Controlled Growth of Highly Oriented Perovskite Crystals in Polymer Solutions via Selective Solvent Vapor Diffusion.

Organic-inorganic hybrid perovskites have garnered significant attention in optoelectronics owing to their outstanding tunable optical characteristics. Controlled growth of perovskite nanocrystals from solutions is key for controlling the emission intensity and photoluminescence lifetime of perovskites. In particular, most studies have focused on controlling the crystallization of perovskite through chemical treatment using chelating ligands or physical treatment via antisolvent diffusion, and there exists a trade-off between the photoluminescence intensity and lifetime of perovskites. Herein, a selective solvent vapor-assisted crystallization with the aid of a functional polymer, which nanoscale perovskite crystals are grown andante from precursor solution, is presented for tuning the crystallization and optical properties of a common halide perovskite, methylammonium lead bromide (MAPbBr3 ). The proposed method here produces perovskite nanocrystals in the range of 200-300 nm. The spin-coated thin film formed from the perovskite solution exhibits strong green photoluminescence with a long lifetime. The effects of the functional group and polymer dosage on the crystallization of MAPbBr3 are systematically investigated, and the crystallization mechanism is explained based on a modified LaMer model. This study provides an advanced solution process for precisely controlling perovskite crystallization to enhance their optical properties for next-generation optoelectronic devices.

Validation of the Efficacy of Ultrasound Speckle Tracking in Measuring Tendon Gliding After Finger Flexor Tendon Repair.

OBJECTIVE: Restricted tendon gliding is commonly observed in patients after finger flexor tendon (FFT) repair. The study described here was aimed at quantifying the amount of FFT gliding to evaluate the recovery of post-operative tendons using a 2-D radiofrequency (RF)-based ultrasound speckle tracking algorithm (UST). METHODS: Ex vivo uniaxial tensile testing of porcine flexor tendons and in vivo isometric testing of human FFT were implemented to verify the efficacy of UST beforehand. The verified UST was then applied to the patients after FFT repair to compare tendon gliding between affected and healthy sides and to investigate its correlation with the joint range of motion (ROM). RESULTS: Excellent validity was confirmed with the average R2 value of 0.98, mean absolute error of 0.15 ± 0.08 mm and mean absolute percentage error of 5.19 ± 2.43% between results from UST and ex vivo testing. The test-retest reliability was verified with good agreement of ICC (0.90). The affected side exhibited less gliding (p = 0.001) and smaller active ROM (p = 0.002) than the healthy side. Meanwhile, a significant correlation between tendon gliding and passive ROM was found only on the healthy side (ρ = 0.711, p = 0.009). CONCLUSION: The present study provides a promising protocol to evaluate post-operative tendon recovery by quantifying the amount of FFT gliding with a validated UST. FFT gliding in patients with different levels of ROM restriction should be further explored for categorizing the severity of tendon adhesion.

Sustained Flexible Photonic Transistor Memories Based on Fully Natural Floating Gate Electrets.

Photonic transistor memory with high-speed communication and energy-saving capabilities has emerged as a new data storage technology. However, most floating-gate electrets are composed of quantum dots derived from petroleum or metals, which are either toxic or harmful to the environment. In this study, an environmentally friendly floating-gate electret made entirely from biomass-derived materials was designed for photonic memories. The results show that the photosensitive hemin and its derivative protoporphyrin IX (PPIX) were successfully embedded in a polylactic acid (PLA) matrix. Correspondingly, their disparate photochemistry and core structure strongly affected the photosensitivity and charge-trapping capacity of the prepared electrets. With an appropriate energy-level alignment, the interlayer exciton formed with the correct alignment of energy levels within the PPIX/PLA electret. In addition, the demetallized core offered a unique relaxation dynamic and additional trapping sites to consolidate the charges. Correspondingly, the as-prepared device exhibited a memory ratio of up to 2.5 × 107 with photo-writing-electrical-erasing characteristics. Conversely, hemin demonstrated self-charge transfer during relaxation, making it challenging for the device to store the charges and exhibit a photorecovery behavior. Furthermore, the effect of trapping site discreteness on memory performance was also investigated. The photoactive components were effectively distributed due to the high dipole-dipole interaction between the PLA matrix and PPIX, resulting in a sustained memory performance for at least 104 s after light removal. The photonic memory was also realized on a bio-derived dielectric flexible substrate. Accordingly, a reliable photorecording behavior was observed, wherein, even after 1000 cycles of bending under a 5 mm bending radius, the data was retained for more than 104 s. To our knowledge, it is the first time that a two-pronged approach has been used to improve the performance of photonic memories while addressing the issue of sustainability with a biodegradable electret made entirely from natural materials.

