Morphology and Photophysical Properties of Light-Emitting Electrospun Nanofibers Prepared from Poly(fluorene) Derivative/PMMA Blends

Light-emitting electrospun (ES) nanofibers with diameters of 250−750 nm were successfully prepared through the binary blends of polyfluorene derivative/poly(methyl methacrylate) (PMMA) using a single-capillary spinneret. The studied poly(fluorene)s included poly(9,9-dioctylfluoreny-2,7-diyl) (PFO), poly[2,7-(9,9-dihexylfluorene)-alt-5,8-quinoxaline] (PFQ), poly[2,7-(9,9-dihexylfluorene)-alt-4,7-(2,1,3-benzothiadiazole)] (PFBT), and poly[2,7-(9,9-dihexylfluorene)-alt-5,7-(thieno[3,4-b]pyrazine)] (PFTP). The transmission electron microscopy (TEM) studies showed that uncontinuous fiberlike structure was obtained at the low PFO/PMMA blend ratio but became a core−shell structure at a high PFO blend ratio. The poorer solubility of PFO in chloroform than that of PMMA probably forced it to be solidified first as the fiber core. Besides, a porous surface structure on the PFO/PMMA blend fibers was observed due to the rapid evaporation of the chloroform solvent. The PFO aggregation domain in the ES fibers was much smaller than that in the spin-coated films and led to higher photoluminescence efficiency. Uniform ES fibers produced from the binary blends of PFO/PMMA, PFQ/PMMA, PFBT/PMMA, and PFTP/PMMA exhibited the following luminescence characteristics (peak maximum (nm); color):  443, blue; 483, green; 539, yellow; 628, red. The present study demonstrates that full color light-emitting ES nanofibers could be produced from the binary blends of polyfluorene derivative/PMMA

A Hybrid Neural Network Model Predictive Control with Zone Penalty Weights for Type 1 Diabetes Mellitus

In this paper, a hybrid neural network model is developed to predict and control the blood glucose (BG) of the patient who has type 1 diabetes mellitus (T1DM). The proposed model consists of two parts: a linear finite impulse response (FIR) model and a nonlinear autoregressive exogenous input (NARX) network. A recently developed and well-acknowledged meal simulation model of the glucose-insulin system for T1DM is employed to create virtual subjects. Data from virtual subjects are used to identify an intermediate physiological model, and then our proposed hybrid model is trained and validated based on this intermediate model. The key features of the resulting hybrid model are that it reveals satisfactory accuracy of long-term prediction and does not require an immeasurable state for model initialization. The developed hybrid model is then embedded in a nonlinear model predictive control (MPC) controller with zone penalty weights, and this closed-loop controller is implemented on these virtual subjects for simulation-based preclinical testing. The results show that promising glycemic control performance can be achieved. Moreover, this overall BG control methodology is easily portable and has the ability to arbitrarily start the therapeutic control at any initial point

Fuzzy-Logic-Based Supervisor of Insulin Bolus Delivery for Patients with Type 1 Diabetes Mellitus

In this article, a fuzzy-logic-based supervisor of insulin bolus delivery for type 1 diabetes mellitus (T1DM) is proposed. The proposed supervisor incorporates expert knowledge into three phases, including recall, inference, and learning phases. A recently developed and well-acknowledged meal simulation model of the glucose–insulin system for T1DM was employed to create virtual subjects for testing. Data from virtual subjects were used to identify an intermediate physiological model, and then our proposed supervisor was synthesized based on this intermediate model. The key features of this fuzzy-logic-based supervisor are that the implementation does not need an online model and it can gradually be updated meal-by-meal. In addition, only two blood glucose measurements between each meal are needed for updating the insulin bolus delivery. The simulation results show that effective and robust glycemic control performance can be achieved. This methodology can be widely applied to patients with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI)

Table_4_Renal and Glucose-Lowering Effects of Empagliflozin and Dapagliflozin in Different Chronic Kidney Disease Stages.DOCX

