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Due to the long latency of accessing services from cloud datacenters, mobile edge computing (MEC) has been proposed to provide the capability of cloud computing in close proximity to mobile users. Mobile devices can offload computation-intensive applications to MEC servers to achieve better performance and reduce power consumption. Owing to user mobility, workloads of MEC servers would vary severely to cause imbalanced loads and incur hotspot servers. Previous studies of power saving and hotspot management apply mechanisms for cloud datacenters to MEC servers, but these studies may not be suitable for MEC servers due to the limited computation and communication capacity. We are motivated to propose a scheme, complementary offloading for hotspot mitigation (COHM), for MEC. COHM consists of mechanisms for MEC servers with different states, namely busy, idle, and available. These mechanisms jointly consider the computation tasks for MEC servers with different states to mitigate hotspots. The simulation results show that COHM can decrease the number of hotspot servers without degrading the quality of service for applications.

Resistive random access memory (RRAM) is vital to neuromorphic computing applications. However, filamentary RRAM cells are affected by transitions from abrupt switching to analog switching. In this...

A new type of two-dimensional (2D) SnO2 semiconductor-based gate-tunable memristor, that is, a memtransistor, an integrated device of a memristor and a transistor, was demonstrated to advance next-generation neuromorphic computing technology. The polycrystalline 2D-SnO2 memristors derived from a low-temperature and vacuum-free liquid metal process offer several interesting resistive switching properties such as excellent digital/analog resistive switching, multistate storage, and gate-tunability function of resistance switching states. Significantly, the gate tunability function that is not achievable in conventional two-terminal memristors provides the capability to implement heterosynaptic analog switching by regulating gate bias for enabling complex neuromorphic learning. We successfully demonstrated that the gate-tunable synaptic device dynamically modulated the analog switching behavior with good linearity and an improved conductance change ratio for high recognition accuracy learning. The presented gate-tunable 2D-oxide memtransistor will advance neuromorphic device technology and open up new opportunities to design learning schemes with an extra degree of freedom.

Two quantitative PCR (qPCR)–based methods, for clonal immunoglobulin or T-cell receptor gene (Ig/TCR) rearrangements and for fusion transcripts, are widely used for the measurement of minimal residual disease (MRD) in patients with B-precursor acute lymphoblastic leukemia (ALL). MRD of bone marrow samples from 165 patients carrying the three major fusion transcripts, including 74 BCR-ABL1, 54 ETV6-RUNX1, and 37 TCF3-PBX1, was analyzed by using the two qPCR-based methods. The correlation coefficient of both methods was good for TCF3-PBX1 (R2 = 0.8088) and BCR-ABL1 (R2 = 0.8094) ALL and moderate for ETV6-RUNX1 (R2 = 0.5972). The concordance was perfect for TCF3-PBX1 ALL (97.2%), substantially concordant for ETV6-RUNX1 ALL (87.1%), and only moderate for BCR-ABL1 ALL (70.6%). The discordant MRD, positive for only one method with a difference greater than one log, was found in 4 of 93 samples (4.3%) with ETV6-RUNX1, 31 of 245 samples (12.7%) with BCR-ABL1, and none of TCF3-PBX1 ALL. None of the eight non-transplanted patients with BCR-ABL1-MRD (+)/Ig/TCR-MRD (–) with a median follow-up time of 73.5 months had hematologic relapses. Our study showed an excellent MRD concordance between the two qPCR-based methods in TCF3-PBX1 ALL, whereas qPCR for Ig/TCR is more reliable in BCR-ABL1 ALL.

Purpose This study aims to use financial stability and health facilities of countries, to cluster them for making a more consensus environment for manifesting the status of Covid-19 in a justifiable manner. The scarcity of the categorisation of the countries of the world in a common platform, and the requirement of manifesting the pandemic status such as Covid-19 in a justifiable manner create the demanding requirement. This study mainly focusses on assisting to generate a liable manifesto to criticise the span of viral infection of the severe acute respiratory syndrome coronavirus-2 over the globe. Design/methodology/approach Data for this study has been gathered from official websites of the World Bank, and the world in data. The Louvain clustering method has been used to cluster the countries based on their financial strength and health facilities. The resulted clusters are visualised using Silhouette plots. The anomalies of the clusters had been used to quantify the pandemic situation. The status of Covid-19 has been manifested with the time series analysis through python programming. Findings The countries of the world have been clustered into seven, where developed countries divided into three clusters and the countries with transition economies and developing clustered together into four clusters. The time series analysis of recognised anomalies of the clusters assist to monitor the government responses and analyse the efficiency of used safety measures against the pandemic. Originality/value This study’s resulted clusters are highly valuable as a division of countries of the whole world for evaluating the health systems and for the regional levels. Further, the results of time series analysis are beneficial in monitoring the government responses and analysing the efficiency of used safety measures against the pandemic.

In this work, we, for the first time, observed the remarkable thermoelectric properties of a few high-quality PtSe2 layered films fabricated by a post selenization of Pt thin films. An excellent po...

