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Point-of-care ultrasound (PoCUS) has high sensitivity and specificity in diagnosing uncomplicated colonic diverticulitis in Western patients. Evidence regarding the accuracy of PoCUS in Asian patients in which diverticulitis frequently occurs in the right-side colon is lacking. This multicenter, 10-y study was aimed at evaluating the diagnostic accuracy of PoCUS in various locations of uncomplicated diverticulitis among Asians. A convenience sample of patients with suspected colonic diverticulitis who had undergone computed tomography (CT) were eligible. Patients undergoing PoCUS before CT were included. The primary outcome was the diagnostic accuracy of PoCUS in the various locations, compared with the final diagnosis made by the expert physicians. The sensitivity, specificity, positive predictive value and negative predictive value were computed. The logistic regression model was used to investigate the possible factors related to the accuracy of PoCUS. A total of 326 patients were included. The overall accuracy of PoCUS was 92% (95% confidence interval [CI]: 89.1%–95.0%) and was lower in the cecum (84.3%, 95% CI: 77.8%–90.8%), compared with other locations (p < 0.0001). Nine of 10 false positives had the final diagnosis of appendicitis: 5 had an outpouching structure whose origin in the cecum could not be traced and 4 had elongated "diverticula." Moreover, body mass index was negatively associated with the accuracy of PoCUS in cecal diverticulitis (odds ratio: 0.79, 95% CI: 0.64–0.97) after adjusting for other covariates. Point-of-care ultrasound exhibits high diagnostic accuracy in diagnosing uncomplicated diverticulitis in the Asian population. However, the accuracy varies according to location, and was relatively low in the cecum. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the characteristics of patients after free falls at the Level-I trauma centers. The factors associated with survival were differentiated.Methods: This retrospective study was conducted at the National Taiwan University Hospital, the Hsin-Chu branch, and the Yun-Lin branch, all accredited as Level-I trauma centers between January 2010 and September 2020. Adult patients with falls from height of more than one story (i.e. 3.6 m) were included. Clinical data were obtained from electronic medical records. Odds ratios (OR) were computed with 95% confidence intervals (CIs) for significant parameters for survival.Results: A total of 371 patients were included. Only 2 survived to discharge with poor neurologic outcomes in 101 patients with OHCA. The overall mortality rate was 98% and 11% in patients with and without OHCA. A higher falling height with a one-meter increase (OR, 1.14, 95% CI, 1.10-1.19) was significantly related to OHCA, especially the height over 6 m (OR, 3.07, 95% CI, 1.19-7.94). A higher trauma injury severity score (TRISS) was significantly related to survival among patients without OHCA (OR, 1.07, 95% CI, 1.04-1.11), especially TRISS≧0.945 (OR, 5.21, 95% CI, 1.28-21.24). Patients without severe head/neck injury of Abbreviated Injury Scale (AIS)≧3 (OR, 0.17, 95% CI, 0.07-0.42) were positively associated with survivors among patients without OHCA.Conclusion: Patients with traumatic OHCA following falls had a high mortality rate of 98% and dismal outcomes, compared with non-traumatic OHCA. Falling heights, especially over 6 m was associated with OHCA. Patients without OHCA had a mortality rate of 11%. Patients with a higher TRISS, especially more than 0.945, or without severe head injury had more chances to survive in the non-OHCA group. The study provided the evidence to guide termination of high futility resuscitation for traumatic OHCA secondary to falls to conserve the clinical resources. [ABSTRACT FROM AUTHOR]

Abstract: This study aims to understand the status quo and changes of juvenile cybercrimes. Online lifestyle variables in Taiwan can serve as good predictors of juvenile cybercrime. Based on an analysis of the results, this study proposes a number of effective recommendations and guidelines for parents, schools, and institutions striving to prevent and reduce cybercrimes. [Copyright &y& Elsevier]

• A lever viscoelastic wall (LVEW) that has VE and friction dampers in a device was proposed. • The LVEW amplifies the frame lateral displacement and damper force to the frame structure. • Three full-scale wall specimens were tested to validate the cyclic response. • An iterative procedure was proposed to obtain the displacement amplification for VE dampers. This paper presents a new steel wind- and seismic-resisting wall, called a lever viscoelastic wall (LVEW) that includes a velocity-dependent VE damper and a displacement-dependent friction damper in a device, characterized by two different motion phases. In Phase one motion (i.e., small drifts), the VE damper which is activated by a lever delivers amplified lateral force and energy dissipation to the frame structure. In Phase two motion (i.e., medium-to-large drifts), the VE damper is constrained by a stopper and the friction damper, instead, is activated to provide frictional energy dissipation to the frame. The damping is provided by incorporating VE material and sliding friction in a wall configuration, reducing both the wind and earthquake responses of structures in a single unit. The objectives of the work were to (1) develop the force transfer mechanism and kinematics of the LVEW, (2) verify the cyclic response of LVEWs at low and large drifts, and (3) evaluate the limitation of LVEWs for the applications. Three full-scale LVEW specimens were designed and tested to validate the hysteretic response in two motion phases. The hysteretic response of LVEWs obtained from the test was compared to that from the analytical formulation. [ABSTRACT FROM AUTHOR]

A thermophilic glycoside hydrolase family 16 (GH16) β-1,3-1,4-glucanase from Clostridium thermocellum (CtLic16A) holds great potentials in industrial applications due to its high specific activity and outstanding thermostability. In order to understand its molecular machinery, the crystal structure of CtLic16A was determined to 1.95 Å resolution. The enzyme folds into a classic GH16 β-jellyroll architecture which consists of two β-sheets atop each other, with the substrate-binding cleft lying on the concave side of the inner β-sheet. Two Bis–Tris propane molecules were found in the positive and negative substrate binding sites. Structural analysis suggests that the major differences between the CtLic16A and other GH16 β-1,3-1,4-glucanase structures occur at the protein exterior. Furthermore, the high catalytic efficacy and thermal profile of the CtLic16A are preserved in the enzyme produced in Pichia pastoris , encouraging its further commercial applications. [ABSTRACT FROM AUTHOR]