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Serious blunt chest trauma usually induces hemothorax, pneumothorax, and rib fractures. More studies have claimed that early video-assisted thoracoscopic surgery with surgical stabilization of rib fractures (SSRF) results in a good prognosis in patients with major trauma. This study aimed to verify the outcomes in patients with chest trauma whether SSRF was performed. Consecutive patients who were treated in a medical center in Taiwan, for traumatic events between January 2015 and June 2020, were retrospectively reviewed. This study focused on patients with major trauma and thoracic injuries, and they were divided into groups based on whether they received SSRF. We used electrical impedance tomography (EIT) to evaluate the change of ventilation conditions. Different scores used for the evaluation of trauma severity were also compared in this study. Among the 8396 patients who were included, 1529 (18.21%) had major trauma with injury severity score > 16 and were admitted to the intensive care unit initially. A total of 596 patients with chest trauma were admitted, of whom 519 (87%) survived. Younger age and a lower trauma score (including injury severity scale, new injury severity score, trauma and injury severity score, and revised trauma score) account for better survival rates. Moreover, 74 patients received SSRF. They had a shorter intensive care unit (ICU) stay (5.24, p = 0.045) and better performance in electrical impedance tomography (23.46, p < 0.001). In patients with major thoracic injury, older age and higher injury survival scale account for higher mortality rate. Effective surgical stabilization of rib fractures shortened the ICU stay and helped achieve better performance in EIT. Thoracoscope-assisted rib fixation is suggested in severe trauma cases. [ABSTRACT FROM AUTHOR]

This study aims to examine whether life insurance futures can serve as a hedge against the COVID-19 pandemic and whether they have the characteristics of a safe haven under the impact of the health shocks of the COVID-19 pandemic. We chose three life insurance stock futures in India and one in Taiwan as samples, including the market index of the two countries and the number of confirmed COVID-19 cases as sample variables. We used the growth rate of COVID-19 cases as the threshold variable, estimated the asymmetric threshold vector autoregression model, and found that insurance futures in the regime with a significant growth rate of confirmed COVID-19 cases can hedge against COVID-19 risks; therefore, insurance futures are a safe haven for the market. We further estimated the time-varying parameter vector autoregression model, and the impulse response results showed that insurance futures are a safe haven for COVID-19 pandemic risks. [ABSTRACT FROM AUTHOR]

The pathogenic influences of uterine bacteria on endometrial carcinogenesis remain unclear. The aim of this pilot study was to compare the microbiota composition of endometrial lavage samples obtained from women with either endometrial hyperplasia (EH) or endometrial cancer (EC) versus those with benign uterine conditions. We hypothesized that specific microbiota signatures would distinguish between the two groups, possibly leading to the identification of bacterial species associated with endometrial tumorigenesis. A total of 35 endometrial lavage specimens (EH, n = 18; EC, n = 7; metastatic EC, n = 2; benign endometrial lesions, n = 8) were collected from 32 women who had undergone office hysteroscopy. Microbiota composition was determined by sequencing the V3-V4 region of 16S rRNA genes and results were validated by real-time qPCR in 46 patients with EC/EH and 13 control women. Surprisingly, we found that Bacillus pseudofirmus and Stenotrophomonas rhizophila - two plastic-degrading bacterial species - were over-represented in endometrial lavage specimens collected from patients with EC/EH. Using computational analysis, we found that the functional profile of endometrial microbiota in EC/EH was associated with fatty acid and amino acid metabolism. In summary, our hypothesis-generating data indicate that the plastic-degrading bacteria Bacillus pseudofirmus and Stenotrophomonas rhizophila are over-represented within the endometrial lavage microbiota of women with EC/EH living in Taiwan. Whether this may be related to plastic pollution deserves further investigation. [ABSTRACT FROM AUTHOR]

Following the outbreak of the coronavirus pandemic in late 2019, Taiwan's international profile rose to prominence. Its public diplomatic campaign in distributing then-depleted stocks of facemasks provided a degree of international solidarity in a growing atmosphere of economic nationalism. Its government-led strategy of preventative measures that kept normalcy on the island while large swaths of the world entered restrictive lockdowns also became a model of resilient public health policies and trust in government directives. Capitalizing on these developments, Taiwan's soft power approach toward its constrained international profile also took on new prominence as it sought to leverage its technological leadership in the context of disrupted, vulnerable global supply chains. This article analyzes Taiwan's strategic narratives as it invests in conceptualizing an arena of increased great power contestation: the Indo-Pacific. It focuses on how elite narratives have employed several discursive strategies that increasingly aim to redirect and reorient supply chains to meet the (un)certainties of geopolitical ideological positioning. [ABSTRACT FROM AUTHOR]

