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Life is ever-changing and unpredictable. Because of drastic changes in our society, numerous people are under pressure from various sources at school, in the workplace, or in their families. People...

Objective This national cohort study investigated the incidence, site-specific mortality and prognostic factors of native septic arthritis (SA). Methods Tapping Taiwan’s National Health Insurance Research Database, we identified inpatients with newly diagnosed SA between 1998 and 2012. They were categorized by site of infection and followed to calculate 30-day, 90-day and 1-year mortality. Predictors of mortality were calculated using Cox models. Results A total of 31 491 patients were identified as having SA, the most common site of infection being the knee (50.1%), followed by the hip (14.4%), other sites (26.8%), the shoulder (5.5%) and multiple sites (1.2%). Knee joint involvement was the most common site for all subgroups. Incidence increased from 9.8/105 in 1998 to 13.3/105 in 2012. The 30-day, 90-day and 1-year mortality rates were 4.3, 8.6 and 16.4% respectively. Predictors for mortality were hip infection, shoulder infection, multiple-site infection, being male, age ≥65 years old and comorbidities. We derived a mortality scoring model over age/SA site/comorbidity, and age ≥65 years old had the greatest risk contribution to mortality. No matter whether 1-month, 3-month or 1-year mortality was being considered, patients with the higher risk scores had the higher mortality rates (P Conclusion SA is an emerging infectious disease with a rising incidence, long duration of hospital stay and high mortality rate. The most common affected joint was knee for all subgroups. Patients aged ≥65 years old had a high SA incidence and the greatest risk contribution.

Maslinic acid is a pentacyclic triterpenoid that is distributed in the peel of olives. Previous studies found that maslinic acid inhibited inflammatory response and antioxidant effects. We investigated whether maslinic acid ameliorates nonalcoholic fatty liver disease in mice with high-fat-diet (HFD)–induced obesity and evaluated the regulation of lipogenesis in hepatocytes. Male C57BL/6 mice fed a normal diet or HFD (60% fat, w/w) were tested for 16 wk. After the fourth week, mice were injected intraperitoneally with maslinic acid for 12 wk. In another experiment, HepG2 cells were treated with oleic acid to induce lipid accumulation or maslinic acid to evaluate lipogenesis. Maslinic acid significantly reduced body weight compared with HFD-fed mice. Maslinic acid reduced liver weight and liver lipid accumulation and improved hepatocyte steatosis. Furthermore, serum glucose, leptin, and free fatty acid concentrations significantly reduced, but the serum adiponectin concentration was higher, in the maslinic acid group than in the HFD group. In liver tissue, maslinic acid suppressed transcription factors involved in lipogenesis and increased adipose triglyceride lipase. In vitro, maslinic acid decreased lipogenesis by activating AMPK. These findings suggest that maslinic acid acts against hepatic steatosis by regulating enzyme activity involved in lipogenesis, lipolysis, and fatty acid oxidation in the liver.—Liou, C.-J., Dai, Y.-W., Wang, C.-L., Fang, L.-W., Huang, W.-C. Maslinic acid protects against obesity-induced nonalcoholic fatty liver disease in mice through regulation of the Sirt1/AMPK signaling pathway.

This book review symposium aims to open a space for discussions and questions responded to the book Education between Speech and Writing: Crossing the Boundaries of Dao and Deconstruction, which is...

As a highly developed religion, Buddhism has very rich ideas related to ethics and morality. Buddhism itself is a way of education. It guides the method and action of cultivating one’s moral character. These practices can be applied in thinking about education, especially specific to education’s ethical and moral implications. In the early 21st century, Buddhist theory has multiple applications in the field such as applied psychology, counseling, and meditation. Though it is an ancient wisdom, its viewpoint can be used to solve contemporary social problems and human crises caused by the process of modernization. Mahāyāna Buddhism believes that this world is constituted by emptiness, which is the perspective on essence-absent ontology. Everything is in its becoming, which is dependent on everything else, following the law of cause and effect. When an important aspect of one’s daily behavior is to cultivate goodwill, the desirable consequences will be returned to them later. That is, one good turn deserves another. On the contrary, bad will receives ill effects back. This is the basis of the Buddhist moral concept. In this way, human beings are active agents who can decide their own conduct and the result of their life. Buddhism encourages an individual to perform practices of precepts, meditation, and wisdom all the time to rid oneself of craving, hatred, and delusion. The latter are origins of human suffering. Humans cannot reach the ultimate spiritual realm of Nirvāṇa until these three poisons are given up. As an approach to self-education, Buddhist ethical thoughts allow learners to search for their self-nature. Buddhist moral claims of compassion and equality can contribute to the thinking of modern educational issues, such as peace education, ecological education, and equality in education.

