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Background Current American Heart Association Pediatric Life Support (PLS) guidelines do not recommend the routine use of sodium bicarbonate (SB) during cardiac arrest in pediatric patients. However, SB administration during pediatric resuscitation is still common in clinical practice. The objective of this study was to assess the impact of SB on mortality and neurological outcomes in pediatric patients with in-hospital cardiac arrest. Methods We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials from inception to January 2021. We included studies of pediatric patients that had two treatment arms (treated with SB or not treated with SB) during in-hospital cardiac arrest (IHCA). Risk of bias was assessed using the Newcastle-Ottawa Scale and the certainty of evidence was assessed using GRADE system. Results We included 7 observational studies with a total of 4877 pediatric in-hospital cardiac arrest patients. Meta-analysis showed that SB administration during pediatric cardiac resuscitation was associated with a significantly decreased rate of survival to hospital discharge (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.25–0.63, p value = 0.0003). There were insufficient studies for 24-h survival and neurologic outcomes analysis. The subgroup analysis showed a significantly decreased rate of survival to hospital discharge in both the “before 2010” subgroup (OR 0.47; 95% CI 0.30–0.73; p value = 0.006) and the “after 2010” subgroup (OR 0.46; 95% CI 0.25–0.87; p value = 0.02). The certainty of evidence ranged from very low to low. Conclusions This meta-analysis of non-randomized studies supported current PLS guideline that routine administration of SB is not recommended in pediatric cardiac arrest except in special resuscitation situations. Trial registration The protocol was registered with PROSPERO on 8 August 2020 (registration number: CRD42020197837).

Background The 2010 Advanced Cardiac Life Support guidelines stated that routine sodium bicarbonate (SB) use for cardiac arrest patients was not recommended. However, SB administration during resuscitation is still common. Objectives To evaluate the effect of SB on return of spontaneous circulation (ROSC) and survival-to-discharge rates in adult cardiac arrest patients. Methods We searched Medline, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to December 2019. We included trials on nontraumatic adult patients after cardiac resuscitation and SB treatment vs. controls. Results A meta-analysis was performed with six observational studies, including 18,406 adult cardiac arrest patients. There were no significant differences in the ROSC rate (odds ratio [OR] 1.185; 95% confidence interval [CI] 0.680–2.065) and survival-to-discharge rate (OR 0.296; 95% CI 0.066–1.323) between the SB and no-SB groups. In the subgroup analysis based on the year factor, there were no significant differences in the mortality rate in the After-2010 group. In the subgroup analysis based on the continent, the ROSC rate (OR 0.521; 95% CI 0.432–0.628) and survival-to-discharge rate (OR 0.102; 95% CI 0.066–0.156) were significantly lower in the North American group. Conclusions SB use was not associated with improvement in ROSC or survival-to-discharge rates in cardiac resuscitation. In addition, mortality was significantly increased in the North American group with SB administration.

Necrotizing fasciitis is a severe soft-tissue infection with a high mortality rate. There is little literature on the relationship between the ultrasonographic finding of fluid accumulation along the deep fascia and the diagnosis and prognosis of necrotizing fasciitis. This retrospective study showed that when fluid accumulation was present along the deep fascia, patients with clinically suspected necrotizing fasciitis had a higher probability of having necrotizing fasciitis. The ultrasonographic finding of fluid accumulation with a cutoff point of more than 2 mm of depth had the best accuracy (72.7%) for diagnosing necrotizing fasciitis. In regard to the prognosis of necrotizing fasciitis, when fluid accumulation was present along the deep fascia, patients with necrotizing fasciitis had a longer length of hospital stay and were at risk of amputation or mortality. Ultrasonography is a point-of-care imaging tool that facilitates the diagnosis and prognosis of necrotizing fasciitis.

