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N-Sulfonyl-activated aziridines are known to undergo anionic-ring-opening polymerizations (AROP) to form polysulfonyllaziridines. However, the post-polymerization deprotection of the sulfonyl groups from polysulfonyllaziridines remains challenging. In this report, the polymerization of tert-butyl aziridine-1-carboxylate (BocAz) is reported. BocAz has an electron-withdrawing tert-butyloxycarbonyl (BOC) group on the aziridine nitrogen. The BOC group activates the aziridine for AROP and allows the synthesis of low-molecular-weight poly(BocAz) chains. A 13C NMR spectroscopic analysis of poly(BocAz) suggested that the polymer is linear. The attainable molecular weight of poly(BocAz) is limited by the poor solubility of poly(BocAz) in AROP-compatible solvents. The deprotection of poly(BocAz) using trifluoroacetic acid (TFA) cleanly produces linear polyethyleneimine. Overall, these results suggest that carbonyl groups, such as BOC, can play a larger role in the in the activation of aziridines in anionic polymerization and in the synthesis of polyimines.

Purpose Uncertainties exist in how respondents interpret response options in patient-reported outcome measures (PROMs), particularly across different domains and for different scale labels. The current study assessed how respondents quantitatively interpret common response options. Methods Members of the general public were recruited to this study via an online panel, stratified by age, gender, and having English as a first language. Participants completed background questions and were randomised to answer questions on one of three domains (i.e. loneliness (negatively phrased), happiness or activities (positively phrased)). Participants were asked to provide quantitative interpretations of response options (e.g. how many times per week is equal to “often”) and to order several common response options (e.g. occasionally, sometimes) on a 0–100 slider scale. Chi-squared tests and regression analyses were used to assess whether response options were interpreted consistently across domains and respondent characteristics. Results Data from 1377 participants were analysed. There was general consistency in quantifying the number of times over the last 7 days to which each response option referred. Response options were consistently assigned a lower value in the loneliness than happiness and activities domains. Individual differences, such as age and English as a second language, explained some significant variation in responses, but less than domain. Conclusion Members of the public quantify common response options in a similar way, but their quantification is not equivalent across domains or every type of respondent. Recommendations for the use of certain scale labels over others in PROM development are provided.

Background: The issue of suboptimal influenza vaccination coverage among pregnant women remains relevant. Our study aimed to explore the determinants and coverage of influenza vaccination ...

Prodigiosin is an intensely red pigment comprising three pyrroles. The biosynthetic pathway includes a two-step proline oxidation catalyzed by phosphatidylinositol N-acetylglucosaminyltransferase subunit A (PigA), with flavin adenine dinucleotide (FAD) as its cofactor. The enzyme is crystallized in the apo form and in complex with FAD and proline. As an acyl coenzyme A dehydrogenase (ACAD) family member, the protein folds into a β-sheet flanked by two α-helical domains. PigA forms a tetramer, which is consistent with analytical ultracentrifugation results. FAD binds to PigA in a similar way to that in the other enzymes of the ACAD family. The variable conformations of loop β4-β5 and helix αG correlate well with the structural flexibility required for substrate entrance to the Re side of FAD. Modeling with PigG, the acyl carrier protein, suggests a reasonable mode of interaction with PigA. The structure helps to explain the proline oxidation mechanism, in which Glu244 plays a central role by abstracting the substrate protons. It also reveals a plausible pocket for oxygen binding to the Si side of FAD.

Objective To investigate the cost-effectiveness of the first patient self-paying pharmacist-assisted warfarin monitoring (PAWM) program in Taiwan. Design A Markov model with a 1-month cycle length and a 20-year time horizon was employed in this study. The model is composed of the following eight states: three no-event states (i.e. 'subtherapeutic,' 'within therapeutic' and 'supratherapeutic' states), two serious adverse events (AEs) (i.e. bleeding and thromboembolism), two sequelae states and death. The likelihood of events, costs and utilities were derived from local databases and literature, if applicable. This study was conducted with a payer's perspective and all costs were discounted with a rate of 3%. Setting A pharmacist-led clinic. Participants A hypothetical cohort of 10 000 participants. Intervention(s) PAWM versus usual care. Main outcome measure(s) Average quality-adjusted life-years (QALYs) gained and cost increments per patient, and incremental cost-effectiveness ratios (ICERs). Results The PAWM program resulted in an average of 0.13 QALYs gained and a cost increment of NT$53 850 (US$1683) per patient. As the ICER (NT$410 749 [US$12 836]) was less than the gross domestic product per capita (NT$631 142 [US$19 723]), the PAWM was considered to be very cost-effective. The sensitivity analyses suggested that our result was robust and that the PAWM program had an 86% probability of being very cost-effective. Conclusions Even if the costs saved from avoiding AEs were thought to be minimal due to the low-medical expenditures in Taiwan, the PAWM program was demonstrated to be economical. According to our findings, the policymakers should consider reimbursing such a service.