Complete disease journey and risk factors for poor outcomes are needed to facilitate effectiveness evaluations of new therapies and clinical decision-making in B-cell Non-Hodgkin lymphoma (B-NHL), particularly in Asia where such data are lacking. This retrospective cohort study used electronic medical records from a regional medical centre in southern Taiwan to follow-up 441 patients newly diagnosed with common B-NHL subtypes: Diffuse Large B-cell Lymphoma (DLBCL), Follicular Lymphoma (FL), Chronic Lymphocytic Leukaemia/Small Lymphocytic Lymphoma (CLL/SLL), Marginal Zone Lymphoma (MZL), Mantle Cell Lymphoma (MCL), and Waldenström macroglobulinemia (WM), between 01-Jan-2008 and 31-Dec-2013, until 31-Dec-2017. Treatment pathways were modelled using a Markov approach. Stage III/IV disease at diagnosis was frequent for patients with DLBCL, FL, MCL and WM. Hepatitis B surface antigen/hepatitis C virus seropositivity was 18.6%/12.3%. Clinical responses to 1st-line treatment were observed in 76.0% (DLBCL), 87.3% (FL), 86.0% (MZL), 60.0% (MCL), and 42.9% (WM) of patients. For DLBCL, disease control was achieved by ~ 50% after 1st-line, ~ 24% after 2nd-line, ~ 17% after 3rd-line. Patients with Stage III/IV DLBCL or age > 65 years at diagnosis had lower rates of active treatment, poorer disease control and higher mortality than patients with early stage disease or age ≤ 65 years. Disease flare

Nasopharyngeal cancer shows a good response to intensity-modulated radiotherapy. However, there is no clear evidence for the benefits of routine use of image-guided radiotherapy. The purpose of this study was to perform a retrospective investigation of the treatment outcomes, treatment-related complications and prognostic factors for nasopharyngeal cancer treated with intensity-modulated radiotherapy and image-guided radiotherapy techniques. Retrospective analysis was performed on 326 consecutive nasopharyngeal cancer patients treated between 2004 and 2015. Potentially significant patient-related and treatment-related variables were analyzed. Radiation-related complications were recorded. The 5-year overall survival and disease-free survival rates of these patients were 77.9% and 70.5%, respectively. Age, AJCC (American Joint Committee on Cancer) stage, retropharyngeal lymphadenopathy, treatment interruption and body mass index were independent prognostic factors for overall survival. Age, AJCC stage, retropharyngeal lymphadenopathy, image-guided radiotherapy and body mass index were independent prognostic factors for disease-free survival. In conclusion, intensity-modulated radiotherapy significantly improves the treatment outcomes of nasopharyngeal cancer. With the aid of image-guided radiotherapy, the advantage of intensity-modulated radiotherapy might be further amplified.

Here, a current-accelerated phase cycling by an in situ current-induced oxidation process was demonstrated to reversibly switch the local metallic Cu and semiconducting Cu2O phases of patterned polycrystalline copper nanobelts. Once the Cu nanobelts were applied by a direct-current bias of ∼0.5 to 1 V in air with opposite polarities, the resistance between several hundred ohms and more than MΩ can be manipulated. In practice, the thickness of 60 nm with a moderate grain size inhibiting both electromigration and permanent oxidation is the optimized condition for reversible switching when the oxygen supply is sufficient. More than 40% of the copper localized beneath the positively biased electrode was oxidized assisted by the Joule heating, blocking the current flow. On the contrary, the reduction reaction of Cu2O was activated by the thermally assisted electromigration of Cu atoms penetrating the interlayer at the reverse bias. Finally, based on a high on/off ratio, the fast switching and the scalable production, reusable feasibility based on copper nanobelts such as the memristor array was demonstrated.

Identifying the credibility of executable files is critical for the security of an operating system. Modern operating systems rely on code signing, which uses a default-valid trust model, for executable files to identify their publishers. A malware could pass software validation of operating systems and security software by using counterfeit code-signing certificates. Although the counterfeit certificates can be revoked by CAs, the previous research showed that the revocation delay takes as long as 5.6 months. In this paper, we attempt to identify the credibility of software with multiple-version executable files without relying on public key infrastructure (PKI), where a new-version executable file is usually developed incrementally based on the previous versions. The sharing features among different versions can be extracted for identifying the software. Accordingly, we present a software-birthmark scheme to serve our purpose. Our scheme generates a cross-version software birthmark for executable files of the same software. The proposed software birthmark is a binary-classification model of a machine learning algorithm based on imported and exported function names extracted from different-version executable files. To evaluate the performance of version-wide software birthmarks, our experiments include 138 versions of Windows kernel32.dll and 545 versions of firefox.exe. We also use multiple machine learning algorithms for performance comparisons. The results show that proposed software birthmark can effectively identify the derivations of these executable files. The proposed software birthmark can be used by operating systems or security software to evaluate the credibility of executable files with suspicious certificates.

A novel double-density hemi-cylindrical (HC) structure 3-D NAND Flash architecture was demonstrated (Lue et al. , 2019). HC 3-D NAND squeezes the gate-all-around (GAA) hole in one direction, followed by a slit cut to split the GAA device to produce twin cells, thus creating >2.5 times of memory density than standard GAA 3-D NAND at the same stacking layer. It is demonstrated that the extremely scaled HC 3-D NAND shows excellent 100k endurance and large memory window >10 V. Contrary to the standard GAA 3-D NAND, HC device has special edge effect issue. For taller HC device, a “wake-up” effect (Du et al. , 2020) by an initial strong –FN erasing can introduce gate injected electrons that electrically suppress the parasitic edge and in turn “wake-up” the device to produce a larger programming window. TCAD simulation clearly shows asymmetrical ${E}$ -field distribution from bottom oxide field to top oxide field at Region I (HC tip) and Region II (bottom edge). Through the comprehensive investigation of HC device “wake-up” effect and strong –FN for initial reset, the variation of cell to cell operation window is minimized and aligned to extremely scaled “hero” HC devices that enjoy field enhancement effect (Hsu et al. , 2007). Our results suggest a promising path of 3-D NAND device toward aggressive dimension scaling and large memory window.

