Comparison of outcomes of laparotomic and minimally invasive radical hysterectomy in women with early-stage cervical cancer.

OBJECTIVE: This study compared the outcomes of laparotomic radical hysterectomy (LRH) and minimally invasive radical hysterectomy (MISRH) in patients with early-stage cervical cancer. METHODS: The clinical data of patients with early-stage cervical cancer who underwent LRH or MISRH (laparoscopic/robotic) at Chang Gung Memorial Hospital, Linkou Branch, from 2002 to 2017 were retrospectively reviewed. The surgical safety (operation time, blood loss, blood transfusion rate, length of postoperative stay, and perioperative complications), overall survival (OS), disease-free survival (DFS), and recurrence pattern were analyzed. Propensity score matching (PSM) at a 3:1 ratio was performed to balance prognostic variables. RESULTS: Of the 760 patients (entire cohort), 614 underwent LRH and 146 underwent MISRH. After PSM, 394 and 140 patients were included in the LRH and MISRH groups, respectively. The 5-year OS rate was significantly lower in the MISRH group than in the LRH group (85.6% vs. 93.2%, p=0.043), and the 5-year DFS rate (p=0.21) did not differ significantly. After PSM, the 5-year OS rates did not differ significantly between the MISRH and LRH groups (87.1% vs. 92.1%, p=0.393). The MISRH group had a significantly shorter operation time (p<0.001), lower intraoperative blood loss (p<0.001), lower blood transfusion rate (p<0.001), and shorter postoperative stay (p<0.001) but a significantly higher rate of intraoperative bladder injury (p<0.001) than the LRH group. CONCLUSION: After PSM, MISRH is associated with nonsignificantly lower OS but a significantly higher risk of intraoperative urological complications than LRH.

A microgel of CdSe quantum dots for fluorescent bisphenol A detection.

A fluorescent microgel for BPA detection has been successfully prepared by cross-linking linear poly(styrene-co-glycidyl methacrylate) (poly (STY-co-GMA)) with L-cysteine-capped CdSe quantum dots (Lcys-caped CdSe QDs). The microgel contained specific binding sites created by the covalent grafting of the copolymer onto the QDs via the GMA units, allowing for selective trapping of BPA molecules through π-π and hydrogen bond interactions with phenyl, carboxylic, and amine groups. After binding, electron transfer from the QDs to the analyte quenched the fluorescence at a wavelength of 547 nm when excited at 400 nm. The rational compositional and structural design allows the microgel to accurately detect BPA concentrations over a wide dynamic range of 1.0×10-1 to 1.0×105 µg/L with a low detection limit (7.0×10-2 to 8.0×10-2 µg/L) in deionized, drinking, and tap waters within just 2.0 min. On top of that, the sensitivity for BPA detection was 2.0-4.6 times higher than that of the other 3 structural analogues, even molecular imprinting was not involved. The influence of the STY/GMA compositions in the copolymers and environmental conditions, including pH and ionic strength, on the sensing performance was determined. Moreover, the sensing mechanism and the selectivity with respect to the molecular features were elucidated.

Plasma cell-free tumor DNA, PIK3CA and TP53 mutations predicted inferior endocrine-based treatment outcome in endocrine receptor-positive metastatic breast cancer.

