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Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique “transaxillary capsulorrhaphy” to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

Abstract This study investigates the impact of foreign direct investment (FDI) motivations and technological resource commitment on headquarters’ employment of process control over subsidiaries, to better understand the process control mechanisms. Drawing on agency theory and the resource dependence perspective, a cross-sectional data model is developed among the 1541 Taiwanese manufacturing firms engaged in foreign investments, 1015 headquarters–subsidiary (HQ–Sub) relationships in China were selected from the database; in each of these relationships, the headquarters is located in Taiwan, while the subsidiary is located in China. Our findings reveal that the headquarters will use process control if the primary motivation for setting up a subsidiary in a host country is resource-seeking, but not use process control with market-seeking motivation. This control process relationship is enhanced/weakened/weakened by the headquarters’/subsidiaries’/partners’ technological resource commitment. Taiwanese multinational corporations (MNCs) from newly industrialized economies (NIEs) seeking to choose control mechanisms that fit their technological resources and FDI motivations in China are given guidelines. It adds to the use of control mechanisms with HQ-Sub literature. Both resource-seeking and market-seeking motivations shed light on technological resource commitment by various units of an MNC, to ward off information asymmetry.

This paper presents a novel digital combining method to implement a multilevel pulse modulation polar transmitter (PMPT) for 5G NR base station applications. Using pulse-width modulation on switch mode power amplifiers (PAs) is a promising method for PA efficiency improvement. Whereas using the interleaved multilevel architecture can eliminate unwanted harmonics. Previous PMPT implementations used passive power combiners to combine multiple PA outputs, this paper proposes combining to be performed digitally prior to the PAs. It was shown the proposed method is no longer susceptible to PA mismatch and is highly suitable for Doherty power amplifiers (DPAs). A transmitter prototype was developed and evaluated with a 256-QAM 5G NR 20-MHz instantaneous bandwidth signal centered at 2140 MHz. The overall system achieved an output level of 39.4 dBm with a power-added efficiency of 39%. It passes the 5G NR adjacent channel leakage ratio (ACLR) downlink spectral requirement with only memoryless digital predistortion.

An optimal modulation scheme with triple-phase-shift (TPS) control could increase the efficiency in the entire load range for a dual-active-bridge (DAB) converter under wide output voltage range conditions. Therefore, this study proposes a convergent approach to TPS mode selection, coupled with an optimal modulation scheme, ensuring the circuit’s efficiency over the entire range in the realm of a high-power and high-efficiency battery charger for electric vehicles. The convergent approach to TPS mode selection also reduces the numerous cases for small-signal analysis through general average modeling. After verifying the small-signal models under various voltage transfer ratios and load conditions to verify the stability, a converter prototype with a rated power of 15 kW is built and tested. Thus, a peak efficiency of 97.7% can be achieved.

Abstract Backgrounds Early integration of palliative care for terminally ill non-cancer patients improves quality of life. However, there are scanty data on Palliative Care Consultation Service (PCCS) among non-cancer patients. Methods In this 9-year observational study Data were collected from the Hospice-Palliative Clinical Database (HPCD) of Taichung Veterans General Hospital (TCVGH). Terminally ill non-cancer patients with 9 categories of diagnoses who received PCCS during 2011 to 2019 were enrolled. Trend analysis was performed to evaluate differences in categories of diagnosis throughout study period, duration of PCCS, patient outcomes, DNR declaration, awareness of disease by patients and families before and after PCCS. Results In total, 536 non-cancer patients received PCCS from 2011 to 2019 with an average age of 70.7 years. The average duration of PCCS was 18.4 days. The distributions of age, gender, patient outcomes, family’s awareness of disease before PCCS, and patient’s awareness of disease after PCCS were significantly different among the diagnoses. Organic brain disease and Chronic kidney disease (CKD) were the most prevalent diagnoses in patients receiving PCCS in 2019. For DNR declaration, the percentage of patients signing DNR before PCCS remained high throughout the study period (92.8% in 2019). Patient outcomes varied according to the disease diagnoses. Conclusion This 9-year observational study showed that the trend of PCCS among non-cancer patients had changed over the duration of the study. An increasing number of terminally ill non-cancer patients received PCCS during late life, thereby increasing the awareness of disease for both patients and families, which would tend to better prepare terminally ill patients for end-of-life as they may consider DNR consent. Early integration of PCCS into ordinary care for terminally non-cancer patients is essential for better quality of life.

