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Sudden infant death syndrome (SIDS), the most common cause of infant death in developed countries, is attributed to diverse trigger factors. Malignant cardiac dysrhythmias are potentially treatable etiologies, and congenital long QT syndrome (LQTS) is the most common cardiac ionic channelopathy confronted. β-Blockers or class Ib agents are the drugs of choice for the control of arrhythmias, and an implantable cardioverter defibrillator (ICD) should be considered for secondary prevention in survivors of lethal cardiac death. We report the case of a 4-day old neonate, later genetically confirmed as LQT type 3 (LQT3), who survived a pulseless torsades de pointes (TdP) attack and was successfully treated with propranolol, mexiletine, and ICD implantation.

Abstract Background Dengue fever is the most common arboviral infection in humans, with viral transmissions occurring in more than 100 countries in tropical regions. A global strategy for dengue prevention and control was established more than 10 years ago. However, the factors that drive the transmission of the dengue virus and subsequent viral infection continue unabated. The largest dengue outbreaks in Taiwan since World War II occurred in two recent successive years: 2014 and 2015. Methods We performed a systematic analysis to detect and recognize spatial and temporal clustering patterns of dengue incidence in geographical areas of Taiwan, using the map-based pattern recognition procedure and scan test. Our aim was to recognize geographical heterogeneity patterns of varying dengue incidence intensity and detect hierarchical incidence intensity clusters. Results Using the map-based pattern recognition procedure, we identified and delineated two separate hierarchical dengue incidence intensity clusters that comprise multiple mutually adjacent geographical units with high dengue incidence rates. We also found that that dengue incidence tends to peak simultaneously and homogeneously among the neighboring geographic units with high rates in the same cluster. Conclusion Beyond significance testing, this study is particularly desired by and useful for health authorities who require optimal characteristics of disease incidence patterns on maps and over time. Among the integrated components for effective prevention and control of dengue and dengue hemorrhagic fever are active surveillance and community-based integrated mosquito control, for which this study provides valuable inferences. Effective dengue prevention and control programs in Taiwan are critical, and have the added benefit of controlling the potential emergence of Zika.

Deregulation of metabolic pathways is one of the hallmarks of cancer progression. Connective tissue growth factor (CTGF/CCN2) acts as a tumor suppressor in oral squamous cell carcinoma (OSCC). However, the role of CTGF in modulating cancer metabolism is still unclear. Methods: OSCC cells stably overexpressing CTGF (SAS/CTGF) and shRNA against CTGF (TW2.6/shCTGF) were established. Oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) were examined by the Seahorse XF24 analyzer. The expression of CTGF and mitochondrial biogenesis related genes was measured by real-time polymerase chain reaction or Western blot analysis. Results: CTGF decreased OCR, ECAR, adenosine triphosphate (ATP) generation, mitochondrial DNA (mtDNA), and mitochondrial transcription factor A (mtTFA) protein expression in OSCC cells. Overexpression of mtTFA restored CTGF-decreased OCR, ECAR, mtDNA copy number, migration and invasion of SAS/CTGF cells. Immunoprecipitation assay showed a higher level of ubiquitinated mtTFA protein after CTGF treatment. MG132, an inhibitor of proteasomal degradation, reversed the effect of CTGF on mtTFA protein expression in SAS cells. Conclusion: CTGF can decrease glycolysis, mitochondrial oxidative phosphorylation, ATP generation, and mtDNA copy number by increasing mtTFA protein degradation through ubiquitin proteasome pathway and in turn reduces migration and invasion of OSCC cells. Therefore, CTGF may be developed as a potential additive therapeutic drug for oral cancer in the near future.

We investigated the application of head-up tilt table testing (HUT) and management of neurocardiogenic syncope (NCS) in children, as pediatric studies are limited. Methods: Seventy-nine patients (ages 6-18 years) underwent HUT for evaluation of syncope. Patient triggers and premonitory symptoms allowed the clinical diagnosis of NCS or non-NCS. Results were divided into four hemodynamic types (1, 2A, 2B, and 3) according to patient response to HUT. Results: NCS occurred in 65 patients and non-NCS in 14 patients. Isoproterenol infusion significantly increased the sensitivity of the test (from 28% to 45%) and was associated with a slight decrease in the specificity (from 93% to 86%). Subjects in the type 1 group accounted for the majority of responses to the test (69%). There were no complications associated with the test. At follow-up (16.6 ± 9.3 months), the overall recurrence rate was 30.8% but NCS was less severe in most patients. The recurrence rate was similar for patients with a positive or negative HUT and for both pharmacologically and non-pharmacologically treated patients. Conclusion: HUT can be safely performed with a high specificity in children, with the sensitivity of HUT improved by isoproterenol. Therefore, a positive response to treatment is reassuring to the physician and family. NCS is generally a self-limited condition despite a high recurrence rate.

A 7-year-old boy developed a left ventricular aneurysm with massive hemopericardium 3 years ago due to a fall from a fourth-floor window. He had mild neurological sequelae including cranial nerve III palsy and abnormal electroencephalography findings at that time. He had no chest pain until recently when he presented with chest tightness and abdominal pain for 2 days prior to admission. Chest X-ray showed marked cardiomegaly. Echocardiography revealed massive pericardial effusion and a large left ventricular aneurysm. The massive hemopericardium was surgically drained, and the aneurysm was resected under cardiopulmonary bypass. He was discharged uneventfully 1 week after operation. Because symptoms and signs can vary in patients with ventricular aneurysm, we strongly suggest a close clinical follow-up, preferably with chest X-ray or echocardiography, for patients experiencing a blunt chest trauma.