Diagnostic accuracy of algorithms to define incident and second hip fractures: A Taiwan validation study.

BACKGROUND: Previous epidemiological researchers have used various algorithms to identify a second hip fracture; however, there has been no validation of these algorithms to date. This study aimed to verify existing algorithms for identifying second hip fracture under the International Classification of Diseases diagnostic coding systems. Furthermore, we examined the validity of two newly proposed algorithms that integrated the concept of periprosthetic fractures and laterality of the ICD-10 coding system. METHODS: Claims data of patients hospitalized for hip fracture from National Taiwan University Hospitals between 2007 and 2020 were retrieved. Hip fracture was confirmed by 2 orthopaedic surgeons with medical records and imaging data as gold standards. The validity of 9 existing and 2 newly proposed algorithms for identifying second hip fracture was evaluated. RESULTS: The positive predictive value (PPV) range between 84% and 90% in existing algorithms for identifying second hip fractures. Noteworthy, the longer time interval for discrimination resulted in slightly increased PPV (from 87% to 90%), while decreased sensitivity noticeably (from 87% to 72%). When considering the information about periprosthetic fracture, the PPV increased to 91% without diminished sensitivity. The PPV of the newly proposed ICD-10-specific algorithm was 100%. CONCLUSION: Algorithms integrated clinical insights of periprosthetic fractures and laterality concept of ICD-10 coding system provided satisfactory validity and help precisely define second hip fracture in future database research.

Molecular template growth of organic heterojunctions to tailor visual neuroplasticity for high performance phototransistors with ultralow energy consumption.

The optical and charge transport properties of organic semiconductors are strongly influenced by their morphology and molecular structures. Here we report the influence of a molecular template strategy on anisotropic control via weak epitaxial growth of a semiconducting channel for a dinaphtho[2,3-b:2',3'-f]thieno[3,2-b]thiophene (DNTT)/para-sexiphenyl (p-6P) heterojunction. The aim is to improve charge transport and trapping, to enable tailoring of visual neuroplasticity. The proposed phototransistor devices, comprising a molecular heterojunction with optimized molecular template thickness, exhibited an excellent memory ratio (ION/IOFF) and retention characteristics in response to light stimulation, owing to the enhanced orientation/packing of DNTT molecules and a favorable match between the LUMO/HOMO levels of p-6P and DNTT. The best performing heterojunction exhibits visual synaptic functionalities, including an extremely high pair-pulse facilitation index of ∼206%, ultralow energy consumption of 0.54 fJ, and zero-gate operation, under ultrashort pulse light stimulation to mimic human-like sensing, computing, and memory functions. An array of heterojunction photosynapses possess a high degree of visual pattern recognition and learning, to mimic the neuroplasticity of human brain activities through a rehearsal learning process. This study provides a guide to the design of molecular heterojunctions for tailoring high-performance photonic memory and synapses for neuromorphic computing and artificial intelligence systems.

Fully Photoswitchable Phototransistor Memory Comprising Perovskite Quantum Dot-Based Hybrid Nanocomposites as a Photoresponsive Floating Gate.

