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Background Peristomal wound infection is a common complication in patients receiving percutaneous endoscopic gastrostomy (PEG). The main reason for peristomal infection might be the oral microbes coating the gastrostomy tube during implantation. Povidone-iodine solution can be applied for skin and oral decontamination. We designed a randomized controlled trial to test the effectiveness of a Betadine® (povidone-iodine) coated gastrostomy tube to reduce peristomal infection after percutaneous endoscopic gastrostomy. Methods A total of 50 patients were randomized to Betadine and control groups (25 patients in each group) from April 2014 to August 2021 at a tertiary medical center. All patients received the pull method for PEG implantation using a 24-french gastrostomy tube. The primary endpoint was peristomal wound infection rate 2 weeks after the procedure. Results Changes in Neutrophil/Lymphocyte ratio (N/L ratio) and C-Reative protein (Delta CRP) at 24 h after PEG were higher in the control group than in the Betadine group (N/L ratio, 3.1 vs. 1.2, p = 0.047; CRP, 2.68 vs.1.16, p = 0.009). The two groups did not differ in post-PEG fever, peristomal infection, pneumonia, or all-cause infection. Delta CRP could predict peristomal infection and all-cause infection within 2 weeks (AUROC 0.712 vs. 0.748; p = 0.039 vs. 0.008). The best cut-off-point of Delta CRP for the diagnosis of peristomal wound infection was 3 mg/dl. Conclusion The betadine coating gastrostomy tube method could not reduce peristomal infection after percutaneous endoscopic gastrostomy. CRP elevation of less than 3 mg/dl may be used to exclude the potential peristomal wound infection. Trial registration NCT04249570 (https://clinicaltrials.gov/ct2/show/NCT04249570).

In the semiconductor and liquid crystal display (LCD) industries, suspended ceilings are widely used in wafer and LCD panel fabrication plants (fabs). Despite several preventive measures having been taken, substantial financial losses have been incurred in past earthquakes, with one of the main causes attributed to damage or collapse of ceilings due to excessive ceiling sway during earthquakes. A practical approach of incorporating customised viscous dampers into suspended ceilings to mitigate their seismic response is described in this article. Unlike the convention in most fabs, where diagonal bracing rods are added between suspended ceilings and the structural floor slab to mitigate ceiling vibration, this new approach installs customised viscous dampers in between the ceiling and the column/wall. An analytical model to simulate the vibration of a suspended ceiling was developed. Shake table tests of the ceiling–structure model were then conducted to verify the effectiveness and feasibility of the proposed approach. The results indicated that, when equipped with viscous dampers, the displacement responses of a suspended ceiling can be significantly reduced. Incorporating the dampers into the ceiling with added bracing rods was found to give the best seismic performance.

In the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been effective in preventing COVID-19 infections and related mortality. The SARS-CoV-2 vaccination was also recommended by the international society for patients with inflammatory bowel disease (IBD). However, IBD patients were not recruited in prospective randomized clinical vaccine studies. To evaluate the efficacy and safety of SARS-CoV-2 vaccination in IBD patients, we conducted this systemic review and meta-analysis.We systematically searched PubMed, Medline, and the Cochrane Library for studies published between January 1, 2019, and September 9, 2021. Studies written in English reported the efficacy, seroconversion (anti-SARS-CoV-2 anti-spike (S) antibody titer beyond the threshold) rate, and adverse events after the SARS-CoV-2 vaccination in IBD patients. We extracted the author, date, study design, country, types of SARS-CoV-2 vaccination, number of IBD patients receiving SARS-CoV-2 vaccinations, and study outcomes. Published data from the enrolled studies were pooled to determine effect estimates. The study protocol was registered in PROSPERO (CRD42021264993).We analyzed findings from 27 454 IBD patients who received SARS-CoV-2 vaccinations in 11 studies that met the inclusion criteria. The post-SARS-CoV-2 vaccination COVID-19 infection rate was comparable between the IBD patients and non-IBD patients (odds ratio [OR], 1.28 [95% CI, 0.96-1.71]) and higher in nonvaccinated IBD patients compared with vaccinated IBD patients (OR, 8.63 [95% CI, 5.44-13.37]). The adverse event rate, severe adverse events, and mortality after the SARS-CoV-2 vaccination were 69%, 3%, and 0%, respectively.The SARS-CoV-2 vaccine is effective and tolerated in preventing COVID-19 infections in IBD patients. Over 98% of patients had seroconversion after receiving all doses of the SARS-CoV-2 vaccination, and the influence of biologics on vaccination was limited. The SARS-CoV-2 vaccination is recommended for IBD patients.

