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While there is currently a steadily growing number of disabled students at universities in Taiwan, there has been as yet no research concerning the attitude towards inclusive education of university instructors. This study investigated differences in attitude towards inclusive education among instructors at universities in Taiwan using a 'University Instructor Attitude towards Inclusive Education' questionnaire to examine instructors' attitudes and the differences in inclusive education of instructors' attitudes in various background variables. The inclusive education attitude questionnaire contained three subscales respectively examining cognition, affection, and behavioural tendencies; 299 valid ones of the 400 distributed questionnaires were collected, the valid questionnaire response rate was 74.7%. The study revealed that while university instructors in Taiwan had an active, positive attitude towards inclusive education, there were significant differences in attitude towards inclusive education among instructors with different gender, special education backgrounds, school type, and teaching field. This study also makes recommendations based on our findings, hopes to provide a reference aiding the drafting of special education policies at the higher education level in Taiwan, and also seeks to provide Taiwan's experience to other countries as a reference.

• Erector spinae plane block (ESPB) administration at varying distances from the incision (ES distance) does not significantly affect postoperative pain scores within the Enhanced Recovery After Surgery (ERAS) protocol for lumbar spine surgery. • Postoperative pain management with ESPB shows no significant difference in Numerical Rating Scale (NRS) pain scores between different ES distances immediately after surgery and up to 72 hours postoperatively within the ERAS group. • Patients in the ERAS group reported significantly lower pain scores and reduced morphine consumption compared to the non-ERAS group, indicating the effectiveness of the ERAS protocol. • ERAS protocols facilitated quicker resumption of diet and reduced the incidence of postoperative nausea and vomiting. • The study suggests that lumbar ESPB may be preferable due to difficulties with sonovisualization and to avoid the risk of pleural injury, establishing a safe and effective range for ESPB application. Postoperative pain control following spine surgery can be difficult. The Enhanced Recovery After Surgery (ERAS) programs use multimodal approaches to manage postoperative pain. While an erector spinae plane block (ESPB) is commonly utilized, the ideal distance for injection from the incision, referred to as the ES (ESPB to mid-surgical level) distance, remains undetermined. We evaluated the impact of varying ES distances for ESPB on Numerical Rating Scale (NRS) measures of postoperative pain within the ERAS protocol. Retrospective observational study. Adult patients who underwent elective lumbar spine fusion surgery. Primary outcome measures include the comparative postoperative NRS scores across groups at immediate (T1), 24 (T2), 48 (T3), and 72 (T4) hours postsurgery. For secondary outcomes, a propensity matching analysis compared these outcomes between the ERAS and non-ERAS groups, with opioid-related recovery metrics also assessed. All included patients were assigned to one of three ERAS groups according to the ES distance: Group 1 (G1, ES > 3 segments), Group 2 (G2, ES = 2–3 segments), and Group 3 (G3, ES<2 segments). Each patient underwent a bilateral ultrasound-guided ESPB with 60 mL of diluted ropivacaine or bupivacaine. Patients within the ERAS cohort reported mild pain (NRS < 3), with no significant NRS variation across G1 to G3 at any time. Sixty-five patients were matched across ERAS and non-ERAS groups. The ERAS group exhibited significantly lower NRS scores from T1 to T3 than the non-ERAS group. Total morphine consumption during hospitalization was 26.7 mg for ERAS and 41.5 mg for non-ERAS patients. The ERAS group resumed water and food intake sooner and had less postoperative nausea and vomiting. ESPBs can be effectively administered at or near the mid-surgical level to the low thoracic region for lumbar spine surgeries. Given challenges with sonovisualization, a lumbar ESPB may be preferred to minimize the risk of inadvertent pleural injury. [ABSTRACT FROM AUTHOR]

School resource room guidance personnel handle services to students with disabilities in institutions of higher education in Taiwan. This study conducted a survey of the kind of work performed by university and college resource room guidance personnel, and used a questionnaire to investigate 244 such personnel. This questionnaire contained 'background variables' and 'five major aspects of work' sections; the five major aspects of work were 'reporting diagnoses', 'recruiting and examination services', 'individualized support plans', 'barrier-free services' and 'assistance with activities'. The findings indicated that differences existed in the work situation of guidance personnel of different ages, years of service, school type, night shift, work evaluation and incentive mechanisms and handling services apart from special education. No significant differences were found in gender, marital status and educational attainment. Based on these findings, the researchers made recommendations about resource room guidance personnel and their work situation at universities and colleges in Taiwan.