Tremendous research efforts have been dedicated into the field of photoresponsive nonvolatile memory devices owing to their advantages of fast transmitting speed, low latency, and power-saving property that are suitable for replacing current electrical-driven electronics. However, the reported memory devices still rely on the assistance of gate bias to program them, and a real fully photoswitchable transistor memory is still rare. Herein, we report a phototransistor memory device comprising polymer/perovskite quantum dot (QD) hybrid nanocomposites as a photoresponsive floating gate. The perovskite QDs offer an effective discreteness with an excellent photoresponse that are suitable for photogate application. In addition, a series of ultraviolet (UV)-sensitive insulating polymer hosts were designed to investigate the effect of UV light on the memory behavior. We found that a fully photoswitchable memory device was fulfilled by using the independent and sequential photoexcitation between a UV-sensitive polymer host and a visible light-sensitive QD photogates, which produced decent photoresponse, memory switchability, and highly stable memory retention with a memory ratio of 104 over 104 s. This study not only unraveled the mystery in the fully photoswitchable functionality of nonvolatile memory but also enlightened their potential in the next-generation electronics for light-fidelity application.

Harnessing of Spatially Confined Perovskite Nanocrystals Using Polysaccharide-based Block Copolymer Systems.

Metal halide perovskite nanocrystals (PVSK NCs) are generally unstable upon their transfer from colloidal dispersions to thin film devices. This has been a major obstacle limiting their widespread application. In this study, we proposed a new approach to maintain their exceptional optoelectronic properties during this transfer by dispersing brightly emitting cesium lead halide PVSK NCs in polysaccharide-based maltoheptaose-block-polyisoprene-block-maltoheptaose (MH-b-PI-b-MH) triblock copolymer (BCP) matrices. Instantaneous crystallization of ion precursors with favorable coordination to the sugar (maltoheptaose) domains produced ordered NCs with varied nanostructures of controlled domain size (≈10-20 nm). Confining highly ordered and low dimension PVSK NCs in polysaccharide-based BCPs constituted a powerful tool to control the self-assembly of BCPs and PVSK NCs into predictable structures. Consequently, the hybrid thin films exhibited excellent durability to humidity and stretchability with a relatively high PL intensity and photoluminescence quantum yield (>70%). Furthermore, stretchable phototransistor memory devices were produced and maintained with a good memory ratio of 105 and exhibited a long-term memory retention over 104 s at a high strain of 100%.

Impact of the Requirement of Bone Mineral Density Evidence on Utilization of Anti-osteoporosis Medications, Clinical Outcome and Medical Expenditures of Patient With Hip Fracture in Taiwan.

BACKGROUND: Since 2011, Taiwan's National Health Insurance Administration (NHIA) issued a regulation on the reimbursement to anti-osteoporosis medications (AOMs). This study aimed to evaluate the impact of this regulation in reimbursement on the utilization of AOMs, clinical outcomes and associated medical expenditures of patients with incident hip fractures. METHODS: By using the National Health Insurance Research Database (NHIRD), patients with incident hip fracture from 2006 to 2015 were identified as our study cohort. Patients younger than 50 years old or prescribed with AOMs within one year prior to incident fracture were excluded. Outcomes of interest were quarterly estimates of the proportion of patients who received bone mineral density (BMD) examination, who were prescribed AOMs, as well as who encountered subsequent osteoporotic fracture-related visits and associated medical expenditures. Particularly, age- and gender specific estimates were reported. An interrupted time series study design with segmented regression model was used to quantitatively explore the impact of the changes of the reimbursement criteria on the level (immediate) and trend (long-term) changes of these outcomes. RESULTS: Our study enrolled 118 493 patients with incident hip fracture with those patients aged older than 80 years old accounting for the largest proportion. A significantly decreased trend of AOMs prescription rates was observed immediately post regulation except for female aged between 65 and 80, while the long-term pattern showed no significant difference. However, the percentage of patients encountered subsequent osteoporotic fracture-related visit was not statistically different between pre- and post-regulation periods. Noteworthy, the policy regulation was associated with an increasing trend of osteoporotic fracture associated medical expenditures, especially for patients older than 80 years old. CONCLUSION: The regulation on the reimbursement for AOMs decreased the prescribing rate of AOMs immediately although the effect did not sustain thereafter. However, higher subsequent osteoporotic fracture-related medical expenditures were introduced, especially among those very old population.

