Impact of Telemedicine on Blood Glucose Control and Ophthalmic Screenings for Patients with Diabetes in Remote Areas During the COVID-19 Pandemic: A Real-World Study in Northern Taiwan.

Introduction: The purpose of this study was to assess the impact of telemedicine on ophthalmic screening and blood glucose control for patients with diabetes in remote areas of Northern Taiwan during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Telemedicine was implemented in Shiding and Wanli Districts using a 5G platform from April 2021 to December 2022. Patients with poorly controlled diabetes received real-time consultations from endocrinologists at Far Eastern Memorial Hospital, 50 km away, for medication adjustment, diet control, and lifestyle recommendations. The study also provided cloud-upload blood glucose meters for self-monitoring and regular medical advice from hospital nurses. Ophthalmic screenings included fundus imaging, external eye image, and intraocular pressure measurement, with instant communication and diagnosis by ophthalmologists through telemedicine. A satisfaction questionnaire survey was conducted. Results: The study enrolled 196 patients with diabetes. Blood glucose and glycosylated hemoglobin levels were significantly reduced after applying telemedicine (p = 0.01 and p = 0.005, respectively). Ophthalmic screenings led to hospital referrals for 16.0% with abnormal fundus images, 15.6% with severe cataract or anterior segment disorders, and 27.9% with ocular hypertension or glaucoma. Fundus screening rates remained high at 86.3% and 80.4% in 2022, mainly using telemedicine, comparable with the traditional screening rate in the past 5 years. The overall satisfaction rate was 98.5%. Conclusions: Telemedicine showed effectiveness and high satisfaction in managing diabetes and conducting ophthalmic screenings in remote areas during the COVID-19 pandemic. It facilitated early diagnosis and treatment of ocular conditions while maintaining good blood glucose control and fundus screening rates.

Functional p-Type, Polymerized Organic Electrode Interlayer in CH3NH3PbI3 Perovskite/Fullerene Planar Heterojunction Hybrid Solar Cells.

Thermal curing of the styrene-functionalized 9,9-diarylfluorene-based triaryldiamine monomer (VB-DAAF) forms an ideal p-type organic electrode interlayer capable of resisting solvation of the polar precursor solution in fabricating methylammonium lead iodide (CH3NH3PbI3) perovskite/fullerene (C60) planar heterojunction hybrid solar cells. The polymerized VB-DAAF film exhibits a good energy level alignment with the valence-band-edge level of the CH3NH3PbI3 perovskite to facilitate the transport of holes. The large energy barrier to the conduction-band-edge level of the CH3NH3PbI3 perovskite effectively blocks electrons from reaching the positive electrode and reduces the photon energy loss due to recombination. The best-performing cell with the configuration of glass/indium-tin oxide/polymerized VB-DAAF/CH3NH3PbI3 perovskite/C60/bathocuproine/aluminum is free of a poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) ( PEDOT: PSS) layer to achieve an open-circuit voltage (VOC) = 1.02 V, a short-circuit current (JSC) = 18.92 mA/cm(2), and a fill factor (FF) = 0.78, corresponding to a power conversion efficiency (PCE) of 15.17% under standard 1 sun AM 1.5G simulated solar irradiation. The performance is much superior to the device applying the PEDOT: PSS interlayer with photovoltaic parameters of VOC = 0.85 V, JSC = 16.37 mA/cm(2), and FF = 0.74, corresponding to a PCE of 10.27%. Additionally, we had applied a UV-assisted process to polymerize the VB-DAAF film at relatively lower temperature and fabricate decent perovskite-based solar cells on the flexible substrate for real applications.

Decolorization of azo dye using PVA-immobilized microorganisms.

A microbial consortium having a high capacity for rapid decolorization of azo dye (RED RBN) was immobilized by a phosphorylated polyvinyl alcohol (PVA) gel. The immobilized-cell beads exhibited a color removal capability of 75%, even at a high concentration of RED RBN (500 mg l(-1)) within 12 h using flask culture. The continuous operation was conducted at a hydraulic retention time (HRT) of 5-20 h in which the dye loading rate ranged from 240 to 60 mg dye h(-1). A removal efficiency exceeding 90% was obtained at the HRT higher than 10 h. No recognizable destruction of bead appearance was observed in the 6-month operation. Examination of the mechanism of the decolorization process by cell beads indicated that it proceeded primarily by biological decolorization associated with partial adsorption of the dye onto the entrapped cells and gel matrix. Microscopic observation revealed that the microbial consortium contained in the gel beads was at least made up of three kinds of bacterial species. From the economical viewpoint, alternative cheaper nitrogen sources such as fish meal, soybean meal, pharmamedia and vita yeast powder were examined.

Decolorization of the textile dyes by newly isolated bacterial strains.

Six bacterial strains with the capability of degrading textile dyes were isolated from sludge samples and mud lakes. Aeromonas hydrophila was selected and identified because it exhibited the greatest color removal from various dyes. Although A. hydrophila displayed good growth in aerobic or agitation culture (AGI culture), color removal was the best in anoxic or anaerobic culture (ANA culture). For color removal, the most suitable pH and temperature were pH 5.5-10.0 and 20-35 degrees C under anoxic culture (ANO culture). More than 90% of RED RBN was reduced in color within 8 days at a dye concentration of 3,000 mg l(-1). This strain could also decolorize the media containing a mixture of dyes within 2 days of incubation. Nitrogen sources such as yeast extract or peptone could enhance strongly the decolorization efficiency. In contrast to a nitrogen source, glucose inhibited decolorization activity because the consumed glucose was converted to organic acids that might decrease the pH of the culture medium, thus inhibiting the cell growth and decolorization activity. Decolorization appeared to proceed primarily by biological degradation.

