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Traditionally, prior to compressing an RGB full-color image, for each converted $2\times 2$ CbCr block $B^{CbCr}$ , chroma subsampling only downsamples $B^{CbCr}$ , but without changing the luma block $B^{Y}$ at all. In the current research, a special linear interpolation-based, namely the COPY-based, chroma subsampling-first luma modification (CSFLM) study has attempted to change the luma block for enhancing the quality of the reconstructed RGB full-color image. In this paper, a fast and effective nonlinear interpolation, namely the bicubic convolution interpolation (BCI), based iterative luma modification method for CSFLM is proposed. In our iterative method, a BCI-based distortion function and its convex property proof are first provided. Next, based on the proposed convex distortion function, a pseudoinverse technique is applied to obtain the initial luma modification solution, and then an iterative method is proposed to improve the initial luma modification solution. Based on five testing image datasets, namely the IMAX, Kodak, SCI (screen content images), CI (classical images), and Video datasets, the thorough experimental results have demonstrated that on the newly released Versatile Video Coding (VVC) platform VTM-12.0, our iterative luma modification method achieves substantial quality, execution-time, and quality-bitrate tradeoff improvements when compared with the existing state-of-the-art methods.

Stereotactic operations are actively used in modern minimally invasive medicine. During such operations, a flexible needle is inserted into the internal organs, with the help of which a biopsy or a local treatment is performed. The applica tion of such approaches in neurosurgery requires the accurate positioning of the needle tip at the target point. The present study is related to the creation of a robotic system that delivers the needle to a given point and uses drives compatible with magnetic resonance imaging devices that visualize the position of the needle. In this paper, we propose a finite-dimensional mathematical model of a mechatronic system that uses a piezoelectric drive (PED) to move the needle (cannula) along a given line. To describe the contact between the cannula and the soft tissue, a mathematical model of their interaction is developed. The contact problem involving two processes occurring during the introduction of the needle into the biological tissue is solved: the introduction of a rigid (compared to the tissue) indenter and its retention at a certain depth. Relaxation properties of the tissue are taken into account. The behavior of tissue is described using a phenomenological approach based on a modified Kelvin-Voigt model. This allowed for reducing the solution of the contact problem to the integration of a system of ordinary differential equations. One of recognized ways to develop medical robotic systems is to test their functioning using phantoms of biological tissues. For this purpose, a phantom of a porcine brain based on agar-agar is made. Experiments are carried out to indent a standard cannula into the phantom body. Based on the obtained experimental data, the parameters of the contact model are identified. An algorithm is proposed for controlling the PED frequency, which ensures the introduction of the cannula into the soft biological tissue to a given depth. Numerical simulation of the insertion of the cannula into the soft tissue using this algorithm is performed. The influence of feedback coefficients on the position and speed of the indenter on the nature of the implementation process is investigated.

Water depth estimation models based on optical satellite images often require ground-truth data for supervised training procedures. However, in the South China Sea (SCS), the ground truth data are limited or outdated. Therefore, it is challenging to derive reasonable water depths around islands or coral reefs without prior knowledge. ICESat-2 is a space-borne LiDAR satellite launched in September 2018 that provides geolocated height at the laser footprint on a global scale and opens an opportunity for bathymetric mapping in regions normally inaccessible. The combination of ICESat-2 data with Sentinel-2 optical images is developed to extend the application of satellite-derived bathymetry (SDB). Three SDB algorithms, including ratio transform (RT), multiple linear regression, and classification-based (CB) algorithms, are applied to investigate the water-depth retrieval capabilities. Five islands located in different parts of the SCS are selected, analyzed, and evaluated with the support of Google Earth Engine. Comparing the ICESat-2 water depth profiles against airborne LiDAR data, the statistical indexes of R2 and RMSE reached 0.99 and 0.31 m, respectively. This demonstrates the suitability of using ICESat-2 data as a reliable data source in shallow water. On the other hand, the CB model is used to address the issue of heterogeneity by dividing the target islands into groups based on spectral characteristics. The results show that an integration of ICESat-2 and Sentinel-2 imageries can achieve R2 at 0.75 to 0.95 and RMSE at 0.66 to 1.87 m with the deepest pixels at 19 to 32 m across these five islands. We conclude that the ICESat-2/Sentinel-2 synergy scheme is capable of overcoming current limitations in various regions and thus can fill the gaps in bathymetry charts.

