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Microsporidial stromal keratitis is an increasingly well-known vision-threatening disease. A large proportion of cases are initially misdiagnosed as herpes simplex keratitis and treated with topical steroids. In most of such cases, medical treatment failed, and corneal transplantation was required. This study reported the results of 0.02% topical chlorhexidine used to treat three cases of microsporidial stromal keratitis and reviewed the literature on the outcomes of microsporidial stromal keratitis treatment. In the first case, histopathology of a specimen from penetrating keratoplasty (PK) revealed severe chronic inflammation involving the entire stromal layer but no microorganism activity after the application of topical chlorhexidine for 10 months. The second case exhibited complete resolution of keratitis after topical chlorhexidine. The patient in the third case did not respond to medical treatment, and therapeutic PK was performed. Histopathological examination revealed numerous microsporidial spores that had colonized in the mid and deep stroma, where few inflammatory cells were observed. These findings explain the variable microsporidial susceptibility to chlorhexidine, suggesting the crucial role of host immunity. In cases of host immunity, topical chlorhexidine may represent a promising option for the treatment of microsporidial stromal keratitis.

BACKGROUND This study aimed to investigate the short-term effect of cycloplegia on higher-order aberrations (HOAs) in school-age myopic children who received 0.25% atropine for cycloplegic refraction. METHODS We performed a retrospective chart review of 24 myopic children between the ages of 5 and 15 years, who had received one topical drop of 0.25% atropine for three consecutive nights before undergoing cycloplegic refraction. Auto-refraction, visual acuity, and HOAs measured with the iTrace aberrometer were compared before and after atropine use. To account for the effect of cycloplegia, the amount of HOAs under matching scanning sizes was compared. RESULTS There were statistically significant differences in the spherical equivalent, with a hyperopic shift after atropine use (p < 0.001). Corrected visual acuity and spherical aberrations showed no significant change under the respective pupil and scanning sizes before and after atropine use. Under identical scanning sizes, there was a significant change in total spherical aberration (from 0.03 to 0.06 μm, p = 0.044) and internal spherical aberration (from -0.10 to -0.05 μm, p = 0.049) after atropine use. Differences in corneal spherical aberration were insignificant. CONCLUSION The positive shift of spherical aberration induced by the inhibition of accommodation in myopic children may have a possible effect against myopic progression. Future studies can focus on the long-term effect on HOAs and impact on visual quality with lower concentrations of atropine.

Pseudophakic bullous keratopathy and Fuchs' endothelial dystrophy are the two most common causes of corneal edema after cataract surgery. We report a 61-year-old alcoholic male with bilateral corneal edema that improved after his alcohol abstinence. He had uneventful bilateral cataract surgery 3 years ago and blurred vision in both eyes developed for weeks. As he had no history of endothelial dystrophy, the treatment for viral endotheliitis was used initially yet in vain. We asked him to stop alcohol and adjusted his psychiatric drugs, but he lied about stopping drinking. The corneal edema progressed, and finally, he underwent penetrating keratoplasty in his left eye 1 year later. During hospitalization for surgery, alcohol withdrawal syndrome was noted because he could not drink alcohol in our hospital. After he quit drinking for months, corneal edema in the right eye disappeared. Our case highlights that alcoholism can result in corneal edema, and stopping drinking is necessary in these patients.

Production management of perishable goods is highly complex and requires well-informed decisions in corresponding stages. In such production environments, scheduling problems with time constraints are of high relevance to ensure the timely flow of the work-in-process material and goods. This study introduces the no-wait flowshop scheduling problem with release times (NWFSP-RT) to help advance decision support systems in the food production industry. For this purpose, an original mixed-integer linear programming (MILP) formulation is proposed for minimizing makespan. A BS algorithm, and an improved variant, the local search-based Beam Search (BSLS) algorithms are developed to solve the NWFSP-RT problem. Extensive numerical analysis is conducted to analyze the performance of the algorithms in solving this highly intractable extension of the scheduling problems. We showed that BSLS effectively avoids early convergence and local optimality while dismissing non-promising search directions within a partial enumeration solution approach. The statistical analysis confirmed that the improved BS algorithm performs better in terms of solution quality. Applications of the developed heuristic are worthwhile research topics to pursue in solving other complex optimization problems.

Transepithelial photorefractive keratectomy (Trans-PRK), laser-assisted in situ keratomileusis (LASIK), and small incision lenticule extraction (SMILE) are three mainstay refractive surgeries worldwide. The applicability, efficacy, safety, and predictability of these different techniques are quite similar. Trans-PRK has the strongest biostability, earliest return to normal corneal sensitivity but the longest recovery time, most uncomfortable postoperative experience, and possibility of corneal haze. LASIK possesses the fastest visual rehabilitation but the slowest corneal nerve reinnervation, and flap displacement is possibly lifelong. SMILE incurs no flap-related complications and has intermediate vision recovery time and biomechanics compared with Trans-PRK and LASIK. However, it lacks the cyclotorsion compensation system, eye tracking system, and customized treatment profile for high astigmatism or irregular corneal surface. This review aims to introduce the mechanisms, pros, and cons of these three types of refractive surgery. With full understanding, practitioners could advise patients on the most suitable treatment of choice.

Objective To analyze the relationship between dry eye symptoms and modern dry eye tests, including the Schirmer I test, lipid layer thickness (LLT), and blinking pattern by LipiView interferometer. Design Cross-sectional study. Participants 115 dry eye outpatients. Methods Dry eye symptoms were quantified by questionnaire scores, such as Ocular Surface Disease Index (OSDI) and Standard Patient Evaluation of Eye Dryness (SPEED). LLT, complete, and incomplete blinking rate were recorded by the LipiView interferometer. Results 115 patients (229 eyes, mean age = 60.5 ± 13.6 years) were enrolled in this study. The mean value of the SPEED and OSDI scores was 9.5 and 10.2, respectively. A total of 44.3% of all subjects had severe dry eye syndrome (SPEED, OSDI ≥ 10). LLT (mean = 71.2 nm) was inversely correlated with both the SPEED and OSDI (p = 0.003 and 0.004, respectively). The incomplete-to-complete ratio of blinking rate (i/c ratio) was correlated with both the SPEED and OSDI (p = 0.0048 and 0.0234, respectively). Patients with LLT less than 69 nm were more likely to have severe dry eye syndrome. There was no significant relationship between the Schirmer I test and the SPEED or OSDI. However, LLT was inversely related to the Schirmer I test (linear regression, p = 0.0002, r = −0.1857). Conclusions LLT and the i/c ratio were significantly correlated to dry eye symptoms. Eyes with thinner LLT are more likely to have better aqueous tear production. The role of the reciprocal influence between each tear component in the maintenance of tear function warrants further investigation.