PURPOSE: How to factor both tumor burden and oncogenic genomic mutations as variables to predict the outcome of endocrine-based therapy (ET) in ER-positive/HER2-negative metastatic breast cancer patients (MBC) remains to be explored. METHOD: Blood samples prospectively collected from 163 ER-positive/HER2-negative female MBC patients, before ET, were used for cell-free tumor DNA (cfDNA) analysis. cfDNA was subjected to next-generation sequencing (NGS) to interrogate oncogenic PIK3CA hotspot and TP53 DNA-binding domain (DBD) mutations, including single nucleotide variants (SNVs) or small insertions and deletions (InDels). The variant calling threshold was set at 0.5%. Progression-free survival (PFS) was measured from the start of the ET treatment to the time of disease progression of the same treatment regimen. RESULTS: Overall, the median PFS was 8.3 months (95% CI 5.7-11.1 months). The median cfDNA was 38.5 ng (range 4.4-1935 ng). The proportion of patients with PIK3CA and TP53 alterations were 25.1 and 15.3%, respectively. Patients with high total cfDNA (HR 1.74, p = 0.003), PIK3CA mutation (HR 1.74, p = 0.007), and TP53 mutation (HR 1.64, p = 0.047) in liquid biopsy conferred worse outcome after ET. Even for patients with low tumor burden, the detrimental effect of PIK3CA or TP53 mutation remained significant (p < 0.001). For patients with either PIK3CA (p < 0.001) or TP53 mutation (p = 0.004), there was significant positive correlation between allele frequency (AF) and total cfDNA. CONCLUSION: After adjustment of cfDNA level, PIK3CA and TP53 mutations observed in liquid biopsy exerted detrimental effects on the outcome of ET-based regimens. The AF of PIK3CA or TP53 may be a surrogate marker for PFS.

Exploring the interior of 3D endoluminal lesions in the air spaces by a novel electronic biopsy technique: A preliminary study of endoluminal colon lesions.

To explore the interior of a lesion in a 3D endoluminal view, this study investigates the application of an 'electronic biopsy' (EB) technique to computed tomographic colonography (CTC) for further differentiation and 2D image correlation of endoluminal lesions in the air spaces. A retrospective study of sixty-two various endoluminal lesions from thirty patients (13 males, 17 females; age range, 31 to 90 years) was approved by our institutional review board and evaluated. The endoluminal lesions were segmented using gray-level threshold and reconstructed into isosurfaces using a marching cube algorithm. EB allows users to interactively erode and apply grey-level mapping (GM) to the surface of the region of interest (ROI) in 3D CTC. Radiologists conducted the clinical evaluation, and the resulting data were analyzed. EB significantly improves 3D gray-level presentation for evaluating the surface and inside of endoluminal lesions over that of SR, GM or target GM (TGM) (P < 0.01) with preservation of the 3D spatial effect. Moreover, 3D to 2D image correlation were achieved in any layer of the lesion using EB as did GM/TGM on the surface. The specificity and diagnostic accuracy of EB are significantly greater than those of SR (P < 0.01). These performance can be better further with GM/TGM and reach the best with EB (specificity, 89.3-92.9%; accuracy, 95.2-96.8%). EB can be used in CTC to improve the differentiation of endoluminal lesions. EB increases 3D to 2D image correlations of the lesions on or beneath the lesion surface.

Evaluation and optimization of a HS-SPME-assisted GC-MS/MS method for monitoring nitrosamine impurities in diverse pharmaceuticals.

The probable carcinogenic nitrosamine impurities, such as N-nitrosodiethylamine (NDEA) and N-nitrosodimethylamine (NDMA), have been detected from various pharmaceuticals in recent years. The sensitive chromatographic methods, including liquid chromatography (LC) and gas chromatography (GC), have been applied for analyzing nitrosamines in the pharmaceutical substrates, such as sartans, ranitidine and metformin. In comparison of LC, the efficacy of GC for analyzing multiple nitrosamines in diverse pharmaceuticals will be limited or attenuated owing to the chemical properties of target analytes or matrix hinderance of pharmaceutical substrates. To extend the applicability of GC analysis for multiple nitrosamines in pharmaceuticals, this study presented a gas chromatograph tandem mass (GC-MS/MS) method for monitoring 14 nitrosamines within 44 pharmaceuticals, whereas the headspace-solid phase microextraction (HS-SPME) sampling mode was introduced. Chromatographic separation was achieved on a DB-heavyWax column (30 m × 0.25 mm; i.d., 0.25 µm), whereas the HS-SPME sampling mode with a 50/30 µm DVB/CAR/PDMS extracting fiber was applied for comparison of the direct injection mode. Meanwhile, the HS-SPME conditions were optimized to evaluate the effects of the parameters on analyzing total nitrosamines in pharmaceuticals by GC-MS/MS. The optimal conditions of HS-SPME were as follows: extracting solution of 90% NaCl, HS incubation time 1 min, SPME adsorbing at 80 â„ƒ for 30 min, and desorbing at 250 â„ƒ for 5 min. The limit of quantification (LOQ) for 14 nitrosamines in pharmaceutical matrices under the optimal conditions was 0.05 µg/g for the optimal HS-SPME, whereas the value was 0.05-0.25 µg/g for direct injection.

