Background: Intravenous Immunoglobulin (IVIg) use for Central Nervous System (CNS) conditions has increased over the last decade. In many CNS disorders, robust evidence for IVIg efficacy is still lacking. Building on the success of the British Columbia (BC) Neuromuscular IVIg utilization initiative, Guidelines for IVIg use in CNS conditions were developed. A provincial screening program was launched in 2023. Methods: For CNS IVIg, requests, diagnosis, dosing, consultation letters and treatment questionnaires were reviewed. Patient management was compared to provincial guidelines. A letter was sent to the ordering physician with the results of the review and treatment recommendations when management differed significantly from guidelines. Review of the first year’s cases was conducted. Results: Over the first 11 months of the program, 79 IVIg renewal requests were reviewed. The most common diagnoses were antibody mediated autoimmune encephalitis, severe drug resistant non-surgical epilepsy and Susac’s syndrome. Recommendations included dose reduction, discontinuation of IVIg, or initiation of alternative therapies for many of the requests. Conclusions: IVIg may be effective in the management of some CNS inflammatory conditions. A physician-led utilization program in BC with targeted education to ordering physicians promotes best practice. Review of year one data will inform a quality improvement cycle to optimize the guidelines.

Types of sugar-sweetened beverages (SSB) can differ greatly between countries, with greater consumption of sweetened tea in Asia. This study aimed to understand changes in SSB consumption by adolescents in Taiwan over 18 years and their association with demographic characteristics and clinical outcome. This study used survey data from the 1993–1996 and 2010–2011 Nutrition and Health Surveys in Taiwan. Participants were high school students aged 13 to 18 years. Data were weighted and analysed using SUDAAN 11.0 and SAS 9.4. Participants were asked about intake frequencies of SSB and were grouped into four different SSB intake groups based on the combination of high or low frequency (including moderate frequency) of intake of sweetened tea and soda/sports/energy drinks. Results indicated over 99 % of teens reported having at least one SSB in the past week. Smoking status was significantly associated with SSB intake types with high tea intake (high tea and low soda (HL) group, OR 7·56, P < 0·001; high tea and high soda (HH) group, OR 9·96, P < 0·001). After adjustment for potential confounders, adolescents in the low tea and high soda (LH) group (β = 0·05, P = 0·034) had significantly higher mean serum uric acid values. In conclusion, sugary tea remains the SSB of choice for Taiwanese adolescents. Those with a frequent intake of soda/sports/energy drinks had a higher chance of being hyperuricaemic.

Two solid state anaerobic digesters (SSADs), 15 L each, were set up for co-digestion of switchgrass with primary digestate of a liquid anaerobic digester (LAD) and the recirculating leachate. Both the LAD and two SSADs were operated at 50°C. The results showed that the bioreactors were not started up stably until day 16 and day 47 for reactors A and B, respectively. The supplement of LAD digestate or injection of sodium hydroxide (NaOH) into the recirculating leachate readily reinitiated the biogas production to normal daily high rates of the two individual SSADs, one on day 16 and the other on day 47. In contrast to reactor A, there was a longer lag phase for bioreactor B, however, it showed 46.2% [77.9 vs 53.3 L kg−1 volatile solid (VS)] more cumulative biogas yields, and higher reduction rate of total solid, VS, cellulose and hemicellulose of 29.5, 31, 40.6 and 15%, respectively, which was likely due to optimized pH and NaOH pretreated switchgrass during start-up period. Methane contents of biogas increased gradually and stabilized at 50% for both reactors, indicating a normal operation of anaerobic digestion lasted for at least 100 days. The determined parameters of digested residues met China organic fertilizer standard (NY 525-2012) except for high moisture and low total nutrient contents. Therefore, the product of SSAD has the potential value of organic fertilizer. It is concluded that the LAD digestate can be reused as inoculums by co-digestion with agricultural residues for biogas and organic fertilizer production in SSAD.