A Multi-Institutional Randomized Controlled Trial to Investigate Whether Zoledronate Prevents Bone Loss After Discontinuation of Denosumab: The Study Protocol of Denosumab Sequential Therapy (DST) Trial.

Background: Though denosumab is an effective treatment for osteoporosis, the rebound effect after discontinuation has drawn investigators' attention. It includes a dramatic loss of gained bone mineral density (BMD) and an increased risk of vertebral fractures. This prospective multi-institutional randomized controlled trial aims to investigate whether zoledronate prevents loss of BMD after discontinuation of denosumab. The trial was registered as Denosumab Sequential Therapy (DST) trial in March 2019 at clinicaltrials.gov, with the identifier NCT03868033. Methods: The study is conducted at National Taiwan University Hospital and its branches. Patients who have continuously received denosumab treatment for two or more years are surveyed for eligibility. Baseline characteristics and questionnaires of life quality are recorded after recruitment. BMD, circulating levels of bone turnover markers (BTMs), including serum N-terminal propeptide of type 1 collagen (P1NP) and C-terminal telopeptide (CTX), are checked before the stratified randomization to 4 groups. Biological sex and the T-scores are used to create 4 strata. The participants in group 1 adhere to regular denosumab therapy for another 2 years. All the other patients receive on-time zoledronate treatment in the first year. The participants in group 2, 3, and 4 have on-time denosumab, on-time zoledronate and drug holiday in the second year, respectively. BMDs are checked annually. Pre-scheduled checkpoints of BTMs are also arranged. For patient safety, rescue treatment with another injection of zoledronate will be applied to the patients on drug holiday if the CTX levels raise above the pre-specified threshold, 0.573 ng/mL for women and 0.584 ng/mL for men. The primary outcomes are the percentage changes of BMDs in lumbar spine, total hip and femoral neck. The secondary outcomes include the changes of serum level of the BTMs, new osteoporotic fractures, extra zoledronate injections needed in group 4 and the differences of quality of life. Discussion: We aim to provide evidence whether zoledronate prevents bone loss after denosumab cessation. To our knowledge, the study has the largest sample size. No other randomized controlled study included all the three different treatment strategies and a positive control. It is also the first associated randomized controlled trial outside Europe.

Increased fracture risk after discontinuation of anti-osteoporosis medications among hip fracture patients: A population-based cohort study.

BACKGROUND: To compare the risks of major osteoporotic, vertebral, and non-vertebral fractures between patients who discontinued anti-osteoporosis medications. METHODS: We conducted a comparative effectiveness study with a nationwide population-based cohort study design. Patients aged ≥50 years admitted between 2012 and 2015 for incident hip fractures and receiving denosumab or bisphosphonates with sufficient compliance for at least 1 year were included. Patients were categorized into persistent or non-persistent denosumab or bisphosphonates users based on their subsequent use pattern. The main outcomes were subsequent hospitalizations for a major osteoporotic, vertebral or non-vertebral fracture. Multivariate, time-varying Cox proportional hazards model was used to evaluate the risk of major outcomes. RESULTS: Compared with persistent denosumab users, non-persistent denosumab users had a significantly higher risk of major osteoporotic fractures (hazard ratio [HR] = 1.60; 95% confidence interval [CI], 1.20-2.14), vertebral fractures (HR = 2.18; 95% CI, 1.46-3.24) and death (HR = 3.57; 95%CI, 2.63-4.84). However, the increased risk of fracture was not found in both persistent and non-persistent bisphosphonates users. Noteworthy, the increased risk of vertebral fractures in non-persistent denosumab users was more pronounced within 1 year post-discontinuation (HR = 2.90; 95% CI, 1.77-4.74) and among patients who discontinued from 2-year denosumab therapy (HR = 3.58; 95% CI, 1.74-7.40). DISCUSSION: Discontinuation of denosumab resulted in an increased risk of major osteoporotic fractures, especially vertebral fractures. The increased risk tends to reveal within 1 year post-discontinuation and be greater after a longer treatment duration. Notably, only fracture with hospitalization was identified as our research outcome, the real risk of osteoporotic fracture post discontinuation is believed to be higher, especially for vertebral fracture.