Response surface models (RSMs) are a new trend in modern anesthesia. RSMs have demonstrated significant applicability in the field of anesthesia. However, the comparative analysis between RSMs and logistic regression (LR) in different surgeries remains relatively limited in the current literature. We hypothesized that using a total intravenous anesthesia (TIVA) technique with the response surface model (RSM) and logistic regression (LR) would predict the emergence from anesthesia in patients undergoing video-assisted thoracotomy surgery (VATS). This study aimed to prove that LR, like the RSM, can be used to improve patient safety and achieve enhanced recovery after surgery (ERAS). This was a prospective, observational study with data reanalysis. Twenty-nine patients (American Society of Anesthesiologists (ASA) class II and III) who underwent VATS for elective pulmonary or mediastinal surgery under TIVA were enrolled. We monitored the emergence from anesthesia, and the precise time point of regained response (RR) was noted. The influence of varying concentrations was examined and incorporated into both the RSM and LR. The receiver operating characteristic (ROC) curve area for Greco and LR models was 0.979 (confidence interval: 0.987 to 0.990) and 0.989 (confidence interval: 0.989 to 0.990), respectively. The two models had no significant differences in predicting the probability of regaining response. In conclusion, the LR model was effective and can be applied to patients undergoing VATS or other procedures of similar modalities. Furthermore, the RSM is significantly more sophisticated and has an accuracy similar to that of the LR model; however, the LR model is more accessible. Therefore, the LR model is a simpler tool for predicting arousal in patients undergoing VATS under TIVA with Remifentanil and Propofol. [ABSTRACT FROM AUTHOR]

Pulmonary auscultation is essential for detecting abnormal lung sounds during physical assessments, but its reliability depends on the operator. Machine learning (ML) models offer an alternative by automatically classifying lung sounds. ML models require substantial data, and public databases aim to address this limitation. This systematic review compares characteristics, diagnostic accuracy, concerns, and data sources of existing models in the literature. Papers published from five major databases between 1990 and 2022 were assessed. Quality assessment was accomplished with a modified QUADAS-2 tool. The review encompassed 62 studies utilizing ML models and public-access databases for lung sound classification. Artificial neural networks (ANN) and support vector machines (SVM) were frequently employed in the ML classifiers. The accuracy ranged from 49.43% to 100% for discriminating abnormal sound types and 69.40% to 99.62% for disease class classification. Seventeen public databases were identified, with the ICBHI 2017 database being the most used (66%). The majority of studies exhibited a high risk of bias and concerns related to patient selection and reference standards. Summarizing, ML models can effectively classify abnormal lung sounds using publicly available data sources. Nevertheless, inconsistent reporting and methodologies pose limitations to advancing the field, and therefore, public databases should adhere to standardized recording and labeling procedures. [ABSTRACT FROM AUTHOR]

Pharmacodynamic models have described the interactions between anesthetics. Applying the models to clinical practice is still problematic due to inherent limitations: 1. modeling conditions are different from practice. 2. One model can only describe one endpoint. To tackle these, we propose a new method of model validation for recovery and intraprocedural sedation adequacy with a three-drug pharmacodynamic model using six published clinical studies that contain midazolam, opioid, and propofol. Mean drug dose, intraprocedural sedation level, procedure, and recovery time are extracted from each study. Simulated drug regimens are designed to best approximate study conditions. A published deep sedation model is used for simulation. Model-predicted recovery time and intraprocedural sedation scores are compared with the original clinical study outcomes. The model successfully predicted recovery times in eight out of nine regimens. Lower doses of midazolam are associated with faster recovery. Model prediction of intraprocedural sedation level was compatible with the clinical studies in five out of seven regimens. The three-drug pharmacodynamic model describes the course of gastrointestinal endoscopy sedations from clinical studies well. Model predictions are consistent with the results from clinical studies. The approach implies that large scale validation can be performed repeatedly. [ABSTRACT FROM AUTHOR]