In order to analyze the boiling and capillary limitations of two-phase heat transport devices, the existing models developed by Chi and Peterson and the existing experimental data carried out with various micro channel wick structures from literature were collected for benchmark. It was found that the dominant parameters for boiling and capillary limitations were the nucleation sites and structure geometries of the micro channels, and important parameters were considered to modify the models empirically. It was also found that for micro channel structures the inclined angle is sensitive to the capillary limitations and not to boiling limitations. By properly estimating the nucleation sites and empirical coefficients for micro channels needed by the newly modified models, the boiling and capillary limitations can be accurately predicted, and hence the applicability of the modified models is confirmed. Based on this, a numerical analysis was then carried out to investigate the trends of boiling and capillary limitations of the micro channel wick structures. Effects of the channel geometries and arrangement were taken into account, including the aspect ratio and structure size of the micro channels. Furthermore, the effects of inclined angle and contact angle were also analyzed. The present results can provide a design reference of performance trends of micro channel wick structures.

The stellar growth of Taiwan's personal-computer (PC) industry over the past three decades represents a paradox. Participating in the global production system, local firms in Taiwan grew in association with established firms in the West. Despite their technical know-how, manufacturing prowess, and size, most leading Taiwanese firms did not develop their own capabilities in branding and marketing. A close examination of the historical evolution of the industry reveals that interactions with established companies in the West, in addition to local competition, decisively shaped capability development among latecomer firms. A few firms in Taiwan that eventually joined the ranks of global PC brands had been investing in marketing early, guided by a strategic vision rather than near-term economic calculation.

Impulsive loading by the ground reaction force (GRF) around heelstrike during walking is closely related to joint degeneration and might be affected by joint movement of the locomotor system. Fifteen healthy males (age: 25.5 ±3 years) were studied to investigate the association between the quantitative joint angles, angular velocities and accelerations of the lower-limb joints, and the loading rates of the GRF. Apart from the gait speed, both the ipsilateral kinematics during the swing phase, and the contralateral kinematics around the beginning of the terminal double limb stance (DLS), may significantly contribute to the heelstrike and maximum loading rates of the GRF. The magnitude of the heelstrike impulsive GRF was particularly affected by the peak ankle dorsiflexion velocity during the swing phase of the ipsilateral limb. However, for generating the maximum loading rate of nearly eight times the magnitude of that of the heelstrike one needed more kinematic variables to be modulated in advance, especially the knee flexion velocities around the beginning of the terminal DLS of the contralateral limb. Knowledge of the joint mechanics of the locomotor system for controlling the magnitude of the impulsive GRF during normal walking might be helpful for gait retraining for the elderly or patients who might have excessive impulsive GRF and a high risk of joint degeneration.

The purpose of this study was to understand the seasonal, geographical and clinical characteristics of Taiwanese patients hospitalized for non-typhoidal Salmonella (NTS) infections and their economic burden. Hospital data obtained from the Taiwan National Health Insurance (NHI) database between 2006 and 2008 were analysed. Infants had the highest annual incidence of 525 cases/100 000 person-years. Elderly patients aged >70 years had the highest in-hospital mortality rate (2·6%). Most (82·6%) gastroenteritis occurred in children aged <10 years. Septicaemia, pneumonia, arthritis and osteomyelitis occurred mainly in patients aged >50 years. A median medical cost for NTS-associated hospitalizations was higher for patients with septicaemia than for those with gastroenteritis. Seasonal variation of NTS-associated hospitalizations was correlated with temperature in different areas of Taiwan. In summary, infants had a high incidence of NTS-associated hospitalizations. However, the elderly had a higher in-hospital mortality rate and more invasive NTS infections than children.