Background: Whether the weaning outcome of solid cancer patients receiving mechanical ventilation (MV) in the intensive care unit (ICU) is comparable to that in non-cancer patients is unknown. The aim of this study was to compare the weaning outcomes between non-cancer patients and patients with different types of cancer. Methods: We studied patients requiring MV during ICU stay for medical reasons between 2012 and 2014. Cancer patients were grouped into those with lung cancer (LC), head and neck cancer (HNC), hepatocellular carcinoma (HCC), and other cancers (OC). The primary endpoint was successful weaning at day 90 after the initiation of MV, and the main secondary endpoints were 28-day and 90-day mortality after ICU admission. Results: Five hundred and eighteen patients with solid cancers and 1362 non-cancer patients were recruited. The rate of successful weaning at day 90 was 57.9% in cancer patients, which was lower than 68.9% in non-cancer patients (p

Introduction: There are currently no specific biomarkers to screen and monitor disease progression in abdominal aortic aneurysms (AAA), which are the 15 th leading cause of death in the United States. Circulating exosomes contain microRNAs (miRNA) that are potential biomarkers of disease. This study aimed to characterize the exosomal miRNA expression profile of patients with AAA in order to identify novel markers of disease. Methods: A total of 109 patients scheduled to undergo a duplex ultrasound (US) for screening or surveillance of AAA were screened to participate in the study. Eleven patients with AAA (max aortic diameter >3cm) and 15 non-aneurysmal controls (max aortic diameter Results: Aortic diameter, as measured by US, was significantly larger in the AAA group (mean maximum diameter 5.2 vs 2.3 cm, p =2.84x10 -6 ). Aneurysm patients were more likely to suffer from CAD (5/11 vs 1/15, p = 0.05) but had similar levels of PAD (4/11 vs 2/15, p =0.35) and COPD (4/11 vs 4/15, p =0.68) compared to controls. A total of 40 miRNAs were differentially expressed ( p p = 1.8x10 -5 ; FDR p =0.02). Conclusions: Plasma exosomes from AAA patients have significantly reduced levels of miRNA-122-5p compared to controls.

Although current studies suggested that conjunctivitis is not a common presentation of coronavirus disease 2019 (COVID-19), several studies have reported the presence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in ocular secretions. Coronavirus had not yet been successfully cultured from tears or conjunctival swabs in humans, neither SARS-CoV-2 nor SARS-CoV. However, live feline coronavirus has been isolated from conjunctival swabs. In addition, infection of COVID-19 through unprotected eye exposure had been suspected in several articles. Reports of ophthalmologists and otolaryngologists died of COVID-19 also raised concern on ocular transmission. As a result, we strongly suggest that personal protective equipment (PPE) should cover the mouth, nose, and eyes of ophthalmologists, especially when conjunctivitis caused by SARS-CoV-2 is clinically indistinguishable from other viral follicular conjunctivitis.

Zaxinone is an apocarotenoid regulatory metabolite required for normal rice growth and development. In addition, zaxinone has a large application potential in agriculture, due to its growth-promoting activity and capability to alleviate infestation by the root parasitic plant Striga through decreasing strigolactone (SL) production. However, zaxinone is poorly accessible to the scientific community because of its laborious organic synthesis that impedes its further investigation and utilization. In this study, we developed easy-to-synthesize and highly efficient mimics of zaxinone (MiZax). We performed a structure–activity relationship study using a series of apocarotenoids distinguished from zaxinone by different structural features. Using the obtained results, we designed several phenyl-based compounds synthesized with a high-yield through a simple method. Activity tests showed that MiZax3 and MiZax5 exert zaxinone activity in rescuing root growth of a zaxinone-deficient rice mutant, promoting growth, and reducing SL content in roots and root exudates of wild-type plants. Moreover, these compounds were at least as efficient as zaxinone in suppressing transcript level of SL biosynthesis genes and in alleviating Striga infestation under greenhouse conditions, and did not negatively impact mycorrhization. Taken together, MiZax are a promising tool for elucidating zaxinone biology and investigating rice development, and suitable candidates for combating Striga and increasing crop growth., Zaxinone is an apocarotenoid growth regulator and plant hormone candidate that promotes rice growth and acts as a negative regulator of strigolactone biosynthesis. Wang et al. performed a structure–activity relationship study and used obtained results to generate a series of easy-to-synthesize mimics of zaxinone (MiZax) that were as efficient as zaxinone in promoting rice growth, repressing strigolactone biosynthesis, and alleviating infestation by the parasitic weed Striga. The developed MiZax will significantly support zaxinone research and are promising candidates for agricultural applications.

Objective To analyze the causes and the clinical features of infertile men with nonobstructive azoospermia and hypospermatogenesis (HS). Materials and Methods This retrospective cohort study included 100 patients with nonobstructive azoospermia and HS and 8 patients with obstructive azoospermia and normal spermatogenesis. The severity of HS was subdivided into 3 groups (mild, moderate, and severe) based on spermatogenic score. Data of history, physical findings, serum hormone profiles, genetic studies, and sperm retrieval rate were collected. Whole genome DNA methylation analysis and microarray mRNA expression analysis were used to identify the candidate genes of methylation dysregulation in HS. Results Thirty-two (32%) patients had at least 1 prior/current testicular insults and 13 (13%) patients had genetic anomalies. Fifty-five (55%) patients were categorized as idiopathic HS. Patients with mild HS had a higher frequency of testicular insults, and patients with severe HS had a significantly higher frequency of genetic anomalies. Sperm retrieval rate was 100%, 100%, and 88.4% for patients with mild, moderate, and severe HS, respectively. Four sterility-related genes, including BOLL , DDX4 , HORMAD1 , and MAEL , were found to have increased methylation at CpGs of the promoter regions and decreased mRNA expressions in HS testis. Conclusion The causes of HS are complex and multifactorial. The main causes of HS were prior or current testicular insults and chromosomal or genetic anomalies. More than half of the patients were categorized as idiopathic HS. With high throughput analysis, methylation dysregulations of BOLL , DDX4 , HORMAD1 , and MAEL are believed to be associated with HS.

