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Background/Purpose Malpractice claims place heavy economic and emotional burdens on both dentists and patients. Recently, medical malpractice lawsuits are decreasing in prevalence but increasing in severity. The percentage of dental malpractice payments is also growing among the health profession. The present study aimed to explore criminal convictions in dental malpractice litigation and to analyze the factors affecting the judgment in dental disputes in Taiwan. Methods The keywords “dentist,” “professional negligence,” “medical malpractice,” and “professional liability” were used to search Taiwan's Law and Regulations Retrieving System for criminal dental malpractice cases in all district courts from January 1, 2000 to June 30, 2021. The eligible judgments were summarized and analyzed. Results Overall, 425 cases were identified, with 28 dental disputes included in the final analysis. The dentists lost in 10 cases (35.7%). The average claim time was 36.75 ± 16.34 months. Taipei and Taichung dealt with more lawsuit cases (n = 8). Local clinics were the most common institution of the defendants (75%) and had the highest number of convictions (n = 9). Implant dentistry was the most common specialty involved. Expert testimony of the Medical Review Committee (MRC) had a high K coefficient of agreement with court judgments regarding professional negligence (p Conclusion The overall criminal conviction rate was 35.7%. Implant therapy and local clinics had the highest rate of lawsuits and a considerably higher conviction rate. All guilty dentists were fined or given probation. The court judgments were highly consistent with the expert testimony of the MRC.

This study examines the reliability of the clinical use of the decision support system.The study collected data based on 107 domestic subjects, who were divided into two groups.The two groups then underwent TOVA and DS-ADHD testing.The survey and testing results underwent the one-way ANOVA and the split-half method statistical analysis.The study results show that the system has the characteristics of screening for ADHD, based on its reliability and validity. Background and objectivesThe purpose of this study is to examine the reliability of the clinical use of the self-built decision support system, diagnosis-supported attention deficit hyperactivity disorder (DS-ADHD), in an effort to develop the DS-ADHD system, by probing into the development of indicating patterns of past screening support systems for ADHD. MethodsThe study collected data based on 107 subjects, who were divided into two groups, non-ADHD and ADHD, based on the doctor's determination, using the DSM-IV diagnostic standards. The two groups then underwent Test of Variables of Attention (TOVA) and DS-ADHD testing. The survey and testing results underwent one-way ANOVA and split-half method statistical analysis, in order to further understand whether there were any differences between the DS-ADHD and the identification tools used in today's clinical trials. ResultsThe results of the study are as follows: 1) The ROC area between the TOVA and the clinical identification rate is 0.787 (95% confidence interval: 0.7010.872); 2) The ROC area between the DS-ADHD and the clinical identification rate is 0.867 (95% confidence interval: 0.8010.933). ConclusionsThe study results show that DS-ADHD has the characteristics of screening for ADHD, based on its reliability and validity. It does not display any statistical differences when compared with TOVA systems that are currently on the market. However, the system is more effective and the accuracy rate is better than TOVA. It is a good tool to screen ADHD not only in Chinese children, but also in western country.

Xerostomia (dry mouth) is the cardinal symptom of Sj&ouml, gren&rsquo, s syndrome (SS), which is an autoimmune disease involving the exocrine glands and other organs. Xerostomia may predispose patients to periodontal disease (PD) and an association between SS and PD has been reported. This association may be bidirectional, therefore, we conducted this study to investigate the risk of SS in patients with PD using data from the National Health Insurance Research Database of Taiwan. A total of 135,190 patients were enrolled in our analysis. In all, 27,041 patients with PD were matched by gender, age, insured region, urbanization and income, with cases and controls in a 1:4 ratio. Both groups were followed and the risks of SS were calculated by Cox proportional hazards regression. Finally, 3292 (2.4%) patients had newly diagnosed SS. Patients with PD had a significantly higher risk of subsequent SS (903 (3.3%) vs. 2389 (2.2%), adjusted hazard 1.47, 95% confidence interval: 1.36&ndash, 1.59). In conclusion, patients with PD had an approximately 50% increased risk of subsequent SS. Physicians should be aware of the symptoms and signs of SS in patients with PD.