Symbiosis is a biological phenomenon in which two dissimilar organisms coexist for mutual subsistence. The concept of symbiosis can be employed to foster mutual learning. In this paper, the idea of...

A 3-10 GHz single-voltage-supply pHEMT direct-conversion receiver with a wideband LC-ladder inductively source-degenerated common-source low-noise amplifier is demonstrated in this paper. A wideband LR-CR LO generator is applied to the Gilbert mixers. The measurement results shows $13 \sim 15$ dB conversion gain and 610 dB noise figure in the 3-10 GHz operating frequency range while the LO power is about 8 dBm and IF=300 MHz. The current consumption of the receiver is 70 mA at 3.3 V supply voltage.

This article explores the significance of sustainability and several ways in which education for sustainable development (ESD) can be considered. It presents several issues related to the theories of sustainability and ESD, which are generated based on a firm concept of anthropocentrism. ESD has been used for developing a scientific understanding of the world and is expected to effectively address the environmental damage facing humans. However, this is a narrow view of sustainability, through which learners do not gain an authentic understanding of nature. If the phenomenon of ecological interdependence is true, a non-anthropocentric stance of sustainability is the actual representation required for ESD teaching. Ecological wisdom in Buddhist philosophy indicates that natural sustainability corresponds to human living in harmony with the natural environment, an insight derived particularly from the Buddhist concept of the no-self. Instead of denying the existence of ‘I’, the no-self is the loss o...

This study examines the concepts of self-realisation and the ecological self in Arne Naess’s ecosophy, which considers the manner in which human inherent potentialities are realised in educational practices. This article first elucidates the meaning of the concepts of self-realisation and the ecological self according to Naess’s work. Second, the manner of developing the ecological self is discussed by drawing on Buddhist concepts, specifically the advice in the Diamond Sutra. Third, the means of achieving self-realisation is further considered from the view of the Chinese philosophy of Taoism. Both of these Eastern philosophies posit that a clear and peaceful mind can realise the inherent potentialities of the self. With the rapid development of science and technology, education has been unconsciously jeopardised by instrumentalism and consumerism. This has endangered the constitution of modern subjectivity, and engendered an alienated relationship with nature. This article concludes with some th...

Background The accuracy of heart rate (HR) measurement by automated blood pressure monitors in patients with atrial fibrillation (AF) remains unclear. The authors investigate the agreement between HR measurements by 2 automated devices and human counting in patients with AF. Methods In 47 patients with persistent AF, HR was recorded using 2 automated blood pressure monitors: Omron M5-I and Microlife BPA100 Plus. Human counting of HR by a stethoscope was used as the reference. For each method, 3 readings were made and the mean was calculated for comparison. In addition to Wilcoxon signed rank test, the correlation between HR measurements by automated devices and human counting was determined using Spearman's rank correlation coefficient (r), and the agreement between HR measurements by both devices and human counting was validated by the Bland-Altman plot and intraclass correlation coefficient (ICC). Results Overall, we found no significant difference in HR measurements between devices and human counting (Omron vs human counting, 81.1 ± 11.1 vs 80.2 ± 10.8 beats per minute [bpm]; P = .21, r = 0.911; ICC, 0.954; Microlife vs human counting, 81.3 ± 10.8 vs 80.2 ± 10.8 bpm; P = .22, r = 0.842; ICC, 0.912). However, in patients with HR greater than 80 bpm, the HR measured by the Microlife device was significantly higher than that measured by human counting (91.1 ± 5.2 vs 87.1 ± 8.6 bpm, P = .034). Conclusion There was a high agreement between HR measurements by 2 automated devices and human counting, but the Microlife device may overestimate HR in AF patients with HR greater than 80 bpm.