Background Brugada syndrome is a disorder associated with sudden cardiac death and characterized by an abnormal electrocardiogram (ECG). Previous studies were predominantly conducted in men, and the data on long-term prognosis are limited. Information about women, especially elderly women, is lacking. Objective The aim of this study was to investigate the long-term prognosis of the Brugada ECG pattern in elderly women. Method We investigated the 10-year prognosis of the Brugada ECG pattern in elderly women in a nationwide community-based population in Taiwan. Community-dwelling women older than 55 years were prospectively recruited from December 2008 to March 2013 by a stratified random sampling method. All enrolled individuals were followed up annually until April 2019, and the cause of death was documented by citizen death records. Results Among 2597 women, 60 (2.31%) had a Brugada-type ECG, and this prevalence was higher than the mean global prevalence of 0.23%. One woman had a type 1 ECG (0.04%), whereas 15 (0.58%) and 44 (1.70%) women had type 2 and type 3 ECG patterns, respectively. Cox survival analysis revealed that all-cause mortality and cardiac mortality were similar in the individuals with and without a Brugada-type ECG during a mean follow-up of 96.1 ± 20.5 months. Conclusions Our findings suggest that Brugada ECG patterns are not infrequent in elderly women but are not associated with increased risk of mortality in long-term follow-up; these findings may help reduce unnecessary anxiety for physicians, nurses, allied health caregivers, and patients.

PurposeThis research proposes a decision framework for using non-financial measures to define a replenishment policy for perishable health products. These products are perishable and substitutable by nature and create complexities for managing inventory. Instead of a financial measure, numerous measures should be considered and balanced to meet business objectives and enhance inventory management.Design/methodology/approachThis research applies a multi-methodological approach and develops a framework that integrates discrete event simulation (DES), analytic hierarchy process (AHP) and data envelopment analysis (DEA) techniques to define the most favourable replenishment policy using non-financial measures.FindingsThe integration framework performs well as illustrated in the numerical example; outcomes from the framework are comparable to those generated using a traditional, financial measures-based, approach. This research demonstrates that it is feasible to adopt non-financial performance measures to define a replenishment policy and evaluate performance.Originality/valueThe framework, thus, prioritises non-financial measures and addresses issues of lacking information sharing and employee involvement to enhance hospitals' performance while minimising costs. The non-financial measures improve cross-functional communication while supporting simpler transformations from high-level strategies to daily operational targets.

Background Open thyroidectomy via conventional midline approach can be challenging in complex thyroid surgeries. This study proposes a U-shaped strap muscle flap (USMF) technique that provides adequately wide exposure of the surgical field. Methods Strap muscles were cut close to the clavicle and along the anterior margin of both sternocleidomastoid muscles followed by total thyroidectomy in 20 patients as USMF group, and surgical outcomes were compared with 40 patients who had received total thyroidectomy via midline approach. Results No patient had postoperative hematoma, vocal cord paralysis, permanent hypocalcaemia, wound infection or flap necrosis. At 2 months post-surgery, objective voice analysis and subjective assessment of voice and swallowing showed no significant difference between groups. Conclusions USMF provides superb surgical field exposure, and the voice and swallowing functions after USMF are comparable to those obtained by midline approach. The USMF approach is a feasible option for selective difficult thyroid surgery.

Big data analytics has been a topical area in the past decade. Despite it is emphased as a promising tool for the B2B sectors, there is a short of academic studies about this phenomenon in the industrial markets. Existing big data analytics focuses more on the consumers' marketing aspect, while in fact both the consumers' data and the machine-generated transaction data can be gathered and analysed at the interorganisational level. Subsequently, there is a need to increase the attention on the B2B aspects of big data analytics and the interactions of stakeholders. This paper, therefore, investigates the digital transformation enabled by big data analytics in the industrial markets and provides a conceptual framework. It solicits research articles that provide insights into various industrial contexts of this topic and applied both qualitative and quantitative approaches to identify the big data gathering and applications for value creation.

Background: Enterovirus-D68 (EV-D68) has been endemic in Taiwan for some years with a small number of positive cases. Detailed information about respiratory presentation is lacking. This study characterized the clinical course in children admitted to the medical center and regional hospital in Taichung during 2015. Methods: Retrospective chart review of patients with confirmed EV-D68 infection admitted to the medical center and regional hospital in Taichung with respiratory symptoms in the second half of 2015. Past medical history, clinical presentation, management, and course in hospital were collected and analyzed. Simple demographic data and clinical symptoms were also collected from patients confirmed with EV-D68 infection who visited clinics in Taichung. Results: Six children were included. Two patients had a prior history of asthma or recurrent dyspnea, and one had other preexisting medical comorbidities. One child was admitted to the pediatric intensive care unit. All the patients were cured. Cough, rhinorrhea, tachypnea and fever were the most common clinical symptoms among inpatients, while influenza-like illness (ILI) was prevalent in outpatients. Conclusion: EV-D68 infection resulted in respiratory presentations of asthma-like illness in the hospitalized pediatric population. Patients with a prior history of asthma or recurrent dyspnea appear to be more severely affected. Key Words: enterovirus D68, respiratory presentation, taiwan

A novel confined nitride (SiN) charge trapping 3-D NAND flash with excellent postcycling retention performances was demonstrated. Using a uniform sidewall lateral recess in the 3-D stack followed by a SiN pull-back process to isolate the SiN trapping layer in a self-aligned way is critical to facilitate this structure. Lower erase saturation ${Z}$ -direction. Therefore, this structure is in favor of the larger memory window (>10 V) design. Random telegraph noise (RTN) characteristics are comparable to the traditional 3-D NAND device with 100 years at 60 °C and even longer at room temperature. Moreover, superior post-1K-cycled multilevel cell (MLC) retention was also illustrated, which even sustains 150 °C and one-week baking. Therefore, the device has the potential to meet the low-cost long-retention archive memory applications.

