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Rotating mandible backward downward is one of the treatment options in non-surgical skeletal class III malocclusion. The purpose of this study was to compare the true vertical changes after camouflage orthodontic treatment of adult patients with skeletal class III malocclusion categorized by vertical facial type.This retrospective study included 27 adult patients (age18 years) with skeletal class III malocclusion (ANB1°) who underwent nonsurgical orthodontic treatment at Taipei Veterans General Hospital. The patients were divided into the low-angle (SN-MP28°), high-angle (SN-MP36°), and normal-angle (28°≤ SN-MP ≤ 36°) groups according to the original vertical facial pattern. Pretreatment (T1) and post-treatment (T2) lateral cephalograms were superimposed and treatment changes were evaluated.In all cases, proper overjet and occlusion were achieved after treatment, and the lower anterior facial height increased with the backward rotation of the mandibular plane. Increase in vertical dimension was the most obvious in the high-angle group, while it was the least obvious in the low-angle group. Extrusion of both the maxillary and mandibular incisors was observed in the high-angle group; however, intrusion of the maxillary and mandibular incisors and decreased overbite were observed in the low-angle group.Camouflage orthodontic treatment of skeletal class III malocclusion improves the facial profile by increasing the vertical dimension and clockwise rotation of the mandible. According to our results, patients with a high mandibular plane angle showed better response to vertical dimension increment treatment mechanics than those with low and normal mandibular plane angles.

Whether oral lichen planus (OLP) was potentially malignant remains controversial. Here, we examined associations of ZNF582 methylation (ZNF582This is a case-control study. ZNF582OLP lesions showed significantly lower ZNF582OLP is unlikely to be potentially malignant based on ZNF582

Background To compare the outcomes of blunt splenic injuries (BSI) managed with proximal (P) versus distal (D) versus combined (C) splenic artery embolization (SAE). Methods This retrospective study included patients with BSI who demonstrated vascular injuries on angiograms and were managed with SAE between 2001 and 2015. The success rate and major complications (Clavien–Dindo classification ≥ III) were compared between the P, D, and C embolizations. Results In total, 202 patients were enrolled (P, n = 64, 31.7%; D, n = 84, 41.6%; C, n = 54, 26.7%). The median injury severity score was 25. The median times from injury to SAE were 8.3, 7.0, and 6.6 h for the P, D, and C embolization, respectively. The overall haemostasis success rates were 92.6%, 93.8%, 88.1%, and 98.1% in the P, D, and C embolizations, respectively, with no significant difference (p = 0.079). Additionally, the outcomes were not significantly different between the different types of vascular injuries on angiograms or the materials used in the location of embolization. Splenic abscess occurred in six patients (P, n = 0; D, n = 5; C, n = 1), although it occurred more commonly in those who underwent D embolization with no significant difference (p = 0.092). Conclusions The success rate and major complications of SAE were not significantly different regardless of the location of embolization. The different types of vascular injuries on angiograms and agents used in different embolization locations also did not affect the outcomes. Graphical abstract

Oral cancers are the seventh most common cancer globally. While progresses in oral cancer treatment has been made, not all patients respond to these therapies in the same way. To overcome this difficulty, numerous studies have been devoted to identifying biomarkers, which enable early identification of patients who may benefit from a particular treatment modality or at risk for poor prognosis. Biomarkers are protein molecules, gene expression, DNA variants, or metabolites that are derived from tumors, adjacent normal tissue or bodily fluids, which can be acquired prior to treatment and during follow-up, thus extending their use to the evaluation of cancer progression and prediction of treatment outcome. In this review, we employed a basic significance level (< 0.05) as the minimal requirement for candidate biomarkers. Effect sizes of the biomarkers in terms of odds ratio, hazard ratio and area under the receiver operating characteristic curves were subsequently used to evaluate the potential of their clinical use. We identified the CCND1 from the tumor, human papillomavirus, HSP70, and IL-17 from the peripheral blood, and high density of CD45RO+ tumor-infiltrating lymphocytes as the clinically relevant biomarkers for oral cancers.

Background Recurrent/ metastatic squamous cell carcinoma of head and neck (R/M SCCNH) is still a difficult-to-treat disease with poor clinical outcomes and limited treatment choices. In view of locoregional recurrent versus distant metastatic SCCHN, the therapeutic efficacy of cetuximab-containing regimen and relevant prognostic factors for these two groups may be different. Thus, the aim of this study was to explore the treatment outcomes of cetuximab-containing regimen in locoregional recurrent and distant metastatic SCCHN groups, and to identify clinical factors correlated with better survival outcomes. Methods From 2016 to 2020, patients with R/M SCCHN who received cetuximab-containing regimen in our institute were enrolled in this study. Clinical outcomes including overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) were evaluated in both locoregional recurrence and distant metastasis groups. Exploratory analysis were conducted to investigate major clinical features associated with better outcomes. Results A total of 107 patients with locoregional recurrent SCCHN (N = 66) and distant metastatic SCCNH (N = 41) who received cetuximab-containing regimen were enrolled in this retrospective study. Patients with oral cavity cancer and patients with disease recurrence within 6 months after radiation therapy were significantly increased in locoregional recurrence group. The median OS (15.6 vs. 9.7 months, P = 0.004) and PFS (5.8 months vs. 4.2 months, P = 0.008) were longer in locoregional recurrence group than in distant metastasis group. In multivariate analysis of clinical features, locoregional recurrence was still an important risk factor associated with better OS (Hazzard ratio (HR) 0.64, p = 0.06) and PFS (HR 0.67, p = 0.075). In addition, a trend of favorable disease control rate (DCR; 62.5% vs. 45.0%, p = 0.056) was noted in locoregional recurrence group. In locoregional recurrence group, prior salvage surgery was associated with longer OS (HR = 0.24, P = 0.008) and PFS (HR = 0.30, P = 0.005). Conclusion SCCHN with locoregional recurrence is associated with better disease control and survival outcomes comparing to distant metastatic SCCHN when treated with cetuximab-containing regimen. Salvage surgery for locoregional recurrence may further improves clinical outcome.

