Search Results (17)

(1) Background: The role of air pollutants as risk factors for tinnitus remains unclear. To address this gap in research, we conducted a nationwide retrospective cohort study in Taiwan by integrating patients’ clinical data with daily air quality data to evaluate the environmental risk factors associated with tinnitus. (2) Methods: The Taiwan National Health Research Database (NHIRD) includes medical records for nearly all residents of Taiwan. To assess pollution levels, we used daily air quality data from the Taiwan Environmental Protection Agency regarding SO₂, CO, NO, NO_X, and particulate matter (PM_2.5 and PM₁₀). We merged the NHIRD data with air quality information based on the residents’ locations and the positions of air quality monitoring stations. Pollutant levels were then categorized into quartiles (Q1, Q2, Q3, and Q4). (3) Results: This study included 284,318 subjects. After controlling for covariates, the adjusted HR (95 CI%) for tinnitus increased with increasing SO₂, CO, NO, NO_X, PM_2.5, and PM₁₀ exposure levels, specifically from 1.24 (95 CI% = 1.18, 1.30) to 1.35 (95 CI% = 1.28–1.41); from 1.15 (95 CI% = 1.09, 1.21) to 1.90 (95 CI% = 1.81, 2.00); from 0.86 (95 CI% = 0.82, 0.91) to 1.69 (95 CI% = 1.62, 1.77); from 1.62 (95 CI% = 1.54, 1.71) to 1.69 (95 CI% = 1.60, 1.77); from 0.16 (95 CI% = 0.15, 0.18) to 2.70 (95 CI% = 2.57, 2.84); and from 2.53 (95 CI% = 2.38, 2.69) to 3.58 (95 CI% = 3.39, 3.78), respectively, compared to the Q1 concentrations for all air pollutants. (4) Conclusions: During the 15-year follow-up period, we found a significant positive correlation between air pollutant exposure and the risk of tinnitus. Full article

Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by the gradual loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc), resulting in reduced dopamine levels in the striatum and eventual onset of motor symptoms. Linalool (3,7-dimethyl-1,6-octadien-3-ol) is a monoterpene in aromatic plants exhibiting antioxidant, antidepressant, and anti-anxiety properties. The objective of this study is to evaluate the neuroprotective impacts of linalool on dopaminergic SH-SY5Y cells, primary mesencephalic and cortical neurons treated with 1-methyl-4-phenylpyridinium ion (MPP⁺), as well as in PD-like mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Cell viability, α-tubulin staining, western blotting, immunohistochemistry and behavioral experiments were performed. In MPP⁺-treated SH-SY5Y cells, linalool increased cell viability, reduced neurite retraction, enhanced antioxidant defense by downregulation of apoptosis signaling (B-cell lymphoma 2 (Bcl-2), cleaved caspase-3 and poly ADP-ribose polymerase (PARP)) and phagocyte NADPH oxidase (gp91^phox), as well as upregulation of neurotrophic signaling (brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF)) and nuclear factor-erythroid 2 related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway. In MPP⁺-treated primary mesencephalic neurons, linalool enhanced the expressions of tyrosine hydroxylase (TH), Sirtuin 1 (SirT1), and parkin. In MPP⁺-treated primary cortical neurons, linalool upregulated protein expression of SirT1, γ-Aminobutyric acid type A-α1 (GABA_A-α1), and γ-Aminobutyric acid type B (GABA_B). In PD-like mice, linalool attenuated the loss of dopamine neurons in SNpc. Linalool improved the motor and nonmotor behavioral deficits and muscle strength of PD-like mice. These findings suggest that linalool potentially protects dopaminergic neurons and improves the impairment symptoms of PD. Full article

Patients undergoing cardiac catheterization are at high risk of post-procedure acute kidney injury (AKI) and may experience persistent renal damage after an initial insult, a state known as acute kidney disease (AKD). However, the association between AKD and urinary renal biomarkers has not yet been evaluated in this population. We enrolled 94 patients who underwent elective cardiac catheterization to investigate patterns of urinary renal biomarkers and their associations with post-procedure AKD. Serial urinary renal biomarker levels were measured during pre-procedure, early post-procedure (12–24 h), and late post-procedure (7–10 days) periods. In our investigation, 42.55% of the enrolled patients developed AKD during the late post-procedure period. While the liver-type free-fatty-acid-binding protein level increased sharply during the early post-procedure period, it returned to baseline during the late post-procedure period. In contrast, interleukin-18 (IL-18) levels increased steadily during the post-procedure period. Early post-procedure ratios of IL-18 and gelsolin (GSN) were independently associated with subsequent AKD (odds ratio (95% confidence interval), 4.742 (1.523–14.759) for IL-18 ratio, p = 0.007; 1.812 (1.027–3.198) for GSN ratio, p = 0.040). In conclusion, post-procedure AKD is common and associated with early changes in urinary IL-18 and GSN in patients undergoing cardiac catheterization. Full article