Abstract Background Blood lipids are essential components for cellular growth. An inverse association between serum lipid levels and risk of cancer has led to a controversy among previous studies. The aim of this prospective cohort study was to investigate the association between blood lipids change and risk of cancer incidence. Methods A cohort of 4130 Taiwanese adults from the Taiwanese Survey on the Prevalence of Hypertension, Hyperglycemia, and Hyperlipidemia database underwent repeated examinations in 2002 and 2007. Six groups were established based on the combined baseline (lower/higher) and interval change (decreasing/stable/increasing) in plasma lipid levels. Multivariable Cox proportional hazard model was used to investigate the relationship between lipids change and all-cause cancer incidence. Results Two hundred and forty cancer events developed over a median follow-up of 13.4 years. Comparing these with individuals with decreasing lower-baseline lipid levels, cancer risk reduction was demonstrated in those with increasing lower-baseline total cholesterol (adjusted hazard ratio [aHR], 0.48; 95% confidence interval [CI], 0.27 to 0.85), low-density lipoprotein cholesterol (LDL-C; aHR, 0.56; 95% CI, 0.35 to 0.92), and non–high-density lipoprotein cholesterol (non-HDL-C) (aHR, 0.54; 95% CI, 0.31 to 0.92) levels. A decreased risk for cancer incidence also presented in participants with stable lower-baseline, decreasing and increasing higher-baseline LDL-C levels, and with decreasing and stable higher-baseline non-HDL-C levels. Conclusions The interval decline in lower-baseline total cholesterol, LDL-C, and non-HDL-C levels was linked to a higher risk for all-cause cancer incidence. More attention to a potential cancer risk may be warranted for an unexplained fall in serum lipids.

Abstract Background This study assessed the performance of visceral adiposity index and body shape index in predicting diabetes mellitus (DM) risk and compared their predictive ability to that of body mass index and waist circumference. Methods Among 8249 consecutive subjects who attended the Nationwide Health Check Up System for Senior Citizens (≥ 65 years) between 2008 and 2018, we examined the associations of several adiposity indices with DM risk and explored gender differences. Results Among all adiposity indicators, Chinese visceral adiposity index (CVAI) demonstrated the highest discriminatory ability for diabetes mellitus with area under receiver operating characteristic curves (AUC) of 0.65, 0.68, and 0.66 for men, women, and all participants, respectively, and optimal cut-offs set as 126.09 in men and 117.77 in women. Compared with body shape index (ABSI), both CVAI and VAI were strongly associated with baseline DM (adjusted OR: 4.85, 95% CI: 4.05–5.82 and 4.22, 95% CI: 3.53–5.05 for 4th vs 1st quartile groups by CVAI and VAI, P

Background To mitigate uncertainty that may arise in the judgment of emergency medical technicians when relying on a prehospital stroke scale at the scene, we propose a hospital selection protocol that considers the uncertainty of a prehospital stroke scale and the actual door‐to‐treatment durations, and we have developed a web‐based system to be used with mobile devices. Methods and Results This hospital selection protocol incorporates real‐time, estimated transport time obtained from Google Maps, historical median door‐to‐treatment duration at hospitals that only provide the standard intravenous thrombolysis treatment, and at hospitals with endovascular thrombectomy for probable large‐vessel occlusion cases. We have validated the efficiency of the proposed protocol and compared it with other strategies used by emergency medical technicians when deciding on a receiving hospital. Using the proposed protocol for the triage reduces the time from onset to receiving definitive treatment by nearly 11 minutes. We found that the nearest endovascular thrombectomy–capable hospital from the scene may not be the most ideal if the door‐to‐treatment durations are discriminative. The results show that, when the tolerable bypass transport threshold and administration time are reduced to 9 minutes and 30.5 minutes, respectively, 228 patients out of 7678 cases, whose receiving hospitals were changed to endovascular thrombectomy–capable hospitals, received definitive treatment in a shorter time. The results of our analysis give recommendations for appropriate allowable bypass transport time for regional planning. Conclusions By applying almost‐real value parameters, we have validated a web‐based model, which can be universally adapted for optimal, time‐saving hospital selection for patients with stroke.

