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Frailty is a significant public health and clinical issue among the elder population. This study aimed to evaluate the nutritional status and renal function in relation to frailty among elderly Taiwanese.We administered community-based health surveys to the elder population in Chiayi County, Taiwan, from 2017 to 2019.We measured nutritional status (including serum albumin and total protein levels), renal function (including serum blood urea nitrogen, creatinine, urine protein, and urine creatinine levels), hand grip strength (GS) and calculated appendicular muscle mass (AMM).The study recruited 3739 participants (2139 women). Participants of both sexes with normal GS had higher serum albumin levels and lower urine protein/creatinine ratios (UPCRs). For the men with normal and weak GS, serum albumin levels were 4.15 ± 0.2 and 4.10 ± 0.2 g/dL (p0.01), and UPCRs were 123.1 ± 219.6 and 188.7 ± 366.2 (p0.001), respectively. GS was positively correlated with serum albumin and urine creatinine levels (r = 0.136 and 0.177, both p0.001). AMM was also positively correlated with serum albumin and urine creatinine levels (r = 0.078 and 0.091, both p0.001). In the multivariate regression model, for every 1 g/dL increase in serum albumin level, there was a 1.9 and 1.7-kg increase in GS for men and women (p0.05 and p0.01), respectively. The final model for predicting GS included age, albumin, BUN, and UPCR (urine creatinine for women) which presented a variance of 22.1% and 13.8%, respectively.Proper dietary nutritional intake and maintaining renal function are key elements for preventing frailty among elder population in Taiwan.

To investigate the clinical efficacy of integrated multidomain intervention among community-living older adults with multimorbidity and physio-cognitive decline syndrome (PCDS).This is the secondary analysis from a randomized controlled trial that data of 340 participants with Montreal Cognitive Assessment (MoCA) scores≥18 were excerpted for analysis.Sixteen 2-hour sessions per year were provided for participants, including physical exercise, cognitive training, dietician education and individualized integrated care for multimorbidity.Handgrip strength, 6-m walking speed, MoCA (total score and sub-domains), Cardiovascular Health Study (CHS) frailty score, quality of life, and serum biochemistry biomarkers.Overall, 96/340 (28.2%) of all participants have PCDS, and the integrated multidomain intervention significantly improved global cognitive performance (overall difference 1.1, 95% CI 0.4 - 1.8, p=0.003), and domains of concentration (overall difference 0.3, 95%CI 0.1 - 0.5, p=0.011), language (overall difference 0.2, 95%CI 0.1 - 0.3, p=0.006), abstract thinking (overall difference 0.1, 95%CI 0.0 - 0.3, p=0.027), and orientation(overall difference 0.2, 95%CI 0.0 - 0.4, p=0.013) across all timepoints among those with PCDS. Besides, interventions also significantly reduced frailty score among those with cognitive impairment no dementia (overall difference -0.3, 95%CI -0.5 - -0.1, p=0.011) and mobility impairment no disability (overall difference -0.3, 95%CI -0.4 - -0.1, p=0.004). and improved quality of life at domain of physical role limitation among those with PCDS (overall difference 5.3, 95%CI 0.3 - 10.4, p=0.038).The integrated multidomain lifestyle intervention plus multimorbidity management significantly improved cognitive function, and enhanced quality of life among older adults with multimorbidity and PCDS in the communities.

This prospective, observational, interventional study sought to determine if the introduction of resuscitative balloon occlusion of the aorta (REBOA) at an Australian adult major trauma centre would improve survival for major trauma patients.Patients aged 18-60 years, transported directly from scene with exsanguinating, sub-diaphragmatic haemorrhage and hypovolaemic shock (systolic BP70 mmHg or hypovolaemic cardiac arrest) were eligible for recruitment and followed up until hospital discharge (ACTRN12618000550202).During the 14-month study period (17 January 2015 to 12 March 2016) 3032 patients were admitted direct from scene with an overall mortality of 97 (3.71%). Of these patients 3019 had trauma centre vital signs recorded in the data set (99.57%) and 1523 were between the ages of 18-60, including 143 patients with a shock index of1.0 (4.74%). There were 13 (0.43%) patients with a systolic BP70 mmHg and/or cardiorespiratory arrest on arrival. The mortality in this group was six out of 13 (46.15%). Of these 13 patients, there were two (0.07% of the total cohort) where REBOA was attempted. There were no eligible patients for whom REBOA was achieved. None of the six patients who died would have benefited from REBOA deployment.Despite considerable training and resource allocation to ensure 24-h availability, the introduction of REBOA failed to effectively demonstrate any impact on patient outcome. Despite retrospective literature supporting the introduction of REBOA, in this 14-month prospective study there was no evidence of benefit. Further studies may define indications and subgroups of patients who may benefit.

