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Information systems (IS) have facilitated workflow in the health care system for years. However, the utilization of IS in disaster medical assistance teams (DMATs) has been less studied.
In Taiwan, we started a program in 2008 to build up an information system, MEDical Assistance and Information Dashboard (MED-AID), to improve the capability and increase the efficiency of our national DMAT.
Method: The mission of our national DMAT was to provide acute trauma care and subacute outpatient care in the field after an emergency event (e.g., earthquakes). We built the IS through a user-oriented process to fit the need of the DMAT. We first analyzed the response work in the DMAT missions and reviewed the current paperwork. We evaluated the eligibility and effectiveness of the core functions of DMATs by experts in Taiwan and then developed the IS. The IS was then tested and revised each year in two table-top exercises and one regional full-scale exercise by the DMAT staffs who came from different hospitals in Taiwan.
During the past 10 years, we identified several core concepts of IS of DMAT: patient tracking, medical record, continuity of care, integration of referral resources, disease surveillance, patient information reporting, and medical resources management. The application of the IS facilitate the DMAT in providing safe patient care with continuous recording and integrate patient referral resources based on geographic information. The IS also help the planning in real-time disease surveillance and logistic function in the medical resources monitoring.
Information systems could facilitate patient care and relieve the workload on information analysis and resources management for DMATs.
Apathy is a condition characterized by a lack of motivation that manifests in emotional, behavioral, and cognitive domains. Although previous studies have indicated that apathy is associated with frontal lesions, few studies have focused on the different subdomains of apathy, and no in vivo human biochemical data have been obtained to examine the neurochemical changes related to apathy in patients with Alzheimer's disease (AD). Thus, we investigated the frontal neurochemical alterations related to apathy among patients with AD using proton magnetic resonance spectroscopy (1H MRS).
Apathy was assessed through the Apathy Evaluation Scale (AES). 1H MRS was performed to measure neurochemical metabolite levels in the anterior cingulate region and right orbitofrontal region. Associations between neurochemical metabolites and the total score and subscores of each domain of the AES were analyzed.
Altogether, 36 patients completed the study. Patients with lower N-acetylaspartate/creatine ratios (NAA/Cr) in the anterior cingulate region demonstrated higher total apathy scores (β = −0.56, p = 0.003) with adjustments for age, gender, educational level, dementia severity, and depression severity. In a further analysis, a lower NAA/Cr in the anterior cingulate region was associated with all subdomains of apathy, including cognition (β = −0.43, p = 0.028), behavior (β = −0.55, p = 0.002), and emotion (β = −0.50, p = 0.005). No statistically significant associations were discovered in the right orbitofrontal region.
Our results suggest that apathy, in each of its cognitive, behavioral, or emotional subdomains is associated with brain neurochemical alterations in the anterior cingulate region. Abnormal neuronal integrity over the anterior cingulate cortex may exhibit a central role in causing all aspects of apathy in patients with AD.
Novel mixed micelle was successfully fabricated by the synergistic self-assembly of poly(methacrylate isobutyl polyhedral oligomeric silsesquioxane (POSS)-co-N-isopropylacrylamide-co-oligo(ethylene glycol)methyl ether methacrylate-co-acrylic acid) (P(methacrylate isobutyl (MAPOSS)-co-NIPAM-co-OEGMA-co-AA)) and poly(methacrylate isobutyl POSS-co-N-isopropylacrylamide-co-oligo(ethylene glycol) methyl ether methacrylate-co-2-vinylpyridine) (P(MAPOSS-co-NIPAM-co-OEGMA-co-2VP)). Dynamic light scattering (DLS) and transmission electron microscopy characterizations demonstrate that the formation of mixed micelles is driven by electrostatic interaction. The formation of the mixed micelles was further implied by a simple fluorescence resonance energy transfer based technique. The mixed micelle possesses the biggest size at pH = 7.0, which is attributed to the strongest electrostatic interaction between the two kinds of micelles. The zeta potential under different pH was detected to further investigate the surface charges corroborating the discussions. DLS and UV-vis indicate that the lower critical solution temperature (LCST) is pH dependent. The mixed micelles reach the highest LCST at pH 7.0. The LCST of the mixed micelle can be tuned by adjusting the volume ratio of the two kinds of micelles as well. Moreover, the thermo-responsive behavior of the mixed micelle is absolutely reversible.
