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Abstract Chronic hepatitis B (CHB) leads to liver inflammation and dysfunction, resulting in liver fibrosis and cancer. Nucleos(t)ide analogues (NAs), inhibitors of hepatitis B virus (HBV), specifically suppress HBV replication. We proposed that immune modulation benefits seroconversion by HBsAg loss. However, activation of T lymphocytes also deteriorates hepatic inflammation. Therefore, we intended to investigate the T cell status and its relationship with hepatic functions in CHB patients treated with NAs. Serum markers, including liver function markers AST, ALT, and HBV-infected markers HBV DNA, HBsAg, HBeAg, and HBsAb were measured in the clinical routine. The T cell levels and markers, including CD69, CD107a, CXCR3, and PD-1 were investigated using flow cytometry. Meanwhile, IFNγ, IL-2, and CXCL10 as immune activation markers in the PBMCs were investigated using qPCR. To validate the effects of NAs on T cell status, qPCR and flow cytometry were used to investigate the gene expression in the HepG2 and PLC5 cells treated with NAs, and in the healthy PBMCs treated with the cell-cultured supernatant. We found that NAs significantly suppressed HBV DNA and reduced AST and ALT levels in the CHB patients. Meanwhile, AST and ALT were both positively correlated with activation marker CD107a in CD8+ T cells. In addition, we found that the CHB patients with seroconversion exhibited a higher CD4/CD8 ratio (p

Background Fetuin-A and leukocyte cell-derived chemotaxin-2 (LECT-2) are liver-derived proteins. Fetuin-A is an independent risk factor for type 2 diabetes (T2D) and obese patients with T2D have higher plasma fetuin-A levels than those without T2D. LECT-2 has positive correlation with the severity of both obesity and insulin resistance. The changes in plasma fetuin-A are not consistent after bariatric surgery and no studies have investigated the changes in LECT-2 on the obese patients with T2D after bariatric surgery. Methods Overall, 18 patients undergoing gastric bypass (GB) and 16 patients undergoing sleeve gastrectomy (SG) were enrolled. The fasting plasma fetuin-A and LECT-2 levels were measured at baseline, one week, three months, and one year after surgery. Results Both the GB and SG groups significantly decreased the body mass index (BMI), waist-to-hip ratio, a body shape index; the triglyceride, fasting blood sugar (FBS), hemoglobin A1c, C-peptide levels; and homeostatic model assessment (HOMA-IR) one year after surgery. The SG group showed a decreasing trend in plasma fetuin-A levels one year after SG surgery. There are no significant changes in LECT-2 one year after either GB or SG. Fetuin-A had a near significant negative relationship with insulin (P = 0.056) and HOMA-IR (P = 0.050) in the SG group. Changes in fetuin-A had a significant positive relationship with changes in BMI (P = 0.031) and waist-to-hip ratio (P = 0.031) in the GB group and had a near significant positive correlation with FBS (P = 0.051) in the SG group. Discussion Neither GB nor SG modifies plasma levels of plasma fetuin-A or LECT-2 in T2D patients after surgery. The changes in plasma fetuin-A have a positive correlation with those of the BMI and waist-to-hip ratio 12 months after GB.

Background The promising postsurgical weight loss and remission of type 2 diabetes (T2D) from bariatric surgery can be attributed to modified eating physiology after surgical procedures. We sought to investigate the changes in the parameters of consumption behaviors and appetite sensations induced by a mixed meal tolerance test, and to correlate these alterations with age, body mass index, C-peptide levels, and duration of T2D 1 year after bariatric surgery. Methods A total of 16 obese patients with T2D who underwent mini-gastric bypass (GB) and 16 patients who underwent sleeve gastrectomy (SG) were enrolled in this study and evaluated using a mixed meal tolerance test one year after surgery. A visual analogue scale was used for scoring appetite sensation at different time points. The area under the curve (AUC) and the incremental or decremental AUC (ΔAUC) were compared between the two groups. Results One year after surgery, a decreasing trend in the consumption time was observed in the GB group compared to the SG group, while the duration of T2D before surgery was negatively correlated with the post-operative consumed time in those after GB. Patients who underwent GB had significantly higher fasting scores for fullness and desire to eat, higher AUC0′–180′ of scores for desire to eat, as well as more effective post-meal suppression of hunger and desire to eat compared with those undergoing SG one year after surgery. Post-operative C-peptide levels were negatively correlated with ΔAUC0′–180′ for hunger and ΔAUC0′–180′ for desire to eat in the GB group, while negatively correlated with ΔAUC0′–180′ for fullness in the SG group. Discussion Patients with T2D after either GB or SG exhibit distinct nutrient-induced consumption behaviors and appetite sensations post-operatively, which may account for the differential effects on weight loss and glycemic control after different surgery.

