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Colonoscopy screening and colonoscopic polypectomy can decrease the incidence and mortality rate of colorectal cancer (CRC). The adenoma detection rate and accuracy of diagnosis of colorectal polyp which vary in different experienced endoscopists have impact on the colonoscopy protection effect of CRC. The work proposed a colorectal polyp image detection and classification system through grayscale images and deep learning. The system collected the data of CVC-Clinic and 1000 colorectal polyp images of Linkou Chang Gung Medical Hospital. The red-green-blue (RGB) images were transformed to 0 to 255 grayscale images. Polyp detection and classification were performed by convolutional neural network (CNN) model. Data for polyp detection was divided into five groups and tested by 5-fold validation. The accuracy of polyp detection was 95.1% for grayscale images which is higher than 94.1% for RGB and narrow-band images. The diagnostic accuracy, precision and recall rates were 82.8%, 82.5% and 95.2% for narrow-band images, respectively. The experimental results show that grayscale images achieve an equivalent or even higher accuracy of polyp detection than RGB images for lightweight computation. It is also found that the accuracy of polyp detection and classification is dramatically decrease when the size of polyp images small than 1600 pixels. It is recommended that clinicians could adjust the distance between the lens and polyps appropriately to enhance the system performance when conducting computer-assisted colorectal polyp analysis.

(1) Background: Physiological changes in nasal patency in response to posture contribute to sleep-related problems. Previously, we reported that the supine and prone positions cause a significant decrease in nasal patency in subjective and objective assessments of healthy individuals. Therefore, we conducted a study to evaluate the effect of posture on nasal patency in patients with allergic rhinitis (AR); (2) Methods: The present study comprised 30 patients diagnosed with AR and 30 healthy subjects without nasal disease (non-AR). Changes in nasal patency were evaluated in the sitting, supine, and prone positions. We used the visual analog scale to evaluate subjective nasal blockage. Acoustic rhinometry and endoscopy were used to objectively measure changes in nasal patency; (3) Results: In the non-AR group, the prone position had a significant effect on subjective nasal blockage compared with the sitting position, with significant decreases in the minimal cross-sectional area (mCSA) measured by acoustic rhinometry. Furthermore, endoscopy demonstrated a significantly increased inferior turbinate hypertrophy in the non-AR group. In the AR group, there was no statistical difference in subjective nasal blockage symptoms between the different positions. However, in objective examinations (acoustic rhinometry and endoscopy), the prone position showed significantly decreased nasal patency; (4) Conclusions: In patients with AR, subjective nasal blockage did not significantly increase in the supine or prone position. Endoscopy demonstrated increased inferior turbinate hypertrophy in supine and prone positions resulting in a significant reduction in nasal cavity mCSA, indicating an objective reduction in nasal patency.

Breast cancer is a significant public health problem globally and prevention strategies have become of great interest as its incidence rises. Exploring the connection between dietary patterns and the reduction of breast cancer risk is considered a promising approach. High levels of fiber, phytochemicals, a good antioxidant profile, and a composition of advantageous fatty acids are characteristics of healthy dietary programs such as the Mediterranean diet. This review summarized and discussed the active compounds that are considered important in preventing breast cancer, including dietary components from recent related reports. These include polyunsaturated fatty acids, fiber, phytochemicals, and alcohol. Although the exact mechanism for preventing breast cancer using these dietary factors is not well understood, the combination of all the elements in a healthy diet plays a role in reducing breast cancer risk. Considering the elevated probability of breast cancer relapse and mortality, it is crucial to investigate the correlation between a nutritious dietary pattern and breast cancer, while identifying bioactive components that have the potential to mitigate the risk of breast cancer incidence.

Acute epiglottitis (AE) is a potential emergency of the respiratory tract caused mainly by bacterial infection. However, nonbacterial infection causes, such as corrosive injuries, may result in death due to gastrointestinal perforation if a timely diagnosis is not available. We report the case of an elderly patient with an acute melancholic episode who encountered corrosive epiglottitis (CE) caused by accidental ingestion of hydrochloric acid and compare the features of CE and AE, including the immediate onset of symptoms, normal findings on blood tests, and endoscopy revealing pale swollen epiglottitis. This case can prove to be an important reference for clinicians for differential diagnosis, especially when treating epiglottitis in patients with psychiatric disorders and unclear expression.

The purpose of this study is to establish a method of hazard assessment for the river terraces along the Chenyulan River and use 40 of them as protected objects. Using a geographic information system, the researchers extracted nine parameters for such terraces. These are length to attack shore, distance away from fault, distance from river channel, number of creeks and streams with possibility of debris flows, height above stream level, average slope degree, geology, number of erosion ditches, and distance from landslide area behind. Next, the weightings identified by analytic hierarchy process analysis were used as the basis for grading the various factors affecting river terraces. Hazard assessment for the river terraces then proceeded via totaling of the potential trends of the various factors and the protected objects, as well as comparison of historical disaster conditions and satellite images. The results showed that there were 8 high-risk river terraces, 14 medium–high-risk river terraces, 14 medium–low-risk river terraces and 4 low-risk river terraces. The evaluation of the current conditions of the settlement environment through parameter weighting has a certain accuracy and reference value in reducing the disaster impact of the riverine terrace settlement.