Background: This study aimed to assess the safety and immunogenicity of MVC-COV1901, a recombinant COVID-19 protein vaccine, containing S-2P protein adjuvanted with CpG 1018 and aluminum hydroxide, for people living with HIV (PWH). Methods: A total of 57 PWH of ≥20 years of age who are on stable antiretroviral therapy were compared with 882 HIV-negative participants. Participants received two doses of MVC-COV1901 28 days apart. Results: No vaccine-related serious adverse events (SAEs) were recorded. Seroconversion rates (SCRs) of 100% and 99.8% were achieved in PWH and comparators, respectively, 28 days after the second dose. After adjusting for sex, age, BMI category, and comorbidity, the adjusted GMT ratio of comparator/PWH was 3.2 (95% CI 2.5–4). A higher CD4/CD8 ratio was associated with a higher GMT (R = 0.27, p = 0.039). MVC-COV1901 has shown robust safety but elicited weaker immune responses in PWH. Conclusions: Further investigations may be needed to determine whether PWH require distinct immunization strategies with improved immunogenicity. The main study is registered at ClinicalTrials.gov (NCT04695652). Full article

Purpose: Breast immobilization with personalized breast holder (PERSBRA) is a promising approach for normal organ protection during whole breast radiotherapy. The aim of this study is to evaluate the skin surface dose for breast radiotherapy with PERSBRA using different radiotherapy techniques. Materials and methods: We designed PERSBRA with three different mesh sizes (large, fine and solid) and applied them on an anthropomorphic(Rando) phantom. Treatment planning was generated using hybrid, intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques to deliver a prescribed dose of 5000 cGy in 25 fractions accordingly. Dose measurement with EBT3 film and TLD were taken on Rando phantom without PERSBRA, large mesh, fine mesh and solid PERSBRA for (a) tumor doses, (b) surface doses for medial field and lateral field irradiation undergoing hybrid, IMRT, VMAT techniques. Results: The tumor dose deviation was less than five percent between the measured doses of the EBT3 film and the TLD among the different techniques. The application of a PERSBRA was associated with a higher dose of the skin surface. A large mesh size of PERSBRA was associated with a lower surface dose. The findings were consistent among hybrid, IMRT, or VMAT techniques. Conclusions: Breast immobilization with PERSBRA can reduce heart toxicity but leads to a build-up of skin surface doses, which can be improved with a larger mesh design for common radiotherapy techniques. Full article

In a previous study, we reported the alterations of primary antioxidant enzymes and decreased citrate synthase (CS) activities in different grades of human astrocytoma tissues. Here, we further investigated coenzyme Q₁₀ (CoQ₁₀) levels and protein levels of polyprenyl diphosphate synthase subunit (PDSS2) and several COQ proteins required for CoQ₁₀ biosynthesis in these tissues. We found that the level of endogenous CoQ₁₀, but not of exogenous α-tocopherol, was higher in nontumor controls than in all grades of astrocytoma tissues. The levels of COQ3, COQ5, COQ6, COQ7, COQ8A, and COQ9, but not of COQ4, were lower in Grade IV astrocytoma tissues than in controls or low-grade (Grades I and II) astrocytomas, but PDSS2 levels were higher in astrocytoma tissues than in controls. Correlation analysis revealed that the levels of CoQ₁₀ and COQ proteins were negatively correlated with malignancy degree and positively correlated with CS activity, whereas PDSS2 level was positively correlated with malignancy. Moreover, lower level of mitochondrial DNA-encoded cytochrome c oxidase subunit 2 was not only associated with a higher malignancy degree but also with lower level of all COQ proteins detected. The results revealed that mitochondrial abnormalities are associated with impaired CoQ₁₀ maintenance in human astrocytoma progression. Full article

Owing to the superior properties of silicon carbide (SiC), such as higher breakdown voltage, higher thermal conductivity, higher operating frequency, higher operating temperature, and higher saturation drift velocity, SiC has attracted much attention from researchers and the industry for decades. With the advances in material science and processing technology, many power applications such as new smart energy vehicles, power converters, inverters, and power supplies are being realized using SiC power devices. In particular, SiC MOSFETs are generally chosen to be used as a power device due to their ability to achieve lower on-resistance, reduced switching losses, and high switching speeds than the silicon counterpart and have been commercialized extensively in recent years. A general review of the critical processing steps for manufacturing SiC MOSFETs, types of SiC MOSFETs, and power applications based on SiC power devices are covered in this paper. Additionally, the reliability issues of SiC power MOSFET are also briefly summarized. Full article