Checkpoint inhibitors have recently achieved many promising outcomes in cancer treatment.2018 These are monoclonal antibodies targeting cytotoxic T‐lymphocyte antigen‐4 (CTLA‐4), programmed death p...

// Chi-Che Hsieh 1, 2 , Yi-Ming Shyr 4, 10 , Wen-Ying Liao 2 , Tien-Hua Chen 4, 5 , Shin-E Wang 4, 10 , Peir-Chuen Lu 6 , Pei-Yu Lin 7 , Yan-Bo Chen 2 , Wan-Yu Mao 2 , Hsin-Ying Han 2 , Michael Hsiao 2 , Wen-Bin Yang 2 , Wen-Shan Li 3 , Yuh-Pyng Sher 1, 8 , Chia-Ning Shen 2, 6, 9 1 The Ph.D. Program for Cancer Biology and Drug Discovery, China Medical University and Academia Sinica, Taiwan 2 Genomics Research Center and Academia Sinica, Taipei, Taiwan 3 Institute of Chemistry, Academia Sinica, Taipei, Taiwan 4 Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan 5 Institute of Anatomy and Cell Biology and National Yang-Ming University, Taipei, Taiwan 6 Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan 7 Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan 8 Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan 9 Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan 10 Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Correspondence to: Chia-Ning Shen, email: cnshen@gate.sinica.edu.tw Keywords: fructose, pancreatic ductal adenocarcinoma, metastasis, β-galactoside α2, 6-sialyltransferase 1 Received: May 24, 2016 Accepted: November 30, 2016 Published: December 09, 2016 ABSTRACT Pancreatic ductal adenocarcinoma (PDAC) is an aggressive type of pancreatic cancer with clinical characteristics of local invasion and early metastasis. Recent cohort studies indicate high fructose intake is associated with an increase in pancreatic cancer risk. However, the mechanisms by which fructose promotes pancreatic tumorigenesis remain unclear. Herein, Kras +/LSLG12D mice were crossed with Elas-CreER transgenic mice to determine whether fructose intake directly contributes to tumor formation. Orthotopic tumor-xenograft experiments were performed to determine whether fructose substitution enhances the metastatic potential of PDAC cells. The mechanisms underlying the effects of fructose were explored by RNAseq analysis in combination with high-performance anion exchange chromatography. Dietary fructose was initially found to promote the development of aggressive pancreatic cancer in mice conditionally expressing Kras G12D in the adult pancreas. We further revealed that fructose substitution enhanced the metastatic potential of human PDAC cell via selective outgrowth of aggressive ABCG2-positive subpopulations and elevating N-acetylmannosamine levels that upregulated β-galactoside α2,6-sialyltransferase 1 (ST6Gal1), thereby promoting distant metastasis. Finally, we observed that PDAC patients expressing higher levels of ST6Gal1 and GLUT5 presented poorer prognosis compared to other groups. In conclusion, our findings have elucidated a crucial role of ST6Gal1 in regulating the invasiveness of PDACs in a fructose-responsive manner.

Background: High myopia is associated with multiple ocular morbidities that may lead to irreversible blindness. Because high myopia in an adult is thought to be related to onset of myopia in very early childhood, detecting myopia early and working to improve modifiable risk factors may help reduce the development of high myopia. In this study, we tried to evaluate the prevalence of myopia and associated risk factors in second-grade primary school children in Taipei, Taiwan. Methods: A questionnaire was distributed to the participants’ parents, and their written informed consent was obtained before performing eye examinations that included visual acuity testing and cycloplegic autorefraction. Multiple logistic regression models were applied to assess possible risk factors associated with myopia. Myopia was defined as spherical equivalent of −0.50 D or less in either eye. Results: The prevalence of myopia in the second graders was 36.4%. After adjustment for other characteristics, the following variables were significantly associated with a higher risk of myopia: male sex [odds ratio (OR)=1.24, p

In recent years, traditional transactions have been replaced by electronic transactions. To protect the security of the electronic transactions, various electronic payment (e-payment) mechanisms have been proposed. However, we find the previous e-payment mechanisms do not provide the non-repudiation requirement in the client side. Thus, a malicious client can easily deny the transaction and the merchant may not get the payment. In addition, these mechanisms have large computation and communication costs so they cannot be applied to the mobile payment for cloud computing. To solve the above problems, we propose a new mobile payment mechanism with anonymity for cloud computing in this paper. The proposed mechanism not only reduces the computation cost but also provides the non-repudiation requirement in the client side. Compared with the related works, the proposed mechanism is securer, fairer, and more efficient. Therefore, the proposed mobile payment mechanism is more suitable and practical for the cloud computing. The client can transact anonymously to protect the payment privacy.The client's bank generates the digital signature as the payment proof.The new payment scheme can eliminate the redundant symmetric keys between the client and the merchant.

QR barcodes are used extensively due to their beneficial properties, including small tag, large data capacity, reliability, and high-speed scanning. However, the private data of the QR barcode lacks adequate security protection. In this article, we design a secret QR sharing approach to protect the private QR data with a secure and reliable distributed system. The proposed approach differs from related QR code schemes in which it uses the QR characteristics to achieve secret sharing and can resist the print-and-scan operation. The secret can be split and conveyed with QR tags in the distribution application, and the system can retrieve the lossless secret when authorized participants cooperate. General browsers can read the original data from the marked QR tag via a barcode reader, and this helps reduce the security risk of the secret. Based on our experiments, the new approach is feasible and provides content readability, cheater detectability, and an adjustable secret payload of the QR barcode.