Background: Hepassocin is a liver-derived protein and its serum concentrations significantly increase in diabetes and fatty liver patients. Hepassocin is also a biomarker for diabetes and fatty liver; therefore, we aimed to investigate the impacts of different types of bariatric surgery on hepassocin plasma levels in obese patients with diabetes, and to determine if hepassocin could be a potential new marker for monitoring the effects of bariatric surgery and a treatment target. Methods: Overall, 12 patients undergoing gastric bypass (GB), 10 patients undergoing sleeve gastrectomy (SG) and 11 patients undergoing duodeno-jejunal bypass with sleeve gastrectomy (DJB-SG) were enrolled. Fasting hepassocin levels were measured at baseline, three, 12, and 24 months after surgery. Results: All the three groups significantly decreased their body mass index, waist-to-hip ratio, a body shape index (ABSI), triglycerides, fasting blood sugar, hemoglobin A1c, C-peptide levels and homeostasis model assessment of insulin resistance 24 months after surgery. There were no significant changes in hepassocin levels, even 24 months after the three surgeries. Hepassocin had a significant negative relationship with the ABSI (p< 0.001) 24 months after the SG. Conclusions: Neither GB, SG, nor DJB-SG altered plasma hepassocin levels in diabetic patients up to 24 months after surgery. The use of hepassocin in clinical settings requires more investigation.

This study collected 220 commercially available samples of γ-Aminobutyric acid (GABA) tea produced in Taiwan from 2016 to 2021. The 220 tea samples were categorized into five types of GABA tea, including 108 GABA Oolong tea, 71 GABA Black tea, 21 GABA Paochong tea, 12 GABA Green tea, and 8 GABA Puerh tea samples. The most common type of GABA tea in Taiwan is GABA Oolong tea, followed by GABA Black tea. The physico-chemical constituents and consumer acceptance of the GABA tea samples were analyzed. The GABA content varied among the different types of GABA tea: GABA Oolong tea ranged from 128–286 mg/100 g, GABA Black tea ranged from 182–360 mg/100 g, GABA Paochong tea ranged from 98–203 mg/100 g, GABA Green tea ranged from 56–174 mg/100 g, and GABA Puerh tea ranged from 142–191 mg/100 g. In terms of the commercial standard of GABA tea, 22 out of the 220 GABA tea samples failed to meet the commercial standard, with a failure rate of 10%. During the fermentation process of GABA tea, the contents of GABA increased significantly, but the total polyphenol and total catechin contents remained stable. In terms of consumer acceptance, GABA Black tea is the most accepted by consumers, followed by GABA Puerh tea, GABA Paochong, and GABA Oolong tea. The sour flavor in GABA tea is similar to the original sour sensory properties found in black tea. It is assumed that this is the main reason GABA Black tea has the highest acceptance.

Individuals with cervical spinal cord injury (C-SCI) often use a tenodesis grip to compensate for their hand function deficits. Although clinical evidence confirms that assistive devices can help achieve hand function improvements, the currently available devices have some limitations in terms of their price and accessibility and the difference in the user’s muscle strength. Therefore, in this study, we developed a 3D-printed wrist-driven orthosis to improve the gripping effect and tested the feasibility of this device by assessing its functional outcomes. A total of eight participants with hand function impairment due to a C-SCI were enrolled, and a wrist-driven orthosis with a triple four-bar linkage was designed. The hand function of the participants was assessed before and after they wore the orthosis, and the outcomes were assessed using a pinch force test, a dexterity test (Box and block test, BBT), and a Spinal Cord Independence Measure Version III questionnaire. In the results, before the participants wore the device, the pinch force was 0.26 lb. However, after they wore the device, it increased by 1.45 lb. The hand dexterity also increased by 37%. After 2 weeks, the pinch force increased by 1.6 lb and the hand dexterity increased by 78%. However, no significant difference was observed in the self-care ability. The results showed that this 3D-printed device with a triple four-bar linkage for individual with C-SCI improved pinch strength and hand dexterity in these patients, but did not improve their self-care ability. It may help patient in the early stages of C-SCI to learn and use the tenodesis grip easily. However, the usability of the device in daily life needs further research.

Over several years, this study examines how biotic interactions and warming affect the entire marine prokaryotic community at a location off the coast of Southern California. Analyses show that free-living and particle-associated prokaryotes were strongly predicted by phytoplankton and viral communities, and El Niño warming shifted cyanobacteria from cold-water ecotypes to warm-water ecotypes.

Background: Neuropsychiatric symptoms (NPS) could increase mortality risk in people with dementia due to Alzheimer's disease (AD). However, whether NPS affects mortality risk in people with mild cognitive impairment (MCI) and whether any specific syndrome of NPS influences this risk are still unclear. Methods: In total, 984 participants with dementia due to AD, 338 with MCI, and 365 controls were enrolled. Over a mean of 5-year follow-up, cause of death data were obtained from the Ministry of Health and Welfare in Taiwan. NPS were assessed using Neuropsychiatric Inventory Questionnaire (NPI-Q), and psychosis, mood, and frontal domain scores were determined. Survival analyses were conducted to determine the hazard ratio (HR) of death. Results: In controlled analyses, HR of death for AD was 2.19 (95% confidence interval [CI] = 1.29–3.71) compared with the control group, whereas no statistical significance was noted for the MCI group. A high NPI-Q score (above the median score) increased mortality risk for both the MCI and AD groups, with HRs of 2.32 (95% CI = 1.07–5.03) and 2.60 (95% CI = 1.51–4.47), respectively. Among NPI-Q domain scores, only high mood domain, but not psychosis or frontal domain, scores increased death risk for both the MCI (HR = 2.89, 95% CI = 1.00–8.51) and AD (HR = 2.59, 95% CI = 1.47–4.55) groups. Conclusion: Mortality risk is high for patients with AD. Not only for AD, patients with MCI presenting with NPS, particularly mood symptoms, have high death risk.