Conception of a Smart Artificial Retina Based on a Dual-Mode Organic Sensing Inverter.

The human visual system enables perceiving, learning, remembering, and recognizing elementary visual information (light, colors, and images), which has inspired the development of biomimicry visual system-based electronic devices. Photosensing and synaptic devices are integrated into these systems to realize elementary information storage and recognition to imitate image processing. However, the severe restrictions of the monotonic light response and complicated circuitry design remain challenges for the development of artificial visual devices. Here, the concept of a smart artificial retina based on an organic optical sensing inverter device that can be operated as a multiwavelength photodetector and recorder is reported first. The device exhibits a light-triggered broadband (red/green/blue) response, a low energy consumption as low as ±5 V, and an ultrafast response speed (<300 ms). Moreover, the multifunctional component is also combined within a single cell for health monitoring of the artificial retina during light surveillance to avoid retinopathy. Proof-of-concept devices, by simplifying the circuitry and providing dual-mode functions, can contribute significantly to the development of bionics design and broaden the horizon for smart artificial retinas in the human visual system.

Stretchable OFET Memories: Tuning the Morphology and the Charge-Trapping Ability of Conjugated Block Copolymers through Soft Segment Branching.

The mechanical properties and structural design flexibility of charge-trapping polymer electrets have led to their widespread use in organic field-effect transistor (OFET) memories. For example, in the electrets of polyfluorene-based conjugated/insulating block copolymers (BCPs), the confined fiberlike polyfluorene nanostructures in the insulating polymer matrix act as effective hole-trapping sites, leading to controllable memory performance through the design of BCPs. However, few studies have reported intrinsically stretchable charge-trapping materials and their memory device applications, and a practical method to correlate the thin-film morphology of BCP electrets with their charge-trapping ability has not yet been developed. In this study, a series of new conjugated/insulating BCPs, poly(9,9-di-n-hexyl-2,7-fluorene)-block-poly(δ-decanolactone)s (PF-b-PDLx, x = 1-3), as stretchable hole-trapping materials are reported. The linear and branched PDL blocks with comparable molecular weights were used to investigate the effect of polymer architecture on morphology and device performance. Moreover, the coverage area of the polyfluorene nanofibers on the BCP films was extracted from atomic force microscopy images, which can be correlated with the trapping density of the polymer electrets. The branched PDL segments not only improve stretchability but also tailor crystallinity and phase separation of the BCPs, thus increasing their charge-trapping ability. The OFET memory device with PF-b-PDL3 as the electret layer exhibited the largest memory window (102 V) and could retain its performance at up to 100% strain. This research highlights the importance of the BCP design for developing stretchable charge-trapping materials.

Backbone Engineering of Diketopyrrolopyrrole-Based Conjugated Polymers through Random Terpolymerization for Improved Mobility-Stretchability Property.