Background To investigate the effectiveness and safety of withholding or restarting antithrombotic agents, and different antithrombotic therapies among patients with atrial fibrillation post‐intracranial hemorrhage. Methods and Results This is a nationwide retrospective cohort study involving patients with atrial fibrillation receiving antithrombotic therapies who subsequently developed intracranial hemorrhage between January 1, 2011 and December 31, 2017. The risk of ischemic stroke (IS), recurrent intracerebral hemorrhage (ICH), and all‐cause mortality were investigated between patients receiving no treatment versus patients reinitiating oral anticoagulants (OACs) or antiplatelet agents, and warfarin versus non‐vitamin K antagonist OACs. We applied inverse probability of treatment weighting to balance the baseline characteristics and Cox proportional hazards model to estimate the hazard ratios (HRs) of different outcomes of interest. Compared with no treatment, OACs reduced the risk of IS (HR, 0.61; 0.42–0.89), without increase in the risk of ICH (1.15, 0.66–2.02); antiplatelet agent users showed a similar risk of IS (1.13, 0.81–1.56) and increased risk of ICH (1.81, 1.07–3.04). Use of OACs or antiplatelet agents did not reduce the risk of all‐cause mortality (0.85, 0.72–1.01; and 0.88, 0.75–1.03, respectively). Compared with warfarin, non‐vitamin K antagonist OAC users showed a similar risk of IS (0.92, 0.50–1.70), non‐significantly reduced risk of ICH (0.53, 0.22–1.30), and significantly reduced all‐cause mortality (0.60, 0.43–0.84). Conclusions OACs are recommended in patients with atrial fibrillation and intracranial hemorrhage because they reduced the risk of IS with no increase in the risk of subsequent ICH. Non‐vitamin K antagonist OACs are recommended over warfarin owing to their survival benefits.

Background: The prognosis of patients with resected esophageal squamous cell carcinoma after neoadjuvant chemoradiotherapy is particularly poor in those who were staged as ypT3/T4 and/or ypN+. This study investigated whether adjuvant chemoradiotherapy was associated with improved clinical outcomes in these patients. Methods: we identified patients with esophageal squamous cell carcinoma who were staged as ypT3/T4 and/or ypN+ after being treated with neoadjuvant chemoradiotherapy followed by esophagectomy between the years 2013 and 2019. Patients were divided into two groups based on whether they received adjuvant chemoradiotherapy. The Kaplan-Meier method and Cox regression modeling were performed for survival analyses and multivariable analysis, respectively. Results: 76 eligible patients were included in the analyses. The median follow-up for the study cohort was 43.4 months. On Kaplan-Meier analyses of the overall population, adjuvant chemoradiotherapy was associated with significantly improved median overall survival (31.7 months vs. 16.3 months, p = 0.036). On Kaplan-Meier analyses of the 35 matched pairs generated by propensity score matching, adjuvant chemoradiotherapy was associated with significantly longer median overall survival (31.7 months vs. 14.3 months; p = 0.004) and median recurrence-free survival (18.9 months vs. 11.7 months; p = 0.020). In multivariable analysis, adjuvant chemoradiotherapy was independently associated with a 60% reduction in mortality (p = 0.003) and a 48% reduction in risk of recurrence (p = 0.035) after adjusting for putative confounders. In addition, microscopic positive resection margin and Mandard tumor regression grade 3–4 were independently associated with increased mortality and risk of recurrence. While a greater number of lymph nodes dissected was independently associated with significantly improved overall survival, the number of positive lymph nodes was independently associated with significantly worse overall survival and a trend (p = 0.058) towards worse recurrence-free survival. Conclusions: This study demonstrated that adjuvant CRT was independently associated with a significantly improved survival and lower risk of recurrence than observation in esophageal squamous cell carcinoma patients staged as ypT3 and/or ypN+ after receiving neoadjuvant chemoradiotherapy and radical surgery. The results of this study have implications for the design of future clinical trials and may improve treatment outcomes of patients in this setting who cannot afford or are without access to adjuvant nivolumab.

