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Hsi-Chung Chen,1,2 Chia-Yi Wu,3– 5 Ming-Been Lee,1,5– 7 Shih-Cheng Liao,1,5,6 Chia-Ta Chan,5,7 Chun-Ying Chen5 1Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; 2Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan; 3School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan; 4Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; 5Taiwan Suicide Prevention Center, Taipei, Taiwan; 6Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan; 7Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanCorrespondence: Chia-Yi WuSchool of Nursing, National Taiwan University College of Medicine, No.1, Sec. 1, Jen-A1 Road, Taipei 100, TaiwanTel +886-2-23123456 ext. 88430Email jennycyw@ntu.edu.tw Ming-Been LeeDepartment of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan S. Road, Taipei 100, TaiwanTel +886-2-23123456 Ext. 66784Email mingbeen@ntu.edu.twBackground: Insomnia is closely related to psychological distress. This study aims to examine the role of age and sex in the association between various psychological distresses and insomnia symptoms.Participants and Methods: This population-based study used data provided by cumulative respondents of the annual survey of the Taiwan Suicide Prevention Center between 2006 and 2019. Potential respondents were aged ≥ 15 years and were selected by a stratified proportional randomization method according to the distribution of population size, sex, and age in different geographic areas of Taiwan. The Five-Item Brief Symptom Rating Scale was used to measure insomnia symptoms and four psychological distresses: depression, anxiety, hostility, and inferiority. The independent relationship between insomnia symptoms with depression, anxiety, hostility, and inferiority was further examined according to age and sex.Results: A total of 28,649 participants were included (women, 50.2%). The four types of psychological distress correlated differentially with insomnia symptoms. Concerning interaction effects, sex moderated the interaction effects between age with depression, anxiety, and hostility. In men, and not in women, age moderated the relationship between insomnia symptoms and all four psychological distresses. Specifically, the effect sizes of the associations between insomnia symptoms and depression, anxiety, and hostility showed an age-dependent decreasing trend in men.Conclusion: The associations between psychological distresses and insomnia symptoms varied in strength and according to age in a sex-specific manner.Keywords: insomnia symptoms, moderation effect, psychological distress, sex-specific

We review some recent progress in the exploration of pseudospin-1 physics using dielectric photonic crystals (PCs). We show some physical implications of the PCs exhibiting an accidental degeneracy induced conical dispersion at the Γ point, such as the realization of zero refractive index medium and the zero Berry phase of a loop around the nodal point. The photonic states of such PCs near the Dirac-like point can be described by an effective spin-orbit Hamiltonian of pseudospin-1. The wave propagation in the positive, negative, and zero index media can be unified within a framework of pseudospin-1 description. A scale change in PCs results in a rigid band shift of the Dirac-like cone, allowing for the manipulation of waves in pseudospin-1 systems in much the same way as applying a gate voltage in pseudospin-1/2 graphene. The transport of waves in pseudospin-1 systems exhibits many interesting phenomena, including super Klein tunneling, robust supercollimation, and unconventional Anderson localization. The transport properties of pseudospin-1 systems are distinct from their counterparts in pseudospin-1/2 systems, which will also be presented for comparison.

We discovered unique Anderson localization behaviors of pseudospin systems in a 1D disordered potential. For a pseudospin-1 system, due to the absence of backscattering under normal incidence and the presence of a conical band structure, the wave localization behaviors are entirely different from those of conventional disordered systems. We show that there exists a critical strength of random potential ([Formula: see text]), which is equal to the incident energy ([Formula: see text]), below which the localization length [Formula: see text] decreases with the random strength [Formula: see text] for a fixed incident angle [Formula: see text] But the localization length drops abruptly to a minimum at [Formula: see text] and rises immediately afterward. The incident angle dependence of the localization length has different asymptotic behaviors in the two regions of random strength, with [Formula: see text] when [Formula: see text] and [Formula: see text] when [Formula: see text] The existence of a sharp transition at [Formula: see text] is due to the emergence of evanescent waves in the systems when [Formula: see text] Such localization behavior is unique to pseudospin-1 systems. For pseudospin-1/2 systems, there is also a minimum localization length as randomness increases, but the transition from decreasing to increasing localization length at the minimum is smooth rather than abrupt. In both decreasing and increasing regions, the [Formula: see text] dependence of the localization length has the same asymptotic behavior [Formula: see text].