This study uses a hybrid method of computational fluid dynamics (CFD) and inverse heat conduction analysis (IHCA) combined with experimental temperatures to investigate the natural convection of plate finned tube heat exchangers with two horizontal tubes located in a chimney. The influence of the position of the two heated tubes on the results obtained is considered. IHCA combined with experimental temperatures is used to estimate h ¯ and h ¯ b . Subsequently, the CFD commercial software combined with the obtained inverse results and experimental temperatures is employed to get the present results. The results reveal that the zero-equation turbulence model can be applied to determine more accurate results than the other two flow models. Therefore, the appropriate flow model for this study is the zero-equation turbulence model. The fringe pattern for each heated tube is mainly aligned in the vertical direction and the two plumes are slightly inclined toward the inward direction. The obtained velocity pattern and air temperature contour are consistent with existing interferometric images or isotherms. The proposed correlation between Ra and Nu agrees with the obtained inverse and CFD results.

Introduction: Corticosteroid treatment for uveitis can lead to delayed-onset pressure-induced interlamellar stromal keratitis (PISK), even years after laser in situ keratomileusis (LASIK). A 35-year-old man presented to our clinic after experiencing blurred vision in his left eye for 1 month. For the past month, he had been prescribed topical steroid and anti-glaucomatous medication. He had undergone LASIK for both eyes 5 years earlier, and had suffered uveitis attacks in his left eye over the last 2 years. Slit-lamp examination revealed stromal haziness with interface fluid accumulation in the left eye. The left eye showed an intraocular pressure (IOP) of 35 mm Hg and visual acuity of 6/20. Anterior segment ocular coherence tomography (OCT) confirmed the diagnosis of PISK. Steroid treatment was tapered, and latanoprost treatment was started. One month later, the patient's symptoms resolved, with IOP reduced to 10 mm Hg and visual acuity increased to 6/6 in the left eye. Latanoprost treatment was discontinued to avoid potential uveitis reactivation, and the patient's visual field defect progressed and IOP rebounded. Due to evident glaucomatous damage, trabeculectomy was suggested but was refused. Conclusion: Patients with PISK plus uveitis should be treated with a tailored regimen involving corticosteroid and antiglaucomatous medication or surgical intervention based on the individual condition. Early recognition and appropriate treatment may aid in preventing severe visual sequela in such patients.

Catheter-related blood stream infection (CRBSI) is a major complication in hemodialysis patients. We assessed the efficacy of systemic daptomycin (DPT) plus DPT antibiotic lock therapy (DPT-ALT) for catheter salvage in patients with Gram-positive CRBSIs. This is a retrospective study of hemodialysis patients with tunneled and cuffed hemodialysis catheters. All patients were from a single institution in Taipei and received systemic DPT plus DPT-ALT for the treatment of Gram-positive CRBSI. Successful resolution of CRBSI was implemented. Resolution of fever within 48 hours, negative result of repeated blood cultures after resolution of fever, no clinical evidence of CRBSI relapse and no need for catheter removal were measured. Fifteen hemodialysis patients received DPT-ALT for CRBSI, nine with coagulase-negative Staphylococcus (CONS), two with methicillin-resistant Staphylococcus aureus (MRSA), three with methicillin-sensitive Staphylococcus aureus (MSSA) and one with polymicrobial infections. Systemic DPT plus DPT-ALT cured 11 patients (73.3%). Treatment failed in all three MRSA cases (two with MRSA and one with MRSA + Enterococcus faecalis). Retrospective design and small sample size were the limitations of this study. Systemic DPT plus DPT-ALT appears to be a promising treatment for CRBSI from CONS and MSSA, but not for MRSA CRBSI. Systemic DPT plus DPT-ALT should be considered for patients with CRBSIs caused by certain species.

A new VC scheme with cheating-prevention ability is proposed.It reveals solid pattern with moderate-scale on partial-superimposed image.The proposed method verifies shares without any additional authentication shares.The proposed method endows conventional VC with cheating-prevention ability. This paper proposes a simple method for establishing a visual cryptographic (VC) scheme with the ability to prevent cheating. Given the n base-shares generated in a conventional (t,n), 2≤t≤n, VC scheme, an authentication pattern stamping process was designed to encode the n base-shares to get n verifiable shares that exhibit the following properties: (1) knowledge of less than t verifiable-shares gets no secret information, (2) the secret can be revealed by completely superimposing t or more verifiable-shares, and (3) the authentication pattern can be revealed by partially superimposing any pair of verifiable-shares. Theoretical proof and computer simulation for the proposed method are provided. The proposed method has smaller pixel expansion than previous cheating prevention VC schemes, and the verification process is fulfilled without resorting to any additional dedicated verification share. It can be attached easily to any reported VC scheme to endow legitimate users with the capability of detecting faked shares provided by malicious participants.

PurposeTo investigate the relationship between seasonal variation of daylight length and spherical equivalent (SE) progression among the schoolchildren participating in the Myopia Investigation Study in Taipei.MethodsWe used the first-year data from grade 2 schoolchildren who completed all the baseline and two follow-up examinations (n=6790). There were two 6-month intervals between visits over winter and summer, respectively. For each interval, we calculated average daily daylight length using data from Taiwan’s Central Weather Bureau and measured 6-month SE progression rate based on right eye cycloplegic autorefraction data. The midpoint month was defined as the month midway between two consecutive visits.ResultsBy the midpoint month, average daily daylight length was the shortest in December (671±7 min/day) and the longest (785±7 min/day) in June, and SE progression rate was the fastest (−0.23±0.48 D) in December and the slowest (−0.17±0.51 D) in June. Significant variation of SE progression rate with season can be observed only among the schoolchildren (n=1905) whose midpoint months for the winter and summer intervals were December and June (winter rate, −0.25±0.47 D; summer rate, −0.17±0.49 D; pConclusionOur data demonstrate a seasonal variation of minus shift in refractive error among Taipei schoolchildren who had significant daytime fluctuation during the 1-year follow-up. Of those, non-myopic children had significant and more pronounced variation of SE progression than myopic children.

Pedestrian detection is an important topic in many applications, such as intelligent transportation systems (ITSs) or surveillance. For the purpose of applications used around the clock, the work for detecting pedestrian based on thermal sensors has attracted significant attention. To achieve this, this paper proposes a LBP (local binary pattern) encoded multi-level classifier for detecting pedestrians in thermal images. The proposed method consists of training and detection stages. The training stage firstly encodes the texture information of all training samples in all possible blocks by using LBP. For a particular block, the patches of all positive and negative samples with the same LBP code are collected to train a SVM (support vector machine) classifier for discrimination. HOGs (Histogram of Oriented Gradients) are used for the description of the patch appearance. By considering a set of learned SVMs for a particular block as a weak classifier, a set of discriminative weak classifiers is selected to form a final classifier (strong classifier) by using Adaboost. The experimental results on the constructed dataset demonstrate that the proposed method outperforms those in the literature.