Micro-grid solutions around the world rely on the operation of DC/DC power conversion systems. The most commonly used solution for these topologies is the use of a dual active bridge (DAB) converter. Increasing the efficiency and reliability of this system contributes to the improvement in the stability of the entire microgrid. This paper discussed an analytical method of energy efficiency and power loss estimation in a single phase dual active bridge (DAB) converter controlled with a single-phase shift (SPS) modulation scheme for microgrid system stability. The presented approach uses conduction and commutation losses of semiconductors and high frequency transformer. All parameters required for the calculation may be obtained from the manufacturers’ datasheets or can be based on a simple measurement. The approach was validated by the comparison of the estimated energy efficiency characteristics with the measured ones for a prototype of a 5 kW single phase DAB converter equipped with silicon carbide metal-oxide semiconductor field-effect transistors (SiC MOSFET).

Abstract Background Different quitting trajectories may reflect the stages of behavior change among smokers. The nature of quitting patterns could help the public health sector to design appropriate cessation plans. This study compared demographic, health, and behavioral characteristics and the effects of long-term abstinence between early and delayed abstainers. Methods We retrospectively sampled 142 abstainers from smoking cessation clinic participants for a study conducted from January 1 to December 31, 2017. Baseline information was obtained at the first clinic visit, and phone interviews were conducted 2 weeks, 3 months, and 6 months later. The 7-day point prevalence abstinence was employed for measuring their quitting status. We defined early abstainers as those who attained abstinence by second week and delayed abstainers as those who had done so by the third month. We compared their characteristics and 6-month quit rates and examined potential predictors between the two quitting patterns. Results One hundred forty-two participants were included with 87 (61.3%) early abstainers and 55 (38.7%) delayed abstainers. Early abstainers were older with more comorbidities, presenting longer smoking duration, higher exhaled carbon monoxide (CO) concentration and Fagerstrom Test of Cigarette Dependence (FTCD) scores. The 6-month abstinence rate was high for both quitting patterns with no significant difference (83.9% versus 81.8%, p = 0.7462). Higher FTCD scores and exhaled CO concentration were potential predictors for early abstainers with adjusted odds ratio 1.16 (95% confidence interval [CI], 1.01–1.33) and 1.04 (95% CI, 1.00–1.08) respectively. Conclusions Our results associated early abstainers with older age, more comorbidities and higher nicotine dependence. Both groups achieved good long-term abstinence maintenance. Although early abstainers may achieve earlier reduction of health risks, smokers could still benefit from long-term abstinence if they can manage to quit smoking even at later phases of cessation courses.

Cervical lymph node enlargement as the first and sole manifestation of IgG4-related disease (IgG4-RD) is rare and is often difficult to distinguish from lymphoma. Here, we report a case of a 63-year-old man initially presenting with bilateral posterior neck masses. Ultrasonography revealed multiple matted, ovoid, homogenous, hypoechoic, and enlarged lymph nodes below the right parotid gland. In addition, there was heterogeneous echotexture with small and indistinct hypoechoic nodules over bilateral parotid and submandibular glands which suggested sclerosing sialadenitis. Pathology of the tissues obtained by core needle biopsy revealed reactive hyperplasia, but a diagnosis of lymphoma could not be excluded. Subsequently, excisional biopsy and serological tests were done. The diagnosis of IgG4-RD was confirmed due to marked elevation of serum IgG4 levels and pathological evidence of IgG+ and IgG4+ plasma cell infiltration in the lymph node specimen. The patient's neck masses subsided gradually after 1 week of oral steroid therapy. The differential diagnosis of IgG4-RD should always be considered when sclerosing sialadenitis is presented with cervical lymphadenopathy.