The purpose of this study is to construct a digital tool and design process for building a carbon footprint calculation to change the current status of Taiwan's carbon footprint calculation in post-use assessment, and to incorporate both carbon emissions and energy consumption in the environmental impact assessment into the initial considerations of the architectural design. Through the connection of carbon emission calculation tools and optimization tools, the advantages and disadvantages of multiple schemes in relation to carbon emissions and energy consumption can be compared simultaneously, thereby assisting designers to achieve faster results when making design decisions. In addition to the building's area, orientation, and height, various schemes could also further facilitate architectural design plans with lower carbon emissions by adjusting factors such as the external shading depth and the window-to-wall ratio by calculating the building dimensions to pursue the maximum percentage of the visual field (maximum window area), thereby reducing carbon emissions. This study is expected to meet the needs of users by simplifying the calculation tools and operation interface required for carbon emission calculations, visualizing the calculation results, and enabling a comparison of multiple design schemes. In addition, it provides recommended projects that can be reviewed in the early decision-making stage of the architectural design process, and provides designers and planners with approximate building carbon emission calculations for projects. Furthermore, to facilitate a calculation process with the best view, the scheme simulation is optimized under the existing design conditions, and the optimal solution (Pareto optimal solution) is obtained following calculation classification and analysis. The simulated data can be listed for design reference, whereby users can make design decisions based on the design conditions.

ABSTRACT Trade-offs between competitive ability and resistance to top-down control manifest the “kill-the-winner” hypothesis that explains how mortality caused by protists and viruses can promote bacterial diversity. However, the existence of such trade-offs has rarely been investigated in natural marine bacterial communities. To address this question, we conducted on-board dilution experiments to manipulate top-down control pressure (protists only or protists plus viruses [protists+viruses] combined) and then applied 16S rRNA gene high-throughput sequencing techniques to assess the responses of each bacterial taxon. Dilution experiments enabled us to measure the top-down-control-free growth rate as the competitive ability and top-down-control-caused mortality as the reverse of resistance to top-down control. Overall, bacterial taxa with higher top-down-control-free growth rates were accompanied by lower top-down-control-caused resistance. Furthermore, competition-resistance trade-offs were stronger and more consistent when top-down control was caused by protists+viruses combined than by protists only. When protists+viruses were diluted, the bacterial rank abundance distribution became steepened and evenness and richness were decreased. However, when protists were diluted, only richness decreased. Our results indicate the existence of competition-resistance trade-offs in marine microbes and demonstrate the positive impacts of such trade-offs on bacterial diversity. Regardless, the strength of the competition-resistance trade-offs and the impacts on bacterial diversity were contingent on whether top-down control was caused by protists+viruses combined or protists only. IMPORTANCE We addressed the “kill-the-winner” hypothesis from the perspective of its principle (the competition-resistance trade-off) in marine bacterial communities incubated in situ. Our results supported the existence of competition-resistance trade-offs and the positive effect on bacterial community diversity. The study linked theoretical expectations and complex natural systems and provided new knowledge regarding how top-down controls and competition trade-offs shaped natural bacterial communities.

Background: The incidence rate of extracorporeal membrane oxygenation (ECMO) use in Taiwan has increased significantly and is now higher than the worldwide incidence since 2000. Several studies have investigated hospital mortality and the risk factors of patients receiving ECMO. Comorbidities and age were not evaluated in these studies. Aim: To investigate the impact of age and comorbidities on hospital mortality of ECMO patients. Methods: A retrospective study of ECMO patients was performed using the claims data from the Taiwan National Health Insurance Research Database. Results: A total of 5834 adult patients were included in the study, and 2270 patients (38.9%) were discharged from the hospital between 2004 and 2012. The most common comorbidities were coronary artery disease (35.7%), hypertension (32.0%), and acute myocardial infarction (28.4%). Age, interstitial lung disease, rheumatologic disease, and lymphoma were the major predictors for hospital mortality in ECMO patients. On the contrary, acute myocarditis was found to be a favorable factor. Conclusion: Our results indicated that age and comorbidities were strongly associated with hospital mortality among ECMO patients. These findings can assist ECMO specialists to improve evaluations of mortality risk, especially among elderly patients with specific comorbidities.