We appreciate the interest in our research1 and could not agree more with the authors of this comment. The purpose of our teaching neuroimage was to point out that not only radiographic appearances of a herniated lumbar disc (HLD) could potentially mimic a spinal tumor but that the clinical presentation of a HLD could mimic a spinal tumor as well.1

Aim:Diabetes-related cerebral small vessel disease (CSVD) causes neurological deficits. Patients with diabetes showed pericyte loss as a hallmark of retinopathy. Cerebral pericytes, which densely localize around brain capillaries, are quiescent stem cells regulating regeneration of brain and may have a role in CSVD development. This study investigated whether diabetes impairs ischemia-provoked dedifferentiation of pericytes.Methods:A murine high-fat diet (HFD)-induced diabetes model was used. After cerebral ischemia induction in the mice, pericytes were isolated and grown for a sphere formation assay.Results:The sphere counts from the HFD group were lower than those in the chow group. As the spheres formed, pericyte marker levels decreased and SOX2 levels increased gradually in the chow group, but not in the HFD group. Before sphere formation, pericytes from the HFD group showed high p21 levels. The use of a p21 inhibitor rescued the reduction of sphere counts in the HFD group. At cellular level, hyperglycemia-induced ROS increased the level of p21 in cerebral pericytes. The p21-SOX2 signaling was then activated after oxygen-glucose deprivation.Conclusion:HFD-induced diabetes compromises the stemness of cerebral pericytes by altering p21–SOX2 signaling. These results provide evidence supporting the role of pericytes in diabetes-related CSVD and subsequent cerebral dysfunction.

Supplemental material, sj-pdf-1-dvr-10.1177_1479164121990641 for Hyperglycemia compromises the ischemia-provoked dedifferentiation of cerebral pericytes through p21–SOX2 signaling in high-fat diet-induced murine model by Hao-Kuang Wang, Chih-Yuan Huang, Yun-Wen Chen and Yuan-Ting Sun in Diabetes & Vascular Disease Research

Background and Purpose— The observation that smokers with stroke could have better outcome than nonsmokers led to the term “smoking paradox.” The controversy of such a complex claim has not been fully settled, even though different case mix was noted. Analyses were conducted on 2 independent data sets to evaluate and determine whether such a paradox truly exists. Methods— Taiwan Stroke Registry with 88 925 stroke cases, and MJ cohort with 541 047 adults participating in a medical screening program with 1630 stroke deaths developed during 15 years of follow-up (1994–2008). Primary outcome for stroke registry was functional independence at 3 months by modified Rankin Scale score ≤2, for individuals classified by National Institutes of Health Stroke Scale score at admission. For MJ cohort, mortality risk by smoking status or by stroke history was assessed by hazard ratio. Results— A >11-year age difference in stroke incidence was found between smokers and nonsmokers, with a median age of 60.2 years for current smokers and 71.6 years for nonsmokers. For smokers, favorable outcome in mortality and in functional assessment in 3 months with modified Rankin Scale score ≤2 stratified by the National Institutes of Health Stroke Scale score was present but disappeared when age and sex were matched. Smokers without stroke history had a ≈2-fold increase in stroke deaths (2.05 for ischemic stroke and 1.53 for hemorrhagic stroke) but smokers with stroke history, 7.83-fold increase, overshadowing smoking risk. Quitting smoking at earlier age reversed or improved outcome. Conclusions— “The more you smoke, the earlier you stroke, and the longer sufferings you have to cope.” Smokers had 2-fold mortality from stroke but endured stroke disability 11 years longer. Quitting early reduced or reversed the harms.

Using a database that enabled longitudinal follow-up, we assessed the cost, outcome, complications, and readmission rate of ruptured cerebral aneurysms repaired by surgical clipping and endovascular coiling.This study was a retrospective review of data from a series of patients who underwent surgical clipping or endovascular coiling of ruptured cerebral aneurysms between 1996 and 2013. The medical records and hospital cost data were all examined.A total of 7690 and 1380 cases were treated with clipping and coiling, respectively. Patients treated with clipping had more comorbidities and were older. The average total cost for endovascular coiling was $13,974.3, whereas the average total cost for surgical clipping was $16,581.7. Perioperative (30-day) mortality was 10.7% in patients with coiled aneurysms, compared with 12.6% in those with clipped aneurysms (P = 0.045). After 1 year of follow-up, clipping was associated with a significantly longer length of hospital stay (P0.001) and significantly higher total hospital costs (P0.001).In Taiwan, the total hospital costs for the surgical clipping of cerebral aneurysms were higher than for endovascular coiling, and the surgical results were associated with significant complications. We suggest that the indications for coiling might need to be expanded from the current standards dictated by the guidelines in Taiwan.

A 47-year-old healthy man presented with intermittent low back pain radiating to the left calf; within 1 month, the pain worsened at night and disturbed his sleep. Examination showed paresthesia in left lateral calf, weakness in left ankle plantarflexion, and decreased ankle reflex. Neuroimaging revealed near-total obliteration of the spinal canal by a 2 × 1.2 cm nodule at L5-S1 level with ring enhancement under gadolinium-enhanced MRI (figure 1). The patient underwent surgery for a presumed spinal tumor. The intraoperative and pathologic findings revealed ruptured intervertebral disc without neoplasm (figure 2). The clinical presentation and image characteristics of a large ruptured disc can mimic a spinal tumor.1,2

The paper presents a model of reliability which captures the process by which reliability is actually determined more accurately than the conventional analysis. In contrast to that conventional analysis, which is based on the characteristics approach, the model of this paper defines reliability as the objective probability of product failure, not as a characteristic of individual goods. Reliability, thus defined, is treated as a choice variable of the firm. The resulting model is applied to a monopolist subject to a price cap. The monopolist can vary reliability and the terms of a warranty or compensation deal in response to price-capping. The monopoly outcome, price-capped monopoly outcome, and Pareto-efficient outcome are compared. The model provides a theoretical explanation of some empirical results in the literature on electricity regulation.