Background. Type 1 diabetes mellitus (T1DM) causes the irreversible destruction of pancreatic beta cells. The Bacillus Calmette–Guerin (BCG) vaccine can modulate the immune response and decelerate disease progression. The aim of this study is to investigate the efficacy of the BCG vaccine for the treatment of T1DM. Objective. Six databases were systematically searched from inception to the end of August 2019. The randomized controlled trials (RCTs) that evaluated glycemic control in response to the BCG vaccine for T1DM were enrolled. The primary outcome was glycated hemoglobin (HbA1c) level, and secondary outcomes included fasting and stimulated C-peptide level, daily insulin dosage, and clinical remission. The revised Cochrane risk of bias tool was used for quality assessment, and meta-analyses were conducted to evaluate the efficacy of the BCG vaccine. Results. Four studies with a total of 198 subjects were included. The results of HbA1c and fasting C-peptide levels were extracted for further quantitative assessment. The pooled meta-analysis demonstrated no significant difference in HbA1c levels (mean difference [MD], −0.12; 95% confidence interval [CI], −0.53 to 0.30; I2=56%) or fasting C-peptide levels (MD, −0.15; 95% CI, −0.35 to 0.06; I2=0%) in the BCG intervention group as compared with that in the placebo group. Conclusions. There is no robust evidence to support the use of the BCG vaccine for the treatment of T1DM although the HbA1c levels tended to improve. Additional RCTs to assess the long-term effects of the BCG vaccine on glycemic control are warranted.

Tubulin post-translational modifications (PTMs) occur spatiotemporally throughout cells, therefore assessing the physiological roles in specific subcellular compartments has been challenging. Here the authors develop a method to rapidly deplete tubulin glutamylation inside the primary cilia by targeting an engineered deglutamylase to the axoneme.

Background Anxiety is commonly experienced during the delivery process and has shown to have adverse effects on maternal and infant health outcomes. Music interventions tend to reduce the effects of anxiety in diverse populations, are low cost, are easily accessible, and have high acceptability. The aim of this review and meta-analysis was to assess the effectiveness of music interventions in reducing anxiety levels among women during labor. Methods Seven databases from inception to the end of December, 2018, without any language or time restriction including Embase, PubMed, the Cochrane Library, the Cumulative Index to Nursing and Allied Health, PsycINFO, Airiti Library, and PerioPath: Index to Taiwan Periodical Literature were searched using key terms related to pregnancy, anxiety, and music. Randomized controlled trials that assessed the effect of music during labor and measured anxiety levels as an outcome were included. Meta-analyses were conducted to assess anxiety reduction following a music intervention compared to that after placebo treatment. Results A total of 14 studies that investigated a total of 1,310 participants were included in this review. The meta-analyses indicated that those in the intervention group had a significant decrease in anxiety scores (standardized mean difference = −2.40, 95% confidence interval (CI) [−3.29 to −1.52], p < 0.001; I2 = 97.66%), heart rate (HR) (difference in means = −3.04 beats/min, 95% CI [−4.79 to −1.29] beats/min, p = 0.001; I2 = 0.00%), systolic blood pressure (SBP) (difference in means = −3.71 mmHg, 95% CI [−7.07 to −0.35] mmHg, p = 0.031; I2 = 58.47%), and diastolic blood pressure (DBP) (difference in means = −3.54 mmHg, 95% CI [−5.27 to −1.81] mmHg, p < 0.001; I2 = 0.00%) as compared to the women in the control group. Conclusions Music interventions may decrease anxiety scores and physiological indexes related to anxiety (HR, SBP, and DBP). Music interventions may be a good non-pharmacological approach for decreasing anxiety levels during labor.

This study examines the effects of noise reflected from the overpass bottom under various conditions using onsite measurements and model simulation. Reflected noise from the overpass bottom may be as high as 8 dB(A). Bottom materials (steel and reinforced concrete (RC)) have no discernible effect on the reflected noise level. As the height of an overpass increases, the level of reflected noise decreases. When an overpass is parallel to the noise source (i.e., the freeway), the size of the area impacted by reflected noise increases. As the sound absorption rating of the material installed at the overpass bottom increased, the level of reflected noise decreased. A sound absorbing material with a sound absorption rate of at least 0.60 is recommended to reduce reflected noise level. When the distance between the overpass side and a receiver exceeded 30 m, the level of reflected noise level reduced significantly. Therefore, if the distance between a residential area and overpass could be increased to create a buffer zone coupled with the installation of sound absorbing material at the overpass bottom, the impact of reflected noise on nearby residents can be reduced.

