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Intracortical brain–computer interfaces (iBCIs) translate neural activity into control commands, thereby allowing paralyzed persons to control devices via their brain signals. Recurrent neural networks (RNNs) are widely used as neural decoders because they can learn neural response dynamics from continuous neural activity. Nevertheless, excessively long or short input neural activity for an RNN may decrease its decoding performance. Based on the temporal attention module exploiting relations in features over time, we propose a temporal attention-aware timestep selection (TTS) method that improves the interpretability of the salience of each timestep in an input neural activity. Furthermore, TTS determines the appropriate input neural activity length for accurate neural decoding. Experimental results show that the proposed TTS efficiently selects 28 essential timesteps for RNN-based neural decoders, outperforming state-of-the-art neural decoders on two nonhuman primate datasets (R2=0.76±0.05 for monkey Indy and CC=0.91±0.01 for monkey N). In addition, it reduces the computation time for offline training (reducing 5–12%) and online prediction (reducing 16–18%). When visualizing the attention mechanism in TTS, the preparatory neural activity is consecutively highlighted during arm movement, and the most recent neural activity is highlighted during the resting state in nonhuman primates. Selecting only a few essential timesteps for an RNN-based neural decoder provides sufficient decoding performance and requires only a short computation time.

Materials capable of light upconversion—transforming low-energy photons into higher-energy ones—are pivotal in advancing optoelectronics, energy solutions, and photocatalysis. However, the discovery in various materials pays little attention on few-layer transition metal dichalcogenides, primarily due to their indirect bandgaps and weaker light-matter interactions. Here, we report a pronounced light upconversion in few-layer transition metal dichalcogenides through upconversion photoluminescence spectroscopy. Our joint theory-experiment study attributes the upconversion photoluminescence to a resonant exciton-exciton annihilation involving a pair of dark excitons with opposite momenta, followed by the spontaneous emission of upconverted bright excitons, which can have a high upconversion efficiency. Additionally, the upconversion photoluminescence is generic in MoS 2 , MoSe 2 , WS 2 , and WSe 2 , showing a high tuneability from green to ultraviolet light (2.34–3.1 eV). The findings pave the way for further exploration of light upconversion regarding fundamental properties and device applications in two-dimensional semiconductors. The authors report upconversion in few-layer transition metal dichalcogenides, and attribute it to a resonant exciton-exciton annihilation involving a pair of dark excitons with opposite momenta, followed by the spontaneous emission of upconverted bright excitons.

Breast milk iodine concentration (BMIC) can be different when median urinary iodine concentration (UIC) is similar. The BMIC, UIC/creatinine (Cr), estimated 24-h urinary iodine excretion (24-h UIE) of lactating women in Taiwan is unknown. This study enrolled lactating women from Taipei Veterans General Hospital (August 2021–February 2023). Each participant provided a random spot urine sample, two breast milk samples, a blood sample, and completed a food frequency questionnaire on the same day. Iodine measurement was performed by inductively coupled plasma mass spectrometry. The median UIC of the enrolled 71 women was 91.1 μg/L, indicating insufficient iodine status; however, the median BMIC was 166.6 μg/L and this suggested that the amount of iodine delivered through breast milk was adequate for the breastfed infants. BMIC was correlated with UIC/Cr and 24-h UIE (both rs = 0.49) but not with UIC (rs = 0.18) or thyroid stimulating hormone (rs = 0.07). Women who did not consume dairy products (adjusted odds ratio: 24.41, 95% confidence interval: 1.26–471.2) and multivitamins (adjusted odds ratio: 8.26, 95% confidence interval: 1.76–38.79) were at increased odds for having lower BMIC. The results suggest that measuring maternal UIC alone may not be sufficient, as BMIC, UIC/Cr, and 24-h UIE are all important biomarkers. Ingestion of dairy products and multivitamins were independently associated with BMIC.

Disparities in electronic health record systems hinder cross-border continuity of care, particularly where labor mobility and tourism intersect (eg, between the Philippines and Taiwan). Both nations collect claim data, yet neither fully aligns with international standards such as the Health Level 7 International, International Patient Summary (IPS). This implementation report aimed to convert health insurance data from Taiwan's My Health Bank (MHB) and the Philippine Health Insurance Corporation's Claim Form 4 (CF4) into a cross-border personal health record (PHR) aligned with the IPS using (Fast Healthcare Interoperability Resources) FHIR standards. We mapped each data element from CF4 (n=7 main sections) and MHB (n=12 major data items) to 17 sections of the IPS. We analyzed whether these elements matched IPS requirements (required or recommended or optional) and identified missing fields (eg, device use, social history, and advanced directives). We also designed a FHIR-based integration architecture, addressing system security with OAuth 2.0/SMART on FHIR and proposing a national uptake strategy for accelerating cross-border PHR implementation. Of the 17 IPS sections, MHB covered 14 sections (82.4%), while CF4 covered 12 sections (70.6%). Both systems lacked sufficient data elements for medical devices, social history (eg, alcohol or tobacco), and advanced directives. We developed an implementation plan focusing on data interoperability, standardization, and privacy or security protocols. We propose a multiphase approach-beginning with the stakeholder engagement and pilot testing in both countries. Aligning CF4 and MHB data with IPS standards via FHIR can facilitate a robust cross-border next-generation PHR ecosystem. This approach may enhance patient safety, continuity of care, and policy development for the Philippines and Taiwan. Further collaboration, regulatory updates, and public awareness are vital to sustain integration and maximize patient benefits.

