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Abstract Background Previous studies have shown a growing need for pediatric palliative care, but there is a lack of knowledge in many countries concerning prevalence of service use among children and young adults with life-limiting conditions. This study aimed to estimate (1) the annual prevalence of children and young adults with a life-limiting condition, and (2) their specialized palliative care and other healthcare utilization. Methods Data from the Health and Welfare Data Science Center in Taiwan were used. All children and young adults aged 0–25 years recorded in inpatient or outpatient data, and infants aged

Retractions serve a crucial role in maintaining the integrity and accuracy of scientific literature. There has been growing interest in understanding the patterns behind retractions. This bibliometric study analyzed retracted articles published between 2003 and 2022, indexed by the Science Citation Index Expanded of the Web of Science Core Collection database. A total of 8466 retracted articles were identified, revealing an overall increase up to 2019, followed by a decline. A total of 109 countries contributed to the retracted articles, with China and the United States having the highest absolute numbers. In addition, the articles were published in 2347 different journals, with Tumor Biology recording the largest number of retracted articles. The top 10 most cited retracted articles indicated that data and image integrity issues were the main reasons for retraction. The primary reasons for retractions, identified by linking the retracted articles to the Retraction Watch Database, were data and results issues followed by plagiarism and duplication. In conclusion, the present bibliometric study offered an overview of the status of retracted articles indexed by the Web of Science Core Collection over the past two decades. These findings provide insight into areas where scientific integrity may be compromised and serve as a guide to foster a responsible research environment.

Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with 752 registered nurses and nurse practitioners recruited from a regional teaching hospital in southern Taiwan. EBP competency was evaluated using the Taipei Evidence-Based Practice Questionnaire (TEBPQ). The results showed that participation in evidence-based courses or training within the past year had the strongest association with EBP competencies (Std. B = 0.157, p < 0.001). Holding a graduate degree (Std. B = 0.151, p < 0.001), working in gynecology or pediatrics (Std. B = 0.126, p < 0.001), searching the literature in electronic databases (Std. B = 0.072, p = 0.039), and able to read academic articles in English (Std. B = 0.088, p = 0.005) were significantly associated with higher TEBPQ scores. Younger age (Std. B = −0.105, p = 0.005) and male gender (Std. B = 0.089, p = 0.010) were also identified as factors contributing to higher EBP competencies. The study highlights the importance of ongoing professional development, including EBP training and language proficiency, in enhancing EBP competencies among nursing professionals in Taiwan.

Introduction Endoscopic endonasal approach(EEA) techniques have been increasingly utilized and have been associated with development of cerebrospinal fluid(CSF) leak, meningitis, diabetes insipidus post‐operatively. Cerebral vasospasm following EEA has rarely been described. Here, we describe the clinical course and management of a patient who underwent EEA for encephalocele repair whose course was complicated by postoperative subarachnoid hemorrhage(SAH) and cerebral vasospasm. Methods n/a Results Case Presentation: 40 year old female with past medical history significant for cerebral venous sinus stent on aspirin, CSF rhinorrhea secondary to right nasal encephalocele s/p endoscopic transnasal transethmoidal repair with nasoseptal flap reconstruction and lumbar drain placement eleven days prior presented with speech difficulties and right sided weakness. On exam, patient was noted to have mild right hemiparesis and expressive aphasia. MRI brain showed subacute infarcts in left greater than right frontal lobes, corpus collosum and right anterior perforated substance. MRA head demonstrated multifocal arterial stenosis. In light of postoperative CT head showing SAH in the basilar, perimesencephalic, prepontine cisterns, interhemispheric fissure and right frontal sulci as well as intraventricular hemorrhage in fourth ventricle, her presentation was thought to be secondary to cerebral vasospasm in the setting of postoperative SAH. She was treated with intravenous hydration, permissive hypertension with head of bed in flat position and transferred for further evaluation. On arrival, she continued have mild right hemiparesis and aphasia. Repeat CTA head/neck and CT perfusion showed severe stenosis of bilateral M1 segments and left greater than right A1 segments as well as ischemic penumbra in left ACA/MCA watershed territory. Diagnostic cerebral angiogram showed bilateral severe A1 stenosis and mild to moderate bilateral M1 and supraclinoid ICA stenosis which improved with intra‐arterial verapamil. She was started on nimodipine. Systolic blood pressure was augmented with vasopressors for goal of 150‐180mmHg. Daily TCDs were followed. She developed worsening right leg weakness following day, thus she was taken for repeat diagnostic cerebral angiogram during which time she was re‐administered intra‐arterial verapamil with improvement in vasospasm. After the second treatment, she had improvement in speech and motor strength. Systolic blood pressure goal was gradually normalized. She was noted to have incidental left internal jugular (IJ) vein thrombosis for which anticoagulation was held in the setting of recent neurosurgical procedure and SAH. Workup for vasculitis and hypercoagulability was unrevealing. Lumbar puncture demonstrated 13 WBC/cu mm with lymphocytic predominance(90%), 23 RBC/cu mm, glucose 89mg/dl, protein 30mg/dl. CSF cultures were negative. Pleocytosis in CSF was attributed to recent neurosurgical procedure. Her neurological exam improved to baseline on hospital day(HD) 9.On HD12, she was found to have left common femoral deep venous thrombus in addition to the left IJ thrombus. Anticoagulation with low dose heparin infusion was started which was transitioned to apixaban on discharge. She was discharged home on HD20. Conclusion We report a case of EEA associated with severe multifocal cerebral vasospasm secondary to postoperative SAH that was successfully treated with induced hypertension, oral nimodipine and intra‐arterial verapamil as an adjunct therapy with an excellent outcome.

