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  • 1
    Online Resource
    Online Resource
    Comparison of Clinical Manifestation, Diagnosis, and Outcomes of Invasive Pulmonary Aspergillosis and Pulmonary Mucormycosis
    MDPI AG ; 2019
    In:  Microorganisms Vol. 7, No. 11 ( 2019-11-05), p. 531-
    Details
    In: Microorganisms, MDPI AG, Vol. 7, No. 11 ( 2019-11-05), p. 531-
    Abstract: Objects: Invasive pulmonary mold infection usually has devastating outcomes. Timely differentiation between invasive pulmonary aspergillosis (IPA) from pulmonary mucormycosis (PM) is critical for treatment decision-making. However, information on IPA and PM differentiation is limited. Methods: We conducted a retrospective, multicenter, observational study, with proven and probable IPA and PM patients from January 2004 to December 2017. Demographics, clinical manifestations, image reports, histopathological findings, and outcomes were analyzed. Results: A total of 46 IPA (33 proven and 13 probable) and 19 PM (18 proven and one probable) cases were analyzed. The majority of tissues (81% in IPA and 61% in PM) were obtained using bronchoscopy. Prior influenza infection was a predisposing factor for IPA, and abscess formation in CT scan was associated with PM (p = 0.0491, p = 0.0454, respectively). The positive culture rate for PM was lower than that for IPA (37% vs. 67%, p = 0.0294). The galactomannan (GM) level from serum and bronchoalveolar lavage (BAL) fluid was significantly higher in IPA than in PM (3.3 ± 0.5 vs. 0.8 ± 0.6, p = 0.0361; 4.0 ± 0.6 vs. 0.59 ± 0.1, p = 0.0473, respectively). The overall mortality rate was 65%, which was similar among IPA and PM groups. Systemic steroid exposure and high Acute Physiology and Chronic Health Evaluation II (APACHE II) scores on admission were independently correlated to mortality in IPA (p = 0.027, p = 0.026, respectively). However, there was no predictor for mortality found in PM patients. Conclusions: Influenza infection, abscess formation in CT scan, and GM level may help physicians to differentiate IPA and PM. Bronchoscopy-guided biopsy and lavage specimen provide timely and definite diagnosis. The prognosis of IPA is associated with systemic steroid exposure and higher APACHE II scores on admission.
    Type of Medium: Online Resource
    ISSN: 2076-2607
    URL: Article
    DOI: 10.3390/microorganisms7110531
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2720891-6
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  • 2
    Online Resource
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    Design and Implementation of a Comprehensive AI Dashboard for Real-Time Prediction of Adverse Prognosis of ED Patients
    MDPI AG ; 2022
    In:  Healthcare Vol. 10, No. 8 ( 2022-08-09), p. 1498-
    Details
    In: Healthcare, MDPI AG, Vol. 10, No. 8 ( 2022-08-09), p. 1498-
    Abstract: The emergency department (ED) is at the forefront of medical care, and the medical team needs to make outright judgments and treatment decisions under time constraints. Thus, knowing how to make personalized and precise predictions is a very challenging task. With the advancement of artificial intelligence (AI) technology, Chi Mei Medical Center (CMMC) adopted AI, the Internet of Things (IoT), and interaction technologies to establish diverse prognosis prediction models for eight diseases based on the ED electronic medical records of three branch hospitals. CMMC integrated these predictive models to form a digital AI dashboard, showing the risk status of all ED patients diagnosed with any of these eight diseases. This study first explored the methodology of CMMC’s AI development and proposed a four-tier AI dashboard architecture for ED implementation. The AI dashboard’s ease of use, usefulness, and acceptance was also strongly affirmed by the ED medical staff. The ED AI dashboard is an effective tool in the implementation of real-time risk monitoring of patients in the ED and could improve the quality of care as a part of best practice. Based on the results of this study, it is suggested that healthcare institutions thoughtfully consider tailoring their ED dashboard designs to adapt to their unique workflows and environments.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare10081498
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2721009-1
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  • 3
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    Caffeic Acid Phenethyl Ester Rescues Pulmonary Arterial Hypertension through the Inhibition of AKT/ERK-Dependent PDGF/HIF-1α In Vitro and In Vivo
    MDPI AG ; 2019
    In:  International Journal of Molecular Sciences Vol. 20, No. 6 ( 2019-03-22), p. 1468-
    Details
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 20, No. 6 ( 2019-03-22), p. 1468-