BACKGROUND With the growth of the aging population, the need for colonoscopies in nonagenarians is rising. However, few data on colonoscopies in extremely elderly individuals are available. To better acknowledge the role of colonoscopies in this specific group of patients, we conducted this study to evaluate the safety and clinical impact of colonoscopy in nonagenarian patients. METHODS We performed a retrospective cohort study comparing nonagenarians who received colonoscopy in a tertiary medical center in Taiwan in 2016 with 76-80-year-old patients (relatively elderly patients) who were 1:1 propensity score matched by sex as the control subjects. The postcolonoscopy 30-day adverse events, mortality and long-term survival were recorded. RESULTS A total of 137 nonagenarians and 137 relatively elderly patients were included. The nonagenarians receiving colonoscopy were more likely to be hospitalized (40.1% vs. 19.7%, p < 0.001), and the adjusted colonoscopy completion rates were comparable in both groups (92.0% vs. 97.1%, p = 0.063). The overall adverse event rate and postcolonoscopy 30-day mortality rates were low in both groups (2.9% vs. 1.5%, p = 0.409 and 2.2% vs. 1.5%, p = 0.652, respectively). A total of 18.2% of the nonagenarians were diagnosed with advanced neoplasia. Among the nonagenarians diagnosed with colorectal cancer, the patients receiving surgery had a significantly lower risk of death than the patients receiving conservative management (hazards ratio 0.1044, 0.01275-0.8529, p = 0.0352). CONCLUSION Colonoscopy in patients older than 90 years is generally safe. Colonoscopy findings that led to surgery in nonagenarians diagnosed with colorectal cancer were associated with survival benefits.

A seismic steel damper designed to deform inelastically in an in-plane flexural bending mode for more efficient utilisation of the material was investigated. This proposed device, referred to as an in-plane elliptical damper (i-PED), consists of two circular arches with intermediate straight arms connected in a closed form to eliminate end rotation at the symmetric axis in order to enhance the ultimate capacity. Test results obtained from a series of component tests on i-PEDs with various dimensions indicated that the energy-dissipation capacities of the dampers under cyclic loads were rich and consistently stable. The i-PED with a shorter arm length and smaller radius of curvature of arch exhibited higher strength and energy-dissipation capacity. Empirical formulae for estimating the mechanical properties of the dampers were developed for preliminary design purposes. The numerical predictions were found to correlate well with the experimental results, demonstrating that using the Bouc–Wen model is sufficient for simulating the inelastic mechanical behaviour of steel dampers. Furthermore, shaking table tests of a five-storey modal frame implemented with i-PEDs were conducted, with non-linear time history analyses carried out for comparison. Encouraging results on seismic response control with good numerical prediction were obtained, suggesting the feasibility of the proposed damper and design scheme for practical application.

Depression is associated with gut dysbiosis that disrupts a gut-brain bidirectional axis. Gray matter volume changes in cortical and subcortical structures, including prefrontal regions and the hippocampus, have also been noted in depressive disorders. However, the link between gut microbiota and brain structures in depressed patients remains elusive. Neuropsychiatric measures, stool samples, and structural brain images were collected from 36 patients with late-life depression (LLD) and 17 healthy controls. 16S ribosomal RNA (rRNA) gene sequencing was used to profile stool microbial communities for quantitation of microbial composition, abundance, and diversity. T1-weighted brain images were assessed with voxel-based morphometry to detect alterations in gray matter volume between groups. Correlation analysis was performed to identify the possible association between depressive symptoms, brain structures and gut microbiota. We found a significant difference in the gut microbial composition between patients with late-life depression (LLD) and healthy controls. The genera Enterobacter and Burkholderia were positively correlated with depressive symptoms and negatively correlated with brain structural signatures in regions associated with memory, somatosensory integration, and emotional processing/cognition/regulation. Our study purports the microbiota-gut-brain axis as a potential mechanism mediating the symptomatology of LLD patients, which may facilitate the development of therapeutic strategies targeting gut microbes in the treatment of elderly depressed patients.