Objective: The objective of this study was to investigate the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on renal function in different stages of chronic kidney disease (CKD).Design and Methods: We conducted a retrospective cohort study using longitudinal claims data from May 2016–December 2017 from the Chang Gung Research Database. Patients who used one of the three types of SGLT2 inhibitor available at Chang Gung Memorial Hospital, namely empagliflozin 10 mg/tab (Empa10), empagliflozin 25 mg/tab (Empa25), and dapagliflozin 10 mg/tab (Dapa), were included, with the same number of matched non-users. Analysis of variance was used for continuous variables and the chi-square test was applied for categorical variables. Differences in data between two groups were analyzed using an independent t-test, and the basic data before and after treatment were analyzed using generalized estimating equation (GEE). The association among renal function changes was analyzed using a Cox proportional hazards model, with the results presented as unadjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs).Results: Among the 7,624 SGLT2 inhibitor users, 1,696 patients used Empa10, 2,654 used Empa25, and 3,274 used Dapa. Compared with non-users, dapagliflozin had the lowest risk of estimated glomerular filtration rate (eGFR) decrease over 40% from baseline within 1 year (HR 0.36, 95% CI 0.25–0.51). By using the ICD-10-CM code N179, the acute kidney injury (AKI)-related hospitalization rate was lower in Empa10 and Dapa users than in non-users (HR 0.65, 95% CI 0.49–0.86).Conclusion: Lower risk of eGFR decrease over 40% and AKI-related hospitalization was found in all SGLT2 inhibitor users across the different CKD stages.</p

Table_1_Renal and Glucose-Lowering Effects of Empagliflozin and Dapagliflozin in Different Chronic Kidney Disease Stages.DOCX

Objective: The objective of this study was to investigate the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on renal function in different stages of chronic kidney disease (CKD).Design and Methods: We conducted a retrospective cohort study using longitudinal claims data from May 2016–December 2017 from the Chang Gung Research Database. Patients who used one of the three types of SGLT2 inhibitor available at Chang Gung Memorial Hospital, namely empagliflozin 10 mg/tab (Empa10), empagliflozin 25 mg/tab (Empa25), and dapagliflozin 10 mg/tab (Dapa), were included, with the same number of matched non-users. Analysis of variance was used for continuous variables and the chi-square test was applied for categorical variables. Differences in data between two groups were analyzed using an independent t-test, and the basic data before and after treatment were analyzed using generalized estimating equation (GEE). The association among renal function changes was analyzed using a Cox proportional hazards model, with the results presented as unadjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs).Results: Among the 7,624 SGLT2 inhibitor users, 1,696 patients used Empa10, 2,654 used Empa25, and 3,274 used Dapa. Compared with non-users, dapagliflozin had the lowest risk of estimated glomerular filtration rate (eGFR) decrease over 40% from baseline within 1 year (HR 0.36, 95% CI 0.25–0.51). By using the ICD-10-CM code N179, the acute kidney injury (AKI)-related hospitalization rate was lower in Empa10 and Dapa users than in non-users (HR 0.65, 95% CI 0.49–0.86).Conclusion: Lower risk of eGFR decrease over 40% and AKI-related hospitalization was found in all SGLT2 inhibitor users across the different CKD stages.</p

Table_2_Renal and Glucose-Lowering Effects of Empagliflozin and Dapagliflozin in Different Chronic Kidney Disease Stages.DOCX

Objective: The objective of this study was to investigate the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on renal function in different stages of chronic kidney disease (CKD).Design and Methods: We conducted a retrospective cohort study using longitudinal claims data from May 2016–December 2017 from the Chang Gung Research Database. Patients who used one of the three types of SGLT2 inhibitor available at Chang Gung Memorial Hospital, namely empagliflozin 10 mg/tab (Empa10), empagliflozin 25 mg/tab (Empa25), and dapagliflozin 10 mg/tab (Dapa), were included, with the same number of matched non-users. Analysis of variance was used for continuous variables and the chi-square test was applied for categorical variables. Differences in data between two groups were analyzed using an independent t-test, and the basic data before and after treatment were analyzed using generalized estimating equation (GEE). The association among renal function changes was analyzed using a Cox proportional hazards model, with the results presented as unadjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs).Results: Among the 7,624 SGLT2 inhibitor users, 1,696 patients used Empa10, 2,654 used Empa25, and 3,274 used Dapa. Compared with non-users, dapagliflozin had the lowest risk of estimated glomerular filtration rate (eGFR) decrease over 40% from baseline within 1 year (HR 0.36, 95% CI 0.25–0.51). By using the ICD-10-CM code N179, the acute kidney injury (AKI)-related hospitalization rate was lower in Empa10 and Dapa users than in non-users (HR 0.65, 95% CI 0.49–0.86).Conclusion: Lower risk of eGFR decrease over 40% and AKI-related hospitalization was found in all SGLT2 inhibitor users across the different CKD stages.</p

Table_3_Renal and Glucose-Lowering Effects of Empagliflozin and Dapagliflozin in Different Chronic Kidney Disease Stages.DOCX