This paper presents a control strategy that is applied in turning control for decentralized electric vehicles known as the electronic differential system. The conventional mechanical differential has drawbacks, such as bulkiness and slow response. The electric system response is not only ten times faster than its mechanical counterpart, but its accurate control even reduces the loss of power from the motor to the wheel. Through the turning radius from the steering angle command that the driver gives, the controller can distribute torque to each wheel. After controlling each wheel’s rotation, the vehicle can turn in neutral steering. The results show that this strategy can be effectively employed on urban roads.

Geriatric depression is associated with the overall quality of life (QOL). However, how depressive symptoms affect the different domains and facets of QOL in older adults, and whether depressive symptoms mediate the relationship between physical disability and QOL in older adults are unclear.A total of 490 ambulatory community-dwelling older adults aged 65 years or above were interviewed using the brief version of the World Health Organisation Quality of Life instrument (WHOQOL-BREF), the Modified Barthel Index (MBI), the 15-item Geriatric Depression Scale (GDS-15), and the Mini-Mental State Examination (MMSE). Sequential models for multiple linear regressions were analysed to determine if the MBI, GDS-15 and MMSE scores predict the WHOQOL-BREF scores. The potential mediation effects of depression (as determined by the GDS-15) on the relationship between MBI and WHOQOL-BREF were also analysed.The GDS-15 score was predictive of the scores of the four domains and all 26 facets of the WHOQOL-BREF. The significant predictive effects of the MBI score on 15 of the 26 facets of the WHOQOL-BREF were reduced to three after the adjustment for the GDS-15 score. Depression (as assessed by the GDS-15) is a mediator of the relationship between MBI and the physical, psychological and environmental domains of the WHOQOL-BREF.Depression (assessed by the GDS-15) may affect the scores of every domain and all facets of the WHOQOL-BREF in the elderly. Furthermore, it may mediate the relationship between the MBI and on QOL scores. We recommend taking depressive symptoms into consideration when measuring community-dwelling older adults' QOL and providing active ageing programs.

Study Objectives. The aim of this study is to investigate the correlation between serum high-sensitivity C-reactive protein (hs-CRP) and other clinical tools including high-resolution computed tomography (HRCT) in patients with stable non-CF bronchiectasis. Design. A within-subject correlational study of a group of patients with stable non-CF bronchiectasis, who were recruited from our outpatient clinic, was done over a two-year period. Measurements. Sixty-nine stable non-CF bronchiectasis patients were evaluated in terms of hs-CRP, 6-minute walk test, pulmonary function tests, and HRCT. Results. Circulating hs-CRP levels were significantly correlated with HRCT scores (n=69, r=0.473, P

The photooxidation of diphenylamine and triphenylphosphine (P(C6H5)(sub 3))sensitized by 9,10-dicyanoanthracene and 9-cyanoanthracene was investigated. The results suggested that (P(C6H5)(sub 3)(super +)), (P(C6H5)(sub 3)(super 2+)), (C6H5)(sub 3)C(super +) were generated.

Background: Candidemia is a life-threatening condition; however, the predictive markers for candidemia and mortality are inadequate in cirrhotic patients. This study was conducted to propose candidate predictors for the occurrence of candidemia and 30-day mortality in hospitalized cirrhotic patients with bloodstream infection (BSI) and review the related literature. Methods: Cirrhotic patients with BSI between January 2011 and March 2020 were screened from the databank of a medical center and eligible patients were enrolled. Patients were separated into candidemia and bacteremia groups according to the results of blood cultures. Baseline characteristics, clinical presentation, and biochemistry data were collected at this time, as were microbiological data, medical management, use of antimicrobial agents, and outcome of the patients. The parameters and 30-day mortality were compared between candidemia and bacteremia groups. A combination of the MeSH terms and text terms related to candidemia and cirrhosis was searched in the electronic databases. Results: Four hundred and sixty cirrhotic patients with BSI were enrolled. Thirty-five patients with candidemia (7.6%) were identified. Nosocomial infection, intensive care unit (ICU) admission, antibiotics exposure ≥14 days, white cell count >10 K/mm³, and model for end-stage liver disease (MELD) score >24 were associated with candidemia. The 30-day mortality was 65.7% in the candidemia group and 37.9% in the bacteremia group (p = 0.001). Nosocomial infection, ICU admission, hepatoma, hepatic encephalopathy, international normalized ratio ≥1.2, platelet ≤150 K/mm³, estimated glomerular filtration rate <60 mL/min/1.73m², and MELD score >24 were associated with 30-day mortality. Six studies were identified. The results were consistent with our findings regarding low incidence of candidemia, and relevant risk factors are listed. Conclusion: Candidemia had low incidence but high mortality in hospitalized cirrhotic patients with BSI. New predictors were proposed for the occurrence of candidemia and 30-day mortality in these patients. [ABSTRACT FROM AUTHOR]

