Search

Mineralocorticoid receptor antagonists (MRAs) have been shown to provide survival benefits in patients with heart failure; however, MRA use in patients with chronic kidney disease has been limited by safety concerns. The effects of MRAs on outcomes in patients with end-stage renal disease (ESRD) and heart failure remain unknown. The aim of this study was to evaluate the effects of MRAs on cardiovascular outcomes in patients with heart failure under maintenance dialysis in a real-world setting.A retrospective cohort study was conducted by collecting data from the Taiwan National Health Insurance Research Database (NHIRD). Patients diagnosed with heart failure and ESRD and who started maintenance dialysis between 1 January 2001 and 31 December 2013 were identified. Patients were grouped according to MRA prescription. The outcomes of interest included cardiovascular (CV) death, hospitalization for heart failure (HHF), all-cause mortality, acute myocardial infarction (AMI), ischaemic stroke, any coronary revascularization procedures, and new-onset hyperkalaemia. Propensity score matching was performed at a 1:3 ratio between MRA users and non-users to minimize selection bias. A total of 50 872 patients who satisfied our inclusion and exclusion criteria were identified. After 1:3 matching, 2176 patients were included in the MRA group, and 6528 patients were included in the non-MRA group. The risk of CV death was significantly lower among patients who received MRAs than those who did not (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.80-0.95), as was the risk of all-cause mortality (HR 0.88, 95% CI 0.83-0.94). Reductions in the risks of CV death and all-cause mortality were more prominent among patients undergoing haemodialysis and those with coronary artery disease.In patients undergoing regular dialysis who are diagnosed with heart failure, the use of MRAs is associated with lower risks of all-cause mortality and CV death. The benefits of MRA treatment in heart failure may persist in patients with ESRD. Further investigations through randomized controlled trials are needed to assess the efficacy and safety of MRAs in this high-risk population.

Purpose Reduced physical activity is reported in the elderly, especially in institutional residents. Institutionalized older adults exhibit a high prevalence of frailty. In this work, we developed an artificial intelligence of things (AIoT)-based feedback assistive strengthening ergometer (AIFASE), for the physical strengthening of the elderly with intelligent assistance. Methods We conducted a 12-week intervention in a long-term care facility. In total, 16 participants (84.38 ± 6.0 years; 4 males and 12 females) were recruited with 1:1 randomization of exercise to control groups. The muscle strength of the lower extremities, timed up and go test (TUG), and Short-form Physical Performance Battery (SPPB) of the participants were measured. The AIFASE system allows the clinical staff to record the personal physical performance of the elderly and generates personalized exercise prescriptions accordingly. AIFASE also displays the current usage status of all ergometers and the users’ physiological conditions. The algorithms were developed to generate warning alerts when the training workload was too large by personal physiological detection. AIFASE automatically customized the exercise prescription according to the user’s exercise performance. Results After a 12-week AIFASE intervention, the intervention group exhibited significant improvements in the strength of the hip flexor, Semi-Tandem Stand, and Tandem Stand. Conclusion In this study, we developed an AIoT ergometer that delivered customized physical training prescriptions to improve the physical performance of long-term care facility residents. We believe that the application of AIFASE will help improve the quality of institutional care.

Acute myocardial infarction (AMI) and colon cancer share similar risk factors. Studies have suggested an association between AMI and colon cancer; however, evidence is conflicting. Whether sex disparities exist in this association in the real world remains unknown.In this population-based retrospective cohort study, 94,780 and 97,987 male patients and 38,697 and 72,007 female patients with and without new-onset AMI, respectively, from January 1, 2001, to December 31, 2012, were enrolled from Taiwan's National Health Insurance Research Database. Inverse probability of treatment weighting (IPTW) was used to balance covariates across study groups. The primary outcome was a new diagnosis of colon cancer.The incidence rate of colon cancer was 1.54 (95% confidence interval [CI] = 1.46-1.62) and 1.40 (95% CI = 1.32-1.48) per 1000 person-years in the male patients and 1.62 (95% CI = 1.50-1.74) and 1.22 (95% CI = 1.13-1.32) in the female patients, in the AMI and non-AMI groups, respectively. AMI was associated with a significantly higher risk of colon cancer in the female patients (hazard ratio [HR] = 1.31, 95% CI = 1.06-1.61) but not in the male patients (HR = 1.09, 95% CI = 0.95-1.26). In the subgroup analysis, the association between AMI and colon cancer in the female patients was stronger in those aged ≥65 years (HR = 1.28, 95% CI = 1.13-1.44).An increased risk of colon cancer was observed only in the female patients with AMI. The association between AMI and colon cancer in the female patients was the most evident in those aged ≥65 years.