Non-typhoidal Salmonella (NTS) is a common pathogen causing foodborne infections, bacteraemia, and extra-intestinal focal infections (EFIs) in humans. The study compares the clinical characteristics of elderly patients with NTS bacteraemia with those of young adults. Of 272 adults with NTS bacteraemia identified in this study, 162 (59·6%) were aged ⩾55 years. EFIs were observed in 36% of the 162 patients. The most common EFIs in the elderly patients (⩾55 years) was mycotic aneurysm, followed by pulmonary infections and bone/joint infections. Elderly patients more often had chronic heart, lung, renal and malignant diseases, had more EFIs, and a higher 30-day mortality rate. Independent factors of 30-day mortality in elderly patients were solid-organ tumour [adjusted odds ratio (aOR) 4·4, P=0·003], mycotic aneurysm (aOR 3·7, P=0·023) and shock (aOR 12·1, P<0·0001). HIV infection, autoimmune diseases, and receipt of immunosuppressive therapy were more often observed in young patients.

Flat heat pipes having mesh capillaries were investigated experimentally in this study. An apparatus was designed to test thermal performance of plate type copper water heat pipe having one or two layers of #50 or #80 mesh capillary structures with 5 to 50 W heat input. The working fluid, water, is charged in volumes equivalent to 25%, 33%, or 50% of the internal space. In addition to horizontal orientation, heat pipes were tested with the evaporator section elevated up to 40 degree inclination angle. Temperature distribution of the heat pipe was measured, and the evaporator, adiabatic and condensation resistances were calculated separately. The effects of mesh size, charge volume fraction, and inclination angle on thermal resistance were discussed. In general, the #80 mesh yielded lower thermal resistance than the #50 mesh. Inclination angle has a more significant effect on condenser than evaporator. Analysis of evaporation and condensation in flat heat pipes was conducted and semi-empirical correlations were derived. The present evaporation correlation predicts evaporation resistance between −20% and +30%, and the condensation correlation predicts most condensation resistance data within ±30% for 25% and 33% charge volume fraction.

External wrist fixators have been widely used to stabilize distal radial fractures. Ideally an external fixator would create a stable environment for the fracture to heal while allowing proper mobility for the wrist. However, this has been a great challenge to the designers.

The current study aimed to develop a bridging wrist external fixator that is easy for surgeons to create a stable environment for the fracture to heal while allowing proper wrist mobility for rehabilitative purposes. The kinematic geometry of the wrist-fixator system was described using loop equations defined by homogeneous transformation matrices (HTM) of the joints involved, and was evaluated numerically for a set of system parameters that are determined by surgeons during surgery. The results were validated with geometric models and computer simulation. The contributions of individual clinical parameters to the kinematic geometry of the wrist-fixator system were also analyzed using the Taguchi method.

Adequate pin placement and hinge alignment function were found to be critical for the postoperative bridged wrist motion. The results of the current study will be helpful for surgeons to perform fixation using the new wrist fixator and for designers to design new fixators in the future.

This study investigates the problem of non-Newtonian liquid evaporation from an impermeable vertical plate in a porous medium under mixed convection conditions. The analysis examines the effects of non-Darcian flow phenomena on the evaporation process and investigates the heat and mass transfer characteristics under a range of flow conditions in the aiding and opposing flow types. The parameters of interest include Rak,non, Pex,non, Pr and Sc. The data required for the calculations include a fixed wall temperature of Tw = 45°C, a free flow temperature of T∞ = 20°C and an air free flow rate of u∞ = 4m/sec and the corresponding humidity of 50% flows over fixed temperature and moist wall.

The results indicate that an increasing buoyancy force enhances the mixing effect and therefore improves the rate of heat transfer, the latent heat flux is the primary mode of heat transfer in evaporation processes and the velocity gradient at the wall increases with an increasing buoyancy effect. Furthermore, the evaporation rate increases with a reducing flow index and an increasing buoyancy effect.