Internalization of macromolecules and membrane into cells through endocytosis is critical for cellular growth, signaling and plasma membrane (PM) tension homeostasis. Although endocytosis is responsive to both biochemical and physical stimuli, how physical cues modulate endocytic pathways is less understood. Contrary to the accumulating discoveries on the effects of increased PM tension on endocytosis, less is known about how a decrease of PM tension impacts on membrane trafficking. Here, we reveal that an acute decrease of PM tension results in phosphatidic acid (PA) production, F-actin and phosphatidylinositol (4,5)-bisphosphate [PI(4,5)P2]- enriched dorsal membrane ruffling and subsequent macropinocytosis in myoblasts. The PA production induced by decreased PM tension depends on phospholipase D2 (PLD2) activation via PLD2 nanodomain disintegration. Furthermore, the 'decreased PM tension-PLD2-macropinocytosis' pathway is prominent in myotubes, reflecting a potential mechanism of PM tension homeostasis upon intensive muscle stretching and relaxation. Together, we identify a new mechanotransduction pathway that converts an acute decrease in PM tension into PA production and then initiates macropinocytosis via actin and PI(4,5)P2-mediated processes. [ABSTRACT FROM AUTHOR]

A simple but effective electrochemical route to functionalize graphene is demonstrated. Cyclic voltammetric sweeps (CV) are performed in a 0.5 M H2SO4 aqueous solution on electrodes consisting of carbon cloth, graphene, and Nafion ionomer. Upon exposure to ambient oxygen, the formation of hydroxyl radicals from the oxygen reduction reaction during the CV cycles initiates the decomposition of the Nafion ionomer, which produces oxygenated functional groups on the graphene surface. Using contact angle measurements and X-ray photoelectron spectroscopy, various amounts of Nafion ionomer are explored to determine the optimum conditions for graphene functionalization. Afterwards, Pd9Ru nanoparticles with an average size of 3-4 nm are synthesized and impregnated on functionalized graphene (FGN). To prepare core-shell electrocatalysts, Pd9Ru/FGN is subjected to Cu underpotential deposition followed by a galvanic displacement reaction to deposit a Pt monolayer on the Pd9Ru surface (Pd9Ru@Pt). The assynthesized sample (Pd9Ru@Pt/FGN) exhibits enhanced performance in methanol electrooxidation, which includes a better activity and lower susceptibility to poisoning by intermediates. The electrochemically active surface area (ECSA) of Pd9Ru@Pt/FGN shows a value that is 1.5-fold larger than that of Pd9Ru@Pt on untreated graphene (Pd9Ru@Pt/GN). In the durability tests, Pd9Ru@Pt/FGN and Pd9Ru@Pt/GN demonstrate losses in the ECSA of 14.9% and 30.3%, respectively. [ABSTRACT FROM AUTHOR]

Mitochondria are dynamic organelles regulated by fission and fusion processes. The fusion of membranes requires elaborative coordination of proteins and lipids and is particularly crucial for the function and quality control of mitochondria. Phosphatidic acid (PA) on the mitochondrial outer membrane generated by PLD6 facilitates the fusion of mitochondria. However, how PA promotes mitochondrial fusion remains unclear. Here, we show that a mitochondrial outer membrane protein, NME3, is required for PLD6-induced mitochondrial tethering or clustering. NME3 is enriched at the contact interface of two closely positioned mitochondria depending on PLD6, and NME3 binds directly to PA-exposed lipid packing defects via its N-terminal amphipathic helix. The PA binding function and hexamerization confer NME3 mitochondrial tethering activity. Importantly, nutrient starvation enhances the enrichment efficiency of NME3 at the mitochondrial contact interface, and the tethering ability of NME3 contributes to fusion efficiency. Together, our findings demonstrate NME3 as a tethering protein promoting selective fusion between PLD6-remodeled mitochondria for quality control. [ABSTRACT FROM AUTHOR]