The aggregation and deposition of transactivation response DNA-binding protein 43 (TDP-43) in neurons and astrocytes is characteristic in a number of neurodegenerative diseases including Alzheimer's disease, frontotemporal lobar degeneration, and amyotrophic lateral sclerosis. Nevertheless, the exact role of TDP-43 in astrocytes is unknown. Recently, TDP-43 was identified in neurons but not astrocytes after traumatic brain injury (TBI) in humans. In the present study, we evaluated TDP-43 expression and proteolysis in astrocytes in a rat model of TBI. We assessed TDP-43 fragment expression, astrocyte morphology, neuronal population numbers, and motor function after TBI with or without intracerebroventricular administration of a caspase-3 inhibitor. Motor dysfunction was observed after TBI in potential association astrocytic TDP-43 short fragment mislocalization and accumulation, astrogliosis, and neuronal loss. Notably, caspase-3 inhibition prevented these changes after TBI. Our findings suggest that TDP-43 proteolysis in astrocytes is related to astrogliosis and subsequent neuronal loss in TBI, and that TDP-43 may be an important therapeutic target for preventing motor dysfunction after TBI.

Using different imaging techniques (primarily, magnetic resonance imaging or MRI) as guidance in robotic-assisted brain surgery becomes more and more wide-spread. One of important issues in this area is using these imaging technologies in online mode. For that, robotic devices that are compatible with MRI systems are required. In particular, conventional electric drives are not suitable; some alternatives should be used, such as piezoelectric drives (PED). In this paper, a robotic system is described intended to deliver a needle (cannula) to a given point by means of a PED. Dependence of the driving force generated by PED upon the needle speed is studied. In order to describe the contact interaction between the cannula and the soft tissue, a mathematical model of their interaction is developed based on modified Kelvin-Voigt approach. A phantom of porcine brain is manufactured. Experiments are carried out where the cannula was indented into the phantom. Based on the obtained experimental data, parameters of the mathematical model are identified. Numerical simulation of the insertion of the cannula into the soft tissue is performed, and the effect of parameters of the feedback control loop upon the cannula dynamics is analysed.

Change detection (CD), enabled by multitemporal multispectral satellite imagery, has many important Earth observation missions such as land cover/use monitoring, for which we observe that change regions are relatively smaller than those caused by disaster (e.g., forest fire) with patterns typically composed of a number of smooth regions. These observations are considered in our new CD criterion, which can effectively mitigate the artifacts and speckle noise suffered by existing statistic-based and difference image (DI) analysis based methods. The proposed CD criterion amounts to a large-scale non-convex optimization, which is first reformulated using the convex relaxation trick with associated change map interpreted in the probability sense, followed by adopting an efficient convex solver known as alternating direction method of multipliers (ADMM). The resulted probabilistic change map would be more practical, and can be thresholded at 0.5 to yield the conventional binary-valued one. We also reveal a link between the proposed criterion and the DI-based criterion, and demonstrate the outstanding performance of our fully unsupervised CD algorithm qualitatively and quantitatively.

Sensor Web and Internet of Things (IoT) (SW-IoT) have been attracting attention from various fields. Both of them deploy networks of embedded devices to monitor physical properties (i.e., sensing capability) or to be controlled (i.e., tasking capability). One of the most important tasks to realize the SW-IoT vision is to establish an open and interoperable architecture, across the device layer, gateway layer, service layer, and application layer. To achieve this objective, many organizations and alliances propose standards for different layers. Among the standards, Open Geospatial Consortium (OGC) SensorThings API is arguably one of the most complete and flexible service standards. However, the SensorThings API only address heterogeneity issues in the service layer. Embedded devices following proprietary protocols need to join closed ecosystems and then link to the SensorThings API ecosystem via customized connectors. To address this issue, one could first follow another device layer and gateway layer open standards and then perform data model mapping with the SensorThings API. However, the data model mapping is not always straightforward as the standards were designed independently. Therefore, this research tries to propose a more direct solution to unify the entire SW-IoT architecture by extending the SensorThings API ecosystem to the gateway layer and the device layer. To be specific, this research proposes SW-IoT Plug and Play (IoT-PNP) to achieve an automatic registration procedure for embedded devices. The IoT-PNP contains three main components: (1) A description file describing device metadata and capabilities, (2) a communication protocol between the gateway layer and the device layer for establishing connections, and (3) an automatic registration procedure for both sensing and tasking capabilities. Overall, we believe the proposed solution could help achieve an open and interoperable SW-IoT end-to-end architecture based on the OGC SensorThings API.

Additional file 5: Figure S5. The assays of tumor-initiating cell (TIC) properties. (A) Tumor formation analysis with limiting dilution (50~1000 cells per injection) of U87-parental and TMZ-resistant (r#10) cells in subcutaneous flank area of NOD-SCID mice was performed and recorded. Tumor formation was defined as the measurement to reach 0.1â cm3 or larger. The number of tumor formation in total implanted mice was shown in the brackets. (B) The frequency of the TIC-featured population of GBM#2 (derived from another recurrent GBM patient) with or without TMZ treatment was estimated using the in vitro extreme limiting dilution assay.