Background: The live donor liver transplantation (LDLT) process is circuitous and requires a considerable amount of coordination and matching in multiple aspects that the literature does not completely address. From the coordinators’ perspective, we systematically analyzed the time and risk factors associated with interruptions in the LDLT process. Methods: In this retrospective single center study, we reviewed the medical records of wait-listed hospitalized patients and potential live donors who arrived for evaluation. We analyzed several characteristics of transplant candidates, including landmark time points of accompanied live donation evaluation processes, time of eventual LDLT, and root causes of not implementing LDLT. Results: From January 2014 to January 2021, 417 patients (342 adults and 75 pediatric patients) were enrolled, of which 331 (79.4%) patients completed the live donor evaluation process, and 205 (49.2%) received LDLT. The median time from being wait-listed to the appearance of a potential live donor was 19.0 (interquartile range 4.0–58.0) days, and the median time from the appearance of the donor to an LDLT or a deceased donor liver transplantation was 68.0 (28.0–188.0) days. The 1-year mortality rate for patients on the waiting list was 34.3%. Presence of hepatitis B virus, encephalopathy, and hypertension as well as increased total bilirubin were risk factors associated with not implementing LDLT, and biliary atresia was a positive predictor. The primary barriers to LDLT were a patient’s critical illness, donor’s physical conditions, motivation for live donation, and stable condition while on the waiting list. Conclusions: Transplant candidates with potential live liver donors do not necessarily receive LDLT. The process requires time, and the most common reason for LDLT failure was critical diseases. Aggressive medical support and tailored management policies for these transplantable patients might help reduce their loss during the process.

Supplementation of high protein oral nutrition shakes supplemented with β-hydroxy-β-methylbutyrate (HP-HMB) has been shown to improve muscle mass, muscle strength, and physical performance in older adults, but the roles of HP-HMB supplementation on the intramuscular adiposity remained unknown. This 12-week randomized controlled trial evaluated the changes of muscle mass, muscle strength, physical performance and intramuscular adiposity among community-dwelling pre-frail older persons. This was an open-label, parallel group, randomized controlled trail that enrolled 70 community-dwelling pre-frail older persons without active or uncontrolled conditions, disability or dementia. The intervention group was provided with two services of HP HMB (Ensure® Plus Advance containing 3g HMB) per day for 12 weeks, and the control group was provided with professional nutritional counselling for sufficient protein intake. All participants received functional assessments, laboratory tests and magnetic resonance imaging (MRI) of the dominant leg before and after study. Intramuscular adipose tissue (IMAT) and the mid-thigh cross-sectional area (CSA) of muscle were obtained by MRI, and the IMAT-to-CSA ratio was calculated to evaluate intramuscular adiposity. Overall, 62 participants (mean age: 71.1±3.8 years, 69.4% female) completed the study (HP-HMB group: 29, control group: 33) and comparisons of baseline characteristics between groups were not statistically different. For the primary outcome, HP-HMB group showed significant improvements in the CSA of mid-thigh muscle (mean increase of CSA: 149.1±272.3 for HMB group vs −22.9±309.1 mm2 for control group, P=0.045). The improvement of MNA-SF was borderline (0.28±0.75 vs. −0.15±0.94, P=0.064), but serum levels of Vit D were significantly increased in the HMB group (3.83±8.18 vs. −1.30±4.81 ng/mL, P=0.002). Moreover, the body weight and BMI were significantly increased in the HMB group (1.10±1.18 vs. 0.24±1.13 kg, P=0.005; 0.56±0.68 vs. 0.22±0.47 kg/m2, P=0.019). In particular, the IMAT-to-CSA ratio was reduced in the HMB group (−0.38±1.21 vs. −0.02±2.56 %, P=0.06). Using the generalized estimating equation, we found that SPPB score in chair rise test was significantly improved (β=0.71, 95% C.I.0.09–1.33, P=0.026). The 12-week supplementation with high protein oral nutrition shake supplemented with 3g HMB per day significantly increased muscle mass, as well as nutritional status and physical performance, and ameliorated the intramuscular adiposity of pre-frail older persons. Further study is needed to explore the long-term benefits of HP-HMB supplementation on muscle and metabolic health for older adults.