About 4% of the population in Taiwan are seropositive for anti-HCV Ab and 70% with HCV RNA. To address this high chronic hepatitis C disease load, Taiwan National Health Insurance started reimbursing genotype-specific DAAs in 2017 and pangenotype DAAs in mid-2018. With a 97% SVR12 rate, there were still 2–3% of patients that failed to clear HCV. To understand the causes of DAA failure in Taiwan, we conducted a multi-center, clinical, and virologic study. A total of 147 DAA-failure patients were recruited, and we searched HCV NS3/4A, NS5A and NS5B for known resistance-associated substitutions (RASs) by population sequencing, and conducted whole genome sequencing (WGS) for those without known RASs. A total of 107 patients received genotype-specific DAAs while 40 had pangenotype DAAs. Clinically, the important cause of failure is poor adherence. Virologically, common RASs in genotype-specific DAAs were NS5A-L31, NS5A-Y93, and NS5B-C316, while common RASs in pangenotype DAAs were NS5A-L31, NS5A-A/Q/R30, and NS5A-Y93. Additionally, new amino acid changes were found by WGS. Finally, we identified 12 cases with inconsistent baseline and post-treatment HCV genotypes, which is suggestive of re-infection rather than treatment failure. Our study described the drug resistance profile for DAA failure in Taiwan, showing differences from other countries. Full article

GaN HEMT has attracted a lot of attention in recent years owing to its wide applications from the high-frequency power amplifier to the high voltage devices used in power electronic systems. Development of GaN HEMT on Si-based substrate is currently the main focus of the industry to reduce the cost as well as to integrate GaN with Si-based components. However, the direct growth of GaN on Si has the challenge of high defect density that compromises the performance, reliability, and yield. Defects are typically nucleated at the GaN/Si heterointerface due to both lattice and thermal mismatches between GaN and Si. In this article, we will review the current status of GaN on Si in terms of epitaxy and device performances in high frequency and high-power applications. Recently, different substrate structures including silicon-on-insulator (SOI) and engineered poly-AlN (QST^®) are introduced to enhance the epitaxy quality by reducing the mismatches. We will discuss the development and potential benefit of these novel substrates. Moreover, SOI may provide a path to enable the integration of GaN with Si CMOS. Finally, the recent development of 3D hetero-integration technology to combine GaN technology and CMOS is also illustrated. Full article

(1) Background: We compared the outcomes of patients with nasopharyngeal carcinoma treated with IMPT and VMAT. (2) Methods: We performed a retrospective propensity score matching analysis (1:1) of patients treated with IMPT (years: 2016–2018) and VMAT (2014–2018). Survival was estimated using the Kaplan–Meier method. Multivariate Cox proportional hazards regression analysis was used to identify the independent predictors of survival. Binary toxicity endpoint analyses were performed using a Cox model and logistic regression. (3) Results: Eighty patients who received IMPT and VMAT were included. The median follow-up time was 24.1 months in the IMPT group. Progression-free survival (PFS) and overall survival (OS) were not statistically different between the two groups but potentially better in IMPT group. In multivariate analysis, advanced N-stage and body weight loss (BWL; >7%) during radiotherapy were associated with decreased PFS. The IMPT group had significantly less requirement for nasogastric (NG) tube placement and BWL during treatment. The mean oral cavity dose was the only predictive factor in stepwise regression analysis, and IMPT required a significantly lower mean dose. However, IMPT increased the grade 3 radiation dermatitis. (4) Conclusions: IMPT is associated with reduced rates of NG tube insertion and BWL through reducing oral mean dose, potentially producing better oncologic outcomes. Full article

GaN has been widely used to develop devices for high-power and high-frequency applications owing to its higher breakdown voltage and high electron saturation velocity. The GaN HEMT radio frequency (RF) power amplifier is the first commercialized product which is fabricated using the conventional Au-based III–V device manufacturing process. In recent years, owing to the increased applications in power electronics, and expanded applications in RF and millimeter-wave (mmW) power amplifiers for 5G mobile communications, the development of high-volume production techniques derived from CMOS technology for GaN electronic devices has become highly demanded. In this article, we will review the history and principles of each unit process for conventional HEMT technology with Au-based metallization schemes, including epitaxy, ohmic contact, and Schottky metal gate technology. The evolution and status of CMOS-compatible Au-less process technology will then be described and discussed. In particular, novel process techniques such as regrown ohmic layers and metal–insulator–semiconductor (MIS) gates are illustrated. New enhancement-mode device technology based on the p-GaN gate is also reviewed. The vertical GaN device is a new direction of development for devices used in high-power applications, and we will also highlight the key features of such kind of device technology. Full article