Over the past years, 360° video streaming is getting popular. Watching these videos with Head-Mounted Displays (HMDs), also known as Virtual Reality (VR) headsets, gives more immersive experience than using traditional planar monitors. To fulfill a real immersive experience, there are several challenges, such as high bandwidth consumption, latency-sensitive, and heterogeneous HMD devices. In this paper, we propose an edge-assisted 360° video streaming system, which leverages edge servers to render viewports for viewers of 360° videos. We formulate an optimization problem to determine which HMD clients should be served by the edge server. We design an algorithm to solve this problem, and implement a real testbed as a proof-of-concept. The resulting edge-assisted 360° video streaming system is extensively evaluated with a public 360° viewing dataset. Leveraging edge servers, we reduce the bandwidth usage and computational workload on HMD clients. Moreover, lower network latency is achieved. The evaluation results show that compared to current 360° video streaming platforms, our edge-assisted rendering platform: (i) saves up to 62% in bandwidth consumption, (ii) achieves higher viewing quality, (iii) reduces the computation workload for those lightweight HMDs, and (iv) saves the battery life of HMD clients.

Significant improvement of stroke symptoms may occur in acute stroke patients due to large artery occlusion (LAO) treated with intravenous thrombolysis (IVT). Directly proceeding with endovascular thrombectomy (EVT) would be a clinical dilemma.A 55-year-old male suddenly suffered from global aphasia and right side hemiplegia at work. Left proximal middle cerebral artery (MCA) occlusion was shown on CT angiography. After IVT, NIHSS significantly improved from 11 to 4 points. EVT was withheld due to rapidly improving symptoms and low NIHSS scores. However, stroke in progression occurred 7 hours after onset with NIHSS scores increasing from 4 to 13 points. A follow-up brain CT scan showed an Alberta Stroke Program Early CT score of 9 and no hemorrhage. Successful recanalization of the left MCA by EVT was performed at 10.5 hours after onset. The patient was discharged with a NIHSS score of 3 and his modified Rankin Scale score was 0 at 3 months.In LAO patients, directly proceeding EVT following IVT may not be hesitated. In addition, while LAO patients with incomplete IV-tPA treatment responses result in transient improvement of neurological symptoms but later reversed, EVT may be a potential rescue therapy in carefully selected patients.

Blends of poly(butylene terephthalate) (PBT) and cellulose acetate propionate (CAP) were found to be immiscible. In order to improve the interfacial strength and miscibility of the PBT/CAP blends, a low-molecular-weight poly(ethylene glycol) (PEG) was thus pre-mixed with the CAP to form the P-CAP mixture. It was then blended with the PBT up to 15 wt% using a twin-screw extruder to prepare the PBT/P-CAP blends, and subsequently processed into the films and fibers by compression-molding and melt-spinning, respectively. The thermal and dynamic mechanical analyses suggested that the PBT and CAP became partially miscible and the interfacial strength was thus improved in the PBT/P-CAP blends, owing to the addition of PEG. The PEG was not only miscible with the CAP but also with the PBT, and it served as a plasticizer as well as a compatibilizer. From the observation of the fractured surface of the PBT/P-CAP films, the PBT component was present as dispersed particles in the P-CAP matrix with size ranging from 1.4 to 3.0 μm; yet it became nanofiber in the spun fibers. Successful fibers of the PBT/P-CAP blends with an average diameter of 20 μm could be spun, where the tensile strength and elongation at break were in the range of 0.6−0.7 g/denier and 12−16%, respectively. Finally, the ultra-fine PBT nanofibers with diameters in the range of 50−70 nm were observed after removing the P-CAP matrix with acetone from the fibers, owing to the formation of PBT nanofibers during spinning and orientation processes. This method thus could successfully produce nano-scale PBT fibers with fineness comparable with the nanofibers developed via electrospinning technology.

A series of environmentally sensitive ABA triblock copolymers with different block lengths were prepared by reversible addition-fragmentation chain transfer (RAFT) polymerization from acrylic acid (AA) and N-isopropylacrylamide (NIPAAm). The GPC and 1H NMR analyses demonstrated the narrow molecular weight distribution and precise chemical structure of the prepared P(AA-b-NIPAAm-b-AA) triblock copolymers owing to the controlled/living characteristics of RAFT polymerization. The lower critical solution temperature (LCST) of the triblock copolymers could be tailored by adjusting the length of PAA block and controlled by the pH value. Under heating, the triblock copolymers underwent self-assemble in dilute aqueous solution and formed nanoparticles revealed via TEM images. Physically crosslinked nanogels induced by inter-/intra-hydrogen bonding or core-shell micelle particles thus could be obtained by changing environmental conditions. With a well-defined structure and stimuli-responsive properties, the P(AA-b-NIPAAm-b-AA) copolymer is expected to be employed as a nanocarrier for biomedical applications in controlled-drug delivery and targeting therapy. © 2015 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2016, 54, 1109–1118