The vascularization of subchondral bone plays a significant role in the progression of knee osteoarthritis (OA). Treatment with platelet-rich plasma (PRP) has positive effects on cartilage lesions. However, PRP's efficacy for subchondral bone marrow lesions and the relationship of these lesions to cartilage are still undiscovered. Therefore, our aims were first to longitudinally investigate the change in subchondral flow by dynamic contrast enhanced MRI and degeneration of cartilage by MRI T2A 32-week investigation in 18 rats allocated to sham-control, ACLT with normal saline injection (ACLT + NS), and ACLT with PRP injection groups ended with histological evaluation. Another rat was used as a donor of allogenic PRP.Compared to the sham-control group, the ACLT + NS group had higher subchondral blood volume A (0.051, 95% confidence interval: 0.009, 0.092) and lower venous washout kSubchondral hyper-perfusion plays a vital role in the pathogenesis of OA and was associated with cartilage degeneration. The efficacy of PRP can be observed from reduced perfusion and MRI T2

Streptococcus agalactiae is a causative agent responsible for massive mortalities of tilapia that has led to catastrophic losses to tilapia culture globally. Bacteriophages represent a new class of antimicrobials against bacteria. In this study, we characterized the bacteriophage HN48, which formed small and round-transparent plaques on a double-layer plate. With a hexagonal head and a long tail, this phage may belong to the Caudovirales according to the International Committee on Taxonomy of Viruses. HN48 was found to have a relatively wide and highly specific host range, to be sensitive to high temperature (60-80°C) and low pH (3-5), and to be relatively stable at alkaline pH (8-10). Intraperitoneal injection with HN48 had no adverse effects on tilapia and effectively inactivated the bacteria in the kidney. Fish that received phage therapy had 60% ± 3.3% survival rates and a delayed mean death time of about 3 days when compared to the control group. To the best of knowledge, this is the first study of tilapia streptococcal phage. Overall, the results indicated that phage HN48 could prevent tilapia from experimental S. agalactiae infection, suggesting it has the potential to control this disease.

Background Acral melanoma (AM) is the most common histopathological subtype of malignant melanoma in Asians. However, differences in the mutational profiles underlying AM and nonacral cutaneous melanoma (NAM) in Asians are not well understood. Objectives To augment the understanding of the prevalence, patterns and associations of various mutations between different subtypes of melanoma. Methods We performed comprehensive genomic profiling of 409 cancer-associated genes, using next-generation sequencing, in 66 primary melanomas comprised of 45 AMs and 21 NAMs. Results Most of the AMs (n = 27/45; 60%), but only five of 21 (24%) NAMs, were triple wild-type (triple-WT) tumours. Compared with AMs, NAMs exhibited a significantly higher frequency of BRAF mutations. The frequencies of NRAS/KRAS mutations, cell-cycle aberrations, copy number gains in BIRC2, BIRC3 and BIRC5, and gains of receptor tyrosine kinase genes were significantly higher in AMs. Ulceration was found at significantly higher rates in the AMs and NAMs with cell-cycle aberrations and gains of receptor tyrosine kinase genes. Notably, cell-cycle aberrations and copy number gains in BIRC2, BIRC3 and BIRC5 were significantly associated with poor melanoma-specific survival in the 66 patients with melanoma and especially in the 45 patients with AM. Multivariate analysis showed that lymph node metastasis and cell-cycle aberrations were independent prognostic factors of melanoma-specific survival. Conclusions This study strengthens our understanding of the patterns and clinical associations of oncogenic mutations in AMs and NAMs in Asians. What's already known about this topic? Mutation frequencies of driver genes vary between melanoma subtypes. Acral melanoma is the most common subtype of melanoma in Asians. KIT mutations and copy number variations occur more frequently in the acral subtype of melanoma than in the nonacral subtype What does this study add? NRAS/KRAS mutations, cell-cycle aberrations, copy number gains in BIRC2, BIRC3 and BIRC5, and amplifications of receptor tyrosine kinase genes were significantly enriched in acral melanoma and could be potential targets for treatment. Melanomas with cell-cycle aberrations and gains in receptor tyrosine kinase genes were significantly more likely to contain ulceration. What is the translational message? Cell-cycle aberrations and copy number gains in BIRC2, BIRC3 and BIRC5 were significantly associated with poor melanoma-specific survival. These observations should be explored further for future drug development.

