Using the Diabetes Care System for a County-Wide Hepatitis C Elimination: An Integrated Community-Based Shared Care Model in Taiwan.

INTRODUCTION: Despite the serious risks of diabetes with hepatitis C virus (HCV) infection, this preventable comorbidity is rarely a priority for HCV elimination. We aim to examine how a shared care model could eliminate HCV in patients with diabetes (PwD) in primary care. METHODS: There were 27 community-based Diabetes Health Promotion Institutes in each township/city of Changhua, Taiwan. PwD from these institutes from January 2018 to December 2020 were enrolled. HCV screening and treatment were integrated into diabetes structured care through collaboration between diabetes care and HCV care teams. Outcome measures included HCV care continuum indicators. Township/city variation in HCV infection prevalence and care cascades were also examined. RESULTS: Of the 10,684 eligible PwD, 9,984 (93.4%) underwent HCV screening, revealing a 6.18% (n = 617) anti-HCV seroprevalence. Among the 597 eligible seropositive individuals, 507 (84.9%) completed the RNA test, obtaining 71.8% positives. Treatment was initiated by 327 (89.8%) of 364 viremic patients, and 315 (86.5%) completed it, resulting in a final cure rate of 79.4% (n = 289). Overall, with the introduction of antivirals in this cohort, the prevalence of viremic HCV infection dropped from 4.44% to 1.34%, yielding a 69.70% (95% credible interval 63.64%-77.03%) absolute reduction. DISCUSSION: Although HCV prevalence varied, the care cascades achieved consistent results across townships/cities. We have further successfully implemented the model in county-wide hospital-based diabetes clinics, eventually treating 89.6% of the total PwD. A collaborative effort between diabetes care and HCV elimination enhanced the testing and treatment in PwD through an innovative shared care model.

Exploiting Thin-Film Properties and Guided-Mode Resonance for Designing Ultrahigh-Figure-of-Merit Refractive Index Sensors.

Guided-mode resonance (GMR) gratings have emerged as a promising sensing technology, with a growing number of applications in diverse fields. This study aimed to identify the optimal design parameters of a simple-to-fabricate and high-performance one-dimensional GMR grating. The structural parameters of the GMR grating were optimized, and a high-refractive-index thin film was simulated on the grating surface, resulting in efficient confinement of the electric field energy within the waveguide. Numerical simulations demonstrated that the optimized GMR grating exhibited remarkable sensitivity (252 nm/RIU) and an extremely narrow full width at half maximum (2 × 10-4 nm), resulting in an ultra-high figure of merit (839,666) at an incident angle of 50°. This performance is several orders of magnitude higher than that of conventional GMR sensors. To broaden the scope of the study and to make it more relevant to practical applications, simulations were also conducted at incident angles of 60° and 70°. This holistic approach sought to develop a comprehensive understanding of the performance of the GMR-based sensor under diverse operational conditions.

Admittance analysis of broadband omnidirectional near-perfect absorber in epsilon-near-zero mode.

In this paper, we propose a broadband omnidirectional near-perfect absorber that transforms light energy into heat. In contrast to previous research on structural metamaterials, this study focuses on light absorption in the epsilon-near-zero (ENZ) layers without any structural patterns. Chromium (Cr) thin films were applied as ENZ layers. Using the admittance method, we found the proper thicknesses of SiO2 layers to match the incident medium and achieve perfect absorption. Also, the absorber is angular insensitive up to 60°. The temperature of the absorber increases from room temperature to 42°C, which is 4°C higher than the uncoated substrate at 38°C, after exposure to sunlight for 20 min.

Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan.

UNLABELLED: Mass screening with abdominal ultrasonography (AUS) has been suggested as a tool to control adult hepatocellular carcinoma (HCC) in individuals, but its efficacy in reducing HCC mortality has never been demonstrated. This study aimed to assess the effectiveness of reducing HCC mortality by mass AUS screening for HCC based on a program designed and implemented in the Changhua Community-based Integrated Screening (CHCIS) program with an efficient invitation scheme guided by the risk score. We invited 11,114 (27.0%) of 41,219 eligible Taiwanese subjects between 45 and 69 years of age who resided in an HCC high-incidence area to attend a risk score-guided mass AUS screening between 2008 and 2010. The efficacy of reducing HCC mortality was estimated. Of the 8,962 AUS screening attendees (with an 80.6% attendance rate), a total of 16 confirmed HCC cases were identified through community-based ultrasonography screening. Among the 16 screen-detected HCC cases, only two died from HCC, indicating a favorable survival. The cumulative mortality due to HCC (per 100,000) was considerably lower in the invited AUS group (17.26) compared with the uninvited AUS group (42.87) and the historical control group (47.51), yielding age- and gender-adjusted relative mortality rates of 0.69 (95% confidence interval [CI]: 0.56-0.84) and 0.63 (95% CI: 0.52-0.77), respectively. CONCLUSION: The residents invited to community-based AUS screening for HCC, compared with those who were not invited, showed a reduction in HCC mortality by ∼ 31% among subjects aged 45-69 years who had not been included in the nationwide vaccination program against hepatitis B virus infection.