    Abstract: Pulmonary arterial hypertension (PAH) is characterized by pulmonary arterial proliferation and remodeling, resulting in a specific increase in right ventricle systolic pressure (RVSP) and, ultimately right ventricular failure. Recent studies have demonstrated that caffeic acid phenethyl ester (CAPE) exerts a protective role in NF-κB-mediated inflammatory diseases. However, the effect of CAPE on PAH remains to be elucidated. In this study, monocrotaline (MCT) was used to establish PAH in rats. Two weeks after the induction of PAH by MCT, CAPE was administrated by intraperitoneal injection once a day for two weeks. Pulmonary hemodynamic measurements and pulmonary artery morphological assessments were examined. Our results showed that administration of CAPE significantly suppressed MCT-induced vascular remodeling by decreasing the HIF-1α expression and PDGF-BB production, and improved in vivo RV systolic performance in rats. Furthermore, CAPE inhibits hypoxia- and PDGF-BB-induced HIF-1α expression by decreasing the activation of the AKT/ERK pathway, which results in the inhibition of human pulmonary artery smooth muscle cells (hPASMCs) proliferation and prevention of cells resistant to apoptosis. Overall, our data suggest that HIF-1α is regarded as an alternative target for CAPE in addition to NF-κB, and may represent a promising therapeutic agent for the treatment of PAH diseases.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    URL: Article
    DOI: 10.3390/ijms20061468
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2019364-6
    SSG: 12
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  • 4
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    The Use of Big Data for Sustainable Development in Motor Production Line Issues
    MDPI AG ; 2020
    In:  Sustainability Vol. 12, No. 13 ( 2020-07-01), p. 5323-
    Details
    In: Sustainability, MDPI AG, Vol. 12, No. 13 ( 2020-07-01), p. 5323-
    Abstract: This study explores big data gathered from motor production lines to gain a better understanding of production line issues. Motor products from Solen Electric Company’s motor production lines were used to predict failure points based on big data analytics, where 3606 datapoints from the company’s testing equipment were statistically analyzed. The current study focused on secondary data and expert interview results to further define the relevant statistical dimensions. Only 14 of the original 88 detection parameters were required for monitoring the production line. The relationships between these parameters and the relevant motor components were established to indicate how an abnormal reading may be interpreted to quickly resolve an issue. Thus, a theoretical model for the monitoring of the motor production line was proposed. Further implications and practical suggestions are also offered to improve the production lines. This study explores big data analysis and smart manufacturing and demonstrates the promise of these technologies in improving production line efficiency and reducing waste to promote sustainable production goals. Big data thus constitute the core technology for advancing production lines into Industry 4.0 and promoting industry sustainability.
    Type of Medium: Online Resource
    ISSN: 2071-1050
    URL: Article
    DOI: 10.3390/su12135323
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2518383-7
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  • 5
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    Online Resource
    Growth of Si3N4 Thin Films on Si(111) Surface by RF-N2 Plasma Nitriding
    MDPI AG ; 2020
    In:  Coatings Vol. 11, No. 1 ( 2020-12-22), p. 2-
    Details
    In: Coatings, MDPI AG, Vol. 11, No. 1 ( 2020-12-22), p. 2-
    Abstract: Ultra-thin Si3N4 films were grown on Si(111) surface by radio frequency (RF)-N2 plasma exposure at 900 °C with 1–1.2 sccm of a flux of atomic nitrogen. We discuss the effect of various conditions such as N2 flow rate, nitriding time and RF power on the optical, chemical, and structural properties of a nitrided Si3N4 layer. The optical properties, surface morphology and chemical composition are investigated by using ellipsometry, atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), and transmission electron microscopy (TEM). Cross-sectional TEM images show that an RF power of 350 W induced some damage to the Si(111) surface. The thickness of nitrided Si3N4 was measured to be about 5–7 nm. XPS results shown that the binding energy of Si 2p3/2 located at 101.9 ± 0.1 eV is attributed to the Si–N bonds in the Si3N4 compound. Smooth Si3N4 ultra-thin films were obtained at a nitridation time close to 1 h with an RF power of 300 W, with a measured refractive index (n) nearly to 1.88 at 632 nm. The increase in refractive index with decreased RF-plasma power and nitrogen flow rate is probably attributed to the change in the stoichiometry of the film and less surface damage.