Augmented reality (AR) has been widely applied in our lives. An AR tag is usually used and stacked on products for sake of being detected and recognized easily. With the recognized pattern, the AR system thereby can superimpose the corresponding virtual object on the AR tag. The AR tag, however, distort the perception of products. In this study, we proposed a mechanism that integrates the AR tag with digital screen by applying the temporal psycho-visual modulation (TPVM) technique. The new method utilizes the difference between the human-eye perception and the imaging of digital camera to produce an invisible AR tag on the digital screen. The AR tag can be detected by mobile devices but not yet by the human eyes. Based on the concepts of AR and TPVM, the new mechanism is practical in the related AR applications, such as the commercial, entertainment, and protection.

Conceal an imperceptible but recognizable pattern on the media captured with mobile devices.Satisfy the essentials of both visible and invisible watermarking techniques.Promote significant property sharing and identification for mobile applications.Guarantee the PSNR of the marked media versus the original media to be above 50-70dB. This paper describes a new methodology of pattern exhibition for digital media that can conceal an imperceptible but recognizable watermark on the media captured with mobile devices. From the human perception, the imperceptible watermark of marked media can preserve the fidelity and readability of the image's content. With the designed, window-based histogram operation, the embedded pattern of the marked media can be exhibited and recognized visually. That is, the designed mechanism can satisfy the essentials of both visible and invisible watermarking techniques to promote significant pattern sharing and identification for mobile applications. Simulations demonstrate that the peak signal-to-noise ratio (PSNR) of the marked image is superior (around 50-70dB) to many of the existing watermarking algorithms. The process is of low computational complexity, efficient and can be applied in the real world via mobile devices via inner histogram operation.

Objectives Individuals with disabilities are often reported to have a high prevalence of undetected hearing disorders/loss, but there is no standardized hearing test protocol for this population. The purposes of this study were (1) to examine the hearing status of students with special needs in Taiwan, and (2) to investigate the use of an on-site hearing test protocol that would adequately detect hearing problems in this population and reduce unnecessary referrals for off-site follow-up services. Methods A total of 238 students enrolled in two schools for special education and one habilitation center participated in the study. Most students had intellectual disabilities and some also had additional syndromes or disorders. A hearing screening protocol including otoscopy, tympanometry, and distortion product otoacoustic emissions was administered to examine students’ outer, middle, and inner ear functions, respectively. Pure tone tests were then administered as an on-site follow-up for those who failed or could not be tested using the screening protocol. Results Only 32.4% of students passed. When administered alone, the referral rate of otoscopy, tympanometry, and otoacoustic emissions were 38.7%, 46.0%, and 48.5%, respectively. The integration of these subtests revealed 52.1% of students needed follow-up services, 11.8% could not be tested, 2.5% had documented hearing loss, and 1.3% needed to be monitored because of negative middle ear pressure. The inclusion of pure tone audiometry increased the passing rate by 9.9% and provided information on hearing sensitivity for an additional 8.6% of students. Conclusion Hearing assessments and regular hearing screening should be provided as an integral part of health care services for individuals with special needs because of high occurrences of excessive cerumen, middle ear dysfunction, and sensorineural hearing loss. The training of care-givers and teachers of students with special needs is encouraged so that they can help identify hearing problems and reduce the negative impact of hearing disorders and hearing loss. The screening protocol needs to include subtests that examine the status of different parts of their auditory system. The addition of pure tone audiometry as an on-site follow-up tool reduced the rate of off-site referrals and provided more information on hearing sensitivity.

A real-world scene captured via digital devices, such as a digital still camera, video recorder and mobile device, is a common behavior in recent decades. With the increasing availability, reproduction and sharing of media, the intellectual property of digital media is incapable of guaranty. To claim the ownership of digital camera media, the imperceptible visible watermarking (IVW) mechanism was designed based on the observation that most camera devices contain the postcamera histogram operation. The IVW approach can achieve advantages both the content readability of invisible watermarking methodology and the visual ownership identification of visible watermarking methodology. The computational complexity of IVW is low and can be effectively applied to almost any of the digital electronic devices when capturing the real-world scene without additional instruments. The following results and analysis demonstrate the novel scheme is effective and applicable for versatile images and videos captured.

In order to solve structural optimization problems in the past, it is necessary to integrate structure analysis software and optimization software. Since structural analysis has been the only function considered when developing most of structure analysis software, they suffer from closeness of system. Therefore, it is not easy to integrate them with optimization software. This study proposes an experimental design method to solve this problem including following steps: (1) generate experimental design, (2) implement experimental design, (3) construct a response variable model, (4) define optimization problem, (5) solve optimization problem. The purpose of step (1) through step (3) is to create a response variable model of alternative structure analysis software. This model is a set of regular and simple functions, it can easily define the optimization problem in step (4), in order to facilitate step (5) to solve the optimization problem. The reason to employ neural network instead of traditional regression analysis in step (3) is that the relationship between internal forces and displaced cross section dimension of the structure are often nonlinear. Neural network is a nonlinear system that gives itself the greatest advantage to accurately construct a nonlinear model. This case study is based on optimization design of cable force and tower height in an extradosed bridge, evaluating the feasibility of above method and comparing with published references to confirm the proposed method in this study is applicable to the optimization design of extradosed bridge.

Intraocular involvement of T-cell lymphoma is rare. We report a case presented with inflammatory glaucoma, neurotrophic keratopathy, and choroidal detachment. An 81-year-old man presented with unilateral high intraocular pressure and keratic precipitates. Polymerase chain reaction of the aqueous humor was negative for herpes simplex virus type 1 and 2, varicella zoster virus, and cytomegalovirus. Progressive pupil dilatation, cornea anesthesia with large epithelial defect, and choroidal detachment were noted in the following month. Diagnostic vitrectomy was then performed, and cytology of the vitreous suggested malignant lymphoma. Further systemic workup revealed ulcerative lesions in the stomach, and biopsy with special stains led to the diagnosis of peripheral T-cell lymphoma of the stomach with ocular involvement. Intraocular involvement of T-cell lymphoma is very rare. Most typically, the skin, followed by the central nervous system, has the most frequently occurring concurrent systemic involvement. In fact, stomach involvement has not been reported. Most cases of intraocular lymphomas presented with vitritis and anterior uveitis, and elevated intraocular pressure was not commonly observed. A review of the literature indicates that a large corneal epithelium defect has been described only in a case of peripheral T-cell lymphoma with the involvement of sclera and oropharynx. Although very rare, inflammatory glaucoma, neurotrophic keratopathy, and choroidal detachment can be the initial presentation of intraocular involvement of T-cell lymphoma.