Green communication for different kinds of wireless networks has begun to receive significant research attention recently. Green communication focuses mainly on the issue of improving energy efficiency substantially. A wireless sensor network (WSN) consists of a large number of randomly and widely deployed sensor nodes, and these nodes themselves have the ability to wireless communicate, detect and process data. Sensor nodes can thus detect their surrounding environment, and transmit related data to a sink via wireless communication. This study proposes two two-tier data dissemination schemes based on Q-learning for wireless sensor networks. In the proposed schemes, a source node uses Q-learning to find the most energy efficient data dissemination path from the source node to the sink. The first scheme is called TTDD-QL, and the second scheme is called TTDD-QL-A which is an advanced version of TTDD-QL. In TTDD-QL, the reward is determined by the distance between the current dissemination node and the sink. In each iteration, the proposed scheme will update the Q values. After multiple learning iterations, the Q values are converged, and the data dissemination path is found according to the Q values. In TTDD-QL-A, the reward is determined not only by the distance between the current dissemination node and the sink but also by the remaining energy of the current dissemination node. Simulation results show that TTDD-QL and TTDD-QL-A can reduce sensor node energy consumption and extend the lifetime of the WSN.

Background: For early recognition of patients with sepsis, quick Sequential Organ Failure Assessment (qSOFA) was proposed by Sepsis-3 criteria as initial sepsis identification outside of intensive care units. However, the new definition has subsequently led to controversy and prompted much discussion for delayed treatment efforts. We aimed to validate Sepsis-3 criteria on bacteremia patients by investigating prognostic impacts of inappropriate administration of empirical antimicrobial therapy (EAT) and delayed source control (SC) compared to Sepsis-2 criteria.Methods: In the multicenter cohort of adults with community-onset bacteremia in emergency departments (EDs), adverse effects of delayed treatment efforts on 30-day mortality were examined in septic and non-septic patients by fulfilling the Sepsis-2 or Sepsis-3 criteria using the Cox regression model after adjusting independent determinants of mortality.Results: Of the 3,898 total adults, septic patients accounted for 92.8% (3,619 patients) by Sepsis-2 criteria (i.e., SIRS criteria). Using Sepsis-3 criteria, 1,827 (46.9%) patients were diagnosed with early sepsis (i.e., initial qSOFA scores ≥ 2) in EDs and 2,622 (67.3%) with sepsis during hospitalization (i.e., increased SOFA scores of ≥ 2 from ED arrival). The prognostic impacts of inappropriate EAT or delayed SC (for complicated bacteremia) were both significant in septic patients with fulfilling the Sepsis-2 or Sepsis-3 (i.e., SOFA) criteria, respectively. Meanwhile, these delayed treatment efforts trivially impact prognoses of non-septic patients recognized by the Sepsis-2 or Sepsis-3 (i.e., SOFA) definitions. Notably, prognostic effects of inappropriate EAT or delayed SC were disclosed for septic patients in EDs, specifically those with qSOFA scores of ≥ 2, and prognostic impacts of delayed treatment efforts remained significant for patients initially recognized early as being non-septic (i.e., initial qSOFA scores of Conclusions: For patients with community-onset bacteremia, inappropriate EAT and delayed SC might result in unfavorable outcomes of patients early identified as being non-septic on ED arrival based on the qSOFA scores (by Sepsis-3 criteria). Accordingly, a more prudent diagnosis of sepsis adopted among bacteremia patients in the ED is necessary.

Objective Pregnancy and menopause are significant life events associated with major changes in female hormone levels and changes in cardiovascular health. The role of estrogen in influencing cardiovascular risk is an ongoing research topic. Many studies have provided evidence that radial pressure wave characteristics are an important indicator to consistently and independently predict cardiovascular events. The aim of this study was to investigate if radial pressure wave analysis provided statistical insights into the physiological variations due to pregnancy and menopause. Furthermore, the study investigated how these variations could serve as an indicator for cardiovascular risks. As the radial pulse measurement is non-invasive and speedy, it may be helpful in evaluating cardiovascular changes and risk during these transitions. Materials and method A total of 702 randomly selected female subjects (90 pregnant and 97 post-menopausal), aged 20–59, enrolled in the study. The visit measured the subject's hemodynamic parameters including heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and radial pressure waves. SBP and DBP were evaluated by an automatic blood pressure monitor. Radial pressure wave data were continuously recorded for 12-s using a TD01C pulse measuring instrument. Spectrum analysis of the radial pressure wave was performed to evaluate the first five harmonic components (C1–C5). Results A comparison of pregnant women to non-pregnant women showed C3 and C5 were lower. Heart rate C2 and C4 were higher in pregnant women. A comparison of women pre-menopausal and post-menopausal showed no significant difference in SBP or DBP. Menopause significantly changed the C1 and C4 radial pressure wave harmonics. An increase in C1 and a decrease in C4 were observed. Conclusion and discussion This study provided further clinical evidence to support the hemodynamic model that describes the cardiovascular changes and risks related to the harmonic components of the pulse spectrum. Beyond blood pressure, the effects of menopause on the radial pressure wave, especially on hemodynamic index C4, independent of age and BMI, may explain increased post-menopausal cardiovascular risk. This and past studies collectively suggest that radial pressure wave components may be an indicator of a female body's ability to supply oxygen and nutrients. Harmonic analysis of the radial pressure wave may provide additional insights into the underlying mechanism of the cardiovascular changes over the lifespan of a woman.