Automated stocker system is widely used in semiconductor and liquid crystal display (LCD) industries for handling and storage of valuable wafers or glass panels. Massive front opening unified pods (foups) containing wafers, or cassettes storing glass panels, are placed in shelf stockers during manufacturing. Although several preventative measures have been taken, during the past earthquakes, substantial financial loss from the industries were reported, and one of the main causes was attributed to collision of the foups or cassettes and shake off from the shelfs. This paper proposes a methodology of incorporating viscous fluid dampers into the stokers to mitigate their seismic response. Unlike conventionally been done in buildings where dampers are placed between adjacent stories, it is proposed to install dampers in between the ceiling and top of the stocker. Such configuration utilizes the large velocity at the stocker top under vibration, resulting in smaller damper size, and enables a leverage mechanism that requires smaller damper force to resist the stocker’s vibration. Both shake table tests and simulation of a full-scale stocker under realistic earthquakes have been conducted. Results indicate that both displacement and acceleration responses of the stocker can be significantly reduced, and dynamic response of the stocker under seismic excitations can be well predicted.

BACKGROUND Older adults with depression more frequently experience somatic and gastrointestinal (GI) problems compared with people without depression and younger adults with depression. However, whether GI symptoms are predictive of elevated rates of depression among older adults is unclear. METHODS We enrolled 106 older adults (>60 years old); 69 had late-life depression (LLD), and 37 were controls. All participants gave ratings on the Gastrointestinal Symptom Rating Scale (GSRS) and Hamilton Depression Rating Scale. Food consumption was assessed using a food frequency questionnaire, and a Mediterranean diet score was used as a covariate. RESULTS Compared with the controls, patients with LLD reported higher levels of depressive and GI symptoms and reported more reflux, abdominal pain, and dyspepsia symptoms, and these symptoms were correlated with Hamilton Depression Rating Scale scores (GSRS total: β = 0.47; reflux: β = 1.47; abdominal pain: β = 1.98; dyspepsia: β = 1.02; all p < 0.01). After demographic variables and Mediterranean diet score were controlled for, a logistic regression analysis indicated that total GSRS score was an independent determinant of LLD (odds ratio: 1.20, 95% CI: 1.04-1.38). Moreover, a stratified analysis by depression severity indicated that higher total GSRS score may contribute to greater depression severity (odds ratio: 1.25, 95% CI: 1.04-1.52). CONCLUSION We provide evidence that GI symptoms are associated with depressive symptoms among patients with LLD. Older people with more specific GI symptoms, such as reflux, abdominal pain, and dyspepsia, are potentially at greater risk of having LLD.

Computer-aided diagnosis (CAD)-based artificial intelligence (AI) has been shown to be highly accurate for detecting and characterizing colon polyps. However, the application of AI to identify normal colon landmarks and differentiate multiple colon diseases has not yet been established. We aimed to develop a convolutional neural network (CNN)-based algorithm (GUTAID) to recognize different colon lesions and anatomical landmarks. Colonoscopic images were obtained to train and validate the AI classifiers. An independent dataset was collected for verification. The architecture of GUTAID contains two major sub-models: the Normal, Polyp, Diverticulum, Cecum and CAncer (NPDCCA) and Narrow-Band Imaging for Adenomatous/Hyperplastic polyps (NBI-AH) models. The development of GUTAID was based on the 16-layer Visual Geometry Group (VGG16) architecture and implemented on Google Cloud Platform. In total, 7838 colonoscopy images were used for developing and validating the AI model. An additional 1273 images were independently applied to verify the GUTAID. The accuracy for GUTAID in detecting various colon lesions/landmarks is 93.3% for polyps, 93.9% for diverticula, 91.7% for cecum, 97.5% for cancer, and 83.5% for adenomatous/hyperplastic polyps. A CNN-based algorithm (GUTAID) to identify colonic abnormalities and landmarks was successfully established with high accuracy. This GUTAID system can further characterize polyps for optical diagnosis. We demonstrated that AI classification methodology is feasible to identify multiple and different colon diseases.

The perovskites used for optoelectronic devices have been more attractive during recent years due to their wide variety of advantages, such as their low cost, high photoluminescence quantum yield (PLQY), high carrier mobility, flexible bandgap tunability, and high light absorption ability. However, optoelectronic applications for traditional inorganic and organic materials present dilemmas due to their hardly tunable bandgap and instability. On the other hand, there are some more important benefits for perovskite nanocrystals, such as a size-dependent bandgap and the availability of anion exchange at room temperature. Therefore, perovskite NC-based applications are currently favored, offering a research direction beyond perovskite, and much research has focused on the stability issue and device performance. Thus, the synthesis and applications of perovskite NCs need to be thoroughly discussed for the future development of solar cells, light-emitting diodes, photodetectors, and laser research.