Syphilis and ischemic stroke: Old question revisited by a nationwide cohort study.

BACKGROUND AND PURPOSE: In the era of easily available antibiotic use, this study provides epidemiological evidence for a re-examination of the relationship between syphilis and ischemic stroke (IS). METHODS: Patients aged 18 years and older with newly diagnosed syphilis were included (n = 1585) from 2000 to 2012, and participants without syphilis in the control group (n = 6340) were matched by propensity score (age, sex, index year, insured amount, urbanization, seasons, and comorbidities). The Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of IS. Five different Cox regression models, sensitivity analyses, and negative control were conducted to test our findings. RESULTS: In all, 1585 patients (1055 (66.56%) men; mean (SD) age, 49.59 (20.32) years) had syphilis, and 3.8% had new-onset IS. The syphilis group had a higher risk of IS than the controls (adjusted HR, 1.35; 95% CI, 1.01-1.80; p value < 0.05) after full adjustment. Serial sensitivity analyses yielded consistent results. CONCLUSION: Syphilis patients have higher risk of IS, and our data raise the question of implementation of prophylactic treatment for IS.

Toxicity assessments and transcriptional effects of monofunctionalized Pt(II) complex under dark and light irradiation condition in Caenorhabditis elegans.

In vivo toxicity of aromatic ring (BODIPY, 1,3,5,7,8-pentamethyl dipyrrin borondifluoride) attached monofunctional Pt(II) complexes mCBP {[cis-Pt(NH3)2Cl] 8-(para-pyridine-methylene),1,3,5,7-tetramethyl dipyrrin borondifluoride}+ Nitrate- and dCBP {[cis-Pt(NH3)2Cl]28-(1,3-pyrimidine-5-methylene),1,3,5,7-tetramethyl dipyrrin borondifluoride}2+ diNitrate2- were tested in Caenorhabditis elegans (C. elegans). dCBP showed promising reactive oxygen ROS (reactive oxygen species) generating capability. This complex resulted reduction of lifespan, body length and egg laying rate under dark and light irradiation in both N2 (wild-type, cisplatin resistant) and ok938 (asna-1, cisplatin sensitive) C. elegans. Expressional change of several key cancer related pathway (JNK (c-Jun N-terminal kinase) and Wnt/ß-catenin (Wingless/Integrated/ß-catenin)) related genes (for instance, jnk-1, wrm-1 and gst-4) were confirmed by RNA sequencing experiments. These transcriptional alternations could explain physiological parameters change in nematode and partially revealed how both Pt(II) based complexes influence cancer related pathways. Furthermore, these associated genes exhibited the function of apoptosis, reduced chemoresistance of cancer cells and most of those expressional changes were linked to extended survival of cancer patients.

Phonetic posteriorgram-based voice conversion system to improve speech intelligibility of dysarthric patients.

BACKGROUND AND OBJECTIVE: Most dysarthric patients encounter communication problems due to unintelligible speech. Currently, there are many voice-driven systems aimed at improving their speech intelligibility; however, the intelligibility performance of these systems are affected by challenging application conditions (e.g., time variance of patient's speech and background noise). To alleviate these problems, we proposed a dysarthria voice conversion (DVC) system for dysarthric patients and investigated the benefits under challenging application conditions. METHOD: A deep learning-based voice conversion system with phonetic posteriorgram (PPG) features, called the DVC-PPG system, was proposed in this study. An objective-evaluation metric of Google automatic speech recognition (Google ASR) system and a listening test were used to demonstrate the speech intelligibility benefits of DVC-PPG under quiet and noisy test conditions; besides, the well-known voice conversion system using mel-spectrogram, DVC-Mels, was used for comparison to verify the benefits of the proposed DVC-PPG system. RESULTS: The objective-evaluation metric of Google ASR showed the average accuracy of two subjects in the duplicate and outside test conditions while the DVC-PPG system provided higher speech recognitions rate (83.2% and 67.5%) than dysarthric speech (36.5% and 26.9%) and DVC-Mels (52.9% and 33.8%) under quiet conditions. However, the DVC-PPG system provided more stable performance than the DVC-Mels under noisy test conditions. In addition, the results of the listening test showed that the speech-intelligibility performance of DVC-PPG was better than those obtained via the dysarthria speech and DVC-Mels under the duplicate and outside conditions, respectively. CONCLUSIONS: The objective-evaluation metric and listening test results showed that the recognition rate of the proposed DVC-PPG system was significantly higher than those obtained via the original dysarthric speech and DVC-Mels system. Therefore, it can be inferred from our study that the DVC-PPG system can improve the ability of dysarthric patients to communicate with people under challenging application conditions.