INTRODUCTION: We hypothesized that discharged heart failure (HF) patients could develop clinical congestion despite adhering to prescribed diuretics, because ambulation attenuates diuretic and natriuretic responsiveness. METHODS: We studied 9 patients aged 57 ± 13 (mean ± SD) years with New York Heart Association functional class II-III symptoms and ejection fraction <40% (28 ± 7%) and receiving furosemide (>=80 mg/d [113 ± 53 mg/d]) plus renin-angiotensin system antagonists and beta-blockade. Inulin and p-amminohippuric acid were infused to estimate glomerular filtration rate (GFR) and renal plasma flow (RPF). Furosemide was administered intravenously at 75% of the usual oral morning dose. Participants were randomized to supine (90 minutes recumbancy) or upright (90 minutes sitting and treadmill walking) posture and assumed the other position on their second day. Primary outcome variables were urine volume and sodium excretion 90 minutes after furosemide. RESULTS: On the upright, compared with the supine, day, urine volume (792 ± 484 vs 1,290 ± 503 mL; P = .02) and sodium (79 ± 55 vs 141 ± 61 mmol; P < .01) were attenuated, whereas plasma norepinephrine (4.4 ± 2.7 vs 2.3 ± 1.8 mmol/L; P = .01) and renin (327 ± 250% of supine; P < .01) were augmented. Urinary K+, mean pressure, GFR, and RPF were similar. CONCLUSIONS: Activation of the sympathetic nervous system and renin-angiotensin axis by upright ambulation may attenuate diuresis and natriuresis by increasing proximal tubular reabsorption of sodium and water. [ABSTRACT FROM AUTHOR]

Introduction: Fluid displacement into nuchal and peripharyngeal soft tissues while recumbent may contribute to narrowing and increased airflow resistance of the pharynx (Rph), and predispose to pharyngeal collapse in patients at risk for obstructive sleep apnea. OBJECTIVES: To determine whether displacement of fluid from the lower body to the neck will increase both neck circumference and Rph in healthy subjects. METHODS: In 11 healthy, nonobese subjects, studied while awake and supine, leg fluid volume, neck circumference, and Rph were measured at baseline. Subjects were then randomized to a control period or to application of lower body positive pressure (LBPP) of 40 mm Hg via antishock trousers to displace fluid from the legs, after which they crossed over to the other arm. Baseline measurements were repeated at 1 and 5 min during the control and LBPP periods. RESULTS: Compared with the control period, application of LBPP caused a significant reduction in leg fluid volume (p < 0.001) and a significant increase in neck circumference (p = 0.004). Rph remained stable during the control period, but increased significantly from baseline after 1 and 5 min of LBPP (from 0.43 +/- 0.10 to 0.60 +/- 0.11 cm H(2)O/L/s, p = 0.034, and to 0.87 +/- 0.19 cm H(2)O/L/s, p < 0.001, compared with baseline, respectively). CONCLUSIONS: Fluid displacement from the legs by LBPP increases neck circumference and Rph in healthy subjects. These findings suggest the hypothesis that fluid displacement to the upper body during recumbency may predispose to pharyngeal obstruction during sleep, especially in fluid overload states, such as heart and renal failure. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore patient training experiences related to the selfadministration of hemodialysis at home. Researchers used a qualitative study using semi-structured interviews and a focus group. The setting was a hospital-based patient education program in Toronto, Ontario, Canada. Qualitative interviews and focus group study were conducted with 23 patients (who had end stage renal disease) and caregivers who have participated in Toronto General Hospital's Nocturnal Home Hemodialysis training program to learn how to operate a hemodialysis machine and to administer their own treatments at home without the supervision of clinicians. Results: Experience as a trainee in the Nocturnal Home Hemodialysis program was framed by 5 diverse themes: patients' perceptions of anxiety, peer support, clinician empathy and understanding, learning while ill, and the compatibility of learning preferences with training practices employed. Conclusions: The study revealed the complexity of the patients' experience with being prepared for a self-treatment regime at home. Although it was anticipated that the most important barrier to patient preparation would be the challenges of managing complex medical technology, psychosocial dimensions of their experiences were the primary factors impacting on the patients' ability to learn and to take on self-care responsibility. If the trend of patient self-treatment at home continues to increase, it is important for clinician educators to be attentive to self-treatment as a socially situated activity. [ABSTRACT FROM AUTHOR]