The deficiency of endothelial progenitor cells has been demonstrated to be associated with cardiovascular events in patients undergoing dialysis. However, their correlation with dialysis graft outcomes remains unknown. The objective of this study was to investigate the relationship between circulating endothelial progenitor cells and dialysis graft outcomes.After excluding 14 patients with acute coronary syndrome, decompensated heart failure or graft thrombosis in the prior three months, a total of 120 patients undergoing dialysis who underwent endovascular therapy of dysfunctional dialysis grafts were prospectively enrolled. Blood was sampled from study subjects in the morning of a mid-week non-dialysis day. Surface makers of CD34, KDR, and CD133 were used in combination to determine the number of circulating endothelial progenitor cells. All participants were prospectively followed until June 2013.The median follow-up duration was 13 months, within which 62 patients experienced at least one episode of graft thrombosis. Patients with graft thrombosis had lower CD34Our study demonstrated an independent association between low circulating endothelial progenitor cell counts and dialysis graft thrombosis.

This study was conducted to address the concept of higher education curricula and its practice from an ecological perspective. First, the significance of ecology is investigated based on two streams of thought; the ecological concept of the university proposed by Ronald Barnett; and the text, The Three Ecologies authored by the Italian philosopher Felix Guattari. Second, the notion of ecology is explored, and thoughts on the ecological curriculum and its feasibility are elaborated. Third, outcome-based education is currently the predominant curriculum practice applied in higher education. From an ecological perspective, this learning approach is insufficient. Finally, the practices used for achieving an ecological connection of curricula in higher education are discussed with particular regard to curriculum organisation, the learning process and students’ role as global citizens.

Curriculum mapping has been emphasized in recent curriculum innovations in higher education in the drive for global competitiveness. This paper begins by providing an outline of current discourses of curriculum mapping in higher education. Curriculum mapping is frequently associated with outcome-based learning and work readiness, and guiding the learner/traveler towards a “prosperous” future. Critiquing this perspective, this article explores other implications of maps (or mapping) in curriculums from a philosophical viewpoint, mainly derived from Gilles Deleuze and Felix Guattari's account of mapping. The paper is intended to overturn the current “sedentary” thinking about curriculum mapping, and to encourage alternative perspectives on curriculum practices. The paper concludes with the view that, in Deleuze and Guattari's terms, current practices of curriculum mapping trace rather than map the ideas, and the paper highlights the value in seeing curriculum mapping rhizomatically.

BACKGROUND:Little is known about the components and contributing factors of door-to-balloon time after implementation of Door-to-Balloon Alliance quality-improving (QI) strategies, including the impact of door-to-ECG time on door-to-balloon time. OBJECTIVE:We investigated whether modification of emergency department (ED) triage processes could improve door-to-ECG and door-to-balloon times after implementation of QI strategies. METHODS:This was a retrospective before-and-after study of a prospectively collected database. From June 2014 to October 2014, interventions were implemented in our ED, including a protocol-driven ECG initiation and moving an ECG station and technician to the triage area. The primary outcome was the percentage of patients with ST-elevation myocardial infarction (STEMI) who received ECG within 10 min of arrival; the secondary outcome was the percentage of patients with door-to-balloon times of

A 2.4-GHz low-noise sub-harmonic direct-conversion receiver (SH-DCR) is demonstrated using standard 0.18-μm CMOS technology. Deep-n-well vertical-NPN (V-NPN) bipolar junction transistors (BJTs) are employed to solve the flicker noise problem in CMOS process. Design optimization of a power-constrained noise-impedance-matched low-noise amplifier (LNA) with the effect of lossy on-chip inductors is fully discussed in this paper. A multi-stage octet-phase polyphase filter is analyzed in detail and implemented to generate well balanced octet-phase LO signals. As a result, the demonstrated receiver achieves 51-dB voltage gain and 3-dB noise figure with flicker noise corner less than 30 kHz when RF = 2.4 GHz. The I/Q amplitude/phase mismatch is below ±0.2 dB/±1°, respectively, covering from 2.35 to 2.6 GHz. The dc current consumption is 5 mA at a 1.8-V supply.