IntroductionType 2 diabetes mellitus (T2DM) is a metabolic disorder due to defects in insulin secretion or insulin resistance leading to the dysfunction and damage of various organs. To improve the clinical evaluation of short-term blood glycemic variability monitoring, it is critical to identify another blood cell status and nutritional status biomarker that is less susceptible to interference. This study identifies the significance of serum lactate dehydrogenase (LDH) level among T2DM patients treated in outpatient clinics and investigates the relationship of LDH level with other variables.MethodsThis study comprised 72 outpatients with T2DM over 20 years of age. Blood samples were collected followed by a hematological analysis of serum glycated albumin (GA), LDH, fasting blood glucose, glycosylated hemoglobin, C-peptide, and insulin antibodies (insulin Ab).ResultsSerum LDH level was significantly correlated with GA (p < 0.001), C-peptide (p = 0.04), insulin Ab (p = 0.03), and thyroid-stimulating hormone (TSH) levels (p = 0.04). Hence, we performed a linear regression analysis of hematological markers. GA (p < 0.001, r2 = 0.45) and insulin Ab (p < 0.001, r2 = 0.40) were significantly associated with LDH level. Then, we classified patients into low (

PurposeThis study aimed to evaluate the oncological outcome of delayed surgical wait time from the diagnosis of upper tract urothelial carcinoma (UTUC) to radical nephroureterectomy (RNU).MethodsIn this multicenter retrospective study, medical records were collected between 1988 and 2021 from 18 participating Taiwanese hospitals under the Taiwan UTUC Collaboration Group. Patients were dichotomized into the early (≤90 days) and late (>90 days) surgical wait-time groups. Overall survival, disease-free survival, and bladder recurrence-free survival were calculated using the Kaplan–Meier method and multivariate Cox regression analysis. Multivariate analysis was performed using stepwise linear regression.ResultsOf the 1251 patients, 1181 (94.4%) were classifed into the early surgical wait-time group and 70 (5.6%) into the late surgical wait-time group. The median surgical wait time was 21 days, and the median follow-up was 59.5 months. Our study showed delay-time more than 90 days appeared to be associated with worse overall survival (hazard ratio [HR] 1.974, 95% confidence interval [CI] 1.166−3.343, p = 0.011), and disease-free survival (HR 1.997, 95% CI 1.137−3.507, p = 0.016). This remained as an independent prognostic factor after other confounding factors were adjusted. Age, ECOG performance status, Charlson Comorbidity Index (CCI), surgical margin, tumor location and adjuvant systemic therapy were independent prognostic factors for overall survival. Tumor location and adjuvant systemic therapy were also independent prognostic factors for disease-free survival.ConclusionsFor patients with UTUC undergoing RNU, the surgical wait time should be minimized to less than 90 days. Prolonged delay times may be associated with poor overall and disease-free survival.

BackgroundIn this study, we aimed to compare the effects of metformin-based dual therapy versus triple therapy on glycemic control and lipid profile changes in Taiwanese patients with type 2 diabetes mellitus (T2DM).MethodsIn total, 60 patients were eligible for participation in this study. Patients received at least 24 months of metformin monotherapy, dual therapy, or triple therapy with metformin plus linagliptin (a dipeptidyl peptidase 4 (DPP-4) inhibitor) or dapagliflozin (a sodium-glucose cotransporter-2 (SGLT2) inhibitor). Blood samples were collected from each patient, followed by evaluation of changes in their blood glucose control and lipid profile-related markers.ResultsA combination of metformin and DPP4 and SGLT2 inhibitor therapy more effectively reduced low-density lipoprotein cholesterol (LDL-C) (p = 0.016) than metformin monotherapy. A combination of metformin and DPP4 and SGLT2 inhibitor therapy more effectively improved total cholesterol (Chol, p = 0.049) and high-density lipoprotein cholesterol (HDL-C) than metformin monotherapy (p = 0.037). Metformin plus linagliptin dual therapy was more effective than metformin monotherapy in reducing glycosylated hemoglobin (HbA1C, p = 0.011). Patients who received a combination of linagliptin and empagliflozin showed a significant reduction in their fasting blood glucose (p = 0.019), HbA1c (p = 0.036), and Chol (p = 0.010) compared with those who received linagliptin dual therapy. Furthermore, patients who received metformin plus dapagliflozin and saxagliptin showed significantly reduced Chol (p = 0.011) and LDL-C (p = 0.035) levels compared with those who received metformin plus dapagliflozin.ConclusionIn conclusion, dual therapy with metformin and linagliptin yields similar glycemic control ability to triple therapy. Among metformin combination triple therapy, triple therapy of empagliflozin and linagliptin might have a better glycemic control ability than dual therapy of linagliptin. Moreover, Triple therapy of dapagliflozin and saxagliptin might have a better lipid control ability than dual therapy of dapagliflozin.

A typical method for normally-off operation, the metal–insulator–semiconductor-high electron mobility transistor (MIS-HEMT) has been investigated. Among various approaches, gate recessed MIS-HEMT have demonstrated a high gate voltage sweep and low leakage current characteristics. Despite their high performance, obtaining low-damage techniques in gate recess processing has so far proven too challenging. In this letter, we demonstrate a high current density and high breakdown down voltage of a MIS-HEMT with a recessed gate by the low damage gate recessed etching of atomic layer etching (ALE) technology. After the remaining 3.7 nm of the AlGaN recessed gate was formed, the surface roughness (Ra of 0.40 nm) was almost the same as the surface without ALE (no etching) as measured by atomic force microscopy (AFM). Furthermore, the devices demonstrate state-of-the-art characteristics with a competitive maximum drain current of 608 mA/mm at a VG of 6 V and a threshold voltage of +2.0 V. The devices also show an on/off current ratio of 109 and an off-state hard breakdown voltage of 1190 V. The low damage of ALE technology was introduced into the MIS-HEMT with the recessed gate, which effectively reduced trapping states at the interface to obtain the low on-resistance (Ron) of 6.8 Ω·mm and high breakdown voltage performance.

