Utilizing a Two-Stage Taguchi Method and Artificial Neural Network for the Precise Forecasting of Cardiovascular Disease Risk.

The complexity of cardiovascular disease onset emphasizes the vital role of early detection in prevention. This study aims to enhance disease prediction accuracy using personal devices, aligning with point-of-care testing (POCT) objectives. This study introduces a two-stage Taguchi optimization (TSTO) method to boost predictive accuracy in an artificial neural network (ANN) model while minimizing computational costs. In the first stage, optimal hyperparameter levels and trends were identified. The second stage determined the best settings for the ANN model's hyperparameters. In this study, we applied the proposed TSTO method with a personal computer to the Kaggle Cardiovascular Disease dataset. Subsequently, we identified the best setting for the hyperparameters of the ANN model, setting the hidden layer to 4, activation function to tanh, optimizer to SGD, learning rate to 0.25, momentum rate to 0.85, and hidden nodes to 10. This setting led to a state-of-the-art accuracy of 74.14% in predicting the risk of cardiovascular disease. Moreover, the proposed TSTO method significantly reduced the number of experiments by a factor of 40.5 compared to the traditional grid search method. The TSTO method accurately predicts cardiovascular risk and conserves computational resources. It is adaptable for low-power devices, aiding the goal of POCT.

A Novel Two-Stage Induced Deep Learning System for Classifying Similar Drugs with Diverse Packaging.

Dispensing errors play a crucial role in various medical errors, unfortunately emerging as the third leading cause of death in the United States. This alarming statistic has spurred the World Health Organization (WHO) into action, leading to the initiation of the Medication Without Harm Campaign. The primary objective of this campaign is to prevent dispensing errors from occurring and ensure patient safety. Due to the rapid development of deep learning technology, there has been a significant increase in the development of automatic dispensing systems based on deep learning classification to avoid dispensing errors. However, most previous studies have focused on developing deep learning classification systems for unpackaged pills or drugs with the same type of packaging. However, in the actual dispensing process, thousands of similar drugs with diverse packaging within a healthcare facility greatly increase the risk of dispensing errors. In this study, we proposed a novel two-stage induced deep learning (TSIDL)-based system to classify similar drugs with diverse packaging efficiently. The results demonstrate that the proposed TSIDL method outperforms state-of-the-art CNN models in all classification metrics. It achieved a state-of-the-art classification accuracy of 99.39%. Moreover, this study also demonstrated that the TSIDL method achieved an inference time of only 3.12 ms per image. These results highlight the potential of real-time classification for similar drugs with diverse packaging and their applications in future dispensing systems, which can prevent dispensing errors from occurring and ensure patient safety efficiently.

Association of HLA-DPA1, HLA-DPB1, and HLA-DQB1 Alleles With the Long-Term and Booster Immune Responses of Young Adults Vaccinated Against the Hepatitis B Virus as Neonates.