Inorganic arsenic speciation analysis in food using HPLC/ICP-MS: Method development and validation.

Arsenic (As) compounds can be classified as organic or inorganic, with inorganic arsenic (iAs) having significantly higher toxicity than organic As. As may accumulate in food materials that have been exposed to As-contaminated environments. Thus, the "Sanitation Standard for Contaminants and Toxins in Foods" published by the Ministry of Health and Welfare set the standard limits for iAs content in rice, seaweed, seafood, and marine oils to safeguard public health. Therefore, a robust analytical method must be developed to selectively and quantitatively determine iAs content in rice, seaweed, seafood, and marine oils. Herein, we reported and verified the method of combined high-performance liquid chromatography/inductively coupled plasma-mass spectrometry (HPLC/ICP-MS) to determine iAs content in a wide variety of food. The fish oil samples were spiked with different concentrations of the As(III) standard solution, and their iAs analyzes were obtained via extraction procedures using the 1% (w/w) nitric acid (HNO3) solution containing 0.2 M hydrogen peroxide (H2O2) under sonication. The extracts were subsequently analyzed for their As(V) contents using HPLC/ICP-MS with aqueous ammonium carbonate as the mobile phase. The As(III) species had completely oxidized into the As(V) species, which prevented interferences between organic and iAs during chromatography. The method showed good extraction efficiencies (generally >90%) for the iAs samples, and their limits of quantification in fish oil were 0.02 mg/kg. The method was verified via the iAs speciation analytes of rice, seaweed, seafood, and marine oil matrices. The average recoveries for the fortified samples of each matrix ranged from 87.5 to 112.4%, with their coefficients of variation being less than 10%. Surveillance studies were conducted on the iAs contents of food samples purchased from local Taiwanese markets. The results showed that the only Hijiki (Sargassum fusiforme) higher than the maximum limit of the sanitation standard for iAs in seaweed, whereas the remaining samples met their corresponding requirements. This method is quick and straightforward, and it can be applied for the routine analysis of iAs content in a wide variety of food products to ensure public health safety.

Central Venous Catheter Penetrating the Spinal Canal via the Spinal Foramen: A Case Report and Literature Review.

The insertion of a neck central venous catheter (CVC) is a common procedure in medical practice; however, malposition and complications frequently occur. A 66-year-old woman had CVC inserted through the right internal jugular vein. CVC malposition was observed on chest radiography and computed tomography. The catheter was accidentally inserted via the vertebral vein and had entered the C6-C7 intervertebral foramen, penetrating the spinal canal with the tip at the T2 epidural space. We present this rare CVC complication to demonstrate the possibility of incorrect insertion of the catheter and penetration of the spinal canal, possibly causing neuronal damage.

Magnetic nanoadsorbents with amino-functionalized polymers for magnetic separation removal of copper ion.