Frozen shoulder (FS) is a common shoulder condition accompanied by shoulder pain and a loss of shoulder range of motion (ROM). The typical clinical assessment tools such as questionnaires and ROM measurement are susceptible to subjectivity and individual bias. To provide an objective evaluation for clinical assessment, this study proposes an inertial measurement unit (IMU)-based identification system to automatically identify shoulder tasks whether performed by healthy subjects or FS patients. Two groups of features (time-domain statistical features and kinematic features), seven machine learning (ML) techniques, and two deep learning (DL) models are applied in the proposed identification system. For the experiments, 24 FS patients and 20 healthy subjects were recruited to perform five daily shoulder tasks with two IMUs attached to the arm and the wrist. The results demonstrate that the proposed system using deep learning presented the best identification performance using all features. The convolutional neural network achieved the best identification accuracy of 88.26%, and the multilayer perceptron obtained the best F1 score of 89.23%. Further analysis revealed that the identification performance based on wrist features had a higher accuracy compared to that based on arm features. The system's performance using time-domain statistical features has better discriminability in terms of identifying FS compared to using kinematic features. We demonstrate that the implementation of the IMU-based identification system using ML is feasible for FS assessment in clinical practice.

Purpose of Review: Among patients with kidney failure, home dialysis modalities, including peritoneal dialysis (PD) and home hemodialysis (HHD) provide several individual and healthcare system benefits over in-center hemodialysis (HD). Infection remains a major source of morbidity and mortality in this population, and a core outcome of critical importance to patients, caregivers, and kidney health professionals. This narrative review provides evidence-based measures for infection prevention among individuals receiving home dialysis, with a particular emphasis on dialysis and access-related infections., Recent Findings: Patient and care partner education and training is an important and major theme for infection prevention in home dialysis. In PD, identifying and managing modifiable risk factors for infections such as hypokalemia, constipation, use of gastric acid suppressants, and domestic pets, along with the use of antimicrobial prophylaxis, when indicated, can substantially reduce peritonitis risk. Reducing the use of central venous catheters (CVC), and duration of CVC dependence is the most effective means of prevention of HD access-related bloodstream infections in individuals receiving HHD. For arteriovenous fistula cannulation, rope ladder technique is associated with lower risk of infection compared to buttonhole cannulation., Summary: Developing and instituting a well structured and evidence-based patient training and education program within home dialysis units is the most important measure in preventing and reducing dialysis and access-related infections. Kidney care providers should be familiar with different infection risk factors among individuals receiving home dialysis., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Disorder, which is ubiquitous in nature, has been extensively explored in photonics for understanding the fundamental principles of light diffusion and localization, as well as for applications in functional resonators and random lasers. Recently, the investigation of disorder in topological photonics has led to the realization of topological Anderson insulators characterized by an unexpected disorder-induced phase transition. However, the observed photonic topological Anderson insulators so far are limited to the time-reversal symmetry breaking systems. Here, we propose and realize a photonic quantum spin Hall topological Anderson insulator without breaking time-reversal symmetry. The disorder-induced topological phase transition is comprehensively confirmed through the theoretical effective Dirac Hamiltonian, numerical analysis of bulk transmission, and experimental examination of bulk and edge transmissions. We present convincing evidence for the unidirectional propagation and robust transport of helical edge modes, which are the key features of nontrivial time-reversal invariant topological Anderson insulators. Furthermore, we demonstrate disorder-induced beam steering, highlighting the potential of disorder as a new degree of freedom to manipulate light propagation in magnetic-free systems. Our work not only paves the way for observing unique topological photonic phases but also suggests potential device applications through the utilization of disorder.

