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DNA damage and oncogenic viruses increase the risk of cancer post-kidney transplantation, including skin cancer, Kaposi's sarcoma, oral cancer, and non-Hodgkin lymphoma. Here we report an uncommon case of liver angiosarcoma that occurred 8 years after kidney transplantation. This study strictly complied with the Helsinki Congress and the Istanbul Declaration regarding donor source.A 57-year-old female patient received a cadaver kidney transplantation 8 years ago. She followed a long-term regimen of tacrolimus, mycophenolate sodium, and everolimus, with good renal function. She received annual regular abdominal ultrasound examinations after kidney transplantation, which showed no findings. The patient suffered from several symptoms for approximately 2 weeks before a scheduled abdominal ultrasound: diarrhea, epigastric pain, abdominal fullness, tea-colored urine, and little stool passage. The abdominal computerized tomography showed multiple hepatic tumors in both the hepatic lobes with engorged vasculatures and mild hemoperitoneum. A liver biopsy revealed the histopathology of angiosarcoma. The patient suffered multiple organ failure within one month of treatment.Various post-transplant malignancies are not uncommon after transplantation, warranting periodic screenings for any symptoms in these patients.

Antimicrobial drug resistance is one of the major threats to global health. It has made common infections increasingly difficult or impossible to treat, and leads to higher medical costs, prolonged hospital stays and increased mortality. Infection rates due to multidrug-resistant organisms (MDRO) are increasing globally. Active agents against MDRO are limited despite an increased in the availability of novel antibiotics in recent years. This guideline aims to assist clinicians in the management of infections due to MDRO. The 2019 Guidelines Recommendations for Evidence-based Antimicrobial agents use in Taiwan (GREAT) working group, comprising of infectious disease specialists from 14 medical centers in Taiwan, reviewed current evidences and drafted recommendations for the treatment of infections due to MDRO. A nationwide expert panel reviewed the recommendations during a consensus meeting in Aug 2020, and the guideline was endorsed by the Infectious Diseases Society of Taiwan (IDST). This guideline includes recommendations for selecting antimicrobial therapy for infections caused by carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, carbapenem-resistant Enterobacterales, and vancomycin-resistant Enterococcus. The guideline takes into consideration the local epidemiology, and includes antimicrobial agents that may not yet be available in Taiwan. It is intended to serve as a clinical guide and not to supersede the clinical judgment of physicians in the management of individual patients.

Increasing the charge separation and the utilization efficiency of sunlight are essential factors in a photocatalytic process. In this study, we prepared crystalline N-CQDs@W18O49 heterostructures, through the in situ growth of W18O49 nanocrystals on nitrogen-doped carbon quantum dots (N-CQDs). N-CQDs@W18O49 nanocomposites showed high activity in the photodegradation of ciprofloxacin (CIP) and methyl orange (MO). The photodegradation activity of the optimized N-CQDs@W18O49-5 sample was four times higher than that of W18O49 under ultraviolet-visible (UV–vis) light irradiation. The photodegradation activity of N-CQDs@W18O49-5 sample was two times higher than that of W18O49 under near-infrared (NIR) light irradiation. The enhanced photosensitivity of the nanocomposites was attributed to the promotion of charge separation by N-CQDs and the local surface plasmon resonance (LSPR) effect of W18O49 under NIR light irradiation. This work provides a promising approach for designing and manufacturing photocatalysts with full-spectral responsiveness and improved charge separation.

Building detection is a critically important task in the field of remote sensing and it is conducive to urban construction planning, disaster survey, shantytown modification, and emergency landing, it etc. However, few studies have focused on the task of the clustered building detection which is inescapable and challenging for some relatively low space resolution images. The appearance structures of those buildings are not clear enough for the single-building detection. Whereas, it has been found that the distributions of clustered buildings are mostly dense and cellular, while the backgrounds are not. This clue will be beneficial to the clustered building detection. Motivated by the fact above and other similar density estimation applications, this work mainly focuses on the information mining mechanism of dense and cellular structure. Firstly, we propose a concept of Clustered Building Detection (CBD), which contributes to develop clustered building detection techniques of remote sensing images. Secondly, a saliency estimation algorithm is proposed to mine the prior information for the clustered buildings. Thirdly and most notably, combining with the CBD and the density saliency map, a Population Capacity Estimation (PCE) method is presented. The PCE can be easily used to estimate the population carrying capacity of certain areas and future applied for national land resource management. Moreover, a Clustered Building Detection Dataset (CBDD) from Gaofen-2 satellite is annotated and contributed for the public research. The experimental results by the representative detection algorithms manifest the effectiveness for the clustered building detection.