The dicentric chromosome assay (DCA), the gold standard for radiation biodosimetry, evaluates an individual absorbed radiation dose by the analysis of DNA damage in human lymphocytes. The conventional (C-DCA) and QuickScan (QS-DCA) scoring methods are sensitive for estimating radiation dose. The Biodosimetry Laboratory at Institute of Nuclear Energy Research (INER), Taiwan, participated in intercomparison exercises conducted by Health Canada (HC) in 2014, 2015 and 2018 to validate the laboratory's accuracy and performance. Blood samples for the conventional dose response curve for Taiwan were irradiated with 0, 0.25, 0.5, 1, 2, 3, 4 and 5 Gy. Ten blind blood samples were provided by HC. Either or both of two methods of conventional (C) or QuickScan (QS) scoring could be chosen for the HC's intercomparison. For C-DCA triage scoring, only cells with 46 centromeres were counted and each scorer recorded the number of dicentrics in the first 50 metaphases or stopped scoring when 30 dicentrics were reached. Scorers also recorded how much time it took to analyze 10, 20, and 50 cells. Subsequently, the data were entered into the Dose Estimate software (DoseEstimate_v5.1) and dose estimates were calculated. With QS-DCA scoring, a minimum of 50 metaphase cells (or 30 dicentrics) were scored in apparently complete metaphases without verification of exactly 46 centromeres. For the blinded blood samples irradiated at HC and shipped to INER, the mean absolute deviation (MAD) derived after scoring 50 cells for C-DCA and QS-DCA was <0.5 Gy for all three intercomparisons, meeting the criteria for acceptance. The results indicated that the Biodosimetry Laboratory at INER can provide reliable dose estimates in the case of a large-scale radiation accident. [ABSTRACT FROM AUTHOR]

Congenital short bowel syndrome (CSBS) is a rare condition characterized by an inborn shortening of bowel length with loss of intestinal functions, which often combines malrotation. CXADR-like membrane protein (CLMP) and filamin A (FLNA) gene mutations are the two major causes of this inherited defect. We presented two siblings with the older brother suffering from a laparotomy for bowel obstruction due to malrotation on the 17th day after birth. The younger sister encountered a laparotomy for lactobezoar at 6 months old. CSBS was diagnosed by measurement of the bowel length during the operations. Compound heterozygous CLMP mutations with the paternal allele harboring a long deletion across exon 3–5 and the maternal allele bearing a non-sense mutation of exon 3 (c.235C > T, p.Q79∗) were identified in both cases. They are the first reported familial CSBS caused by novel CLMP mutations in Taiwan. [ABSTRACT FROM AUTHOR]

This article uses Granger causality test and multivariate threshold model’s causality to test the existence of dynamic nonlinear relationship among tourist arrival, the crime rate, and macroeconomic variables 2001-2016 in Taiwan. The empirical result shows that tourist arrival has a negative effect on the crime rate and there is two-way causality between the exchange rate and tourist arrival. Where the CPI or the exchange rate as the threshold variables in the multivariate threshold model, the Regime 1 and linear results are same, but the Regime 2 results are different, which shows that not all variables have the same dynamic relation. [ABSTRACT FROM AUTHOR]

The three most common sexually transmitted infections (STIs) are Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and Trichomonas vaginalis (TV). The prevalence of these STIs in Taiwan remains largely unknown and the risk of STI acquisition affected by the vaginal microbiota is also elusive. In this study, a total of 327 vaginal swabs collected from women with vaginitis were analyzed to determine the presence of STIs and the associated microorganisms by using the BD Max CT/GC/TV molecular assay, microbial cultures, and 16S rRNA sequencing. The prevalence of CT, TV, and GC was 10.8%, 2.2% and 0.6%, respectively. A culture-dependent method identified that Escherichia coli and Streptococcus agalactiae (GBS) were more likely to be associated with CT and TV infections. In CT-positive patients, the vaginal microbiota was dominated by L. iners, and the relative abundance of Gardnerella vaginalis (12.46%) was also higher than that in TV-positive patients and the non-STIs group. However, Lactobacillus spp. was significantly lower in TV-positive patients, while GBS (10.11%), Prevotella bivia (6.19%), Sneathia sanguinegens (12.75%), and Gemella asaccharolytica (5.31%) were significantly enriched. Using an in vitro co-culture assay, we demonstrated that the growth of L. iners was suppressed in the initial interaction with TV, but it may adapt and survive after longer exposure to TV. Additionally, it is noteworthy that TV was able to promote GBS growth. Our study highlights the vaginal microbiota composition associated with the common STIs and the crosstalk between TV and the associated bacteria, paving the way for future development of health interventions targeting the specific vaginal bacterial taxa to reduce the risk of common STIs. [ABSTRACT FROM AUTHOR]