Poststroke aphasia hinders patients' emotional processing and social adaptation. This study estimated the risks of depression and related symptoms in patients developing or not developing aphasia after various types of stroke. Using data from the US Collaborative Network within the TriNetX Diamond Network, we conducted a retrospective cohort study of adults experiencing their first stroke between 2013 and 2022. Diagnoses were confirmed using corresponding International Classification of Diseases, Tenth Revision, Clinical Modification codes. Patients were stratified by poststroke aphasia status and stroke type, with propensity score matching performed to control for confounders. The primary outcome was depression within one year post-stroke; secondary outcomes included anxiety, fatigue, agitation, emotional impact, and insomnia. Each matched group comprised 12,333 patients. The risk of depression was significantly higher in patients with poststroke aphasia (hazard ratio: 1.728; 95% CI 1.464-2.038; p < 0.001), especially those with post-hemorrhagic-stroke aphasia (hazard ratio: 2.321; 95% CI 1.814-2.970; p < 0.001). Patients with poststroke aphasia also had higher risks of fatigue, agitation, and emotional impact. Anxiety and insomnia risks were higher in those with post-hemorrhagic-stroke aphasia. Poststroke aphasia, particularly post-hemorrhagic-stroke aphasia, may increase the risks of depression and associated symptoms, indicating the need for comprehensive psychiatric assessments., (© 2024. The Author(s).)

Background: Nocturnal hemodialysis (nHD) restores the attenuated brachial artery vasodilator responsiveness of patients receiving conventional intermittent hemodialysis (iHD). Its impact on coronary vasodilatation is unknown., Methods: We evaluated 25 patients on hemodialysis who fulfilled transplant criteria: 15 on iHD (4-hour sessions, 3 d/wk) and 10 on nHD (≈40 h/wk over 8-10-hour sessions) plus 6 control participants. Following diagnostic angiography, left anterior descending (LAD) coronary flow reserve and mean luminal diameter were quantified at baseline and during sequential intracoronary administration of adenosine (infusion and bolus), nitroglycerin (bolus), acetylcholine (infusion), acetylcholine coinfused with vitamin C, and, finally, sublingual nitroglycerin., Results: Coronary flow reserve in those receiving nHD was augmented relative to iHD (3.28±0.26 versus 2.17±0.12 [mean±SEM]; P <0.03) but attenuated, relative to controls (4.80±0.63; P =0.011). Luminal dilatations induced by intracoronary adenosine and nitroglycerin were similar in nHD and controls but blunted in the iHD cohort ( P <0.05 versus both). ACh elicited vasodilatation in controls but constriction in both dialysis groups (both P <0.05, versus control); vitamin C coinfusion had no effect. Sublingual nitroglycerin increased mid-left anterior descending diameter and reduced mean arterial pressure in controls (+15.2±2.68%; -16.00±1.60%) and in nHD recipients (+14.78±5.46%; -15.82±1.32%); iHD responses were markedly attenuated (+1.9±0.86%; -5.89±1.41%; P <0.05, all comparisons)., Conclusions: Coronary and systemic vasodilator responsiveness to both adenosine and nitroglycerin is augmented in patients receiving nHD relative to those receiving iHD, whereas vasoconstrictor responsiveness to acetylcholine does not differ. By improving coronary conduit and microvascular function, nHD may reduce the cardiovascular risk of patients on dialysis., Competing Interests: None.