Interleukin (IL)-20 is a proinflammatory cytokine in the IL-10 family. IL-20 is associated with tumor promotion in the pathogenesis of oral, bladder, and breast cancer. However, little is known about the role of IL-20 in prostate cancer. We hypothesize that IL-20 promotes the growth of prostate cancer cells. Immunohistochemical staining showed that IL-20 and its receptors were expressed in human PC-3 and LNCaP prostate cancer cell lines and in prostate tumor tissue from 40 patients. In vitro, IL-20 upregulated N-cadherin, STAT3, vimentin, fibronectin, RANKL, cathepsin G, and cathepsin K, and increased the migration and colony formation of prostate cancer cells via activated p38, ERK1/2, AKT, and NF-κB signals in PC-3 cells. We investigated the effects of anti-IL-20 monoclonal antibody 7E on prostate tumor growth in vivo using SCID mouse subcutaneous and intratibial xenograft tumor models. In vivo, 7E reduced tumor growth, suppressed tumor-mediated osteolysis, and protected bone mineral density after intratibial injection of prostate cancer cells. We conclude that IL-20 is involved in the cell migration, colony formation, and tumor-induced osteolysis of prostate cancer. Therefore, IL-20 might be a novel target for treating prostate cancer.

With cancer now the leading cause of death, the importance of palliative care importance is increasingly evident. However, the focus of current policies is on inpatient and home-based care, which neglects the specialized needs of outpatients and results in many not receiving timely palliative care. Integrating palliative care into outpatient clinics using standardized referral criteria and automated systems will allow for timely patient selection and intervention, early symptom management, and psychological support as well as promote patient autonomy in treatment decision-making. Specialized oncology palliative care nurses play a crucial role in related assessment, care planning, and implementation activities. They help patients and families cope with disease progression and end-oflife care through education and support. Early outpatient palliative care benefits many patients and families, realizing a holistic and comprehensive care model. [ABSTRACT FROM AUTHOR]

Taiwan has been an aging society since 2018. As a result, long-term care, end-of-life autonomy, and hospice care have received increasing attention. The government of Taiwan promotes home-based healthcare through the National Health Insurance System to enable the efficient utilization of medical resources and reduce overall medical costs. Taiwan's community hospice and palliative care network is expected to serve as the main care model supplementing partial hospitalization and institutional care. In this article, we review the history of and policies related to hospice and palliative care in Taiwan using a literature review and examining Pingtung County as a case study. The implementation of home-based palliative care is also outlined and policy revisions are proposed. The results are intended to provide a reference for healthcare authorities and medical institutions to promote community hospice and palliative care policies. The integrated care model can enhance the capacity of community-based palliative care, support patients receiving palliative care and their family members and caregivers, and ensure physical and psychological comfort for patients. This model contributes to the realization of older adults' preference for dying at home, which is especially pronounced in cultures where traditional Chinese ideas are deeply rooted. [ABSTRACT FROM AUTHOR]

Building high voltage overhead transmission lines (HVOTL)may incur huge external social cost. This study attempts to estimate such external cost using the Taipower Company's Nantou-Changlin HVOTL as a case study. This HVOTL likely affects the values of farmland. Data were collected from a field survey de- signed from the contingent valuation method (CVM). An econometric model using farmland price as the dependent variable was specified and estimated by two-stage least squares (2SLS) and Heckman two-step model (Heckit). The econometric results show that building this HVOTL would reduce the value of farmland within 600 meters from this line with 23.6 km on both sides. The closer to HVOTL, the lower is the farmland price. The total lost farmland value amounts to 17.1 billion NT dollars. This amount is more than six times the construction cost of 2.7 billion. These research results should be very useful to the Taipower Company and government agencies in assessing the external social cost of the construction of HVOTLs in Taiwan. [ABSTRACT FROM AUTHOR]

A simple capillary zone electrophoresis (CZE) method was used to characterize human very low-density lipoprotein (VLDL) particles for four healthy donors. One major peak was observed for native, in vitro oxidized and glycated VLDL particles. The effective mobilities and peak areas of the capillary electrophoresis (CE) profiles showed good reproducibility and precision. The mobility of the oxidized VLDL peak was higher than that of the native VLDL. The mobility of the glycated VLDL peak was similar to that of the native VLDL. Phospholipids isolated from VLDL particles were analyzed by our recently developed micellar electrokinetic chromatography (MEKC) with a high-salt stacking method. At absorbance 200 nm, the native VLDL phospholipids showed a major peak and a minor peak for each donor. For oxidized VLDL phospholipids, the area of the major peak reduced for three donors, possibly due to phospholipid decomposition. For glycated VLDL phospholipids, the peak mobilities were more positive than native VLDL phospholipids for two donors, possibly due to phospholipid-linked advanced glycation end products (AGEs). Very interestingly, at absorbance 234 nm, the major peak of oxidized VLDL phospholipids was resolved as two peaks for each donor, possibly due to conjugated dienes formed upon oxidation. [ABSTRACT FROM AUTHOR]

A new bandpass shielding enclosure (BPSE) made by etching the apertures of a periodic hexagon array on its top and bottom surfaces is proposed for modern portable digital devices having wireless communication functions. The BPSE is required to provide high transmittance at the specified communication band and high shielding effectiveness outside this band, and to have little influence on the radiation characteristics of an internal antenna located inside the enclosure. All three required features are difficult to achieve simultaneously. A prototype of the BPSE was built and studied. Both the simulated and measured results obtained show the promising performance of the BPSE and its potential in practical applications. © 2007 Wiley Periodicals, Inc. Microwave Opt Technol Lett 50: 15–18, 2008; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.22978 [ABSTRACT FROM AUTHOR]