Since the accident of Fukushima Daiichi nuclear power plant, the environmental radiation dose was increasingly concerned as a global issue. In Taiwan, the detection capability of the all calibration laboratories is just about 50 times the naturally occurring environmental radiation for environmental radiation protection detectors. Undoubtedly the use of environmental radiation detector shows relative low performance in accuracy and the public are very sensitive to the amount of environmental radiation. Thus, the National Radiation Standard Laboratory (NRSL) of the Institute of Nuclear Energy Research (INER) designed a multi-source of low air kerma rate calibration system to respond to the measurement and calibration needs in Taiwan. The system was verified to meet the needs of measurement and calibration through a series of evaluations and comparisons based on ISO 4037-1 criteria (ISO 4037, 1996). This environmental-level dose rate measurement and calibration system contains three radioactive sources respectively penetrating by sets of filter of three different thicknesses and then producing radiation fields of three different strengths. A total of nine standard radiation fields are provided with intensity ranges from 1746.6 μGy/h to 0.092 μGy/h, and the expanded uncertainties of the system were from 1.02% to 5.77% (k = 2). • A pressure-adjustable 10 L-nitrogen-filled ion chamber was used for air kerma determination. • A multi sources irradiator produced the irradiation field from 0.06 to 1.25 MeV gamma rays and 0.1–∼1700 μGy/h. • The tunnel-shaped shielding could reduce background interference to one tenth at the reference point. • A movable collimator and multi filters devices respectively adjust the suitable field size and air kerma rate. [ABSTRACT FROM AUTHOR]

This study investigated the series of proficiency testing held by the Institute of Nuclear Energy Research (INER) from 2010 to 2017 and the benchmark of one type of dose evaluation system for personnel dosimeters in Taiwan. Based on the latest American National Standard Institute/Health Physics Society (ANSI/HPS) N13.11–2009 (R2015) performance testing standard, the personnel dose equivalent, H p (d) data of the proficiency testing programs were reanalyzed to research the dose assessment ability and the criteria update feasibility. The results showed that the tolerance level (L), absolute of bias (|B|) and standard deviation (S) for all categories of all the 8 laboratories and 4 types of dosimeter well met the latest ANSI/HPS N13.11 criteria. In addition, the measurements of the H p (d) with LiF: Mg, Ti-based TLD personnel dosimeters were also demonstrated by comparing with the MCNP6 Monte Carlo code. The dose responses were satisfactory in M100, M150 X-ray and 137Cs (including the angle tests) beams produced by INER for radiation protection level application. • In Taiwan, all 8personal dosimeter laboratories met the ANSI/HPS N13.11–2009 (R2015) criteria based on the reanalysis of pervious performance test. • The results could improve measurement quality and traceability for service laboratory using 4 different types of dosimeters. • The simulated model of Harshaw LiF:Mg, Ti-based TLD personnel dosimeter were established with MCNP6 code. • For irradiation verification, the results of equivalent dose comparison agreed within 5%–26% in the 137Cs, M100 and M150 X-ray beams. [ABSTRACT FROM AUTHOR]

Background: Intestinal parasitic infections are the most common infectious diseases among Southeast Asian migrant workers in Taiwan, especially for infections with Blastocystis hominis. However, little is known about the impact of Blastocystis subtypes (STs) on the gut microbiota., Methods: We retrospectively evaluated the prevalence of intestinal parasites in a teaching hospital in Northern Taiwan in the period of 2015-2019. Blastocystis-positive stool specimens were collected for ST analysis by polymerase chain reaction in 2020. Intestinal microbiota analyses of different Blastocystis STs and Blastocystis-free individuals were conducted by 16S rRNA sequencing., Results: A total of 13,859 subjects were analyzed, of which 1802 cases (13%) were diagnosed with intestinal parasitic infections. B. hominis infections were the most prevalent (n = 1546, 85.7%). ST analysis of Blastocystis-positive samples (n = 150) indicated that ST1 was the most common type, followed by ST3, ST4, ST2, ST7, and ST5. Different Blastocystis STs (ST1, ST3, and ST4) were associated with distinct richness and diversity of the microbiota. Taxonomic profiles revealed that Akkermansia muciniphila was significantly enriched for all analyzed Blastocystis STs, whereas Holdemanella biformis was more abundant in the Blastocystis-free group. Additionally, Succinivibrio dextrinosolvens and Coprococcus eutactus were specifically more abundant in ST3 carriers than in non-infected individuals., Conclusion: This study demonstrates that A. muciniphila is positively associated with all Blastocystis STs, while H. biformis was negatively associated with them. Several bacteria were enriched in specific STs, highlighting the need for further microbiota analysis at the ST level to elucidate the pathogenicity of Blastocystis., Competing Interests: Conflict of interest The authors declare no conflicts of interest., (© 2023 The Authors. Published by Elsevier B.V. on behalf of Chang Gung University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).)