In this study a numerical simulation was carried out to analyze the transport phenomena in a vertical type metal organic chemical vapor deposition (MOCVD) reactor for Gallium Nitride (GaN) growth. The simulated results were compared and validated by experiment. The effects of showerhead design and chamber height are investigated and discussed. It was found that, by properly adjusting the height of the chamber, both the growth rate and film uniformity could be significantly improved. This is attributed to the suppression of the thermal and mass transfer boundary layers by the injection flow of reacting gas mixtures, as well as the confined vertical vortices caused by the geometry of the reduced space. However, inappropriate design of the distance between the showerhead and the susceptor can result in uneven distribution of the organic source in the vicinity of the substrate surface resulting in an uneven growth rate of the GaN film. Consequently, there exists an optimal chamber height that will give the best growth rate and uniformity to the GaN film as discussed in this study. This study provides comprehensive insight into the transport phenomena of GaN growth that includes coupled heat and mass transfer as well as chemical reactions. The results provide important information in a succinct format and enable decisions to be made about the showerhead and the geometrical design and size of a vertical MOCVD reactor.

The aim of the study is to identify associations between dental anxiety and postoperative pain in patients undergoing extraction of horizontally impacted wisdom teeth. A total of 119 volunteers provided demographic data, and completed questionnaires, the State-Trait Anxiety Inventory (STAI), Chinese Index of Dental Anxiety and Fear (C-IDAF)-4C, and the Numeric Rating Scale (NRS) for pain. Mean SAI, TAI, and C-IDAF-4C scores were 42.5 ± 8.7, 46.4 ± 10.9, and 16.9 ± 7.2, respectively. Mean postoperative pain level score was 3.0 ± 1.8 (range: 0.3–8.4). SAI scores increased as preoperative pain levels increased (β = 1.30, 95% confidence interval [CI]: 0.62–1.98, P

The interfacial reaction and crystallographic orientation of Ni(P)/Au/SnAgCu/Cu and Ni(P)/Pd/Au/SnAgCu/Cu assembled solder joints were investigated. With the aid of crystallographic analysis, the Pd influence on the grain structure and preferred growth orientation of intermetallic compound (IMC) on both Cu and Ni(P) substrates were revealed. On the Ni(P) substrate, the enhanced nucleation of (Cu,Ni,Pd) 6 Sn 5 resulted in the random grain texture and needle-like morphology in the Pd-doping assembled joints. This random texture of (Cu,Ni,Pd) 6 Sn 5 could hinder the crack propagation directly through (0 0 0 1) plane of adjacent grains. As for the Cu substrate, the granular (Cu,Ni,Pd) 6 Sn 5 formed near the substrate and subsequently grew into a layer-like morphology after thermal aging. The granular grains of (Cu,Ni,Pd) 6 Sn 5 exhibited the concentrated texture after aging, whereas (Cu,Ni) 6 Sn 5 stilled revealed the random texture. Most important, the absence of high angle grain boundary among (Cu,Ni,Pd) 6 Sn 5 grains on the Cu substrate could further guarantee the lifetime of solder joint during the reliability test. Finally, the detailed correlation between microstructure variation and grain orientation will be investigated and discussed as well as the possible mechanism.

This study investigated the interfacial reaction and mechanical strength of Sn–3.0Ag–0.5Cu solder jointed with electroless Ni–P/immersion Au (ENIG) and electroless Ni–P/electroless Pd/immersion Au (ENEPIG) surface finishes under various reflow times. The morphology of interfacial (Cu,Ni,Pd) 6 Sn 5 was refined to needle-like by the Pd insertion in the ENEPIG surface finish. The impact energy of solder joints with Pd doped declined slower than that without Pd-doped after prolonged reflow. By inspecting the fracture surface, the cleavage of interfacial (Cu,Ni) 6 Sn 5 was frequently observed in the ENIG joints after prolonged soldering, whereas ductile dimple-like failure dominated the fracture surface of ENEPIG joints. The enhanced impact strength and the transition of failure mode in the ENEPIG joints was attributed to the needle-like morphology of (Cu,Ni,Pd) 6 Sn 5 . The detailed mechanism of improved mechanical strength for solder joints with Pd dissolved will be deliberately addressed and discussed regarding the distinct microstructural evolution in the ENEPIG joint.

