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Background Maintenance of the optimal fluid status in hemodialysis patients is still a challenging task in daily clinical practice. A bioelectric impedance technique has been applied for evaluation of hydration status in the dialysis population in recent years, but serial observations of its role in clinical dry weight determination are lacking. In this study, serial follow-up data of a body composition monitor based on bioimpedance spectroscopy (BCM-BIS) applied in dialysis patients were analyzed to define the technique's feasibility, precision and possible role in dry weight determination. Methods BCM-BIS was applied monthly to 194 hemodialysis patients for 6 months. Intra-patient precision was analyzed. Bland–Altman analysis and repeated-measures analysis of variance (ANOVA) were used to define the relationship between the dry weights determined by BCM-BIS and by clinical judgment. Results The coefficients of variation (CVs) of fluid parameters were <5%. Serial changes in dry weight differences were compared in groups with different post-dialysis hydration status and dry weight differences decreased gradually. Bland–Altman analysis revealed that the range of these differences was significantly narrower towards the latter part of the study. The upper limit of agreement with 95% confidence interval (CI) was 1.47 L and the lower limit was −3.02 L. Conclusions BCM-BIS is precise and can be easily applied in the clinical setting. Discrepancy between the dry weights determined by BCM-BIS and by clinical judgment significantly decreased during the study. It is sensitive in dry weight determination, especially for those patients with obvious over-hydration (OH) by BCM-BIS. Patients with post-dialysis OH results beyond some critical values (>1.5 L or <−3 L) should be closely monitored. [ABSTRACT FROM PUBLISHER]

In this paper, a novel circuit topology of aCMOS divide-by-4 direct injection-locked frequency divider is presented for millimeter-wave applications. To enhance the locking range for circuit operations with a division ratio of 4, a series peaking technique is introduced in the proposed divider structure such that improved input injection efficiency can be achieved. Using a standard 0.18-\mu\ m CMOS process, a V-band frequency divider is fabricated for demonstration. Operated at a supply voltage of 1.8 V, the divider core consumes a dc power of 12.6 mW. At an incident power of 0 dBm, the fabricated circuit exhibits an input locking range of 2.44 GHz in the vicinity of 60 GHz. The measured output power and locked phase noise at 1-MHz offset are -\7 dBm and -\133 dBc/Hz, respectively. [ABSTRACT FROM AUTHOR]

Few population-based studies have looked at the risk of uveitis among syphilis patients. Our study addresses the knowledge gap by reporting on uveitis risk in syphilis patients through a retrospective cohort study. The Taiwan National Health Insurance database was used for this study, covering the period from January 1st, 2009, to December 31st, 2020. We created a 1:4 propensity score matched cohort between the syphilis patients and controls, which accounted for gender, age, and comorbidities. The primary endpoint was the incidence of newly recorded uveitis. The assessment of uveitis risk in syphilis patients included the use of the Kaplan-Meier method and multivariate Cox proportional hazard model. A total of 31,597 syphilis patients and 126,379 matched comparisons were recruited. The uveitis incidence rate from our syphilis patients was 1.25 per 1000 person-years. The uveitis incidence rate from our non-syphilis group was 0.8 per 1000 person-years. After matching, the syphilis group was found to have a higher risk of developing uveitis (adjusted hazard ratio (aHR) [95% CI]: 1.57 [1.36-1.81], P  < .001). Among males and individuals aged 20-34 years, subgroup analysis showed an increased risk of uveitis in the presence of syphilis infection. The Kaplan-Meier survival curve showed a significant difference in uveitis incidence between syphilis and non-syphilis groups (log-rank test P  < .001). In summary, our study revealed that Taiwanese syphilis patients were at a higher risk of developing uveitis. These results highlight the need for regular ocular monitoring and screening in individuals with syphilis.

Background: Community-acquired urinary tract infection (UTI) is the most common bacterial infection encountered at hospitals. Effective empirical antibiotic therapy relies on updated epidemiological data., Aim: We described the epidemiology of patients with urosepsis presenting to a community hospital in Taiwan in order to assess the appropriateness of empirical therapy., Methods: Retrospective cohort study of hospitalized adult patients with UTI from January 1 to December 31 in 2010. The clinical and microbiological characteristics were analyzed using descriptive statistics. Logistic regression analysis was performed to determine predictors of antibiotic resistance., Findings: A total of 420 consecutive patients with 599 isolates were identified. Most patients were >=65 years old and women (75.4%), and 114 patients (27.1%) had bacteremia. Escherichia coli (69%) was the most common organism. Cefazolin was effective against E. coli, K. pneumoniae , and P. mirabilis in greater than 80% of the cases. In male patients, urinary catheter and renal stone were independent predictors for cefazolin resistance; while diabetes mellitus and malignancy were predictors among female patients., Conclusion: Patients admitted with UTI should be screened to identify risk factors for bacteremia and antimicrobial resistance. The treatment guideline in Taiwan needs to be revised in the current era of increasing antimicrobial resistance.

Background and Purpose: Central venous catheter (CVC) infection is a common problem during hospitalization and nosocomial bloodstream infection in these patients is associated with increased morbidity, mortality, and health care cost. This prospective study examined the risk factors of CVC-related infections., Methods: During a 6-month period, a total of 281 patients who underwent central venous catheterization after general surgery were enrolled., Results: The mean duration from CVC insertion to the development of infection was 7.12 days. The rate of bloodstream infection without isolation of the same organism from the catheter was 1.4% (4/281). The rate of catheter-related bloodstream infection was 6.0% (17/281). The rate of catheter bacteremia, defined as positive culture from a catheter blood sample in a patient without signs of infection, was 8.5% (24/281). The incidence of catheter-related bloodstream infection was 7.5/1000 catheter-days. Risk factors for catheter-related infection on univariate analysis included place of insertion (operating room or surgical ward), total parenteral nutrition (TPN), more than 3 tubings, and duration of catheterization. TPN was a significant risk factor in the logistic regression analysis., Conclusions: Established infection control guidelines should be rigorously observed with regard to catheter use and various risk factors controlled to prevent the occurrence of CVC-related infection, especially in patients receiving TPN.