The adsorption of copper ions on magnetic adsorbents with amino-functionalized polymers (DETA/SiO2/Fe3O4) has been investigated. In addition, the structure and characterization of magnetic nano-adsorbents were confirmed using FTIR, TGA, TEM, VSM, and BET. The results showed that DETA/SiO2/Fe3O4 exhibited a paramagnetic behaviour and could be easily recovered and quickly separated from a suspension solution. The optimum pH level for adsorption of copper ions was proposed to be in the range of pH level from 5 to 6, and the maximum adsorption capacity (qm) and activated energy (Ea) at 298 K was 13.459 mg g-1 and 22.421 kJ mol-1, respectively. The copper ions adsorption behaviour by DETA/SiO2/Fe3O4 was in good agreement with the Langmuir isotherm rather than Freundlich equation. A pseudo-second-order model could best describe the adsorption kinetics, and the optimal condition of copper ions desorption (99%) from DETA/SiO2/Fe3O4 was provided by 1.0 M HNO3. The novel magnetic nano-adsorbents could not only be regenerated by HNO3 solutions but also reused by the recovery of magnetic force without requiring further downstream treatment.

Risk of non-typhoidal Salmonella infection in patients with cholecystectomy: Results from a nationwide matched cohort study in Taiwan.

BACKGROUND: The current study was designed to investigate the association between cholecystectomy and the risk of non-typhoidal Salmonella (NTS) infection. METHODS: We obtained claims-based data from the Taiwan National Health Insurance Research Database (NHIRD) to perform a nationwide cohort study. A propensity score (PS)-matching analysis was performed with a ratio of 1:2 in the cholecystectomy cohort and cholecystectomy-free group to reduce selection bias. Both groups were followed until NTS diagnosis, a dropout from the insurance programme or the end of 2013. Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the risk of NTS infection between the cholecystectomy and cholecystectomy-free groups. RESULTS: Our study enrolled 197 444 patients who had undergone cholecystectomy and 394 888 patients who did not receive cholecystectomy. The adjusted HR (aHR) of NTS infection was 1.34 (95% CI, 1.13-1.58; P < .001) for the cholecystectomy group after adjusting for demographical characteristics and relevant comorbidities. The study population is predominantly female patients (55%) and older (58% older than 50 years). The subgroup analysis revealed that both sexes and notably, patients aged >50, who underwent cholecystectomy had a higher risk of NTS infection than the matched controls. Follow-up of patients who underwent cholecystectomy showed that they had a significantly higher risk of NTS infection for more than 6 months after the procedure. CONCLUSIONS: Our study showed that cholecystectomy might be an independent risk factor for subsequent NTS infection.

Metastatic Smooth Muscle Tumor of Uncertain Malignant Potential after Laparoscopic Presuming Myomectomy.

A 38-year-old para-2 female underwent laparoscopic myomectomy with uncontained morcellation. Three years later, she complained of epigastric pain. An intraperitoneal 3 cm mass beneath the umbilicus was showed on computed tomography (CT) scan. With the impression of gastrointestinal stromal tumor, she underwent open laparotomy at the general surgery department. A tumor was excised. Pathological examination showed that the tumor was consistent with a smooth muscle tumor of uncertain malignant potential smooth muscle tumors of uncertain malignant (STUMP). Six years postlaparoscopic myomectomy, during a regular follow-up, three parauterine masses were found on ultrasonography and CT scan. She underwent laparoscopic surgery for hysterectomy, bilateral salpingectomy, and excision of the masses. The masses were again diagnosed as STUMP. This case presents a recurrence of a rare type of smooth muscle tumor after uncontained morcellation. If myomas are to be removed with morcellation, it should only be used appropriately with a compatible containment system, and the risk of occult malignancy should be counseled.

Comparison of the Efficacy and Safety of Dinalbuphine Sebacate, Patient-Controlled Analgesia, and Conventional Analgesia After Laparotomy for Gynecologic Cancers: A Retrospective Study.

