Effectiveness of early palliative care in patients with head and neck cancer in Taiwan.

BACKGROUND: Early palliative care (EPC) benefits some cancers, but its clinical outcomes differ depending on patients' racial and ethnic disparities, and customs. To determine whether EPC improves symptoms, emotional distress, and quality of life among Taiwanese patients with early or advanced-stage head and neck cancer (HNC). METHODS: Based on participants' pathological stages, they were categorized as having early and advanced-stage HNC. Those willing and unwilling to undergo EPC were assigned to the EPC and standard groups, respectively. Their daily cancer-related symptoms were assessed using the Distress Thermometer (DT) and MD Anderson Symptom Inventory (MDASI), whose scores' concurrent validity was evaluated using the European Organization for Research and Treatment of Core Quality of Life (EORTC-QLQ-C30) and Head and Neck 35 (EORTC-QLQ-H&N35) questionnaires. RESULTS: Patients (n = 93) diagnosed with HNC at Taiwan's Chia-Yi Christian Hospital from November 2020 to October 2022 were recruited. The patients voluntarily split into two groups: EPC groups and standard groups (23 and 11 in early-stage; 46 and 13 in advanced-stage, respectively). DT assessment showed significant emotional distress improvements for all patients with HNC who received EPC. The EORTC-QLQ-C30 questionnaire indicated that, compared to standard interventions, EPC groups significantly improved the quality of life and some symptoms for both early and advanced-stage HNC patients. However, the EORTC-QLQ-H&N35 questionnaire found no significant difference between the two groups. Furthermore, advanced-stage patients' anticancer treatment completion rates with EPC and standard interventions were 95.35% and 75%, respectively. CONCLUSION: EPC improves symptoms, emotional distress, quality of life, and treatment completion rates in Taiwanese patients with early or advanced-stage HNC. Nonetheless, further extensive clinical studies are required for validation.

Characteristics and risk of stroke in emergency department patients with acute dizziness.

Background: Acute dizziness is a common symptom in the emergency department (ED), with strokes accounting for 3 %-5 % of cases. We investigated the risk of stroke in ED patients with acute dizziness and compared stroke characteristics diagnosed during and after the ED visit. Methods: We identified adult patients with acute dizziness, vertigo, or imbalance using a hospital research-based database. Patients with abdominal or flank pain were used as the comparison group. Patients with dizziness were 1:1 matched to comparison patients. Each patient was traced for up to one year until being hospitalized for a stroke. Results: Out of the 24,266 eligible patients, 589 (2.4 %) were hospitalized for stroke during the ED visit. For the remaining 23,677 patients, the risk of stroke at 7, 30, 90, and 365 days after ED discharge was 0.40 %, 0.52 %, 0.71 %, and 1.25 % respectively. Patients with dizziness had a higher risk of stroke compared to the comparison group at 7, 30, 90, and 365 days. The risk ratios decreased from 5.69 (95 % confidence interval [CI], 3.34-9.68) to 2.03 (95 % CI, 1.65-2.49). Compared to patients hospitalized for stroke during the ED visit, those hospitalized for stroke after the ED visit had greater stroke severity despite a lower initial triage acuity. Patients with early stroke (≤7 days) after ED discharge were less likely to have hypertension, diabetes, hyperlipidemia, and atrial fibrillation. They mostly experienced posterior circulation stroke. Patients with late stroke (>7 days) were older and less likely to have hypertension and hyperlipidemia but more likely to have a history of prior stroke and ischemic heart disease. Their strokes were mainly located in the anterior circulation territory. Conclusions: The risk of stroke after ED discharge was higher in patients with dizziness than in the comparison group, with gradually decreasing risk ratios in the following year. Patients hospitalized for stroke during and after the ED visit had different profiles of vascular risk factors and clinical characteristics.

Enhanced electrical properties of amorphous In-Sn-Zn oxides through heterostructuring with Bi2Se3 topological insulators.