Approximately 30% of inflammatory bowel disease (IBD) patients develop depression. Conversely, several studies reported increased IBD risk among patients with depression. Such bidirectional relationship has not been reported within one representative cohort, nor investigated among patients' family members. These associations may further implicate the gut-brain axis in IBD.We conducted parallel retrospective cohort analyses to investigate depression risk among IBD patients and their unaffected siblings, and IBD risk among patients with depression and their unaffected siblings using the Taiwanese National Health Insurance Research Database. Individuals were followed up to 11 years for new-onset depression or IBD. Controls were matched to unaffected siblings based on predefined characteristics.To investigate depression risk among IBD - 422 IBD patients, 537 unaffected siblings, and 2148 controls were enrolled. During follow-up, 78 (18.5%) IBD patients, 26 (4.8%) unaffected siblings, and 54 (2.5%) controls developed depression. Adjusted odds ratios (ORs) for depression among IBD patients and unaffected siblings were 9.43 (95% CI 6.43-13.81; P 0.001) and 1.82 (95% CI 1.14-2.91; P = 0.013), respectively. To investigate IBD risk among depression - 25 552 patients with depression, 26 147 unaffected siblings, and 104 588 controls were enrolled. During follow-up, 18 (0.70/1000) depression patients, 25 (0.96/1000) unaffected siblings, and 58 (0.55/1000) controls developed IBD. ORs for IBD among depression patients and unaffected siblings were 1.87 (95% CI 1.07-3.26; P = 0.028) and 1.69 (95% CI 1.05-2.69; P = 0.029), respectively.This population-based study elucidates bidirectional association between IBD and depression. Elevated risks for either disease among patients and their unaffected siblings suggest shared etiologic contributors, offering novel insight into the gut-brain axis' influence in IBD pathophysiology.

ObjectiveIncreasing evidence supports reciprocal communication between the enteric and the central nervous system in disease, termed the ‘gut–brain axis’. Recent findings suggest a connection between IBD and development of Parkinson’s disease. The role of IBD in dementia, another insidious neurodegenerative disorder, has not been explored.DesignUsing the Taiwanese National Health Insurance Research Database, we performed comparative analysis of 1742 patients with IBD ≥45 years old against 17 420 controls to assess dementia risk following IBD diagnosis. Controls were matched on bases of sex, access to healthcare, income and dementia-related comorbidities. All individuals were followed for dementia diagnosis for up to 16 years. Subanalyses included the relationship between sex, ulcerative colitis (UC) and Crohn’s disease (CD), and dementia risk.ResultsOverall incidence of dementia among patients with IBD was significantly elevated (5.5% vs 1.4% among controls). Patients with IBD were diagnosed with dementia at 76.24 years old on average, compared with 83.45 among controls. The HR of developing dementia among patients with IBD was 2.54 (95% CI 1.91 to 3.37). Among dementia types, the risk of developing Alzheimer’s dementia demonstrated the greatest increase. Dementia risk did not differ between sex differences nor UC versus CD.ConclusionThis population-based cohort study demonstrates significant association between IBD and subsequent development of dementia. Dementia was diagnosed at an earlier age among patients with IBD, and disease risk appeared to increase with IBD chronicity. These findings highlight the need for future research to elucidate the relationship between IBD and dementia.

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects an estimated 11% of people across the world. IBS patients are one of the largest subgroups seen in gastroenterology clinics, exhibit a lesser quality of life, and take greater use of the healthcare system. The exact etiology of IBS remains uncertain. Alterations in the gut microbiome may characterize apotential mechanism in the pathogenesis of IBS. This hypothesis is paralleled by rodent models in which manipulation of the gut microbiota leads to disturbed physiological functions along the brain‐gut axis. Recent research in IBS treatments has redirected its focus towards gu microbiome based therapeutics. In this review, we discuss potential roles of enteric bacteria in the pathogenesis of IBS and its comorbidities. We then explore the manipulation of the enteric microbiota by prebiotics, probiotics, antibiotics, dietary changes, and fecal microbiota transfer. We also discuss the positive and negative effects of these therapeutics on IBS symptoms.

Imaging sonar systems are widely used for monitoring fish behavior in turbid or low ambient light waters. For analyzing fish behavior in sonar images, fish segmentation is often required. In this paper, Mask R-CNN is adopted for segmenting fish in sonar images. Sonar images acquired from different shallow waters can be quite different in the contrast between fish and the background. That difference can make Mask R-CNN trained on examples collected from one fish farm ineffective to fish segmentation for the other fish farms. In this paper, a preprocessing convolutional neural network (PreCNN) is proposed to provide “standardized” feature maps for Mask R-CNN and to ease applying Mask R-CNN trained for one fish farm to the others. PreCNN aims at decoupling learning of fish instances from learning of fish-cultured environments. PreCNN is a semantic segmentation network and integrated with conditional random fields. PreCNN can utilize successive sonar images and can be trained by semi-supervised learning to make use of unlabeled information. Experimental results have shown that Mask R-CNN on the output of PreCNN is more accurate than Mask R-CNN directly on sonar images. Applying Mask R-CNN plus PreCNN trained for one fish farm to new fish farms is also more effective.