Background: The literature emphasizes the importance of matching the demand and supply of endocrinology and metabolism (EM) specialists. This study analyzed the current status of EM specialists in Taiwan. The gender effects on the workplace of EM specialists were also evaluated. Methods: The number of internal medicine (IM) specialists was obtained from the websites of the Ministry of Health and Welfare. Data about EM specialists were retrieved from the database of the Endocrine Society of the Republic of China (ESROC; Taiwan). Differences in age distribution and workplace levels or locations between female and male EM specialists were analyzed. Results: Since 1988, 809 physicians were certified as EM specialists. The average age of 739 EM specialists (509 male, 230 female) who remained as active members of the ESROC was 49.9 ± 11.1 years. The age distribution (p

We analyzed particulate matter (PM10 and PM2.5) from 4 urban sites (Wuwei, Zhangye, Jiuquan and Dunhuang) located on the Silk Road of Northwest China in summer and winter of 2018 for water-soluble ions, carbonaceous aerosols and heavy metals. The focus was to examine patterns in mass concentration, chemical nature and predominant sources. The average concentrations of PM10 and PM2.5 in this region were in the range of 112–152 μg/m3 and 70–81 μg/m3, respectively, and water-soluble inorganic ions (WSIIs) and mineral dust were the two main species of PM. PM10 and PM2.5 showed a relatively homogeneous spatial distribution in this area. The ratios of chemical composition and the enrichment factors of heavy metals were also analyzed. Four sources were identified by the positive matrix factorization (PMF) model. Dust and secondary inorganic aerosols were the dominant PM10 and PM2.5 contributors, respectively, accounting for 32.2% for PM10 and 34.7% for PM2.5. The contribution of dust and factory combustion emission sources to PM2.5 in this region was higher than that in the North, East and South regions of China, while that of secondary inorganic aerosol sources was relatively lower than in these other areas. The backward-trajectory model revealed that high PM pollution was related to the air masses from adjacent polluted regions in Inner Mongolia and was characterized by high PM contributions from secondary aerosols.

Ankle arthrodesis (AA) and total ankle arthroplasty (TAA) are the 2 primary surgical treatments for patients with end-stage ankle arthritis. The comparative outcomes between AA and TAA using modern techniques remain unclear. A systematic search to identify all relevant articles comparing AA with TAA was conducted through 3 online databases. The clinical outcomes were extracted for meta-analysis, including AOFAS (American Orthopaedic Foot & Ankle Society) score, VAS (visual analog scale), AOS (Ankle Osteoarthritis Scale), gait analysis, ROM (range of motion), satisfaction, complication, and reoperation. Our meta-analysis shows no heterogeneity in any subgroup analyses. There were no significant differences in AOFAS total, pain, and alignment scores between the AA and TAA groups. The TAA group had significant improvement in AOFAS function score compared with the AA group. There was no significant difference in VAS and AOS total scores between the 2 groups. No significant differences in gait analysis were observed between the 2 groups. The TAA group had significant improvement in both ROM and change in ROM compared with the AA group. There was no significant difference in satisfaction rate between the 2 groups. The TAA group had significantly higher complication and reoperation rates compared with the AA group. Our meta-analysis provides updated evidence on clinical outcomes comparing AA with TAA using third-generation implants. The TAA group had better improvement in AOFAS function and ROM than the AA group. No significant differences in pain relief, gait analysis, or patient satisfaction were observed between the 2 groups.

Large-scale production of an antibacterial hydrogel is of critical importance for its practical application in biomedical field. In this regard, herein we report on the construction of a double-syringe injection device by using all the commercial parts and its use for continuous production of carboxymethyl chitosan-zinc (CMCh-Zn) supramolecular hydrogel fiber. The resultant CMCh-Zn hydrogel fibers exhibit good stretchability and knittability. The Zn loading into the hydrogel fibers can be easily controlled by adjusting the concentration of Zn2+ solution. Scanning electron microscope measurements indicate that the CMCh-Zn hydrogel fibers have a relatively smooth and thin skin layer, as well as, a 3-dimensional interconnected microporous interior architecture. Antibacterial activities of the CMCh-Zn hydrogel fibers against both Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli are also investigated. The results show that the intrinsic blue fluorescence of the as-prepared CMCh-Zn hydrogel fibers can be employed as optical indicator of their antibacterial effectiveness.