BACKGROUND This study assessed the perception of facial taperness in Taiwanese females among people with dental knowledge and laypersons. Additionally, this study also specified the criteria by which "square face" was defined regarding Taiwanese females' facial taperness. METHODS A series of digitally modified photos with different levels of facial taperness (Gonion to Gonion/Zygoma point to Zygoma point-Go-Go/Zy-Zy ratio ranges from 65% to 90%) were randomly arranged and presented to the raters. Visual analog scale (VAS) lines were used for scoring the photos on a scale of 0-100. The true or false question about "defining square face" was incorporated in the same questionnaire. The reliability of the true/false square face question and the esthetic evaluation by VAS were assayed. The receiver operating characteristic curve was used to define the cutoff point on "square face." The effects on the raters' genders, orthodontic treatment experience, and their professional background on the perception of a square face were assayed. RESULTS The overall reliability of the raters was within the acceptable range. The VAS score evaluation revealed that the average expectation for best facial taperness was 75%, whereas the facial taperness of over 83% was considered as the square face. The facial taperness reaching to 90% was regarded as the most unattractive. Gender, therapy, and professional experience have no impact on the standard of square facial form evaluation. CONCLUSION A face with a taperness greater than 83% was evaluated as a square face, and a face with a taperness around 75% was considered as the most attractive.

This study investigates an improvement in memory characteristics through depositing an In2O3 layer as an oxygen ion reservoir in the switching layer (SL) of resistive random access memory (RRAM). The deposition of In2O3, denoted as Pt/HfO2/In2O3/TiN device, provides better memory characteristics including lower forming voltage ( ${V}_{F}$ ), set/reset voltage ( ${V}_{\mathrm {SET}}/{V}_{\mathrm {RESET}}$ ), larger memory window, and higher resistances with higher uniformity at low resistance state (LRS) and high resistance state (HRS), compared to the devices without the In2O3 deposition, denoted as Pt/HfO2/TiN device. The conduction mechanisms, verified through fitting current–voltage ( ${I} - {V}$ ) curves, are consistent with the results of a varied temperature ${I} - {V}$ experiment. Finally, a physical model is proposed to explain our observations.

Roll-to-roll technology is used to form optoelectronic products because it allows fast, continuous production and a short cycle time. It has become the mass production technology with the most potential for development for the production of plastic products with a microstructure. This study designs and manufactures a composite light guide plate (LGP) to replace a traditional LGP with two pieces of prism sheet. The bottom surface of the composite LGP features dot microstructures and the upper surface features prism microstructures. The optical design is optimized separately for the dot microstructure and the prism microstructure. T he optimum designs are used to produce a composite LGP. One side uses the optimized dot distribution, and the other side uses pyramid microstructures. A PMMA substrate with a thickness of 2 mm is manufactured using roll-to-plate UV-cured embossing. In order to manufacture LGPs with microstructures on both sides, a rolling machine with an adjustment and positioning function is manufactured. Taguchi analysis is used to determine the single-sided optimized parameters. The dot structure is replicated 97% and the pyramid structure is replicated 96%. The proposed design for a composite light guide plate with a double-sided structure significantly increases the central average brightness and the uniformity of luminance.

Background This study aimed to evaluate the management of blunt splenic injury (BSI) and highlight the role of splenic artery embolization (SAE). Methods We conducted a retrospective review of all patients with BSI over 15 years. Splenic injuries were graded by the 2018 revision of the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS). Our hospital provide 24/7 in-house surgeries and 24/7 in-house interventional radiology facility. Patients with BSI who arrived hypotensive and were refractory to resuscitation required surgery and patients with vascular injury on abdominal computed tomography were considered for SAE. Results In total, 680 patients with BSI, the number of patients who underwent nonoperative management with observation (NOM-obs), SAE, and surgery was 294, 234, and 152, respectively. The number of SAEs increased from 4 (8.3%) in 2001 to 23 (60.5%) in 2015 (p p = 0.001). The spleen-related mortality rate of NOM-obs, SAEs, and surgery was 0%, 0.4%, and 7.2%, respectively. In the SAE subgroup, according to the 2018 AAST-OIS, 234 patients were classified as grade II, n = 3; III, n = 21; IV, n = 111; and V, n = 99, respectively.; and compared with 1994 AST-OIS, 150 patients received a higher grade and the total number of grade IV and V injuries ranged from 96 (41.0%) to 210 (89.7%) (p Conclusions Our data confirm the superiority of the 2018 AAST-OIS and support the role of SAE in changing the trend of management of BSI. Graphical abstract

In this paper, the instability mechanism of resistive random access memory (RRAM) was investigated, and a technique was developed to stabilize the distribution of high resistance states (HRS) and better concentrate the set voltage. Due to the accumulation of oxygen, an interface-type switching characteristic was observed on the I-V curves beneath the filament-type switching behavior. In this work, the interface-type switching characteristic is used to fit the natural distribution of HRS as an analysis of the instability mechanism. According to the results, the HRS distribution is attributed to the accumulation of excess oxygen ions left from the lower oxygen content and oxygen vacancy recombination during the reset process. The proposed solution with simple plasma treatment, can create an excess oxygen reservoir by changing the surface topography of the electrode to store the surplus oxygen ions from the reset process, eliminating the oxygen accumulation effect and further improving the device stability.