Background Pregnant women are susceptible to iodine deficiency. Most iodine nutritional studies in pregnant women have involved cross-sectional evaluations of iodine status. This prospective observational study was designed to longitudinally follow the iodine status of pregnant women in different trimesters of pregnancy and to assess the demographic characteristics and dietary influences on iodine status. Methods A prospective cohort study was conducted at Taipei Veterans General Hospital from March 2019 to July 2022. A total of 211 women were enrolled and each subject was asked to provide a spot urine sample at each trimester. Urinary iodine concentration (UIC) was measured using inductively coupled plasma-mass spectrometry. Dietary habit was assessed via food frequency questionnaires (FFQs) at each trimester. Results The median UICs for the first, second and third trimesters were 156.3 µg/L (interquartile range [IQR]: 100.7-241.1), 146.2 µg/L (84.6-224.4), and 169.9 µg/L (94.4-283.5), respectively. Compared to the first trimester, participants consumed seaweed ( p  = 0.004 and p  < 0.001, respectively), fish ( p  < 0.001 for both), and prenatal multivitamins ( p  < 0.001 for both) more frequently during the second and third trimesters. Additionally, an increasing number of women raised their intake of dairy products as their pregnancies progressed. Multivariate analysis indicated a positive association between nulliparity and UIC < 150 µg/L (adjusted odds ratio [OR]: 2.258, 95% confidence interval [CI]: 1.167–4.367, p  = 0.02). Additionally, less prenatal iodine-containing multivitamin intake increased the odds of UIC < 150 µg/L across all trimesters (adjusted OR: 2.562, 95% CI: 1.234–5.319; p  = 0.01 for the first trimester; adjusted OR: 2.264, 95% CI: 1.167–4.395; p  = 0.02 for the second trimester; and adjusted OR: 2.022, 95% CI: 1.031–3.967; p  = 0.04 for the third trimester). Conclusions Mild iodine deficiency was observed in the second trimester despite adequate iodine status in the first and third trimesters. Nulliparous women and those not ingesting iodine-containing multivitamins are at greater risk of iodine deficiency, highlighting the need for targeted dietary education and interventions.

Pregnant women are considered as one of the most vulnerable groups for iodine deficiency. The Nutrition and Health Survey in Taiwan 2013 revealed that the median urinary iodine concentration (UIC) of non-pregnant women of child-bearing age of 15-44 years was 124 μg/L, which was adequate in general, but insufficient according to pregnancy criteria. The aim of this study was to determine the iodine nutritional status of pregnant women in an urban area of Northern Taiwan. A hospital-based cross-sectional survey was conducted in Taipei Veterans General Hospital. Random spot urine samples were collected from January to October, 2018 and UIC was determined by inductively coupled plasma mass-spectrometry. A food frequency questionnaire was also delivered to the participants. The overall median UIC was 225.3 μg/L (IQR: 109.1-514.2 μg/L) for 257 pregnant women ranging from 21-47 years-old. The distribution of UIC was as follows: 35.4% with UIC <150 μg/L, 17.1% with UIC within 150-249 μg/L, 21.8% with UIC within 250-499 μg/L, and 25.7% with UIC ≥500 μg/L. The use of prenatal multivitamin was very common among the participants: 79.4% (n = 204) took multivitamin either every day or less frequently, with 52.5% (n = 135) taking one pill every day, and only 20.6% (n = 53) never took multivitamin during their pregnancy. Other commonly consumed iodine-containing foods were dairy products and fish. Our results indicate that the iodine status in the studied women is adequate. However, efforts are still needed to avoid iodine deficiency as well as iodine excess.