In this study, the interfacial reaction of Sn–3.5Ag and Sn–3.0Ag–0.5Cu solders jointed with electroless Ni(P) substrate was investigated. Thick Ni 3 P and Ni 2 SnP layers formed in the Sn–3.5Ag joints because of the formation of Ni–Sn compound. In contrast, with the Cu addition in the solder, the interfacial (Cu,Ni) 6 Sn 5 suppressed the growth of P-rich layers. However, after multiple reflows, the phase transformation occurred in the Sn–Ag–Cu joints, indicating a potential risk for crack to propagate through the dual IMC structure. To evaluate the bonding strength of solder joint, the high speed impact test was utilized to find out the weakest position among these two joints. By the comparison of the bonding energy and the X-ray fracture surface mapping between these two joints, both thick P-rich layers and dual IMC structure deteriorate the metallurgical bonding of solder joint. Eventually, the elemental cross-interaction should be considered in the final board assembled solder joints. The continuous Cu migration from the Cu metallization of board side inhibited the phase transformation on the electroless Ni(P) substrate, which might ensure the superior reliability of Cu-bearing solder joint. The roles of Cu on the interfacial reaction and mechanical strength would be addressed in the Sn–Ag–Cu/Ni(P) joints. Finally, the detailed correlation between microstructure variation and fracture failure as well as the possible mechanism was investigated and discussed.

The mechanical stability of solder joints with Pd added to Sn-Ag-Cu alloy with different aging conditions was investigated in a high-G level shock environment. A test vehicle with three different strain and shock level conditions in one board was used to identify the joint stability and failure modes. The results revealed that Pd provided stability at the package-side interface with an overall shock performance improvement of over 65% compared with the Sn-Ag-Cu alloy without Pd. A dependency on the pad structure was also identified. However, the strengthening mechanism was only observed in the non-solder mask defined (NSMD) pad design, whereas the solder mask defined (SMD) pad design boards showed no improvement in shock performance with Pd-added solders. The effects of Sn grain orientation on shock performance, interconnect stability, and crack propagation path with and without Pd are discussed. The SAC305 + Pd solder joints showed more grain refinements, recrystallization, and especially mechanical twin deformation during the shock test, which provides a partial explanation for the ability of SAC305 + Pd to absorb more shock-induced energy through active deformation compared with SAC305.

A powerful integrated fan-out (InFO) wafer level system integration (WLSI) technology has been developed to integrate application processor chip with memory package for smart mobile devices. This novel InFO technology is the first high performance Fan-Out Wafer Level Package (FO_WLP) with multi-layer high density interconnects proposed to the industry. In this paper we present the detailed comparison of InFO packages on package (InFO_PoP) with several other previously proposed 3D package solutions. Result shows that InFO_PoP has more optimized overall results on system performance, leakage power and area (form factor) than others, to meet the ever-increasing system requirements of mobile computing. InFO technology has been successfully qualified on package level with robust component and board level reliability. It is also qualified at interconnect level with high electromigration resistance. With its high flexibility and strong capability of multi-chips integration for both homogeneous and heterogeneous sub-systems, InFO technology not only provides a system scaling solution but also complements the chip scaling and helps to sustain the Moore's Law for the smart mobile as well as internet of things (IoT) applications.

The mechanical properties of new lead-free Sn–Ag–Cu solder alloys containing 0.05–0.1 wt.% boron were investigated under a range of isothermal aging and reflow conditions. The boron-doped solder joints showed higher ball pull strength than the baseline Sn-1.0Ag-0.5Cu solder joint under all isothermal aging and reflow conditions examined. In particular, the high-speed ball pull strength of the 0.05 wt.% B-doped solder joint was approximately 2.5 times greater than that of the baseline Sn-1.0Ag-0.5Cu solder joint aged at 150 °C for 200 h, which is attributed mainly to the reduced rate of grain growth in the intermetallic compound (IMC) layers of B-doped solder joints under aging conditions.