Engineers have proposed many watermark mechanisms for protecting the content of digital media from unauthorized use. The visible watermark scheme indicates the copyright of digital media posted over the Internet by embedding an inconspicuous but recognizable pattern into media. However, the embedding process often results in serious distortion of the protected image. Since the strength of the watermark in conventional methods mainly depends on the feature of protected media, this may lead to unsatisfactory transparency of watermarked images. This paper proposes a removable solution for visible watermark mechanism. By adopting the subsampling technique, the method proposes a contrast-adaptive strategy to solve this problem. This method can also guarantee the essentials of general visible watermark schemes. Experimental results show that the proposed method outperforms related works in terms of preserving the quality of the restored image.

QR code is the commonly used two-dimensional (2D) barcode recently with the advantages of larger QR content and error correction capability. General QR reader can scan the contents of the QR code. When the content of the QR code is secret information, the information security becomes important. To protect the security of secret information, the new proposed method can embed secret information into the content of QR code. In this new proposed method, the QR content can be easily decoded by a QR reader. Because general browsers can read the QR content, so few people can decoded the QR code can scanning to the secret information. The new method is based on the error correction of the QR code, the QR code reduced distortion, and increases the capacity of hiding secret information. The mechanism based on module so the new method is more efficient. The new way can be applied to mobile phones and mobile devices.

To evaluate the 1-year progression of myopia and associated risk factors in second-grade primary school children.The myopia investigation study in Taipei provided semiannual visual acuity testing and cycloplegic refraction for all second-grade primary school children (mean age: 7.49 years) in Taipei who provided parental consent. A questionnaire was distributed to the participants' parents before the first and third examinations. We evaluated 1-year follow-up data for children noted to have myopia on the first examination. Multinomial logistic regression models were applied to assess risk factors associated with myopia progression. Myopia progression was categorised, based on the change in spherical equivalent (ΔSE) over 1 year, as slow (ΔSE-0.5 dioptres (D)), moderate (-1.0 DΔSE≤-0.5 D) or fast (ΔSE≤-1.0 D). Of the 4214 myopic children, data were analysed for 3256 (77.3%) who completed the 1-year follow-up evaluation.The baseline SE was -1.43±1.1 D. The average ΔSE was -0.42±0.85 D, with 46.96%, 28.50% and 24.54% of the study subjects showing slow, moderate and fast myopia progression, respectively. When compared with slow myopia progression, fast myopia progression was associated with a greater myopic SE at baseline (OR: 0.67, 95% CI: 0.61 to 0.72) and a shorter eye-object distance when doing near work (OR: 1.45, 95% CI: 1.18 to 1.78). More outdoor activity time and self-reported cycloplegic treatment were not associated with slow myopia progression.Children with fast annual myopia progression were more myopic at baseline and had a shorter reading distance. Our study results highlight the importance of having children keep a proper reading distance.

Nowadays, augmented reality (AR) has entered our lives. An AR tag is usually used and stacked on the products for sake of being detected and recognized easily. With the recognized pattern, AR system thereby can superimpose the corresponding virtual object on the AR tag. The AR tag, however, distort the perception of products. In this study, we proposed a method that the AR tag could be embedded on a digital screen by applying the technique of temporal psycho visual modulation (TPVM). The new method utilizes the differences between the human-eye perception and digital camera image-forming to stack an invisible AR tag on digital screen and projector. The AR tag can be detected by digital devices but not yet by human eyes. Based on this concept of AR and TPVM, the related applications would be achieved, such as the immersive virtual scene created in entertainment, commercial and entertainment.

Different from one-dimensional barcode, QR (quick response) code is a popular two-dimensional barcode due to the fact that it can carry greater data capacity and capable of resisting damage. The content of QR code can be easily revealed by barcode scanners. However, in the real world QR applications, the content could be private information, such as the e-ticket and e-coupon. The QR content should be protected to resist from unauthorized users/scanners. In this article, we explore the characteristic of QR barcode and design a QR barcode steganography mechanism. The private information can be embedded into a cover QR tag with high secret payload. For a normal scanner, a browser can only reveal the cover QR content from the marked QR code. Only the authorized user/scanner can further reveal the private secret from the marked QR tag. According to the experimental, the new algorithm can convey satisfactory secret payload in to a QR tag. The mechanism is efficient and feasible for private QR applications.

Purpose To report the long-term outcomes of topical ganciclovir (GCV) and corticosteroids as a maintenance therapy for cytomegalovirus (CMV) corneal endotheliitis. Methods This retrospective study included 10 eyes of 9 patients diagnosed with CMV corneal endotheliitis with a minimum 1-year follow-up at a tertiary referral hospital between 2008 and 2014. CMV corneal endotheliitis was defined by corneal edema associated with typical keratic precipitates (KPs) and a positive CMV polymerase chain reaction from aqueous humor taps. Patients receiving long-term topical 0.5% GCV and topical corticosteroids without discontinuation were included. The final corneal condition and endothelial cell density (ECD) were reported. Results The mean age was 45.6 ± 11.7 years. The mean follow-up duration was 48 ± 25 months. All patients exhibited typical coin-shaped and/or linear KPs. A significant resolution of corneal edema and decreased KPs were achieved within 1 month in all patients after initiating topical 0.5% GCV every 2 hours and topical corticosteroids twice a day. The dose frequency was gradually tapered to GCV 4 times and corticosteroids once or twice a day as a maintenance therapy. All 10 eyes had a clear graft or corneas at the end of this study. The mean ECD was 1630 ± 699 cells per millimeter square before treatment and 1776 ± 834 cells per millimeter square at the end of the study period. Conclusions Topical 0.5% GCV and corticosteroids as a maintenance regimen without interruption effectively preserved long-term corneal endothelial function.