Inflammatory bowel disease (IBD) is a chronic gastrointestinal inflammatory disorder with increasing global prevalence. The risk of IBD in patients with schizophrenia remains unclear. We aim to investigate the risk of new-onset IBD in patients with schizophrenia compared with matched controls.We conducted a retrospective, population-based cohort study utilising patient data from the Taiwan National Health Insurance Research Database collected between January 1, 2001, and December 31, 2011. Patients diagnosed with schizophrenia by board-certified psychiatrists without prior diagnosis of IBD were enrolled and matched to controls in 1:4 fashion by age, sex, residence, income level and medical comorbidities. Adjusted hazard ratios (HRs) for new-onset IBD and sub-analyses were determined using Cox regression analysis with adjustments.Among 116 164 patients with schizophrenia and 464 656 matched controls, overall incidence of IBD among patients was significantly higher (1.14% vs. 0.25%). Average age of IBD diagnosis was 46.82 among patients with schizophrenia, versus 55.30 among controls. The HR of developing IBD among patients was 3.28, with a 95% confidence interval (95% CI) 2.49-4.33. IBD risk was higher among patients with psychiatric admissions more than once per year (HR 7.99, 95% CI 5.25-12.15) compared to those hospitalised less frequently (HR 2.72, 95% CI 2.03-3.66).This population-based cohort study demonstrates a significant association between schizophrenia and subsequent IBD development. Patients with schizophrenia develop IBD at a younger age, and the risk increases with inadequately controlled schizophrenia. Physician vigilance and awareness of this correlation will improve IBD diagnosis and management among this vulnerable patient population.

Background/purpose Clostridium difficile infection (CDI) leads to a significant cause of hospital-acquired morbidity and mortality. Fecal microbiota transplantation (FMT) is effective to treat recurrent or refractory CDI (rCDI). However, the change of microbial composition contributed by FMT and its association with treatment outcomes is not well determined in Taiwan. We aimed to investigate the efficacy of FMT and the association with microbial alteration endemically. Methods Twelve patients who received FMT for rCDI in Taipei Veterans General Hospital were prospectively enrolled from April 2019 to July 2020. The clinical assessments and fecal microbial analyses in comparison with fecal materials of unrelated donors were conducted before and after FMT. Results The overall success rate of FMT for rCDI was 91.7%. A prominence of Proteobacteria, Gammaproteobacteria and Enterobacteriales were observed in the feces of patients with rCDI. Increased fecal phylogenetic diversities and a significant microbial dissimilarity were provided by successful FMT compared to patients before treatment. However, the distinctness was not obvious between patients’ feces at baseline and after unsuccessful FMT. Moreover, dynamic change of fecal microbial composition after FMT was observed during follow-up but did not interrupt the treatment effects of FMT. Conclusion Gut dysbiosis commonly co-exists in patients with rCDI. Restoration of gut microbial communities by FMT provides a promising strategy to treat antibiotic-failed CDI, and the extent of microbial change would be related to the treatment outcomes of FMT. Besides, the effectiveness of FMT for CDI could be maintained even the gut microbiota has diverged over time.

BACKGROUND Depressive disorder is a major psychiatric illness, and a disturbed brain-gut-microbiome axis may contribute to its pathophysiology. Chronic Helicobacter pylori (H. pylori) infections are common in the general population and using multiple antibiotics is required for its eradication, which is associated with gut dysbiosis and may lead to depression. We aimed to evaluate the risk of psychiatrist-diagnosed depression in patients with peptic ulcer diseases (PUD) receiving anti-H. pylori therapy. MATERIALS AND METHODS We collected data from the National Health Insurance Research Database (NHIRD) in Taiwan on PUD patients undergoing antibiotic treatment for H. pylori infection; patients and controls were matched for age, sex, income, level of urbanization, and comorbidities. RESULTS Of the 1 million beneficiaries in the NHIRD, we identified 7087 patients for inclusion in the eradication cohort and 7087 matched non-eradication controls with PUD. Antibiotic therapy is associated with a short-term (