Surface roughness and machining accuracy are essential indicators of the quality of parts in milling. With recent advancements in sensor technology and data processing, the cutting force signals collected during the machining process can be used for the prediction and determination of the machining quality. Deep-learning-based artificial neural networks (ANNs) can process large sets of signal data and can make predictions according to the extracted data features. During the final stage of the milling process of SUS304 stainless steel, we selected the cutting speed, feed per tooth, axial depth of cut, and radial depth of cut as the experimental parameters to synchronously measure the cutting force signals with a sensory tool holder. The signals were preprocessed for feature extraction using a Fourier transform technique. Subsequently, three different ANNs (a deep neural network, a convolutional neural network, and a long short-term memory network) were applied for training in order to predict the machining quality under different cutting conditions. Two training methods, namely whole-data training and training by data classification, were adopted. We compared the predictive accuracy and efficiency of the training process of these three models based on the same training data. The training results and the measurements after machining indicated that in predicting the surface roughness based on the feed per tooth classification, all the models had a percentage error within 10%. However, the convolutional neural network (CNN) and long short-term memory (LSTM) models had a percentage error of 20% based on the whole-data training, while that of the deep neural network (DNN) model was over 50%. The percentage error for the machining accuracy prediction based on the whole-data training of the DNN and CNN models was below 10%, while that of the LSTM model was as large as 20%. However, there was no significant improvement in the results of the classification training. In all the training processes, the CNN model had the best analytical efficiency, followed by the LSTM model. The DNN model performed the worst.

(1) Background: Little is known about the subsequent renal function change following incident infectious diseases in living-donor liver transplant (LT) recipients. (2) Methods: We studied patients who underwent living-donor LT from January 2003 to January 2019 to evaluate the association of incident hospitalization with major infections or pneumonia with adverse renal outcomes, including a sustained 40% reduction in estimated glomerular filtration rate (eGFR) and renal composite outcome (a 40% decline in eGFR, end-stage renal disease, or death.). Multivariable-adjusted time-dependent Cox models with infection as a time-varying exposure were used to estimate hazard ratio (HR) with 95% confidence interval (CI) for study outcomes. (3) Results: We identified 435 patients (mean age 54.6 ± 8.4 years and 76.3% men), of whom 102 had hospitalization with major infections during follow-up; the most common cause of infection was pneumonia (38.2%). In multiple Cox models, hospitalization with a major infection was associated with an increased risk of eGFR decline > 40% (HR, 3.32; 95% CI 2.13–5.16) and renal composite outcome (HR, 3.41; 95% CI 2.40–5.24). Likewise, pneumonia was also associated with an increased risk of eGFR decline > 40% (HR, 2.47; 95% CI 1.10–5.56) and renal composite outcome (HR, 4.37; 95% CI 2.39–8.02). (4) Conclusions: Our results illustrated the impact of a single infection episode on the future risk of adverse renal events in LT recipients. Whether preventive and prophylactic care bundles against infection and judicious modification of the immunosuppressive regimen benefit renal outcomes may deserve further study.

Although boron neutron capture therapy (BNCT) is a promising treatment option for malignant brain tumors, the optimal BNCT parameters for patients with immediately life-threatening, end-stage brain tumors remain unclear. We performed BNCT on 34 patients with life-threatening, end-stage brain tumors and analyzed the relationship between survival outcomes and BNCT parameters. Before BNCT, MRI and 18F-BPA-PET analyses were conducted to identify the tumor location/distribution and the tumor-to-normal tissue uptake ratio (T/N ratio) of 18F-BPA. No severe adverse events were observed (grade ≥ 3). The objective response rate and disease control rate were 50.0% and 85.3%, respectively. The mean overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) times were 7.25, 7.80, and 4.18 months, respectively. Remarkably, the mean OS, CSS, and RFS of patients who achieved a complete response were 17.66, 22.5, and 7.50 months, respectively. Kaplan–Meier analysis identified the optimal BNCT parameters and tumor characteristics of these patients, including a T/N ratio ≥ 4, tumor volume &lt, 20 mL, mean tumor dose ≥ 25 Gy-E, MIB-1 ≤ 40, and a lower recursive partitioning analysis (RPA) class. In conclusion, for malignant brain tumor patients who have exhausted all available treatment options and who are in an immediately life-threatening condition, BNCT may be considered as a therapeutic approach to prolong survival.

(1) Background: Sleep apnea may be a risk factor for deep neck infection (DNI). The objective of this study was to investigate the effects of sleep apnea on DNI. (2) Methods: In this first nationwide retrospective cohort study on the sleep apnea–DNI correlation, we obtained data from the Longitudinal Health Insurance Database 2005, a subset of the Taiwan National Health Insurance Research Database. Patients who were newly diagnosed with sleep apnea between 1997 and 2012 were identified, and patients without sleep apnea were matched at a 1:4 ratio in age, sex, socioeconomic status, and urbanization level. The primary outcome of this study was DNI occurrence. The treatment modalities for sleep apnea and the comorbidities that occurred during the study period were also analyzed. (3) Results: Our sleep apnea and comparison (non-sleep apnea) cohorts comprised 6114 and 24,456 patients, respectively. We compared the cumulative incidence of DNI between these cohorts and found a greater incidence of DNI in the sleep apnea cohort (p &lt, 0.001). A strong sleep apnea–DNI association was found following analysis via the adjusted Cox proportional-hazards model (full model hazard ratio, 1.71, 95% confidence interval, 1.28–2.28, p &lt, 0.001). In the subgroup analysis, sleep apnea increased DNI risk in men, in those aged &lt, 50 years, and in those without diabetes mellitus, end-stage renal disease, liver cirrhosis, autoimmune disease, obesity, tonsillectomy, or adenotonsillectomy. (4) Conclusions: Our results confirmed sleep apnea to be an independent risk factor for DNI. Physicians should be aware of the potential occurrence of DNI in patients with sleep apnea.