Conjugated polymers synthesized through random terpolymerization have recently attracted great research interest due to the synergetic effect on the polymer's crystallinity and semiconducting properties. Several studies have demonstrated the efficacy of random terpolymerization in fine-tuning the aggregation behavior and optoelectronic property of conjugated polymers to yield enhanced device performance. However, as an influential approach of backbone engineering, its efficacy in modulating the mobility-stretchability property of high-performance conjugated polymers has not been fuller explored to date. Herein, a series of random terpolymers based on the diketopyrrolopyrrole-bithiophene (DPP-2T) backbone incorporating different amounts of isoindigo (IID) unit are synthesized, and their structure-mobility-stretchability correlation is thoroughly investigated. Our results reveal that random terpolymers containing a low IID content (DPP95 and DPP90) show enhanced interchain packing and solid-state aggregation to result in improved charge-transporting performance (can reach 4 order higher) compared to the parent polymer DPP100. In addition, owing to the enriched amorphous feature, DPP95 and DPP90 deliver an improved orthogonal mobility (µh) of >0.01 cm2 V-1 s-1 under a 100% strain, higher than the value (∼0.002 cm2 V-1 s-1) of DPP100. Moreover, DPP95 even yields 20% enhanced orthogonal µh retention after 800 stretching-releasing cycles with 60% strain. As concluded from a series of analyses, the improved mobility-stretchability property exerted by random terpolymerization arises from the enriched amorphous feature and enhanced aggregation behavior imposed by the geometry mismatch between different acceptors (DPP and IID). This study demonstrates that backbone engineering through rational random terpolymerization not only enhances the mobility-stretchability of a conjugated polymer but also realizes a better mechanical endurance, providing a new perspective for the design of high-performance stretchable conjugated polymers.

High-Performance Nonvolatile Organic Photonic Transistor Memory Devices using Conjugated Rod-Coil Materials as a Floating Gate.

A novel approach for using conjugated rod-coil materials as a floating gate in the fabrication of nonvolatile photonic transistor memory devices, consisting of n-type Sol-PDI and p-type C10-DNTT, is presented. Sol-PDI and C10-DNTT are used as dual functions of charge-trapping (conjugated rod) and tunneling (insulating coil), while n-type BPE-PDI and p-type DNTT are employed as the corresponding transporting layers. By using the same conjugated rod in the memory layer and transporting channel with a self-assembled structure, both n-type and p-type memory devices exhibit a fast response, a high current contrast between "Photo-On" and "Electrical-Off" bistable states over 105 , and an extremely low programing driving force of 0.1 V. The fabricated photon-driven memory devices exhibit a quick response to different wavelengths of light and a broadband light response that highlight their promising potential for light-recorder and synaptic device applications.

Study on Intrinsic Stretchability of Diketopyrrolopyrrole-Based π-Conjugated Copolymers with Poly(acryl amide) Side Chains for Organic Field-Effect Transistors.

The development of a π-conjugated polymer with hydrogen-bonding moieties has aroused great attention because of the improved molecular stacking and the hydrogen-bonding network. In this study, PDPPTVT (diketopyrrolopyrrole-thiophenevinylenethiophene) and PDPPSe (diketopyrrolopyrrole-selenophene) alkylated with a carbosilane (SiC8) side chain and poly(acryl amide) (PAM)-incorporated alkyl side chain were prepared, and their structure-performance and structure-stretchability correlation were evaluated. By incorporating the DPPTVT backbone and 0, 5, 10, or 20% PAM-incorporated alkyl side chain, the µh value could reach 2.0, 0.97, 0.74, and 0.42 cm2 V-1 s-1, respectively (P1 to P4). The polymer with the PDPPSe backbone and 5% PAM-incorporated alkyl side-chain (P5) exhibited the maximum µh value of 0.96 cm2 V-1 s-1. By extending the PAM moiety from the backbone with alkyl spacers, the solid-state packing and edge-on orientation can be properly maintained. Surprisingly, the PAM-incorporated alkyl side-chain can provide a hydrogen-bonding network serving as sacrificial bonding to mechanical deformation. Therefore, the relevant changes in the crystallographic parameters including the crystalline size and the in-plane π-π stacking distance with a 100% external strain were less than 4 and 0.8%, respectively, from P1 to P3. Therefore, P3 achieved an excellent stretchability while maintaining its molecular orientation and charge-transporting performance. Even with 100% external strain, P3 still provided an orthogonal µh over 0.1 cm2 V-1 s-1. Moreover, by substituting the TVT moiety with the Se moiety, the ductility of the backbone can be further increased when the elastic modulus decreases from 0.80 to 0.36 GPa for P2 to P5. The achieved high µh retention is over 20% after 500 stretching-releasing cycles with a 60% external strain perpendicular to the channel direction for the polymer composed of PDPPSe and 5% PAM content. The results manifest that our newly designed DPP with the PAM-incorporated alkyl side chain provides a promising approach to promote the intrinsic stretchability of the π-conjugated polymers.