Background Little research has been done on ischemic outcomes related to left ventricular ejection fraction (EF) in acute decompensated heart failure (ADHF). Methods A retrospective cohort study was conducted between 2001 and 2021 using the Chang Gung Research Database. ADHF Patients discharged from hospitals between January 1, 2005, and December 31, 2019. Cardiovascular (CV) mortality and heart failure (HF) rehospitalization are the primary outcome components, along with all-cause mortality, acute myocardial infarction (AMI) and stroke. Results A total of 12,852 ADHF patients were identified, of whom 2,222 (17.3%) had HFmrEF, the mean (SD) age was 68.5 (14.6) years, and 1,327 (59.7%) were males. In comparison with HFrEF and HFpEF patients, HFmrEF patients had a significant phenotype comorbid with diabetes, dyslipidemia, and ischemic heart disease. Patients with HFmrEF were more likely to experience renal failure, dialysis, and replacement. Both HFmrEF and HFrEF had similar rates of cardioversion and coronary interventions. There was an intermediate clinical outcome between HFpEF and HFrEF, but HFmrEF had the highest rate of AMI (HFpEF, 9.3%; HFmrEF, 13.6%; HFrEF, 9.9%). The AMI rates in HFmrEF were higher than those in HFpEF (AHR, 1.15; 95% Confidence Interval, 0.99 to 1.32) but not in HFrEF (AHR, 0.99; 95% Confidence Interval, 0.87 to 1.13). Conclusion Acute decompression in patients with HFmrEF increases the risk of myocardial infarction. The relationship between HFmrEF and ischemic cardiomyopathy, as well as optimal anti-ischemic treatment, requires further research on a large scale.

Background Chronic hepatitis C virus (HCV) infection is associated with increased cardiovascular risks. We aimed to investigate the impact of direct acting antiviral (DAA) on HCV-associated cardiovascular events. Methods In this retrospective cohort study, patients with the diagnosis of chronic HCV were retrieved from multi-institutional electronic medical records, where diagnosis of HCV was based on serum HCV antibody and HCV–RNA test. The patients eligible for analysis were then separated into patients with DAA treatment and patient without DAA treatment. Primary outcomes included acute coronary syndrome, heart failure (HF), venous thromboembolism (VTE), stroke, cardiovascular death, major adverse cardiovascular event (MACE), and all-cause mortality. Outcomes developed during follow-up were compared between DAA treatment and non-DAA treatment groups. Results There were 41 565 patients with chronic HCV infection identified. After exclusion criteria applied, 1984 patients in the DAA treatment group and 413 patients in the non-DAA treatment group were compared for outcomes using inverse probability of treatment weighting. Compared to patients in non-DAA treatment group, patients in DAA treatment group were associated with significantly decreased HF (hazard ratio [HR]: 0.65, 95% confidence interval [CI]: 0.44–0.97, P = 0.035), VTE (HR: 0.19, 95% CI: 0.07–0.49, P = 0.001), MACE (HR: 0.73, 95% CI 0.59–0.92, P = 0.007), and all-cause mortality (HR: 0.50, 95% CI: 0.38–0.67, P Conclusions Chronic HCV patients treated with DAA experienced lower rates of cardiovascular events and all-cause mortality than those without treatment. The reduction of VTE was the most significant impact of DAA treatment among the cardiovascular outcomes.

A tunable metamaterial nanograting coupler (MNC) is presented that is composed of a one-dimensional surface nanograting coupler with a bottom reflector and the metamaterial atop. For a single nanograting coupler, by introducing a reflector and optimizing nanograting parameters, the spatial coupling efficiency exceeds 97% around near-infrared wavelength of 1.43 μm. The metamaterial can be tuned by using micro-electro-mechanical system (MEMS) technique. The relative height or lateral offset between metamaterial and coupling nanograting can be controlled, that the light-emitting efficiency can be separated into two different directions. In addition, the coupling efficiency is as high as 91% at the optical C-band communication window. Therefore, the proposed MEMS-based MNC not only has the possibility of coupling optical fibers with high-density integrated optoelectronic chips, but also has potential application prospects in light path switching, variable optical attenuation, and optical switch.

Background The World Health Organization (WHO) suggests that some high-risk patient groups should receive latent tuberculosis infection (LTBI) screening and tuberculosis prevention treatment, including people living with human immunodeficiency virus (PLHIV). We performed an updated meta-analysis to compare the different LTBI therapeutic regimens for LTBI test-positive PLHIV. Methods We searched PubMed, Embase, Cochrane library, clinicaltrials.gov, and the International Clinical Trials Registry Platform for all literature and ongoing trials from their inception until November 30th, 2022. We performed a meta-analysis of the efficacy, adhesion rate, and severe adverse events; and graded the evidence quality. Results Nine studies were eligible, including two non-randomized studies (NRS) with 470 participants and seven randomized control trials (RCT)with 3,979 participants. The quality of evidence was very low for the results of the NRSs and low for the RCTs. Compared with placebo or non-treatment, both isoniazid (OR: 0.56; 95%CI 0.33-0.93) and rifamycin-based treatments (OR: 0.44; 95%CI 0.26-0.72) had efficacy for active TB prevention. Rifamycin-based regimens seem to have a better adhesion rate than isoniazid alone (RR: 1.11; 95%CI 1.04-1.19) and similar adverse events (RR: 0.73; 95%CI 0.49-1.09). Conclusions LTBI treatment decreased the active rate of TB in LTBI test-positive PLHIV. Rifamycin-based therapies may have a higher adhesion rate, while their efficacy and adverse events appear similar to isoniazid. More studies focusing on LTBI test-positive PLHIV participants would help gather high-quality evidence for decision-making.