Purpose: The benefits of intraoperative dialysis during orthotopic liver transplantation remain controversial. In patients with anuric renal failure and portopulmonary hypertension, maintaining venous return during caval clamping and unclamping along with minimizing fluid overload is critical to avoiding right ventricular strain and failure., Clinical Features: We present the case of a 54-yr-old female who underwent orthotopic liver transplantation for alcohol-related liver disease with acute decompensation including severe hepatorenal syndrome (anuric requiring dialysis), probable hepatopulmonary syndrome, moderate pulmonary hypertension (right ventricular systolic pressure, 44 mm Hg), hepatic encephalopathy (grade 2), and esophageal varices. Prior to incision, pulmonary arterial pressures were 48/28 (mean, 35) mm Hg with a central venous pressure of 30 mm Hg, cardiac output of 7.4 L·min -1 , and pulmonary vascular resistance of 98 dynes·sec·cm -5 . In the context of right ventricular strain and volume overload observed on transthoracic echocardiography, we inserted an additional dialysis catheter into the right femoral vein. We initiated dialysis using the two catheters as a circuit (femoral line to the dialysis machine; blood was reinjected via the subclavian line) acting as a limited venovenous bypass, allowing right ventricular offloading and hemodialysis throughout the case. We removed 4.5 L via hemodialysis during the surgery, while avoiding acidosis, hyperkalemia, and sodium shifts. The patient tolerated reperfusion adequately despite pre-existing right ventricular dilation and dysfunction., Conclusion: We report on the use two hemodialysis catheters in a patient undergoing orthotopic liver transplantation as a circuit for simultaneous anuric hepatorenal syndrome and moderate pulmonary hypertension with right ventricular dilation and dysfunction. We believe this technique was instrumental in the patient's successful transplant., (© 2024. Canadian Anesthesiologists' Society.)

There is a global interest in expanding home dialysis utilization among patients with ESKD. Home hemodialysis (HHD) is an appealing KRT option for this population because of its multiple clinical and quality of life benefits. Central to successful HHD is the establishment and maintenance of a functioning vascular access that serves as a patient's lifeline while on therapy. While the selection of a vascular access type is influenced by individual patient circumstances, the arteriovenous fistula is generally the preferred access method. Training patients to use their dialysis access requires attention to safety, risk management, and monitoring for complications to minimize adverse events and technique failure. Policies incorporating systematic frameworks for quality improvement and assurance, in conjunction with the measurement of metrics relating to vascular access, are tools that should be used by HHD programs to enhance the value of care delivered. In this perspective, we aim to describe what is currently known about the various vascular access options in HHD and to elucidate what needs to be taken into consideration in the selection and care of this access., (Copyright © 2024 by the American Society of Nephrology.)

Foodborne pathogens, particularly antimicrobial-resistant (AMR) bacteria, remain a significant threat to global health. Given the limitations of conventional culture-based approaches, which are limited in scope and time-consuming, metagenomic sequencing of food products emerges as a promising solution. This method provides a fast and comprehensive way to detect the presence of pathogenic microbes and antimicrobial resistance genes (ARGs). Notably, nanopore long-read sequencing provides more accurate bacterial taxonomic classification in comparison to short-read sequencing. Here, we revealed the impact of food types and attributes (origin, retail place, and food processing methods) on microbial communities and the AMR profile using nanopore metagenomic sequencing. We analyzed a total of 260 food products, including raw meat, sashimi, and ready-to-eat (RTE) vegetables. Clostridium botulinum, Acinetobacter baumannii, and Vibrio parahaemolyticus were identified as the top three foodborne pathogens in raw meat and sashimi. Importantly, even with low pathogen abundance, higher percentages of samples containing carbapenem and cephalosporin resistance genes were identified in chicken and RTE vegetables, respectively. In parallel, our results demonstrated that fresh, peeled, and minced foods exhibited higher levels of pathogenic bacteria. In conclusion, this comprehensive study offers invaluable data that can contribute to food safety assessments and serve as a basis for quality indicators., Competing Interests: Declaration of competing interest None, (Copyright © 2024. Published by Elsevier Ltd.)

Bound states in the continuum (BICs), which are confined optical modes exhibiting infinite quality factors and carrying topological polarization configurations in momentum space, have recently sparked significant interest across both fundamental and applied physics. Here, we show that breaking time-reversal symmetry by an external magnetic field enables a new form of chiral BICs with spin-orbit locking. Applying a magnetic field to a magneto-optical photonic crystal slab lifts doubly degenerate BICs into a pair of chiral BICs carrying opposite pseudospins and orbital angular momenta. Multipole analysis verifies the nonzero angular momenta and reveals the spin-orbital-locking behaviors. In momentum space, we observe ultrahigh quality factors and near-circular polarization surrounding chiral BICs, enabling potential applications in spin-selective nanophotonics. Compared to conventional BICs, the magnetically induced chiral BICs revealed here exhibit distinct properties and origins, significantly advancing the topological photonics of BICs by incorporating broken time-reversal symmetry.