BackgroundHeart rate variability (HRV) and respiratory sinus arrhythmia (RSA) are indices of cardiac autonomic and cardiac vagal control (CVC), both of which are markers of emotional regulation and physical health. This study examined (1) the differences in cardiac autonomic regulation and CVC during baseline, depressive, and happiness autobiographical memory tasks between participants with major depressive disorder (MDD group) and healthy controls (HC group); (2) the associations between depressive symptoms and cardiac autonomic and CVC; and (3) the reactivity and recovery of cardiac autonomic and CVC between the MDD and HC groups.MethodsA total of 168 and 178 participants were included in the MDD and HC groups, respectively. Demographic data and the Beck Depression Inventory-II were collected before the experimental procedure. Lead II electrocardiograph (ECG) was measured during baseline, depressive, and happiness autobiographical memory tasks, and then interbeat intervals from ECG were converted to the time and frequency domains of HRV and RSA.ResultsThe participants in the MDD group showed lower HRV (including standard deviation of normal to normal intervals, low frequency, the natural logarithm of low frequency, and the natural logarithm of high frequency) and CVC (RSA and lnRSA) than those in the HC group. Depressive symptoms were positively correlated with heart rate and negatively correlated with the indices of cardiac autonomic and CVC. There was significantly increased reactivity and recovery of cardiac autonomic and CVC during and after depressive and happiness autobiographical memory tasks in the HC group, but not in the MDD group.DiscussionParticipants with MDD had cardiac autonomic and CVC dysregulation, decreased reactivity, and did not recover to baseline after emotional provocations. These results can be the theoretical basis for clinical intervention by using HRV biofeedback to restore cardiac autonomic regulation and CVC during and after emotional events in the future.

Traditional Chinese herbal medicine has widespread use in Taiwan. This cross-sectional questionnaire survey investigates the preoperative use and discontinuation of Chinese herbal medicine and dietary supplements among Taiwanese patients. We obtained the types, frequency, and sources of Chinese herbal remedies and supplements used. Among 1428 presurgical patients, 727 (50.9%) and 977 (68.4%) reported the use of traditional Chinese herbal medicine and supplements in the past one month, respectively. Only 17.5% of the 727 patients stated discontinuation of herbal remedies 4.7 ± 5.1 (1–24) days before the surgery, and 36.2% took traditional Chinese herbal medicine with concomitant physician-prescribed Western medicine for their underlying diseases. The most commonly used Chinese herbs are goji berry (Lycium barbarum) (62.9%) and Si-Shen-Tang (48.1%) in single and compound forms, respectively. The presurgical use of traditional Chinese herbal medicine was common in patients undergoing gynecologic (68.6%) surgery or diagnosed with asthma (60.8%). Women and those with a high household income had a greater tendency to use herbal remedies. This study demonstrates the high proportion of the presurgical use of Chinese herbal remedies and supplements along with physician-prescribed Western medicine in Taiwan. Surgeons and anesthesiologists should be aware of the potential adverse effects of drug–herb interaction for Chinese patients.

Lower urinary tract symptoms (LUTS), such as urgency, urinary incontinence, and/or difficulty voiding, hamper the quality of life (QoL) of patients with spinal cord injury (SCI). If not managed adequately, urological complications, such as urinary tract infection or renal function deterioration, may further deteriorate the patient’s QoL. Botulinum toxin A (BoNT-A) injection within the detrusor muscle or urethral sphincter yields satisfactory therapeutic effects for treating urinary incontinence or facilitating efficient voiding; however, adverse effects inevitably follow its therapeutic efficacy. It is important to weigh the merits and demerits of BoNT-A injection for LUTS and provide an optimal management strategy for SCI patients. This paper summarizes different aspects of the application of BoNT-A injection for lower urinary tract dysfunctions in SCI patients and provides an overview of the benefits and drawbacks of this treatment.

Necrotizing fasciitis is a relatively rare and serious fatal soft-tissue infection that is characterized by a rapidly spreading bacterial infection located in the subcutaneous tissues. We report a 59-year-old man who was diagnosed with acute necrotizing fasciitis, following a primary total knee replacement. He received primary total knee replacement that was uneventful and smooth intraoperatively. An immediate high fever was reported in the next few days, with several complications, confirming a diagnosis of necrotizing fasciitis. The most effective treatment for this disease is a rapid primary diagnosis and surgical debridement. Gold standard treatment includes intravenous therapy, such as antibiotics, surgical debridement, and intensive care. As a result of possible GI complications that triggered necrotizing fasciitis, the patient underwent flap reconstruction. This report’s aim is to review the comprehensive treatment, management, and experience of necrotizing fasciitis, highlighting the roles with a multidisciplinary care team for improving the condition of this patient.