Bone resorption around implants is quite common, and the maturity and popularization of computer-aided design and computer-aided manufacturing (CAD/CAM) technology have made the use of aftermarket abutment screws more widespread. This study aimed to explore the biomechanical influence of these two common factors on the internal stress of an implant system using three-dimensional finite element analysis (3D FEA). The FEA results indicated that under the same loading conditions, the use of an aftermarket screw had the greatest impact on the screw itself among the three components of the implant system, while the maximum stress increased by 6.3% and 10.5% in the bone integrity and bone loss models, respectively. Moreover, the marginal bone loss models had the greatest impact on the implant fixture, with a maximum stress increase of 51.8% on average. Evidently, the influence of bone loss might be far greater than that of the aftermarket screw; however, any factor could be enough to cause clinical failure. Therefore, we should pay more attention to the maintenance of the long-term peri-implant marginal bone integrity.

To develop a method of estimating surface dose in whole breast irradiation, we used an anthropomorphic phantom with accessories for the simulation of different breast sizes. The surface points, which are measured by TLDs, are set along with two main directions, superior-inferior and medial-lateral. The incident angle between the photon beam and the surface and the doses at 1 cm beneath the surface at every point are assessed by a computerized treatment planning system (cTPS). With the prescription dose of 200 cGy, the average surface doses under tangential irradiation are 97.73 (±14.96) cGy, 99.90 (±10.73) cGy, and 105.26 (±9.21) cGy for large, medium, and small breast volumes, respectively. The surface dose increased in the model of small breast volume without significance (p = 0.39). The linear analysis between surface dose and the incident angle is y = 0.5258x + 69.648, R2 = 0.7131 (x: incident angle and y: surface dose). We develop the percentage of skin surface dose with reference to a depth of 1 cm (PSDR1cm) to normalize the inhomogeneous dose. The relationship between incident angle and PSDR1cm is y = 0.1894x + 36.021, R2 = 0.6536 (x: incident angle and y: PSDR1cm) by linear analysis. In conclusion, the surface dose in whole breast irradiation could be estimated from this linear relationship between PSDR1cm and incident angle in daily clinical practice by cTPS. Further in vivo data should be studied to verify this formula.

This research proposed a novel global maximum power point tracking (global-MPPT) algorithm. The proposed algorithm eliminates the perturbation and observation (P&O) technique disturbance problem that the power point will be stuck at the local peak power point under a partial shading condition (PSC). The proposed global-MPPT algorithm detects the photovoltaic module (PV-M) environment irradiance level by the relationship between the output power and voltage of the PV-M. In the proposed algorithm, the important parameter w is determined by the PV-M output power and irradiance level, which is also the compensation parameter that corresponds to the relationship of temperature. The proposed global-MPPT algorithm is aimed to predict the best duty cycle of the global-MPPT based on the irradiance level, parameter w, PV-M output voltage, and load, and then achieve the maximum power point (MPP) quickly and accurately. The measurement results under UIC and PSC verify that the proposed global-MPPT technique performs better than the particle swarm optimization (PSO) and P&O techniques. This research contributes to the proposed method that can find the global-MPP in time based on the irradiance level, temperature, and load.

Semantic segmentation of medical images with deep learning models is rapidly being developed. In this study, we benchmarked state-of-the-art deep learning segmentation algorithms on our clinical stereotactic radiosurgery dataset. The dataset consists of 1688 patients with various brain lesions (pituitary tumors, meningioma, schwannoma, brain metastases, arteriovenous malformation, and trigeminal neuralgia), and we divided the dataset into a training set (1557 patients) and test set (131 patients). This study demonstrates the strengths and weaknesses of deep-learning algorithms in a fairly practical scenario. We compared the model performances concerning their sampling method, model architecture, and the choice of loss functions, identifying suitable settings for their applications and shedding light on the possible improvements. Evidence from this study led us to conclude that deep learning could be promising in assisting the segmentation of brain lesions even if the training dataset was of high heterogeneity in lesion types and sizes.