Background: Stroke is a major cause of disability in the elderly and considerably increases the risk of dementia, which is another important source of disability. This population-based study aimed to examine the risk of dementia in patients with stroke compared with non-stroke cases with similar comorbidities. Methods: Using the Taiwan National Health Insurance databank covering the period 2001-2007, this retrospective cohort study evaluated the risk of dementia in 10,884 patients with first stroke who had no history of dementia. In this study, we performed a 1:5 case-control matched analysis, in which cases were matched to controls based on their estimated propensity scores, which were estimated with demographics and associated risk factors. This approach reduced selection bias. Cox proportional hazards regression analysis was then used to estimate the risk of dementia in stroke patients. Results: During the 5-year follow-up period, 1,487 (13.74%) stroke and 1,402 (2.59%) non-stroke patients suffered dementia. Stroke was independently associated with a 6.09 (95% confidence interval [CI], 5.66 to 6.55) times greater risk of dementia 5 years after stroke. Older age was associated with a higher incidence of dementia after stroke. Each stroke type had different impacts on the occurrence of dementia. The hazard ratio of dementia among hemorrhagic stroke patients was much higher than those of ischemic stroke and controls. Conclusion: The findings of this study suggest that stroke confers an increased risk of dementia, especially in the elderly and in patients with hemorrhagic stroke. We advocate the need for close observation and enhanced health education programs to benefit patients with stroke.

Fog computing has been widely adopted to meet the performance of explosive growth of IoT applications. In both 5G and IoT applications, low latency and ultra-reliable communication are two key features which cloud-based only architecture cannot meet those performance requirements. Fog computing which adds a hierarchy of elements between the cloud and endpoint devices can meet those requirements in a secure, high performance, open, and interoperable way. To validate whether future fog node products can meet trusted computing criteria and performance requirements or not, a common testbed is necessary. In this paper, we will first discussion the security practice (the fundamental pillar of OpenFog architecture) required for future testbed designs. National Chiao Tung University (NCTU) is leading to attempt to provide Security-as-a-Service (SECaaS) in NCTU testbed based on 4G wireless networks and two other fog enabled testbeds provided by ITRI's smart lamp posts testbed and Shanghai Tech's software defined (SD) LTE fog nodes testbed are also discussed for rapid prototyping of vertical industry applications. Two use cases, indoor autonomous vehicle and BATS codes multihop wireless will also be presented as the potential examples for testbeds.

Objective: Recent case reports suggest that zolpidem usage may be associated with infection events. The aim of this study was to determine the risk of infection events in patients with sleep disturbance taking zolpidem in a full 3-year follow-up study. Methods: A total of 17474 subjects with a diagnosis of sleep disturbance in 2002 and 2003 were identified, of whom 5882 had used zolpidem after recruitment. A Cox proportional hazard model was used to estimate the 3-year infection event-free rates for the patients using zolpidem and those not using zolpidem after adjusting for confounding factors. To maximize case ascertainment, only patients hospitalized for infection events were included. Results: A total of 646 patients had had infection events, 331 (5.63%) of whom had been taking zolpidem and 315 (2.71%) had not. Zolpidem usage increased the risk of infection events. After adjustments for gender, age, co-morbidities, and other medications, patients using zolpidem with cDDD 1-28, 29-84, and >84 had hazard ratios of 1.67 (95% CI, 1.32e2.11), 1.91 (95% CI, 1.47e2.49) and 1.62 (95% CI, 1.32e1.98) respectively, compared with patients who did not use zolpidem. Conclusions: Zolpidem increased the risk of infection events in sleep disturbance patients. This increased risk of infection should be explained to sleep disturbance patients, and prescriptions of zolpidem to chronic insomnia patients should be restricted.

Background: This retrospective cohort study was designed to assess whether there is an association between newly diagnosed dementia and the risk of stroke. Methods: From Taiwan’s National Health Insurance Research Database of reimbursement claims, we identified 2811 patients with newly diagnosed dementia and 14,055 randomly selected, agematched patients without dementia. A Cox proportional hazards model was constructed to calculate the development of stroke, including ischemic stroke, and intracerebral, or subarachnoid hemorrhage. Results: During the 3-year follow-up period, 339 patients with dementia (12.06%) and 691 patients without dementia (4.92%) developed stroke. The adjusted HRs of developing stroke among newly diagnosed dementia patients were 2.33-times (range, 2.05–2.66), and the incidence of hemorrhagic stroke was higher than that of other stroke types. Patients who had Alzheimer’s disease were at the highest risk of hemorrhagic stroke. Conclusion: Individuals with dementia, especially Alzheimer’s disease, are at greater risk of developing stroke, especially in intracerebral and subarachnoid hemorrhage than patients without dementia. Early mental screening programs and health education should be initiated for dementia patients.