Facile, room-temperature, and surfactant-free seed-mediated chemical bath deposition was developed to directly grow CuBi2O4 nanostructures on an electrode substrate for applications in electrochemical reforming of glucose and photoelectrochemical (PEC) hydrogen generation. The metal precursor concentration and Cu2+/Bi3+ molar ratio were found to be decisive factors in determining the structure of CuBi2O4, and single crystal CuBi2O4 submicron-square columns (microCuBi2O4), nano-square columns (nanoCuBi2O4), and c-axis oriented nano-square columns (c-nanoCuBi2O4) were selected for detailed electrochemical and PEC characterization. The results of Tauc plots and ultraviolet photoelectron spectroscopy (UPS) resolved the band structure of these CuBi2O4 compounds. Mott–Schottky and UPS analyses showed that these CuBi2O4 compounds had flat-band potentials of >1.10 V vs. RHE, which makes them promising photocathodes for PEC hydrogen generation. The synthesized CuBi2O4 compounds exhibited different levels of electrocatalytic activity towards electroreforming of glucose, in the order of nanoCuBi2O4 > c-nanoCuBi2O4 > microCuBi2O4, which is attributed to the structure-dependent kinetics of the chemical reaction between glucose and electrochemically activated Cu species in CuBi2O4 at elevated anodic potentials. Additionally, all synthesized CuBi2O4 samples showed high selectivity (faradaic efficiency > 93%) for formate generation from electro-oxidative conversion of glucose. This study opens up a new avenue for the synthesis of nanostructured CuBi2O4 with promising bi-functionality towards PEC biomass reforming.

Oral squamous cell carcinoma (OSCC) is a type of malignancy characterized by high relapse and recurrence rates in the late stage despite optimal surgical intervention and postoperative chemoradiotherapy. Because the management of relapse following definitive treatment is challenging, accurate risk stratification is of clinical significance to improve treatment outcomes. Circular RNAs (circRNAs) are noncoding RNAs featured with cell-type specificity and high stability, owing to their circular structure, making these molecules excellent biomarkers for a variety of diseases.The levels of hsa_circ_0000190 and 0001649 in plasma samples from 30 healthy controls and 66 OSCC patients were determined by droplet digital polymerase chain reaction. The same primer sets were used with PCR to examine the expression of these two circRNAs in cancerous and adjacent normal tissues. A receiver operating characteristics curve was generated to evaluate the diagnostic value. The Kaplan-Meier method with a log-rank test was used for survival analysis.We identified two circRNAs as potential biomarkers for OSCC, showing that the plasma level of hsa_circ_0000190 was significantly decreased in the late stage and marginally correlated with the development of second primary OSCC. We also found that the decreased plasma hsa_circ_0001649 was correlated with the recurrence and poor prognosis of patients. Additionally, we found that high plasma hsa_circ_0000190, but not hsa_circ_0001649, possibly predicted a better response of patients to induction chemotherapy.Our study demonstrated the potential of biomarkers in plasma to inform not just the tumor but the entire oral cavity, thereby offering a prediction for early recurrence and second primary OSCC. The plasma circRNAs remain valuable for OSCC, albeit the easy accessibility to the oral cavity.

This retrospective study aimed to evaluate the outcomes of 13 patients with acute superior mesenteric artery (SMA) occlusion who underwent intra-arterial urokinase thrombolysis between 2008 and 2020. On angiography, seven presented with complete SMA occlusion versus six with incomplete occlusion. The median time from abdominal pain to attempting urokinase thrombolysis was 15.0 h (interquartile range, 6.0 h). After urokinase therapy, bowel perfusion was restored with bowel preservation in six patients; however, treatment failed in the other seven patients. The degree of SMA occlusion (complete vs. incomplete, p = 0.002), degree of recanalisation (p = 0.012), and length of stay (p = 0.032) differed significantly between groups. Of the seven patients with complete SMA occlusion, six underwent bowel resection, of whom three died, and the remaining patient died of shock due to delayed surgery. Among the six patients with incomplete SMA occlusion, no bowel resection was performed. In our experience, intra-arterial urokinase thrombolysis may serve as an adjunctive treatment modality, being a potential replacement for open thrombectomy that is able to preserve the bowel and obviate surgery in cases of incomplete SMA occlusion; however, its use is unsuitable in cases of complete SMA occlusion, for which surgery is warranted.

Failure of conservative management for controlling postpartum hemorrhage (PPH) is not uncommon, particularly when PPH is caused by vascular lesions. Awareness of this possibility and initiating timely trans-arterial embolization (TAE) are essential for improving the outcome. Herein, we describe the case of a 34-year-old woman presenting with arterial aneurysms with arteriovenous fistulas in the lower vagina bilaterally, which caused intractable PPH. Conservative management failed to resolve the PPH; however, TAE successfully controlled the bleeding, and the patient recovered smoothly. Knowledge of this possible etiology for intractable PPH is crucial for timely TAE. This case report aims to highlight the pivotal role of TAE in detecting and treating this unusual cause of PPH.

Background: Portal vein thrombosis (PVT) was infrequently complicated by acute cholecystitis. The clinical signs of PVT are usually non-specific and subclinical. The treatment aim was to re-canalize the portal vein and to avoid serious complications. An early anticoagulation treatment would result in favorable outcome. Case Report: We present a case of acute cholecystitis with sole left portal vein thrombosis causing left liver atrophy in a 59-year-old woman.Conclusions: While the surgeon is familiar with this uncommon condition, the PVT could be detected on the pre-operative images through a tailored CT or MRI. The condition of PVT is often subclinical and might complicate liver atrophy, an early anticoagulation treatment would result in a favorable outcome.

Background: Failure of the primary management at controlling the post-partum hemorrhage (PPH) is occasionally encountered. A catastrophic cause of PPH as vagina arterial aneurysms with AVF is rare and not reported in English literature.Case presentations: We present a 34-year-old woman of arterial aneurysms with arteriovenous fistulas (AVF) at bilateral lower vagina causing intractable PPH with aggressive bleeding. By trans-arterial embolization (TAE) the bleeding is successfully controlled, and patient then could recover smoothly.Conclusion: These vascular anomalies being fierce culprit of the PPH would result in primary management failure. Knowledge of the possible etiology of post-partum hemorrhage is crucial for treatment management. This case report aims to point out a pivotal role of TAE at detecting and treating this unusual cause of PPH.