Bibliometric analysis has gained popularity as a quantitative research methodology to evaluate scholarly productivity and identify trends within specific research areas. However, there are currently no established reporting guidelines for bibliometric studies. The present study aimed to investigate the reporting practices of bibliometric research related to health and medicine based on a guidelines “Preferred Reporting Items for Bibliometric Analysis (PRIBA)” proposed in this study. The Science Citation Index, Expanded of the Web of Science was used to identify the top 100 articles with the highest normalized citation counts per year. The search was conducted on April 9, 2022, using the search topic “bibliometric” and including publications from 2019 to 2021. The results substantiated the need for a standardized reporting guideline for bibliometric research. Specifically, among the 25 proposed items in the PRIBA, only five were consistently reported across all articles examined. Further, 11 items were reported by at least 80% of the articles, while nine items were reported by less than 80% of the articles. In conclusion, our findings suggest that the reporting practices of bibliometric studies in the field of health and medicine are in need of improvement. Future research should be conducted to refine the PRIBA guidelines.

To provide coordinate information for the use of intelligent transportation systems (ITSs) and autonomous vehicles (AVs), the global positioning system (GPS) is commonly used in vehicle localization as a cheap and easily accessible solution for global positioning. However, several factors contribute to GPS errors, decreasing the safety and precision of AV and ITS applications, respectively. Extensive research has been conducted to address this problem. More specifically, several optimization-based cooperative vehicle localization algorithms have been developed to improve the localization results by exchanging information with neighboring vehicles to acquire additional information. Nevertheless, existing optimization-based algorithms still suffer from an unacceptable performance and poor scalability. In this study, we investigated the development of deep learning (DL) based cooperative vehicle localization algorithms to provide GPS refinement solutions with low complexity, high performance, and flexibility. Specifically, we propose three DL models to address the problem of interest by emphasizing the temporal and spatial correlations of the extra given information. The simulation results confirm that the developed algorithms outperform existing optimization-based algorithms in terms of refined error statistics. Moreover, a comparison of the three proposed algorithms also demonstrates that the proposed graph convolution network-based cooperative vehicle localization algorithm can effectively utilize temporal and spatial correlations in the extra information, leading to a better performance and lower training overhead.

Objective We aimed to investigate factors associated with nonadherence to antihypertensive medication among middle-aged Taiwanese adults with hypertension. Methods We used data from the 2009 Taiwan National Health Interview Survey (NHIS) to identify adults age 40 to 65 years with hypertension. We used logistic regression analyses to investigate factors associated with nonadherence to antihypertensive medication. Results A total 1,256 respondents with hypertension taking antihypertensive medication were included in this study. Multiple logistic regression analyses revealed that six factors were significantly and independently associated with nonadherence to medication: younger age (odds ratio, [OR] = 1.85), mean monthly personal income

Background Adolescents with brain stem dysfunction may undergo many invasive treatments, and parents are often faced with making the decision to withdraw treatment. However, in the face of their child’s death, the spiritual practices of parents dealing with end-of-life decision-making remain under investigated. Purpose This study explores the spiritual practices in parents making end-of-life decisions for adolescents on life support with brain stem dysfunction. Method A descriptive phenomenological study was conducted through in-depth interviews with three parents of two adolescents in Taiwan. Data were analysed using Colaizzi’s seven-step protocol. Results Three main themes emerged: (1) faith during decision-making, (2) struggles during decision-making, (3) transformation during decision-making. The findings indicate that “transforming the nature of hope” is the essence of the experience. Conclusion Family-centred care, gaining insight into parental spiritual practices, and developing culturally-appropriate care are recommended.