The neonatal hepatitis B vaccination (HBVac) was implemented 35 years ago in Taiwan, but many vaccinees exhibit inadequate long-term vaccine-induced seroprotective hepatitis B surface antibody (anti-HBs) levels. We investigated the association of the human leukocyte antigen (HLA) alleles (DPA1, DPB1, DQA1, and DQB1) with the long-term immunological response to the neonatal HBVac and adolescent booster HBVac in a Taiwanese cohort. We divided 281 Han students (median age 22, age range 17-29 years) into the following groups: (1) Group A (n = 61): anti-HBs titer ≥ 10 mIU/mL at the beginning of the study; (2) Group B (n = 75): anti-HBs level > 1000 mIU/mL after the first booster; (3) Group C (n = 37): anti-HBs level < 10 mIU/mL after the first booster; and (4) Group D (n = 5): anti-HBs level < 10 mIU/mL after three boosters. DQA1, DQB1, DPA1, and DPB1 typing of the participants was performed using sequence-specific oligonucleotides. Associations of HLA alleles and haplotypes with effects on neonatal HBVac and booster HBVac were examined through logistic regression analysis and Fisher's exact test. A false discovery rate-based measure of significance, the q-value, was used for multiple comparisons, and an association was considered significant if the corresponding q-value was < 0.1. DPA1 alleles were associated with the long-term immunological response to the neonatal HBVac. The estimated odds ratio (OR) of the lack of HBV protective immunity when carrying an additional DPA1*01 and DPA1*02 was 0.36 [95% confidence interval (CI) = 0.17-0.76, p = 0.0076] and 2.39 (95% CI = 1.17-4.87, p = 0.016), respectively. DPB1 and DQB1 alleles were associated with a response to the adolescent booster vaccination. The estimated ORs of being nonresponsive to the first booster when carrying an additional DPB1*05 and DQB1*02 were 2.11 (95% CI = 1.13-3.93, p = 0.019) and 3.73 (95% CI = 1.43-9.71, p = 0.0070), respectively. All DPB1*03 carriers responded to the first booster (p of Fisher's exact test = 0.0045). In our study, we discovered that HLA-DPA1 was primarily associated with the long-term response of primary infantile HBVac, and HLA-DPB1 and HLA-DQB1 exhibited associations with the HBV booster vaccination.

The Polymorphism of SMIM1 Gene in Chinese Dividuals.

The SMIM1 gene, which encodes the high-frequency blood group antigen Vel, has not been systematically analyzed at the molecular level in Chinese individuals. To better understand the SMIM1 genetic polymorphism, we assessed mutations among healthy Chinese individuals, patients with red blood cell autoantibodies and hematological disease. A total of 130 patients with hematological disease (case I group), 50 patients with red blood cell autoantibodies (case II group), and 500 healthy controls (control group) were enrolled. Exons 3 and 4 in the SMIM1 gene were sequenced to identify genetic variants or mutations. A polyclonal anti-Vel antibody was used to evaluate the expression of the Vel antigenon red blood cells in patients with novel alleles. The novel alleles of the SMIM1 gene were intron 3 position 193 (TT, CT, CC), 194 (GG, AG), 3' untranslated region positions 81 (CC, CA) and 87 (AA, CA). The single nucleotide polymorphism (SNP) frequencies of intron 3 position 193 TT, CT, CC were 13.1, 39.2, 47.7% in case group I, 6.7, 33.3, 60.0% in case group II and 8.5, 35.6, 56.2% in the control group, respectively. Other minor allele frequencies were all greater than 10% and all SNPs in Chinese showed Vel antigen expression on RBC membranes. The allele at intron 3 position 193 was the most frequent mutant allele found in the Chinese population and Vel antigen deficiency may not cause problems in Chinese patients with hematological diseases and RBC autoantibodies.

Improved Performance of Perovskite Light-Emitting Diodes by Quantum Confinement Effect in Perovskite Nanocrystals.

In this study, we demonstrate an easy and reliable solution-processed technique using an extra adductive in the perovskite precursor solution. Using this method, a dense and uniform morphology with full surface coverage and highly fluorescent films with nanoscale crystal grains can be obtained. The high exciton binding energy in the resulting films employing octylammonium bromide (OAB) adductives proved that high fluorescence originated from the quantum confinement effect. The corresponding perovskite light-emitting diodes (PeLEDs) that were based on this technique also exhibited excellent device performance.

Unraveling current hysteresis effects in regular-type C60-CH3NH3PbI3 heterojunction solar cells.

Comprehensive studies were carried out to understand the origin of the current hysteresis effects in highly efficient C60-CH3NH3PbI3(MAPbI3) heterojunction solar cells, using atomic-force microscopy, transmittance spectra, photoluminescence spectra, X-ray diffraction patterns and a femtosecond time-resolved pump-probe technique. The power conversion efficiency (PCE) of C60-MAPbI3 solar cells can be increased to 18.23% by eliminating the point (lattice) defects in the MAPbI3 thin film which is fabricated by using the one-step spin-coating method with toluene washing treatment. The experimental results show that the point defects and surface defects of the MAPbI3 thin films can be minimized by varying the dropping time of the washing solvent. The point defects (surface defects) can be reduced with an (a) increase (decrease) in the dropping time, resulting in an optimized dropping time for obtaining the defect-minimized MAPbI3 thin film deposited on top of the C60 thin film. Consequently, the formation of the defect-minimized MAPbI3 thin film allows for high-efficiency MAPbI3 solar cells.