Cu under bump metallurgy (UBM) has been widely used in flip-chip technology. The major disadvantages of Cu UBM are fast consumption of copper, rapid growth of intermetallic compounds (IMCs), and easy formation of Kirkendall voids. In this study we added two different contents of Mn (2 at.% and 10 at.%) to Cu UBM by sputtering to modify the conventional Cu metallization. For the higher Mn concentration in the Cu-Mn UBM, a new Sn-rich phase formed between Cu 6 Sn 5 and the Cu-Mn UBM, and cracks formed after aging. For the lower Mn concentration, growth of Cu 3 Sn and Kirkendall voids was significantly suppressed after thermal aging. Kinetic analysis and x-ray elemental mapping provided evidence that Mn diffusion into Cu 3 Sn slowed diffusion of Cu in the Cu 3 Sn layer. The Mn-enriched Cu 3 Sn layer may serve as a diffusion barrier to reduce the interfacial reaction rate and Kirkendall void formation. These results suggest that Cu-Mn UBM with low Mn concentration is beneficial in terms of retarding Cu pad consumption in solder joints.

The interfacial reactions of Sn–3.0Ag–0.5Cu solder jointed with electroless Ni–P/immersion Au (ENIG) and electroless Ni–P/electroless Pd/immersion Au (ENEPIG) were investigated. Cu 6 Sn 5 grew rather slower in ENEPIG samples among all aging conditions as compared with ENIG. Furthermore, the second phase, Ni 3 Sn 4 , started to form in the ENIG aged joints, but not in the ENEPIG aged joints. It was demonstrated that ENEPIG could inhibit the formation of Ni 3 Sn 4 , which further decreased the growth of columnar Kirkendall voids inside the Ni 3 P layer. With less voids formed in the Ni 3 P layer, it is expected that the reliability of ENEPIG joints would be superior to that of ENIG joints. Detailed mechanisms of Ni 3 Sn 4 suppression and void formation were discussed and proposed.

Chen-Hsi Hsieh,1–3 Pei-Wei Shueng,1,4 Li-Ying Wang,5 Li-Jen Liao,6 Yu-Chin Lin,7 Ying-Shiung Kuo,8 Wu-Chia Lo,6 Chien-Fu Tseng,8 Hui-Ju Tien,1 Hsiu-Ling Chou,9,10 Yen-Ping Hsieh,11 Le-Jung Wu,1 Yu-Jen Chen3,12–14 1Department of Radiation Oncology, Far Eastern Memorial Hospital, 2Department of Medicine, 3Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, 4Department of Radiation Oncology, National Defense Medical Center, 5School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 6Department of Otolaryngology, 7Division of Medical Oncology and Hematology, Department of Internal Medicine, 8Department of Dentistry and Oral Surgery, 9Department of Nursing, Far Eastern Memorial Hospital, 10Department of Nursing, Oriental Institute of Technology, Taipei, 11Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, 12Department of Radiation Oncology, 13Department of Medical Research, Mackay Memorial Hospital, 14Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan Background: The outcome of postoperative high- and intermediate-risk oral cavity cancer (OCC) patients receiving helical tomotherapy (HT) remains limited. Materials and methods: Between November 2006 and November 2012, 53 postoperative high- and intermediate-risk OCC patients treated with HT were enrolled. Results: The 4-year locoregional, local, and regional control rates were 66%, 76.4%, and 94.3%, respectively. The 4-year locoregional control rates of oral tongue and buccal mucosa cancer were 88.3% and 37.1%, respectively (P=0.012). Eleven (20.8%) patients experienced locoregional failure. In-field failure occurred in six of 53 (11.3%) in the primary area and three of 53 (5.7%) in the regional lymph-node area. No marginal failure was noted. Two of 53 (3.8%) experienced out-of-field failure. The rates of grade 3 dermatitis, mucositis, and dysphagia were 11%, 34%, and 13%, respectively. No grade 3 xerostomia was noted. Grade 2 xerostomia was 33% at month 6 and declined to 0 at month 48. A rate of 56% of grade 2 trismus at month 6 was noted, and declined to around 30% after 2 years. No grade 3 trismus was noted after 2 years. Conclusion: HT as a postoperative modality provided satisfying results, especially for xerostomia and trismus, and was impressive in high- and intermediate-risk OCC patients receiving postoperative HT. Keywords: concurrent chemoradiation, helical tomotherapy, locoregional control rate, oral cavity cancer, trismus