We characterize the critical peak current which causes melting of various metals interconnects under short-pulse conditions. High-current with 100ps pulse width is achieved using an on-die pulse generator. A model incorporating the heating of the metal layer and heat diffusion through the insulator layer is supported by the experimental results. The model accurately describes the relationship between peak current and pulse width ( $20\boldsymbol{\mu} \mathbf{s}$ -100ps), and can be used to generate reliable guidelines for high-current applications.

Background Living-donor kidney transplantation has a positive influence on recipients' life expectancy and improves quality of life for patients with end-stage renal disease compared with dialysis patients. Evaluation of the physical and mental quality of life for donors can promote positive perceptions about donation and help potential donors in their decision-making process. The aim of this study was to explore the predictive factors of quality of life for living kidney donors. Methods A cross-sectional and descriptive design was used, and the study was conducted from January to July 2013. The donors were a convenience sample of 34 participants who had undergone kidney transplant surgery >1 year earlier. Results The results showed that kidney donors had a low to moderate physical and mental quality of life. Multiple regression analysis revealed that financial concerns and anxiety explained 27.8% of the total variance of quality of life in the physical component. Anxiety and paid work explained 61.4% of the total variance of quality of life in the mental component. Conclusions After renal transplantation, living kidney donors experienced low to moderate quality of life. Because donors are family members (siblings, sons or daughters, spouses, or parents), monthly family income is a significant issue that influences both the decision to donate and quality of life after transplantation. Our findings suggest that pre-transplantation assessment must include social workers as part of the health care team to evaluate the impact of a donor's financial status on post-transplantation quality of life.

To evaluate the prevalence of malnutrition and its impact on mortality, functional decline and cognitive impairment among elder residents in long-term care settings.A prospective cohort study.Two veteran homes in Taiwan.A total of 1,248 male residents aged equal or more than 65 years.Charlson's comorbidity index (CCI), Minimum data set (MDS), resident assessment protocols (RAP), Activity of daily living-Hierarchy scale, Cognitive Performance Scale, MDS Social engagement scale.The mean age of participants is 83.1 ± 5.1 years, and the prevalence of malnutrition was 6.1%. Inadequate dietary content (57.9%) and unintentional weight loss (31.6%) account for the majority of malnutrition identified by MDS tool. Higher 18-month mortality rate (25% vs. 14.2%), higher baseline CCI (median 1 vs. 0), and higher baseline sum of RAP triggers (median 8.5 vs. 5) were noted among residents with malnutrition. Furthermore, malnutrition was shown predictive for functional decline (OR: 3.096, 95% CI: 1.715-5.587) and potential cognitive improvement (OR: 2.469, 95% CI: 1.188-5.128) among survivors after adjustment for age, body mass index and CCI.Malnutrition among elder men residing in veteran homes was associated with multimorbidities and higher care complexity, and was predictive for mortality and functional decline.