Overcoming the Intrinsic Difference between Hydrophilic CH3NH3PbI3 and Hydrophobic C60 Thin Films to Improve the Photovoltaic Performance.

Dimethylformamide/dimethyl sulfoxide solvent mixtures were used as the CH3NH3PbI3 (MAPbI3) precursor solvent in a one-step spin coating method to fabricate smooth and hydrophilic crystalline MAPbI3 thin films on top of hydrophobic carbon-60 (C60) thin film for highly efficient photovoltaics. The structural, optical, and excitonic characteristics of the resultant MAPbI3 thin films were analyzed using X-ray diffraction (XRD), atomic-force microscopy, absorbance spectroscopy, photoluminescence (PL) spectrometry, and nanosecond time-resolved PL. There was a trade-off between the crystallinity and surface roughness of the MAPbI3 thin films, which strongly influenced the device performance of MAPbI3-based photovoltaics. The high power conversion efficiency (PCE) of 17.55% was achieved by improving the wettability of MAPbI3 precursor solutions on top of the C60 thin films. In addition, it was predicted that the fill factor and PCE could be further improved by increasing the crystallinity of the MAPbI3 thin film while keeping it smooth.

Accelerating Multiple Compound Comparison Using LINGO-Based Load-Balancing Strategies on Multi-GPUs.

Compound comparison is an important task for the computational chemistry. By the comparison results, potential inhibitors can be found and then used for the pharmacy experiments. The time complexity of a pairwise compound comparison is O(n (2)), where n is the maximal length of compounds. In general, the length of compounds is tens to hundreds, and the computation time is small. However, more and more compounds have been synthesized and extracted now, even more than tens of millions. Therefore, it still will be time-consuming when comparing with a large amount of compounds (seen as a multiple compound comparison problem, abbreviated to MCC). The intrinsic time complexity of MCC problem is O(k (2) n (2)) with k compounds of maximal length n. In this paper, we propose a GPU-based algorithm for MCC problem, called CUDA-MCC, on single- and multi-GPUs. Four LINGO-based load-balancing strategies are considered in CUDA-MCC in order to accelerate the computation speed among thread blocks on GPUs. CUDA-MCC was implemented by C+OpenMP+CUDA. CUDA-MCC achieved 45 times and 391 times faster than its CPU version on a single NVIDIA Tesla K20m GPU card and a dual-NVIDIA Tesla K20m GPU card, respectively, under the experimental results.

CUDA ClustalW: An efficient parallel algorithm for progressive multiple sequence alignment on Multi-GPUs.

For biological applications, sequence alignment is an important strategy to analyze DNA and protein sequences. Multiple sequence alignment is an essential methodology to study biological data, such as homology modeling, phylogenetic reconstruction and etc. However, multiple sequence alignment is a NP-hard problem. In the past decades, progressive approach has been proposed to successfully align multiple sequences by adopting iterative pairwise alignments. Due to rapid growth of the next generation sequencing technologies, a large number of sequences can be produced in a short period of time. When the problem instance is large, progressive alignment will be time consuming. Parallel computing is a suitable solution for such applications, and GPU is one of the important architectures for contemporary parallel computing researches. Therefore, we proposed a GPU version of ClustalW v2.0.11, called CUDA ClustalW v1.0, in this work. From the experiment results, it can be seen that the CUDA ClustalW v1.0 can achieve more than 33× speedups for overall execution time by comparing to ClustalW v2.0.11.

