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The coupling between chemical weathering (including silicate, carbonate and pyrite weathering) and physical erosion is of high interest in active mountain belts. Participation of pyrite weathering which, results in CO2 emission to the atmosphere, also is of great research attention. Nevertheless, the responses of the (de-)couplings to landslide and typhoon are unclear. We used records of riverine TDS (total dissolved solids) and TSS (total suspended solids) with high-frequency sampling during typhoons to estimate chemical denudation rates of silicate (CDRsil), carbonate (CDRcarb), pyrite (CDRpyrite) and physical denudation rates (PDR) in two adjacent catchments, eastern Taiwan. Results show that the CDRsil in the two catchments is approx. 10-fold higher than the global mean, whereas the CDRcarb, CDRpyrite and PDR are over 15-fold higher than the global averages. Landslides likely elevate carbonate and sulfate dissolution, and streamflow is a kinetic control on the CDRs. Among CDRs, CDRsil remains constant with various landslides and typhoons. Yet, CDRcarb and CDRpyrite rapidly respond to typhoons and then contribute more CO2 emission. In sum, landslides expose fresh minerals to enhance chemical weathering; typhoons, which transport the dissolved solids within a short time and prompt new rainwater for weathering, are also dominant agents. We demonstrate the importance of dynamic partitioning of sulfuric and carbonic acid on silicate weathering for quantitative estimation of weathering-associated CO2 budget in active mountain belts.

This study examines the effects of economic policy uncertainty (EPU) and tourism in Brazil, Russia, India and China (BRIC). It used a three-dimensional wavelet technique based on Granger causality ...

The impacts of renewable energy adoption and environmental sustainability ratings on the validity of the environmental Kuznets curve and the pollution haven hypothesis are examined using annual balanced panel data from 64 middle and low-income countries and spanning the 2005–2014 period. We show that the GDP per capita/CO2 emissions per capita relationship is an inverse S curve for the full sample of low and middle-income countries and for each subsample. The renewable energy/CO2 emissions per capita relationship is an inverse N curve for the full and the middle-income samples, but a V curve for the low-income sample. The foreign direct investment net inflows/CO2 emissions per capita relationship is an N curve for the full and the middle-income samples, and a positive relationship in the low-income subsample. High levels of government environmental sustainability ratings in low-income countries with relatively higher incomes can attract foreign direct investment net inflows while reducing pollution. In contrast, middle-income countries with high environmental sustainability ratings can attract foreign direct investment net inflows only if they allow small increases in pollution.

This paper examines whether the 1997 Asian financial crisis affected the renewable energy/carbon dioxide (CO2) emissions relationship differently when compared to the 2008 global financial crises. Using the Dynamic Panel Data Model, we examine separately the impact of the 1997 crisis and the 2008 crises on the stated relationship for annual data between the 1987–2018 period for a group of high, upper-middle, and lower middle-income countries. Our findings suggest that the results were crisis and country specific. For the overall sample, the relationship between the two variables was positive (and significant post-1997 and pre-2008 crises) but negative post-2008 crisis. In contrast, the positive relationship remained unchanged for the lower middle-income subsample through the two crises. We also find evidence that the 1997 Asian crisis altered the relationship differently than the 2008 financial crisis especially for the upper and middle-income groups. Clearly, reduction of CO2 emissions may not be guaranteed even if host countries adopt renewable energy sources since country income levels and the nature of the crisis may matter. Future research may consider how the degree of pollution controls and differential costs of renewable energy adoption in countries may alter this relationship.

Vitiligo is a common, psychologically devastating pigmentary disorder. Surgical graftings are used to treat stable vitiligo when medical treatment fails. An automated epidermal micrograft harvesting (AEMH) system was first designated to treat wounds, and very few studies investigated the application of AEMH in vitiligo. In this study, we investigated the efficacy and safety of the AEMH system in patients with stable segmental and nonsegmental vitiligo. The rate of repigmentation and adverse events was recorded bimonthly for at least 12 months. We analyzed the efficacy based on patient characteristics, vitiligo subtypes, and different anatomical locations. A total of 56 depigmented lesions from 34 patients were included. 95.50% of the automated epidermal micrografts were successfully grafted at the recipient sites. There was a significant improvement in Vitiligo Area Scoring Index (VASI) and Dermatologic Life Quality Index (DLQI) in patients treated with AEMH (p < 0.001). The rate of repigmentation by VASI score improves from 96.25 ± 8.59 to 48.30 ± 28.16 after the treatment (p < 0.001). Treatment outcomes were comparable between the patients of segmental and stable nonsegmental vitiligo. The face and neck region achieved a better outcome, followed by the trunk (chest, abdomen, back, and axilla), limbs, and the worse outcome was found in the acral region (p < 0.014). Conclusively, AEMH is an effective treatment procedure with limited adverse events in patients with stable vitiligo. This harvesting method may be a feasible option for vitiligo surgical treatment.