Urban tourism has gradually been emphasized in past years; especially, it is regarded as a savior of urban regeneration in old industrial cities. When losing the competitive advantages and getting declined, old industrial cities are facing the challenge of transformation. The development of urban tourism is considered as the opportunity of industrial cities in dark recession that they start to involve in the development of tourism. Analytic Hierarchy Process (AHP) is applied in this study to evaluate key success factors in the tourism development strategy of Kaohsiung City after the urban style regeneration. AHP is used for confirming the levels of various evaluation factors. The first hierarchy contains four evaluation dimensions, and 14 evaluation standards are covered in the second hierarchy. The results reveal the important sequence of four evaluation factors in the second hierarchy as (1) marketing activity, (2) management strategy, (3) recreational environment, and (4) infrastructure, where the importance of evaluation factors in the third hierarchy is sequenced as (1) urban attraction, (2) environmental facility maintenance, (3) celebrations, (4) local characteristics, and (5) natural landscape. The research results and suggestions in this study are expected to enhance the tourism development of Kaohsiung City in Taiwan after the urban style regeneration. Keywords: urban style, tourism development strategy, key success factors, Delphi method, AHP

To investigate the role of Jagged2 in triple negative breast cancer (TNBC) and its underlying mechanism.Breast cancer tissues of patients diagnosed with TNBC in Fujian Medical University Affiliated MinDong Hospital from January 2015 to September 2017 were selected. TNBC patients were divided into the paclitaxel-resistant group (n=34) and non-resistance group (n=11). Jagged2 expression in paclitaxel-resistant group and non-resistance group before and after treatment was detected by quantitative Real-time-polymerase chain reaction (qRT-PCR), respectively. After Jagged2 knockdown in paclitaxel-resistant MDA-MB-231 cells (MDA-MB-231/TXR), expression of CD44+CD24-ESA+ subset was detected by flow cytometry. MicroRNA-200 expression was detected after Jagged2 knockdown in MDA-MB-231/TXR cells.Jagged2 was highly expressed in paclitaxel-resistant TNBC tissues and cells. Jagged2 expression was found to be associated with cancer stem cell (CSC) properties of TNBC cells. Knockdown of Jagged2 inhibited CSC properties and paclitaxel resistance, whereas upregulated microRNA-200 expression. The inhibited CSC properties and paclitaxel resistance induced by Jagged2 knockdown were reversed by microRNA-200 knockdown.Jagged2 maintains CSC properties of TNBC cells and paclitaxel resistance via regulating microRNA-200.

We characterize the critical peak current which causes melting of Cu/low-k interconnects under short-pulse conditions. High-current with 100ps pulse width is achieved using an on-die pulse generator A model incorporating the heating of the metal layer and heat diffusion through the insulator layer is supported by the experimental results. The model accurately describes the relationship between peak current and pulse width (20 μs–100ps), and can be used to generate reliable guidelines for high-current applications.

The effects of passive (inactive) sinks and reservoirs on electromigration failure distributions close to critical current density jc are examined. We develop a model to accurately predict failure distributions where the inactive segment modifies the void nucleation component of jc. We show that failure distributions can exhibit large deviations of median time to fail in the presence of sinks and reservoirs, but at low percentiles typical of reliability requirements, failure time modifications are much reduced.

Chronic kidney disease (CKD) is characterized by metabolic disturbances in calcium and phosphorus homeostasis as kidney function declines. Alterations in blood perfusion in bone resulting from arteriosclerosis of bone vessels may relate to the progression of CKD. Herein, change in dynamic contrast enhanced (DCE) MRI parameters (A: amplitude, kTwo groups of male Sprague-Dawley rats received either (1) no intervention or (2) 5/6 nephrectomy.We found that the CKD group (compared with the control group) had lower A and kPerfusion deficiency and CKD may be related. DCE parameters and MRI T2

12″ manufacturable 90nm CMOS fully compatible 1Mb HfO 2 -ReRAM by 2 extra masks between Metals with BEoL thermal stress immunity is for the first time achieved in this work. Cycle random soft error, for the first time systematically observed in this work, due to improper phase-transition of TiO δ on filament are successfully suppressed by stoichiometric engineering on HfO 2 / reservoir interface to achieve reliable 20K / 100K endurance and 85°C 10 years retention. This technology can thus offer potential applications of embedded IoT systems due to low energy consumption and cost effective benefit.

