Increased risk of sudden sensorineural hearing loss in patients with cervical spondylosis.

Whether cervical spondylosis (CS) is a risk factor for sudden sensorineural hearing loss (SSNHL) remains unclear. This study used national population-based data to investigate the risk of SSNHL in patients with CS in Taiwan of different ages and sexes. This study used data covering 2 million people in Taiwan, which were obtained from the National Health Insurance Research Database. The data that support the findings of this study are available from National Health Insurance Research Database but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the corresponding authors upon reasonable request and with permission of National Health Insurance Research Database. This retrospective cohort study enrolled 91,587 patients with a newly diagnosed CS between January 2000 and December 2018. Case and control cohorts were matched 1:1 according to age, sex, and comorbidities. SSNHL incidence rate and risk were compared between the groups. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). The mean follow-up period was 8.80 (SD = 4.12) and 8.24 (SD = 4.09) years in the CS and control cohorts, respectively. The incidence rate of SSNHL in the CS cohort (85.28 per 100 000 person-years) was 1.49-fold significantly higher than that in the non-CS cohort (57.13 per 100,000 person-years) (95% CI 1.32-1.68, P < .001). After age, sex, and selected comorbidities were adjusted for, CS exhibited an independent risk factor for SSNHL (adjusted HR = 1.52; 95% CI 1.34-1.71, P < .001). An age-stratified analysis in this study demonstrated a strong and highly significant association between CS and SSNHL in patients aged < 35 years (IRR = 2.28, 95% CI 1.18-4.39, P = .013). This large-scale Taiwanese-population-based retrospective study found that CS was associated with an increased risk of SSNHL. Acute hearing loss in patients with CS, particularly at a young age, should be carefully evaluated, and prompt treatment for SSNHL should be initiated.

Multilayer dielectric reflector using low-index nanolattices.

Dielectric mirrors based on Bragg reflection and photonic crystals have broad application in controlling light reflection with low optical losses. One key parameter in the design of these optical multilayers is the refractive index contrast, which controls the reflector performance. This work reports the demonstration of a high-reflectivity multilayer photonic reflector that consists of alternating layers of TiO2 films and nanolattices with low refractive index. The use of nanolattices enables high-index contrast between the high- and low-index layers, allowing high reflectivity with fewer layers. The broadband reflectance of the nanolattice reflectors with one to three layers has been characterized with peak reflectance of 91.9% at 527 nm and agrees well with theoretical optical models. The high-index contrast induced by the nanolattice layer enables a normalize reflectance band of Δλ/λo of 43.6%, the broadest demonstrated to date. The proposed nanolattice reflectors can find applications in nanophotonics, radiative cooling, and thermal insulation.

Modeling the co-assembly of binary nanoparticles.

In this work, we present a binary assembly model that can predict the co-assembly structure and spatial frequency spectra of monodispersed nanoparticles with two different particle sizes. The approach relies on an iterative algorithm based on geometric constraints, which can simulate the assembly patterns of particles with two distinct diameters, size distributions, and at various mixture ratios on a planar surface. The two-dimensional spatial-frequency spectra of the modeled assembles can be analyzed using fast Fourier transform analysis to examine their frequency content. The simulated co-assembly structures and spectra are compared with assembled nanoparticles fabricated using transfer coating method are in qualitative agreement with the experimental results. The co-assembly model can also be used to predict the peak spatial frequency and the full-width at half-maximum bandwidth, which can lead to the design of the structure spectra by selection of different monodispersed particles. This work can find applications in fabrication of non-periodic nanostructures for functional surfaces, light extraction structures, and broadband nanophotonics.

Rural-urban disparities in the incidence and treatment intensity of periodontal disease among patients with diabetes.