A man in his 60s presented with painful erythematous plaques and vesicles on the right side of his nose and palate that had appeared three days earlier. Before he noticed the skin lesions, he had a stinging and itchy sensation for two days on the external aspect of his nose. Cutaneous examination showed scattered erythematous plaques and crusted blisters on the right side of his nose, midface (fig 1a), upper eyelid, and forehead (fig 1b), extending to the anterior scalp. Intraoral inspection showed multiple ulcerations overlying whitish slough on the right side of the hard palate, gingiva, and oral mucosa (fig 1c). Fig 1 Cutaneous and mucosal lesions Nasopharyngoscopy to evaluate the intranasal lesions showed a pre-existing perforation of the nasal septum. Lesions were present …

Background Patients with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) have high mortality rates. Disseminated intravascular coagulation has been reported in SJS/TEN patients. The influence of this lethal complication in patients with SJS/TEN is not well known. Objective This study aimed to investigate the risk and outcomes of disseminated intravascular coagulation in patients with SJS/TEN. Methods We analyzed the disseminated intravascular coagulation profiles of patients receiving a diagnosis of SJS/TEN between 2010 and 2019. Results We analyzed 150 patients with SJS/TEN (75 with SJS, 22 with overlapping SJS/TEN, and 53 with TEN) and their complete disseminated intravascular coagulation profiles. Disseminated intravascular coagulation was diagnosed in 32 patients (21.3%), primarily those with TEN. It was significantly associated with systemic complications, including gastrointestinal bleeding, respiratory failure, renal failure, liver failure, infection, and bacteremia. Additionally, SJS/TEN patients with disseminated intravascular coagulation had elevated procalcitonin levels. Among patients with SJS/TEN, disseminated intravascular coagulation was associated with a greater than 10-fold increase in mortality (78.1% vs 7%). Limitations The study limitations include small sample size and a single hospital system. Conclusion Disseminated intravascular coagulation is a potential complication of SJS/TEN and associated with higher mortality. Early recognition and appropriate management of this critical complication are important for patients with SJS/TEN.

Background Cutaneous lupus erythematosus (CLE) includes a broad range of dermatologic manifestations. Periorbital involvement, however, is a relatively rare clinical presentation of CLE. Objectives This clinical study aimed to investigate the characteristics of this unique presentation of CLE in tertiary medical centers. Methods We enrolled patients with periorbital erythema and swelling as the presenting sign of lupus erythematosus, from January 2003 to November 2017, using the data of 553 pathologically proven CLE cases from the registration database of the Chang Gung Memorial Hospitals in Taiwan. Results We enrolled a total of 25 patients. The mean age was 46.7 years and 68% of the patients were female. Most of the patients (84.0%) presented with unilateral involvement, with the left orbit involved in 15 patients (60%); the upper eyelid was the most frequently involved (72%). Mean duration between the onset of clinical manifestations and the diagnosis of CLE was approximately 59 weeks. Nineteen patients had been previously misdiagnosed. All patients had features compatible with CLE on histopathological examination. In contrast, laboratory analysis of the autoimmune profile often revealed negative results, including those for antinuclear antibodies (25%). Notably, anti-SSA/SSB (45.5%) showed the highest positive rate. During follow-up, six patients developed systemic lupus erythematosus (SLE) and two patients developed Sjögren syndrome. Conclusions The diagnosis of CLE presenting as periorbital erythema and swelling is often delayed because of clinical mimicry and the high proportion of negative results on autoantibody tests. Increased clinical suspicion and prompt histopathological examination are crucial for early diagnosis. Moreover, one-fourth of the patients ultimately developed SLE, which highlights the importance of clinical awareness.

Immune checkpoint receptors with co-stimulatory and co-inhibitory signals are important modulators for the immune system. However, unrestricted co-stimulation and/or inadequate co-inhibition may cause breakdown of self-tolerance, leading to autoimmunity. Systemic lupus erythematosus (SLE) is a complex multi-organ disease with skewed and dysregulated immune responses interacting with genetics and the environment. The close connections between co-signaling pathways and SLE have gradually been established in past research. Also, the recent success of immune checkpoint blockade in cancer therapy illustrates the importance of the co-inhibitory receptors in cancer immunotherapy. Moreover, immune checkpoint blockade could result in substantial immune-related adverse events that mimic autoimmune diseases, including lupus. Together, immune checkpoint regulators represent viable immunotherapeutic targets for the treatment of both autoimmunity and cancer. Therefore, it appears reasonable to treat SLE by restoring the out-of-order co-signaling axis or by manipulating collateral pathways to control the pathogenic immune responses. Here, we review the current state of knowledge regarding the relationships between SLE and the co-signaling pathways of T cells, B cells, dendritic cells, and neutrophils, and highlight their potential clinical implications. Current clinical trials targeting the specific co-signaling axes involved in SLE help to advance such knowledge, but further in-depth exploration is still warranted.