Abstract Background Previous studies have shown that depressive symptoms in middle-aged women were associated with a number of factors such as climacteric symptoms. Nevertheless, studies based on population-based data with a wide range of potential correlates are still scarce. Therefore, the aim of this study was to investigate the correlates of depressive symptoms in late middle-aged Taiwanese women using data from a nationally-representative, population-based survey. Methods Women aged 50.0–65.0 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome measure was depressive symptoms in the past week, evaluated using the Center for Epidemiologic Studies Short Depression Scale (CES-D 10) with a cut-off score of 10 or greater. Univariate and multiple logistic regression analyses were used to evaluate the correlates of depressive symptoms. Results The mean age of the 533 respondents was 56.7 years. Depressive symptoms were present in 53 respondents (9.9%). Multiple logistic regression analysis revealed that an education level of elementary school or below (adjusted odds ratio [AOR] = 3.19, P = 0.003), nulliparity (AOR = 8.10, P = 0.001), living alone (AOR = 5.47, P = 0.003), never having worked (AOR = 4.14, P = 0.008), lack of regular exercise (AOR = 3.01, P = 0.003), a perceived health status of fair or bad (AOR = 4.34, P

Introduction. Helicobacter pylori (H. pylori) infection could lead to chronic local and systemic immune response. The resulting increase in proinflammatory cytokines could affect bone resorption and might increase the risk of osteoporosis. This study aimed to investigate the association between H. pylori infection and osteoporosis in elderly female patients with upper gastrointestinal diseases. Methods. A retrospective patient record review study was conducted in a regional teaching hospital in south Taiwan. Relevant information on female patients aged 65 and over who were diagnosed with diseases of esophagus, gastric ulcer, or duodenal ulcer during January 2008 to December 2010 were abstracted. Association between H. pylori infection and osteoporosis was evaluated using multivariate logistic regression analysis. Results. Of the 365 patients with a mean age of 77.3 years, 77 (21.1%) had H. pylori infection and 101 (27.7%) had been diagnosed with osteoporosis. Multivariate logistic regression analysis revealed that osteoporosis was significantly associated with H. pylori infection (adjusted odds ratio = 2.03, 95% confidence interval = 1.14–3.62) after adjusting for age group, body mass index group, and use of proton pump inhibitor. Conclusion. Osteoporosis was found to be associated with H. pylori infection in Taiwanese female patients with upper gastrointestinal diseases. Further studies with information on potential confounders are needed to confirm the association.

The three-dimensional virtual world generated in virtual reality (VR) environments involves vision, hearing, touch, and potentially other user senses. VR environments are designed to closely simulate real situations/scenarios, allowing users to observe and engage in experiences free of time and space restrictions. Virtual patients are an extension of virtual reality. In recent years, virtual reality exercises have been widely used in various medical education and training programs to promote professional competence. The clinical practice of nurse practitioners is similar to physicians in some institutions. Nurse practitioners perform supplementary medical services such as physical assessment, medical history collection and consultation, problem detection, test result assessment, differential diagnosis, and patient health problem decision-making under the supervision of physicians. The critical thinking component in nurse practitioner education is largely similar to that taught in medical education. VR is often used in medical education to train medical students. Also, VR may be applied in critical thinking training for nurse practitioners to promote competence in reasoning and differential diagnosis. However, few studies in the literature have evaluated the effectiveness of VR-based training for nurse practitioners in Taiwan. In the future, this issue needs to be studied further. [ABSTRACT FROM AUTHOR]