We show that analysis of steady-state stress is required to accurately predict the location of electromigration vulnerabilities in multi-segment conductors. Electromigration voids form at regions of maximum stress, and these do not necessarily coincide with the highest current density regions. Failure time distributions of circuit-like interconnects are predicted by incorporating the effect of stress on critical current densities. Conventional current density analysis is generally inaccurate in identifying locations of electromigration damage and predictions of failure time.

Metabolic syndrome (MetS) was common in the elderly, but its prognostic significance in older old population remained unclear. The main purpose of this study was to evaluate the survival impact of MetS among older men aged 75 and over in Taiwan.From 2008, residents aged 75 years and older of Banciao Veterans Home were invited for study and were followed for 3 years. All participants received history taking, physical examinations, and laboratory tests. Mortality was determined by Veteran Affairs Death Registry, which was linked to the National Death Registry.Overall, 680 men (mean age: 82.5±4.7 years) were enrolled for study and the prevalence of MetS was 31.6%. During the follow-up period, 140 (20.6%) participants died, and the causes of death included infectious diseases (62, 9.1%), cardiovascular disease (37, 5.4%), cancer (20, 2.9%), and others (21, 3.1%). MetS subjects had a significantly higher prevalence of hypertension, diabetes mellitus, and having higher body mass index, waist circumferences, systolic blood pressure, fasting blood glucose, serum triglyceride and lower HDL-C level than non-MetS subjects. However, MetS subjects were less likely to die during study period (16.3% vs. 22.6%, P=0.059). Multivariate logistic regression showed that older age (OR:1.04, 95% C.I.: 1.00-1.08, P=0.04), diabetes mellitus (OR: 2.10, 95% CI: 1.34-3.30, P=0.001) were independent risk factors for mortality; and serum total cholesterol and triglyceride were protective factors (OR: 0.99, 95% CI: 0.99-1.00, P=0.037 for cholesterol; OR: 0.99, 95% CI: 0.99-1.00, P=0.013 for triglyceride). Adjusted for age, diabetes mellitus, serum levels of total cholesterol, and triglyceride, MetS played a potential trend of survival benefits among study subjects (HR: 0.71, 95% CI: 0.45-1.12, P=0.144).The prevalence of MetS among men aged 75 years and over was 31.6%, and the 3-year mortality rate was 20.6%. Older age, diabetes mellitus, lower serum cholesterol and lower serum triglyceride were independent risk factors for mortality. Further investigation is needed to clarify the prognostic impact of MetS in older adults.

The purpose of this study was to develop a Physician's Spiritual Well-Being Scale (PSpWBS). The significance of a physician's spiritual well-being was explored through in-depth interviews with and qualitative data collection from focus groups. Based on the results of qualitative analysis and related literature, the PSpWBS consisting of 25 questions was established. Reliability and validity tests were performed on 177 subjects. Four domains of the PSpWBS were devised: physician's characteristics; medical practice challenges; response to changes; and overall well-being. The explainable total variance was 65.65%. Cronbach α was 0.864 when the internal consistency of the whole scale was calculated. Factor analysis showed that the internal consistency Cronbach α value for each factor was between 0.625 and 0.794 and the split-half reliability was 0.865. The scale has satisfactory reliability and validity and could serve as the basis for assessment of the spiritual well-being of a physician.

A multiple-regime threshold nonlinear financial time series model, with a fat-tailed error distribution, is discussed and Bayesian estimation and inference is considered. Further, approximate Bayesian posterior model comparison among competing models with different numbers of regimes is considered: effectively a test for the number of required regimes. An adaptive MCMC sampling scheme is designed, while importance sampling is employed to estimate Bayesian residuals for model diagnostic testing. Our modeling framework provides a parsimonious representation of well-known stylized features of financial time series and facilitates statistical inference in the presence of high or explosive persistence and dynamic conditional volatility. We focus on the three-regime case: the main feature of the model is the capturing of mean and volatility asymmetries in financial markets, while allowing an explosive volatility regime. A simulation study highlights the properties of our MCMC estimators and the accuracy and favourable performance as a model selection tool, compared to a deviance criterion, of the posterior model probability approximation method. An empirical study of eight international oil & gas markets illustrates strong support for the three-regime model over its competitors, in most markets, in terms of model posterior probability and in showing three distinct regime behaviours: falling/explosive, dormant and rising markets.