Corynespora cassiicola is a common plant pathogen, but C. cassiicola infection in human hosts is extremely rare. In this report, we present an 84-year-old male with long-term use of inhaled corticosteroids who developed a subcutaneous infection caused by C. cassiicola. The organism was isolated from both wound culture and biopsy specimen from the skin lesion. However, no microscopic diagnostic characters could be obtained because the isolates failed to sporulate on different culture media. Molecular diagnosis by amplification and sequencing of the internal transcribed spacer regions of ribosomal DNA was performed, and the sequences of the isolates were identical to those of C. cassiicola. The patient was treated successfully with oral terbinafine therapy for 12 weeks. In this report, we also review the epidemiology, clinical and therapeutic facets of cutaneous C. cassiicola infection.

This paper investigates the link between inward foreign direct investment flows and host country corruption levels using annual data for developed, developing and transitional countries, over the 2002-2015 period. We find that the nonlinear specification provides a better characterisation of the relationship between corruption and inward FDI flows. Furthermore, we find that this relationship is a function of the development status of the host country. Finally, the marginal impact of corruption levels on FDI seems to be statistically significant at a higher level when a nonlinear (as opposed to a linear) specification is used.

A 47-year-old man presented with multiple tender, erythematous-to-violaceous macules and pustules on his palms and lower legs (Fig [1][1]). Spike fever, malaise and arthralgia in wrists and right ankle were noted for 3 days. There was no history of urogenital symptoms. Laboratory surveillance showed

Aim: Acute appendicitis is the most common disease in pregnant women. Based on the premise of the protection of fetus, diagnosis sometimes would be difficult. The purpose of this study is to evaluate the risk and benefit of magnetic resonance imaging for suspected acute appendicitis in Pregnancy. Method: From Oct 2015 to Apr 2017, 10 pregnant women came to our emergency department because of suspected acute appendicitis. We bring MRI to participate the diagnosis in case ultrasound is insufficient to make accurate detection. Result: 5 cases with nonvisualization of appendicitis and 5 cases were confirmed acute appendicitis. Ultrasound of these women couldn't clearly show the abnormal anatomy. But with non-radiation MRI acute appendicitis with presence of appendicoliths were identified. Conclusion: The use of MRI in pregnant women with suspected acute appendicitis is meaningful, not only in confirmation or exclusion of appendicitis but also alternative non-radiation diagnosis tool for further treatment.

To date, there is ample evidence on the determinants of domestic charitable contributions made by US firms. However, to the best of our knowledge, no one has investigated the determinants of foreign charitable contributions made by US firms. Using the Socrates KLD database and the US M&A data for the 2004–2010 period, we find evidence that foreign giving by US manufacturing firms is linked to certain key variables. Specifically, we find evidence that variables found significant in the domestic giving literature (pre entry return on assets, size, debt to asset ratio, market to book ratio, and research and development expense as a function of sales) are also found significant for foreign giving. However, and notably, cultural distance and foreign sales percentage have been found to be important discriminators between manufacturing firms who give abroad and those who do not. It appears that high international business experience (proxied by the foreign sales ratio) and operations in culturally distant countries motivate foreign giving. Finally, subsample analysis involving developed and developing countries suggests that cultural distance matters for developing countries, but does not for the developed country subsample. Firm level profitability matters for developed countries, but not for developing countries. Future research may be expanded to include the dollar amounts of giving and a bigger sample size. Differences in foreign giving patterns between manufacturing and non-manufacturing firms, and by firms in countries other than the US, may also be explored.

Threshold vector error correction model is used to study the nonlinear relationships between market volatility expectations and ordering behavior. Futures price, market volatility expectations, and derivatives ordering behavior data are used in the study. The intraday data of the VIX index, stock index futures price, and stock index options ordering volume from the Taiwan Futures Exchange are used for the study. Research results show the existence of asymmetric impacts of lagged VIX index on futures price, lagged VIX index on put options buy order to sell order volume ratio, lagged futures price on VIX index, lagged call options buy order to sell order volume ratio on VIX index, and lagged put options buy order to sell order volume ratio on VIX index when using VIX index as threshold.

A fully-compliant high-definition video decoder LSI for Blu-ray Disc (BD) player is presented. It supports MPEC-2 MP@HL, H.264 HP@L4.1, and VC-1 AP@L3 video decoding in a single chip and features resource sharing and memory management unit to achieve area/throughput efficiency. A test chip is fabricated and integrates 515 K logic gates with 522 Kbits of embedded SRAM in 90nm single-poly seven-metal CMOS process with area of 5.06 mm2. For Blu-ray player requirements, video decoding of full 1920times1080 high-definition sequences at 60 frames per second requires 125 Mpixels/sec of processing throughput which is two times higher than comparable designs [5][6] and is achieved at 200 MHz clock frequency with power dissipation of 317 mW at 1.0 V supply voltage.