Background: Diabetes threatens population health, especially in rural areas. Diabetes and periodontal diseases have a bidirectional relationship. A persistence of rural-urban disparities in diabetes may indicate a rural-urban difference in periodontal disease among patients with diabetes; however, the evidence is lacking. This retrospective study aimed to investigate rural-urban discrepancies in the incidence and treatment intensity of periodontal disease among patients who were newly diagnosed with type 2 diabetes in the year 2010. Methods: The present study was a retrospective cohort design, with two study samples: patients with type 2 diabetes and those who were further diagnosed with periodontal disease. The data sources included the 2010 Diabetes Mellitus Health Database at the patient level, the National Geographic Information Standardization Platform and the Department of Statistics, Ministry of Health and Welfare in Taiwan at the township level. Two dependent variables were a time-to-event outcome for periodontal disease among patients with type 2 diabetes and the treatment intensity measured for patients who were further diagnosed with periodontal disease. The key independent variables are two dummy variables, representing rural and suburban areas, with urban areas as the reference group. The Cox and Poisson regression models were applied for analyses. Results: Of 68,365 qualified patients, 49% of them had periodontal disease within 10 years after patients were diagnosed with diabetes. Compared to urban patients with diabetes, rural (HR = 0.83, 95% CI: 0.75-0.91) and suburban patients (HR = 0.86, 95% CI: 0.83-0.89) had a lower incidence of periodontal disease. Among 33,612 patients with periodontal disease, rural patients received less treatment intensity of dental care (Rural: RR = 0.87, 95% CI: 0.83, 0.92; suburban: RR = 0.93, 95% CI: 0.92, 0.95) than urban patients. Conclusion: Given the underutilization of dental care among rural patients with diabetes, a low incidence of periodontal disease indicates potentially undiagnosed periodontal disease, and low treatment intensity signals potentially unmet dental needs. Our findings provide a potential explanation for the persistence of rural-urban disparities in poor diabetes outcomes. Policy interventions to enhance the likelihood of identifying periodontal disease at the early stage for proper treatment would ease the burden of diabetes care and narrow rural-urban discrepancies in diabetes outcomes.

Anelasticity in thin-shell nanolattices.

In this work, we investigate the anelastic deformation behavior of periodic three-dimensional (3D) nanolattices with extremely thin shell thicknesses using nanoindentation. The results show that the nanolattice continues to deform with time under a constant load. In the case of 30-nm-thick aluminum oxide nanolattices, the anelastic deformation accounts for up to 18.1% of the elastic deformation for a constant load of 500 µN. The nanolattices also exhibit up to 15.7% recovery after unloading. Finite element analysis (FEA) coupled with diffusion of point defects is conducted, which is in qualitative agreement with the experimental results. The anelastic behavior can be attributed to the diffusion of point defects in the presence of a stress gradient and is reversible when the deformation is removed. The FEA model quantifies the evolution of the stress gradient and defect concentration and demonstrates the important role of a wavy tube profile in the diffusion of point defects. The reported anelastic deformation behavior can shed light on time-dependent response of nanolattice materials with implication for energy dissipation applications.

An AI-powered Electronic Nose System with Fingerprint Extraction for Aroma Recognition of Coffee Beans.

Aroma and taste have long been considered important indicators of quality coffee. Specialty coffee, that is, coffee from a single estate, farm, or village in a coffee-growing region, in particular, has a unique aroma that reflects the coffee-producing region. In order to enable the traceability of coffee origin, in this study we have developed an e-nose system to discriminate the aroma of freshly roasted coffee in different production regions. In the case study, we employed the e-nose system to experiment with various machine learning models for recognizing several collected coffee beans such as coffees from Yirgacheffe and Kona. Additionally, our contribution also includes the development of a method to create an aromatic digital fingerprint of a specific coffee bean to identify its origin. The experimental results show that the developed e-nose system achieves good recognition performance for coffee aroma recognition. The extracted digital fingerprints have great potential to be stored in an extensible coffee aroma database similar to a comprehensive library of specific coffee bean aroma characteristics, for traceability and reconfirmation of their origin.

Inverse Probability of Treatment Weighting in 5-Year Quality-of-Life Comparison among Three Surgical Procedures for Hepatocellular Carcinoma.

This prospective longitudinal cohort study analyzed long-term changes in individual subscales of quality-of-life (QOL) measures and explored whether these changes were related to effective QOL predictors after hepatocellular carcinoma (HCC) surgery. All 520 HCC patients in this study had completed QOL surveys before surgery and at 6 months, 2 years, and 5 years after surgery. Generalized estimating equation models were used to compare the 5-year QOL among the three HCC surgical procedures. The QOL was significantly (p < 0.05) improved at 6 months after HCC surgery but plateaued at 2−5 years after surgery. In postoperative surveys, the effect size was largest in the nausea and vomiting subscales in patients who had received robotic surgery, and the effect size was smallest in the dyspnea subscale in patients who had received open surgery. It revealed the following explanatory variables for postoperative QOL: surgical procedure type, gender, age, hepatitis C, smoking, tumor stage, postoperative recurrence, and preoperative QOL. The comparisons revealed that, when evaluating QOL after HCC surgery, several factors other than the surgery itself should be considered. The analysis results also implied that postoperative quality of life might depend not only on the success of the surgical procedure, but also on preoperative quality of life.