The aim of the study was to elucidate the epidemiological features of Hepatitis C virus (HCV) infection among teenagers in an endemic area by conducting a mass screening study. We also investigated the clinical outcome of the anti-HCV-positive subjects by conducting subsequent short-term and long-term follow-up studies. All 2837 students of two junior middle schools in Tzukuan, aged 13–16 years, were invited to be screened for anti-HCV, HBsAg, AST and ALT in October 1995. A total of 2726 (96%) students responded. Anti-HCV, HCV RNA and aminotransferase levels were evaluated among anti-HCV-positive students 1 month and 30 months later, respectively. A total of 38 (1·4%; M/F = 22/16) participants were anti-HCV-positive. The anti-HCV-positive students had higher rates of exposures to transfusion, anti-HCV-positive families and surgery. The prevalence (2·8%) of the 7 maritime villages was markedly higher than that (0·7%) of the other 8 villages (P < 0·001). Subsequent follow-up studies demonstrated that there might be 5 cases of acute or recent HCV infection, and 6 cases who had recovered from chronic HCV infection.

Mycoplasma fermentans is suspected in the development of ‘Gulf War illness’ in veterans of Operation Desert Storm. We conducted a matched case-control study for the prevalence of M. fermentans-specific antibodies before and after the operation, as well as seroconversion rates in veterans with and without complaints of ‘Gulf War illness’. Cases consisted of Gulf War veterans, who complained of various illnesses and were enrolled in the second phase of the health evaluation by the Army Comprehensive Clinical Examination Program (CCEP). Controls were selected from Gulf War veterans who did not participate in the registry and did not request a health evaluation by the CCEP. Before operation deployment, 34 out of 718 of the cases (4·8%) and 116 out of 2233 of the controls (5·2%) tested positive for M. fermentans-specific antibodies. There was no difference in rates of seroconversion between cases and controls (1·1 vs. 1·2%) to M. fermentans during Operation Desert Storm. Thus, there is no serological evidence that suggests infection by M. fermentans is associated with development of ‘Gulf War illness’.

Well-aligned carbon nitride nanotubes were prepared with a porous alumina membrane as a template when using electron cyclotron resonance (ECR) plasma in a mixture of C2H2 and N2 as the precursor with an applied negative bias to the graphite sample holder. The hollow structure and good alignment of the nanotubes were verified by field-emission scanning electron microscopy. Carbon nitride nanotubes were transparent when viewed by transmission electron microscopy, which showed that the nanotubes were hollow with a diameter of about 250 nm and a length of about 50–80 μm. The amorphous nature of the nanotubes was confirmed by the absence of crystalline phases arising from selected-area diffraction patterns. Both Auger electron microscopy and x-ray photoelectron spectroscopy spectra indicated that these nanotubes are composed of nitrogen and carbon. The total N/C ratio is 0.72, which is considerably higher than other forms of carbon nitrides. No free-carbon phase was observed in the amorphous carbon nitride nanotubes. The absorption bands between 1250 and 1750 cm−1 in Fourier transform infrared spectroscopy provided direct evidence for nitrogen atoms, effectively incorporated within the amorphous carbon network. Such growth of well-aligned carbon nitride nanotubes can be controlled by tuning the ECR plasma conditions and the applied negative voltage to the alumina template.

We proposed a concise and novel scheme to determine the crystallographic misorientation of heteroepitaxial structures. In addition to subtle high-resolution transmission electron microscope images, the information revealed from selected-area diffraction patterns at the interfaces offers another path to determine the angles of misorientations. The principle is to extract the basically three-dimensional misorientation information from a two-dimensional selected-area diffraction pattern through the employment of the Laue circle

Co-sputtering has been used to fabricate equiatomic thin films of TiNi, a shape memory alloy, which form the basis of microactuators with many applications in MEMS. The stress evolution of TiNi films will be described. The performance of the TiNi actuators has been characterized, with regards to actuation force, recoverable strain, time response, and fatigue resistance. The performance of microvalves using these actuators will also be presented.