SUMMARYReporting of percutaneous injuries (PIs) to the Chinese Exposure Prevention Information Network (EPINet) became mandatory for all public and tertiary referral hospitals in Taiwan in 2011. We have estimated the number of microbially contaminated PIs and the national PI incidence using a retrospective secondary data analysis approach to analyse 2011 data from the Chinese EPINet to determine the types of PI, mechanisms of occurrence and associated risks. The results revealed a national estimate of PIs between 6710 and 8319 in 2011. The most common incidents for physicians were disposable syringes, suture needles, and disposable scalpels; while for nurses they were disposable syringes, intravenous catheters, and lancets. About 13·0% of the source patients were seropositive for hepatitis B virus (HBV) surface antigen, 13·8% were seropositive for hepatitis C virus (HCV), and 1·1% seropositive for human immunodeficiency virus (HIV). From these results we estimate that annually 970 full-time healthcare workers (HCWs) would be exposed to HBV, 1094 to HCV, and 99 to HIV. This study improves our understanding of the mechanisms and risks of PIs and informs the development of more efficient preventive measures to protect HCWs from such injuries.

This paper develops an efficient three-dimensional numerical procedure to predict incompressible flow in long microchannels. The major advantage of the present numerical procedure is its fast speed due to the parabolic character of the governing equations.

Objective: To evaluate the effect of ultra-short (12 days) metformin pretreatment in clomiphene-citrate (CC) resistant polycystic ovary syndrome (PCOS). Method: Eighty women with CC-resistant PCOS were randomly allocated to metformin pretreatment or usual treatment. Forty women received 1500 mg metformin daily for 12 days, followed by clomiphene 150 mg daily for 5 days along with metformin. Forty women (control group) received the same dose of clomiphene but no metformin pretreatment. Results: In the metformin group, 17 (42.5%) women ovulated, and 6 (15%) conceived. In the control group, 5 (12.5%) women ovulated but none conceived. Compared with the control group, the metformin group had significantly higher ovulation (P = 0.03) and pregnancy rates (P = 0.026). Conclusion: Twelve days of metformin pretreatment improves ovulation and pregnancy rates in women with CC-resistant PCOS.

Electromigration reliability of Cu interconnects is an important issue for continued performance improvement of IC technologies. In this paper, we investigate the impact of Mn impurities on the electromigration drift velocity of Cu conductors. Under accelerated test conditions, the drift velocity in CuMn alloys is reduced by an order of magnitude compared with pure Cu with polycrystalline microstructure. Dilute CuMn alloys exhibit a large activation energy for drift of 1.05 eV, which is significantly increased above that for pure Cu as a result of a 0.2 eV impurity(Mn)-vacancy binding energy. There is no measurable impact of the presence of the Mn dopant on diffusion along the Cu/dielectric cap interface in the samples studied here.

A novel image compression scheme based on the side match vector quantization (SMVQ) scheme is proposed. The goal of this scheme is to improve the image quality of the SMVQ scheme while keeping a low bit rate. The required bit rate of this scheme is variable, and the bit rate can be control by the proposed adaptive bit rate encoding mechanism. Three techniques are applied in this scheme: the local skewness of the image, the adaptive irregular sampling and the modified side-match distortion measurement to satisfy the variant encoding requirements of the various image contents. The experimental results show that the derailment is suppressed and the image quality is approximated to VQ and enhanced ~2 dB from SMVQ at the same bit rate. Furthermore, the proposed scheme supports the adaptive bit rate encoding approach, which enables it to solve the trade-off between the image quality and the encoding bit rate.

In this paper, a dynamic state codebook-based side-match vector quantization (DSMVQ) is presented. The super codebook generation procedure is extended to explore the characteristics of codewords and to determine the dynamic state codebook sizes. In encoding, the 'near' codeword from the super codebook is selected based on the side-match distortion measurement. The size of the state codebook is retrieved according to the 'near' codeword. Then, side-match prediction encoding is employed to find the appropriate codeword from the state codebook. The experimental results show that the proposed scheme provides a lower encoding bit rate than classified SMVQ (CSMVQ) and two-level CSMVQ, and maintains better image quality than SMVQ and three-sided SMVQ. Furthermore, the adaptive encoded image quality is obtained according to the predefined VQ approximation rate. The adaptive encoding provides a possible solution to the trade-off between the encoding bit rate and the image quality.