Amorphous indium tin zinc oxide (a-ITZO)/Bi2Se3 nanoplatelets (NPs) were fabricated using a two-step procedure. First, Bi2Se3 NPs were synthesized through thermal chemical vapor deposition at 600 °C on a glass substrate, and then a-ITZO was deposited on the surface of the Bi2Se3 NPs via magnetron sputtering at room-temperature. The crystal structures of the a-ITZO/Bi2Se3 NPs were determined via X-ray diffraction spectroscopy and high-resolution transmission electron microscopy. The elemental vibration modes and binding energies were measured using Raman spectroscopy and X-ray photoelectron spectroscopy. The morphologies were examined using field-emission scanning electron microscopy. The electrical properties of the a-ITZO/Bi2Se3 NPs were evaluated using Hall effect measurements. The bulk carrier concentration of a-ITZO was not affected by the heterostructure with Bi2Se3. In the case of the Bi2Se3 heterostructure, the carrier mobility and conductivity of a-ITZO were increased by 263.6% and 281.4%, respectively, whereas the resistivity of a-ITZO was reduced by 73.57%. This indicates that Bi2Se3 significantly improves the electrical properties of a-ITZO through its heterostructure, expanding its potential applications in electronic and thermoelectric devices.

Zinc oxide nanostructures enhanced photoluminescence by carbon-black nanoparticles in Moiré heterostructures.

ZnO/carbon-black heterostructures were synthesized using a sol-gel method and crystallized by annealing at 500 °C under 2 × 10-2 Torr for 10 min. The crystal structures and binding vibration modes were determined by XRD, HRTEM, and Raman spectrometry. Their surface morphologies were observed by FESEM. The Moiré pattern that is observed in the HRTEM images confirms that the carbon-black nanoparticles were covered by the ZnO crystals. Measurements of optical absorptance revealed that the optical band gap of the ZnO/carbon-black heterostructures increased from 2.33 to 2.98 eV as the carbon-black nanoparticle content increases from 0 to 8.33 × 10-3 mol owing to the Burstein-Moss effect. The photoluminescence intensities at the near-band edge and of the violet, and blue light were increased by factors about 68.3, 62.8, and 56.8, respectively, when the carbon-black contents is of the 2.03 × 10-3 mol. This work reveals that the proper carbon-black nanoparticle content involved increases the PL intensities of the ZnO crystals in the short wavelength regime, supporting their potential application in the light-emitting devices.

A High-Accuracy Detection System: Based on Transfer Learning for Apical Lesions on Periapical Radiograph.

Apical Lesions, one of the most common oral diseases, can be effectively detected in daily dental examinations by a periapical radiograph (PA). In the current popular endodontic treatment, most dentists spend a lot of time manually marking the lesion area. In order to reduce the burden on dentists, this paper proposes a convolutional neural network (CNN)-based regional analysis model for spical lesions for periapical radiographs. In this study, the database was provided by dentists with more than three years of practical experience, meeting the criteria for clinical practical application. The contributions of this work are (1) an advanced adaptive threshold preprocessing technique for image segmentation, which can achieve an accuracy rate of more than 96%; (2) a better and more intuitive apical lesions symptom enhancement technique; and (3) a model for apical lesions detection with an accuracy as high as 96.21%. Compared with existing state-of-the-art technology, the proposed model has improved the accuracy by more than 5%. The proposed model has successfully improved the automatic diagnosis of apical lesions. With the help of automation, dentists can focus more on technical and medical diagnoses, such as treatment, tooth cleaning, or medical communication. This proposal has been certified by the Institutional Review Board (IRB) with the certification number 202002030B0.

Fabrication, characterization and optical properties of Au-decorated Bi2Se3 nanoplatelets.