Siglecs, sialic acid (SA)-binding immunoglobulin (Ig)-like lectins, belong to a family of Ig-like lectins. All Siglecs have at least two domains including an extracellular domain with variable (V) and constant (C)-set immunoglobulin (Ig) regions, and a transmembrane domain. Some of the Siglecs (Siglec-2–12, −17, -E, -F and -G) with three domains including immunoreceptor tyrosine-based inhibitory motif associated with Src homology 2 (SH2) tyrosine phosphatases (SHP1/2) usually deliver an inhibitory signal. Certain Siglecs (Siglec-14, -15, −16 and -H) containing no intracellular domain carry certain basic amino acid in transmembrane domain coupled with immunoreceptor tyrosine-based activating motif for cell activation. The number of Siglec-encoding genes has been correlated to lifespan of mammals, indicating its evolutional advantage on acquisition of Siglecs in humans. Certain polymorphisms of Siglecs have been associated with premature delivery, infection, schizophrenia, allergy, dementia or chronic obstructive pulmonary disease. Siglecs mainly expressing on leukocytes could interact with cis- or trans-SA ligands for cell–cell and host–organism interactions on infections, inflammations and cancers. Amplifying or eliminating the SA-Siglec interactions is a promising strategy to treat cancers, infections and inflammations, based on SA modifications in different linkages or nanoparticle decoration, and on the antibodies in conjugation of chimeric receptor design or toxins.

Background: Primary intestinal lymphomas (PILs) are rare, and this study compared the clinical outcomes of aggressive primary intestinal B-cell lymphomas (aB-PILs) and T/natural killer-cell lymphomas (T/NK-PILs). Methods: The clinical information of patients diagnosed with aggressive PILs at our institution between 1995 and 2015 were retrospectively investigated. Pathological subtypes were confirmed according to the 2016 revision of the World Health Organization classification. The correlation between clinicopathological features and overall survival (OS) was determined using univariate and multivariate analyses. Results: Cases of T/NK-PILs had higher initial bowel perforation incidence (67% vs. 7%, P

This work demonstrates high-performance AlInGaN/AlN/GaN high electron mobility transistors grown on 150 mm p-type low resistivity (resistivity~ 20–100 $\Omega $ -cm) silicon substrate with state-of-the-art Johnson’s figure-of-merit (JFOM). Current gain cut-off frequency ( $\text{f}_{\mathrm{ T}}$ ) of 83 GHz and 63 GHz and power gain cut-off frequency ( $\text{f}_{\mathrm{ max}}$ ) of 95 GHz and 77 GHz with a three-terminal off-state breakdown voltage of 69 V and 127 V, resulting in a high JFOM of 5.7 THz-V and 8.1 THz-V are achieved on the devices with a gate length of 0.16 $\mu \text{m}$ and gate to drain distance of 2 $\mu \text{m}$ and 4 $\mu \text{m}$ , respectively. The $\text{f}_{\mathrm{ T}}$ and J-FOM are comparable or better than the reported values obtained on high resistivity silicon and SiC substrates for devices with similar gate length. On the other hand, GaN-on-Si HEMT structure on the LR-Si substrate exhibits lower power gain and power added efficiency due to strong capacitive coupling effects. TCAD large signal output power simulation indicates significant improvements in output power by minimizing the defects and free charge carriers in the GaN buffer even in the presence of the parasitic channel conduction and conductive silicon substrate. We further propose a modified equivalent circuit model of the parasitic conduction to take into account the conductivity of the GaN and AlGaN buffer.

Abstract Background The risk of tuberculosis (TB) in patients with impaired kidney function remains unclear by different stages of renal function impairment. Methods We retrospectively recruited all patients with kidney function in a tertiary-care referral center from January 2008 to December 2013 and followed them till December 2016. We defined the primary outcome as active TB development and analyzed the impact of kidney function impairment. Results During the study period, a total of 289,579 patients were enrolled for analysis, and of them, 1012 patients had active TB events in an average of 4.13 years of follow-up. According to kidney function impairment, the incidence rate of TB was similar in patients with no chronic kidney disease (CKD) or stage 1 and stage 2, and it increased apparently at stage 3a (167.68 per 100,000 person-years) to stage 3b, stage 4 and stage 5 (229.25, 304.95 and 349.29 per 100,000 person-years, respectively). In a Cox proportional hazard regression model, the dose response of TB risk among different stages of kidney function impairment increased significantly from CKD stage 3a to stage 5. Patients with long-term dialysis had a hazard ratio of 2.041 (1.092–3.815, p = 0.0254), which is similar to that of stage 4 CKD but lower than that of stage 5. Conclusion In patients with impaired kidney function, the risk of TB increases from CKD stage 3, and in stage 5, the risk is even higher than that of those receiving dialysis. Further strategies of TB control need to consider this high-risk group.

