Diamond is not only the hardest material in nature, but is also an extreme electronic material with an ultrawide bandgap, exceptional carrier mobilities, and thermal conductivity. Straining diamond ...can push such extreme figures of merit for device applications. We microfabricated single-crystalline diamond bridge structures with ~1 micrometer length by ~100 nanometer width and achieved sample-wide uniform elastic strains under uniaxial tensile loading along the 100, 101, and 111 directions at room temperature. We also demonstrated deep elastic straining of diamond microbridge arrays. The ultralarge, highly controllable elastic strains can fundamentally change the bulk band structures of diamond, including a substantial calculated bandgap reduction as much as ~2 electron volts. Our demonstration highlights the immense application potential of deep elastic strain engineering for photonics, electronics, and quantum information technologies.
Background. Many patients with cancer seek complementary and alternative medicine treatments. We investigated the use of traditional Chinese medicine (TCM) by adult cancer patients in Taiwan. ...Methods. We reviewed the Registry for Catastrophic Illness Patients Database of Taiwan, and included all adult patients diagnosed cancer, based on the International Classification of Diseases (ninth revision), from 2001 to 2009 and followed until 2011. This database allowed categorization of patients as TCM users (n = 74 620) or non-TCM users (n = 508 179). All demographic and clinical claims data were analyzed. Results. Compared with non-TCM users, TCM users were younger and more likely to be female, white-collar workers, and reside in highly urbanized areas. The average interval between cancer diagnosis and TCM consultation was 15.3 months. The most common cancer type was breast cancer in TCM users (19.4%), and intrahepatic bile duct cancer in non-TCM users (13.6%). The major condition for which TCM users visited clinics were endocrine, nutritional and metabolic diseases, and immunity disorders (23.2%). A total of 33.1% of TCM users visited TCM clinics more than 9 times per year and their time from diagnosis to first TCM consultation was 5.14 months. The most common TCM treatment was Chinese herbal medicine. The common diseases for which cancer patients sought TCM treatment were insomnia, malaise and fatigue, dizziness and headache, gastrointestinal disorders, myalgia and fasciitis, anxiety, and depression. Overall, TCM users had a lower adjusted hazard ratio (aHR) for mortality (aHR = 0.69, 95% CI = 0.68-0.70) after adjustment for age, sex, urbanization of residence, occupation, annual medical center visits, and annual non–medical center visits. Conclusions. This study provides an overview of TCM usage among adult cancer patients in Taiwan. TCM use varied among patients with different types of cancer. Physicians caring for cancer patients should pay more attention to their patients’ use of complementary TCM.
Background
We aimed to assess the latest prevalence and secular trend of Helicobacter pylori infection and its association with the incidence and mortality of gastric cancer in Taiwan.
Materials and ...Methods
Adults naive to H. pylori eradication received 13C‐urea breath test (13C‐UBT), H. pylori stool antigen test, and serology test during 2019–2020 in this prospective screening program. Children and adolescent aged between 7 and 19 years received 13C‐UBT for H. pylori screening. We also conducted a systematic review and meta‐analysis to assess the secular trend of prevalence of H. pylori from 1990 to 2020 in Taiwan. The secular trends of age‐standardized incidence and mortality of gastric cancer were obtained from the Taiwan Cancer Registry.
Results
A total of 1494 participants were enrolled, including 294 children or adolescents and 1200 adults. The overall prevalence of active H. pylori infection by 13C‐UBT was 26.6% (397/1494), which was 30.8% in adults and 9.5% in adolescents/children. The age‐standardized prevalence of active H. pylori infection was 32.3% in adults after adjustment of the population structure in Taiwan. Of the 29 studies including 38,597 subjects eligible for the meta‐analysis, the pooled prevalence of H. pylori infection decreased from 63.8% (95% CI: 55.9%–71%) in 1990–2000 to 28.2% (95% CI:21.8%–35.6%) in 2016–2020. The age‐standardized incidence and mortality of gastric cancer have also declined from 15.2 to 10.75 per 100,000, respectively, in 1999 to 9.29 and 5.4 per 100,000, respectively, in 2019.
Conclusions
The prevalence of H. pylori infection has declined in Taiwan, which correlates with the declining trends of age‐standardized incidence and mortality of gastric cancer in Taiwan.