In this paper, we propose the idea of gray optical apertures in contrast to the conventional binary apertures for holographic data storage (HDS). A gray aperture can be realized by a liquid crystal display or a binary aperture with a coating near the edge. In our simulation, HDS with a gray aperture shows a better page signal-to-noise ratio and modeling accuracy than HDS using a binary aperture.

In holographic data storage systems, it is straightforward to increase the storage capacity by mean of reducing the pitches among data symbols. However, this may lead to severe inter-symbol interference (ISI) and also unacceptable data error rate. To deal with the problem, we first model the channel as a partial response (PR) and use the maximum-likelihood (ML) detection to control the ISI. The Viterbi decoder is employed to implement ML detection.

We derive the formula for intensity distribution of a holographic reconstructed image related to the effect of the recording material shrinkage for an off-axis holographic storage system with a plane wave reference beam using the Born approximation method. It is shown that even under the Bragg condition, the intensity across the reconstructed image decreases significantly when the angle between write reference beam and object beam becomes large. We also introduce a simple method to compensate for the effect of the recording material shrinkage by shifting the read reference beam angle.

To develop magnetic resonance imaging (MRI) indicators to predict trismus outcome for post-operative oral cavity cancer patients who received adjuvant intensity-modulated radiation therapy (IMRT), 22 patients with oral cancer treated with IMRT were studied over a two-year period. Signal abnormality scores (SA scores) were computed from Likert-type ratings of the abnormalities of nine masticator structures and compared with the Mann-Whitney U-test and Kruskal-Wallis one-way ANOVA test between groups. Seventeen patients (77.3%) experienced different degrees of trismus during the two-year follow-up period. The SA score correlated with the trismus grade (r = 0.52, p

In flip chip technology, Cu thin-film is a widely used under bump metallization (UBM). However, the major disadvantages of Cu UBM are fast consumption of copper, rapid growth of IMCs and easy formation of Kirkendall voids [1, 2]. Many efforts have been focused on suppression of Kirkendall voids which are detrimental to solder joints reliability in the microelectronics industry [3, 4]. In this study, a novel Cu(Mn) UBM design was provided by sputtering to improve the conventional Cu metallization. For the higher Mn concentration (10 at.% Mn) in the Cu(Mn) UBM, a new Sn-rich phase formed between Cu 6 Sn 5 and the Cu(Mn) UBM. However, a layer of crack formed after aging. For the lower Mn concentration (2 at.% Mn), the growth of Cu 3 Sn and Kirkendall voids was significantly suppressed during thermal aging. The interfacial reaction was analyzed by a field emission electron probe microanalyzer (FE-EPMA) to evaluate the composition distribution. Kinetic analysis and X-ray color mapping gave the evidence that Mn diffusion into Cu 3 Sn slowed down the diffusivity of Cu in Cu 3 Sn layer. The Mn-enriched Cu 3 Sn might serve as a diffusion barrier to reduce interfacial reaction and Kirkendall voids formation. These results suggest the Cu-Mn UBM with a low Mn concentration is beneficial to retarding the Cu pad consumption in solder joints.

In this paper, a novel two-dimensional run-length-limit code is proposed to reduce the inter-symbol-interference due to mis-registration and bright pixel broadened. The proposed code has information for position-recovery and performance is better than 4/9 code.