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BackgroundMobile health (mHealth) apps have recently demonstrated the potential to engage and empower people to improve their own health. Although the availability of health-related apps is increasing, their adoption rate in Taiwan is exceptionally low mainly due to the preponderance of Western culture-based app designs that are challenging for non-English-speaking individuals. To our knowledge, no mHealth app is available in Taiwan that is culturally tailored for Chinese-speaking users and that applies a patient-centered approach to self-manage medication and health. ObjectiveThe purpose of this study was to design and deploy a culturally tailored mHealth system that could be easily integrated into current clinical practice and to evaluate how this mHealth system could support the continuity of patient care in Taiwan. MethodsAn mHealth information system and a mobile app were designed. To promote the best patient experience, a Quick Response (QR) code system was developed to enable efficient registration of personal medication information through the mobile app. The app also supported notifications for drug utilization, refills, and symptom checks. Patients were encouraged to record medication use, symptoms, and self-assessments in the app during their treatment period. Evaluation of the novel mHealth system was conducted from August 1, 2016 to December 31, 2016 at MacKay Memorial Hospital, Taipei, Taiwan. Population data and app usage statistics were analyzed. ResultsDuring the 5-month implementation period, a total of 25,909 users downloaded the app with an overall 7-day retention rate of 15.4% (SD 3.9). Young male adults (range 25-44 years) were the predominant user population. Patients’ feedback on app usability and design, QR code system as drug input method, medication reminders, and linking family or friends into care networks was generally positive. Physicians showed great interest in utilizing patient-generated data in their care process, and the positive medication adherence rate was the most highly valued component of this system. ConclusionsThis pilot study demonstrated the value of a novel mHealth approach for individualized medication and health management in Taiwan. The mHealth system shows the potential to optimize personalized care into existing clinical services and may help hospitals and health authorities perform continuous quality improvement and policy development.

Battery is the core power component in electric vehicles, and the battery's thermal management system is an important guarantee for the best performance of the battery. Based on the 21700NCA cylindrical ternary lithium-ion battery, a battery pack system with foamed aluminum as the supporting framework was established in this paper. Phase change materials (PCM) were injected into the pores between the framework and the battery to improve the internal temperature uniformity of the structure. A liquid cooling plate was added to the bottom of the battery to enhance the cooling effect, and the coupled heat dissipation effect of the single battery was analyzed by computational fluid dynamics (CFD) simulation technology. Results showed that, compared with the single cooling mode, the coupling cooling system of metal foam, phase change material and liquid cooling can achieve better cooling effect. For phase change materials, within a certain density range, the higher the density, the better the cooling effect of the battery system. The mixing ratio of PCM mainly affects the solidification and melting rate of PCM. [ABSTRACT FROM AUTHOR]

Of these, 65 patients tested positive by RT-PCR (prevalence: 0.71%), 15 (23%) of Panbio SP TM sp COVID-19 rapid antigen test revealed positive results, and 12 cases were rapid antigen test positive/RT-PCR negative. Of these, 15 tests were rapid antigen test positive, and four were rapid antigen test negative. [Extracted from the article]

Background. This study aims to investigate the coronary microcirculatory resistance and prognosis of patients with acute myocardial infarction (AMI) concomitant with hyperhomocysteinemia (HHcy) after an elective percutaneous coronary intervention (PCI). Methods. A total of 101 patients that underwent elective PCI between May 2015 and July 2018 due to AMI were consecutively enrolled in this study. Patients were divided into a HHcy group (53) and a normal Hcy group (control; 48) based on their plasma homocysteine concentration. The characteristics of coronary angiography, the index of microcirculatory resistance (IMR) of infarct-related vessels (IRV), changes in left ventricular end diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) before and after PCI, and the incidence of major adverse cardiovascular events (MACE) three months after PCI were compared between these groups. Results. Compared to the results from the Hcy group, the HHcy group had a higher IMR. The HHcy group had significantly higher LVEDd and a lower LVEF than the Hcy group 3 months after PCI. Additionally, the incidence of MACE at three months after PCI was higher in the HHcy group than in the Hcy group. Pearson correlation analysis revealed a positive correlation with IMR in the HHcy group. Furthermore, there was a difference in the LVEDd measured at one day after PCI and at three months after PCI in the HHcy group. Conclusion. AMI patients concomitant with HHcy that undergo elective PCI are prone to coronary microcirculatory dysfunction and have a poor cardiac function and poor prognosis at three months after PCI. [ABSTRACT FROM AUTHOR]

Spiranthes sinensis is an important medicinal plant of Spiranthes family and is currently in an endangered state. To better guide the systematic classification of S. sinensis, the complete genome of its chloroplast was sequenced and characterized. The complete chloroplast genome is 152,786 bp in length and contains a large single copy (LSC) region of 83,446 bp, a small single copy (SSC) region of 17,938 bp, and two inverted repeat (IRA and IRB) regions of 25,701 bp. The genome encodes 132 genes (112 unique genes), including 86 protein-coding genes (78 unique genes), 8 rRNA genes (4 unique genes), and 38 tRNA genes (30 unique genes). The total GC content of plasmid genome is 36.18%. Phylogenetic results indicated that S. sinensis is more closely related to Ludisia discolor, Goodyera schlechtendaliana, Goodyera fumata, and Goodyera procera. The study enriches the plasmid genomic information of S. sinensis and is of great significance for the genetic protection of this species. [ABSTRACT FROM AUTHOR]