A multifunctional ion-sensitive floating gate Fin field-effect transistor (ISFGFinFET) for hydrogen and sodium detection is demonstrated. The ISFGFinFET comprises a FGFET and a sensing film, both of which are used to detect and improve sensitivity. The sensitivity of the ISFGFinFET can be adjusted by modulating the coupling effect of the FG. A nanoseaweed structure is fabricated via glancing angle deposition (GLAD) technology to obtain a large sensing area to enhance the sensitivity for hydrogen ion detection. A sensitivity of 266 mV per pH can be obtained using a surface area of 3.28 mm2 . In terms of sodium ion detection, a calix[4]arene sensing film to monitor sodium ions, obtaining a Na+ sensitivity of 432.7 mV per pNa, is used. In addition, the ISFGFinFET demonstrates the functionality of multiple ions detection simultaneously. The sensor arrays composed of 3 × 3 pixels are demonstrated, each of which comprise of an FGFET sensor and a transistor. Furthermore, 16 × 16 arrays with a decoder and other peripheral circuits are constructed and simulated. The performance of the proposed ISFGFinFET is competitive with that of other state-of-the-art ion sensors.

Hepatitis B virus (HBV) reactivation is a well-known complication after rituximab-based chemotherapy in patients with B cell lymphoma (BCL) who have resolved HBV infection. This retrospective cohort study used electronic medical records from the Kaohsiung Chang Gung Memorial Hospital. There were 128 patients with BCL and resolved HBV infection treated with 1st-line rituximab-containing therapy from 2008 to 2013. No patient received antiviral prophylaxis. Patients with high pretreatment hepatitis B surface antibody (anti-HBs titer ≥100 mIU/mL), had significantly less HBV reactivation (2.0%, 1/49) than patients with low (10-100 mIU/mL, 10.8%, 4/37) or negative anti-HBs (

With the popularity of mobile devices, data transmission between mobile devices and cloud datacenters not only introduces tremendous data computation and network traffic but also causes high transmission delay. Mobile edge computing (MEC) is proposed to improve Quality of Service (QoS) for mobile applications in 5G networks. However, the data consistency for mobile applications still relies on replication schemes. Frequent updates may thus result in high communication over-head and long transmission latency. In this paper, we design an adaptive replication scheme for real-time mobile applications by considering the number of failed requests and the read/write request ratios. Our scheme adaptively allocates replicas to share loads among MEC servers. It can avoid overloading MEC servers and shorten latency. The simulation results show that our scheme can reduce the response time of replication requests to increase QoS performance.

Healthcare industries are facing an enormous flow of medical records due to the progression of information technology and the trend of digital transformation. Thus, medical information digitalization is a huge digital dataset that can be utilized to benefit healthcare systems and patients. While many studies focus on the application of the digitalized medical information in the healthcare field, only a few mentioned its resistance. The theoretical background depicts a comprehensive overview of medical information digitalization and the barriers in previous literature. This study emphasized the interaction of medical information digitalization barriers and applies the importance-resistance analysis model (IRA) to identify the resistant factors overcoming strategy. It also clarifies the pathway to eliminating the innovation resistance and reveals the interaction of medical information digitalization barriers. The acquisition, management, and application of medical information digitalization are the key foundation of medical technology innovation, digital transformation, and the application of artificial intelligence. This work can reduce the limitation of a narrow healthcare context. This study helps healthcare industries to clarify and solve barriers and realizes the innovation and application of medical information digitalization. In the long term, the results provide a basis for the future development direction of medical information digitalization and affect the medical industry.

Background and Aim:The risk factors of Barrett's esophagus (BE) include advancing age, male gender, obesity, and long-term reflux symptom. The aim of this study was to analyze the differences in risk factors and presentation of symptoms between young and elderly Chinese patients with BE. Methods:Data from VGHTC were prospectively collected from October 2012 to December 2014. The data of young ( Results:The 67 enrolled subjects comprised 36 (53.7%) young patients and 31 (46.3%) elderly patients. Most BE subjects were male (63.6~77.4%) and had short-segment BE (94.4~93.5%). The waist circumference, BMI, and prevalence of obesity were similar between the two groups. A non-significantly higher rate of hiatal hernia was noted in the elderly cases (58.1% vs. 38.9%, P=0.117). Two young cases (5.6%) and two elderly cases (6.5%) had dysplasia. One elderly subject (3.2%) had adenocarcinoma. Most patients had typical reflux symptoms (58.1%~61.1%), and cigarette smoking was more prevalent in elderly patients. SF-12 scores in the two groups were similar. Conclusion:Young BE patients had similar presentations to those of elderly BE patients. Further study is needed. Keywords:Age; Barrett's esophagus; Young patients

Inotuzumab ozogamicin (InO) is a targeted treatment for adults with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). InO was previously studied in INO-VATE, an international, open-label, randomized phase 3 trial comparing InO against standard of care (SoC). In the present subgroup analysis, we evaluated outcomes in the 55 Asian patients who were randomized in INO-VATE (31 InO and 24 SoC). Complete remission (CR) or CR with incomplete hematologic recovery (CRi) was achieved in 22/31 patients treated with InO versus 5/24 treated with SoC. In the InO arm, more of the patients achieving CR/CRi were minimal residual disease (MRD)-negative (17/22 versus 1/5), and more patients proceeded directly to hematopoietic stem cell transplantation (15/31 versus 3/24). Median overall survival for the respective arms was 5.8 versus 3.9 months (hazard ratio 0.67; 97.5% CI 0.28, 1.62). In the safety analysis (n = 51), the most common adverse events were hematologic. Sinusoidal obstruction syndrome was reported in five InO patients and one SoC patient. In conclusion, Asian patients with relapsed or refractory B-cell ALL experienced improved efficacy with InO versus SoC, with an efficacy and safety profile consistent with results of the overall INO-VATE population. Clinical trial registration: ClinicalTrials.gov identifier: NCT01564784.