Materials possessing an effective zero refractive index are often associated with Dirac-like cone dispersion at the center of the Brillouin zone (BZ). It has been reported the presence of hidden symmetry-enforced triply degenerate points [nexus points (NP)] away from the Brillouin zone center with the stacked dielectric photonic crystals. The spin-1 Dirac-like dispersion in the xy plane near the nexus point suggests a method for achieving zero refractive index materials. The stacked photonic crystals at the nexus points can be deemed as an effective moving double-zero-index medium (MDZIM) traveling with a speed relative to the laboratory reference. The ability of this moving double-zero-index medium to enable perfect wave tunneling across barriers without reflection has been demonstrated, dependent on the incident waves' specific angular orientations.

Introduction: Many individuals start dialysis in an acute setting with suboptimal pre-dialysis education. These individuals are often treated with central venous catheter insertion and initiation of in-center hemodialysis and only a minority will transfer to a home-based therapy. The dialysis start unit is a program performing in-center hemodialysis in a separate space while providing support and education on chronic kidney disease and treatment options in the initial weeks of kidney replacement therapy. We aimed to assess the uptake of home dialysis therapies between 2013 and 2021 among patients who started acute inpatient hemodialysis at University Health Network, Toronto and underwent dialysis at the dialysis start unit., Methods: This is a retrospective observational cohort study based on prospectively collected data. Patients' demographics were obtained from electronic charts. In the dialysis start unit, all patients received dialysis modality education by a nurse educator, dedicated home dialysis nurses, and the allied health care team., Findings: During 2013-2021, 122 patients were dialyzed in the dialysis start unit and included in the study. Among those patients, 68 patients ultimately chose home dialysis (57 peritoneal dialysis and 11 home hemodialysis). Fifty-four patients continued in-center hemodialysis. Patients adopting home dialysis were less likely to have diabetes and hypertension as the etiology of kidney failure and more likely to have glomerulonephritis or vasculitis., Discussion: Dialysis modality education is implementable in advanced chronic kidney disease. Individualized education and care after unplanned start dialysis can potentially enhance home dialysis choice and utilization., (© 2024 International Society for Hemodialysis.)

The Chern number has been widely used to describe the topological properties of periodic structures in momentum space. Here, we introduce a real-space spin Chern number for the optical near fields of finite-sized structures. This new spin Chern number is intrinsically quantized and equal to the structure's Euler characteristic. The relationship is robust against continuous deformation of the structure's geometry and is irrelevant to the specific material constituents or external excitation. Our Letter enriches topological physics by extending the Chern number to real space, opening exciting possibilities for exploring the real-space topological properties of light.

Peritoneal dialysis (PD) and home hemodialysis (HHD) are the two home dialysis modalities offered to patients. They promote patient autonomy, enhance independence, and are generally associated with better quality of life compared to facility hemodialysis. PD offers some advantages (enhanced flexibility, ability to travel, preservation of residual kidney function, and vascular access sites) but few patients remain on PD indefinitely due to peritonitis and other complications. By contrast, HHD incurs longer and more intensive training combined with increased upfront health costs compared to PD, but is easier to sustain in the long term. As a result, the integrated home dialysis model was proposed to combine the advantages of both home-based dialysis modalities. In this paradigm, patients are encouraged to initiate dialysis on PD and transfer to HHD after PD termination. Available evidence demonstrates the feasibility and safety of this approach and some observational studies have shown that patients who undergo the PD-to-HHD transition have clinical outcomes comparable to patients who initiate dialysis directly on HHD. Nevertheless, the prevalence of PD-to-HHD transfers remains low, reflecting the multiple barriers that prevent the full uptake of home-to-home transitions, notably a lack of awareness about the model, home-care "burnout," clinical inertia after a transfer to facility HD, suboptimal integration of PD and HHD centers, and insufficient funding for home dialysis programs. In this review, we will examine the conceptual advantages and disadvantages of integrated home dialysis, present the evidence that underlies it, identify challenges that prevent its success and finally, propose solutions to increase its adoption., Competing Interests: A.C.N.F. received speaker honoraria by Baxter Healthcare and holds a FRQS scholarship. J.B. serves as consultant to and received speaker honoraria with both DaVita Healthcare Partners and Baxter Healthcare. C.C. holds the R Fraser Elliott Chair in Home Dialysis and serves as consultant to Medtronic, Quanta, and Dialco Inc. He received an investigator—initiated grant from Medtronic ERP program. He also serves as the President of the International Society for Hemodialysis. L.C.D. has no disclosures relevant to the current submission., (© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)

