (0.7 vs. 4.3%, P = 0.007). In multivariate analysis, pocket haematoma (P = 0.020), atrial fibrillation (P = 0.033), and complex procedures (P = 0.047) were independent predictors for CIED infection. In contrast, the bundled skin antiseptic preparation was a significant predictor against CIED infection (P = 0.014).Conclusion: Pocket haematoma was the most important risk factor for CIED infection. The bundled skin antiseptic preparation strategy significantly reduced the risk of minor CIED infection. [ABSTRACT FROM AUTHOR]

Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course. [ABSTRACT FROM AUTHOR]

Background: Differentially expressed genes in the left atria of mitral regurgitation (MR) pigs have been linked to peroxisome proliferator-activated receptor (PPAR) signaling pathway in the KEGG pathway. However, specific genes of the PPAR signaling pathway in the left atria of MR patients have never been explored.Methods: This study enrolled 15 MR patients with heart failure, 7 patients with aortic valve disease and heart failure, and 6 normal controls. We used PCR assay (84 genes) for PPAR pathway and quantitative RT-PCR to study specific genes of the PPAR pathway in the left atria.Results: Gene expression profiling analysis through PCR assay identified 23 genes to be differentially expressed in the left atria of MR patients compared to normal controls. The expressions of APOA1, ACADM, FABP3, ETFDH, ECH1, CPT1B, CPT2, SLC27A6, ACAA2, SMARCD3, SORBS1, EHHADH, SLC27A1, PPARGC1B, PPARA and CPT1A were significantly up-regulated, whereas the expression of PLTP was significantly down-regulated in the MR patients compared to normal controls. The expressions of HMGCS2, ACADM, FABP3, MLYCD, ECH1, ACAA2, EHHADH, CPT1A and PLTP were significantly up-regulated in the MR patients compared to patients with aortic valve disease. Notably, only ACADM, FABP3, ECH1, ACAA2, EHHADH, CPT1A and PLTP of the PPAR pathway were significantly differentially expressed in the MR patients compared to patients with aortic valve disease and normal controls.Conclusions: Differentially expressed genes of the PPAR pathway have been identified in the left atria of MR patients compared with patients with aortic valve disease and normal controls. [ABSTRACT FROM AUTHOR]

In this study, we characterized the rotational efficiency of the photo-driven Archimedes screw. The micron-sized Archimedes screws were fabricated using the two-photon polymerization technique. Free-floating screws trapped by optical tweezers align in the laser irradiation direction and rotate spontaneously. The influences of the screw pitch and the number of screw blades have been investigated in our previous studies. In this paper, the blade thickness and the central rod of the screw were further investigated. The experimental results indicate that the blade thickness contributes to rotational stability, but not to rotational speed, and that the central rod stabilizes the rotating screw but is not conducive to rotational speed. Finally, the effect of the numerical aperture (NA) of the optical tweezers was investigated through a demonstration. The NA is inversely proportional to the rotational speed. [ABSTRACT FROM AUTHOR]