Background: Pancreatic cancer is a difficult-to-treat cancer with a late presentation and poor prognosis. Some patients seek traditional Chinese medicine (TCM) consultation. We aimed to investigate ...the benefits of complementary Chinese herbal medicine (CHM) among patients with pancreatic cancer in Taiwan. Methods: We included all patients with pancreatic cancer who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 1997 and 2010. We used 1:1 frequency matching by age, sex, the initial diagnostic year of pancreatic cancer, and index year to enroll 386 CHM users and 386 non-CHM users. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time. Results: According to the Cox hazard ratio model mutually adjusted for CHM use, age, sex, urbanization level, comorbidity, and treatments, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.67, 95% CI = 0.56-0.79). Those who received CHM therapy for more than 90 days had significantly lower hazard ratios of mortality risk than non-CHM users (90- to 180-day group: adjusted HR = 0.56, 95% CI = 0.42-0.75; >180-day group: HR = 0.33, 95% CI = 0.24-0.45). The survival probability was higher for patients in the CHM group. Bai-hua-she-she-cao (Herba Oldenlandiae; Hedyotis diffusa Spreng) and Xiang-sha-liu-jun-zi-tang (Costus and Chinese Amomum Combination) were the most commonly used single herb and Chinese herbal formula, respectively. Conclusions: Complementary Chinese herbal therapy might be associated with reduced mortality among patients with pancreatic cancer. Further prospective clinical trial is warranted.
Background
Post-stroke hemiparesis strongly affects stroke patients’ activities of daily living and health-related quality of life. Scalp acupuncture (SA) is reportedly beneficial for post-stroke ...hemiparesis. However, there is still no standard of SA for the treatment of post-stroke hemiparesis.
Apriori
algorithm-based association rule analysis is a kind of “if-then” rule-based machine learning method suitable for investigating the underlying rules of acupuncture point/location selections. This study aimed to investigate the core SA combinations for the treatment of post-stroke hemiparesis by using a systematic review and
Apriori
algorithm-based association rule analysis.
Methods
We conducted a systematic review to include relevant randomized controlled trial (RCT) studies investigating the effects of SA treatment in treating patients with post-stroke hemiparesis, assessed by the Fugl-Meyer Assessment (FMA) score. We excluded studies using herbal medicine or manual acupuncture.
Results
We extracted 33 SA locations from the 35 included RCT studies. The following SA styles were noted: International Standard Scalp Acupuncture (ISSA), WHO Standard Acupuncture Point Locations (SAPL), Zhu’s style SA, Jiao’s style SA, and Lin’s style SA. Sixty-one association rules were investigated based on the integrated SA location data.
Conclusions
SAPL_GV20 (Baihui), SAPL_GV24 (Shenting), ISSA_MS6_i (ISSA Anterior Oblique Line of Vertex-Temporal, lesion-ipsilateral), ISSA_MS7_i (ISSA Posterior Oblique Line of Vertex-Temporal, lesion-ipsilateral), ISSA_PR (ISSA Parietal region, comprised of ISSA_MS5, ISSA_MS6, ISSA_MS7, ISSA_MS8, and ISSA_MS9), and SAPL_Ex.HN3 (Yintang) can be considered the core SA location combination for the treatment of post-stroke hemiparesis. We recommend a core SA combination for further animal studies, clinical trials, and treatment strategies.
Chronic obstructive pulmonary disease (COPD) is highly prevalent and a major burden on the healthcare system worldwide. It has a severe impact on patients due to poor health-related quality of life ...(HRQL), dyspnea, and exertional intolerance. Our previous meta-analysis revealed that body acupuncture therapy had adjuvant benefits of improving HRQL in COPD patients undergoing optimal medical treatment. Previous studies indicated that treatment with combinations of acupoints was more effective than single acupoint treatment. The association rule analysis has been widely used to explore relationships in acupoint combination. Therefore, we aimed to investigate the potential core acupoint combination in COPD treatment by mining the association rules from the retrieved randomized control trials (RCTs) of the previous meta-analyses. This study was conducted based on Apriori algorithm-based association rule analysis, which is a popular data mining method available in software R. We extracted acupoints as binary data from the 12 included RCTs for analysis. There were 27 acupoints extracted from 12 RCTs. The top 10 frequently selected acupoints were BL12, BL13, BL20, BL23, BL43, CV17, EXB1, LU5, LU7, and ST36. We investigated 2444 association rules, and the results showed that {ST36, BL12} ≥ {CV17}, {ST36, BL12} ≥ {EXB1}, {CV17, BL12} ≥ {ST36}, and {EXB1, BL12} ≥ {ST36} were the most associated rules in the retrieved RCTs. The acupoint combinations of ST36, BL12, and CV17 and ST36, BL12, and EXB1 could be considered as the core of acupoint combination for further acupuncture treatment of COPD.
Severe acute respiratory syndrome (SARS) is an emerging infectious disease caused by a novel human coronavirus. Viral maturation requires a main protease (3CLpro) to cleave the virus-encoded ...polyproteins. We report here that the 3CLpro containing additional N- and/or C-terminal segments of the polyprotein sequences undergoes autoprocessing and yields the mature protease in vitro. The dimeric three-dimensional structure of the C145A mutant protease shows that the active site of one protomer binds with the C-terminal six amino acids of the protomer from another asymmetric unit, mimicking the product-bound form and suggesting a possible mechanism for maturation. The P1 pocket of the active site binds the Gln side chain specifically, and the P2 and P4 sites are clustered together to accommodate large hydrophobic side chains. The tagged C145A mutant protein served as a substrate for the wild-type protease, and the N terminus was first digested (55-fold faster) at the Gln-1-Ser1 site followed by the C-terminal cleavage at the Gln306-Gly307 site. Analytical ultracentrifuge of the quaternary structures of the tagged and mature proteases reveals the remarkably tighter dimer formation for the mature enzyme (Kd = 0.35 nm) than for the mutant (C145A) containing 10 extra N-terminal (Kd = 17.2 nm) or C-terminal amino acids (Kd = 5.6 nm). The data indicate that immature 3CLpro can form dimer enabling it to undergo autoprocessing to yield the mature enzyme, which further serves as a seed for facilitated maturation. Taken together, this study provides insights into the maturation process of the SARS 3CLpro from the polyprotein and design of new structure-based inhibitors.