Numerous studies have attempted to examine industry performance from an agglomeration perspective. However, many are still focused on the manufacturing sector. This study examines the travel and tourism service industry's economic position using an agglomeration perspective and whether this relates to its economic performance. This study discovered that, apart from being related to its intra-region position relative to other industries within the region, the economic performance of an industry in a region is also related to its intra-industry position relative to other distributive regions within the industry and to its national geographical concentration. A more significant finding is that regardless of either the intra-industry or intra-region position of the industry in a region, enhancing agglomeration not only increases competition and profit erosion but also improves labour productivity. For employment creation, it is more effective to develop an industry with more uniform national geographical dist...

Due to the benefits of Schottky diodes, 0.18-μm CMOS technology is being promoted for millimeter wave applications. In this paper, 60-GHz dual-conversion down-/up-converters using Schottky diodes are realized by using 0.18-μm foundry CMOS technology. A CoSi2-Si Schottky diode, fabricated on a lower doped N-well by blocking the threshold voltage adjustment implant, has a lower reverse leakage current and a better ideality factor. Thus, it is ideal for the 60-GHz sub-harmonic mixer design. Two new types of Schottky-diode mixers, a down-conversion sub-harmonic mixer with a dual-band lump-distributed phase-inverter rat-race coupler and an up-conversion sub-harmonic mixer with a trifilar transformer, are realized and employed at the high-frequency conversion stage of the dual-conversion architecture to achieve small size and broadband isolations. The silicon-based Schottky diode with a low turn-on voltage offers great advantage in LO pumping power, especially for an antiparallel diode pair structure. In our Schottky-diode sub-harmonic mixers, the required LO power is only 1 dBm. The dual-conversion down-converter achieves 5-dB conversion gain and 19 dB noise figure under Vdd=2.5 V and Idd=22 mA, and the dual-conversion up-converter, with Vdd=2.5 V and Idd=26 mA, attains greater than 40-dB sideband rejection and -1 dB conversion gain over the whole 60-GHz bandwidth.

A 2.4-GHz low-power low-noise direct-conversion receiver is demonstrated using parasitic vertical-NPN bipolar junction transistors (BJTs) in a standard 0.18-μm CMOS process. The current switching operation of a Gilbert mixer with finite transistor cutoff frequency (fT) is thoroughly analyzed and discussed in this paper. When the mixer operates near or higher than the transistor f T, the loss of the polyphase filter due to the capacitive loading of the mixer is a main issue. Thus, BJT devices with smaller base resistance and an inductive peaking technique with symmetric 3-D realization are employed in this paper to reduce local oscillator power by 4.5 dB. At 2.4 GHz, the demonstrated receiver has conversion gain of 51 dB and noise figure of 3.2 dB with 70-kHz 1/f noise corner, while the current consumption is 4.5 mA at a 1.8-V supply.

This paper explores the significance of the concept of power/knowledge in educational theory. The argument proceeds in two main parts. In the first, I consider aspects of Stephen J. Ball's highly influential work in educational theory. I examine his reception of Foucault's concept of power/knowledge and suggest that there are problems in his adoption of Foucault's thought. These problems arise from the way that he settles interpretations into received ideas. Foucault's thought, I try to show, is not to be seen in a confined way. In the second part, I seek a different reading of Foucault's notion of power/knowledge in order to break with this tendency to confine, referring to the work of Gilles Deleuze. I draw particularly on Deleuze's thought of the outside as a means of manifesting the significance of power/knowledge in relation to processes of subjectification. At the end of the paper, I suggest how educational theory might be reconceived in the light of potencies of power/knowledge that the paper has demonstrated.