Templated Assembly of Nanoparticles into Continuous Arrays.

The templated assembly of nanoparticles has been limited so far to yield only discontinuous nanoparticle clusters confined within lithographically patterned cavities. Here, we explored the templated assembly of nanoparticles into continuous 2D structures, using lithographically patterned templates with topographical features sized as the assembled nanoparticles. We found that these features act as nucleation centers, whose exact arrangement determines four possible assembly regimes (i) rotated, (ii) disordered, (iii) closely packed, and (iv) unpacked. These regimes produce structures strikingly different from their geometry, orientation, long-range and short-range orders, and packing density. Interestingly, for templates with relatively distant nucleation centers, these four regimes are replaced with three new ones, which produce large monocrystalline domains that are either (i) uniformly rotated, (ii) uniformly aligned, or (iii) nonuniformly rotated relative to the nucleation lattice. We rationalized our experimental data using a mathematical model, which examines all the alignment possibilities between the nucleation centers and the ideal hexagonal assembly. Our finding provides a new approach for the à la carte obtainment of various nanoscale structures unachievable by natural self-assembly and opens a route for the fabrication of numerous functional nanodevices and nanosystems that could not be realized so far by the standard bottom-up approach.

Recovering cavity effects in corrugated organic light emitting diodes.

Cavity effects play an important role in determining the out-coupling efficiency of an OLED. By fabricating OLEDs on corrugated substrates, the waveguide and SPP modes can be extracted by diffraction. However, corrugation does not always lead to an enhancement in out-coupling efficiency due to the reduction of the electrode reflectance and hence the cavity effects. Based on the results of our rigorous couple-wave analysis (RCWA) simulation, we found that the cavity effects can be partially recovered using a low index Teflon layer inserted between the ITO anode and the substrate due to the enhancement of the reflectance of the corrugated electrodes. To verify the simulation results, we fabricated corrugated OLEDs having a low-index Teflon interlayer with an EQE of 36%, which is 29% higher than an optimized planar OLED. By experimentally measuring the OLED air mode dispersion, we confirm the cavity emission of a corrugated OLED is enhanced by the low index layer.

Continuous roll-to-roll patterning of three-dimensional periodic nanostructures.

In this work, we introduce a roll-to-roll system that can continuously print three-dimensional (3D) periodic nanostructures over large areas. This approach is based on Langmuir-Blodgett assembly of colloidal nanospheres, which diffract normal incident light to create a complex intensity pattern for near-field nanolithography. The geometry of the 3D nanostructure is defined by the Talbot effect and can be precisely designed by tuning the ratio of the nanosphere diameter to the exposure wavelength. Using this system, we have demonstrated patterning of 3D photonic crystals with a 500 nm period on a 50 × 200 mm2 flexible substrate, with a system throughput of 3 mm/s. The patterning yield is quantitatively analyzed by an automated electron beam inspection method, demonstrating long-term repeatability of an up to 88% yield over a 4-month period. The inspection method can also be employed to examine pattern uniformity, achieving an average yield of up to 78.6% over full substrate areas. The proposed patterning method is highly versatile and scalable as a nanomanufacturing platform and can find application in nanophotonics, nanoarchitected materials, and multifunctional nanostructures.

Recent progress in near-field nanolithography using light interactions with colloidal particles: from nanospheres to three-dimensional nanostructures.

The advance of nanotechnology is firmly rooted in the development of cost-effective, versatile, and easily accessible nanofabrication techniques. The ability to pattern complex two-dimensional and three-dimensional nanostructured materials are particularly desirable, since they can have novel physical properties that are not found in bulk materials. This review article will report recent progress in utilizing self-assembly of colloidal particles for nanolithography. In these techniques, the near-field interactions of light and colloids are the sole mechanisms employed to generate the intensity distributions for patterning. Based on both 'bottom-up' self-assembly and 'top-down' lithography approaches, these processes are highly versatile and can take advantage of a number of optical effects, allowing the complex 3D nanostructures to be patterned using single exposures. There are several key advantages including low equipment cost, facile structure design, and patterning scalability, which will be discussed in detail. We will outline the underlying optical effects, review the geometries that can be fabricated, discuss key limitations, and highlight potential applications in nanophotonics, optoelectronic devices, and nanoarchitectured materials.