Background: Intradialytic hypotension (IDH) is a serious complication and a major risk factor of increased mortality during hemodialysis (HD). However, predicting the occurrence of intradialytic blood pressure (BP) fluctuations clinically is difficult. This study aimed to develop an intelligent system with capability of predicting IDH.Methods: In developing and training the prediction models in the intelligent system, we used a database of 653 HD outpatients who underwent 55,516 HD treatment sessions, resulting in 285,705 valid BP records. We built models to predict IDH at the next BP check by applying time-dependent logistic regression analyses.Results: Our results showed the sensitivity of 86% and specificity of 81% for both nadir systolic BP (SBP) of <90 mmHg and <100 mmHg, suggesting good performance of our prediction models. We obtained similar results in validating via test data and data of newly enrolled patients (new-patient data), which is important for simulating prospective situations wherein dialysis staff are unfamiliar with new patients. This compensates for the retrospective nature of the BP records used in our study.Conclusion: The use of this validated intelligent system can identify patients who are at risk of IDH in advance, which may facilitate well-timed personalized management and intervention. [ABSTRACT FROM AUTHOR]

Objective: In addition to high-quality chest compression, parameters of resuscitation efficiency such as early chest compression, early defibrillation, and decreased hands-off time are also vital in the Advanced Cardiac Life Support (ACLS) protocol. However, because of limited time and equipment in ACLS courses, efficiency of performance is difficult to evaluate. Materials and Methods: A free, easy-to-use iOS and Android app (CodeTracer®) was developed for real-time recording of cardiopulmonary resuscitation (CPR) performance. Interventions performed during resuscitation were set up as buttons. When the simulated scenario in the ACLS course began, instructors recorded every intervention and the team performed by pushing the appropriate buttons. When the scenario ended, the CodeTracer® automatically computed parameters, including the percentage of no-flow time, time to initiating CPR, and time to initiating defibrillation and also generated a graphic log for later discussion. Results: A total of 76 resuscitation episodes were recorded, 27 in the practice scenarios and 49 in the final Megacode simulations. After the course, the average percentage of no-flow time decreased 5.79%, time to initiating CPR decreased 3.05 s, and time to initiating defibrillation decreased up to 20.27 s. Of note, physicians as leaders seem to have better performance after the ACLS course than before, but the results were insignificant except for the percentage of no-flow time. Conclusions: CodeTracer® can record and calculate objective parameters for resuscitation performance in ACLS courses and can assist instructors in disseminating important concepts to participants. It can be a useful tool in ACLS courses. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to determine the feasibility of using an ultrasound image tracking algorithm ( UITA) combined with a respiration compensating system ( RCS) to track and compensate the respiration pattern of the diaphragm in real time. Methods Diaphragm motions and various respiration patterns were tracked and captured in volunteers using our previously developed UITA (Kuo et al., J Xray Sci Technol, 2016:875). A diaphragm phantom was placed on a respiration simulation system ( RSS) that received signals with different respiration patterns to simulate actual human respiration signals. The RSS was mounted on the RCS, which is 180 cm long and driven by inputting a compensating signal to a linear actuator underneath with and without using a phase-lead compensator ( PLC) (Chuang et al., J Xray Sci Technol, 2015:503). The target displacement was calculated automatically by the UITA and compensated by the RCS. The phantom displacements were observed using a fluoroscopic imaging system on the linear accelerator at the Department of Radiation Oncology, Taipei Medical University Hospital, and the results were also compared with the displacements measured by the UITA and the RSS for correlation verification. In addition, the compensating effect was analyzed after activating the RCS. Results The experimental results indicate a significant correlation between the UITA-calculated and actual displacements, with a correlation coefficient of up to 91% for the simulated respiration patterns. After activating the RCS, the obtained compensating effect was more than 65%, and even up to 85% if a PLC was used. Moreover, the compensation of 10 extreme respiration patterns of diaphragm was improved significantly through the use of a PLC, with a peak compensating rate of 88.92% being achieved. Finally, compensation effects ranging from 52% to 74% were obtained in 10 human volunteers. Conclusions This study combined ultrasound imaging tracking technology with the RCS to offset the respiration-induced diaphragm displacement and compensate the various respiration patterns, even including those with baseline-shift phenomenon in real time with the aid of a noninvasive ultrasound imaging system. [ABSTRACT FROM AUTHOR]

Background: Previous studies have established a relationship between chronic kidney disease (CKD) and cataract, but the relationship between the severity of renal impairment and risk of cataract is uncertain. This study investigates the relationship between the severity of renal disease and cataract in a nationwide sample from Taiwan.Methods: The cohort from 1-million National Health Insurance beneficiaries from Taiwan was retrospectively analyzed. All adult beneficiaries were followed from January 1, 2005 until December 31, 2013, to identify patients who underwent cataract surgeries. On the basis of the ambulatory care records, those diagnosed with CKD (ICD-9-CM code: 585) during the follow-up period were enrolled as CKD patients after careful evaluation. Each patient with CKD was age- and gender-matched with 4 individuals who did not have CKD. Cox regression models were applied to compare the hazard of cataract surgery in individuals with and without CKD. Subgroup analysis was used to compare patients with end-stage renal disease (ESRD) with age- and gender-matched non-CKD individuals. ESRD was defined by CKD patients who need regular renal replacement therapy. The same method was applied to evaluate hazard ratios (HRs).Results: After age and gender matching, there were 11,881 patients in the CKD group and 47,524 in the non-CKD group. After control for possible confounding, the adjusted HR (aHR) of cataract was 1.84 (95% CI 1.73-1.95) for the CKD group. Subgroup analysis of patients with ESRD (n = 3,209) and non-CKD individuals (n = 12,836), with matching done on the basis of age and gender, indicated an aHR of cataract was 2.33 (95% CI 2.10-2.59) for the ESRD group.Conclusions: This study indicates a relationship between CKD and cataract, and suggests that the risk for cataract increases with the severity of renal impairment. [ABSTRACT FROM AUTHOR]