Human papillomavirus infection in human immunodeficiency virus-positive Taiwanese women incarcerated for illicit drug usage.

BACKGROUND: The number of female injection drug users infected with human immunodeficiency virus (HIV) is increasing in Taiwan. Their human papillomavirus (HPV) infection has not been fully discussed. METHODS: A cross-sectional study was conducted in a prison for women. Both HIV-positive and HIV-negative women were enrolled voluntarily. All patients answered self-administered questionnaires, had a Pap smear, and underwent linear array HPV genotype tests. RESULTS: A total of 72 female patients infected with HIV and 76 women who were not infected with HIV were enrolled in this cross-sectional study (mean age, 33.4 years). HPV infection was detected in 63.9% of patients infected with HIV and 47.4% of HIV-negative counterparts (p=0.043). Oncogenic HPV was detected in 41.6% of patients infected with HIV and 28.9% of their counterparts (p=0.10). A mean of 2.41 types of HPV were detected in HIV-positive women and 1.53 types were detected in the HIV-negative counterparts (p=0.014). HPV 52 was the most commonly encountered oncogenic type. Only 10.2% of the patients (10.9% of HIV-positive patients) had vaccine-preventable HPV types. Patients with abnormal cytology (81.3%) tended to have oncogenic types of HPV infection. HIV serostatus was the significant factor associated with oncogenic HPV infection (odds ratio=2.583, 95% confidence interval 1.071-6.231, p=0.0347). CONCLUSION: Drug-using women infected with HIV had significantly higher rates of HPV infections, justifying the aggressive screening for cervical dysplasia.

Efficacy of hepatitis B vaccine boosters among neonatally vaccinated university freshmen in Taiwan.

BACKGROUND & AIMS: Long-term protection against hepatitis B virus (HBV) after vaccination remains widely debated. We evaluated the efficacy of a modified 3-dose booster protocol in neonatally vaccinated university students in Taiwan. METHODS: Changes in the levels of antibodies to the hepatitis B surface antigen (anti-HBs) were examined in 250 university students over a 3-year period. Group A (n=39) lacked seroprotective levels of anti-HBs, and declined to receive a booster dose of the HBV vaccine. Group B (n=128) lacked seroprotective levels of anti-HBs, and received booster doses of the HBV vaccine according to a modified 3-dose booster protocol. Group C (n=83) possessed seroprotective levels of anti-HBs, and did not receive a booster dose. RESULTS: The levels of seroprotective anti-HBs increased in 12.8% of Group A and 14.5% of Group C, suggesting that our entire cohort had experienced booster effects from natural HBV exposure. However, no new HBV infections were observed, and 53.9% of Group B maintained protective levels of anti-HBs during the follow-up period. CONCLUSIONS: The use of the modified 3-dose booster protocol induced significant long-term increases in the titer of anti-HBs in over 50% of the neonatally vaccinated participants with previously non-protective titers. However, in the absence of a vaccine booster, some neonatally vaccinated people with low anti-HBs titers may nonetheless produce anamnestic responses to HBV upon exposure, suggesting that protection from neonatal vaccination may persist, despite low titers of anti-HBs.

Influence of age and CD4+ T cell counts on the prevalence of genital human papillomavirus infection among HIV-seropositive men who have sex with men in Taiwan.

This study aimed to examine the baseline prevalence of genital human papillomavirus (HPV) infection among human immunodeficiency virus (HIV)-seropositive men who have sex with men in Taiwan and to determine the association of age and CD4+ T cell counts with HPV infection. In 2010, 305 men who have sex with men infected with HIV and 100 HIV-seronegative men who have sex with men were recruited. Genital swabs were collected and 37 HPV genotypes were detected using linear array HPV genotyping. HPV infection was present in 45.3% of the patients infected with HIV and in 18% of the HIV-negative subjects (P < 0.001). HPV types 52, 51, and 16 were the most commonly identified oncogenic types. Oncogenic HPV types were identified in 31.2% of the patients infected with HIV and in 13% of the seronegative subjects (P < 0.001). Adjusted odd ratios (ORs) for the detection of any HPV type were 2.9 (95% confidence interval [CI], 1.4-5.9) for men who have sex with men aged 30-34 and 2.1 (95% CI, 1.1-4.3) for those aged >35 compared with that for those aged <25. ORs were 2.8 (95% CI, 1.0-7.4) for a CD4+ T cell count of 200-350 cells/µl and 8.5 (95% CI, 2.9-24.5) for a CD4+ T cell count of <200 cells/µl compared with that for seronegative subjects. In conclusion, this novel HPV study, carried out in Northern Taiwan on men who have sex with men, revealed that age and immune state were associated significantly and independently with HPV infection.