OBJECTIVE: We aimed to investigate the effects of dinalbuphine sebacate (DNS), fentanyl-based patient-controlled analgesia (PCA), and conventional analgesia (CA) for pain management after laparotomy for gynecologic cancers. METHODS: A total of 137 eligible patients who underwent laparotomy through a midline incision wound for gynecologic cancer between July 2019 and June 2020 were retrospectively evaluated. The patients were divided into three groups as follows: the intramuscular DNS, intravenous PCA, and CA groups. Postoperative pain (POP) intensity as measured with a numerical rating scale (NRS), total consumption of analgesics, and incidence of treatment-emergent adverse events were compared between the three groups. RESULTS: The DNS group showed significant reduction in NRS pain intensity than the PCA and CA groups on day 1 (4.8 vs 6.2, p < 0.01 and 6.2, p < 0.05, respectively), day 2 (3.0 vs 4.7, p < 0.01 and 4.8, p < 0.001, respectively), day 3 (2.0 vs 3.9, p < 0.001 and 3.5, p < 0.001, respectively), day 4 (1.1 vs 3.1, p < 0.001 and 2.9, p < 0.001, respectively), and day 5 (0.7 vs 2.3, p < 0.001 and 2.4, p < 0.001, respectively). The total consumption of morphine equivalents per day was similar between the DNS and PCA groups (142.8 ± 7.3 mg vs 137.7 ± 70.0 mg, p = 0.8032) and lowest in the CA group (11.7 ± 30.7 mg, p < 0.0001). The overall safety profile was comparable between the DNS, PCA, and CA groups. The patients in the DNS group complained less of dizziness postoperatively than those in the PCA group (27% vs 47%) and had less nausea than those in the CA group (13% vs 33%). CONCLUSION: A single DNS injection was more effective for relieving POP than PCA and CA in the patients who had a longitudinal incision for gynecologic cancer surgery. DNS was well tolerated and had less adverse effects than PCA and CA.

Incidence of dementia after dengue fever: Results of a longitudinal population-based study.

OBJECTIVE: To investigate the epidemiological relationship between dengue fever and the subsequent development of dementia. METHODS: Using nationwide Taiwan registries from the National Health Insurance Research (NHIRD), we identified adults aged over 40 years who received a dengue fever diagnosis from 1 January 2000 to 31 December 2012 and who did not have a history of dementia. We used a propensity score match (PSM) to balance the baseline characteristics between groups. All eligible adults were sorted into either the dengue group or non-dengue group at a ratio of 1:4, matching by age, sex, index years, income level, and relevant comorbidities. Using Cox regression with proportional hazards models, we estimated the risk of dementia. The study period started from 1 January 2000 to 31 December 2013. We conducted sensitivity analyses to cross-validate study results. RESULTS: With a median of 8.01 years of follow-up, patients in the dengue group were more at risk of developing dementia than the non-dengue group. The estimated cumulative incidence of dementia was 7.21% in the dengue group and 4.03% in the non-dengue group (adjusted hazard ratio (aHR), 1.71; 95% CI, 1.03 to 2.83). Sensitivity analyses yielded consistent findings. We excluded any stroke cases before the end of the study, and subgroup analysis by follow-up time showed that the dengue group has a significantly higher risk of new-onset dementia >6 years after the index date (aHR 3.24; 95% CI, 1.42 to 7.37). The P value for interaction was significant (<.0001). CONCLUSIONS: This study demonstrated a significantly higher risk of dementia in patients with dengue fever in Taiwan than in those without dengue fever.

Transwell Insert-Embedded Microfluidic Devices for Time-Lapse Monitoring of Alveolar Epithelium Barrier Function under Various Stimulations.

This paper reports a transwell insert-embedded microfluidic device capable of culturing cells at an air-liquid interface (ALI), mimicking the in vivo alveolar epithelium microenvironment. Integration of a commercially available transwell insert makes the device fabrication straightforward and eliminates the tedious device assembly processes. The transwell insert can later be detached from the device for high-resolution imaging of the cells. In the experiments, the cells showing type-I pneumocyte markers are exploited to construct an in vitro alveolar epithelium model, and four culture conditions including conventional liquid/liquid culture (LLC) and air-liquid interface (ALI) cell culture in normal growth medium, and ALI cell culture with inflammatory cytokine (TNF-α) stimulation and ethanol vapor exposure are applied to investigate their effects on the alveolar epithelium barrier function. The barrier permeability is time-lapse monitored using trans-epithelial electrical resistance (TEER) measurement and immunofluorescence staining of the tight junction protein (ZO-1). The results demonstrate the functionalities of the device, and further show the applications and advantages of the constructed in vitro cell models for the lung studies.