Real-time control of an immobilized-cell reactor for wastewater treatment using ORP.

The performance of an immobilized-cell reactor for simultaneous carbon nitrogen removal in synthetic wastewater with an intermittent aeration (IA) process under real-time control of oxygen supply was investigated. The oxidation-reduction potential (ORP) was monitored during operation. The ORP-time profile showed distinctive turning points. which directly correlated with the changes in the system chemistry and biological activity. The reactor was conducted by cyclic fixed-time aeration nonaeration operation at the beginning, followed by real-time control technology using ORP setpoint. A moving window along the slope of the ORP curve was employed to search for the nitrate breakpoint of the aeration cycle. Once the breakpoint was found, the reactor was aerated for a fixed period. The treatment process could effectively avoid the anoxic fermentation state under the real-time control. The cycle time was reduced around 30%. The duration of aeration period was found to be optimum at 3 h under the consideration of the removal efficiencies of COD and total nitrogen. The real-time control system not only exhibited a better nitrogen removal efficiency than the fixed-time control operation, but it also showed a stable effluent quality during the change of HRT from 3 to 8 h. Good operation stability was demonstrated even when a very high disturbance of the influent loading occurred.

Nickel oxide electrode interlayer in CH3 NH3 PbI3 perovskite/PCBM planar-heterojunction hybrid solar cells.

This study successfully demonstrates the application of inorganic p-type nickel oxide (NiOx ) as electrode interlayer for the fabrication of NiOx /CH3 NH3 PbI3 perovskite/PCBM PHJ hybrid solar cells with a respectable solar-to-electrical PCE of 7.8%. The better energy level alignment and improved wetting of the NiOx electrode interlayer significantly enhance the overall photovoltaic performance.

Using redox potential to detect microbial activities during clavulanic acid biosynthesis in Streptomyces clavuligerus.

Production of clavulanic acid (CA) by Streptomyces clavuligerus in a shake-flask culture increased from 92 to 180 mg l(-1) with an increased O2 transfer efficiency (0.039 --> 0.058 s(-1)), which maintained the redox potential values above -250 mV. Compared with traditional measures, such as dissolved O2 concentration and respiratory activity, the redox potential can easily be determined and correlates closely with CA production. It can therefore be used to monitor microbial activities during biosyntheses of secondary metabolites.

Hydrodynamic characteristics of immobilized cell beads in a liquid-solid fluidized-bed bioreactor.

This study examined the hydrodynamic characteristics of a liquid-solid fluidized-bed bioreactor using elastic particles (PVA gel beads) of various diameters as carriers. The drag coefficient-Reynolds number, velocity-voidage, and expansion index-Reynolds number relationships observed during fluidization of PVA gel beads in a fluidized bed in our experiments were compared with the published results. Predictions made from previous correlations were examined with our new experimental findings, revealing the inadequacy of most of these correlations. Thus, new correlations describing the above-mentioned relationships are suggested. The drag coefficient of immobilized cell beads is larger than that of free cell ones at the same Reynolds number because the surface of the immobilized cell beads is rougher. For multiparticle systems, the correction factor, f(epsilon), is a function of the falling gel bead properties (Reynolds number) as well as the fluidized gel bead properties (Archimedes number), and depend strongly on the bed voidage (epsilon). A new simple relation was developed to predict easily the epsilon value from 0.5-0.9 at 4,986 < A(r) < 40,745 or 34 < Re(t) < 186. For all the immobilized cell beads used in this study, the prediction error of the bed voidage was less than 5% at epsilon > 0.5. The prediction equations in this study can be further applied to analyzing the hydrodynamic characteristics of a fluidized-bed reactor using similar entrapped elastic particles as carriers.

Evaluation of effective diffusion coefficient and intrinsic kinetic parameters on azo dye biodegradation using PVA-immobilized cell beads.

An immobilized mixed culture (Aeromonas hydrophila, Comamonas testosteroni, and Acinetobacter baumannii) was prepared by entrapment into phosphorylated polyvinyl alcohol (PVA) gel beads. The unsteady-state diffusion mechanism in a gel bead was applied to estimate the effective diffusion coefficients (D(e)) and the partition coefficients (K(p)) of azo dye. In addition, a simple method was developed to determine the intrinsic kinetic parameters of immobilized cells from observed reaction rates and the intrinsic kinetic parameters were then verified by fitting the experimental data into the reaction-diffusion model in a batch reactor running at a well-stirred state. The calculated effectiveness factor (eta(cal)) approached unity at Thiele modulus (Phi) < 0.3 (i.e., d(p) < 0.475 mm). The experimental effectiveness factor (eta(exp)) was in the range of 0.71-0.45 for a corresponding sphere diameter (d(p)) of 1.91 +/- 0.16 to 4.43 +/- 0.07 mm at an initial dye concentration of 200 mg/L. The results show that intraparticle diffusion resistance has a significant effect on the azo dye biodegradation rate.