BACKGROUND Adequate bowel cleansing is important for a complete examination of the colon mucosa during colonoscopy. Current bowel cleansing evaluation scales are subjective with a wide variation in consistency among physicians and low reported rate. Artificial intelligence (AI) has been increasingly used in endoscopy. OBJECTIVE We aim to use machine learning to develop a fully automatic segmentation method to mark the fecal residue-coated mucosa for objective evaluation of the adequacy of colon preparation. METHODS Colonoscopy videos were retrieved from a video data cohort and transferred to qualified images, which were randomly divided into training, validation and verification datasets. The fecal residue was manually segmented by skilled technicians. Deep learning model based on the U-Net convolutional network architecture was developed to perform automatic segmentation. TheA total of 10,118 qualified images from 119 videos were captured, and labelled manually. The model averaged 0.3634 seconds to segmentate one image automatically. The models produced a strong high-overlap area with manual segmentation to 94.7% ± 0.67% with an intersection over union (IOU) of 0.607 ± 0.17. The area predicted by our AI model correlated well with the area measured manually (r=0.915, p RESULTS A total of 10,118 qualified images from 119 videos were captured, and labelled manually. The model averaged 0.3634 seconds to segmentate one image automatically. The models produced a strong high-overlap area with manual segmentation to 94.7% ± 0.67% with an intersection over union (IOU) of 0.607 ± 0.17. The area predicted by our AI model correlated well with the area measured manually (r=0.915, p CONCLUSIONS We used machine learning to establish a fully automatic segmentation method to rapidly and accurately mark the fecal residue-coated mucosa for objective evaluation of colon preparation.

Two low-cost 9-(2,2-diphenylvinyl)carbazole-based derivatives with aryl substitutions were synthesized by simple procedure and then investigated. The respective glass transition temperatures of the materials were estimated to be higher than 90 °C, which can provide morphologically-stable amorphous films for applications in organic light emitting diodes. The compounds possess adequate ionization potentials and suitable triplet energies, which make them suitable hole transporting materials for use in red phosphorescent organic light-emitting diodes. The respective peak efficiencies of the red devices with the p-type dopants were recorded at 8.7% (5.6 cd/A and 3.9 lm/W) and at 8.7% (5.4 cd/A and 3.8 lm/W), correspondingly, demonstrating high potential of the material for applications in light emitting diodes. The characteristics indicated that the devices with the aryl substituted 9-(2,2-diphenylvinyl)carbazoles exhibit better performance than those of widely used hole transporting 1,1-bis[(di-4-tolylamino)phenyl]cyclohexane (TAPC) -based device.

As an effort to minimize material utilization, seismic steel dampers designed to deform inelastically in an in-plane flexural mode have attracted serious attention recently. This paper presents a new type of metallic yielding damper referred to as the in-plane arch-shaped damper modified from its portal frame-shaped counterpart by replacing the straight beam with a circular arch to minimize the effects of stress concentration and warping, and therefore to avoid premature failure. Component tests of both the portal frame-shaped and arch-shaped in-plane dampers were conducted for comparison. Hysteresis loops obtained from the component tests under cyclic loads indicate substantial improvement on the energydissipative characteristics of the proposed damper. Moreover, seismic performance assessment of the proposed damper was carried out further via shaking table tests of a five-story model frame. Encouraging results have been achieved in terms of acceleration reduction, damping enhancement and peak suppression of the frequency response functions, suggesting the potential of the proposed device to be used in earthquake-resisting systems.