Obesity and hyperlipidaemia increase the risk of CVD. Some strains of probiotics have been suggested to have potential applications in cardiovascular health by lowering serum LDL-cholesterol. In this work, high-fat diet-induced hyperlipidaemia in hamsters was treated with different doses (5×108 and 2·5×109 cells/kg per d) of heat-killed Lactobacillus reuteri GMNL-263 (Lr263) by oral gavage for 8 weeks. The serum lipid profile analysis showed that LDL-cholesterol and plasma malondialdehyde (P-MDA) were reduced in the GMNL-263 5×108 cells/kg per d treatment group. Total cholesterol and P-MDA were reduced in the GMNL-263 2·5×109 cells/kg per d treatment group. In terms of heart function, the GMNL-263 2·5×109 cells/kg per d treatments improved the ejection fraction from 85·71 to 91·81 % and fractional shortening from 46·93 to 57·92 % in the high-fat diet-fed hamster hearts. Moreover, the GMNL-263-treated, high-fat diet-fed hamster hearts exhibited reduced Fas-induced myocardial apoptosis and a reactivated IGF1R/PI3K/Akt cell survival pathway. Interestingly, the GMNL-263 treatments also enhanced the heat-shock protein 27 expression in a dose-dependent manner, but the mechanism for this increase remains unclear. In conclusion, supplementary heat-killed L. reuteri GMNL-263 can slightly reduce serum cholesterol. The anti-hyperlipidaemia effects of GMNL-263 may reactivate the IGF1R/PI3K/Akt cell survival pathway and reduce Fas-induced myocardial apoptosis in high-fat diet-fed hamster hearts.
Understanding solvent transport in polymers is of practical importance for the applications of polymers in the fields of food packaging, biomedical bandages, materials engineering, etc. We studied one-side desorption in poly(methyl methacrylate) (PMMA). Experimental results showed that methanol desorption in PMMA depended on temperature and the initial distribution of concentration. The diffusion coefficient in PMMA and the evaporation rate of methanol across the PMMA surface followed the Arrhenius relation. The activation energies for the diffusion and the evaporation of methanol are 18.3, 42.6 and 8.6, 18.3 kJ/mol for the specimens with the ratio of initial mass to the equilibrium saturated absorbed mass, Mi/M∞, being 14.6% and 35.3%, respectively. The partial molal volume increased with the increase of the desorption temperature for Mi/M∞ = 14.6%, while it had an opposite trend for Mi/M∞ = 35.5%. The chemical stresses developed in PMMA during the desorption were also studied.
Cancer is a serious public health problem worldwide, and its relationship
with affective disorders is not clear.
To investigate alcohol- and tobacco-related cancer risk among patients
with affective disorders in a large Taiwanese cohort.
Records of newly admitted patients with affective disorders from January
1997 through December 2002 were retrieved from the Psychiatric Inpatient
Medical Claims database in Taiwan. Cancers were stratified by site and
grouped into tobacco- or alcohol-related cancers. Standardised incidence
ratios (SIRs) were calculated to compare the risk of cancer between those
with affective disorders and the general population.
Some 10 207 patients with bipolar disorder and 9826 with major depression
were included. The risk of cancer was higher in patients with major
depression (SIR = 2.01, 95% CI 1.85–2.19) than in those with bipolar
disorder (SIR 1.39, 95% CI 1.26–1.53). The elevated cancer risk among
individuals ever admitted to hospital for affective disorders was more
pronounced in tobacco- and/or alcohol-related cancers.
Elevated cancer risk was found in patients who had received in-patient
care for affective disorders. They require holistic approaches to
lifestyle behaviours and associated cancer risks.
A novel allergy biosensor is designed and fabricated by using thin film bulk acoustic resonator (TFBAR) devices with shear mode ZnO piezoelectric thin films. To fabricate TFBAR devices, the off-axis RF magnetron sputtering method for the growth of piezoelectric ZnO piezoelectric thin films is adopted. The influences of the relative distance and sputtering parameters are investigated. In this report, the piezoelectric ZnO thin films with tilting angle are set by controlling the deposition parameters. The properties of the shear mode ZnO thin films are investigated by X-ray diffraction and scanning electron microscopy. The frequency response is measured using an HP8720 network analyzer with a CASCADE probe station. The resonance frequency of the shear mode is 796.75 MHz. The sensitivity of the shear mode is calculated to be 462.5 kHz·cm2/ng.