Deep neck infection (DNI) is a lethal emergent condition. Patients with types 1 and 2 diabetes mellitus (T1DM and T2DM, respectively) are predisposed to DNI and have poorer prognoses. The mainstay of the treatment is surgical drainage and antibiotics, however, the pathogenic bacteria of T1DM-DNI have not been studied before. We obtained the data of 8237 patients with DNI who were hospitalized from 2004 to 2015 from the Chang Gung Research Database, which contains multi-institutional medical records in Taiwan. Using diagnostic codes, we classified them into T1DM-DNI, T2DM-DNI, and non-DM-DNI and analyzed their pathogenic bacteria, disease severity, treatment, and prognosis. The top three facultative anaerobic or aerobic bacteria of T1DM-DNI were Klebsiella pneumoniae (KP, 40.0%), Viridans Streptococci (VS, 22.2%), and methicillin-sensitive Staphylococcus aureus (MSSA, 8.9%), similar for T2DM (KP, 32.2%, VS, 23.3%, MSSA, 9.5%). For non-DM-DNI, it was VS (34.6%), KP (9.8%), and coagulase-negative Staphylococci (8.7%). The order of anaerobes for the three groups was Peptostreptococcus micros, Prevotella intermedia, and Peptostreptococcus anaerobius. Patients with T1DM-DNI and T2DM-DNI had higher white blood cell (WBC) counts and C-reactive protein (CRP) levels, more cases of surgery, more cases of tracheostomy, longer hospital stays, more mediastinal complications, and higher mortality rates than those without DM-DNI. Patients in the death subgroup in T1DM-DNI had higher WBC counts, band forms, and CRP levels than those in the survival subgroup. Patients with DM-DNI had more severe disease and higher mortality rate than those without DM-DNI. KP and Peptostreptococcus micros are the leading pathogens for both patients with T1DM-DNI and those with T2DM-DNI. Clinicians should beware of high serum levels of infection markers, which indicate potential mortality.

Objective: To investigate the hepatoprotective mechanisms of taxifolin in mice with acute liver injury induced by CCl4. Methods: ICR (Institute of Cancer research) mice were orally pretreated using taxifolin for 7 consecutive days and were then given single intraperitoneal (i.p.) injections of 0.2% CCl4 (10 mL/kg body weight, i.p.). Liver injury was then determined using assays of serum alanine aminotransferase (sALT) and serum aspartate aminotransferase (sAST). Further, to investigate the hepatoprotective mechanisms of taxifolin, we determined malondialdehyde (MDA) levels and superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione reductase (GRd) activities. Results: CCl4-induced liver injury led to significant increases in sALT and sAST activities, and these increases were limited by taxifolin and silymarin (Sily) pretreatments. Histological analyses also indicated that taxifolin and Sily decreased the range of liver lesions in CCl4-treated mice and vacuole formation, neutrophil infiltration, and necrosis were visibly reduced. In addition, SOD, GPx, and GRd activities were increased and MDA levels were decreased after taxifolin and Sily treatments. Conclusion: The hepatoprotective mechanisms of taxifolin and Sily are related to decreases in MDA levels presumably due to increased antioxidant enzyme activities. These outcomes suggest that taxifolin mitigates acute liver injury resulted from CCl4 in mice, demonstrating the hepatoprotective effects of taxifolin.

Accelerated urbanization and the ensuing rapid increase in urban populations led to the need for a tremendous number of parking spaces. Automated parking systems coupled with new parking lot layouts can effectively address the need. However, most automated parking systems available on the market today use ultrasonic sensors to detect vacant parking spaces. One limitation of this method is that a reference vehicle must be parked in an adjacent space, and the accuracy of distance information is highly dependent on the positioning of the reference vehicle. To overcome this limitation, an around view monitoring-based method for detecting parking spaces and algorithms analyzing the vacancy of the space are proposed in this study. The framework of the algorithm comprises two main stages: parking space detection and space occupancy classification. In addition, a highly robust analysis method is proposed to classify parking space occupancy. Two angles of view were used to detect features, classified as road or obstacle features, within the parking space. Road features were used to provide information regarding the possible vacancy of a parking space, and obstacle features were used to provide information regarding the possible occupancy of a parking space. Finally, these two types of information were integrated to determine whether a specific parking space is occupied. The experimental settings in this study consisted of three common settings: an indoor parking lot, an outdoor parking lot, and roadside parking spaces. The final tests showed that the method&rsquo, s detection rate was lower in indoor settings than outdoor settings because lighting problems are severer in indoor settings than outdoor settings in around view monitoring (AVM) systems. However, the method achieved favorable detection performance overall. Furthermore, we tested and compared performance based on road features, obstacle features, and a combination of both. The results showed that integrating both types of features produced the lowest rate of classification error.

Increased dietary fiber consumption has been shown to increase human gut microbial diversity, but the mechanisms driving this effect remain unclear. One possible explanation is that microbes are able to divide metabolic labor in consumption of complex carbohydrates, which are composed of diverse glycosidic linkages that require specific cognate enzymes for degradation. However, as naturally derived fibers vary in both sugar composition and linkage structure, it is challenging to separate out the impact of each of these variables. We hypothesized that fine differences in carbohydrate linkage structure would govern microbial community structure and function independently of variation in glycosyl residue composition. To test this hypothesis, we fermented commercially available soluble resistant glucans, which are uniformly composed of glucose linked in different structural arrangements, in vitro with fecal inocula from each of three individuals. We measured metabolic outputs (pH, gas, and short-chain fatty acid production) and community structure via 16S rRNA amplicon sequencing. We determined that community metabolic outputs from identical glucans were highly individual, emerging from divergent initial microbiome structures. However, specific operational taxonomic units (OTUs) responded similarly in growth responses across individuals’ microbiota, though in context-dependent ways, these data suggested that certain taxa were more efficient in competing for some structures than others. Together, these data support the hypothesis that variation in linkage structure, independent of sugar composition, governs compositional and functional responses of microbiota.