Abdominal obesity is an independent risk factor for cardiovascular disease and chronic kidney disease (CKD). Visceral adiposity index (VAI), a simple formula representing visceral adipose dysfunction, has already been proven to have a strong correlation with various cardiometabolic disorders. Limited studies are available regarding the relationship between VAI and renal function decline. Therefore, the purpose of this study was to evaluate the relationship between VAI and renal function and to estimate the risk of chronic kidney disease in a relatively healthy adult population in Taiwan.The design of the study is retrospective cross-sectional analysis.This study involved 23,570 subjects aged ≥18 years who underwent annual heath checkups between January and December 2013. A multivariate logistic regression model was used to assess the relationship between VAI and CKD. Receiver-operating characteristic curve and Youden index were developed to determine the discrimination power of VAI for metabolic syndrome and CKD.None, observational study.The main outcome measure of this study was CKD.In our study, the adjusted odds ratio (OR) of abnormal VAI for CKD was 1.5 (95% confidence interval [CI], 1.08-2.08; P = .016) in all subjects. A higher VAI was superior in association with CKD in men than women (OR, 1.62; 95% CI, 1.13-2.32; P = .009 vs. OR, 1.28; 95% CI, 0.66-2.47; P = .469, respectively). The area under the curve for VAI was 0.694 (95% CI, 0.660-0.729; P .001), and using a Youden index with a cut-off VAI value of 2.96 for CKD discrimination obtained a sensitivity of 67.7% and specificity of 65.1%.A higher VAI score was associated with increased risks of CKD. VAI would be an applicable tool for early detection of CKD in relatively healthy adults in Taiwan, especially men.

In this work, silver (Ag) precursors with different thicknesses were sputtered on the surfaces of CuIn alloys, and (AgCu)InSe2 (ACIS) films were formed after selenization at 550 °C under nitrogen condition using a rapid thermal process furnace. The structure and electrical properties of the ACIS films were investigated. The result showed that the distribution of Ag+ ion was more uniform with increasing the thickness of Ag precursor, and the surface of the thin-film became more homogeneous and denser. When Ag/Cu ratio ≥0.249, the small grain particles disappeared. The band gap can be rationally controlled by adjusting Ag content. When (Ag + Cu)/In ratio ≥ 1.15, the surface of the ACIS thin-film mainly exhibited n-type semiconductor. Through the photoelectrochemistry measurement, it was observed that the incorporation of Ag+ ions could improve photocurrent by adjusting the band gap. With the Ag precursor thickness increased, the dark current decreased at the more negative potential.

We measured the typical developmental trajectory of the window of audiovisual simultaneity by testing four age groups of children (5, 7, 9, and 11 years) and adults. We presented a visual flash and an auditory noise burst at various stimulus onset asynchronies (SOAs) and asked participants to report whether the two stimuli were presented at the same time. Compared with adults, children aged 5 and 7 years made more simultaneous responses when the SOAs were beyond ± 200 ms but made fewer simultaneous responses at the 0 ms SOA. The point of subjective simultaneity was located at the visual-leading side, as in adults, by 5 years of age, the youngest age tested. However, the window of audiovisual simultaneity became narrower and response errors decreased with age, reaching adult levels by 9 years of age. Experiment 2 ruled out the possibility that the adult-like performance of 9-year-old children was caused by the testing of a wide range of SOAs. Together, the results demonstrate that the adult-like precision of perceiving audiovisual simultaneity is developed by 9 years of age, the youngest age that has been reported to date.