Respiratory oscillometry is widely explored in asthma management; however, there is currently no consensus on its routine work-up in patients with difficult-to-treat asthma. We conducted a retrospective, cross-sectional study involving patients with difficult-to-treat asthma at Asia University Hospital between January 2017 and October 2020. We aimed to correlate clinical significance of respiratory oscillometry and asthma treatment outcomes including symptoms control and exacerbation in patients with difficult-to-treat asthma. Among the 69 patients enrolled in the study, a total of 26.1% of the patients experienced at least one severe or two moderate exacerbations. Patients with ACT P = 0.037) There was a higher proportion of frequent exacerbations in patients with higher FDR (FDR ≥ 0.10 vs.

A voltage-controllable VO2 based metamaterial perfect absorber (MPA) is proposed for CO2 gas sensing application.

Background Impaired renal function is frequently observed in patients with heart failure and reduced ejection fraction (HFrEF). The differential effect of sacubitril/valsartan and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (ACEIs/ARBs) on the clinical and renal outcomes in patients with HFrEF and chronic kidney disease (CKD) remains unknown. Aims This study aimed to explore the differential effect of sacubitril/valsartan and ACEI/ARB on the clinical and renal outcomes as well as renal function over a 12-month follow-up period in HFrEF patients with and without CKD. Methods Patients with HfrEF (LVEF ≤35%) and NYHA class ≥II were enrolled from the Chang Gung Research Database between 2017 and 2020. Baseline characteristics were compared between patients prescribed sacubitril/valsartan and ACEI/ARB. After propensity score matching, the following clinical and renal outcomes were compared between the two groups in patients with and without CKD over a 12-month follow-up period: acute kidney injury (AKI), emergent dialysis/renal death, HF hospitalization, cardiovascular mortality, and all-cause mortality. Results This study enrolled 3735 HFrEF patients with a mean left ventricular EF of 27.56 ± 5.86%, who had been prescribed sacubitril/valsartan (N = 1708) or ACEI/ARB (N = 2027). After propensity score matching, the clinical and renal outcomes did not differ between the sacubitril/valsartan and ACEI/ARB groups in patients without CKD. In patients with CKD, the ACEI/ARB group had a significantly higher incidence of all-cause mortality than the sacubitril/valsartan group (14.89% vs. 10.50%; hazard ratio 1.46; 95% confidence interval 1.06–2.00; p = 0.02), and the incidence of AKI, HF hospitalization, and CV mortality did not differ between the two groups. Conclusions Sacubitril/valsartan had a lower all-cause mortality compared to ACEI/ARB in symptomatic HFrEF patients with CKD. Further prospective randomized studies are warranted to confirm our findings.

This research is aimed at exploring the influencing factors of users’ behavioral intention toward the Nike Training Club (NTC) app, using the decomposed theory of planned behavior as the main research framework. In this study, users of the NTC app were the research objects. A total of 300 questionnaires were distributed on the Internet by the purposive sampling method. After excluding invalid questionnaires, a total of 280 copies were obtained. The effective questionnaire recovery rate was 93.33%. All data were verified by descriptive statistics and multiple regression analysis. The results of this study were as follows. First, the NTC app users were mostly female, aged between 19 and 25 years, were students, had a monthly income below 20,000, and exercised one to two times a week. Second, the application of the decomposed theory of planned behavior found the following: perceived usefulness and perceived ease of use had positive effects on attitude; interpersonal influence and electronic word of mouth had a positive influence on subjective norms; self-efficacy and technology facilitation had positive effects on perceptual behavior control; and attitude, subjective norms, and perceptual behavior control all had a positive impact on behavioral intention. The NTC app users thought that the program interface was easy to use and that the app could help them effectively achieve the effect of exercise and fitness, which increased the benefits of continuously using the program.