This paper presents a numerical prediction of the formation of Goertler vortices on a curved surface with effect of rotation. The criterion of flow visualization marking the onset position of Goertler vortices is employed in the present paper. For facilitating the numerical study, the computation is carried out in the transformed x and ηplane. The results show that the onset position characterized by the Goertler number, depends on the rotation number Ro, the Prandtl number and the wave number. The value of critical Goertler number increases with the increase in negative rotation, while the value of Goertler number decreases with the increase in positive rotation on a concave surface. On the contrary, the value of critical Goertler number decreases with the increase in negative rotation on a convex surface. The obtained critical Goertler number and wave number are compared with the previous theoretical and experimental data. Copyright © 2002 John Wiley & Sons, Ltd.

The majority of interconnects on a circuit is composed of via terminated segments that are connected to sinks or reservoirs. In this paper we investigate electromigration failure of Cu/low-k conductors with active (current carrying) sinks and reservoirs. We observe that both active sinks and reservoirs lower failure times of via terminated segments. We develop a modeling methodology based on steady - state electromigration - induced stress distributions to predict vulnerable locations and failure time distributions in the presence of sinks and reservoirs.

KIDNEY transplantation (KT) has evolved as a successful therapy for patients struggling with end-stage renal disease. Advances in surgical and medical protocols have resulted in the excellent survival rates. 1,2 Debates regarding the quality of life (QOL) of dialysis and transplant recipient groups have been ongoing for about two decades. 3‐11 Although most studies show that QOL is one of the most important benefits of KT, 3,7‐24 some researchers still argue that KT does not significantly improve QOL over dialysis. 4‐6 The health-related QOL of KT recipients is a complex phenomenon. Recipients’ assessment of QOL often reflects their adaptation to their postdischarge, posttransplant lives. During the predischarge stage, most Taiwanese KT recipients are anxious about the quality of medical care, their self-efficacy, and related social support. Alleviating the anxiety of KT recipients with regard to these issues may be critical in determining their recovery and QOL after discharge. 25 However, few researchers have prospectively monitored the monthly changes in the selfrated QOL of KT recipients during the first postdischarge year. Instead, the QOL is often examined from a crosssectional view, according to the time frame of standard posttransplant evaluation visits; these evaluations tend to center around the medium- or long-term survivors. 4 ‐ 6,8 ‐18 Working capacity (WC) as well as income are important indicators of self-assessed QOL among Taiwanese KT recipients. 2 However, the challenge of transplantation to a recipient’s postoperative economic status, and the relationship between recipients’ QOL and WC during the first posttransplant year have not been carefully investigated. The purpose of this study was to examine the trend of changes in the QOL and WC after KT, from the preoperative stage to 1 year after discharge from the hospital after KT. PATIENTS AND METHODOLOGY A descriptive, prospective design was used to explore the trends in QOL and WC perceived by KT recipients before and after surgery. The inclusion criteria were as follows: (1) at least 18 years old; (2) clear consciousness; (3) no transplant surgeries other than KT; and (4) prepared to be discharged from National Taiwan University Hospital the next day. The first interview was conducted 1 day before the patient’s discharge from the hospital, and follow-up interviews were conducted 1, 2, 3, 6, and 12 months after discharge from the hospital during outpatient, posttransplant visits. The patient profile was used to collect information about the patient’s demographic information, medical history, medications that the subjects had taken in the floor unit, postoperative complications, and the length of floor unit stay. The subjects were asked to rate their perceptions of QOL and WC on separate visual analog scales (VASs). The VAS used in this study was a 100-millimeter (mm) vertical line. This line was anchored at the bottom with the words “Worst quality of life” or “Unable to work,” and at the top by “Optimal quality of life” or “Optimal working capacity,” respectively. During the first interview, the participants were also asked to rate their perceptions of overall preoperative QOL and WC on VASs, based on their 24 hours preoperatively.