Solid-State Synthesis of Highly Dispersed Nitrogen-Coordinated Single Iron Atom Electrocatalysts for Proton Exchange Membrane Fuel Cells.

Fe-N-C with atomically dispersed Fe single atoms is the most promising candidate to replace platinum for the oxygen reduction reaction (ORR) in fuel cells. However, the conventional synthesis procedures require quantities solvents and metal precursors, sluggish adsorption process, and tedious washing, resulting in limited metal doping and uneconomical for large-scale production. For the first time, Fe2O3 is adopted as the Fe precursor to derive abundant single Fe atoms dispersed on carbon surfaces. The Fe-N-C catalyst synthesized by this simple method shows an excellent ORR activity with half-wave potentials of 0.82 and 0.90 V in acidic and alkaline solutions, respectively. A single fuel cell with an optimized Fe-N-C cathode shows a high peak power density of 0.84 W cm-2. The solid-state transformation synthesis method developed in this study may shed light on mass production of single-atom-based catalysts.

The utilization of automated external defibrillators in Taiwan.

BACKGROUND: Increasing attention to care of patient succumbed to out-of-hospital cardiac arrest (OHCA) and evidence for improved survival have resulted in many countries to encourage the use automated external defibrillators (AEDs) by legislation. In Taiwan, the amendment of the Emergency Medical Services Act mandated the installation of AEDs in designated areas in 2013. Since then, 6151 AEDs have been installed and registered in mandated and non-mandated locations. The purpose of this study was to investigate the utilization of AEDs at mandated and non-mandated locations. METHODS: This paper analyzed 217 cases in whom AEDs was used between July 11, 2013 and July 31, 2015. Descriptive statistics were used to analyze the data. RESULTS: The highest frequency of AEDs used was in long-term care facilities, accounting for 34 (15.7%) cases. The second and third highest was in schools and commuting stations. The highest utilization rate of registered AED was in long-term care facilities (73.9%), the second was in residential areas, and the third was in hot spring areas. Employees at the designated locations or medical personnel operated the AED in 143 cases (84.6%), and bystanders, relatives, friends or others operated the AEDs in 26 cases (15.4%). On-site Return of Spontaneous Circulation (ROSC) after applying AEDs occurred in 76 cases (45.8%). CONCLUSION: Long-term care facilities had the highest utilization of AEDs and government should pay more attention to enforce the installing of AEDs in these places. The government also needs to promote the education public on how to search the AEDs locations.

Ethnic variations in the estimated prevalence of orofacial clefts in Taiwan, 2004 to 2006.

BACKGROUND: Foreign-born mothers have been reported to have better pregnancy outcomes as measured by the preterm birth rate, neonatal mortality, and birth weight compared with native-born mothers in Belgium, France, Taiwan, and the United States. However, little is known about the association between maternal nationality and the prevalence of orofacial clefts in Asian countries. METHODS: Taiwan Birth Registry data from 2004 to 2006 were analyzed for an association between maternal nationality and orofacial clefts. Singleton live births with a gestational age ≥24 weeks were included in this study. RESULTS: The overall estimated prevalence percentages of orofacial clefts were 0.11 (95% confidence interval [CI]  =  0.03 to 0.12) among newborns of Taiwan-born mothers (TBMs) and 0.13 (95% CI  =  0.04 to 0.16) among newborns of foreign-born mothers (FBMs), respectively. The estimated prevalence of orofacial clefts of all live births of FBMs in Taiwan was similar to that of the FBMs from Southeast Asian countries. CONCLUSION: There was a slightly higher but no significant difference of estimated prevalence of orofacial clefts between newborns of TBMs and newborns of FBMs in Taiwan.

Pheochromocytoma presented as intestinal pseudo-obstruction and hyperamylasemia.

Pheochromocytoma has wide variations in alimentary presentations and complications. Here, we report a patient with pheochromocytoma who developed intestinal pseudo-obstruction and hyperamylasemia. The intestinal pseudo-obstruction responded promptly to intravenous infusions of phentolamine, an alpha-adrenergic blocker managed to control hypertensive crisis. The hyperamylasemia regressed gradually after resection of the tumor. The role of catecholamines liberated from the tumor is discussed in the associated pathogenesis. Early recognition of pheochromocytoma with gastrointestinal manifestations will facilitate proper management and prevent possible lethal outcome.

Healthy lifestyle and normal waist circumference are associated with a lower 5-year risk of type 2 diabetes in middle-aged and elderly individuals: Results from the healthy aging longitudinal study in Taiwan (HALST).

Type 2 diabetes mellitus (DM) is known to be closely associated with lifestyle and obesity and has a prevalence that increases with age. This study aimed to assess the short-term composite effect of diet, physical activity, psychosocial health, and waist circumference (WC) on the incidence of DM in the elderly and to provide a lifestyle-based predictive index.We used baseline measurements (2009-2013) of 5349 community-dwelling participants (aged 55 years and older, 52% female) of the Healthy Aging Longitudinal Study in Taiwan (HALST) for fasting plasma glucose, HbA1C, serum cholesterol, triglycerides, blood pressures, WC, and outcomes of home-visit questionnaire. Principal component analysis (PCA) was used to identify participants with a healthy lifestyle (HLF: higher diet, physical activity, and psychosocial scores) and a lower WC, with cutoffs determined by the receiver-operating characteristics. A Cox regression model was applied to 3424 participants without DM at baseline by linking to their National Health Insurance records (median follow-up of 3.1 years).In total, 247 new DM cases (7.2%) were identified. The HLF and lower WC group had a relative risk (RR) of DM of 0.54 (95% CI 0.35-0.82) compared to the non-HLF and higher WC group. When stratified by the presence of impaired glucose tolerance (IGT) or metabolic syndrome (MS), only participants with IGT/MS showed significant risks (RR 0.55; 95% CI 0.33-0.92). However, except for WC, the individual lifestyle factors were nonsignificant in the overall model without PCA.A composite protective effect of HLF and normal WC on DM within 5 years was observed, especially in those with IGT or MS. Psychosocial health constituted an important lifestyle factor in the elderly. The cutoffs identified could be used as a lifestyle-based risk index for DM. Maintaining an HLF to prevent DM is especially important for the elderly.