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

Objectives: This study aimed to compare the short-term and long-term follow-up outcomes of catheter-directed thrombolysis (CDT) with those of pulmonary artery embolectomy (PAE) for patients with acute pulmonary embolism (PE) included in a nationwide cohort. Background: Data allowing direct comparisons between CDT and PAE are lacking in the literature, and the optimal management of high-risk and intermediate-risk PE is still debated. Methods: A retrospective cohort study was conducted with data for 2001 through 2013 collected from the Taiwan National Health Insurance Research Database (NHIRD). Patients who were first admitted for PE and treated with either CDT or PAE were included and compared. In-hospital outcomes included in-hospital death and safety (bleeding and cardiac arrhythmias) outcomes. Follow-up outcomes included all-cause mortality and recurrent PE during the 1- and 2-year follow-up periods and through the last follow-up. Inverse probability of treatment weighting (IPTW) based on the propensity score was used to minimize possible selection bias, including indices for multimorbidity such as the Charlson’s Comorbidity Index (CCI) and HAS-BLED scores. Results: A total of 389 patients treated between January 1, 2001, and December 31, 2013, were identified; 169 underwent CDT and 220 underwent PAE. After IPTW, there were no significant differences in in-hospital mortality (18.2% vs 21.3%; odds ratio 1.07, 95% confidence interval [CI]: 0.70–1.62) or the incidence of safety outcomes between the CDT and PAE groups. The risks of all-cause mortality (30% vs 29.5%; hazard ratio 1.16, 95% CI: 0.89–1.53), recurrent PE (7.2% vs 8.7%; subdistribution hazard ratio [SHR] 0.68, 95% CI: 0.39–1.21) and new-onset pulmonary hypertension (SHR 0.25, 95% CI: 0.05–1.32) were also not significantly different between the CDT and PAE groups at 2 years of follow-up. Subgroup analysis indicated that PAE may be associated with a more favorable 2-year mortality in patients Conclusions: In patients with PE who required reperfusion therapy, CDT and PAE resulted in similar in-hospital and long-term all-cause mortality rates and long-term rates of recurrent PE. Bleeding risks were also comparable in the 2 groups.

Objective This study assesses the mortality outcomes of non‐vitamin K antagonist oral anticoagulants (NOACs) in cancer patients with venous thromboembolism (VTE) and atrial fibrillation (AF). Methods Medical records of cancer patients receiving NOACs for VTE or AF between January 1, 2011, and December 31, 2016, were retrieved from Taiwan's National Health Institute Research Database. NOACs were compared using the inverse probability of treatment weighting (IPTW) method. The primary outcome was cancer‐related death. Secondary outcomes were all‐cause mortality, major bleeding, and gastrointestinal (GI) bleeding. Results Among 202,754 patients who received anticoagulants, 3591 patients (dabigatran: 907; rivaroxaban: 2684) with active cancers were studied. Patients who received dabigatran were associated with lower risks of cancer‐related death at one year (HR = 0.71, 95% CI = 0.54–0.93) and at the end of follow‐ups (HR = 0.79, 95% CI = 0.64–0.98) compared with rivaroxaban. Patients who received dabigatran were also associated with lower risks of all‐cause mortality (HR = 0.81, 95% CI = 0.67–0.97), major bleeding (HR = 0.64, 95% CI = 0.47–0.88), and GI bleeding (HR = 0.57, 95% CI = 0.39–0.84) at the end of follow‐ups compared with rivaroxaban. Conclusion Compared with rivaroxaban, the use of dabigatran may be associated with a lower risk of cancer‐related death and all‐cause mortality., The outcomes of non‐vitamin K antagonist oral anticoagulants (NOACs) in cancer patients with venous thromboembolism (VTE) or atrial fibrillation (AF) are not known. A total of 3591 patients with active cancers were studied (907 on dabigatran; 2684 on rivaroxaban). In comparison with rivaroxaban, the use of dabigatran may be associated with lower risk of cancer‐related death and all‐cause mortality.

Amyloidogenesis, self-propagation of protein or peptide monomers to amyloid fibrils, has been linked to incurable pathogenesis of neurodegenerative diseases such as Alzheimer's disease and prion diseases. Investigations of amyloid structures and how monomers are transformed through seeding are therefore crucial for developing therapeutics toward these diseases. Here we describe a cross-seeding method to explore the amyloid core in prion fibrils that uses preformed amyloid fibrils as a seed to induce the transformation of other protein or peptide monomers to amyloid fibrils.

Background Vitamin K antagonists and different direct oral anticoagulants (DOACs) have different renal clearance rates. However, the impact of different stages of chronic renal impairment on the efficacy and safety of warfarin, dabigatran, rivaroxaban, apixaban, and edoxaban in atrial fibrillation (AF) patients remains unclear. Methods This study enrolled AF patients from the Chang Gung Research Database. The study endpoints included thromboembolic events, major/fatal bleeding, gastrointestinal (GI) bleeding and intracranial hemorrhage (ICH). The risks of time to study endpoints between groups were compared using a Cox proportional hazards regression model with adjustment. Results This study enrolled 3525 patients with moderate renal impairment (30 ≤ creatinine clearance (CrCl) Conclusion There did not appear to be major differences in bleeding or thromboembolic risk compared to warfarin in AF patients across a range of degree of renal failure when appropriate dose reductions of the DOACs are made.