We present the new concept of photonic alloy as a nonperiodic topological material. By mixing nonmagnetized and magnetized rods in a nonperiodic 2D photonic crystal configuration, we realized photonic alloys in the microwave regime. Our experimental findings reveal that the photonic alloy sustains nonreciprocal chiral edge states even at very low concentration of magnetized rods. The nontrivial topology and the associated edge states of these nonperiodic systems can be characterized by the winding of the reflection phase. Our results indicate that the threshold concentrations for the investigated system within the first nontrivial band gap to exhibit topological behavior approach zero in the thermodynamic limit for substitutional alloys, while the threshold remains nonzero for interstitial alloys. At low concentration, the system exhibits an inhomogeneous structure characterized by isolated patches of nonpercolating magnetic domains that are spaced far apart within a topologically trivial photonic crystal. Surprisingly, the system manifests chiral edge states despite a local breakdown of time-reversal symmetry rather than a global one. Photonic alloys represent a new category of disordered topological materials, offering exciting opportunities for exploring topological materials with adjustable gaps.

Topological photonic insulators show promise for applications in compact integrated photonic circuits due to their ability to transport light robustly through sharp bendings. The number of topological edge states relies on the difference between the bulk Chern numbers across the boundary, as dictated by the bulk edge correspondence. The interference among multiple topological edge modes in topological photonics systems may allow for controllable functionalities that are particularly desirable for constructing reconfigurable photonic devices. In this work, we demonstrate magnetically controllable multimode interference based on gyromagnetic topological photonic insulators that support two unidirectional edge modes with different dispersions. We successfully achieve controllable power splitting in experiments by engineering multimode interference with the magnetic field intensity or the frequency of wave. Our work demonstrates that manipulating the interference among multiple chiral edge modes can facilitate the advancement of highly efficient and adaptable microwave devices., (© 2024. The Author(s).)

The incidence of isoniazid (INH) resistant Mycobacterium tuberculosis is increasing globally. This study aimed to identify the molecular mechanisms behind the development of INH resistance in M. tuberculosis strains collected from the same patients during the standard course of treatment. Three M. tuberculosis strains were collected from a patient before and during antituberculosis (anti-TB) therapy. The strains were characterized using phenotypic drug susceptibility tests, Mycobacterial Interspersed Repeated Unit-Variable-Number Tandem Repeats (MIRU-VNTR), and whole-genome sequencing (WGS) to identify mutations associated with INH resistance. To validate the role of the novel mutations in INH resistance, the mutated katG genes were electroporated into a KatG-deleted M. tuberculosis strain (GA03). Three-dimensional structures of mutated KatG were modeled to predict their impact on INH binding. The pre-treatment strain was susceptible to INH. However, two INH-resistant strains were isolated from the patient after anti-TB therapy. MIRU-VNTR and WGS revealed that the three strains were clonally identical. A missense mutation (P232L) and a nonsense mutation (Q461Stop) were identified in the katG of the two post-treatment strains, respectively. Transformation experiments showed that katG of the pre-treatment strain restored INH susceptibility in GA03, whereas the mutated katG genes from the post-treatment strains rendered negative catalase activity and INH resistance. The protein model indicated that P232L reduced INH-KatG binding affinity while Q461Stop truncated gene transcription. Our results showed that the two katG mutations, P232L and Q461Stop, accounted for the co-emergence of INH-resistant clones during anti-TB therapy. The inclusion of these mutations in the design of molecular assays could increase the diagnostic performance.IMPORTANCEThe evolution of drug-resistant strains of Mycobacterium tuberculosis within the lung lesions of a patient has a detrimental impact on treatment outcomes. This is particularly concerning for isoniazid (INH), which is the most potent first-line antimycobacterial drug. However, the precise genetic factors responsible for drug resistance in patients have not been fully elucidated, with approximately 15% of INH-resistant strains harboring unknown genetic factors. This raises concerns about the emergence of drug-resistant clones within patients, further contributing to the global epidemic of resistance. In this study, we revealed the presence of two novel katG mutations, which emerged independently due to the stress exerted by antituberculosis (anti-TB) treatment on a parental strain. Importantly, we experimentally demonstrated the functional significance of both mutations in conferring resistance to INH. Overall, this research sheds light on the genetic mechanisms underlying the evolution of INH resistance within patients and provides valuable insights for improving diagnostic performance by targeting specific mutations., Competing Interests: The authors declare no conflict of interest.