    Type of Medium: Online Resource
    ISSN: 2079-6412
    URL: Article
    DOI: 10.3390/coatings11010002
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2662314-6
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  • 6
    Online Resource
    Online Resource
    Risk Factors and Outcomes of Heart Failure Following First-Episode of Acute Myocardial Infarction—A Case Series Study of 161,384 Cases
    MDPI AG ; 2021
    In:  Healthcare Vol. 9, No. 10 ( 2021-10-16), p. 1382-
    Details
    In: Healthcare, MDPI AG, Vol. 9, No. 10 ( 2021-10-16), p. 1382-
    Abstract: Background: Heart failure (HF) is one of the important complications of acute myocardial infarction (AMI), but the epidemiology, associated risks and outcomes have not been well investigated in the era of broad use of fluoroscopy-guided angiographic intervention. Methods: We analysed 161,384 subjects who had experienced the first episode of AMI during 1 January 2000 and 31 December 2012 using the Taiwan National Health Insurance Research Database. Results: During the index AMI hospitalization, 23.6% of cases developed HF. Female, ≥65 years-old, non-ST-segment elevation type of MI, diabetes mellitus (DM), peripheral vascular occlusion disease (PAOD), chronic obstructive pulmonary disease (COPD), atrial fibrillation, and ventricular tachycardia/fibrillation (VT/VF) were associated with higher risks of developing HF. HF cases had inferior survival outcomes compared to non-HF cases in both the short and long term. Among those HF patients, ≥65 years, DM, PAOD, and VT/VF were associated with worse outcomes. On the contrary, coronary reperfusion intervention and treat-to-target pharmacologic treatment were associated with favourable survival outcomes. Conclusions: HF remains common in the modern age and poses negative impacts in survival of AMI patients. It highlights that prudent prevention and early treatment of HF during AMI hospitalization is an important medical issue.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare9101382
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2721009-1
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  • 7
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    (E)-Guggulsterone Inhibits Dengue Virus Replication by Upregulating Antiviral Interferon Responses through the Induction of Heme Oxygenase-1 Expression
    MDPI AG ; 2021
    In:  Viruses Vol. 13, No. 4 ( 2021-04-20), p. 712-
    Details
    In: Viruses, MDPI AG, Vol. 13, No. 4 ( 2021-04-20), p. 712-
    Abstract: Dengue virus (DENV) infection, which causes dengue fever, dengue hemorrhagic fever, and dengue shock syndrome, is a severe global health problem in tropical and subtropical areas. There is no effective vaccine or drug against DENV infection. Thus, the development of anti-DENV agents is imperative. This study aimed to assess the anti-DENV activity of (E)-guggulsterone using a DENV infectious system. A specific inhibitor targeting signal molecules was used to evaluate the molecular mechanisms of action. Western blotting and qRT-PCR were used to determine DENV protein expression and RNA replication, respectively. Finally, an ICR suckling mouse model was used to examine the anti-DENV activity of (E)-guggulsterone in vivo. A dose-dependent inhibitory effect of (E)-guggulsterone on DENV protein synthesis and RNA replication without cytotoxicity was observed. The mechanistic studied revealed that (E)-guggulsterone stimulates Nrf2-mediated heme oxygenase-1 (HO-1) expression, which increases the antiviral interferon responses and downstream antiviral gene expression by blocking DENV NS2B/3B protease activity. Moreover, (E)-guggulsterone protected ICR suckling mice from life-threatening DENV infection. These results suggest that (E)-guggulsterone can be a potential supplement for controlling DENV replication.