The design, fabrication and characterization of a transparent atom chip.

This study describes the design and fabrication of transparent atom chips for atomic physics experiments. A fabrication process was developed to define the wire patterns on a transparent glass substrate to create the desired magnetic field for atom trapping experiments. An area on the chip was reserved for the optical access, so that the laser light can penetrate directly through the glass substrate for the laser cooling process. Furthermore, since the thermal conductivity of the glass substrate is poorer than other common materials for atom chip substrate, for example silicon, silicon carbide, aluminum nitride. Thus, heat dissipation copper blocks are designed on the front and back of the glass substrate to improve the electrical current conduction. The testing results showed that a maximum burnout current of 2 A was measured from the wire pattern (with a width of 100 µm and a height of 20 µm) without any heat dissipation design and it can increase to 2.5 A with a heat dissipation design on the front side of the atom chips. Therefore, heat dissipation copper blocks were designed and fabricated on the back of the glass substrate just under the wire patterns which increases the maximum burnout current to 4.5 A. Moreover, a maximum burnout current of 6 A was achieved when the entire backside glass substrate was recessed and a thicker copper block was electroplated, which meets most requirements of atomic physics experiments.

Enhanced performance of proton exchange membrane fuel cells by Pt/carbon/antimony-doped tin dioxide triple-junction catalyst.

A composite material comprising carbon black and Sb-doped SnO2 (ATO) is employed as a support for a Pt catalyst in a membrane electrode assembly (MEA) to improve the performance of a proton-exchange membrane fuel cell under low-humidity conditions. The effects of Sb-doping on the crystal, structural, and electrochemical characteristics of ATO particles are being examined. In a single cell test, the ratio of Sb in ATO is systematically optimized to improve performance. The distribution of Pt nanoparticles is uniform on carbon black and ATO carrier, forming notable triple-junction points at the interface of carbon black and ATO carrier. This structure thus induces a strong interaction between Pt and ATO, promoting the content of metallic Pt. Compared with a Pt/C catalyst, the best-performing Pt/C-ATO catalyst exhibits superior electrochemical activity, stability, and CO tolerance. The power density of MEA with the Pt/C-ATO catalyst is 15% higher than that of the MEA with the Pt/C catalyst.

Polarization phase-shifting Newton interferometer for plane optical surface measurements.

This Letter introduces a polarization phase-shifting Newton interferometer that can be utilized for plane optical surface measurements, a setup constructed to realize the interferometer, and the experimental results from the use of the setup. The results confirm not only the validity but also the feasibility of the interferometer.

Design of a High-Efficiency Multilayer Dielectric Diffraction Grating with Enhanced Laser Damage Threshold.

Diffraction gratings are becoming increasingly widespread in optical applications, notably in lasers. This study presents the work on the characterization and evaluation of Multilayer Dielectric Diffraction Gratings (MDG) based on the finite element method using Comsol MultiPhysics software. The optimal multilayer dielectric diffraction grating structure using a rectangular three-layer structure consisting of an aluminum oxide Al2O3 layer sandwiched between two silicon dioxide SiO2 layers on a multilayer dielectric mirror is simulated. Results show that this MDG for non-polarized lasers at 1064 nm with a significantly enhanced -1st diffraction efficiency of 97.4%, reaching 98.3% for transverse-electric (TE) polarization and 96.3% for transverse-magnetic (TM) polarization. This design is also preferable in terms of the laser damage threshold (LDT) because most of the maximum electric field is spread across the high LDT material SiO2 for TE polarization and scattered outside the grating for TM polarization. This function allows the system to perform better and be more stable than normal diffraction grating under a high-intensity laser.

Specular scattering probability of acoustic phonons in atomically flat interfaces.

We report a direct determination of the specular scattering probability of acoustic phonons at a crystal boundary by observing the escape of incident coherent phonons from the coherent state during reflection. In the sub-THz frequency range where the phonon wavelength is much longer than the lattice constant, the acoustic phonon-interface interaction is found to agree well with the macroscopic theory on wave scattering from rough surfaces. This examination thus quantitatively verifies the dominant role of atomic-scale corrugations in the Kapitza anomaly observed at 1-10 K and further opens a new path to nondestructively estimate subnanoscale roughness of buried interfaces.

The deviation of growth model for transparent conductive graphene.

An approximate growth model was employed to predict the time required to grow a graphene film by chemical vapor deposition (CVD). Monolayer graphene films were synthesized on Cu foil at various hydrogen flow rates from 10 to 50 sccm. The sheet resistance of the graphene film was 310Ω/□ and the optical transmittance was 97.7%. The Raman intensity ratio of the G-peak to the 2D peak of the graphene film was as high as ~4 when the hydrogen flow rate was 30 sccm. The fitting curve obtained by the deviation equation of growth model closely matches the data. We believe that under the same conditions and with the same setup, the presented growth model can help manufacturers and academics to predict graphene growth time more accurately.