Purpose This study developed a novel multi-axial alveolar distractor and evaluated its safety and effectiveness by performing various mechanical tests and finite element (FE) analysis. Materials and methods A ball-and-socket joint with a high degree of freedom was proposed as the design concept to make the distractor produce a cone trajectory motion range of up to 60° with respect to the transport screw (central axis). This device was manufactured with Ti6Al4V alloy. Mechanical functional tests included four-point bending resistance testing of the base bone plate, pull-out testing of the multi-axial alveolar distractor, welding strength testing between the base bone plate and ball-and-socket joint mechanism, and torque strength testing of the ball-and-socket joint. These tests were performed to ensure the effectiveness and safety of the multi-axial alveolar distractor. The base bone plate FE analysis of four-point bending resistance and pull-out testing of the multi-axial alveolar distractor were performed to confirm the results obtained from the experimental testing. Results The bending strength for the four-point bending test and the maximum force for pull-out testing were 530.88 N mm and 716.33 N, respectively. Substantial equivalence FE simulations also found that large deformations for four-point bending and pull-out testing were smaller than those for the commercial alveolar distractor, indicating that our new distractor is as safe and effective as the commercially available device. The maximum debonding torque resistance for ball-and-socket joint mechanism welding strength was 3481.1 N mm, meaning it is unable to fall off during a surgical operation. No damage was found at the welding edge. The maximum average resistance force in the ball-and-socket joint was 30.26 N without rotation, allowing it to resist distraction forces during bone regeneration — an important safety consideration. Conclusion The alveolar distractor designed using a ball-and-socket joint concept can achieve multi-axial distraction with various angle adjustments in 3D space. Thorough mechanical/functional tests confirm the effectiveness and safety of our new multi-axial alveolar distractor.

This letter investigates Au30Ag70 (alloy electrode)/SiO2/TiN conductive-bridge random access memory (CBRAM) to verify the influence of ambient conditions on forming voltage ( $\text{V}_{\textsf {F}}$ ) and the location of galvanic reaction. Previous literature demonstrates that the galvanic reaction in CBRAM with an alloy electrode results in a lower $\text{V}_{\textsf {F}}$ . In this work, a higher environmental H2O concentration results in a decrease in $\text{V}_{\textsf {F}}$ . From this change in $\text{V}_{\textsf {F}}$ , we infer that environmental H2O concentration influences the amount of galvanic reaction. Moreover, we verify the location of the galvanic reaction by varying electrode thickness. Finally, we propose a physical model to explain our observations.

We report the synthesis of lanthanide-doped core/shell upconverting nanoparticles (UCNPs) LiYF4:Yb3+/Er3+/Ho3+/Tm3+@LiYF4:Yb3+. The photoluminescence (PL) spectra of the tetragonal-phase nanoparticles could be tuned by varying the doping ratio of lanthanide ions (Er3+, Ho3+, Tm3+) and their intensities were much enhanced through the active core/active shell strategy. The as-synthesized UCNPs were characterized and confirmed by X-ray diffraction (XRD), transmission electron microscope (TEM), and PL spectroscopy. By varying the composition and concentration of the dopant ions, the upconversion emissions upon near-infrared (NIR) excitation at 980 nm can be precisely modulated. After overcoating UCNP cores with LiYF4:Yb3+ shell, the upconversion emissions for all core/shell nanoparticles were about 3 times of those corresponding core nanoparticles. After ligand exchange, the hydrophobic LiYF4:Yb3+/Er3+/Ho3+/Tm3+@LiYF4:Yb3+ core/shell nanoparticles could be transferred into hydrophilic UCNPs. The colloid nanoparticles could be employed as a chemosensor for detection of Hg2+ at near-infrared excitation wavelengths.

Hot embossing is a novel technique for the cost-effective production of micro-parts. Misalignment between the top and bottom surfaces of a product that has double-sided microstructures reduces its functions. Most solutions involve repairing or reproducing the embossing mold, which increases the cost for the molding process. This study proposes a hybrid alignment platform that allows accurate positioning and angular alignment for the embossing processes. The hybrid alignment platform includes two units. The upper unit allows angular adjustment using a precision rotary table. The lower unit allows positional adjustment using two orthogonal micrometers. Calibration tests are conducted for a series of adjustment steps along the X, Y and C axis. Only one alignment step is necessary for each axis. The alignment platform allows rapid positioning and increases replicability. The hybrid mold adjustment platform is used to resolve a problem with gear misalignment and the problem of eccentricity in the production of micro-gears is effectively resolved.

In this study, CoOx nanoparticles decorated CuBi2O4 submicron-sized square columns (microCuBi2O4|CoOx) modified electrodes were fabricated and their electrocatalytic properties were investigated. microCuBi2O4, for the first time, was directly grown onto the electrode substrate using chemical bath deposition (CBD) at room temperature, whereas microCuBi2O4|CoOx was prepared by subjecting microCuBi2O4 to additional CBD process and subsequent electrochemical treatment. It was found that the crystalinity of microCuBi2O4 and the amount of CoOx play a decisive role in the overall electrocatalytic activity of microCuBi2O4|CoOx. In addition, the redox couples of the active species, responsible for the electrocatalytic glucose oxidation, in microCuBi2O4 and CoOx overlaps, and these active species exert a synergetic electrocatalytic effect in enhancing the overall electrocatalytic activity, in terms of overpotential and catalytic current, of microCuBi2O4|CoOx towards glucose oxidation. Under optimal conditions, the developed microCuBi2O4|CoOx exhibits a promising sensing characteristics for glucose detection, including a high sensitivity of 383.0 ± 32.3 µA/cm2/mM, a low limit of detection of 0.8 µM, a wide linear range upto 8.0 mM, a fast response time (t95) of

Dry eye disease (DED), also called the keratoconjunctivitis sicca, is one of the most common diseases in the ophthalmology clinics. While DED is not a life-threatening disease, life quality may be substantially affected by the discomfort and the complications of poor vision. As such, a large number of studies have made contributions to the investigation of the DED pathogenesis and novel treatments. DED is a multifactorial disease featured with various phenotypic consequences; therefore, animal models are valuable tools suitable for the related studies. Accordingly, selection of the animal model to recapitulate the clinical presentation of interest is important for appropriately addressing the research objective. To this end, we systemically reviewed different murine and rabbit models of DED, which are categorized into the quantitative (aqueous-deficient) type and the qualitative (evaporative) type, based on the schemes to establish. The clinical manifestations of dry eye on animal models can be induced by mechanical or surgical approaches, iatrogenic immune response, topical eye drops, blockage of neural pathway, or others. Although these models have shown promising results, each has its own limitation and cannot fully reproduce the pathophysiological mechanisms that occur in patients. Nonetheless, the animal models remain the best approximation of human DED and represent the valuable tool for the DED studies.