The number of diabetic patients with chronic kidney disease (CKD) undergoing shoulder arthroplasty is growing. This study aims to compare perioperative outcomes of shoulder arthroplasty in diabetic patients at different renal function stages. Between 1998 and 2013, a total of 4443 diabetic patients with shoulder arthroplasty were enrolled: 1174 (26%) had CKD without dialysis (CKD group), 427 (9%) underwent dialysis (dialysis group), and 3042 (68%) had no CKD (non-CKD group). Compared with the non-CKD group, the CKD (odds ratio [OR], 4.69; 95% confidence interval [CI], 2.02–10.89) and dialysis (OR, 6.71; 95% CI, 1.63–27.73) groups had a high risk of in-hospital death. The dialysis group had a high risk of infection after shoulder arthroplasty compared with the CKD (subdistribution hazard ratio [SHR], 1.69; 95% CI, 1.07–2.69) and non-CKD (SHR, 1.76; 95% CI, 1.14–2.73) groups. The dialysis group showed higher risks of all-cause readmission and mortality than the CKD and non-CKD groups after a 3-month follow-up. In conclusion, CKD was associated with worse outcomes after shoulder arthroplasty. Compared with those without CKD, CKD patients had significantly increased readmission and mortality risks but did not have an increased risk of surgical complications, including superficial infection or implant removal. Full article

The implications of boosting Omalizumab treatment (OT) in patients with severe allergic asthma (SAA) remain unclear. The study aimed to explore and compare the 12-month effectiveness between continuous, at least 10-month OT (continuation group) and four-month boost of Omalizumab (boost group) in adult patients with SAA. In this retrospective cohort study, clinical data were collected for further analysis. Of all participants (n = 124), a significant reduction in annual exacerbations (baseline = 0.8 ± 1.5, follow-up = 0.5 ± 1.0, p = 0.047 *) and improvement in small airway ventilation as evaluated by forced expiratory flow at 25–75% (baseline = 55.1 ± 11.1%, follow-up = 59.4 ± 8.4%, p < 0.001 *) were found in the continuation group (n = 110). By contrast, the boost group (n = 14) had significantly increased annual exacerbations (baseline = 0.7 ± 1.4, follow-up = 2.9 ± 3.6, p = 0.031 *) and impaired small airway function (baseline = 55.3 ± 12.9, follow-up = 52.1 ± 12.5, p = 0.026 *). Furthermore, the continuation group rather than the boost group had significant decreases in the frequency of oral corticosteroid (OCS) use as controllers (baseline = 32.7%, follow-up = 20.0%, p = 0.047 *; baseline = 50.0%, follow-up = 21.4%, p = 0.237, respectively) and OCS maintenance dose (mg/month) (baseline = 85.9 ± 180.8, follow-up = 45.8 ± 106.6, p = 0.020 *; baseline = 171.4 ± 221.5, follow-up = 50.0 ± 104.3, p = 0.064, respectively), and increases in asthma control test scores (baseline = 16.0 ± 3.0, follow-up = 19.8 ± 4.4, p < 0.001 *; baseline = 14.6 ± 3.8, follow-up = 19.7 ± 4.7, p = 0.050, respectively). Continuous OT would be beneficial for adult patients with SAA, while boost of Omalizumab would worsen their long-term outcomes. Full article

This work presents a fall detection system that is worn on the head, where the acceleration and posture are stable such that everyday movement can be identified without disturbing the wearer. Falling movements are recognized by comparing the acceleration and orientation of a wearer’s head using prespecified thresholds. The proposed system consists of a triaxial accelerometer, gyroscope, and magnetometer; as such, a Madgwick’s filter is adopted to improve the accuracy of the estimation of orientation. Moreover, with its integrated Wi-Fi module, the proposed system can notify an emergency contact in a timely manner to provide help for the falling person. Based on experimental results concerning falling movements and activities of daily living, the proposed system achieved a sensitivity of 96.67% in fall detection, with a specificity of 98.27%, and, therefore, is suitable for detecting falling movements in daily life. Full article

This study proposes the approach of context-dependent data envelopment analysis (DEA) to measure operating performance in halfway houses to enable suitable adjustments at the current economic scale. The proposed approach can be used to discriminate the performance of efficient halfway houses and provide more accurate DEA results related to the performance of all halfway houses in a region or a country. The relative attractiveness and progress were also evaluated, and individual halfway houses’ competitive advantage and potential competitors could be determined. A case study of 38 halfway houses in Taiwan was investigated by our proposed approach. Findings suggest that fifteen halfway houses belong to the medium level, which can be classified into a quadrant by examining both their attractiveness score and progress score. The results can be used to allocate community resources to improve the operational directions and develop incentives for halfway houses with attractive and progressive values, which can reduce the institutionalization and waste of medical resources caused by the long-term hospitalization of patients with mental illnesses. Our proposed approach can also provide references for operators and policy makers to improve the management, accreditation, and resource allocation of institutions. Full article