We have previously reported that testosterone (Tes) is able to interact with magnesium chloride dissolved in methanol. In this study, we have applied 1H and 13C NMR spectroscopies to a series of Tes solutions containing Mg2+ at various concentrations. High-resolution 13C NMR spectra of Tes/Mg2+ revealed well-resolved 13C signals, and the intensities of those arising from C3, C5, C16, and C17 decreased linearly with increasing Mg2+ concentration. The magnitude of the chelation affinity could be deduced from the slopes of the 13C intensity variations; typically, the greater the slope the higher the chelation affinity. The results revealed Tes/Mg2+ chelation to be mediated by the oxygen atom attached to C3 in ring A, and the hydroxyl group attached to C17 in ring D. With regard to the chelation specificity, we showed that Tes chelates Mg2+, but not Ca2+ or Zn2+. We also explored the cation-induced signal shift effects of Tes in the presence of Mg2+, Ca2+, or Zn2+. We demonstrate that high-resolution 13C NMR spectroscopy provides a better probe than 1H NMR for the detection of cation chelation and cation-induced signal shift effects for steroid compounds such as Tes.

ObjectivesTo date, a value set for the EQ-5D-5L based on the health state preferences of the general Taiwanese population has not been available. This study aimed to develop a Taiwanese value set for EQ-5D-5L to facilitate health technology assessment for medical products and services.MethodsAn international standardized protocol for EQ-5D-5L valuation studies developed by the EuroQol group was adopted. Adult members of the general public were recruited from six geographic regions in Taiwan. In computer-based face-to-face interviews, each participant completed 10 composite time trade-off (C-TTO) tasks and 7 discrete choice experiment (DCE) tasks. The C-TTO and DCE data were modeled alone or in combination (using hybrid models) with additive models containing 20 dummy variables as main effects. The model performance was assessed both quantitatively and qualitatively (mainly logical consistency and prediction patterns).ResultsOf 1,073 recruited participants, 1,000 completed the study. Approximately 13% of observed utility values were -1 in the C-TTO tasks. The hybrid model, using all available data that assumed C-TTO response values left-censored at -1 and with main effects coefficients with logical consistency (monotonicity), was considered as the most appropriate model. The predicted utility ranged from -1.0259 to 1.ConclusionsAn EQ-5D-5L value set was developed for Taiwan using an established study protocol and a representative sample of the general population. This may facilitate health economic evaluations and decision making on resource allocation under Taiwan's national health insurance program in the future.

Introduction. A short harvest window is common in litchi production worldwide, leading to imbalance between supply and demand for fresh fruit. This problem can be mitigated with early-maturing cultivars, such as ‘Early Big’, released in 2010 in Taiwan. Our goal was to characterize the generative development in this novel litchi cultivar. Materials and methods. The patterns of female flowering and fruit development, and fruit abscission were investigated in ‘Early Big’ litchi in 2013 and 2014. The relationship between the second round (2nd R) blooming and the first round (1st R) fruit was studied. The ambient temperature in both years was recorded. Results and discussion. 2–3 weeks after full female bloom (AFFB) the 2nd R flowering occurred, followed by fruit abscission with loss of 95% fruit within 4 weeks AFFB in ‘Early Big’ litchi, resulting in low yield at harvest. The 2nd R blooming was negatively correlated with the 1st R fruit retention rate from week 4 AFFB in 2013. Overall, the period of low temperature from November through to the following March was longer in 2013/2014 than in 2012/2013. The trait of early maturing in ‘Early Big’ is mainly due to early flowering. Temperature may be related to the generative development in ‘Early Big’. The accumulation of low temperature in early spring may be related to poor initial fruit set. Conclusion. The presence of 2nd R flowering also potentially reduced the 1st R fruit set and retention. These issues must be addressed to develop field strategies to improve yield in ‘Early Big’ litchi.