Head and neck squamous cell carcinomas (HNSCCs) are the most common cancers of the head and neck, and their prevalence is rapidly increasing. HNSCCs present a clinical challenge because of their high recurrence rate, therapeutic resistance to radiation and chemotherapy drugs, and adverse effects. Hence, traditional Chinese herbal treatment may be advantageous to therapeutic strategies for HNSCCs. Danshen (Salvia miltiorrhiza), a well-known Chinese herb, has been extensively applied in treatments for various diseases, including cancer, because of its high degree of safety and low rate of adverse effects despite its unclear mechanism. Thus, we aimed to explore the possible anticancer effects and mechanisms of dihydroisotanshinone I (DT), a compound in danshen (extract from danshen), on HNSCCs. Three HNSCCs cell lines were used for in vitro studies, and a Detroit 562 xenograft mouse model was chosen for in vivo studies. Our in vitro results showed that DT could initiate apoptosis, resulting in cell death, and the p38 signaling partially regulated DT-initiated cell apoptosis in the Detroit 562 model. In the xenograft mouse model, DT reduced tumor size with no obvious adverse effect of hepatotoxicity. The present study suggests that DT is a promising novel candidate for anti-HNSCCs therapy.

A convolutional neural network (CNN) that was trained using datasets for multiple scenarios was proposed to facilitate real-time road semantic segmentation for various scenarios encountered in autonomous driving. However, the CNN inhibited the mutual suppression effect between weights, thus, it did not perform as well as a network that was trained using a single scenario. To address this limitation, we used a model-switching architecture in the network and maintained the optimal weights of each individual model which required considerable space and computation. We, subsequently, incorporated a lightweight process into the model to reduce the model size and computational load. The experimental results indicated that the proposed lightweight CNN with a model-switching architecture outperformed and was faster than the conventional methods across multiple scenarios in road semantic segmentation.

Background: Peritonsillar abscess (PTA) is an infectious emergency in the head and neck, and patients with end-stage renal disease (ESRD) have an immunocompromised status. However, no relevant research has focused on the ESRD–PTA relationship. This study explored PTA in ESRD patients and their prognosis. Methods: We identified 157,026 patients diagnosed as having ESRD over January 1997 to December 2013 from Taiwan’s National Health Insurance Research Database (NHIRD). Each patient with ESRD (hereafter, patients) was matched with one control without chronic kidney disease (CKD, hereafter, controls) by sex, age, urbanization level, and income. Next, PTA incidence until death or the end of 2013 was compared between the two groups, and the relative risk of PTA was analyzed using a multiple logistic regression model. Results: The patients had a significantly higher PTA incidence than did the controls (incidence rate ratio: 2.02, 95% confidence interval [CI]: 1.40–2.91, p &lt, 0.001). The Kaplan–Meier analysis revealed that the patients had a higher cumulative incidence of PTA than did the controls (p &lt, 0.001). In Cox regression analysis, the patients had nearly twofold higher PTA risk (adjusted hazard ratio [HR]: 1.98, 95% CI: 1.37–2.86, p &lt, 0.001). The between-group differences in the PTA-related hospital stay length (8.1 ± 10.3 days in patients and 5.7 ± 4.6 days in controls, p = 0.09), consequent deep-neck infection complication (4.2% in patients and 6.3% in controls, p = 0.682), and mortality (0.0% in both groups) were nonsignificant. Conclusions: Although ESRD does not predict a poor prognosis of PTA, it is an independent PTA risk factor.

It is important to understand variations in hydro-meteorological variables to provide crucial information for water resource management and agricultural operation. This study aims to provide comprehensive investigations of hydroclimatic variability in the Bilate watershed for the period 1986 to 2015. Coefficient of variation (CV) and the standardized anomaly index (SAI) were used to assess the variability of rainfall, temperature, and streamflow. Changing point detection, the Mann–Kendell test, and the Sen’s slope estimator were employed to detect shifting points and trends, respectively. Rainfall and streamflow exhibited higher variability in the Bega (dry) and Belg (minor rainy) seasons than in the Kiremt (main rainy) season. Temperature showed an upward shift of 0.91 °C in the early 1990s. Reduction in rainfall (−11%) and streamflow (−42%) were found after changing points around late 1990s and 2000s, respectively. The changing points detected were likely related to the ENSO episodes. The trend test indicated a significant rise in temperature with a faster increase in the minimum temperature (0.06 °C/year) than the maximum temperature (0.02 °C/year). Both annual mean rainfall and streamflow showed significant decreasing trends of 8.32 mm/year and 3.64 mm/year, respectively. With significant increase in temperature and reduction in rainfall, the watershed has been experiencing a decline in streamflow and a shortage of available water. Adaptation measures should be developed by taking the increasing temperature and the declining and erratic nature of rainfall into consideration for water management and agricultural activities.