Computer-aided diagnosis (CAD)-based artificial intelligence (AI) has been shown to be highly accurate for detecting and characterizing colon polyps. However, the application of AI to identify normal colon landmarks and differentiate multiple colon diseases has not yet been established. We aimed to develop a convolutional neural network (CNN)-based algorithm (GUTAID) to recognize different colon lesions and anatomical landmarks.Colonoscopic images were obtained to train and validate the AI classifiers. An independent dataset was collected for verification. The architecture of GUTAID contains two major sub-models: the Normal, Polyp, Diverticulum, Cecum and CAncer (NPDCCA) and Narrow-Band Imaging for Adenomatous/Hyperplastic polyps (NBI-AH) models. The development of GUTAID was based on the 16-layer Visual Geometry Group (VGG16) architecture and implemented on Google Cloud Platform.In total, 7838 colonoscopy images were used for developing and validating the AI model. An additional 1273 images were independently applied to verify the GUTAID. The accuracy for GUTAID in detecting various colon lesions/landmarks is 93.3% for polyps, 93.9% for diverticula, 91.7% for cecum, 97.5% for cancer, and 83.5% for adenomatous/hyperplastic polyps.A CNN-based algorithm (GUTAID) to identify colonic abnormalities and landmarks was successfully established with high accuracy. This GUTAID system can further characterize polyps for optical diagnosis. We demonstrated that AI classification methodology is feasible to identify multiple and different colon diseases.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by abdominal pain and alterations in bowel habits. Current treatments for IBS are unsatisfactory due to its multifactorial pathogenesis involving the microbiota–gut–brain axis. Lactobacillus plantarum PS128 (PS128) was reported to exhibit neuromodulatory activity which may be beneficial for improving IBS. This study aimed to investigate the effect of PS128 on visceral hypersensitivity (VH) and the gut–brain axis using a 5-hydroxytryptophan (5-HTP)-induced VH rat model without colonic inflammation induction, mimicking the characteristics of IBS. Male Sprague–Dawley rats were administered with PS128 (109 CFU in 0.2 mL saline/rat/day) or saline (0.2 mL saline/rat/day) for 14 days. Colorectal distension (CRD) with simultaneous electromyography recording was performed 30 min before and 30 min after the 5-HTP injection. Levels of neuropeptides and neurotrophins were analyzed. PS128 significantly reduced VH induced by the 5-HTP injection and CRD. Neurotransmitter protein levels, substance P, CGRP, BDNF, and NGF, were decreased in the dorsal root ganglion but increased in the spinal cord in response to the 5-HTP injection; PS128 reversed these changes. The hypothalamic–pituitary–adrenal axis was modulated by PS128 with decreased corticosterone concentration in serum and the expression of mineralocorticoid receptors in the amygdala. Oral administration of PS128 inhibited 5-HTP-induced VH during CRD. The ameliorative effect on VH suggests the potential application of PS128 for IBS.

An exciplex could be formed by blending a selected hole-transporting material (HTM)/electron-transporting material (ETM) pair, and the corresponding energy band gap is roughly determined by the energy difference between the lowest unoccupied molecular orbital (LUMO) of the ETM and the highest occupied molecular orbital (HOMO) of the HTM. In this study, three HTM/ETM combinations are adopted to generate blue, green, and red exciplexes, allowing us to design precise device architectures for the fabrication of exciplex-based white OLEDs (WOLEDs) with daylight-like emissions. The CIE coordinates of this WOLED varied close to the Planckian locus as the biases increase, with a high color rendering index of about 96. This high performance suggests this exciplex-based WOLED can provide high-quality white-light illumination. Photoluminance and lifetime measurements of the exciplex behavior of the HTM/ETM combinations indicate that the HTM and ETM selected should possess higher triplet energy bandgaps than those of their corresponding exciplex to avoid energy loss.

Statin use decreases the risk of decompensation and mortality in patients with cirrhosis due to hepatitis C virus (HCV). Whether this beneficial effect can be extended to cirrhosis in the general population or cirrhosis due to other causes, such as hepatitis B virus (HBV) infection or alcohol, remains unknown. Statin use also decreases the risk of hepatocellular carcinoma (HCC) in patients with chronic HBV and HCV infection. It is unclear whether the effect can be observed in patients with pre-existing cirrhosis. The goal of this study was to determine the effect of statin use on rates of decompensation, mortality, and HCC in HBV-, HCV-, and alcohol-related cirrhosis. Patients with cirrhosis were identified from a representative cohort of Taiwan National Health Insurance beneficiaries from 2000 to 2013. Statin users, defined as having a cumulative defined daily dose (cDDD) ≥28, were selected and served as the case cohort. Statin nonusers (

This paper introduces a new capacitive coupling Wireless Power Transfer (WPT) system to solve the angular misalignment between transmitter and receiver. Inductive and Capacitive Coupling Transmitter (ICCT) uses inductive and capacitive region of solenoidal coil to transfer energy wirelessly is presented in this paper. Conductive sheet material is used as receiver antenna to link the capacitive coupling of the ICCT. The ICCT is powered using only one coil instead of multiple coils to solve the angular misalignment. The practical ICCT prototype was implemented with an DC voltage of 6V, 600 mW input power and it has demonstrated that at distance of 10 mm, power of 47 mW can be received using the conductive sheet receiver (10 mm × 20 mm) without angular concerning. The performance of the proposed design is compared with other related works and has shown improvement on receiver power with different angular position.