Background: Hypoglycemia is associated with a higher risk of death. This study analyzed various body mass index (BMI) categories and mortalities of severe hypoglycemic patients with type 2 diabetes mellitus (DM) in a hospital emergency department. Methods: The study included 566 adults with type 2 diabetes who were admitted to 1 medical center in Taiwan between 2008 and 2009 with a diagnosis of severe hypoglycemia. Mortality data, demographics, clinical characteristics and the Charlson's Comorbidity Index were obtained from the electronic medical records. Patients were stratified into 4 study groups as determined by the National Institute of Health (NIH) and World Health Organization classification for BMI, and the demographics were compared using the analysis of variance and χ2 test. Kaplan-Meier's analysis and the Cox proportional-hazards regression model were used for mortality, and adjusted hazard ratios were adjusted for each BMI category among participants. Results: After controlling for other possible confounding variables, BMI

Many Chinese characters consist of two radicals and it has long been debated whether characters are decomposed into radicals during the processing of character recognition. Here we examine this issue utilizing a novel repetition blindness (RB) paradigm that provides a sensitive measure of internal representations in the early stages of processing. We found a radical-RB effect (i.e., two characters are less likely to be correctly reported when they share a common radical) for both high- and low-frequency characters (Experiment 1). Experiment 2 was to exclude the possibility that radical-RB effect can be explained by character-level similarity. Finally, the radical-RB effect was found to be robust irrespective of how frequently a radical is presented in different characters (Experiment 3). All these results suggest that radicals are represented during the processing of characters, supporting the analytic (rather than holistic) hypothesis of Chinese character recognition. A model that highlights a dynamic process of binding radicals to construct character representations is proposed.

Dioscorea japonica Thunb. var. pseudojaponica (DP) is consumed as food and widely used in traditional Chinese medicine in Taiwan. The aims of this study are to investigate the antioxidant and anti-inflammatory effects of ethanol extract of DP (EDP) and its reference compounds. Fingerprint chromatogram from HPLC indicated that EDP contains gallic acid and vanillic acid. EDP was evaluated for its antioxidant effects and LPS-induced nitrite oxide (NO) production in RAW264.7 cells. EDP decreased the LPS-induced NO production and expressions of iNOS and COX-2 in RAW264.7 cells. In-vivo anti-inflammatory activities of EDP were assessed in mouse paw oedema induced by λ-carrageenan (Carr). We investigated the antioxidant mechanism of EDP via studies of the activities of catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) and the levels of malondialdehyde (MDA) in the oedematous paw. The results showed that EDP might be a natural antioxidant and anti-inflammatory agent.

A two-step wet chemical process with economic and practical advantages was developed to prepare arrayed ZnO nanorods on glass substrates using zinc acetate dihydrate (Zn(CH3COO)2·2H2O, ZnAc2) and monoethanolamine (NH2CH2CH2OH, MEA) as raw materials. The proposed method includes the pre-deposition of a thin ZnO seed layer using the sol–gel technique and the subsequent hydrothermal growth of ZnO nanorods at 130 °C for 2 or 4 h. The synthesis process was monitored using X-ray diffraction (XRD), Fourier transformation infrared (FTIR) spectroscopy, atomic force microscopy (AFM), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The ZnO nanorods exhibited a diameter of 25–75 nm with an aspect ratio ranging from 10 to 50 after growing for 4 h. Each ZnO nanorod was confirmed to be a single crystal with a wurtzite structure and grow along the [0 0 0 2] direction during the hydrothermal process. Photoluminescence (PL) measurements confirmed that the ZnO nanorods exhibited a near-UV emission at ∼380nm together with a green emission that was centered at ∼500 nm. We note that the PL properties may be affected by the hydrothermal time.

The solubility property of high fluorine content ligands allows us to report in this article the accomplishment under the fluorous biphasic system (FBS) the Pd-catalyzed Sonogashira reactions using novel recyclable Pd catalysts with fluorous-ponytails in the structure of 2,2′-bpy ligands that are only soluble in perfluorinated solvents at room temperature. Alternatively, without using any fluorous solvent but under the thermomorphic mode, the same Pd catalysts proceed with the Cu-free Sonogashira reactions homogeneously in DMF at 135 ± 5 °C, whereas the product mixtures after reaction remain in solution and the Pd catalysts precipitate from DMF at low temperature.