Purpose The purpose of this study is to investigate the motivational process underlying users’ intention to provide feedback on user-contributed knowledge in professional online communities. User feedback can serve as a means of indicating the credibility of the online content, which can help community members in their knowledge-seeking process. Adopting such a user feedback mechanism is beneficial for users to identify relevant and credible content efficiently and for an online community to sustain itself. Design/methodology/approach Drawing on self-determination theory, an integrated model is proposed. In this model, behavioural intention is defined as the consequence of motivational orientations whose antecedences include various social factors. The model is empirically tested using survey data collected online and the structural equation modelling techniques. Findings The results show that users’ intention to provide feedback is primarily influenced by autonomous motivation. Autonomous motivation is in turn affected by social factors, including reciprocity, online reputation, trust in the user involvement mechanisms and affective and normative community commitments. Originality/value This study adds value to prior studies by stressing the significance and feasibility of user feedback in helping members of professional online communities with their knowledge-seeking process. It also contributes to the literature on user participation in these communities by showing the efficacy of a motivational process perspective and the role of motivational orientations, in particular, in explaining users’ behavioural intention.

Copper nanowires are widely used as on-chip interconnects due to their superior conductivity. However, with aggressive Cu interconnect scaling, surface scattering of electrons drastically increases the electrical resistivity. In this work, we have studied the electrical performance of Cu thin films deposited on different materials. By comparing the thickness dependence of Cu films' resistivity on MoS2 and SiO2, we have demonstrated that MoS2 can be used to enhance the electrical performance of ultrathin Cu films due to improved specular surface scattering by up to 40%. By fitting the experimental data with the theoretical Fuchs-Sondheimer (FS) model, we have determined the specularity parameter at the Cu/MoS2 interface to be p ≈ 0.4 at room temperature. Furthermore, first principle calculations based on density functional theory (DFT) indicate that the localized density of states (LDOS) at the Cu/amorphous SiO2 interface is larger than the LDOS at the Cu/MoS2 interface, which is believed to be responsible for the higher resistivity in the Cu thin films that are deposited on SiO2 substrates. Our results suggest that MoS2 may serve as a performance enhancer for future generations of Cu interconnects.

Purpose Online shopping has continued to grow in popularity, and the advance of internet technology has enhanced customers’ experiences. One technology online retailers have been using to increase sales is virtual try-on (VTO). The purpose of this paper is to investigate how such technology affects online consumers’ purchase decision process towards purchase intention, especially from an integration of utilitarian, hedonic and risk perspectives, by using advanced partial least square (PLS) approaches. Design/methodology/approach This study applied a web-based survey approach for data collection from online apparel retailing websites. The survey instrument was developed by adapting previously validated measurement items. The valid data collected were analysed using PLS with multi-group analyses. Advanced PLS techniques such as examination of discriminant validity using heterotrait-monotrait ratio, tests of out-of-sample prediction performance, and measurement invariance of composite models were applied. Findings The results of examining the proposed model reveal that customers’ attitude towards VTO technology can affect their intention to purchase a garment online, which is affected by perceived usefulness, perceived enjoyment and perceived privacy risk. Perceived ease of use is found to affect perceived usefulness and perceived helpfulness. The results also show no significant differences among age groups and genders in terms of the role of VTO technology in the full decision process towards online purchase intention. Originality/value This study enhances the understanding of the roles that VTO technology plays in consumers’ online purchase intention by providing an integrative view of its utilitarian value, hedonic value and risk. This study demonstrates the feasibility of applying advanced PLS techniques to investigate online consumer behaviour, particularly in the field of VTO application in online retailing. Implications for online retailers and designers of VTO technology are also derived from the findings.

A simple technique for extracting the bias-dependent parasitic series resistances of the GaN-based high electron mobility transistor (HEMT) is demonstrated in this paper. With considering the non-quasi-static effect in devices, new analytical Z-parameter formulations are derived to determine parasitic resistances using the curve-fitting algorithm. More accuracy parasitic resistances can be obtained over a wide fitting frequency range compared to the conventional method which ignores the non-quasi-static effect. Here the intrinsic parameters are then calculated directly from intrinsic Y-parameters after de-embedding the parasitic elements in the small-signal equivalent circuit. An excellent agreement between the measured and simulated S-parameters from 100 MHz to 40 GHz is achieved, which validates the feasibility of our method for extracting the bias-dependent parasitic resistances.

The latent attribute space in cognitive diagnosis models (CDMs) is often assumed to be unstructured or saturated. In recent years, the number of latent attributes in real tests has often been found to be large, and polytomous latent attributes have been advocated. Therefore, it is preferable to adopt substantive theories to connect seemingly unrelated latent attributes, to replace the unstructured or saturated latent structural models (LSMs) with structured or parsimonious ones, with simplified parameter estimation. In the present study, we developed a partial mastery, higher-order LSM for polytomous attributes, which was built upon the framework of adjacent-category logit models to account for a higher-order latent structure of multiple polytomous attributes. The proposed model can be incorporated into many existing CDMs. We conducted simulations to evaluate the psychometric properties of the proposed model and obtained good parameter recovery. We then provided an empirical example to demonstrate the applications and the advantages of the proposed model.

