Metal-Free Transparent Three-Dimensional Flexible Electronics by Selective Molecular Bridges.

Flexible and transparent electronics is a new generation of device enabling modern interactive designs, which facilitates the recent development of low-cost, lightweight, and flexible materials. Although conventional indium tin oxide material still dominates the major market, its brittleness and steadily increasing price drive scientists to search for other alternatives. To meet the high demand, numerous metallic or organic conductive materials have been developed, but their poor adhesion toward supporting substrates and the subsequent circuit patterning approach remains problematic. In this study, a robust metal-free flexible conductive film fabrication strategy is introduced. The flexible polyethylene terephthalate (PET) film is utilized as the base, where a poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS) conductive layer is tightly linked onto this supporting substrate. An interface activation process, i.e., oxygen plasma treatment, generates PET surface active spots to react with the subsequently introduced poly(vinyl alcohol) (PVA) molecule functional groups. This spatially selective PVA molecular bridge therefore acts as a dual-function intermediate layer through covalent bonding toward PET and hydrogen bonding toward PEDOT:PSS to conjugate two distinct materials. This PEDOT:PSS/PVA/PET film delivers superior physical properties, such as a high conductivity of 38.2 Ω/sq and great optical transmittance of 84.1%, which are well tunable under conductive polymer thickness controls. The film is also durable and can maintain original electrical properties even under serious bending for hundreds of cycles. Relying on these outstanding performances, arbitrary conductive circuits are built on this flexible substrate and can function as normal electronics when integrated with multiple electronic parts, e.g., light-emitting diodes (LEDs). Superior electrical signal outputs are achieved when complicated stereo structures including folding, splicing, interlacing, and braiding are incorporated, enabling the use of these films for flexible three-dimensional electronics assembling. Space identifying smart key and lock pair, origami rabbit-carrot touch response, pressure-stimulated jumping frog, and moving dinosaur recognition designs realize these PEDOT:PSS/PVA/PET film-based human-machine interactive devices. This flexible, transparent, and conductive film generation approach by molecular bridge creation should facilitate future development of flexible or foldable devices with complex circuits.

First-4-week erythrocyte sedimentation rate variability predicts erythrocyte sedimentation rate trajectories and clinical course among patients with pyogenic vertebral osteomyelitis.

BACKGROUND: The trajectory pattern of erythrocyte sedimentation rate (ESR) in patients with pyogenic vertebral osteomyelitis (PVO) and its clinical significance is unclear. We further evaluated whether the first-4-week ESR variability can predict the trajectory pattern, treatment duration and recurrence of PVO. METHODS: The longitudinal ESR patterns of adults with PVO within the first 6 months were characterized through group-based trajectory modeling (GBTM). The ESR variability within the first 4 weeks was defined using the absolute difference (AD), coefficient of variation, percent change, and slope change. The first-4-week ESR variabilities were analyzed using ordinal logistic regression to predict the 6-month ESR trajectory and using logistic regression to predict treatment duration and recurrence likelihood. The discrimination and calibration of the prediction models were evaluated. RESULTS: Three ESR trajectory patterns were identified though GBTM among patients with PVO: Group 1, initial moderate high ESR with fast response; Group 2, initial high ESR with fast response; Group 3, initial high ESR with slow response. Group 3 patients (initial high ESR with slow response) were older, received longer antibiotic treatment, and had more comorbidities and higher recurrence rates than patients in the other two groups. The initial ESR value and ESR - AD could predict the 6-month ESR trajectory. By incorporating the first-4-week ESR variabilities and the clinical features of patients, our models exhibited moderate discrimination performance to predict prolonged treatment (≥12 weeks; C statistic, 0.75; 95% confidence interval [CI], 0.70 to 0.81) and recurrence (C statistic, 0.69; 95% CI, 0.61 to 0.78). CONCLUSIONS: The initial ESR value and first-4-week ESR variability are useful markers to predict the treatment duration and recurrence of PVO. Future studies should validate our findings in other populations.

Recommendations and guidelines for the treatment of pneumonia in Taiwan.

Pneumonia is a leading cause of death worldwide, ranking third both globally and in Taiwan. This guideline was prepared by the 2017 Guidelines Recommendations for Evidence-based Antimicrobial agents use in Taiwan (GREAT) working group, formed under the auspices of the Infectious Diseases Society of Taiwan (IDST). A consensus meeting was held jointly by the IDST, Taiwan Society of Pulmonary and Critical Care Medicine (TSPCCM), the Medical Foundation in Memory of Dr. Deh-Lin Cheng, the Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines. The final guideline was endorsed by the IDST and TSPCCM. The major differences between this guideline and the 2007 version include the following: the use of GRADE methodology for the evaluation of available evidence whenever applicable, the specific inclusion of healthcare-associated pneumonia as a category due to the unique medical system in Taiwan and inclusion of recommendations for treatment of pediatric pneumonia. This guideline includes the epidemiology and recommendations of antimicrobial treatment of community-acquired pneumonia, hospital-acquired pneumonia, ventilator-associated pneumonia, healthcare-associated pneumonia in adults and pediatric pneumonia.

Clinical characteristics, treatments, and outcomes of hematogenous pyogenic vertebral osteomyelitis, 12-year experience from a tertiary hospital in central Taiwan.

BACKGROUND: In Taiwan, studies about hematogenous pyogenic vertebral osteomyelitis (HPVO) are limited. We conducted a retrospective study to evaluate the clinical presentations, treatment, and outcomes of patients with the diagnosis of HPVO. METHOD: This 12.5-year retrospective study included patients with a diagnosis of HPVO. Medical records of all HPVO patients were thoroughly reviewed and their clinical data were analyzed by the SPSS software. RESULT: 414 HPVO cases were included and the mean age was 61.6 ± 13.4 years. The mean duration of symptoms was 29 ± 35.3 days and pain over the affected site was reported by most patients (86.0%). Gram-positive bacteria, especially Staphylococcus aureus (162/399 = 40.6%), were the main HPVO pathogens. Escherichia coli (42/399 = 10.5%) was the most common gram-negative isolate. Surgery was performed in 68.8% of cases and the mean duration of total antibiotic treatment was 104.7 ± 77.7 days. All-cause mortality and recurrence rates were 6.3% and 18.8%, respectively. In multivariate analysis, polymicrobial infection (OR: 4.154, 95% CI: 1.039-16.604, p = 0.044), multiple vertebral body involvement (OR: 2.202, 95% CI: 1.088-4.457, p = 0.028), abscess formation treated with antibiotics alone (OR: 2.912, 95% CI: 1.064-7.966, p = 0.037), and the duration of antimicrobial treatment less than 4 weeks (OR: 3.737, 95% CI: 1.195-11.683, p = 0.023) were associated with HPVO recurrence. CONCLUSION: In Taiwan, HPVO mainly affected the elderly and S. aureus remained the most common HPVO pathogen. In patients with risk factors associated with HPVO recurrence, a longer duration (≥6 weeks) of antimicrobial therapy is suggested.