This paper presents a novel method based on a dual-cavity fiber Fabry–Pérot interferometer (DCFFPI) for simultaneously measuring the thermo-optic coefficient (TOC) and thermal expansion coefficient (TEC) of a polymer. The polymer is, by nature, highly responsive to temperature (T) in that its size (length, L) and refractive index (RI, n) are highly dependent on the thermal effect. When the optical length of the polymer cavity changes with T, it is difficult to distinguish whether there is a change in L or n, or both. The variation rates of L and n with a change in T were the TOC and TEC, respectively. Therefore, there was a cross-sensitivity between TOC and TEC in the polymer-based interferometer. The proposed DCFFPI, which cascades a polymer and an air cavity, can solve the above problem. The expansion of the polymer cavity is equal to the compression of the air cavity with the increase in T. By analyzing the individual optical spectra of the polymer and air cavities, the parameters of TOC and TEC can be determined at the same time. The simultaneous measurement of TOC and TEC with small measured deviations of 6 × 10−6 (°C−1) and 3.67 × 10−5 (°C−1) for the polymer NOA61 and 7 × 10−6 (°C−1) and 1.46 × 10−4 (°C−1) for the NOA65 can be achieved. Experimental results regarding the measured accuracy for the class of adhesive-based polymer are presented to demonstrate the feasibility and verify the usefulness of the proposed DCFFPI.

Background: A regional antibiotic susceptibility database of certain pathogens is crucial for first-line physicians in terms of providing clinical judgement and appropriate selection of antimicrobial agents. The aim of this study is to update the epidemiological data of Salmonella serogroups and drug resistance in pediatric patients. Methods: This is a single-center retrospective study enrolling patients aged from 0 to 18 years who were hospitalized with cultured proven non-typhoidal Salmonella (NTS) infection from 2004 to 2019. The isolates were collected and the demographic data, serogroups of Salmonella and antimicrobial susceptibilities were further analyzed. Results: A total of 1583 isolates of NTS were collected. Serogroup C2 was prone to cause invasive non-typhoidal salmonellosis (iNTS), especially bacteremia. Patients aged < 2 years were associated with serogroups B and C2 infection, while those aged ≥ 2 years were associated with serogroups D and E infection. The prevalence of serogroup B declined with simultaneous increase in prevalence of serogroups D and E. Serogroups B and E were associated with ceftriaxone resistance, while Serogroup D was less drug-resistant than the others. The prevalence of ceftriaxone-resistant Salmonella had not increased, although more ciprofloxacin-resistant isolates were found in iNTS infection. Conclusions: Age < 2 years is a risk factor of iNTS for children, and the distribution of serogroup changes should be closely monitored. Ceftriaxone is still the drug of choice for treating pediatric iNTS infection, and although no increase was observed in the prevalence of ceftriaxone-resistant strains in this study, continuing surveillance of such cases is warranted.

Capacity limitations in visual tasks can be observed when the number of task-related objects increases. An influential idea is that such capacity limitations are determined by competition at the neural level: two objects that are encoded by shared neural populations interfere more in behavior (e.g., visual search) than two objects encoded by separate neural populations. However, the neural representational similarity of objects varies across brain regions and across time, raising the questions of where and when competition determines task performance. Furthermore, it is unclear whether the association between neural representational similarity and task performance is common or unique across tasks. Here, we used neural representational similarity derived from fMRI, MEG, and a deep neural network (DNN) to predict performance on two visual search tasks involving the same objects and requiring the same responses but differing in instructions: cued visual search and oddball visual search. Separate groups of human participants (both sexes) viewed the individual objects in neuroimaging experiments to establish the neural representational similarity between those objects. Results showed that performance on both search tasks could be predicted by neural representational similarity throughout the visual system (fMRI), from 80 ms after onset (MEG), and in all DNN layers. Stepwise regression analysis, however, revealed taskspecific associations, with unique variability in oddball search performance predicted by early/posterior neural similarity and unique variability in cued search task performance predicted by late/anterior neural similarity. These results reveal that capacity limitations in superficially similar visual search tasks may reflect competition at different stages of visual processing. [ABSTRACT FROM AUTHOR]

Deep sequencing of T-cell receptor (TCR) genes is powerful at profiling immune repertoire. To prepare a TCR sequencing library, multiplex polymerase chain reaction (mPCR) is widely applied and is highly efficient. That is, most mPCR products contain the region critical for antigen recognition, which also indicates regular V(D)J recombination. Multiplex PCR, however, may suffer from primer bias. A promising alternative is 5'-RACE, which avoids primer bias by applying only one primer pair. In 5'-RACE data, however, non-regular V(D)J recombination (e.g., TCR sequences without a V gene segment) has been observed and the frequency varies (30-80%) between studies. This suggests that the cause of or how to reduce non-regular TCR sequences is not yet well known by the science community. Although it is possible to speculate the cause by comparing the 5'-RACE protocols, careful experimental confirmation is needed and such a systematic study is still not available. Here, we examined the 5'-RACE protocol of a commercial kit and demonstrated how a modification increased the fraction of regular TCR-β sequences to >85%. We also found a strong linear correlation between the fraction of short DNA fragments and the percentage of non-regular TCR-β sequences, indicating that the presence of short DNA fragments in the library was the main cause of non-regular TCR-β sequences. Therefore, thorough removal of short DNA fragments from a 5'-RACE library is the key to high data efficiency. We highly recommend conducting a fragment length analysis before sequencing, and the fraction of short DNA fragments can be used to estimate the percentage of non-regular TCR sequences. As deep sequencing of TCR genes is still relatively expensive, good quality control should be valuable.