Stroke leads to tremendous impacts on patients and the healthcare system. It is crucial to explore the potential management of rehabilitation. Acupuncture and traditional Chinese herbal medicine ...(TCHM) integrated with conventional rehabilitation benefit post-stroke functional recovery.
We retrospectively reviewed the medical records of all patients included in the Integrated Traditional Chinese-Western Medicine care program for stroke (ITCWM-stroke care program) in 2019 in Taipei Tzu Chi Hospital to investigate the effects of acupuncture and TCHM integrated with conventional rehabilitation on National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI) scores before and after the program.
A total of 255 stroke inpatients were retrieved and divided into acupuncture and acupuncture + TCHM group by hemorrhagic and ischemic stroke types, respectively. All the patients were recruited in the program at the early subacute phase after stroke onset. Of the hemorrhagic and ischemic stroke subjects, the NIHSS and BI total scores were significantly improved in the acupuncture and acupuncture + TCHM groups. The subgroup analysis results showed that in subjects with a baseline BI score ≤ 40, the acupuncture + TCHM group significantly improved BI total score better than the acupuncture group in both hemorrhagic (
< 0.05) and ischemic (
< 0.05) stroke subjects.
Acupuncture and TCHM integrated with conventional rehabilitation significantly improve stroke patients' functional recovery at the early subacute phase. Acupuncture + TCHM contributes to better activities of daily living (ADL) improvements in stroke patients with a baseline BI score ≤ 40. We suggest integrating acupuncture and TCHM into the post-stroke rehabilitation strategy, especially for stroke patients with poor ADL function.
Abstract Atomically thin indium selenide (InSe) exhibits a sombrero-like valence band, leading to distinctive excitonic behaviors. It is known that the indirect band gap of atomically thin InSe leads ...to a weak emission from the lowest-energy excitonic state (A peak). However, the A peak emission of monolayer (ML) InSe was observed to be either absent or very weak, rendering the nature of its excitonic states largely unknown. Intriguingly, we demonstrate that ML InSe exhibits pronounced PL emission because of the efficient brightening of the momentum-indirect dark excitons. The mechanism is attributed to acoustic phonon-assisted radiative recombination facilitated by strong exciton-acoustic phonon coupling and extended wavefunction in momentum space. Systematic analysis of layer-, power-, and temperature-dependent PL demonstrates that a carrier localization model can account for the asymmetric line shape of the lowest-energy excitonic emission for atomically thin InSe. Our work reveals that atomically thin InSe is a promising platform for manipulating the tightly bound dark excitons in two-dimensional semiconductor-based optoelectronic devices.
Background:
Chronic obstructive pulmonary disease (COPD), which is a disease characterized by dyspnea, cough, and respiratory symptoms, leading to impaired health-related quality of life (HRQL) and ...exercise capacity, is highly prevalent worldwide. Some studies demonstrated that acupuncture point stimulation treatments (APSTs) are effective and safe in treating patients with COPD. The aim of this systematic review and network meta-analysis is to analyze the effects on HRQL and FEV1% predicted of diverse APSTs in treating patients with COPD.
Materials and Methods:
We searched seven electronic databases. Randomized controlled trials (RCTs) with stable COPD patients comparing APSTs and conventional treatment (Tx) were included. The primary outcome was HRQL measured by COPD Assessment Test or St. George's Respiratory Questionnaire. The secondary outcome was FEV1% predicted. We performed random effect network meta-analysis using a consistency model.
Results:
This network meta-analysis analyzed 21 RCTs with 1,577 stable COPD participants. In comparison with Tx, acupressure massage (AM) + Tx −5.11; 95% confidence interval (CI), −6.65 to −3.57 was the most effective intervention in improving HRQL, followed by moxibustion (Mx) + Tx (−2.86; 95% CI, −3.86 to −1.86). Moreover, in comparison with Tx, Mx + Tx (7.79; 95% CI, 2.16 to 13.42) was the most effective intervention in improving FEV1% predicted, followed by acupuncture (A) + Tx (5.79; 95% CI, 2.90 to 8.68).
Conclusions:
Combined interventions (APSTs + Tx) are more effective than single intervention in improving both HRQL and FEV1% predicted. AM, Mx, and A can be considered effective non-pharmacological complementary interventions in treating patients with COPD under Tx.
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