Does fully-threaded Headless Compression Screw provide a length-stable fixation in undisplaced femoral neck fractures?

OBJECTIVE: Femoral neck shortening is a common complication after surgical treatment for intracapsular femoral neck fractures. This study investigated whether fully-threaded Headless Compression Screw (FTHCS) can be a more length-stable implant than partially-threaded cannulated screw (PTCS) in reducing femoral neck shortening. METHODS: A total of 50 patients with undisplaced femoral neck fractures (17 treated by internal fixation with three FTHCS, and 33 treated by three PTCS) from 2011 to 2014 were enrolled in this study. The radiography of the hips and medical records were reviewed for proximal femur geometry and complications. RESULTS: Significant shortening of the femoral neck length until union were noted in both group (FTHCS group: -2.5 mm, p = 0.045; PTCS group: -2.4 mm, p = 0.011). There was no significant difference in the length of femoral neck shortening between groups (p = 0.855). Age was the only significant risk factor for >5 mm of femoral neck shortening (p = 0.041). The femoral neck-shaft angle tended to reduce and become more varus in both groups (FTHCS: -2.7°, SD = 4.5, p = 0.028; PTCS: -5.0°, SD = 8.3, p = 0.002), but the differences between groups were nonsignificant (p = 0.577). The complication rates were similar between FTHCS and PTCS (17.6% and 21.2%, p > 0.999). CONCLUSION: The FTHCSs may be a substitute for PTCSs, but it cannot prevent femoral neck shortening and varus collapse after fracture fixation. Future studies should focus on how to preserve femoral neck length and hip function after femoral neck fractures.

Effects of anti-osteoporosis medications on total hip arthroplasty risks in osteoporotic patients with hip osteoarthritis in Taiwan: a nationwide cohort study.

This nationwide cohort study examined the potential disease-modifying effect of anti-osteoporosis medication on hip osteoarthritis. The results revealed that the usage of anti-osteoporosis medication is not associated with decreased risk in undergoing total hip arthroplasty in patient with hip osteoarthritis. PURPOSE: This study aimed to assess the association between use of anti-osteoporosis medications (AOMs) and the risk of undergoing total hip arthroplasty (THA) in patients with hip osteoarthritis (OA). METHODS: Using the 2008-2013 National Health Insurance Research Database, we identified patients who were first diagnosed as having hip OA. All identified patients were followed until THA, death of any cause, or December 31, 2013, whichever occurred first. All AOM exposures were divided into three categories: bisphosphonates use, non-bisphosphonates use, and no use of AOMs and assessed in a time-varying manners. The primary outcome was THA. The secondary outcome was the differences in the longitudinal utilization of NSAIDs between AOM users and non-users. Time-dependent Cox proportional hazards models were used to investigate the effect of AOM use on the risk of THA. RESULTS: We identified 35,870 patients who were first diagnosed as having hip OA and had no history of AOM use between 2009 and 2012. Among them, 3162 and 1667 patients had their first prescription of bisphosphonates and other non-bisphosphonates AOMs during the follow-up period. Mean age of bisphosphonates users, non-bisphosphonates users, and non-users was 75.62, 76.84, and 67.39 years, respectively. Bisphosphonates or non-bisphosphonates users did not show significant change when compared to non-users in terms of risk of undergoing THA [adjusted hazard ratio (aHR) 0.972, 95% confidence interval (CI) 0.743-1.273; aHR 0.926, 95% CI 0.672-1.277]. CONCLUSION: Our results showed that the use of AOMs is not associated with decreased risk of THA in patients with hip OA.