Improving Image Correlation and Differentiation of 3D Endoluminal Lesions in the Air Spaces Using a Novel Target Gray Level Mapping Technique: A Preliminary Study of Its Application to Computed Tomographic Colonography and Comparison with Traditional Surface Rendering Method.

Purpose: To improve the three dimensional (3D) and two dimensional (2D) image correlation and differentiation of 3D endoluminal lesions in the traditional surface rendering (SR) computed tomographic endoscopy (CTE), a target gray level mapping (TGM) technique is developed and applied to computed tomographic colonography (CTC) in this study. Methods: A study of sixty-two various endoluminal lesions from thirty patients (13 males, 17 females; age range 31-90 years) was approved by our institutional review board and evaluated retrospectively. The endoluminal lesions were segmented using gray level threshold. The marching cubes algorithm was used to detect isosurfaces in the segmented volumetric data sets. TGM allows users to interactively apply grey level mapping (GM) to region of interest (ROI) in the 3D CTC. Radiologists conducted the clinical evaluation and the resulting data were analyzed. Results: TGM and GM are significantly superior to SR in terms of surface texture, 3D shape, the confidence of 3D to 2D, 2D to 3D image correlation, and clinical classification of endoluminal lesions (P < 0.01). The specificity and diagnostic accuracy of GM and TGM methods are significantly better than those of SR (P < 0.01). Moreover, TGM performs better than GM (specificity: 75.0-85.7% vs. 53.6-64.3%; accuracy: 88.7-93.5% vs. 77.4-83.9%). TGM is a preferable display mode for further localization and differentiation of a lesion in CTC navigation. Conclusions: Compared with only the spatial shape information in traditional SR of CTC images, the 3D shapes and gray level information of endoluminal lesions can be provided by TGM simultaneously. 3D to 2D image correlations are also increased and facilitated at the same time. TGM is less affected by adjacent colon surfaces than GM. TGM serves as a better way to improve the image correlation and differentiation of endoluminal lesions.

Plasmonic random laser from dye-doped cholesteric liquid crystals incorporating silver nanoprisms.

Plasmonic random lasers have been demonstrated in combining dye-doped cholesteric liquid crystals (DD-CLCs) and silver nanoparticles (AgNPs). The DD-CLC laser reveals the lowest threshold and highest slope efficiency through the localized surface plasmon resonance of AgNPs with the best coupling of the emission spectrum of lasing dye and resonance of electron oscillation on the metal surface. Thermal control of the DD-CLC lasers has been achieved to simultaneously shift the long- and short-edge lasing peaks. By the α-stable analysis, the DD-CLC random laser (RL) reveals heavy tail distribution with relatively low α∼1.06 to show the Lévy behavior. Owing to its low spatial coherence, the DD-CLC RL has been demonstrated to produce a speckle-reduced image with a lower contrast of about 0.04.

A case-control study of perfluoroalkyl substances and the risk of breast cancer in Taiwanese women.

Breast cancer (BC) is a common cancer in women worldwide; however, the incidence of BC is increasing in younger women, possibly associated with the environment. Perfluoroalkyl substances (PFAS) are one of endocrine disruptors that accumulate in environment and impact human health. This study aimed to investigate whether the PFAS and BC are associated. We enrolled 120 BCE patients and 119 controls at National Taiwan University Hospital (NTUH) and also collected bio-specimen and questionnaire from 2013 to 2015. All subjects' plasma PFAS levels were analyzed by ultra-performance liquid chromatography tandem mass spectrometry method with electrospray ionization (UHPLC-ESI-MS/MS). A logistic regression model was used to estimate the association between PFAS and BC. In the ≤50 years age group, the adjusted odds ratio (OR) was 2.34 (95% CI = 1.02, 5.38) for perfluorooctane sulfonate (PFOS) exposure per natural log unit increase. After stratifying the estrogen receptor (ER) status and age group, we obtained a positive association for PFHxS and PFOS concentrations with respect to the risk of ER positive tumors for ≤50 years age group. In conclusion, we found that PFAS were associated with the BC risk of ER positive tumors in young Taiwanese women. Further studies are needed to follow and explore whether these associations are causal.