Antrodia salmonea (AS) is a fungus, which belongs to a fungal family of Taiwanofungus salmoneus with the features of anti-oxidant, anti-inflammatory, and anticancer. Recent studies have shown that AS has anti-cancer functions in ovarian and breast cancer. However, the effects of AS on prostate cancer (PCa) proliferation remain unknown. Therefore, we investigated the role of AS in PCa proliferation through apoptosis, and cell cycle regulation in PCa cell lines. Our results showed that Antrodia salmonea extract (ASE) inhibited PCa cells growth with a dose-dependent manner. In addition, ASE decreased the anchorage-independent growth formation ability in PC3 cells. Moreover, ASE-induced cell growth inhibition in PCa cells (DU145, PC3) was correlated to decreased cell cycle-related proteins such as cyclin A/B and cyclin-dependent kinase CDK1/2/4, and increased cell cycle inhibitor proteins p21. Besides, ASE decreased the total protein level of epidermal growth factor receptor and its downstream signaling pathways Akt and Erk in both PCa cells. We found that apoptotic markers such as cleaved-PARP protein levels increased significantly in DU145 cells indicating ASE might induce apoptosis. In conclusion, our results suggest that ASE may have the ability to induce PCa cell death through regulating cell cycle arrest and apoptosis pathways. [ABSTRACT FROM AUTHOR]

Propofol and fentanyl are commonly used agents for the induction of anesthesia, and are often associated with hemodynamic disturbances. Understanding pharmacodynamic impacts is vital for parasympathetic and sympathetic tones during the anesthesia induction period. Inspired by the thermodynamic interaction between drug concentrations and effects, we established a machine-learning-based response surface model (MLRSM) to address this predicament. Then, we investigated and modeled the biomedical phenomena in the autonomic nervous system. Our study prospectively enrolled 60 patients, and the participants were assigned to two groups randomly and equally. Group 1 received propofol first, followed by fentanyl, and the drug sequence followed an inverse procedure in Group 2. Then, we extracted and analyzed the spectrograms of electrocardiography (ECG) and pulse photoplethysmography (PPG) signals after induction of propofol and fentanyl. Eventually, we utilized the proposed MLRSM to evaluate the relationship between anesthetics and the integrity/balance of sympathetic and parasympathetic activity by employing the power of high-frequency (HF) and low-frequency (LF) bands and PPG amplitude (PPGA). It is worth emphasizing that the proposed MLRSM exhibits a similar mathematical form to the conventional Greco model, but with better computational performance. Furthermore, the MLRSM has a theoretical foundation and flexibility for arbitrary numbers of drug combinations. The modeling results are consistent with the previous literature. We employed the bootstrap algorithm to inspect the results' consistency and measure the various statistical fluctuations. Then, the comparison between the modeling and the bootstrapping results was used to validate the statistical stability and the feasibility of the proposed MLRSM. [ABSTRACT FROM AUTHOR]

This study investigates an association between obesity and cardiorespiratory fitness concerning their potential effects on cognitive flexibility in young adults from behavioral and neuroelectrical perspectives. Eligible young adults (N = 140, 18–25 years) were assigned into one of four groups, according to their status of obesity (i.e., body mass index) and cardiorespiratory fitness levels (i.e., estimated maximal oxygen uptake), namely, normal weight with high cardiorespiratory fitness (NH), obese with high cardiorespiratory fitness (OH), normal weight with low cardiorespiratory fitness (NL), and obese with low cardiorespiratory fitness (OL). The task-switching test was utilized, and its induced endogenous (P3) and exogenous (N1) event-related potential components were recorded. Concerning behavioral indices, the NH demonstrated superior behavioral performance across global switching and local switching of the task-switching test compared to individuals with lower cardiorespiratory fitness and obesity (i.e., NL, OH, and OL). Additionally, the OH demonstrated better performance than the OL during the heterogeneous condition. For neuroelectrical indices, the NH had larger mean P3 amplitudes during global and local switching than the other three groups. A larger N1 amplitude was also observed in the NH during local switching than in the OH group. The findings suggest that cardiorespiratory fitness has beneficial effects on cognitive flexibility, attentional resource allocation, and sensory evaluation in young adults. Furthermore, our research provided novel evidence showing that cardiorespiratory fitness might potentially alleviate the adverse effects of obesity on cognitive flexibility in young adults. [ABSTRACT FROM AUTHOR]