Background We investigated the effects of dietary calcium (Ca) and magnesium (Mg) intakes on cardiovascular disease risks in older patients with diabetes. Methods In this cross-sectional study, 197 patients with type 2 diabetes aged 65 years and above were recruited. The 24-h dietary recalls and 1-week self-reported typical dietary intake patterns were collected. The Ca and Mg intakes of <67% of the recommended dietary allowance (RDA), 67%-100% of RDA, and >100% of RDA were defined as low, moderate, and high Ca and Mg intakes, respectively. Anthropometric measurements were determined and biochemical analysis of blood and urine was performed. Results Our data indicated that 60.9% and 87.3% of our patients were Ca and Mg intakes below RDA, respectively. Patients whose Ca intake was high or low (81.2%) had significantly higher C-reactive protein (CRP) than those whose Ca intake was moderate (p = 0.043). Furthermore, patients whose Mg intake was low (87.3%) had significantly higher CRP than that of those who took adequate Mg (p = 0.025). The dietary Ca:Mg intake ratios were highly correlated with CRP, platelet counts, and red blood cell distribution (p < 0.05). A dietary Ca:Mg intake ratio of 2.0-2.5 was significantly correlated to lower CRP levels (p = 0.013). Conclusions High or low calcium intake increases cardiovascular disease risks. We suggest that "moderate" intake of 402-600 mg Ca/day (approximately 67%-100% of Taiwan RDA for Ca) and adequate Mg intake (or meeting RDA for Mg) with Ca:Mg intake ratio of 2.0-2.5 are important for reducing cardiovascular disease risks in older patients with diabetes. [ABSTRACT FROM AUTHOR]

In this study, a gasoline-contaminated site was selected to evaluate the biodegrading potential of methyl tert-butyl ether (MTBE) and benzene (B), toluene (T), ethylbenzene (E) and xylenes (X), collectively known as BTEX under aerobic, nitrate reducing, and methanogenic conditions at the site. Results show that in situ microorganisms had capabilities of degrading MTBE and BTEX using MTBE and BTEX as major carbon sources under aerobic condition. Under conditions of nitrate reduction and methanogenesis, BETX could be decomposed by in situ microorganism; but MTBE was not decomposed. The decomposition of BTEX under anaerobic condition was much slower than aerobic condition. Benzene had the slowest degrading rate. In addition, BTEX was decomposed faster and more completely under methanogenic condition than nitrate reducing condition. The on-site activated sludge system is effective in decomposing BTEX but not effective in decomposing MTBE. Results of this study reveal that the enhanced aerobic bioremediation method is more feasible for renovating this site. Injecting air, pure oxygen or oxygen-releasing chemicals will raise the removal rate of pollutants. Results of this study will be helpful in designing a practical system for bioremediation of this and other similar sites. [ABSTRACT FROM AUTHOR]

Centrosomal protein 55 (Cep55), which is localized to the centrosome in interphase cells and recruited to the midbody during cytokinesis, is a regulator required for the completion of cell abscission. Up-regulation of Cep55 and inactivation of p53 occur in the majority of human cancers, raising the possibility of a link between these two genes. In this study we evaluated the role of p53 in Cep55 regulation. We demonstrated that Cep55 expression levels are well correlated with cancer cell growth rate and that p53 is able to negatively regulate Cep55 protein and promoter activity. Down-regulation of expression of Cep55 was accompanied by repression of polo-like kinase 1 (Plk1) levels due to p53 induction. Overexpression of Plk1 and knockdown of p53 expression both enhanced the post-translational protein stability of Cep55. BI 2356, a selective Plk1 inhibitor, however, prevented Cep55 accumulation in p53 knockdown cells while persistently keeping Plk1 levels elevated. Our results, therefore, indicate the existence of a p53-Plk1-Cep55 axis in which p53 negatively regulates expression of Cep55, through Plk1 which, in turn, is a positive regulator of Cep55 protein stability. [ABSTRACT FROM AUTHOR]