Aims and objectives. The aim of this study was to elucidate the experiences of first encountering death by nursing students during clinical practice. The objective is to assist nursing educational and clinical professionals to provide essential assistance for nursing students who encounter patient death. Background. Increasingly, deaths are occurring in hospitals. However, there has been little qualitative research in Taiwan on the experiences of nursing students who encounter patient death for the first time. Design. A descriptive qualitative method was employed to explore nursing students’ first experience with death during clinical practice in Taiwan. Methods. Purposive sampling, one-on-one, in-depth with semi-structured interviews were conducted to collect data. Participants were selected from an acute haematological ward in a major teaching hospital in Central Taiwan. Narratives were analysed using Colaizzi’s seven-step method. Results. Data saturation was achieved after interviewing 12 nursing students. The average age of the students was 20, and seven and half days was the average time spent attending dying patients. Three themes and eleven sub-themes were identified: Providing Care During the Dying Period (feelings of dread and terror, hardship of experiencing patient’s life fading away, devotion to patient care and self-affirmation); Facing the Moment of Patient Death (state of being scared or trapped, emotional breakdown); Adjustment after Patient Death (acceptance or avoidance, growth or escape). Conclusions. Findings demonstrate the importance of understanding such first experiences, and the results are beneficial to clinical instructors and nursing personnel in understanding the students’ pressure and difficulties experienced before, during and after the patients’ death. Relevance to clinical practice. Several recommendations have been made, including teaching and support not only in the period of dying, but at the moment of patient death and postmortality. Avoiding topics about death in local culture have been noted.

Miniaturized TOSA/ROSA by using silicon optical bench (SiOB) technology is experimentally demonstrated with parallel transmission of 4-channel×10-Gbps. Whole module assembly is passive alignment achievable, and no coupling lens needed.

The aim of this study was to elucidate the experiences of first encountering death by nursing students during clinical practice. The objective is to assist nursing educational and clinical professionals to provide essential assistance for nursing students who encounter patient death.Increasingly, deaths are occurring in hospitals. However, there has been little qualitative research in Taiwan on the experiences of nursing students who encounter patient death for the first time.A descriptive qualitative method was employed to explore nursing students' first experience with death during clinical practice in Taiwan.Purposive sampling, one-on-one, in-depth with semi-structured interviews were conducted to collect data. Participants were selected from an acute haematological ward in a major teaching hospital in Central Taiwan. Narratives were analysed using Colaizzi's seven-step method.Data saturation was achieved after interviewing 12 nursing students. The average age of the students was 20, and seven and half days was the average time spent attending dying patients. Three themes and eleven sub-themes were identified: Providing Care During the Dying Period (feelings of dread and terror, hardship of experiencing patient's life fading away, devotion to patient care and self-affirmation); Facing the Moment of Patient Death (state of being scared or trapped, emotional breakdown); Adjustment after Patient Death (acceptance or avoidance, growth or escape).Findings demonstrate the importance of understanding such first experiences, and the results are beneficial to clinical instructors and nursing personnel in understanding the students' pressure and difficulties experienced before, during and after the patients' death.Several recommendations have been made, including teaching and support not only in the period of dying, but at the moment of patient death and postmortality. Avoiding topics about death in local culture have been noted.

We report the first experimental demonstration of active narrowband multiple wavelength filters in aperiodically poled lithium niobate (APLN) crystals. Simultaneous transmission of >90% (~100% in design) of 8 telecom wavelengths was achieved in this device.

In this paper, the flattened bandstop spectral response of 85 nm at the central wavelength of 1.22 mum and the high angular deviation of incident are experimentally obtained by guided mode resonance (GMR) filters.

Four-to-six fold rotation-symmetry with sub-mum domain size is observed in periodically-poled LiNbO3. Depth-resolved pyroelectric microscopy analysis indicates the 2D-confinement of inverted domains is ascribed to selective nucleation and minimized fringe-field effect by flattened polystyrene spheres on the surface

In this work, diffractive microlenses were fabricated in GaN-based material by using gravy-level mask and inductively coupled plasma etching technique. We also propose to insert the GaN/AlN anti-reflection thin films in the microlenses to enhance the ultraviolet/visible rejection ratio. Due to high transparency of GaN and AlN in UV, the microlenses can be potentially used in the UV micro-optics system such as solar-blind detection applications. In the design example of this work, the structure may enhance the ultraviolet/visible rejection to be 10/sup 2/.

In this paper, a silicon mold, with spherical/aspherical concave microlens arrays, was made by using ICP dry etching technique. A PMMA microlens was molded by using this mold and then tested by SEM, Dektakprofiler and etc.

We report on the design and experimental characterization of aperiodically poled lithium niobate (APLN) crystals for use in monolithically integrated dual nonlinear-optical devices. A cascade and a single aperiodic-domain-structure designs based on simulated annealing method were constructed in LiNbO(3) to simultaneously perform as 4-channel electro-optically active (EOA) filters and 4-channel frequency doublers in the telecom band. We found that we could obtain a 2.44-fold enhancement in second-harmonic-generation conversion efficiency and a 2.4-time reduction in filter transmission bandwidth with the single APLN device over the cascade one when the same device length of 2 cm and the EOA field of 1027 V/mm were used.