Significance and anamnestic response in isolated hepatitis B core antibody-positive individuals 18 years after neonatal hepatitis B virus vaccination in Taiwan.

AIM: To investigate the significance of isolated hepatitis B core antibody (anti-HBc) and to analyze the response to hepatitis B virus (HBV) booster vaccination in young adults with isolated anti-HBc who had been fully vaccinated with HBV vaccine as infants. MATERIALS AND METHODS: We screened 1734 new university entrants who had been fully vaccinated against HBV in infancy for the presence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and anti-HBc upon university entry. Results positive for isolated anti-HBc were reconfirmed by testing for the presence of HBsAg and anti-HBc once more, and further evaluated for anti-HCV, anti-HIV, and HBV DNA status 6 months later. Students were also offered HBV booster vaccinations at that time. Geometric mean titers (GMT) of anti-HBs after one booster dose of HBV were compared between students with isolated anti-HBc and students with HBV naïve status. RESULTS: The overall prevalence of isolated anti-HBc in our student cohort was 1.2% (21 of 1734). No evidence of occult HBV infection was observed. A "booster" anamnestic response (anti-HBs titer ≥ 10 mIU/mL) was noted in 95% (20 of 21) of subjects with isolated anti-HBc. After re-measurement of anti-HBc, 13 (62%) of the 21 subjects with isolated anti-HBc were reclassified as having resolved HBV infection with a loss of anti-HBs. In the remaining 8 subjects (38%), isolated anti-HBc was determined to be false positive. The HBV status of these 8 subjects was HBV naïve due to the waning-off effect of anti-HBs of the neonatal HBV vaccination. There was no significant difference in anamnestic response to a single HBV booster dose of vaccine between students with isolated anti-HBc (n=13) and those with HBV naïve (n=323) status (GMT 50.6 vs 47.7 mIU/mL, P=0.90). CONCLUSION: The presence of isolated anti-HBc 18 years after HBV vaccination can be attributed to post-HBV infection with a loss of anti-HBs and to a decline in anti-HBs elicited by vaccine. A single HBV booster dose of vaccine is recommended for subjects with isolated anti-HBc who were fully vaccinated with HBV vaccine as infants. This finding needs to be replicated in further studies with larger cohorts.

Hepatitis B surface antigen confirmatory testing for diagnosis of hepatitis B virus infection in Taiwan.

This study aimed to examine the application of hepatitis B surface antigen (HBsAg) confirmatory testing when diagnosing hepatitis B infection among young persons in Taiwan with a low prevalence rate of hepatitis B infection. HBsAg status, the presence of antibodies against HBsAg (anti-HBs), and the presence of antibodies against hepatitis B core antigen (anti-HBc) were compared among 403 graduate students (mean age 22.8 ± 0.7 years) and 1,745 undergraduate students (18.6 ± 1.0 years) from one university, and 367 adult subjects (41.1 ± 15.8 years) in 2008. Any HBsAg-positive subjects were tested with an HBsAg confirmatory test. Chi-square tests for trend and predictive values of positivity (PVP) when using HBsAg-positive only for determining confirmed cases of hepatitis B infection were compared across the three cohorts. The prevalence of HBsAg positivity among subjects decreased from 16.3% in the adults to 5.2% in the graduate students and then to 2.8% for the undergraduate students (P = 0.0007). The PVP of HBsAg testing when determining cases of hepatitis B decreased from 0.97 for the adults to 0.81 for the graduate students and then to 0.56 for the undergraduate students (P < 0.0001). Thus, a significant decrease in the true-positive rate of HBsAg among the students born after the introduction of hepatitis B vaccination was observed only when HBsAg testing was applied. Additional neutralization tests may therefore become mandatory for persons with a positive HBsAg test result who were born after the commencement of the universal neonatal hepatitis B vaccination program in Taiwan.