This paper reports a novel means of integrating a high-performance dual-modal ZnO piezoelectric transducer with a flexible stainless steel substrate (SUS304) to construct dual-modal vibration-power transducers. To fabricate vibration-power transducers, the off-axis RF magnetron sputtering method for the growth of ZnO piezoelectric thin films is adopted. The stainless steel substrate has a higher Young’s modulus than those of the other substrates, and behaves the long-term stability under vibration. The transducer includes a ZnO piezoelectric thin film deposited on the stainless steel substrate combined with Pt/Ti layers at room temperature, which is fabricated by an RF magnetron two-step sputtering system. In this report, the ZnO piezoelectric thin films deposited with the tilting angle of 34° are set by controlling the deposition parameters. Scanning electron microscopy and X-ray diffraction of ZnO piezoelectric thin films reveal a rigid surface structure and a high dual-modal orientation. To investigate the generating characteristics of the dual-modal transducer, two basic experiments of longitudinal and shear modes are carried out. Based on cantilever vibration theory, the cantilever length of 1 cm and a vibration area of 1 cm2 are used to fabricate a transducer with a low resonant-frequency of 65 Hz for the natural vibration. A mass loading at the front-end of the cantilever is critical to increase the amplitude of vibration and the power generated by the piezoelectric transducer. The maximum open circuit voltage of the power transducer is 19.4 V.
Unawareness of deficits is common and is associated with poor outcomes in Alzheimer's disease (AD); however, little is known about correlated neurobiochemical changes.
Proton magnetic resonance spectroscopy was used to examine neurobiochemical correlates of unawareness of deficits as assessed by the Dementia Deficit Scale in 36 patients with AD. Magnetic resonance spectroscopy spectra were acquired from the anterior cingulate area and right orbitofrontal area. Concentrations of N-acetyl-aspartate (NAA), total creatine, and other neurometabolites were calculated.
Nineteen (52.8%) participants had relative unawareness of deficits. This condition was negatively correlated with NAA/creatine in the anterior cingulate area (β = −0.36, p = 0.025) and positively correlated with NAA/creatine in the right orbitofrontal area (β = 0.41, p = 0.009) after controlling for dementia severity.
These findings suggest unawareness of deficits in AD was associated with the altered neurochemical metabolites in the anterior cingulate area and right orbitofrontal area. However, the two areas might have opposite neuronal functions in unawareness of deficits.
Three types of Ganium Nitride (GaN) transistors were studied in this work. The devices were fabricated and exhibited unique characteristics over on-state current and off-state blocking performances. We also compared the performance differences of devices fabricated by multiepitaxial GaN/AlGaN layers on different substrates (Sapphire and Si) and evaluated the correlations among starting substrate, device variation, and manufacturing uniformity. The first device is a normally-on device with Sapphire substrate which shows good drain saturation current (Idsat) and breakdown characteristics, but the gate leakage current is quite large. The second device is a normally-off GaN transistor named metal-insulate-semiconductor (MIS) heterojunction field-effect transistor (MIS-HFET) which exhibits good performance with threshold voltage (Vth) of 3V and breakdown voltage (Vbd) of over 1800V. However the third device is a normally-off GaN metal-oxide-semiconductor field-elect transistor (MOSFET) structure which is rather difficult to exhibit good blocking characteristic due to inadequate doping process control of the reduce-surface-field (RESURF) region.
We have developed a fabrication procedure for growing photonic crystals in the lithographic defined microchannels, which enables easy integration with other planar optical components. This technique is based on the directed evaporation induced self-assembly of nanoparticles in the microchannels. Substrates with pre-patterned microchannels (30-100 μm wide) were dipped into solution of nanoparticles for several days. By controlling the evaporation rate, the meniscus contacting the microchannels will undergo evaporation-induced self-assembly. The capillary forces cause nanospheres to crystallize within the microchannels forming colloidal photonic crystals in the microchannels. Two types of colloidal particles, polystyrene and silica, have been employed to fabricate colloidal photonic crystals in the microchannels. Both types of colloidal particles were found to form large-area well-ordered colloidal single crystals in the microchannels. The optical reflection spectra from the (111) surfaces of the colloidal crystals formed by various sizes of nanoparticles have been measured. And the measured reflection peaks agree with the photonic bandgap calculated by the plane wave expansion method.