Au-decorated Bi2Se3 nanoplatelet heterostructures are fabricated by a two-step process of thermal CVD at 600 °C and magnetron sputtering at room-temperature. The crystal structures and binding energies of rhombohedral Bi2Se3 and FCC Au are determined by XRD, HRTEM, XPS, and Raman spectroscopy. XPS and Raman spectroscopy reveal the interaction between Au and Bi2Se3 by shifting in the binding energies of Au-Au, Au-Se and Bi-Se bonds and the wavenumber of A1g2 and Eg2 modes. Au-decorated Bi2Se3 nanoplatelet heterostructures are observed using FESEM, and confirmed by XPS, Raman spectroscopy, and HRTEM imaging. Their optical band gap of the Au-decorated Bi2Se3 nanoplatelet heterostructures increases with Au thickness about 1.92-fold as much as that of pristine Bi2Se3 (0.39 eV), owing to the Burstein-Moss effect. The optical absorptance of the Au-decorated Bi2Se3 nanoplatelet heterostructures revealed increment with wavelength from 200 to 500 nm and decrement with increasing wavelength from 500 to 800 nm.

N-doped reduced graphene oxide for room-temperature NO gas sensors.

In this study, we use nitrogen-doped to improving the gas-sensing properties of reduced graphene oxide. Graphene oxide was prepared according to a modified Hummers' method and then nitrogen-doped reduced graphene oxide (N-rGO) was synthesized by a hydrothermal method using graphene oxide and NH4OH as precursors. The rGO is flat and smooth with a sheet-like morphology while the N-rGO exhibits folded morphology. This type of folding of the surface morphology can increase the gas sensitivity. The N-rGO and the rGO sensors showed n-type and p-type semiconducting behaviors in ambient conditions, respectively, and were responsive to low concentrations of NO gases (< 1000 ppb) at room temperature. The gas-sensing results showed that the N-rGO sensors could detect NO gas at concentrations as low as 400 ppb. The sensitivity of the N-rGO sensor to 1000 ppb NO (1.7) is much better than that of the rGO sensor (0.012). Compared with pure rGO, N-rGO exhibited a higher sensitivity and excellent reproducibility.

Adenosquamous carcinoma arising from a thyroglossal duct cyst: A case report.

The current study describes a case of adenosquamous carcinoma originating from a thyroglossal duct cyst (TGDC). A 77-year-old man presented with an asymptomatic mass in the left mid-neck, which was soft and mobile on palpation. Fine-needle aspiration was performed, but cytology did not detect any malignant cells. Computed tomography demonstrated a single cystic lesion in the left lobe of the thyroid gland; therefore, surgery was performed on the suspected thyroid cyst. However, it was identified intraoperatively that the lesion was separated from the thyroid gland and instead adhered to an additional hyoid bone; therefore, the Sistrunk procedure was performed. Histopathological examination of the resected tumor confirmed the diagnosis of adenosquamous carcinoma originating from a TGDC. Carcinoma arising from a TGDC is rare, and accounts for 1% of all TGDC cases. The most common subtype of carcinoma associated with TGDC is papillary carcinoma, whilst adenosquamous carcinoma developing from a TGDC is extremely rare, with only one case currently reported in the literature. Although a consensus for the management of this disease has not yet been established, adequate surgical excision with long-term follow-up is currently the preferred treatment.

Ionic effect investigation of a potentiometric sensor for urea and surface morphology observation of entrapped urease/polypyrrole matrix.

Potentio-dynamic polymerization of buffered urease and pyrrole monomer onto carbon papers was conducted to fabricate an immobilized urease electrode for measuring the urea concentration. To use carbon paper as the substrate for the electro-growth of polypyrrole matrix not only created sufficient adhesion of the conducting polymer layer but also provided superior entrapment of urease enzymes. The potentiometric response corresponding to ammonia, the product formed from the urease catalyzed urea reaction, was employed for the urea concentration measurement. Scanning electron microscopic photographs showed that the polypyrrole matrix deposited on the carbon papers appeared to be of a cylindrical nanotube shape. The charge density applied in the polymerization was found to affect the potentiometric response while the potential-scanning rate showed minor influence. The composite electrodes had high sensitivity in urea detection, showing a response linear to the logarithm of the urea concentration in the range of 10(-3) to 10 mM. The detection of urea solution prepared in water and buffer was also compared. Ionic effect on the sensing of urea solution was investigated. By comparing the data reported in literature, the urease/polypyrrole/carbon paper electrode developed in this work showed superior long-term stability and reusability. The detection of urea in serum was also well performed.