Visualisation of the unmet treatment need of osteoporotic fracture in Taiwan: A nationwide cohort study.

AIMS: Recent clinical guidelines have suggested that patients experience an osteoporotic fracture should initiate anti-osteoporosis medications (AOMs). However, whether clinical guidelines translate well in "real-world" practices remain questioned. This study aimed to evaluate the "real-world" prescription pattern of AOMs and visualise the unmet treatment needs in different geographical areas in Taiwan. METHODS: Using Taiwan's National Health Insurance Research Database, we identified patients diagnosed with a hip or vertebral fracture between 2009 and 2012. The treatment rate was defined as the proportion of patients receiving AOMs within 1 year after their index fracture. The qualitative geographical information systems approach was adopted to visualise the treatment needs of postfracture patients in different geographical areas. RESULTS: Our study included 276,492 patients diagnosed with a hip or vertebral fracture between 2009 and 2012. The proportion of patients who received AOMs within 1 year after their index fracture increased with age and differed with fracture types and sex. For patients with hip fractures, the treatment rate ranged from 3.43% to 20.88% for female patients and from 0.69% to 10.04% for male patients in different age groups. For patients with vertebral fractures, the treatment rate ranged from 3.23% to 37.08% for female patients and from 1.85% to 23.05% for male patients. Cities in the mid-northern and southern areas of Taiwan had the highest unmet treatment need, with a treatment rate of less than 15%. CONCLUSION: The treatment rate of osteoporotic fractures with AOMs was diverse and suboptimal in Taiwan, especially among male patients. This study used a visualisation technique to display information about the treatment status in different geographical areas and help policymakers allocate resource appropriately.

RGB-Switchable Porous Electrospun Nanofiber Chemoprobe-Filter Prepared from Multifunctional Copolymers for Versatile Sensing of pH and Heavy Metals.

Novel red-green-blue (RGB) switchable probes based on fluorescent porous electrospun (ES) nanofibers exhibiting high sensitivity to pH and mercury ions (Hg2+) were prepared with one type of copolymer (poly(methyl methacrylatete-co-1,8-naphthalimide derivatives-co-rhodamine derivative); poly(MMA-co-BNPTU-co-RhBAM)) by using a single-capillary spinneret. The MMA, BNPTU, and RhBAM moieties were designed to (i) permit formation of porous fibers, (ii) fluoresce for Hg2+ detection, and (iii) fluoresce for pH, respectively. The fluorescence emission of BNPTU (fluorescence resonance energy transfer (FRET) donor) changed from green to blue as it detected Hg2+. The fluorescence emission of RhBAM (FRET acceptor) was highly selective for pH, changing from nonfluorescent (pH 7) to exhibiting strong red fluorescence (pH 2). The full-color emission of the ES nanofibers included green, red, blue, purple, and white depending on the particular pH and Hg2+-concentration combination of the solution. The porous ES nanofibers with 30 nm pores were fabricated using hydrophobic MMA, low-boiling-point solvent, and at a high relative humidity (80%). These porous ES nanofibers had a higher surface-to-volume ratio than did the corresponding thin films, which enhanced their performance. The present study demonstrated that the FRET-based full-color-fluorescence porous nanofibrous membranes, which exhibit on-off switching and can be used as naked eye probes, have potential for application in water purification sensing filters.