Objectives: To study the applicability of National Institutes of Health Stroke Scale (NIHSS) in early predicting the prognosis of poststroke dysphagia in an acute ward. Methods: This is an observational retrospective cohort study including adult patients with ischemic stroke. Patients with various factors affecting swallowing were excluded to obtain a representative sample of 165 patients. The main outcome measure was the improvements of oral intake function. Results: The scores of facial palsy (NIHSS item 4) (odds ratio [OR]: 0.484, 95% confidence interval [CI]: 0.279-0.838, P = .0096] and language/aphasia (NIHSS item 9) (OR: 0.562, 95% CI: 0.321-0.982, P = .0430) demonstrated significantly negative effects on the early improvement of dysphagia. Moreover, the improved patients had a 4.14-fold (95% CI: 2.53-11.23, P = .005) increased odds of returning home compared with nonimproved patients. Conclusions: Our findings provide evidence that early improvement of poststroke dysphagia was significantly associated with a favorable discharge destination and NIHSS items of facial palsy and language/aphasia can be used at the onset of stroke to identify dysphagic patients at risk of achieving limited improvement. These findings provide valuable prognostic indicators for clinicians to make a precise outcome prediction at very early stage.

Aim. Autoimmune rheumatic diseases (ARD) are characterized by systemic inflammation and may affect multiple organs and cause vascular events such as ischemic stroke and acute myocardial infarction. However, the association between ARD and increased risk of dementia is uncertain. This is a retrospective cohort study to investigate and compare the risk of dementia between patients clinically diagnosed with ARD and non-ARD patients during a 5-year follow-up period.Methods. Data were obtained from the Longitudinal Health Insurance Database 2000 (LHID2000). We included 1221 patients receiving ambulatory or hospitalization care and 6105 non-ARD patients; patients were matched by sex, age, and the year of index use of health care. Each patient was studied for 5 years to identify the subsequent manifestation of dementia. The data obtained were analyzed by Cox proportional hazard regression.Results. During the 5-year follow-up period, 30 ARD (2.48%) and 141 non-ARD patients (2.31%) developed dementia. During the 5-year follow-up period, there were no significant differences in the risks of any type of dementia (adjusted hazard ratio (HR), 1.18; 95% CI, 0.79–1.76) in the ARD group after adjusting for demographics and comorbidities.Conclusions. Within the 5-year period, patients with and without ARD were found to have similar risks of developing dementia.

Background. Wehavereported thatminocycline (Mino) induced autophagic death in glioma cells. In the present study, we characterize the upstream regulators that controlautophagyandswitchcelldeathfromautophagic to apoptotic. Methods. Western blotting and immunofluorescence were used to detect the expressions of eukaryotic translation initiation factor 2a (eIF2a), transcription factor GADD153 (CHOP), and glucose-regulated protein 78 (GRP78). Short hairpin (sh)RNA was used to knock down eIF2a or CHOP expression. Autophagy was assessed by the conversion of light chain (LC)3-I to LC3-II andgreenfluorescentproteinpunctaformation.Anintracranial mouse model and bioluminescent imaging were usedtoassesstheeffectofMinoontumorgrowthandsurvival time of mice. Results. The expression of GRP78 in glioma was high, whereas in normal glia it was low. Mino treatment increased GRP78 expression and reduced binding of GRP78 with protein kinase-like endoplasmic reticulum kinase. Subsequently, Mino increased eIF2a phosphorylation and CHOP expression. Knockdown of eIF2a or CHOP reduced Mino-induced LC3-II conversion and glioma cell death. When autophagy was inhibited, Mino induced cell death in a caspase-dependent manner. Rapamycin in combination with Mino produced synergistic effects on LC3 conversion, reduction of the Akt/ mTOR/p70S6K pathway, and glioma cell death. Bioluminescent imaging showed that Mino inhibited the growth of glioma and prolonged survival time and that these effects were blocked by shCHOP. Conclusions. Minoinducedautophagybyelicitingendoplasmic reticulum stress response and switched cell death from autophagy to apoptosis when autophagy was blocked. These results coupled with clinical availability and a safe track record make Mino a promising agent for the treatment of malignant gliomas.

The Sensor Web is a growing phenomenon where an increasing number of sensors are collecting data in the physical world, to be made available over the Internet. To help realize the Sensor Web, the Open Geospatial Consortium (OGC) has developed open standards to standardize the communication protocols for sharing sensor data. Spatial Data Infrastructures (SDIs) are systems that have been developed to access, process, and visualize geospatial data from heterogeneous sources, and SDIs can be designed specifically for the Sensor Web. However, there are problems with interoperability associated with a lack of standardized naming, even with data collected using the same open standard. The objective of this research is to automatically group similar sensor data layers. We propose a methodology to automatically group similar sensor data layers based on the phenomenon they measure. Our methodology is based on a unique bottom-up approach that uses text processing, approximate string matching, and semantic string matching of data layers. We use WordNet as a lexical database to compute word pair similarities and derive a set-based dissimilarity function using those scores. Two approaches are taken to group data layers: mapping is defined between all the data layers, and clustering is performed to group similar data layers. We evaluate the results of our methodology.