This work investigates the influence of a supercritical fluid (SCF) treatment on the characteristics of resistive random access memory. A comparison between the experimental results for the device at initial, after the overset process, and after the SCF treatment, shows that the treatment dopes oxygen ions and generates defects in the switching region (SR). Moreover, the changes in the ratio of the components of the SR after the SCF treatment improve memory characteristics, including a lower set/reset voltage (V SET/V RESET), and higher resistances at low resistance state and high resistance state.

Massive hepatic necrosis after therapeutic embolization has been reported. We employed a 320-detector CT scanner to compare liver perfusion differences between blunt liver trauma patients treated with embolization and observation. This prospective study with informed consent was approved by institution review board. From January 2013 to December 2016, we enrolled 16 major liver trauma patients (6 women, 10 men; mean age 34.9 ± 12.8 years) who fulfilled inclusion criteria. Liver CT perfusion parameters were calculated by a two-input maximum slope model. Of 16 patients, 9 received embolization and 7 received observation. Among 9 patients of embolization group, their arterial perfusion (78.1 ± 69.3 versus 163.1 ± 134.3 mL/min/100 mL, p = 0.011) and portal venous perfusion (74.4 ± 53.0 versus 160.9 ± 140.8 mL/min/100 mL, p = 0.008) were significantly lower at traumatic parenchyma than at non-traumatic parenchyma. Among 7 patients of observation group, only portal venous perfusion was significantly lower at traumatic parenchyma than non-traumatic parenchyma (132.1 ± 127.1 vs. 231.1 ± 174.4 mL/min/100 mL, p = 0.018). The perfusion index between groups did not differ. None had massive hepatic necrosis. They were not different in age, injury severity score and injury grades. Therefore, reduction of both arterial and portal venous perfusion can occur when therapeutic embolization was performed in preexisting major liver trauma, but hepatic perfusion index may not be compromised.

BackgroundAngiopoietin-Tie2 and nitric oxide pathway is crucial in tumor angiogenesis and closely correlates with tumor development, growth, and metastasis. This study aimed to investigate the angiopoietin-Tie2 and nitric oxide signaling of the erythrocyte membrane in response to surgical trauma in head and neck cancer.MethodsWe prospectively enrolled the patients with histology-proven head and neck squamous cell carcinoma undergoing surgical resection of primary tumors at the medical center between August and November 2019. We measured the preoperative and postoperative levels of angiopoietin-1, angiopoietin-2 in plasma using enzyme-linked immunosorbent assays, nitric oxide in plasma using nitrate/nitrite colorimetric assays, and Tie2 phosphorylation in erythrocyte membrane using Western blotting.ResultsThe plasma angiopoietin-1 was downregulated from the median 971.3 pg/mL (interquartile range [IQR] 532.1–1569.3) to 417.9 (IQR 270.5–597.3) after tumor resection (p= 0.0020). Conversely, the plasma angiopoietin-2 was enhanced from 1173.6 pg/mL (IQR 977.7–1450.2) to 2353.7 (IQR 1352.4–2954.3) after surgery (p= 0.0021), with a concomitant increase in plasma nitric oxide level from 7.73 μM (IQR 5.39–10.06) to 10.50 (IQR 7.65–14.18) after surgical resection (p= 0.0093). Subgroup analyses further showed the angiopoietin-Tie2 and nitric oxide signaling was significant only in stage III and IV cancer.ConclusionsThe dynamic change of angiopoietin-Tie2 signaling in the erythrocyte membrane along with the enhanced nitric oxide in plasma after tumor resection suggests erythrocytes play a significant role in modulating surgery-induced angiogenesis, which may provide a novel marker for cancer surveillance and control.

Background The aim of this study was to evaluate the outcome of intra-arterial urokinase thrombolysis for acute superior mesenteric artery (SMA) occlusion. Methods Ten patients with acute SMA occlusion who underwent intra-arterial urokinase therapy between 2008 and 2019 were retrospectively evaluated. Results Among the 10 patients, 7 were men and 3 were women (median age, 75.5 years). The median time from onset of abdominal pain to emergency department admission was 11 hours (interquartile range [IQR], 4.9 hours). None of the patients presented with shock in the triage screening or acute peritonitis on physical examination, and 4 (40%) had bloody stools. On angiography, 6 patients presented with complete SMA occlusion and the other 4 patients had incomplete occlusion. The median time from abdominal pain to attempting urokinase thrombolysis was 15.5 hours (IQR, 8.0 hours). During the course of the urokinase therapy, all the patients showed various degrees of recanalization (near-total, n = 2; partial, n = 8) on follow-up angiography. The median urokinase therapy duration was 39.0 hours (IQR, 48.0 hours). After urokinase therapy, bowel perfusion was restored with bowel preservation in 4 patients; however, in the other 6 patients, bowel perfusion was not restored. Comparison between the 4 patients with restored bowel perfusion and 6 patients with unrestored bowel perfusion revealed that the degree of SMA occlusion was statistically significant (complete vs. incomplete, p = 0.012). Of the 6 patients with complete SMA occlusion, 5 underwent bowel resection, of whom 2 died, and the remaining patient died of shock due to delayed surgery. Of the 4 patients with incomplete SMA occlusions, no bowel resection was performed except a partial omentectomy. Of the 3 deaths, one was attributed to delayed surgery, and the other two developed short bowel syndrome with sepsis and multiple-organ failure, with a 30% in-hospital mortality rate. The median hospital stay was 20.0 days (IQR, 32.0 days). Conclusion In our experience, thrombolysis with intra-arterial urokinase may serve as an adjunctive treatment modality to preserve the bowel and obviate surgery for incomplete SMA occlusion. However, it was not suitable for complete SMA occlusion, which requires surgery.