(1) Background: A high volume of chylous leakage (>1 L/day) is a potentially lethal complication after neck dissection. However, a strategic treatment for when the leakage progresses from high to massive (>4 L/day) is lacking. (2) Methods: The PubMed database was searched for articles on neck dissection–associated chylous leakage. Nine articles that included 14 cases with >1 L/day chylous leakage (CL) were analyzed. (3) Results: Of the nine patients with 1–4 L/day CL, three were successfully managed with conservative treatment, two with thoracic ductal ligation, three with ductal embolization, and one with local repair with a strap muscle flap. Of the remaining five cases with >4 L/day chylous leakage, three were successfully treated with the pectoralis major myocutaneous flap (PMMF) and one was successfully treated with thoracic ductal ligation and one case died. (4) Conclusions: In this review, when leakage was >4 L/day, the aforementioned interventions were ineffective, but applying the PMMF could rescue the intractable complication. We propose a strategic treatment for high (1–4 L/day) and massive (>4 L/day) chylous leakage.

(1) Background: Post-transplant lymphoproliferative disorder (PTLD) is a hematological disease and occurs because of immunosuppression after organ transplantation. Only a few studies have reported PTLD in the nasopharynx. In most cases, PTLD developed after solid organ transplantation, and cases of PTLD after bone marrow transplantation, are uncommon. (2) Case presentation: We report the case of a 40-year-old woman with myelodysplastic disorder who underwent hematopoietic stem cell transplantation (HSCT). After 3 months, she developed low-grade fever, progressive nasal obstruction, and bloody rhinorrhea. Endoscopy revealed a mass completely occupying the nasopharynx. A polymorphic PTLD was diagnosed on the basis of histopathological examination results. Reduction in immunosuppression and low-dose radiotherapy were prescribed for treatment. After a 3-year follow-up, no recurrence of PTLD or myelodysplastic disorder was detected. (3) Conclusions: While nasopharyngeal PTLD is rare, a routine examination of the nasopharynx should be considered in the post-transplant follow-up of patients for early detection and treatment of PTLD.

Background: Neuroblastoma (NB) is one of the most common malignant solid tumors to occur in children, characterized by a wide range of genetic and epigenetic aberrations. We studied whether modifications of the latter with a 5-aza-2&prime, deoxycytidine (decitabine, Dac) DNA methyltransferase inhibitor can provide a therapeutic advantage in NB. Methods: NB cells with or without MYCN amplification were treated with Dac. We used flow cytometry to measure cell apoptosis and death and mitochondrial reactive oxygen species (mtROS), microarray to analyze gene expression profile and bisulfite pyrosequencing to determine the methylation level of the DDX58/RIG-I promoter. Western blot was used to detect markers related to innate immune response and apoptotic signaling, while immunofluorescent imaging was used to determine dsRNA. We generated mtDNA depleted &rho, 0 cells using long-term exposure to low-dose ethidium bromide. Results: Dac preferentially induced a RIG-I-predominant innate immune response and cell apoptosis in SK-N-AS NB cells, significantly reduced the methylation level of the DDX58/RIG-I promoter and increased dsRNA accumulation in the cytosol. Dac down regulated mitochondrial genes related to redox homeostasis, but augmented mtROS production. &rho, 0 cells demonstrated a blunted response in innate immune response and apoptotic cell death, as well as greatly diminished dsRNA. The response of NB cells to CDDP and poly(I:C) was potentiated by Dac in association with increased mtROS, which was blunted in &rho, 0 cells. Conclusions: This study indicates that Dac effectively induces a RIG-I-related innate immune response and apoptotic signaling primarily in SK-N-AS NB cells by hypomethylating DDX58/RIG-I promoter, elevated mtROS and increased dsRNA. Dac can potentiate the cytotoxic effects of CDDP and poly(I:C) in NB cells.

Hepatocellular carcinoma (HCC) is a common cause of cancer death worldwide. Sorafenib, a multikinase inhibitor, is the first-line drug approved by the Food and Drug Administration (FDA) for the treatment of patients with advanced HCC. However, most patients who continuously receive sorafenib may acquire resistance to this drug. Therefore, it is important to develop a new compound to treat liver cancer and sorafenib-resistant liver cancer. Barbituric acid derivatives have been used as antiasthmatic drugs in the clinic. We previously reported that a novel barbituric acid derivative inhibited carbon tetrachloride-induced liver fibrosis in mice, but its effects on liver cancer remain unknown. Thus, the purpose of this study was to investigate the antitumor effect of barbituric acid derivatives on HCC cells and sorafenib-resistant HCC cells (HCC-SRs). Our findings reveal that one of the barbituric acid derivatives, BA-5, significantly inhibited HCC and HCC-SR cell viability in a dose- and time-dependent manner. Therefore, compound BA-5 was selected for further experiments. Western blot data revealed that BA-5 treatment decreased the phosphorylation of AKT/p70s6k without affecting the MAPK pathway and increased cleaved PARP and cleaved caspase-7 in both HCC and HCC-SR cells. Since epithelial-mesenchymal transition plays a significant role in regulating cancer invasion and migration, we used the wound healing assay to evaluate the antimigratory effect of compound BA-5. The results showed that BA-5 treatment inhibited HCC and HCC-SR cell migration and reduced Vimentin protein expression. These results were confirmed by microarray analysis showing that BA-5 treatment influenced cancer cell motility and growth-related pathways. In the xenograft mouse model experiment, BA-5 administration significantly inhibited HCC cancer cell growth in mice. Furthermore, the combination of BA-5 with a low dose of regorafenib synergistically inhibited HCC-SR cell proliferation. In conclusion, our study showed that the barbituric acid derivative BA-5 is a new candidate for HCC and sorafenib-resistant HCC therapy.