Nuclear factor-κB (NF-κB) is an important nuclear transcription factor which regulates pro-inflammatory cytokines such as TNF-α, IL-6. Its role as immunoregulatory mediator makes it an attractive target in the development of treatments for inflammatory and autoimmune diseases. In this study, we synthesized derivatives of IMD0354, a known inhibitor for NF-κB, in attempt to understand the effect of benzanilide substitutions on its activity. The inhibition of these analogs on NF-κB activation was analyzed by luciferase assay. The inhibition of IKKβ phosphorylation and pro-inflammatory cytokines was determined by Western blot and real-time PCR. The structure activity relationships showed that the hydroxyl group on IMD0354 is a critical moiety that resulting in the inhibition of NF-κB. Derivatives 1m, 2b, and 2c were shown to inhibit pro-inflammatory cytokine production at low concentration. These newly synthesized compounds may be useful for the treatment of chronic inflammatory disorders or for cancer prevention.

The Internet of Things (IoT) is an infrastructure that interconnects uniquely-identifiable devices using the Internet. By interconnecting everyday appliances, various monitoring, and physical mashup applications can be constructed to improve human’s daily life. In general, IoT devices provide two main capabilities: sensing and tasking capabilities. While the sensing capability is similar to the World-Wide Sensor Web, this research focuses on the tasking capability. However, currently, IoT devices created by different manufacturers follow different proprietary protocols and are locked in many closed ecosystems. This heterogeneity issue impedes the interconnection between IoT devices and damages the potential of the IoT. To address this issue, this research aims at proposing an interoperable solution called tasking capability description that allows users to control different IoT devices using a uniform web service interface. This paper demonstrates the contribution of the proposed solution by interconnecting different IoT devices for different applications. In addition, the proposed solution is integrated with the OGC SensorThings API standard, which is a Web service standard defined for the IoT sensing capability. Consequently, the Extended SensorThings API can realize both IoT sensing and tasking capabilities in an integrated and interoperable manner.

Objective The relationship between traumatic brain injury (TBI) and the risk of dementia remains controversial. This population based study was designed to estimate and compare the risk of dementia in TBI and non-TBI individuals during the 5 year period after TBI. Methods This study was a retrospective cohort study. Data were obtained from the Longitudinal Health Insurance Database 2000. We included 44 925 patients receiving ambulatory or hospital care and 224 625 non-TBI patients; patients were matched for sex, age and year of index use of healthcare. Patients Results During the 5 year follow-up period, 1196 TBI (2.66%) and 224 625 non-TBI patients (1.53%) patients developed dementia. During the 5 year follow-up period, TBI was independently associated with a 1.68 (range 1.57–1.80) times greater risk of dementia after adjusting for sociodemographic characteristics and selected comorbidities. Conclusions The findings of this study suggest an increased risk of dementia among individuals with TBI. We suggest the need for more intensive medical monitoring and health education in individuals with TBI.

Aims: Taiwan has the highest incidence and prevalence of end-stage renal disease worldwide. Haptoglobin (Hp) has a role in renal protection, and there are known differences in the function of different Hp alleles. We aim to study the association between Hp genotype and chronic kidney disease (CKD) in Taiwan. Methods: We performed one hospital-based, age-matched case-control study of 213 patients with CKD and 213 controls to evaluate the association between Hp polymorphism and CKD. Three major Hp genotypes were determined using polymerase chain reaction and electrophoresis. An unconditional logistic regression model was used to identify the associated risk factors for the development of CKD. Results: The frequency of Hp2-2 genotype and Hp2 allele was significantly higher in the CKD group than in controls (p = 0.032 and 0.024, respectively). After adjustment for covariates, the Hp2-2 genotype (vs. Hp1-1; OR 3.841) remained significantly associated with the development of CKD, together with diabetes (OR 3.131), hypertension (OR 1.748) and dyslipidemia (OR 1.646). Conclusion: This present study shows that Hp2-2 genotype is an independent risk factor for CKD. Determination of the Hp genotype may be of potential value to the prediction of genetic risk for CKD.

Numerous studies employed remote sensing techniques on regional air quality in terms of aerosols, in particular, the observations from polar-orbiting satellites offer more detail on spatial distribution. Since the air pollutants/aerosols dramatically vary in location with time, diurnal observations on a timescale are restricted by the temporal resolution of the polar-orbiting satellite. To address this issue, this research proposes a spatially and temporally adaptive reflectance fusion model for measuring atmospheric properties to synthesize high-spatial–temporal resolution images from polar and geostationary satellite imagery for air quality monitoring. The reflectivity from short-wave infrared is employed to preserve the atmospheric effect within the fused image in the green band for further aerosol optical depth (AOD) retrieval. Taking the Landsat-8 Operational Land Imager as the reference, the spatial resolution of the Himawari-8 Advanced Himawari Imager (in kilometers) can thus be resampled into 30 m every 10 min during the daytime, by considering the surface bidirectional reflectivity from the variation of the solar zenith angle. The AOD retrieved with fused images containing atmospheric effect could have a better performance after comparison with in situ measurements, and therefore, be suggested for high-spatial–temporal aerosol monitoring.