Background & Aims Gastric variceal bleeding (GVB) frequently recurs after hemostasis by gastric variceal obturation (GVO). We performed a multicenter, randomized controlled trial to determine the efficacy of carvedilol plus GVO in secondary prophylaxis of GVB. Methods We performed a prospective study of 121 patients with cirrhosis (ages 20–80 years) with GVB proven by endoscopy within 24 hours of bleeding and stable hemodynamics for at least 3 days after initial GVO. Patients were randomly assigned into a group that underwent repeated GVO (n = 61) or a group received repeated GVO plus carvedilol (n = 60). Recurrent GVB, upper gastrointestinal bleeding (UGIB), adverse events, and survival were compared between the groups. Results GVB recurred in 21 patients (34%) in the group that received repeated GVO and 14 patients (23%) in the group that received repeated GVO plus carvedilol (P = .18). Ascites (relative risk [RR], 2.69; 95% CI, 1.33–5.48; P = .006) and hepatoma (RR, 2.10; 95% CI, 1.03–4.28; P = .04) were associated with recurrent GVB. Twenty-nine patients (48%) in the group that received repeated GVO and 17 patients (28%) in the group that received repeated GVO plus carvedilol had recurrent UGIB (P = .03). Carvedilol (RR, 0.44; 95% CI, 0.24–0.80; P = .007) was associated with reduced risk of UGIB recurrence. Ascites (RR, 3.02; 95% CI, 1.59–5.73; P = .001) and hepatoma (RR, 2.07; 95% CI, 1.10–3.88; P = .02) were associated with recurrent UGIB. A higher proportion of patients in the group that received repeated GVO plus carvedilol (53%) had adverse events than the group that received repeated GVO (15%) (P Conclusion In a randomized controlled trial, we found that addition of carvedilol to GVO did not decrease recurrence of GVB in patients with cirrhosis but was associated with decreased recurrence of UGIB. However, carvedilol plus GVO produced significantly more adverse events. Mean survival times did not differ significantly between groups. ClinicalTrials.gov no: NCT02504723

This study proposes an innovative displacement-dependent metallic yielding damper for seismic protection of building structures. The damper is designed to deform inelastically under in-plane flexural bending and becomes energy-dissipative with an improved efficiency in terms of material utilization, as compared with those designed to bend in an out-of-plane manner. Both component test and seismic performance test of the proposed damper have been conducted in this study. Hysteresis of the component test indicates consistent and effective energy-dissipative characteristics of the damper. The contour of cracks on the surface of the damper after testing is well correlated with the stress distribution obtained from numerical analysis. Moreover, excellent seismic performance of the proposed in-plane arched damper has been demonstrated via a series of shaking table tests on a five-story model structure. Experimental results indicate that, with the dampers implemented, the acceleration responses in both peak and root-mean-squares of all floors are significantly reduced and more pronounced with the earthquake intensity increased. Effectiveness of the seismic damper is also revealed from the increase of the effective modal damping of all modes identified.

Background: The immunochemical fecal occult blood test (iFOBT) is an alternative method to colonoscopy that can be used for colorectal cancer (CRC) screening. If the iFOBT result is positive, a colonoscopy is recommended. In this retrospective study, we identify factors associated with negative colonoscopy and positive iFOBT results obtained during CRC screening. Methods: We collected data for subjects who received a colonoscopy at Taipei Veterans General Hospital after receiving a positive iFOBT result during CRC screening from January 2015 to December 2015. Subjects' baseline data, medications, and co-morbidities as well as colonoscopy and histological findings were recorded. A negative colonoscopy result was defined as no detection of any colorectal neoplasia including non-advanced adenoma, advanced adenoma, and adenocarciona. Multivariate logistic regression analysis was conducted to identify the associated factors in screening subjects with positive iFOBT but negative colonoscopy results. Results: 559 (46.3%) out of 1207 eligible study subjects received a colonoscopy with a negative result. Multivariate logistic regression analysis revealed that the use of antiplatelets [odds ratio (OR) = 0.654; 95% confidence interval (CI), 0.434–0.986], occurrence of hemorrhoid (OR = 0.595; 95% CI, 0.460–0.768), and the existence of colitis/ulcer (OR = 0.358; 95% CI, 0.162–0.789) were independent factors associated with negative colonoscopy but positive iFOBT results during CRC screening. The colon clean level, underlying diseases of gastrointestinal bleeding tendency (e.g., chronic kidney disease, cirrhosis), and the use of anticoagulant or nonsteroidal anti-inflammatory agents were not associated with negative colonoscopy and positive iFOBT results. Conclusion: The use of antiplatelet agents and the presence of hemorrhoids and colitis/ulcers were factors associated with negative colonoscopy and positive iFOBT results. Keywords: Antiplatelet agents, Colonoscopy, Colorectal neoplasia, Hemorrhoid, Immunochemical fecal occult blood test