The optimized N2O fluence is demonstrated for plasma enhanced chemical vapor deposition (PECVD) of Si-rich substoichiometric silicon oxide (SiOx) films with buried Si nanocrystals. Strong room-temperature photoluminescence (PL) at 550-870 nm has been observed in SiOx films grown by PECVD under a constant SiH4 fluence of 20 sccm with an N2O fluence varying from 105 sccm to 130 sccm. A 22-nm-redshift in the central PL wavelength has been detected after annealing from 15 min to 180 min. The maximum PL irradiance is observed from the SiOx film grown at the optimal N2O fluence of 120 sccm after annealing for 30 minutes. Larger N2O fluence or longer annealing time leads to a PL band that is blue-shifted by 65 nm and 20 nm, respectively. Such a blue shift is attributed to shrinkage in the size of the Si nanocrystals with the participation of oxygen atoms from N2O incorporated within the SiOx matrix. The (220)-oriented Si nanocrystals exhibit radii ranging from 4.4 nm to 5.0 nm as determined by transmission electron microscopy (TEM). The luminescent lifetime lengthens to 52 μs as the nc-Si size increase to > 4 nm. Optimal annealing times for SiOx films prepared at different N2O fluences are also reported. A longer annealing process results in a stronger oxidation effect in SiOx films prepared at higher N2O fluences, yielding a lower PL irradiance at shorter wavelengths. In contrast, larger Si nanocrystals can be precipitated when the N2O fluence becomes lower; however, such a SiOx film usually exhibits weaker PL at longer wavelength due to a lower nc-Si density. These results indicate that a N2O/SiH4 fluence ratio of 6:1 is the optimized PECVD growth condition for the Si-rich SiO2 wherein dense Si nanocrystals are obtained after annealing.
In this work, we report on the growth of ultraviolet (UV) AlGaN/GaN multiple quantum wells (MQWs) structure using atomic layer deposition (ALD) technique. The AlGaN/GaN MQW sample grown on the sapphire substrate consisted of three GaN QWs and four AlGaN barriers comprised AlN/GaN superlattices (SLs). The root-mean-square value of the surface morphology was only 0.35 nm observed from the atomic force microscope image and no crack was found on the surface. Both of the high resolution X-ray diffraction curves and transmission electron microscope images showed sharp interfaces between SLs layers and QWs with good periodicity. These results demonstrate that the ALD could be a very useful technique for controlling the crystalline quality and thickness of the III-nitride epilayer.
Highy-quality nano-structured ZnO samples have been synthesized by simple chemical solution and post-thermal treatment. The samples were characterized by x-ray diffraction (XRD), scanning electron microscope (SEM), transmission electron microscope (TEM), temperature-dependent photoluminescence (PL) spectra measurements. XRD patterns illustrated that there were no second phases in these ZnO samples, and the TEM results indicated that the ZnO samples are single crystalline with a hexagonal structure. Room-temperature PL spectra of ZnO thin films showed a strong UV near-band-edge (NBE) emission located at about 390 nm and a green defect-related (G) emissions, where the intensity ratio (INBE/IG) varies with the annealing temperatures. Meanwhile, the ZnO samples exhibited free exciton and very sharp exciton emissions at low temperatures. Particularly, room-temperature UV random lasing characteristic of ZnO films has been observed as well. It is shown that these nano-structured ZnO samples can exhibit random laser action depending on the growth condition. The threshold intensity for the lasing is comparable to earlier reported data. These results indicate that nano-structured ZnO samples prepared by simple techniques may be a promising material for further photonic devices. Possible lasing mechanism is discussed and further investigation to clarify the mechanism between the nano-structured ZnO samples is still underway.
We report on a method based on cross-sectional scanning photoelectron microscopy and spectroscopy (XSPEM/S) for studying electronic structure of III-nitride surfaces and interfaces on a submicrometer scale. Cross-sectional III-nitride surfaces prepared by in situ cleavage were investigated to eliminate the polarization effects associated with the interface charges/dipoles normal to the cleaved surface. In contrast to the as-grown polar surfaces which show strong surface band bending, the cleaved nonpolar surfaces have been found to be under the flat-band conditions. Therefore, both doping and compositional junctions can be directly visualized at the cleaved nonpolar surfaces. Additionally, we show that the “intrinsic” valence band offsets at the cleaved III-nitride heterojunctions can be unambiguously determined.
The present study aimed to investigate genetic and environmental influences on behavioral problems, personality features, and neuropsycho-logical performance among adolescents in Taipei, Taiwan. Between 1996 and 1998, with the assistance of the Twin Association and junior high schools in Taipei City, we solicited a list of twins from 51 junior high schools in Taipei. Names, addresses, and telephone numbers of the twins enrolled in these schools were obtained. The vast majority of the recruited twins were between 12 and 16 years old. The recruited twins received assessments for behavioral problems, general and schizotypal personality, and cognitive functions. Their parents rated their children on behavioral/ emotional problems and were assessed on their own general and specific personality. Same-sex sibling pairs (ages vary within 2 years) and their parents from three schools were also recruited to increase sample size for the group with a kinship coefficient of .50. Twins' zygosity was determined by a combination of DNA typing and physical similarity. The Mx program was used to estimate parameters for the full model and its reduced models. The recruitment, measurements, data managements, and published results are described in this article.