BACKGROUND Oral squamous cell carcinoma (OSCC) leads to thousands of deaths every year in Taiwan. Nearly 40% of OSCC patients are diagnosed with stage IV disease, which has a poor prognosis. Multimodality treatments including surgery and adjuvant therapy have been utilized, but their treatment outcomes are generally poor. In this study, we sought to identify possible clinical impact factors that may contribute to the survival of stage IV OSCC. METHODS Data for patients with malignant neoplasms of the oral cavity registered in the Cancer Registry Database of Taipei Veterans General Hospital between 2002 and 2011 were retrieved. The study patients consisted of OSCC patients with clinical stage IV disease who had undergone a surgery and adjuvant therapy. The primary endpoints were the 5-year disease-free survival (DFS) and overall survival (OS) rates. The clinicopathological characteristics of the patients were also stratified and compared. RESULTS A total of 191 OSCC patients were included for retrospective analysis. The different subgroups of stage IV disease presented different treatment outcomes. The 5-year OS versus DFS rates of each subgroup were as follows: T4N0: 70.9% versus 52.6%; T1-3N23: 66.1% versus 49.8%; T4N1: 49.6% versus 31.6%; and T4N23: 40.9% versus 31.0% (p < 0.01). Patients with diabetes, moderate or poor cell differentiation, perineural invasion, and extracapsular spread presented lower 5-year OS rates (hazard ratio [HR] = 1.87, 1.65, 2.42, and 2.14, respectively), and patients with perineural invasion, positive cut margin, and extracapsular spread presented lower 5-year DFS rates (HR = 1.57, 1.62, and 1.71, respectively). CONCLUSION In this study, we elucidated the different survival rates of different subgroups of stage IV OSCC following the same treatment scheme. The results of the study provide clinical physicians with references by which to evaluate prognosis and determine post-operative disease monitoring timetables based upon different characteristics.

Oral squamous cell carcinoma (OSCC) is a common malignancy worldwide. This study clarified the oncogenic role of miR-134 in OSCC. Reporter assays, using both wild-type and mutant constructs, confirmed that Programmed Cell Death 7 (PDCD7) gene was a potential target of miR-134. The OSCC cells exogenously expressed miR-134 exhibited reduced PDCD7 expression. As expected, exogenous miRZip-134 expression increased PDCD7 expression in the OSCC cells; additionally, PDCD7 expression suppressed the oncogenicity of the OSCC cells. By contrast, PDCD7 knockout through gene editing increased in vitro oncogenicity and neck nodal metastasis in mice, and reduced E-cadherin (E-cad) expression. PDCD7 transactivated E-cad expression via the GC-box in the promoter. Moreover, miR-134-associated cellular transformation and E-cad downregulation was attenuated by PDCD7. Downregulation of both PDCD7 and E-cad and high levels miR-134 expression was observed in OSCC tumor tissues. Activation of the miR-134-PDCD7-E-cad pathogenesis cascade occurred early during the human and murine oral carcinogenesis process. In conclusion, the oncogenic effect of miR-134 in oral carcinoma is mediated by reducing PDCD7 and E-cad expression.

In this letter, we determine the importance of the electrical field distribution and strength during the switching process by demonstrating different trends in the degree of reset and the reset pulse time. In general, a longer reset pulse time results in a higher reset energy; a higher reset energy leads to a higher degree of reset, which we obtained by applying different width square waves. But quite notably, the opposite result was obtained using triangle waves, where a higher degree of reset occurred with a shorter rising time and lower reset energy. We believe that this is due to the electric field effect: if the voltage rises faster than the filament oxidation, the device can produce a larger effective electric field and a higher resistance in the reset process. To further investigate the mechanism, the procedure of the reset process was analyzed in detail, and COMSOL simulation is also carried out for confirmation.

This letter introduces a method of using bipolarity bias voltages in the forming process to effectively reduce the forming voltage of a one-transistor and one-resistance random access memory device. A bipolar incremental-step-pulse programming process is applied, and a complete operation pulse for the forming process is described. This method reduces forming voltage without any cost to the device performance, and the device maintains good reliability. The likely physical mechanism of this bipolar operation is also presented based on the measured electrical characteristics.

Background Although transarterial embolization (TAE) can powerfully control postpartum hemorrhage (PPH), clinical failure of TAE is not uncommon. Purpose To discover whether any parameters could predict timely clinical failure of TAE, then whether a supplementary intervention could be promptly initiated. Material and Methods We retrospectively analyzed 118 TAE procedures in 113 patients with PPH performed at our institution between January 2012 and May 2015. The patients were divided into the following groups: clinically successful TAE and failed TAE. Successful TAE was defined as obviation of supplementary embolization or surgical intervention for hemostasis. Gestational conditions, angiographic factors, maternal vital signs, and laboratory data were compared between the two groups. Results In total, 100 (84.8%) TAEs were clinically successful. Multivariate logistic regression analyses revealed independent risk factors of TAE clinical failure, including the requirement for augmented embolic agents, placental retention, and international normalized ratio > 1.3 ( P = 0.009, 0.001, and 0.005, respectively). The post-TAE shock index was significantly associated with TAE failure, using a cut-off value of 0.8. Conclusion The discovered independent risk factors of TAE clinical failure existed before or during the TAE procedure and could not reflect the post-TAE conditions. Although the post-TAE shock index was not an independent factor, it reflected the conditions after TAE and could indicate TAE clinical failure timely.