BackgroundAn extended interval between the two primary doses may reduce the risk of myocarditis/pericarditis after COVID-19 mRNA vaccination. Taiwan has implemented a two-dose regimen with a 12-week interval for adolescents. Here we present nationwide data of mRNA COVID-19 vaccination-associated myocarditis and pericarditis in Taiwan.MethodsData on adverse events of myocarditis/pericarditis were from the Taiwan Vaccine Adverse Events Reporting System between March 22, 2021, and February 9, 2022. The rates according to sex, age, and vaccine type were calculated. We investigated the reporting rates among young individuals under different two-dose intervals and among those who received two doses of different vaccines.ResultsAmong 204 cases who met the case definition of myocarditis/pericarditis, 75 cases occurred after the first dose and 129 after the second. The reporting rate of myocarditis/pericarditis after COVID-19 vaccination varied across sex and age groups and was highest after the second dose in males aged 12–17 years (126.79 cases per million vaccinees) for the BNT162b2 vaccine and in males aged 18–24 years (93.84 cases per million vaccinees) for the mRNA-1273 vaccine. The data did not suggest an association between longer between-dose interval and lower rate of myocarditis/pericarditis among males and females aged 18–24 or 25–29 years who received two doses of the BNT162b2 or mRNA-1273 vaccine. Rates of myocarditis/pericarditis in males and females aged 18–49 years after receiving ChAdOx1-S - mRNA-1273 vaccination was significantly higher than after ChAdOx1-S - ChAdOx1-S vaccination.ConclusionsMyocarditis and pericarditis are rare following mRNA vaccination, with higher risk occurring in young males after the second dose.

Although continuous positive airway pressure is the gold standard for obstructive sleep apnea (OSA), it does not improve obesity. By contrast, bariatric surgery significantly improves obesity but with sustained OSA in the majority of patients. This study proposes a comprehensive technique—combined airway and bariatric surgery (CABS)—to improve both obesity and OSA. The aims of the study are to evaluate the feasibility, safety and efficacy of CABS in morbidly obese OSA patients. The retrospective study enrolled 20 morbidly obese OSA patients (13 males; median age, 44 years; median apnea–hypopnea index (AHI), 63.2 event/h; median body mass index (BMI), 41.4 kg/m2). The study population was divided into two groups based on patients’ volition after shared decision making. The bariatric surgery (BS) group included laparoscopic sleeve gastrectomy (LSG, n = 8) and laparoscopic Roux-en-Y gastric bypass (LRYGB, n = 2). CABS involved bariatric surgery—LSG (n = 8) and LRYGB (n = 2) in conjunction with airway surgery (concurrent nasal/palatal/lingual surgery [n = 8], concurrent palatal/lingual surgery [n = 2]). Patients received a home sleep apnea test at baseline and one year after surgery. The two patient groups were not different in age, sex, preoperative AHI or preoperative BMI. There was no airway compromise, wound bleeding or infection throughout the postoperative period. One year after surgery, patients in both groups achieved significant improvement in AHI and BMI. Furthermore, the improvement in AHI was significantly higher (p = 0.04) in the CABS group than in the BS group despite the insignificant change in BMI reduction (p = 0.63) between the two groups. In the CABS group, the BMI dropped from 40.4 to 28.4 kg/m2 (p < 0.0001) and the AHI decreased from 75.1 to 4.5 event/h (p = 0.0004). The classic success rate for OSA was 90% and the cure rate was 60% in the CABS group. A perioperative assessment of CABS group patients also revealed a significant improvement in the Epworth sleepiness scale, minimal O2 saturation, snoring index and heart rate. CABS is feasible and safe in treating OSA with morbid obesity. CABS achieves more reduction in AHI than BS alone with high success and cure rates for OSA. CABS can also significantly improve quality of life and general health and offers a comprehensive alternative for morbidly obese OSA patients.

NVMe SSDs are deployed in data centers for applications with high performance, but its capacity and bandwidth are often underutilized. Remote access NVMe SSD enables flexible scaling and high utilization of Flash capacity and bandwidth within data centers. The current issue of remote access NVMe SSD has significant performance overheads. The research focuses on remote access NVMe SSD via NTB (non-transparent bridge). NTB is a type of PCI-Express; its memory mapping technology can allow to access memory belonging to peer servers. NVMe SSD supports multiple I/O queues to maximize the I/O parallel processing of flash; hence, NVMe SSD can provide significant performance when comparing with traditional hard drives. The research proposes a novel design based on features of NTB memory mapping and NVMe SSD multiple I/O queues. The remote and local servers can access the same NVMe SSD concurrently. The experimental results show the performance of remote access NVMe SSD can approach the local access. It is significantly excellent and proved feasible.