Groundwater, a salient water resource in Taiwan, has been subject to incessant and excessive pumping, inducing serious regional land subsidence and seawater intrusion. This study aims at assessing how excessive pumping impacts groundwater variations over the Pingtung Alluvial Plain (PAP) in Southwest Taiwan using both statistical and numerical techniques. We apply nonparametric methods to analyze the changing point and annual trend in various hydro-meteorological time series (e.g., rainfall, temperature, and groundwater levels (GLs)). Afterwards, we employ an integrated surface-subsurface model referred to as WASH123D to simulate GLs under the pumping-free scenario; any discrepancies identified between simulated and observed GLs could be an indicator of unregulated/illegal pumping. We find that annual GLs exhibit a significant increasing (decreasing) trend in the western (eastern) PAP. Our numerical experiment reveals diverging trends in simulated and observed GLs, mostly at the downstream of all the major tributaries, suggesting the consequence of unregulated/illegal pumping. Furthermore, upstream pumping may reduce lateral flow towards the downstream coastal area, triggering land subsidence in remote locations.

Recent studies have shown that M. elongata (M. elongata) isolated from Populus field sites has a dual endophyte–saprotroph lifestyle and is able to promote the growth of Populus. However, little is known about the host fidelity of M. elongata and whether M. elongata strains differ from one another in their ability to promote plant growth. Here, we compared the impacts of three Populus-associated M. elongata isolates (PMI 77, PMI 93, and PMI 624) on the growth of seven different crop species by measuring plant height, plant dry biomass, and leaf area. M. elongata isolates PMI 624 and PMI 93 increased the plant height, leaf area, and plant dry weight of Citrullus lanatus, Zea mays, Solanum lycopersicum, and Cucurbita to a much greater degree than PMI 77 (33.9% to 14.1%). No significant impacts were observed for any isolate on the growth of Abelmoschus esculentus or Glycine max. On the contrary, Glycine max significantly decreased in height by 30.6% after the inoculation of M. elongata PMI 77. In conclusion, this study demonstrates that M. elongata generally promoted metrics of the plant performance among a diverse set of importantly non-leguminous crop species. Future research on understanding the molecular mechanisms that underlie strain and host variability is warranted.

The purpose of this in vitro study is to compare the maximum load capacity and modes of failure under static loading in three types of titanium abutments (n = 3) with different processes or manufacturers. The Pre-Ti group consists of prefabricated titanium abutments from original equipment manufacturers (OEM), the CAD-Ti group consists of OEM titanium abutments fabricated with computer-assisted design/manufacturing (CAD/CAM) technique, and the AM-Ti group is CAD/CAM titanium abutment made by aftermarket manufacturers. A full zirconia crown was fabricated and cemented to each abutment. An all-electric dynamic test instrument was used to place loading on the zirconia crown with a crosshead speed set at 1 mm/min. The mean maximum load capacity of both OEM titanium abutments was significantly higher than the aftermarket titanium abutments. All these three types of implant&ndash, abutment complexes exhibited similar modes of failure, which included deformation of the abutment and implant, fracture of the abutment and retentive screw.

In this paper, we report the synthesis of iron silicide and β-iron disilicide nanowires with chemical vapor deposition; remarkably, the latter has drawn much attention but has seldom been achieved. We also propose the formation mechanisms for the two phases. To investigate the effects of the growth parameters on compositions and morphologies of the iron silicide nanowires, we changed and studied the reaction time, substrate temperature, position of samples, and pressure. The reaction concentration was found to be altered by all of the parameters; thus, we observed different nanowires in terms of morphologies and compositions with scanning electron microscopy. To confirm the growth direction and crystal structure of the nanowires, we conducted x-ray diffraction and high-resolution transmission electron microscopy studies. With the potential of being utilized as circuit elements in electronic devices for Schottky barriers, ohmic contacts, and interconnection among silicon-based transistors, the silicide work at nanoscale is beneficial for nanoelectronics. Understanding the effects of these growth parameters facilitates the control of nanowire growth with better quality.

This research utilizes a plasma electrolysis technique to clean the surface of stainless steel 316. The resulting microstructure enhances the self-cleaning properties of the stainless steel surface. The position of the cathode electrode is varied to enlarge the total surface being processed and achieves a uniform processing surface. We propose a self-made plasma electrolysis reaction system supplemented with a 3-axis platform to control the speed at which the cathode electrode moves. The electrolyte is an aqueous solution of sodium bicarbonate (NaHCO3) and water. We obtain the optimal parameters for applied voltage, moving speed of the specimen at the cathode, and electrode distance using a one-factor-at-a-time experimental approach to achieve uniform distribution of the surface microstructure. We then observe and measure surface micrographs showing the surface roughness of the specimens after experiments, using a scanning electron microscope (SEM) and an atomic force microscope (AFM). The contact angle is experimentally proven to be greater than 100&deg, indicating that the surface is hydrophobic.