Enlargement of memory window through forming compliance current was demonstrated in Gd:SiO2 resistive random access memory (RRAM) with a gadolinium (Gd) electrode. Lower forming compliance current for Gd:SiO2 RRAM with a Gd electrode results in larger memory window as compared with the RRAM with a Pt electrode. Through analyses on the current conduction mechanism, we demonstrate that a lower forming compliance current leads to a thinner conductive filament forming and less oxygen ions penetrating into Gd electrode, which caused higher on current and lower off current. Furthermore, a possible resistive switching model was proposed to explain the effect of Gd electrode on RRAM device.

Human tumorous imaginal disc (Tid1), a DnaJ co-chaperone protein, is classified as a tumor suppressor. Previously, we demonstrated that Tid1 reduces head and neck squamous cell carcinoma (HNSCC) malignancy. However, the molecular details of Tid1-mediated anti-metastasis remain elusive. Methods: We used affinity chromatography and systemic mass spectrometry to identify Tid1-interacting client proteins. Immunohistochemical staining of Tid1 in HNSCC patient tissues was examined to evaluate the association between the expression profile of Tid1-interacting client proteins with pathologic features and prognosis. The roles of Tid1-interacting client proteins in metastasis were validated both in vitro and in vivo. The interacting partner and downstream target of Tid1-interacting client protein were determined. Results: Herein, we first revealed that Galectin-7 was one of the Tid1-interacting client proteins. An inverse association of protein expression profile between Tid1 and Galectin-7 was determined in HNSCC patients. Low Tid1 and high Galectin-7 expression predicted poor overall survival in HNSCC. Furthermore, Tid1 abolished the nuclear translocation of Galectin-7 and suppressed Galectin-7-induced tumorigenesis and metastasis. Keratinocyte-specific Tid1-deficient mice with 4-nitroquinoline-1-oxide (4NQO) treatment exhibited increased protein levels of Galectin-7 and had a poor survival rate. Tid1 interacted with Galectin-7 through its N-linked glycosylation to promote Tid1-mediated ubiquitination and proteasomal degradation of Galectin-7. Additionally, Galectin-7 played a critical role in promoting tumorigenesis and metastatic progression by enhancing the transcriptional activity of TCF3 transcription factor through elevating MMP-9 expression. Conclusions: Overall, future treatments through activating Tid1 expression or inversely repressing the oncogenic function of Galectin-7 may exhibit great potential in targeting HNSCC progression.

To determine predictors of active angiographic hemorrhage in pelvic fracture patients. This retrospective study included 66 trauma patients who had major hemorrhages due to pelvic fractures, and who underwent pelvic angiography between January 2012 and December 2014. The study population comprised 31 males and 35 females (mean age 44.2 ± 20.7 years). The main outcome was active hemorrhage on pelvic angiography. Clinical and imaging variables including demographics, hemodynamic parameters, injury severity, types of pelvic fracture, laboratory data, blood transfusions and CT findings were analyzed. Multivariate logistic regression was used to identify predictors of active angiographic hemorrhage. Of the 66 study patients included, 41 patients had active angiographic hemorrhage. These patients had more blood transfusions, higher activated partial thromboplastin times and higher rates of contrast extravasation on CT (p

We present a detailed study on fabrication and characterization of Ge/GeSn heterojunction p-type tunnel-field-effect-transistors (TFETs). Critical process modules as high-k stack and p-i-n diodes are addressed individually. As a result an ultrathin equivalent oxide thickness of 0.84 nm with an accumulation capacitance of $3~\mu \text{F}$ /cm2 was achieved on an extremely scaled tri-layer stack of GeSnOx/Al2O3/HfO2 deposited by atomic-layer deposition monitored in situ by spectroscopic ellipsometry. Combining these process modules, Ge/GeSn heterojunction pTFETs are fabricated and characterized to demonstrate the best in-class pTFET performance in the GeSn material system. The transfer characteristics of the TFETs show signatures of the trap-assisted thermal generation in the subthreshold regime which is explained by a modified Shockley–Read–Hall model. For the ON-state current, we used band-to-band tunneling models calculated using parameters from the density functional theory. We then use the calibrated model to project performance of GeSn pTFETs with increased Sn content (lower bandgap), reduced trap density and ultrathin body geometry. Both experimental and projected results are benchmarked against state-of-the art III–V (e.g., In0.65Ga0.35/GaAs0.4Sb0.6) pTFETs. We demonstrate the ability of GeSn to achieve superior performance with both high ON-current and sub-60mV/decade switching benefiting from the small and direct bandgap for higher Sn contents.

Background To evaluate the failure pattern and identify predictors of locoregional control in lateralized buccogingival cancer after postoperative radiotherapy (RT) at a single institution. Methods We retrospectively reviewed the clinical data of 150 patients with lateralized oral squamous cell carcinoma, including carcinoma of the buccal mucosa, gingiva and retromolar trigone. All patients underwent radical surgery followed by postoperative RT with or without concurrent chemotherapy. We registered planning computer tomography images with images obtained at recurrence and categorized the failure pattern as in-field, marginal, or out-field recurrence. Results The median follow-up duration was 47 months (range, 2–131 months). Twenty-eight patients (19%) experienced locoregional failure, including 20 local failure, 5 regional failure and 3 with both. Among the 24 patients who had image studies at recurrence, 15 patients had in-field recurrence, 5 were marginal recurrence and 4 were out-field recurrence. Seven patients (5%) had contralateral neck failure. Four of 5 patients with marginal failure had recurrent tumors in the infratemporal fossa. In multivariate analysis, extracapsular spread and positive or close surgical margin were associated with poor locoregional control. Conclusion Local in-field recurrence is the most common failure pattern in lateralized buccogingival cancer after postoperative RT. The infratemporal fossa is a risk area for marginal failure and should be encompassed adequately in the postoperative RT field. Extracapsular spread and positive or close margin are predictors of locoregional control for lateralized oral cancer. Patients exhibiting such adverse features require more aggressive treatment.