As a critical research topic toward the new era of big data, how to develop a high-performance data analytics system has received significant research attention from different disciplines since the 2000s. In the literature, many recent works attempted to develop a high-performance data analytics system to handle the large amount of data (i.e., volume) from different information systems (i.e., variety) that typically will be created very quickly in a short time (i.e., velocity). In particular, several recent studies have shown that metaheuristic algorithms can be applied to many data mining optimization problems to provide a better way to find a high-quality result than traditional deterministic algorithms. A high-performance clustering algorithm for big data analytics system will be presented in this paper. The proposed algorithm is designed based on a new kind of metaheuristic algorithm, coral reef optimization with substrate layers (CRO-SL), to get a better cluster result. To improve the effectiveness and efficiency, the proposed CRO-SL scheme has been applied to a cloud computing platform as well to reduce the response time of a data analytics system. The simulation results show that the proposed algorithm is able to provide a better clustering result than the other clustering algorithms compared in this research, including k-means, genetic k-means algorithm, particle swarm optimization, and simple coral reef optimization algorithm in terms of the sum of squared errors.

Background and objectives The calcaneus is the most fracture-prone tarsal bone and injuries to the surrounding tissue are some of the most difficult to treat. Currently there is a lack of consensus on treatment or interpretation of computed tomography (CT) images for calcaneus fractures. This study proposes a novel computer-assisted method for automated classification and detection of fracture locations in calcaneus CT images using a deep learning algorithm. Methods Two types of Convolutional Neural Network (CNN) architectures with different network depths, a Residual network (ResNet) and a Visual geometry group (VGG), were evaluated and compared for the classification performance of CT scans into fracture and non-fracture categories based on coronal, sagittal, and transverse views. The bone fracture detection algorithm incorporated fracture area matching using the speeded-up robust features (SURF) method, Canny edge detection, and contour tracing. Results Results showed that ResNet was comparable in accuracy (98%) to the VGG network for bone fracture classification but achieved better performance for involving a deeper neural network architecture. ResNet classification results were used as the input for detecting the location and type of bone fracture using SURF algorithm. Conclusions Results from real patient fracture data sets demonstrate the feasibility using deep CNN and SURF for computer-aided classification and detection of the location of calcaneus fractures in CT images.

Cloud applications such as virtualized network functions usually rely on static or dynamic replication mechanisms to achieve high service reliability and satisfy the requirements of service level agreement. Because replicas are allocated in geographically distributed datacenters, their updates increase the difficulty of maintaining consistency among replicas in different datacenters. The consistency overheads among replicas increase bandwidth consumption and transmission latencies to degrade the quality of service (QoS) performance and service reliability. Although previous mechanisms attempt to shorten response time, reduce bandwidth consumption, or maintain high service reliability with minimized storage cost, they do not consider the overhead of data consistency. In this paper, we study the problem of replica placement with consistency overheads by analyzing the latency and reliability for different types of operations. A replication algorithm, write-aware replica placement (WARP), is then presented based on the analysis. The simulation results show that WARP can shorten response time and improve QoS without degrading reliability.

Studies of childhood anaplastic large cell lymphoma (ALCL) are less reported from East Asian countries. Clinical features and outcome of 90 children with ALCL in Taiwan were analyzed. The median age at diagnosis was 11.7 years. The most common presentation was lymph node involvement (86.7%). Advanced diseases accounted for 70% of patients at diagnosis. Most patients (93.1%) had positive staining for anaplastic lymphoma kinase. The five-year overall survival and event-free survival (EFS) rates were 79.7% and 73.3%, respectively. Bone marrow involvement, advanced stage, and thoracopulmonary ALCL were adverse prognostic factors for EFS (

Background: Quality of life (QoL) is important for clinicians to evaluate how cancer survivors judge their sense of well-being, and WHOQOL-BREF may be a good tool for clinical use. However, at least three issues remain unresolved: (1) the psychometric properties of the WHOQOL-BREF for cancer patients are insufficient; (2) the scoring method used for WHOQOL-BREF needs to be clarify; (3) whether different types of cancer patients interpret the WHOQOL-BREF similarly. Methods: We recruited 1000 outpatients with head/neck cancer, 1000 with colorectal cancer, 965 with liver cancer, 1438 with lung cancer and 1299 with gynecologic cancers in a medical center. Data analyses included Rasch models, confirmatory factor analysis (CFA), and Pearson correlations. Results: The mean WHOQOL-BREF domain scores were between 13.34 and 14.77 among all participants. CFA supported construct validity; Rasch models revealed that almost all items were embedded in their expected domains and were interpreted similarly across five types of cancer patients; all correlation coefficients between Rasch scores and original domain scores were above 0.9. Conclusion: The linear relationship between Rasch scores and domain scores suggested that the current calculations for domain scores were applicable and without serious bias. Clinical practitioners may regularly collect and record the WHOQOL-BREF domain scores into electronic health records. Keywords: Confirmatory factor analysis, Cancer, Psychometric properties, Quality of life, Rasch analysis

Introducing an anti-reflective coating (ARC) is the last step of fabricating Cu(In,Ga)Se2 solar cells with enhanced photo-generated current by reducing the reflectance of visible light. The use of nanostructures in ARC has been intensively investigated because this can prolong the optical path length by a scattering effect or by the formation of a refractive index gradient. Herein, we proposed the use of TiO2 helical nanostructures using glancing angle deposition (GLAD), and then synthesized SiO2 surrounding the helical nanostructures to further decrease the reflectance by producing a refractive index gradient. The optimized values of TiO2 and SiO2 thicknesses are 150 nm and 3 nm determined by the finite-difference time-domain (FDTD) simulation on Cu(In,Ga)Se2 solar cells. The suppression of reflectance led to enhanced light absorption across a broad wavelength range, and boosted the JSC from 20.66 to 22.51 mA cm−2, resulting in improved power conversion efficiency (PCE) from 6.32 to 7.00% after applying the TiO2–SiO2 core–shell nanostructures as the ARC. This 10.75% PCE enhancement suggests that the novel TiO2–SiO2 core–shell nanostructures have great potential as ARC for Cu(In,Ga)Se2 solar cells, and it would be beneficial for development in the photovoltaic field in both research and applications.