Heteronemin, the most abundant secondary metabolite in the sponge Hippospongia sp., exhibited potent cytotoxic activity against several cancer cell lines. It increased the percentage of apoptotic cells and reactive oxygen species (ROS) in Molt4 cells. The use of ROS scavenger, N-acetyl cysteine (NAC), suppressed both the production of ROS from mitochondria and cell apoptosis that were induced by heteronemin treatment. Heteronemin upregulated talin and phosphorylated talin expression in Molt4 cells but it only upregulated the expression of phosphorylated talin in HEK293 cells. However, pretreatment with NAC reversed these effects. Talin siRNA reversed the activation of pro-apoptotic cleaved caspases 3 and 9. On the other hand, the downstream proteins including FAK and NF-&kappa, B (p65) were not affected. In addition, we confirmed that heteronemin directly modulated phosphorylated talin expression through ROS generation resulting in cell apoptosis, but it did not affect talin/FAK complex. Furthermore, heteronemin interfered with actin microfilament and caused morphology changes. Taken together, these findings suggest that the cytotoxic effect of heteronemin is associated with oxidative stress and induction of phosphorylated talin expression. Our results suggest that heteronemin represents an interesting candidate which can be further developed as a drug lead against leukemia.

High transmittance ratio in visible range, low resistivity, and high mobility of IGZO thin films were prepared at room temperature for 30 min by co-sputtering of Zn2Ga2O5 (Ga2O3 + 2 ZnO, GZO) ceramic and In2O3 ceramic at the same time. The deposition power of pure In2O3 ceramic target was fixed at 100 W and the deposition power of GZO ceramic target was changed from 80 W to 140 W. We chose to investigate the deposition power of GZO ceramic target on the properties of IGZO thin films. From the SEM observations, all of the deposited IGZO thin films showed a very smooth and featureless surface. From the measurements of XRD patterns, only the amorphous structure was observed. We aimed to show that the deposition power of GZO ceramic target had large effect on the Eg values, Hall mobility, carrier concentration, and resistivity of IGZO thin films. Secondary ion mass spectrometry (SIMS) analysis in the thicknesses’ profile of IGZO thin films found that In and Ga elements were uniform distribution and Zn element were non-uniform distribution. The SIMS analysis results also showed the concentrations of Ga and Zn elements increased and the concentrations of In element was almost unchanged with increasing deposition power.

Atmospheric pressure plasma jet (APPJ) technology is a versatile technology that has been applied in many energy harvesting and storage devices. This feature article provides an overview of the advances in APPJ technology and its application to solar cells and batteries. The ultrafast APPJ sintering of nanoporous oxides and 3D reduced graphene oxide nanosheets with accompanying optical emission spectroscopy analyses are described in detail. The applications of these nanoporous materials to photoanodes and counter electrodes of dye-sensitized solar cells are described. An ultrashort treatment (1 min) on graphite felt electrodes of flow batteries also significantly improves the energy efficiency.

Calcium phosphate cements (CPCs) have several advantages for use as endodontic materials, and such advantages include ease of use, biocompatibility, potential hydroxyapatite-forming ability, and bond creation between the dentin and appropriate filling materials. However, unlike tricalcium silicate (CS)-based materials, CPCs do not have antibacterial properties. The present study doped a nonwashable CPC with 0.25–1.0 wt % hinokitiol and added 0, 5, and 10 wt % CS. The CPCs with 0.25–0.5 wt % hinokitiol showed appreciable antimicrobial properties without alterations in their working or setting times, mechanical properties, or cytocompatibility. Addition of CS slightly retarded the apatite formation of CPC and the working and setting time was obviously reduced. Moreover, addition of CS dramatically increased the compressive strength of CPC. Doping CS with 5 wt % ZnO provided additional antibacterial effects to the present CPC system. CS and hinokitiol exerted a synergic antibacterial effect, and the CPC with 0.25 wt % hinokitiol and 10 wt % CS (doped with 5 wt % ZnO) had higher antibacterial properties than that of pure CS. The addition of 10 wt % bismuth subgallate doubled the CPC radiopacity. The results demonstrate that hinokitiol and CS can improve the antibacterial properties of CPCs, and they can thus be considered for endodontic applications.

Four new sulfur-containing compounds, named clinamides A-C (1–3), and 2-cis-entadamide A (4), were isolated together with three known compounds from the bioactive ethanol extract of the aerial parts of Clinacanthus nutans. These secondary metabolites possess sulfur atoms and acrylamide functionalities. The structures of the isolated components were established by interpretation of their spectroscopic data, especially 1D and 2D NMR.

Much energy-related construction causes environmental concern. Sometimes the environmental issue is so huge that it is difficult to make a policy decision even with the assistance of traditional valuation techniques. The third natural gas receiving station at Datan, Taiwan, is one example of this. The construction would be beneficial to energy security, economic development, and particulate matter (PM) 2.5 reduction. However, it would destroy a precious algal reef, which is a habitat for endangered species, biodiversity, and a unique ecological system. Thus, we used willingness-to-pay to show the strength of both pro-energy and pro-ecology opinions specifically to help with decision-making. First, respondents were asked to choose between the gas station and the reef. Then they were asked about their willingness to pay for that choice. We then estimated parametric/nonparametric models—traditional probit, structured probit, and Turnbull—to obtain reliable estimates. We found that the per-person value for pro-gas-station respondents was higher than that for pro-reef respondents, while the percentage of pro-reef respondents was higher than the percentage of pro-gas-station respondents. These results together form a clear policy implication for this case.