Trends and outcome predictors after traumatic brain injury surgery: a nationwide population-based study in Taiwan.

OBJECT: The authors sought to analyze trends in hospital resource utilization and mortality rates in a population of patients who had received traumatic brain injury (TBI) surgery. METHODS: This nationwide population-based cohort study retrospectively analyzed 18,286 patients who had received surgical treatment for TBI between 1998 and 2010. The multiple linear regression model and Cox proportional hazards model were used for multivariate assessment of outcome predictors. RESULTS: The prevalence rate of surgical treatment for patients with TBI gradually but significantly (p < 0.001) increased by 47.6% from 5.0 per 100,000 persons in 1998 to 7.4 per 100,000 persons in 2010. Age, sex, Deyo-Charlson comorbidity index score, hospital volume, and surgeon volume were significantly associated with TBI surgery outcomes (p < 0.05). Over the 12-year period analyzed, the estimated mean hospital treatment cost increased 19.06%, whereas the in-hospital mortality rate decreased 10.9%. The estimated mean time of overall survival after TBI surgery (± SD) was 83.0 ± 4.2 months, and the overall in-hospital and 1-, 3-, and 5-year survival rates were 74.5%, 67.3%, 61.1%, and 57.8%, respectively. CONCLUSIONS: These data reveal an increased prevalence of TBI, especially in older patients, and an increased hospital treatment cost but a decreased in-hospital mortality rate. Health care providers and patients should recognize that attributes of the patient and of the hospital may affect hospital resource utilization and the mortality rate. These results are relevant not only to other countries with similar population sizes but also to countries with larger populations.

Long-term prediction of emergency department revenue and visitor volume using autoregressive integrated moving average model.

This study analyzed meteorological, clinical and economic factors in terms of their effects on monthly ED revenue and visitor volume. Monthly data from January 1, 2005 to September 30, 2009 were analyzed. Spearman correlation and cross-correlation analyses were performed to identify the correlation between each independent variable, ED revenue, and visitor volume. Autoregressive integrated moving average (ARIMA) model was used to quantify the relationship between each independent variable, ED revenue, and visitor volume. The accuracies were evaluated by comparing model forecasts to actual values with mean absolute percentage of error. Sensitivity of prediction errors to model training time was also evaluated. The ARIMA models indicated that mean maximum temperature, relative humidity, rainfall, non-trauma, and trauma visits may correlate positively with ED revenue, but mean minimum temperature may correlate negatively with ED revenue. Moreover, mean minimum temperature and stock market index fluctuation may correlate positively with trauma visitor volume. Mean maximum temperature, relative humidity and stock market index fluctuation may correlate positively with non-trauma visitor volume. Mean maximum temperature and relative humidity may correlate positively with pediatric visitor volume, but mean minimum temperature may correlate negatively with pediatric visitor volume. The model also performed well in forecasting revenue and visitor volume.

Suppression of transcription factor early growth response 1 reduces herpes simplex virus lethality in mice.

Herpes simplex virus type 1 (HSV-1) infection is the most common cause of sporadic, fatal encephalitis, but current understanding of how the virus interacts with cellular factors to regulate disease progression is limited. Here, we show that HSV-1 infection induced the expression of the cellular transcription factor early growth response 1 (Egr-1) in a human neuronal cell line. Egr-1 increased viral replication by activating promoters of viral productive cycle genes through binding to its corresponding sequences in the viral promoters. Mouse studies confirmed that Egr-1 expression was enhanced in HSV-1-infected brains and that Egr-1 functions to promote viral replication in embryonic fibroblasts. Furthermore, Egr-1 deficiency or knockdown of Egr-1 by a DNA-based enzyme greatly reduced the mortality of HSV-1-infected mice by decreasing viral loads in tissues. This study provides what we believe is the first evidence that Egr-1 increases the mortality of HSV-1 encephalitis by enhancing viral replication. Moreover, blocking this cellular machinery exploited by the virus could prevent host mortality.