This study explains the adoption of Passenger Service Systems (PSS) in airlines through the lens of Inter-organizational Systems adoption and home-region orientation. It examined 20 causal factors influencing PSS adoption and tested an original research model in the technology–organization–environment context, by applying transactional cost theory and neo-institutional theory. Prior to a cross-case study across multiple airlines, the explanatory single-case research analyzed interview data from four informants with a Taiwanese carrier and multiple industry reports; the key findings highlight: (i) interoperable functionality and industry standards as external technological drivers strongly influenced full conversion to the PSS platform; (ii) within the organizational context, commitment to global network, organizational transformation and top management support were identified as salient internal factors in decision-making and resource allocation, while normative pressures from an alliance body exerted a stronger influence over the airline than any other isomorphic forces; and (iii) in the context of environment, full conversion was also facilitated by PSS vendors and powered by the need for mutual worldwide learning to effectively operate foreign markets from home region. This in-depth case study provides insights that PSS in a common-use environment can bring business value to PSS user airlines in accessing a broader global market, offering greater competitive services and expanding distribution channels. To increase causality and generalizability, future work involving an embedded multi-case study with three East Asian carriers will be undertaken.

The high global prevalence, irreversible health burden, and expenditures of diabetes mellitus lead to a proliferative research area of prognosis and diagnosis of diabetes and its complications through machine learning techniques. Although the risk scoring and prediction models have been proposed for decades, challenges still persist. Feature selection is one challenging problem that is still remains when building accurate models. Since each risk factor's contribution in predicting complications of diabetes vary with the recognition of novel risk factors, it is a requirement to make an up-to-date standard feature subset that can predict the risk of complications of diabetes mellitus. This research in progress paper proposes a systematic review study that aims to extract frequent feature subsets for predicting complications of diabetes. Diabetic retinopathy, neuropathy, nephropathy, and cardiovascular diseases have been considered as the most common complications of diabetes. PRISMA guidelines will be used to conduct the systematic review. Further, the proposed study will be strengthened by selecting credible journal repositories, optimising the search query, utilising inclusion and exclusion criteria, and determining top-ranked journals. The paper presents data analysis design with feature subsets to predict the aforementioned four complications of diabetes, which is directly beneficial for clinicians, researchers, and model developers to assist their clinical decisions, research purposes, and feature selection phase in model designing respectively.

In addition to the benefits of facilitating doctor-patient communication and diagnosis, the wide application of online medical consultation (OMC) platforms is of possible significance to medical demand forecasting. However, studies examining the relationship between OMC data and medical demand are lacking. This study aims to assess the predictive value of OMC data for medical demand. Using sentiment analysis and word analysis results from OMC platform data, this study develops a medical demand forecasting model using OMC data in China. It is proposed that the research framework for forecasting highlights the importance of OMC data and would positively improve the accuracy of medical demand forecasting.

Recently, we have developed a novel vertical split-gate Flash (or vertical 2T NOR) architecture in a n-channel device. In this work, we further develop the p-channel device counterpart, and demonstrate 4 different electron and hole injection methods, including band-to-band tunneling-induced hot-electron (BBHE), +FN electron, source-side injection hot-hole (SSIH), and-FN hole injections. The split-gate Flash allows both over-erase and over-program supported by the select-gate (SG) transistor. Bit-alterable operations are possible, thus providing very flexible and versatile memory operations. Various combinations of P/E cycling endurance are studied, and it is found that BBHE electron together with-FN hole injections produce the best match for endurance, while other combinations especially with SSIH induce more degradations. The advantages of this device are (1) Both n- and p-channel Flash can be fabricated on the same wafer; (2) The Flash transistors enjoy high ON/OFF ratio> 7 orders, good for a re-configurable switch; (3) Large tunable Vt window of 6V. These advantages offer good potential of realizing functional memories, such as being used in a reconfigurable circuit, especially for the connection block in a field programmable array (FPAA or FPGA).

Recently, we proposed a novel 3D AND-type Flash memory [1]–[3] architecture for 3D NOR Flash solution. In this work, we further propose a “write-in-place” (or “in-place write”) operation (like EEPROM) and demonstrate the feasibility. “Write-in-place” is to provide the same erase unit (page erase) as the program unit (page program). Thus to overwrite a page data the users just need one page erase followed by the page program, without the need to deal with a large erase unit (like NAND and NOR Flash memories). The in-place write does not require complex GC (garbage collection) algorithms by system controller, and can eliminate the write amplifications effect and improve the QoS (quality of service) of system performances. After optimization of BE-MANOS charge-trapping device, the in-place page write time can be minimized to around 110usec. Small neighbor-WL interferences, free from pattern loading effects and hot-carrier disturbs are merits of 3D AND architecture to enable write-in-place. We also suggest the future extensions of integrating ferroelectric memory FeFET device in the 3D AND architecture to further boost the in-place write speed to nearly 1 micro second at lower write voltages (∼5V).

Computing-In-Memory (CIM) using Flash memory is a potential solution to support a heavy-weight DNN inference accelerator for edge computing applications. Flash memory provides the best high-density and low-cost non-volatile memory solution to store the weights, while CIM functions of Flash memory can compute AI neural network calculations inside the memory chip. Our analysis indicates that Flash CIM can save data movements by ~85% as compared with the conventional Von-Neumann architecture. In this work, we propose a detail device and design co-optimizations to realize Flash CIM, using a novel vertical split-gate Flash device. Our device supports low-voltage (