In this paper, we implement a post-oxidation method to modify surface characteristics of indium tin oxide (ITO) films by using an O2 inductively coupled plasma (ICP) treatment. Based on field emission-scanning electron microscope (FE-SEM) and atomic force microscope (AFM) analysis, we found that the surface morphologies of the ITO films become slightly flatter after the O2 plasma treatment. The optical characteristics and X-ray diffraction (XRD) experiments of either pure ITO or O2 plasma treated ITO films were also verified. Even though the XRD results showed no difference from bulk crystallizations, the oxygen concentrations increased at the film surface after O2 plasma treatment, according to the XPS inspection results. Moreover, this study investigated the effects of two different plasma treatment times on oxygen concentration in the ITO films. The surface sheet resistance of the plasma treated ITO films became nearly non-conductive when measured with a 4-point probe. Finally, we applied the O2 plasma treated ITO films as the insulator in resistive random access memory (RRAM) to examine their potential for use in resistive switching storage applications. Stable resistance switching characteristics were obtained by applying the O2 plasma treatment to the ITO-based RRAM. We also confirmed the relationship between plasma treatment time and RRAM performance. These material analyses and electrical measurements suggest possible advantages in using this plasma treatment technique in device fabrication processes for RRAM applications.

In this letter, we propose a resistive switching memory with outstanding comprehensive performance by inserting buffer layers of silicon dioxide doped with boron nitride (BN: SiO2 into HfO resistance random access memory (RRAM). X-ray photoelectron spectroscopy (XPS) spectra confirms that hexagonal boron nitride (h-BN) exists in the BN:SiO2 layer. The Pt/BN:SiO2/HfO/BN:SiO2 /TiN structure was observed to have superior switching endurance >1012 cycles) and higher stability. This can be attributed to the oxygen ions generated during the forming process being localized by h-BN flakes which are formed during the sputter process. A physical model is proposed to explain the resistive switching behavior of HfO RRAM with the inserted BN-based layers.

In this study, a chemically modified electrode, consisting of CuO nanoparticles decorated nano-dendrite-structured CuBi2O4 (nanoCuBi2O4|CuO), was fabricated and its application as an electrocatalyst in catalyzing the oxidation of glucose was investigated. nanoCuBi2O4|CuO was fabricated by firstly electrodepositing BiOI nanosheet array (nanoBiOI) on the flourine-doped tin oxide coated glass substrate, followed by its conversion into nanoCuBi2O4|CuO via drop-casting an ethanolic Cu2+ solution and follow-up thermal treatment. The degree of conversion of nanoBiOI into nanoCuBi2O4|CuO and electrocatalytic activites of resultant nanoCuBi2O4|CuO were controlled by adjusting the dosage of the ethanolic Cu2+ precursor solution. Surface morphology, structure, crystal phase, chemical composition, and electrocatalytic properties of the nanoCuBi2O4|CuO were characterized using scanning electron microscopy, transmission electron microscopy, X-ray diffraction, cyclic voltammetry, linear sweep voltammetry, and chronoamperometry. It was found that both CuO and CuBi2O4 are active in electrocatalyzing the oxidation of glucose, but the porous structure of nanoCuBi2O4|CuO along with the synergistic catalytic enhancement, exerted by CuBi2O4 and CuO, renders nanoCuBi2O4|CuO superior electrocatalytic activity than CuO or CuBi2O4 alone. The mechanism of electrocatalytic oxidation of glucose on nanoCuBi2O4|CuO is proposed. Finally, the sensing characteristics of nanoCuBi2O4|CuO was evaluated, and the results indicate nanoCuBi2O4|CuO is a promising sensing material for the electrochemical detection of glucose.

To investigate whether peritoneal fluid of low CT Hounsfield units is an important screening criterion for traumatic bowel perforation. We performed a retrospective study on two cohorts of blunt trauma patients who had peritoneal fluid. Intravenous and oral contrast was used for the first cohort (61 patients) as opposed to intravenous contrast only for the second cohort (60 patients). We compared the CT Hounsfield units of peritoneal fluid with bowel perforation. The optimal cutoff value of CT Hounsfield units was determined, and its diagnostic values for bowel perforation were calculated. The mean CT Hounsfield units (HU) of peritoneal fluid with bowel perforation were significantly lower (30.3 ± 9.0 versus 44.1 ± 13.6 HU, p = 0.008) in the second cohort. The optimal cutoff value was 43 HU, and its sensitivity, specificity, accuracy and positive likelihood ratio were 100.0, 69.2, 73.3% and 3.3, respectively, for bowel perforation. Comparisons of CT HUs of peritoneal fluid with bowel perforation in the first cohort that used additional oral contrast for CT did not show statistically significant differences. Peritoneal fluid of low CT HU is a sensitive and important CT screening criterion for traumatic bowel perforation.

The aim of this study was used a weighted topology optimization method to design a patient-specific mandibular implant for reconstruction and restoration of appearance in patients with severe mandibular defects. A finite element (FE) model was constructed and the defect region was defined from the unilateral first premolar to the second molar. The reconstruction implant included main body, fixation wing and dental prosthesis. Standard topology optimization was performed using stress constraint to identify optimal fixation wing structure (denoted as WOS) with solid core main body. Two independent optimal main body with internal beam supporting structures defined as WOSA and WOSO optimized from the WOS model under axial and oblique conditions were then obtained, respectively. Final optimal model (WBOS) was generated using a weighted topology optimization that considered 60% and 40% contributions of WOSA and WOSO models, respectively. The WBOS model was fabricated using metal 3D printing and fixed on the resting acrylonitrile butadiene styrene (ABS) bone to perform fracture testing. Stress concentration were found in the upper area connected to the main body of the mesial wing and corresponding maximum values under axial/oblique loads were reduced from 778/925 MPa of the WOS model to 764/720 MPa of the WBOS model. The reduction in percentage variations of weight between original (91.1 g) and final optimal (24.5 g) models was 73.14% for fabricated 3D printing models. The WBOS model also exhibited a higher resistant force (2163 N) when compared with the original model (1678 N). This study developed a design strategy with weighted topology optimization and fabrication for producing patient-specific implants using metal 3D printing. The obtained reconstruction implant can provide good biomechanical performance and recovery of appearance for oral rehabilitation.