Objective: The objective of this study was to investigate the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on renal function in different stages of chronic kidney disease (CKD).Design and Methods: We conducted a retrospective cohort study using longitudinal claims data from May 2016–December 2017 from the Chang Gung Research Database. Patients who used one of the three types of SGLT2 inhibitor available at Chang Gung Memorial Hospital, namely empagliflozin 10 mg/tab (Empa10), empagliflozin 25 mg/tab (Empa25), and dapagliflozin 10 mg/tab (Dapa), were included, with the same number of matched non-users. Analysis of variance was used for continuous variables and the chi-square test was applied for categorical variables. Differences in data between two groups were analyzed using an independent t-test, and the basic data before and after treatment were analyzed using generalized estimating equation (GEE). The association among renal function changes was analyzed using a Cox proportional hazards model, with the results presented as unadjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs).Results: Among the 7,624 SGLT2 inhibitor users, 1,696 patients used Empa10, 2,654 used Empa25, and 3,274 used Dapa. Compared with non-users, dapagliflozin had the lowest risk of estimated glomerular filtration rate (eGFR) decrease over 40% from baseline within 1 year (HR 0.36, 95% CI 0.25–0.51). By using the ICD-10-CM code N179, the acute kidney injury (AKI)-related hospitalization rate was lower in Empa10 and Dapa users than in non-users (HR 0.65, 95% CI 0.49–0.86).Conclusion: Lower risk of eGFR decrease over 40% and AKI-related hospitalization was found in all SGLT2 inhibitor users across the different CKD stages.</p

Table_5_Renal and Glucose-Lowering Effects of Empagliflozin and Dapagliflozin in Different Chronic Kidney Disease Stages.DOCX

Objective: The objective of this study was to investigate the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on renal function in different stages of chronic kidney disease (CKD).Design and Methods: We conducted a retrospective cohort study using longitudinal claims data from May 2016–December 2017 from the Chang Gung Research Database. Patients who used one of the three types of SGLT2 inhibitor available at Chang Gung Memorial Hospital, namely empagliflozin 10 mg/tab (Empa10), empagliflozin 25 mg/tab (Empa25), and dapagliflozin 10 mg/tab (Dapa), were included, with the same number of matched non-users. Analysis of variance was used for continuous variables and the chi-square test was applied for categorical variables. Differences in data between two groups were analyzed using an independent t-test, and the basic data before and after treatment were analyzed using generalized estimating equation (GEE). The association among renal function changes was analyzed using a Cox proportional hazards model, with the results presented as unadjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs).Results: Among the 7,624 SGLT2 inhibitor users, 1,696 patients used Empa10, 2,654 used Empa25, and 3,274 used Dapa. Compared with non-users, dapagliflozin had the lowest risk of estimated glomerular filtration rate (eGFR) decrease over 40% from baseline within 1 year (HR 0.36, 95% CI 0.25–0.51). By using the ICD-10-CM code N179, the acute kidney injury (AKI)-related hospitalization rate was lower in Empa10 and Dapa users than in non-users (HR 0.65, 95% CI 0.49–0.86).Conclusion: Lower risk of eGFR decrease over 40% and AKI-related hospitalization was found in all SGLT2 inhibitor users across the different CKD stages.</p

Understanding Healthcare Providers’ Care for Patients with Medications Treating Opioid Use Disorder in the Emergency Department: A Scoping Review

There is limited research exploring the changing clinical practices among healthcare providers (HPs) care for patients with Emergency Department (ED)-initiated Medication for Opioid Use Disorder (MOUD). This scoping review followed the methodological framework of Arksey and O’Malley to map relevant evidence and synthesize the findings. We searched PubMed, EMBASE, CINAHL, Web of Science, and Scopus for related studies from inception through October 12, 2022. Following the application of inclusion and exclusion criteria, 16 studies were included. Subsequently, they were charted and analyzed thematically based on ecological systems theory. The main determinants in the four ecological systems were generated as follows: (1) microsystem: willingness and attitude, professional competence, readiness, and preference; (2) mesosystem: ED clinical practices, departmental factors; (3) exosystem: multidisciplinary approaches, discharge planning, and (4) macrosystem: stigma, health insurance, policy. The findings have implications for HPs and researchers, as insufficient adoption, implementation, and retention of MOUD in the ED affect clinical practices. Across the four ecological systems, ED-initiated MOUD is shaped by multifaceted determinants. The microsystem underscores pivotal patient-HP trust dynamics, while the mesosystem emphasizes interdepartmental synergies. Exosystemically, resource allocation and standardized training remain paramount. The macrosystem reveals profound effects of stigma, insurance disparities, and evolving policies on treatment access and efficacy. Addressing these interconnected barriers is crucial for optimizing patient outcomes in the context of MOUD.</p

Impact of Carbohydrate on Glucose Variability in Patients with Type 1 Diabetes Assessed Through Professional Continuous Glucose Monitoring: A Retrospective Study

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