Lactone monomers with different chain lengths are copolymerized with poly(ethylene glycol) or methoxypoly(ethylene glycol) to form triblock and diblock pegylated polyester copolymers. The pegylated polyester copolymers have an amphiphilic character because they are comprised of both hydrophobic and hydrophilic domains, which spontaneously assemble in aqueous media to form nano-sized micelles at concentrations above the critical micelle concentration. The type of lactone monomer, the chain lengths of the hydrophobic as well as the hydrophilic blocks, the molecular weight of poly(ethylene glycol), and the formation of triblock or diblock polymeric micelles all play important roles in micelle performance. The triblock and diblock pegylated poly(d-valerolactone) copolymers show higher in vitro cytotoxicity than the others. Triblock PCL-PEG 10,000 -PCL micelles possess high drug loading, low in vitro cytotoxicity, proper in vitro sustained release performance and prolonged mean residence time of drug in blood circulation. Diblock PCLMPEG micelles have lower critical micelle concentration, higher biocompatibility, and higher drug loading than PVL-MPEG micelles. The enzyme-catalyzed chain cleavage of labile ester linkages of pegylated polyester copolymer occurs in rat plasma, and the changes in mass, molecular weight and morphology of the copolymers are associated with changes in its composition.

Cyphomandra betacea Sendt. (tamarillo) is a subtropical fruit containing rich contents of anthocyanins and carotenoids. The antioxidant activity was investigated using a crude ethanol extract of C. betacea fruit and its partitioned fractions, i.e. the ethyl acetate, butanol and water fractions. The ethyl acetate fraction exhibited the highest DPPH scavenging activity, Trolox equivalent antioxidant capacity (TEAC) and total phenol content. C. betacea phenolics in ethyl acetate fraction inhibited copper-induced LDL oxidation equally to or more effectively than dl -α-tocopherol, as measured by decreased formation of thiobarbituric acid-reactive substances (TBARS), conjugated diene and relative electrophoretic mobility (REM). Furthermore, 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl tetrazolium (MTT) reduction assay showed that C. betacea phenolics in ethyl acetate fraction prevent oxidative stress-induced cell death in neuronal PC12 cells in a dose-dependent manner via attenuation of ROS production. In conclusion, C. betacea phenolics are potent antioxidants which can inhibit LDL oxidation in vitro and ROS production in PC12 cells.

Ginkgolide C, isolated from Ginkgo biloba leaves, is a flavone reported to have multiple biological functions, from decreased platelet aggregation to ameliorating Alzheimer disease. The study aim was to evaluate the antiadipogenic effect of ginkgolide C in 3T3-L1 adipocytes. Ginkgolide C was used to treat differentiated 3T3-L1 cells. Cell supernatant was collected to assay glycerol release, and cells were lysed to measure protein and gene expression related to adipogenesis and lipolysis by western blot and real-time PCR, respectively. Ginkgolide C significantly suppressed lipid accumulation in differentiated adipocytes. It also decreased adipogenesis-related transcription factor expression, including peroxisome proliferator-activated receptor and CCAAT/enhancer-binding protein. Furthermore, ginkgolide C enhanced adipose triglyceride lipase and hormone-sensitive lipase production for lipolysis and increased phosphorylation of AMP-activated protein kinase (AMPK), resulting in decreased activity of acetyl-CoA carboxylase for fatty acid synthesis. In coculture with an AMPK inhibitor (compound C), ginkgolide C also improved activation of sirtuin 1 and phosphorylation of AMPK in differentiated 3T3-L1 cells. The results suggest that ginkgolide C is an effective flavone for increasing lipolysis and inhibiting adipogenesis in adipocytes through the activated AMPK pathway.

This paper uses panel data of Taiwanese electronics firms to investigate the Granger causality relationship between R&D and productivity growth, while taking into account the effect of R&D spatial spillovers. Unlike previous studies, the R&D spatial spillover effect is calculated by a geographic formula of longitude and latitude. Before determining the direction of causality between the TFP growth and R&D effort, we execute the panel unit root test to examine the stationarity of the data. Results indicate that all variables in the model are stationary, and that R&D stock and R&D spatial spillovers Granger cause productivity growth.