Adversary imaging condition such as in a hazy weather is a challenge in the community of image processing. To address the challenge of haze removal, several model-based approaches have been reported recently. Among them, a single image haze removal scheme based on dark channel prior (DCP) was presented in [1] and has been getting popular because of its satisfactory performance for most of cases. However, it is well-known that the DCP scheme is inherent of two fundamental problems: high computational cost and over-exposure. In this paper, the objective of proposed dehazing algorithm (PDA) is to deal with the two problems in [1], where atmospheric light is estimated from the dark channel and pixel-based transmission map estimation is employed. Examples are given to verify the PDA where comparison with the DCP scheme and other well-known schemes are made as well. The simulation results indicate that the PDA has similar or better dehazing performance than the compared schemes in the given examples, when both mood retention and visibility improvement are considered.

Exposure to polycyclic aromatic hydrocarbons (PAHs) has been associated with both systematic inflammation and renal dysfunction. Reports have suggested that anti-inflammatory properties of vitamin D may provide protection against renal injury. This cross-sectional study tested the hypothesis that serum 25-hydroxyvitamin D [25(OH)D] moderates the inflammation and albuminuria associated with PAH exposure. Data were obtained from 5,982 subjects aged 20-79 years in the National Health and Nutrition Examination Survey (2001-2010). PAH exposure was estimated by urinary PAH metabolites. Inflammation was defined as serum C-reactive protein (CRP)3 mg/L and albuminuria as urinary albumin-to-creatinine ratio30 mg/g. The results found that greater PAH exposure was linked with inflammation and albuminuria. Individuals with PAH exposure also tended to have lower 25(OH)D and lower vitamin D was associated with both elevated CRP (Odds ratio [OR] = 1.28, 95% confidence interval [CI] = 1.07-1.54) and urinary albumin (1.35, 95%CI = 1.03-1.77) for any given PAH exposure. Those with lower serum 25(OH)D-to-urinary PAH ratios were likewise at a greater risk of elevated CRP and albuminuria. The findings support prior suggestions that exposure to PAHs is associated with inflammation and albuminuria but suggests further that the risk is higher when vitamin D is lower. Thus, nutritional status becomes an important variable in PAH risk assessment.

We propose the design of symmetrical and asymmetrical tunable color filters (TCFs) by using hybrid metasurface nanostructures in the visible wavelength range. They are composed of circular zinc oxide (ZnO) nanopillars and silver (Ag) nanoholes on a silica substrate. These TCFs exhibit ultrahigh transmission intensity over 90%, different tuning ranges, and polarization-dependent/independent characteristics. By changing the distance between the ZnO nanopillars and silica substrate, the resonant wavelength of TCFs could be tuned remarkably. Moreover, we also demonstrate the stability of TCFs under different disturbances and angles of incident light. Furthermore, the resonant wavelengths are red-shifted by increasing the ambient refraction index. TCFs exhibit great tunability and ultrahigh transmission intensity up to 100%. This design opens up an avenue to widespread optoelectronic applications, such as ultrahigh resolution color displays, high-efficiency biosensors, pressure sensors, and selective color filters.

Orf is highly contagious zoonoses which is caused by the orf virus (ORFV). In order to determine the characteristics of B2L genes between vaccine strain and wild strain of ORFV in China. In this study we choose the weak vaccine of ORFV produced in biological products (Shandong Taifeng, China) and the wild strain (FJ-PN) isolated and identified in our laboratory to amplify, clone and sequence the B2L genes, and the changes in nucleotide, amino acid and secondary and tertiary protein structure of the B2L proteins were compared and analyzed by bioinformatics software. Comparison results showed that the nucleotide sequence similarity and amino acid sequence similarity of the B2L genes of vaccine strain and wild strain were 98.6% and 98.7% respectively. There was no significant difference between the primary, secondary and tertiary structures of the B2L proteins. The results of this study provide ideas for the study on the function and molecular biological characteristics of related proteins after the ORFV is weakened.

A design of electric split-ring metamaterial (eSRM) with tunable terahertz (THz) free spectra range (FSR) characteristic is presented. The proposed eSRM is composed of double semicircle-shaped ring resonators with two connected metallic bars. By changing the radius of the semicircle-shaped ring resonators, the tuning ranges of FSR are 0.187 THz and 0.024 THz in transverse electric (TE) and transverse magnetic (TM) modes, respectively, which indicates eSRM could operate stably in TE and TM modes. Furthermore, eSRM exhibits switching and polarization-dependent characteristics by exploiting comb driver to control the distances between ring resonators along ${x}$ -and ${y}$ -axis directions. The electromagnetic responses could be tuned and switched between dual- and quad-resonance in both TE and TM modes. eSRM shows polarization angle-sensitive characteristic and the corresponding FSR could be tuned from 919 GHz to 336 GHz by changing the polarization angle of incident THz wave. In view of the above optical characteristics of eSRM, it is used for the sensing application exposed on different surrounding refraction index. The sensitivity, quality factor (Q-factor), and figure of merit (FOM) are calculated. The sensitivity is 0.457 THz/RIU and the average Q-factor and FOM are 40.65 and 35.47, respectively. These results indicate the proposed eSRM could be used in widespread applications, such as dual-/quad-resonance switches, polarization switches, and high-efficient environmental sensors. [2021-0006]