Ketoconazole is effective for treating Cushing's syndrome (CS) but its use is limited by the risk of hepatotoxicity. Fluconazole, with similar antifungal properties, is being investigated as a potentially safer alternative for managing CS. This study aims to evaluate the efficacy and safety of fluconazole in patients with CS. This retrospective study evaluated a total of 22 patients with CS, including 12 with Cushing's disease (CD), 3 with adrenal Cushing's syndrome (ACS), and 7 with ectopic Adrenocorticotropic hormone (ACTH) syndrome. Fluconazole was administered orally, ranging from 112.5 to 450 mg daily, with the duration varying from 2 weeks to over 5 years. The efficacy of fluconazole was assessed by changes in 24-hour urinary free cortisol (24-h UFC) levels. Additionally, hepatic safety was assessed by monitoring changes in alanine aminotransferase (ALT) levels. Following fluconazole treatment, 24-h UFC levels significantly decreased from 717.6 ± 1219.4 to 184.1 ± 171.8 µg/day (  = 0.035). ALT levels showed an increase from 38.5 ± 28.4 to 56.5 ± 47.8 U/L, though this change was not statistically significant (  = 0.090). ALT levels exceeding the upper limit of normal range (ULN) were observed in 12 patients (54.5%), with only 4 patients (18.2%) showing ALT levels more than three times the ULN. Out of 10 patients who received treatment for over 1 year, 5 patients (50.0%) experienced a recurrence, with 24-h UFC levels more than 1.5 times the ULN within 3 to 12 months after fluconazole treatment. Fluconazole effectively reduces hypercortisolism in patients with CS without significant liver injury, suggesting it as a viable therapeutic option for CS. While some cases have shown treatment escape, more studies are required to confirm the long-term efficacy.

The purpose of this study was to assess the prevalence and distribution of dental caries and periodontal disease in Taiwanese high school students aged 15–18. A total of 1069 Taiwanese students participated in a cross-sectional nationwide dental survey. By using a stratified method based on the National Health Insurance administration regions, 24 high schools were randomly sampled in different areas of Taiwan. The participants were examined with dental mirrors and community periodontal index (CPI) probes without using radiographs, to measure dental caries and periodontal status. Demographic information and other relevant risk indicators for the two diseases were gathered via a self-report questionnaire. In this study population, the weighted mean decayed, missing and filled teeth (DMFT) scores for ages 15 to 18 were 5.2, 6.1, 6.1, and 5.7. The weighted mean decayed, missing and filled surfaces (DMFS) scores were 9.0, 12.0, 13.1, and 11.2 at ages 15, 16, 17, and 18, respectively. Additionally, 88.2% of the subjects had periodontal disease, with calculus as the most prevalent type. Moreover, 5.2% of these students showed loss of attachment. There was no significant association between dental caries and periodontal disease. Dental caries and periodontal disease were prevalent among Taiwanese high school students in this national dental survey.

NTRK1/3 rearrangements have been reported in 2.3–3.4% of papillary thyroid carcinoma (PTC) and are regarded as potential therapeutic targets. Recently, the application of immunohistochemistry (IHC) to detect NTRK rearrangements has been widely discussed. The current study aimed to characterize the clinicopathological features of PTC with NTRK1/3 fusions, to examine the utility of pan-TRK IHC, and to compare IHC with fluorescent in situ hybridization (FISH) and next-generation sequencing (NGS). In a cohort of 525 consecutive PTC cases, 60 BRAFV600E-negative cases underwent complete analyses of FISH, and 12 (2.3%) cases with NTRK1/3 break-apart were found. A novel ERC1-NTRK3 fusion was identified by NGS in one case. Pathological features of non-infiltrative tumor border, clear cell change, and reduced nuclear elongation and irregularity were significantly more common in NTRK1/3-rearranged PTC when compared with 48 BRAFV600E-negative non-NTRK1/3 PTC cases. In whole tissue sections, pan-TRK IHC was positive in 3/7 (42.9%) cases with an ETV6-NTRK3 rearrangement including 2 cases with low percentage of stained tumor cells, 2/3 (66.7%) with non-ETV6 NTRK3 rearrangements, and 2/2 (100%) with NTRK1 rearrangements. All FISH-negative cases were negative for pan-TRK in tissue microarray sections. As a result, pan-TRK IHC showed a sensitivity of 58.3% and specificity of 100% for NTRK1/3 rearrangements in BRAFV600E-negative PTC. In conclusion, NTRK1/3-rearranged PTC shared some unique morphologic features. Pan-TRK IHC showed high specificity and moderate sensitivity for NTRK1/3-rearranged PTC and should be interpreted with caution due to staining heterogeneity. Based on the above findings, we propose an algorithm integrating morphology, IHC, and molecular testing to detect NTRK1/3 rearrangements in PTC.

There are few published studies that report the prevalence of intraoral anomalies for young children. The purpose of this study was to investigate the prevalence and distribution of several congenital oral and paraoral anomalies in Taiwanese children under age six. Twenty-five cities and townships were randomly sampled in different areas of Taiwan using the stratified method. These cities and townships represent cross-sectional samples of geographic locations and socioeconomic levels. A total of 981 Taiwanese children under age six were examined with dental mirrors and explorers as part of the national dental survey. The results of this survey indicated an 11.31% prevalence of geographic tongue. This number is higher than that reported in studies previously performed in different countries. The occurrence of double teeth in primary dentition was found to be 2.14%. Ankyloglossia had a frequency of 1.22%, and primary talon cusp a frequency of 0.61%. Seven (0.71%) children exhibited fissured tongues. Thirteen (1.33%) cases of hypodontia were found. These values were different from those reported in several other countries, which may be attributed to differences in the ethnic and racial composition of the population studied.