Three types of pegylated amphiphilic copolymers of poly(δ-valerolactone) (PVL) were copolymerized with methoxy poly(ethylene glycol) (MePEG) and poly(ethylene glycol) (PEG4000 and PEG10,000), respectively. Pegylation of PVL allowed copolymers possessing amphiphilic property and efficiently self-assembled to form micelles with a low critical micelle concentration (CMC) in the range of 10−7–10−8M. The average molecular weight of copolymers was in the range of 10,000–20,000 Da, and the polydispersity of copolymers was about 1.7–1.8. Higher mobility of low molecular weight PEG (i.e., MePEG and PEG4000) than high molecular weight PEG10,000 allowed valerolactone ring opening more efficient in terms of PVL/MePEG and PVL/PEG4000 copolymers possessing longer chain length in hydrophobic domain. Pegylated PVL with low CMC and triblock structure was preferred to encapsulate drug during micelle formation. Although all of these amphiphilic copolymers exhibited controlled release character, the micelles formed by triblock copolymer possessed a more stable core-shell conformation than that by diblock copolymer, and resulted in the release of drug from triblock micelles slower than that from diblock micelles. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 100: 1836–1841, 2006

The aim of this study was to evaluate the ability of forming micelles from two types of synthesized diblock pegylated amphiphilic copolymers and their potential as a drug carrier. Two lactone monomers, epsilon-caprolactone (CL) and delta-valerolactone (VL), were copolymerized with methoxy poly(ethylene glycol) (MePEG), respectively. The properties of copolymers were investigated and their biocompatibility was tested through an in vitro cytotoxicity study. The influences of the type of lactone monomer (CL and VL) and the feed molar ratios of lactone/MePEG (50/1, 80/1, 160/1) on the performance and release behavior of drug-loaded micelles were investigated. The opening of CL and VL rings by MePEG was efficient, and the pegylation of poly(lactone)s allowed copolymers possessing amphiphilic property and efficiently self-assembled to form micelles with a low critical micelle concentration (CMC) in the range of 10(-7)-10(-8) M. The nano-sized micelles were able to incorporate hydrophobic drug and regulate drug release, and the release of drug was dominated by the hydrophobic poly(lactone) chain length. Although both amphiphilic copolymers exhibited similar controlled release character, the PCL/MePEG micelles possessed lower CMC, higher biocompatibility, and higher drug loading than PVL/MePEG micelles. These suggested that results choosing pegylated PCL as a drug carrier could be better than PVL/MePEG.

A low-power sub-harmonic direct-down receiver is demonstrated using 0.18 μm CMOS technology. The dynamic range of the receiver is increased by incorporating voltage gain controls with wide tuning range at RF and IF stages. For the flicker noise problem, vertical-NPN bipolar junction transistors (BJTs) in standard CMOS process are employed as the mixer switching core and at the input stage of the subsequent IF VGA. As a result, this work achieves a 45 dB gain from 5–6 GHz with 6 dB noise floor. The total current consumption is 5.5 mA at 1.8 V supply voltage.

Current guidelines recommend getting a 12-lead electrocardiogram (ECG) within 10 minutes after the arrival of Emergency Department for patients with ST elevation myocardial infarction (STEMI). Previous quality–improving activities in our hospital revealed that failing to target door-to-ECG time

This paper demonstrates a 5.8 GHz low-power, low-flicker-noise direct-conversion receiver using deep-n-well vertical-NPN BJT based subharmonic Gilbert mixer. The deep-n-well vertical-NPN BJT is placed in the LO switching core of the bottom-level subharmonic mixer and the input transconductance stage of the subsequent IF VGA. As a result, the flicker noise corner is improved and the noise figure is 9.5 dB at IF=100 kHz. The maximum gain reaches 50 dB in the operated frequency. The total power consumption is 10 mW at 1.8 V supply voltage.

We present a method whereby the excited triplet state of diphenylmethylene can be populated in a spin‐polarized manner. The method features sensitization by benzophenone triplet excitons. We ascertain the spin‐polarized nature of the excited triplet by observing magnetic field effects on the fluorescence. The observed effects provide information concerning the spin dipolar and intersystem crossing nature of excited diphenylmethylene.

We present a method whereby the excited triplet state of diphenylmethylene can be populated in a spin‐polarized manner. The method features sensitization by benzophenone triplet excitons. We ascertain the spin‐polarized nature of the excited triplet by observing magnetic field effects on the fluorescence. The observed effects provide information concerning the spin dipolar and intersystem crossing nature of excited diphenylmethylene.