To improve color conversion performance for color display application, we study the near-field-induced nanoscale-cavity effects on the emission efficiency and Förster resonance energy transfer (FRET) under the condition of surface plasmon (SP) coupling by inserting colloidal quantum dots (QDs) and synthesized Ag nanoparticles (NPs) into surface nano-holes fabricated on a GaN template and an InGaN/GaN quantum-well (QW) template. In the QW template, the inserted Ag NPs are close to either QWs or QDs for producing three-body SP coupling to enhance color conversion. Time-resolved and continuous-wave photoluminescence (PL) behaviors of the QW- and QD-emitting lights are investigated. The comparison between the nano-hole samples and the reference samples of surface QD/Ag NP shows that the nanoscale-cavity effect of the nano-hole leads to the enhancements of QD emission, FRET between QDs, and FRET from QW into QD. The SP coupling induced by the inserted Ag NPs can enhance the QD emission and FRET from QW into QD. Its result is further enhanced through the nanoscale-cavity effect. The relative continuous-wave PL intensities among different color components also show the similar behaviors. By introducing SP coupling to a color conversion device with the FRET process in a nanoscale cavity structure, we can significantly improve the color conversion efficiency. Simulation results confirm the basic observations in experiment.

Photonic nano/microstructures (e [...]

To improve the color conversion performance, we study the nanoscale-cavity effects on the emission efficiency of a colloidal quantum dot (QD) and the Förster resonance energy transfer (FRET) from quantum well (QW) into QD in a GaN porous structure (PS). For this study, we insert green-emitting QD (GQD) and red-emitting QD (RQD) into the fabricated PSs in a GaN template and a blue-emitting QW template, and investigate the behaviors of the photoluminescence (PL) decay times and the intensity ratios of blue, green, and red lights. In the PS samples fabricated on the GaN template, we observe the efficiency enhancements of QD emission and the FRET from GQD into RQD, when compared with the samples of surface QDs, which is attributed to the nanoscale-cavity effect. In the PS samples fabricated on the QW template, the FRET from QW into QD is also enhanced. The enhanced FRET and QD emission efficiencies in a PS result in an improved color conversion performance. Because of the anisotropic PS in the sample surface plane, the polarization dependencies of QD emission and FRET are observed.

Involvement of extracellular nicotinamide phosphoribosyltransferase (eNAMPT, i.e., visfatin or pre-B-cell colony-enhancing factor), a cancer metabokine, in chronically hepatitis C virus (HCV)-infected (CHC) patients with sustained virological responses (SVRs) remains elusive. This 8-year prospective cohort study evaluated eNAMPT profiles of 842 consecutive CHC patients, including 519 who had completed an anti-HCV therapy course and pre-therapy and 24-week post-therapy surveys. For 842 patients, pre-therapy associations were HCV RNA, homeostatic model assessment for insulin resistance (HOMA-IR) index, and body mass index with eNAMPT levels, and NAMPT-rs61330082 T allele with total cholesterol levels. NAMPT-rs10953502, NAMPT-rs2058539, and NAMPT-rs61330082 were in a linkage disequilibrium block, which was associated with total cholesterol levels. Compared to pre-therapy levels, at 24 weeks post-therapy, decreased eNAMPT and increased lipid levels were observed in SVR patients (n = 427). Among SVR patients, higher cumulative incidences of cardiovascular events occurred in those with a NAMPT-rs61330082 TT genotype than those with non-TT genotypes (28.2% vs. 8.4%, p < 0.001). NAMPT-rs61330082 TT genotype was independently associated with incident cardiovascular events (95% CI hazard ratio (HR): 1.88–10.37; HR: 4.415); no eNAMPT profiles were associated with incident malignancies. Of CHC patients, hepatic vascular endothelial cells and baseline peripheral leukocytes expressed higher eNAMPT levels than controls, and peripheral eNAMPT-positive leukocyte proportions decreased after SVR. During HCV infection, eNAMPT involvement in glucose metabolism was modulated by HCV RNA linked to lipid metabolism and NAMPT-associated SNPs. Hepatic endothelial cells and peripheral leukocytes potentially secrete eNAMPT. Caution is required for incident cardiovascular events in SVR patients with NAMPT-rs61330082 TT genotype.