Blastocystis hominis infection in long-term care facilities in Taiwan: prevalence and associated clinical factors.

Blastocystis hominis is probably the most common protozoan found in the human gut worldwide. In Taiwan, the prevalence of B. hominis infection is yet to be determined but is expected to be relatively higher among foreign workers. No data is available on the prevalence of B. hominis infection in long-term care facilities in Taiwan. This study included 713 subjects (552 residents and 161 care workers) from ten long-term care facilities in Taiwan who completed stool microscopic examinations with Merthiolate-iodine-formalin stain technique. The prevalence rate of blastocystosis was the highest among foreign and domestic care workers followed by residents (12.2%, 4.6%, and 2.7%, respectively). Older age (p = 0.04) and lower educational level (p = 0.008) were significantly associated with blastocystosis among care workers. Among residents, B. hominis infection was negatively associated with prolonged use of antibiotics within 3 months prior to examination (p = 0.05) and positively associated with tracheostomy in-place (p = 0.028). In conclusion, B. hominis infection was the most prevalent intestinal parasitic infection among both care workers and residents of long-term care facilities in Taiwan. Use of antibiotics was negatively associated with B. hominis infection among residents. Additionally, appropriate preventive measures should be implemented to older care workers with lesser educational attainment in order to reduce the risk of blastocystosis infection.

Asymmetric synthesis of 4- and 5-substituted pipecolic esters by ring-closing metathesis and palladium-catalyzed formate reduction.

Asymmetric synthesis of 4- and 5-substituted pipecolic esters was achieved by the sequence of allylation, ring-closing metathesis, and palladium-catalyzed formate reduction.

Diels-Alder reactions of 4-triflyloxy-2,6,6-trimethyl-2,4-cyclohexadienone. An expedient methodology for the synthesis of bicyclo[2.2.2]oct-5-en-2-ones and bicyclo[2.2.2]octa-5,7-dien-2-ones.

The synthesis of 4-triflyloxy-2,6,6-trimethyl-2,4-cyclohexadienone (13), bicyclo[2.2.2]octenones 1a-j and 15a-j, and bicyclo[2.2.2]octadienones 2a-f, 6a-d, and 11a-f is described. The 2,4-cyclohexadienones 4 and 13 were used for the first time as nondimerizing and easily accessible alternatives to 2,6,6-trimethyl-2,4-cyclohexadienone 12 in Diels-Alder reactions with acetylene derivatives 5a-d to prepare the adducts 6a-d and 11a-e in excellent yields. Compounds 11a-d were initially prepared by the alcoholysis of 6a-d to afford bicyclo[2.2.2]octene-2,5-diones 7a-dfollowed by treatment of 7a-d with N-phenyltriflimide in the presence of LHMDS at -78 degrees C. Diels-Alder reaction of 13 with an acetylene equivalent, phenyl vinyl sulfoxide, was also studied. A detailed study of the Diels-Alder reactions of various olefinic dienophiles 14a-j with 13 has been carried out to furnish cycloadducts 15a-j in high yields. Reductive removal of triflyloxy group of vinyl triflates 11a-f and 15a-j was performed in the presence of [Pd(PPh(3))(2)Cl(2)-Bu(3)N-HCO(2)H] to obtain the desired bicyclo[2.2.2]octadienones 2a-f and bicyclo[2.2.2]octenones 1a-j, respectively, in good overall yields.