A manual pumping test is commonly used to verify the patency of a ventriculoperitoneal (V-P) shunt. Complications occurring after manual pumping of the reservoir are rare. Here, we report a 73-year-old male hydrocephalic patient who had undergone uneventful V-P shunt surgery 9 years ago. He developed a cerebellar hemorrhage after repetitive pressing of the shunt reservoir. The clinical manifestations, characteristic radiologic images, treatment outcome, and possible mechanisms of this late complication are presented. The risk of massive cerebrospinal fluid over-drainage after repetitive manual pumping of the V-P shunt reservoir, which can contribute to the formation of a cerebellar hemorrhage, warrants special attention and hydrocephalic patients and their caregivers should be informed and educated about this potential complication.

Background and Objectives Pre-dialysis care by a nephrology out-patient department (OPD) may affect the outcomes of patients who ultimately undergo maintenance dialysis. This study examined the effect of pre-dialysis care by a nephrology OPD on the incidence of one-year major cardiovascular events after initiation of dialysis. Design, Setting Participants, & Measurements The study consisted of Taiwanese patients with chronic kidney disease (CKD) who commenced dialysis from 2006 to 2008. The number of nephrology OPD visits during the critical care period (within 6 months of initiation of dialysis) and the early care period (6–36 months before initiation of dialysis) were analyzed. The primary outcome measure was one-year major cardiovascular events. Results A total of 1191 CKD patients who initiated dialysis from 2006 to 2008 were included. Binary logistic regression showed that patients with ≧3 visits during the critical care period and those with ≧11 visits during the early care period had fewer composite major cardiovascular events than those with 0 visits. Patients with early referral are less likely to experience composite major cardiovascular events than those with late referral, with aOR 0.574 (95% CI = 0.43–0.77, P

Introduction. Although palliative chemotherapy during end-of-life care is used for relief of symptoms in patients with metastatic cancer, chemotherapy may lead to more aggressive end-of-life care and less use of hospice service. This is a population-based study of the association between palliative chemotherapy and aggressiveness of end-of-life care. Patients and Methods. Using the National Health Insurance Research Database of Taiwan, we identified 49,920 patients with metastatic cancer who underwent palliative chemotherapy from January 1, 2009, to December 31, 2011. Patients who received chemotherapy 2–6 months before death were included. Aggressiveness of end-of-life care was examined by previously reported indicators. Cardiopulmonary resuscitation and endotracheal tube intubation were included as indicators of aggressive end-of-life care. The association between palliative chemotherapy and hospice care was studied. Results. Palliative chemotherapy was associated with more aggressive treatment. After adjustment for patient age, sex, Charlson Comorbidity Index score, cancer group, primary physician’s specialty, postdiagnosis survival, hospital characteristics, hospital caseload, urbanization, and geographic regions, more than one emergency room visit (p < .001), more than one intensive care unit admission (p < .001), and endotracheal intubation (p = .02) during end-of-life care were significantly more common in patients receiving palliative chemotherapy. Patients who did not receive palliative chemotherapy received more hospice care in the last 6 months of life (p < .001). Conclusion. Although the decision to initiate palliative chemotherapy was made several months before death, this study showed that palliative chemotherapy was associated with more aggressive end-of-life care, including more emergency room visits and intensive care unit admissions, and endotracheal intubation. The patients who received palliative chemotherapy received less hospice service toward the end of life.

Delayed cerebral vasospasm is an important pathological feature of subarachnoid hemorrhage (SAH). The cause of vasospasm is multifactorial. Impairs nitric oxide availability and endothelial nitric oxide synthase (eNOS) dysfunction has been reported to underlie vasospasm. Memantine, a low-affinity uncompetitive N-methyl-d-aspartate (NMDA) blocker has been proven to reduce early brain injury after SAH. This study investigated the effect of memantine on attenuation of vasospasm and restoring eNOS functionality. Male Sprague-Dawley rats weighing 350–450 g were randomly divided into three weight-matched groups, sham surgery, SAH + vehicle, and SAH + memantine groups. The effects of memantine on SAH were evaluated by assessing the severity of vasospasm and the expression of eNOS. Memantine effectively ameliorated cerebral vasospasm by restoring eNOS functionality. Memantine can prevent vasospasm in experimental SAH. Treatment strategies may help combat SAH-induced vasospasm in the future.

Objectives To examine the association of individual income and end of life (EOL) care in older cancer decedents in Taiwan. Design Retrospective cohort study. Setting National Health Insurance Research Database (NHIRD) in Taiwan. Participants 28,978 decedents >65 years were diagnosed with cancer and died during 2009-2011 in Taiwan. Of these decedents, 10941, 16535, and 1502 were categorized by individual income as having low, moderate, and high SES, respectively. Main outcome measures Indicators of aggressiveness of EOL care: chemotherapy use before EOL, more than one emergency department (ER) visit, more than one hospital admission, hospital length of stay >14 days, intensive care unit (ICU) admission, and dying in a hospital. Results Low individual income was associated with more aggressive EOL treatment (estimate -0.30 for moderate income, -0.27 for high income, both p14 days. Conclusions Low individual income is associated with more aggressive EOL treatment in older cancer decedents. Public health providers should make available appropriate education and hospice resources to these decedents and their families, to reduce the amount of aggressive terminal care such decedents receive.