Here, we investigated whether the abbreviated burn severity index (ABSI) scoring system predicts acute respiratory distress syndrome (ARDS) in a retrospective analysis of a severe flammable starch-based powder burn population. Demographics, total body surface area (TBSA) burn, the presence of mouth and nose burn, ABSI, inhalation injury, and clinical outcomes for each patient were analysed for association with inpatient ARDS based on the Berlin definition. We treated 53 patients (64% male, 36% female) and observed no fatalities. The median age, TBSA burn, and the ABSI were 22.2±3.6, 42.2±21, and 7.8±2.8, respectively. Inhalation injury was present in 56.6% of the cases, and mouth and nose burn was present in 30.2%. ARDS was prevalent at 30%. The mean abbreviated burn severity index (ABSI) was 10.6±1.5 in the ARDS group and 6.6±2.3 in the non-ARDS (P<0.001) group. The mean TBSA burn percentage for ARDS and the non-ARDS groups were 61.4±13.9% and 34±18%, respectively (P<0.001). The area under the curve of the receiver operating characteristic curves for an ABSI≥9 was 0.905. Our results show that the ABSI is effective for predicting ARDS in young individuals with severe starch-based powder burn., (Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.)

Oral squamous cell carcinoma is a prominent cancer worldwide, particularly in Taiwan. By integrating omics analyses in 50 matched samples, we uncover in Taiwanese patients a predominant mutation signature associated with cytidine deaminase APOBEC, which correlates with the upregulation of APOBEC3A expression in the APOBEC3 gene cluster at 22q13. APOBEC3A expression is significantly higher in tumors carrying APOBEC3B-deletion allele(s). High-level APOBEC3A expression is associated with better overall survival, especially among patients carrying APOBEC3B-deletion alleles, as examined in a second cohort (n = 188; p = 0.004). The frequency of APOBEC3B-deletion alleles is ~50% in 143 genotyped oral squamous cell carcinoma -Taiwan samples (27A3B -/- :89A3B +/- :27A3B +/+ ), compared to the 5.8% found in 314 OSCC-TCGA samples. We thus report a frequent APOBEC mutational profile, which relates to a APOBEC3B-deletion germline polymorphism in Taiwanese oral squamous cell carcinoma that impacts expression of APOBEC3A, and is shown to be of clinical prognostic relevance. Our finding might be recapitulated by genomic studies in other cancer types.Oral squamous cell carcinoma is a prevalent malignancy in Taiwan. Here, the authors show that OSCC in Taiwanese show a frequent deletion polymorphism in the cytidine deaminases gene cluster APOBEC3 resulting in increased expression of A3A, which is shown to be of clinical prognostic relevance.

Objectives: This study aims to test the hypothesis that gallstone disease (GSD) is a risk factor for the development of idiopathic sudden sensorineural hearing loss (ISSNHL). Research has shown risks of cardiovascular and cerebrovascular events in patients with GSD; however, well-conducted English studies on the association between GSD and the development of ISSNHL are lacking., Design and Setting: Retrospective cohort study using the Taiwan Longitudinal Health Insurance Database., Participants: We compared 26,449 patients diagnosed with GSD between 1 January 2001 and 31 December 2007, with 52,898 age-matched, gender-matched and comorbidities propensity scores-matched controls., Outcome Measured: We followed each patient until the end of 2011 and evaluated the incidence of ISSNHL for at least 4 years after the initial GSD diagnosis., Results: The incidence of ISSNHL was 1.42 times higher in the GS cohort than in the non-GS cohort (9.27 vs 6.52/10,000 person-years). Using Cox proportional hazard regressions, the adjusted HR was 1.44 (95% CI 1.19 to 1.74). In the cohort of patients with GSD who needed a cholecystectomy, 37 patients suffered from ISSNHL. Among those patients, 31 (83.7%) patients sustained ISSNHL before cholecystectomy and 6 (16.2%) patients sustained ISSNHL after cholecystectomy., Conclusions: A diagnosis of GSD may be an independent risk for ISSNHL. This finding suggests that an underlying vascular and inflammatory mechanism may contribute to the development of ISSNHL. Physicians may want to counsel patients with GSD to seek medical attention if they have hearing impairments, because patients may be at an increased risk of developing ISSNHL., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)