Poly(HEMA) microbeads were prepared by suspension polymerization of 2-hydorxyethylmethacrylate and ethyleneglycoldimethacrylate (EGDMA). The water content, ligand density, and selectivity for poly(His)-tagged d -hydantoinase of the poly(HEMA)-based adsorbents were affected by the concentration of EDGMA used during polymerization. The Ni(II)-loaded poly(HEMA) adsorbent exhibited an adsorption capacity of 1.0 mg/g for poly(His)-tagged d -hydantoinase under optimal conditions with buffer containing 100–300 mM NaCl at pH 6.0. One-step purification protocol with the adsorbent gave a purity of at least 92%. The adsorption capacity of adsorbent declined by 54% after 7 cycles, due to the leaching of Ni(II) from the adsorbent. However, upon regeneration the adsorption capacity can be restored. Given the ease of preparation and the chemical and microbial resistance, the poly(HEMA)-based IMAC adsorbent could be a promising substitute for the polysaccharide-based IMAC adsorbents.

Recombinant Escherichia coli cells expressing d -hydantoinase were used as the biocatalysts for the production of N-carbamoyl- d -hydroxyphenylglycine from dl -p-hydroxyphenylhydantoin. Although high concentrations of DMSO could lead to enzyme denaturation, in the presence of 1.5% DMSO, the rate of product formation increased by more than 80% due to enhanced permeability of the cell membrane and increased substrate concentration. Reduced mass transfer resistance, achieved by the permeabilization of cell membrane with CTAB and glutaraldehyde, led to a 60% increase in the rate of production. However, in addition to causing a shift of optimal pH toward lower pH, permeabilization of the cell membrane resulted in reduced enzyme stability toward thermal and organic denaturation. Nevertheless, the stability of the d -hydantoinase of the recombinant cells toward pH, temperature and organic solvents can be significantly enhanced by immobilization.

Recombinant Escherichia coli BL21 (DE3) harbouring plasmid pET36 encoding d -hydantoinase from Pseudomonas putida were used as biocatalyst for the production of N -carbamoyl- d -hydroxyphenylglycine from dl - p -hydroxyphenylhydantoin. The optimum d -hydantoinase activity was observed at 40°C and pH 8.5. At a substrate concentration of 300 mg/l, an initial reaction rate of 24.52 mM/h g cells was obtained and 91% of the substrate was converted into product after a 24-h reaction. Recombinant cells were immobilized within calcium alginate beads with diameters ranging from 2 to 3 mm. The specific activity of the immobilized cells increased with cell loads, probably due to reduced mass transfer resistance. The immobilized cells also exhibited an optimal pH of 8.5. However, under the conditions described above, the initial reaction rate with the immobilized cells as the biocatalysts was reduced by 87% to 3.19 mM/h g cells, probably due to the formation of cell aggregates inaccessible to substrate. Thermostability and reusability of d -hydantoinase were increased upon immobilization. The initial reaction rate with immobilized cells was increased with temperature at least up to 60°C. More than 95% of the d -hydantoinase activity was recovered after three cycles for the immobilized cells, compared to 22% for the free cell systems.

A general approach for the development of HPLC methods for biosurfactant analysis and purification was proposed. By comparing the chromatograms of the cell-free fermentation broth, the ultrafiltration filtrate, and the ultrafiltration filtrate of a methanol–surfactant mixture, the peaks corresponding to biosurfactants can be identified without any prior structural information of the biosurfactants. It can be assumed that the peaks observed only on the chromatogram of the filtrate of methanol–surfactant mixture but not on the chromatogram of the filtrate are biosurfactant peaks. This approach can be applied for the development of a HPLC assay for any biosurfactants as long as the concentration of biosurfactants in the fermentation broth is higher than the critical micelle concentration. The HPLC methods thus developed can also be adapted for the preparation of homogeneous biosurfactant samples useful for chemical analysis for the elucidation of chemical structure of biosurfactants and for the determination of the physical properties of biosurfactants.