BackgroundDepression is common in dialysis patients, but the clinical impact of this condition is poorly defined.MethodsOut of 57,703 patients starting dialysis during 2000-2007 recorded in the National Health Insurance Research Database of Taiwan, we identified 2,475 patients with a clinical diagnosis of depression, and compared them with 1:5 age- and sex-matched patients without a depression diagnosis (n = 12,375). Patients were followed up for hospitalisation due to severe infections, major adverse cardiovascular events (MACE) and death. Multivariable Cox regression and competing risk analyses (accounting for death when appropriate) were used to estimate risk associations.ResultsPatients with depression had a higher frequency of comorbidities. During a mean follow-up of 3.2 years, 1,140 severe infections, 806 MACE, and 1,121 deaths were recorded. Compared to controls, patients with depression were at increased risk of death (adjusted hazard ratio 1.24; 95%CI 1.16-1.33). Patients with depression were also at higher risk of severe (1.14; 1.06-1.22) and fatal infections (death within 30 days, 1.22; 1.09-1.35), attributed mainly to sepsis (1.19; 1.08-1.31), septic shock (1.36; 1.13-1.62) and pneumonia (1.19; 1.07-1.33). Conversely, no association was observed between depression and the MACE risk (1.04; 0.94-1.15).ConclusionDialysis patients with depression are associated with increased risk of infections and death.

This paper investigates the economic and institutional determinants of Taiwan's outward direct investment in six Southeast Asian countries from 1998 to 2017, applying the panel ARDL--Pooled Mean Group estimation. We specially examine the effects of institutional quality with five dimensions inclusively, using the Worldwide Governance Indicators. The results show the locational economic factors are the primary determinants in the long run. The tight and historic trading relation with Southeast Asia has a long-run positive effect. On the contrary, the institutional quality of the host countries has strong positive effects in both the long run and short run. Further, the paper displays the dynamics of this investment in the last 20 years. These results are important for Taiwan and Southeast Asia policy-makers in setting up the short-run and long-run policies to sustain their diversified economic growth. [ABSTRACT FROM AUTHOR]

This study collected 220 commercially available samples of γ-Aminobutyric acid (GABA) tea produced in Taiwan from 2016 to 2021. The 220 tea samples were categorized into five types of GABA tea, including 108 GABA Oolong tea, 71 GABA Black tea, 21 GABA Paochong tea, 12 GABA Green tea, and 8 GABA Puerh tea samples. The most common type of GABA tea in Taiwan is GABA Oolong tea, followed by GABA Black tea. The physico-chemical constituents and consumer acceptance of the GABA tea samples were analyzed. The GABA content varied among the different types of GABA tea: GABA Oolong tea ranged from 128–286 mg/100 g, GABA Black tea ranged from 182–360 mg/100 g, GABA Paochong tea ranged from 98–203 mg/100 g, GABA Green tea ranged from 56–174 mg/100 g, and GABA Puerh tea ranged from 142–191 mg/100 g. In terms of the commercial standard of GABA tea, 22 out of the 220 GABA tea samples failed to meet the commercial standard, with a failure rate of 10%. During the fermentation process of GABA tea, the contents of GABA increased significantly, but the total polyphenol and total catechin contents remained stable. In terms of consumer acceptance, GABA Black tea is the most accepted by consumers, followed by GABA Puerh tea, GABA Paochong, and GABA Oolong tea. The sour flavor in GABA tea is similar to the original sour sensory properties found in black tea. It is assumed that this is the main reason GABA Black tea has the highest acceptance. [ABSTRACT FROM AUTHOR]

This study investigated laser-induced periodic surface structures (LIPSS) produced on laser powder bed fusion (LPBF) fabricated SUS316L (LPBF-SUS) and typical cold-rolled SUS 304 (CRSUS) by femtosecond fiber laser with a wavelength of 515 nm. The HSFL (high spatial frequency LIPSS) appeared related to CR-SUS grain boundary characteristics and was partially formed. In addition, the uniform HSFL on the LPBF-SUS with a period of about 60~70 nm (~/8) was demonstrated. [ABSTRACT FROM AUTHOR]

This study used an instrument to examine undergraduate students' preferred and actual learning environment perceptions in an introductory earth science course. The results show that science students expect to learn in a learning environment combining teacher-centred and student-centred approaches. However, an expectation incongruence was found in that the instruction did not match with the students' preference on student-centred learning environment in this course. The results carry important implications in the interpretation of students' classroom behaviours and their school culture background. It is noted that students and teachers perceive differently whether the classroom environment is constructed as being student-centred. (Contains 5 tables and 3 figures.)