    Type of Medium: Online Resource
    ISSN: 1999-4915
    URL: Article
    DOI: 10.3390/v13040712
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2516098-9
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  • 8
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    Impact of Smoking-Related Chronic Obstruction Pulmonary Disease on Mortality of Invasive Ductal Carcinoma Patients Receiving Standard Treatments: Propensity Score-Matched, Nationwide, Population-Based Cohort Study
    MDPI AG ; 2021
    In:  Cancers Vol. 13, No. 15 ( 2021-07-21), p. 3654-
    Details
    In: Cancers, MDPI AG, Vol. 13, No. 15 ( 2021-07-21), p. 3654-
    Abstract: Purpose: the survival effect of smoking-related chronic obstructive pulmonary disease (COPD) and COPD with acute exacerbation (COPDAE) is unclear for patients with invasive ductal carcinoma (IDC) receiving standard treatments. Methods: we recruited women with clinical stage I–III IDC from the Taiwan Cancer Registry Database who had received standard treatments between 1 January 2009 and 31 December 2018. The time-dependent Cox proportional hazards model was used to analyze all-cause mortality. To reduce the effects of potential confounders when all-cause mortality between Groups 1 and 2 were compared, 1:2 propensity score matching (PSM) was performed. We categorized the patients into two groups based on COPD status to compare overall survival outcomes: Group 1 (current smokers with COPD) and Group 2 (nonsmokers without COPD group). Results: PSM yielded 2319 patients with stage I–III IDC (773 and 1546 in Groups 1 and 2, respectively) eligible for further analysis. In the multivariate time-dependent Cox regression analyses, the adjusted hazard ratio (aHR; 95% confidence interval (CI)) of all-cause mortality for Group 1 compared with Group 2 was 1.04 (0.83–1.22). The aHRs (95% CIs) of all-cause mortality for ≥1 hospitalization for COPDAE within one year before breast surgery was 1.51 (1.18–2.36) compared with no COPDAE. Conclusion: smoking-related COPD was not a significant independent risk factor for all-cause mortality in women with stage I–III IDC receiving standard treatments. Being hospitalized at least once for COPDAE within one year before breast surgery is highly associated with high mortality for women with IDC receiving standard treatments. The severity of smoking-related COPD before treatments for breast cancer might be an important prognostic factor of survival. Thus, the information of the severity of COPD before treatment for breast cancer might be valuable for increasing the survival rate in treatment of breast cancer, especially in the prevention of progress from COPD to COPDAE.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers13153654
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2527080-1
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  • 9
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    Grape Seed Proanthocyanidins Inhibit Replication of the Dengue Virus by Targeting NF-kB and MAPK-Mediated Cyclooxygenase-2 Expression
    MDPI AG ; 2023
    In:  Viruses Vol. 15, No. 4 ( 2023-03-30), p. 884-
    Details
    In: Viruses, MDPI AG, Vol. 15, No. 4 ( 2023-03-30), p. 884-
    Abstract: Dengue virus (DENV) infection is a serious global health issue as it causes severe dengue hemorrhagic fever and dengue shock syndrome. Since no approved therapies are available to treat DENV infection, it is necessary to develop new agents or supplements that can do this. In this study, grape seed proanthocyanidins extract (GSPE), which is widely consumed as a dietary supplement, dose-dependently suppressed the replication of four DENV serotypes. The inhibitory mechanism demonstrated that GSPE downregulated DENV-induced aberrant cyclooxygenase-2 (COX-2) expression, revealing that the inhibitory effect of the GSPE on DENV replication involved targeting DENV-induced COX-2 expression. Mechanistic studies on signaling regulation have demonstrated that GSPE significantly reduced COX-2 expression by inactivating NF-κB and ERK/P38 MAPK signaling activities. Administrating GSPE to DENV-infected suckling mice reduced virus replication, mortality, and monocyte infiltration of the brain. In addition, GSPE substantially reduced the expression of DENV-induced inflammatory cytokines associated with severe dengue disease, including tumor necrosis factor-α, nitric oxide synthase, interleukin (IL)-1, IL-6, and IL-8, suggesting that GSPE has potential as a dietary supplement to attenuate DENV infection and severe dengue.
    Type of Medium: Online Resource
    ISSN: 1999-4915
    URL: Article
    DOI: 10.3390/v15040884
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2516098-9
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  • 10
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    Correction of Young’s Modulus Calculation in the Flexural Mode of Resonant Column Test
    MDPI AG ; 2020
    In:  Applied Sciences Vol. 10, No. 19 ( 2020-09-24), p. 6675-
    Details
    In: Applied Sciences, MDPI AG, Vol. 10, No. 19 ( 2020-09-24), p. 6675-
    Abstract: The resonant column test includes torsional and flexural modes that can be used to obtain reduction curves for the shear modulus and Young’s modulus of the soil, respectively. When the resonant column test is performed under flexural mode, Young’s modulus is calculated mainly using the measured resonant frequency following the formula proposed by Cascante et al. However, this formula does not consider the rotational inertia effect of the electromagnetic drive disk of the resonant column apparatus and thus may inaccurately calculate Young’s modulus. In this study, the formula was modified by considering the rotational inertia effect of the electromagnetic drive disk, and its accuracy was verified by using three aluminum calibration rods with different diameters as a dummy specimen for the resonant tests in flexural and torsional modes.
    Type of Medium: Online Resource
    ISSN: 2076-3417
    URL: Article
    DOI: 10.3390/app10196675
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2704225-X
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