Purpose: Loneliness is a critical issue affecting the general population. Current evidence from national surveys of loneliness is scarce. The study aimed to examine the impact of COVID-19 pandemic on the prevalence of loneliness and its associating suicide risks in Taiwan., Methods: Four annual telephone interview surveys were performed by the Taiwan Suicide Prevention Center in 2015-2017 and 2020 during COVID outbreak. Each year the sample was randomly selected by stratifying the general public in different geographical areas and fulfilled a questionnaire collecting information including loneliness, psychological distress, and suicide risk assessment. All the data were analyzed using SPSS25 analysis., Results: A total of 8460 participants were recruited. The average prevalence of loneliness was 12.6 %. Feelings of loneliness was significantly correlated with psychological distress and most risk factors relating to suicide. The odds of loneliness for lifetime suicidal ideation, lifetime suicide attempt, and future suicide intent were 4.9, 5.1, and 9.2, respectively. During the COVID-19 period, loneliness and suicidality demonstrated a noteworthy decline trend, whereas "no one trustworthy to talk to" was the only item that showed significant increase under the pandemic and also impacted on loneliness., Conclusion: Nearly one in ten Taiwanese people felt lonely before and during COVID-19. Loneliness was closely linked with various suicide risk factors such as lifetime suicide ideation and attempt or future intention. Although psychological distress and suicide risk were not increased during COVID-19, maintaining trustful relationships to seek support appeared to be critical to prevent the risks of loneliness or suicide., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2023 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

A boundary mode localized on one side of a finite-size lattice can tunnel to the opposite side which results in unwanted couplings. Conventional wisdom tells that the tunneling probability decays exponentially with the size of the system which thus requires many lattice sites before eventually becoming negligibly small. Here we show that the tunneling probability for some boundary modes can apparently vanish at specific wavevectors. Thus, similar to bound states in the continuum, a boundary mode can be completely trapped within very few lattice sites where the bulk bandgap is not even well-defined. More intriguingly, the number of trapped states equals the number of lattice sites along the normal direction of the boundary. We provide two configurations and validate the existence of this peculiar finite barrier-bound state experimentally in a dielectric photonic crystal at microwave frequencies. Our work offers extreme flexibility in tuning the coupling between localized states and channels as well as a new mechanism that facilitates unprecedented manipulation of light., (© 2024. The Author(s).)

Non-Abelian phenomena arise when the sequence of operations on physical systems influences their behaviors. By possessing internal degrees of freedom such as polarization, light and sound can be subjected to various manipulations, including constituent materials, structured environments, and tailored source conditions. These manipulations enable the creation of a great variety of Hamiltonians, through which rich non-Abelian phenomena can be explored and observed. Recent developments have constituted a versatile testbed for exploring non-Abelian physics at the intersection of atomic, molecular, and optical physics; condensed matter physics; and mathematical physics. These fundamental endeavors could enable photonic and acoustic devices with multiplexing functionalities. Our review aims to provide a timely and comprehensive account of this emerging topic. Starting from the foundation of matrix-valued geometric phases, we address non-Abelian topological charges, non-Abelian gauge fields, non-Abelian braiding, non-Hermitian non-Abelian phenomena, and their realizations with photonics and acoustics and conclude with future prospects.