Fragile watermarking is applied to protect the content integrity of digital images. The main concerns related to watermarking include retaining the quality of the watermarked image and retaining the ability to detect whether any manipulation has occurred. Because recent watermarking techniques seriously distort the quality of the protected image after embedding the authentication code into the image content, attention has been drawn to how to satisfy both the need for image fidelity and detection ability. To account for the influence from both essentials, a novel algorithm is proposed in this article. The new scheme utilizes a weighted-sum function to embed ( n + 1) authentication bits into a block with 2 n pixels by modifying only one original pixel with (±1). With fewer authentication codes, the new process can protect the content of the image. The experimental results demonstrate that the approach can guarantee the fidelity of the watermarked image while retaining tamper-proof functionality.

The essence of invertible image sharing approaches is that the revealed content of the secret image must be lossless and the distorted stego images must be able to be reverted to the original cover image. In order to achieve these purposes, we first transform the secret pixels into the m-ary notational system and then calculate the information data used to reconstruct original pixels from camouflaged pixels such that the information data and transformed secret data are shared using the (t,n)-threshold sharing scheme. In this way, we can retrieve the lossless secret image and reverse the stego image to the original image. Based on our experiments, the shadows can be successfully camouflaged in the cover image, and the stego images have satisfactory quality. Moreover, our scheme allows for a large capacity of embedded secret data.

ObjectiveVaricocele is associated with male infertility and/or scrotal pain. Microsurgical varicocelectomy provides advantages of reliable identification of spermatic vessels and has been advocated as the gold standard procedure for varicocele repair. The purpose of this study was to assess the outcome after microsurgical subinguinal varicocelectomy in patients with varicocele associated infertility or scrotal pain.Materials and MethodsA total of 224 men underwent 327 operations of microsurgical subinguinal varicocelectomy at a single university hospital because of infertility or painful scrotum. The diagnosis of varicocele was based on the findings of physical examination. The vast majority of the surgeries were performed on an outpatient basis. All patients underwent pre- and postoperative semen analysis or pain scale evaluation.ResultsFor the 114 infertile patients who underwent varicocelectomy, significant improvements were noted between pre- and postoperative mean sperm count and total motile sperm count. Patients who received bilateral surgery had greater improvement than patients who received unilateral surgery. Repair of larger varicocele was associated with postoperative sperm count changes. Induction of spermatogenesis was observed in at least two of 11 patients with nonobstructive azoospermia. The overall semen improvement rate (improvement index, >0.5) was 70.2% and the 1-year spontaneous pregnancy rate was 33.3%. Of the 102 patients with painful scrotum, 66 patients (64.7%) reported complete resolution of pain, 30 patients (29.4%) had partial resolution, and no change was claimed in six patients (5.9%). For all patients, the pre-and postoperative mean verbal pain scale were 5.8 ±0.4 and 1.2 ± 0.4, respectively (p

This paper presents a novel dual watermarking mechanism for digital media that embeds a recognizable pattern into the spatial domain and an invisible logo into the frequency domain. Undoubtedly, visible watermarking is important for protecting online resources from unauthorized reproduction. Due to the visibility of embedded patterns, however, watermarked digital media are vulnerable to the inpainting attack and common signal processing operations. Utilizing hybrid strategies, simulation results show that the novel method can resist these attacks. In particular, the new mechanism allows legal subscribers to restore an unmarked image, whereas other dual watermarking schemes do not. This feature makes it suitable for protecting artistic and valuable media.

Watermarking techniques are applied to digital media to protect their integrity and copyright. The embedding of a watermark, however, often distorts the quality of the protected image. This may be intolerable since the protected media is for preserving artistic and valuable images. Hence, engineers have proposed removable solutions permitting authorized users to restore watermarked images to unmarked images with satisfactory quality. Unfortunately, these mechanisms cannot resist signal processing attacks to protect the ownership. In this article, we propose a novel watermarking mechanism by utilizing pair-difference correlations upon subsampling and the technique of JND. This new approach can guarantee the robust essentials of watermarking schemes. Experimental results reveal that the new method outperforms others in terms of restored image quality. More specifically, this novel approach can resist various attacks to which related works are vulnerable.

The (t, n)-threshold has been extended to secret image sharing due to its practicability. In this article, we provide a novel version that employs the modulus operator to embed the secret share into a host image. The simulator shows that the modulus operator is useful for decreasing shadow image distortion. Using Rabin's signature cryptosystem, participants can detect if a cheater exists in the cooperation. In particular, the new mechanism permits involved members to restore a lossless secret image and to reconstruct a distortion-free host image.

The third generation partner project (3GPP) has standardized general packet radio service (GPRS) and the universal mobile telecommunications system (UMTS) to provide cell phone communications and wireless Internet services. Although the data transmission rate is lower than that of wireless local area networks (WLANs), GPRS/UMTS covers larger areas. Hence, to achieve higher speed ubiquitous access, we propose a lightweight secure roaming mechanism (LSRM) that integrates GPRS/UMTS and WLAN. Taking advantage of these two technologies, LSRM offers anonymous roaming and friendly subscriber management. Besides, we give a formal security analysis to LSRM based on BAN authentication logic.

Watermarking is used to protect the integrity and copyright of images. Conventional copyright protection mechanisms; however, are not robust enough or require complex computations to embed the watermark into the host image. In this article, we propose an adaptive copyright protection scheme without the use of discrete cosine transformation (DCT) and discrete wavelet transformation (DWT). This novel approach allows image owners to adjust the strength of watermarks through a threshold, so that the robustness of the watermark can be enhanced. Moreover, our scheme can resist various signal processing operations (such as blurring, JPEG compression, and noising) and geometric transformations (such as cropping, rotation, and scaling). The experimental results show that our scheme outperforms related works in most cases. Specifically, our scheme preserves the data lossless requirement, so it is suitable for medical and artistic images.

Image authentication is applied to protect the integrity of the digital image. Conventional image authentication mechanisms, however, are unfit for the palette-based color images. Palette-based color images such as GIF images are commonly used for media communications. This article proposes a palette-based color image authentication mechanism. This novel scheme can guarantee the essentials of general authentication schemes to protect palette-based color images. Morphological operations are adopted to draw out the tampered area precisely. According to the experimental results, the images embedded with the authentication data still can preserve high image quality; specifically, the new scheme is highly sensitive to altered areas.