In this article, the effects of active Ag electrodes on the ${R}_{ \mathrm{\scriptscriptstyle OFF}}/{R}_{ \mathrm{\scriptscriptstyle ON}}$ ratio, SET/RESET voltages, and endurance characteristics of a sol–gel TiO x resistive memory are investigated. Stable bipolar resistive switching (RS) behavior with a large ${R}_{ \mathrm{\scriptscriptstyle OFF}}/{R}_{ \mathrm{\scriptscriptstyle ON}}$ ratio of 105 is observed in an Ag/TiO x /n+-Si resistive memory. The SET and RESET processes can only be triggered by positive and negative voltages, respectively. Nonpolar RS behavior is found when directly using a tungsten probe to measure the ${I}$ – ${V}$ curves of a TiO x /n+-Si device. A high voltage of ~±40 V is needed to induce the SET process. In addition, the RS behavior is not stable and can only repeat few times. When the top and bottom electrodes are both Ag (Ag/TiO x /Ag), the SET process can be easily triggered by a low voltage regardless of the voltage polarity. However, the RESET process does not happen in the following voltage cycles. Dramatic differences in the RS characteristics of these devices verify the impact of the Ag electrode on the RS characteristics of the sol–gel TiO x layer.

Background Women have been underrepresented in the literature; the effects of female sex on outcomes in patients with acute myocardial infarction (AMI) remain unclear. Objectives This study compares the real-world outcomes of women and men with AMI who have undergone revascularization via percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). Methods This is a retrospective cohort study utilizing data from the Taiwan National Health Insurance database. We identified patients who were admitted for AMI and who underwent coronary revascularization during the index admission period between January 1, 2001, and December 31, 2013. Patients were then categorized based on the treatment received into PCI and CABG groups. In-hospital and long-term outcomes were compared between women and men in each group. Interaction tests were then performed to determine whether the differences between sexes were modified by the mode of revascularization. Analyses were repeated after propensity score matching between women and men in each group to minimize possible confounders. We also conducted subgroup analyses, stratifying by the presence of diabetes mellitus, congestive heart failure, and chronic kidney disease. Results We enrolled 67,534 patients who met the inclusion criteria in the analysis; 60,207 patients had undergone PCI (13,514 female and 46,693 male), while 7327 patients had received CABG (1762 female and 5565 male). Prior to matching, enrolled female patients were older on average, with more comorbidities. In-hospital and long-term outcomes were worse in women, particularly in the PCI group. After matching, the incidence of hospitalization for heart failure (HHF) was higher in women (10.4% vs 8.0%, OR 1.32, 95% CI 1.22–1.43), with fewer repeat revascularizations (28.1% vs 32.4%, OR 0.84, 95% CI 0.81–0.88). Both observations were more pronounced in the PCI group (HHF: P for interaction = 0.0496; repeat revascularization: P for interaction = 0.021). Conclusions Women presenting with AMI exhibited worse in-hospital and long-term outcomes than men, especially among women who received PCI as the initial mode of revascularization. Women who underwent PCI were more likely to be admitted for heart failure during follow-up. Possible socioeconomic inequalities or a distinct pathobiology of cardiac ischemia between sexes may underlie these results; thus, further investigation is needed.

Introduction: Regular physical exercise is believed to counteract the adverse physiological consequences of aging. However, smart fitness equipment specifically designed for older adults is quite rare. Here we designed an exergame-integrated internet of things (IoT)-based ergometer system (EIoT-ergo) that delivers personalized exercise prescriptions for older adults. First, physical fitness was evaluated using the Senior Fitness Test (SFT) application. Then, radio frequency identification (RFID) triggered the EIoT-ergo to deliver the corresponding exercise session based on the individual level of physical fitness. The exercise intensity during each workout was measured to generate the next exercise session. Further, EIoT-ergo provides an exergame to help users control and maintain their optimal cadence while engaging in exercise. Methods: This was a randomized controlled trial with 1:1 randomization. Participants were older adults, 50+ years of age (N = 35), who are active in their community. Participants in the EIoT-ergo group received a 12-week personalized exercise program delivered by EIoT-ergo for 30 min per session, with 2 sessions per week. Participants in the control group continued with their usual activities. A senior’s fitness test and a health questionnaire were assessed at baseline and at a 13-week reassessment. The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) was used to evaluate the satisfaction of EIoT-ergo. Results: Compared with the control group, the EIoT-ergo group showed significant improvements in muscle strength (time-by-group interaction, sit-to-stand: β = 5.013, p < 0.001), flexibility (back stretch: β = 4.008, p = 0.005; and sit-and-reach: β = 4.730, p = 0.04), and aerobic endurance (2-min step: β = 9.262, p = 0.03). The body composition was also improved in the EIoT-ergo group (body mass index: β = −0.737, p < 0.001; and skeletal muscle index: β = 0.268, p = 0.03). Satisfaction with EIoT-ergo was shown in QUEST, with an average score of 4.4 ± 0.32 (5 for very satisfied). The percentage maximum heart rate in each session also indicated that EIoT-ergo can gradually build up the exercise intensity of users. Conclusions: EIoT-ergo was developed to provide personal identification, exergames, intelligent exercise prescriptions, and remote monitoring, as well as to significantly enhance the physical fitness of the elderly individuals under study.