The marker-based augmented reality (AR) system can produce 3D virtual object to satisfy the user interaction in the real-world. The marker is a tag/pattern and used to help the AR system to locate the corresponding virtual object on the scene. The marker, however, needs to be designed firstly and the recognition capability is limited. The exhibited virtual object and the marker, unfortunately, are linked in the AR system. Hence, such conventional AR system treats all users as the same role. In this article, we proposed a diversity AR system that can provide the differential virtual objects exhibitions for specific users, such as the joint member and different degree person. The new schemes exploited the error correction capability of QR barcode to conceal the individual secret stream of users into a QR marker. Consequently, the general user can only observe the normal 3D virtual object on the marked QR tag. The assigned members can further reveal the various virtual objects from the same QR tag. The proposed diverse AR system can distinguish different users from same QR marker and thereby exhibit the corresponding virtual objects. The new system is practical and can be widely applied in specific customer AR applications.

This paper presents an active tamper detection and content recovery scheme for digital gray images. It mainly adopts vector quantization compression and treats the index codes as the authentication and recovery data of an image. In order to achieve the purpose of detecting and locating whether an image has been tampered with, this scheme embeds the essential information of authentication and recovery into each pixel value's LSB bit. In addition, this paper also utilizes Chan's LSB matching function to improve the quality of embedded image. Experimental results showed that the authentication data of index codes are able to detect those possible modified regions effectively and clearly. Moreover, the embedded image quality also improves nearly to 1.66dB.

A 15-year-old girl with right tibial osteosarcoma, diagnosed 22 months previously, developed right orbital and skull base metastases, with symptoms including painful protrusion of the right eyeball and severe visual impairment. She underwent embolization of the metastatic tumor, local irradiation, and chemotherapy followed by intralesional resection of the mass because extensive involvement of the skull base precluded complete surgical resection. The best corrected visual acuity in her right eye initially decreased to 20/200, then dropped to no light perception after embolization, and then improved to counting fingers at 50 cm after radiotherapy. The symptoms of pain and proptosis subsided completely. After 24 months of follow-up from the presentation of orbital metastasis, the patient's right-eye vision remained unchanged. The surgical specimen revealed a necrotic tumor similar to osteosarcoma. In conclusion, orbital metastasis of osteosarcoma is rare, but may lead to severe visual impairment. Combined radiotherapy, chemotherapy and surgery can partially relieve symptoms, but cannot completely eradicate the tumors.

Purpose To report an unusual presentation of Schnyder's corneal crystalline dystrophy (SCCD), sharing the feature of central corneal mosaic opacities. Design Observational case report. Methods A 51-year-old man and his family members were examined. Investigations included slit-lamp biomicroscopy, radiography of knee joint, plasma lipid level, and genotyping of the SCCD candidate region in chromosome 1p34.1-1p36. Results A symmetric, central, disciform, full-thickness opacity was seen in both corneas of the patient. The opacities appeared in a mosaic pattern, instead of collections of crystals or a diffuse haze as typically detected in SCCD. Small clumps of crystalline deposits and arcus lipoides were also observed. Systemically, hyperlipidemia and bilateral genu valgus were identified. He had 2 daughters, and both of them had bilateral corneal crystalline deposits and genu valgus. No other family members had findings suggesting SCCD. The genetic study demonstrated that all of the affected individuals shared a common haplotype within the region of previously reported SCCD locus. However, 1 unaffected sibling of the proband also had the same haplotype. Conclusions Central corneal mosaic opacities may be another variant of SCCD.

Purpose To describe the epidemiology of dry eye in an elderly Chinese population in Taipei, Taiwan. Design A population-based cross-sectional study. Participants The Shihpai Eye Study was a population-based survey of eye diseases in the elderly (≥65 years) in Shihpai, Taipei, Taiwan. Noninstitutionalized residents, as of July 1999, were identified by using the official household registration database. A total of 2045 subjects were selected, and 1361 (66.6%) people participated in the study. Among them, 822 (60.4%) were men. Methods Trained interviewers administered a standardized questionnaire pertaining to dry-eye symptoms. Objective examinations of dry eye included tear film breakup time, Schirmer test, fluorescein stain of the cornea, and anatomic assessment of the meibomian glands via slit-lamp biomicroscopy. Main outcome measures Frequency of dry-eye symptoms and positive dry-eye tests. Results In this population, 33.7% (459/1361) were symptomatic, defined as reporting 1 or more dry-eye symptoms often or all of the time. Women were more likely to report frequent symptoms of dry eye (odds ratio, 1.49; 95% confidence interval, 1.19–1.87). Among those who were symptomatic, 78.9% (362/459) had a low tear film breakup time (≤10 seconds), 62.5% (287/459) had a low Schirmer test result (≤5 mm), and 61.7% (283/459) had abnormal anatomic features of the meibomian glands. Furthermore, 85.4% (392/459) were symptomatic and had either a low Schirmer score or an abnormal meibomian gland assessment. Of those symptomatic, 49.9% (229/459) indicated that they had visited an eye doctor, 5.4% (25/459) responded that they had been diagnosed with dry eye, and 47.5% (218/459) reported current use of eyedrops. Conclusions This is the first report of population-based data of dry eye that includes symptoms and signs in elderly Asians. The prevalence of dry eye, although varied according to definition, is relatively higher in this study than that reported for whites. Further studies are needed to determine whether this is due to racial or environmental factors.

A 59-year-old Chinese female had been diagnosed with choroidal osteoma of the right eye when she was 36. At that time, the best corrected visual acuity was 6/6 but this decreased to 6/12 due to the rapid growth of choroidal osteoma within 10 months. She returned to our clinic 23 years later due to gradual decreased vision (2/60). Ocular examination disclosed spontaneous decalcification of the tumor leaving an area of depigmentation and atrophy of choriocapillaris in the previous osteoma. Time-domain optical coherence tomography showed marked thinning and absence of the inner segment/outer segment photoreceptor junction with irregular elevated retinal pigment epithelium. To sum up, choroidal osteoma is a benign intraocular tumor that can cause visual acuity loss due to retinal pigment epithelium atrophy and photoreceptor degeneration over the years.