Background: Menstrual disorders and their adverse symptoms can have a deleterious effect on both the private and working lives of women. Previous studies indicated that female nurses have elevated risk of menstrual disorders. Moreover, female nurses showed a higher incidence of ambulatory care visit for genitourinary diseases compared with other female medical personnel. However, little is known whether the medical services utilization for menstrual disorders were different among personnel from various medical professions. Therefore, the present study compared the ambulatory medical services utilization for menstrual disorders among personnel of six different medical professions in Taiwan using a nationwide, population-based health claim research database. Methods: The National Health Insurance Research Database (NHIRD) was used to identify female medical professionals, aged 18 to 45 years, who obtained their licenses during January 1, 2000 to December 31, 2012. Personnel from six different medical professions were examined and they included (1) medical technologists and therapists, (2) registered nurses, (3) physicians, (4) doctors of Chinese medicine, (5) dentists, and (6) pharmacists. Diagnoses of menstrual disorders, based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, were obtained from the ambulatory medical services utilization that occurred after their license date. Cox proportional hazards model was used to assess the hazards of medical services utilization for menstrual disorders using medical technologists and therapists as the reference category. Results: A total of 7653 medical personnel were included in the analysis. Using the group containing medical technologists and therapists as the reference category, registered nurses (adjusted hazards ratio [AHR] = 1.13, p = 0.018) and doctors of Chinese medicine (AHR = 2.52, p < 0.001) showed a significant increased risk of medical services utilization for menstrual disorders. Conversely, physicians showed a significant decreased risk of medical services utilization for menstrual disorders (AHR = 0.58, p < 0.001). Regarding the nine specific menstrual disorders observed in this study, registered nurses and doctors of Chinese medicine showed an increased risk in six and four of them, respectively. Pharmacists showed an increased risk only in menorrhagia (AHR = 1.64, p = 0.020) and dentists showed no significant differences in any of the nine specific menstrual disorders compared with medical technologists and therapists. Physicians showed a significant decreased risk all specific menstrual disorders except menorrhagia and dysfunctional uterine bleeding. Conclusions: Findings from this population-based cohort study revealed that, compared with medical technologists and therapists, registered nurses and doctors of Chinese medicine exhibited significant increased risks in medical services utilization for menstrual disorders whereas physicians showed a significant decreased risk in menstrual disorders. Further studies should be conducted to delineate whether the differences in the medical services utilization is an indicator of risk of menstrual disorders or the results of varying patterns of health care seeking behavior among women of different medical professions. [ABSTRACT FROM AUTHOR]

Background: Developmental care has been broadly applied to identify the behavioral cues and care needs of preterm infants. Past studies indicate a significantly higher level of physical distress in bottle-fed preterm infants than in preterm infants who are breastfed. However, no evidence has yet been reported that supports the influence of feeding methods on behavioral cues. Purpose: This study compares differences in the type and frequency of behavioral cues between breast- and bottle-fed preterm infants. Methods: A comparison study design and secondary data analysis method were used to assess data from two previous research projects. Infant feeding behavioral cues were observed and compared between two groups: 7 preterm infants who were breastfed and 7 preterm infants who were bottle-fed. After cases were matched by infant gestational age, behavioral responses were coded according to the preterm feeding cues coding system (PFCCS) from 7 paired maternal-infant feeding videos that featured preterm infants of 25 to 32 weeks gestational age at birth. Results: The PFCCS classifies 24 feeding behavioral cues into hunger cues, self-regulatory cues, stress cues, and satiety cues. Infants in the breastfeeding group had a higher hunger cue frequency than their bottle-fed peers (p = .013), while bottle-fed infants had a higher stress cue frequency than their breastfed peers (p = .041). Other significant differences in behavioral cues between the two feeding methods included "fluid spillage" (bottle- > breast-, p = .008), "central cyanosis" (bottle- >breast-, p = .024) and "hand pushing" (breast- >bottle-, p = .034). Conclusions / Implications for Practice: Preterm infants in this study who breastfed showed significantly fewer stress cues than those who bottle fed. These findings support the importance of enhancing care provider sensitivity with regard to behavioral-cue observation. Findings further support breastfeeding rather than bottle-feeding for preterm infants. [ABSTRACT FROM AUTHOR]

Population aging is a progressing issue in Taiwan, and osteoporosis, one of the most common diseases of elderly, has an occurrence positively correlated with aging. It is the major risk factor for bone fractures in elderly, which not only increases medical and social costs, but also higher risk of death. Therefore, prevention of osteoporosis is an important public health issue. The main preventive strategies for osteoporosis included evaluation of the risk for osteoporosis, screening of high-risk populations, pharmacologic therapy dietary intervention, and exercise. We reviewed literatures on osteoporosis and aimed to enhance clinical nurses' knowledge and ability of elderly caring. [ABSTRACT FROM AUTHOR]

Previous studies examining the associations between sleep hygiene practices and insomnia have produced inconsistent results. This study further investigates this issue by examining different domains of sleep hygiene separately. One hundred and six insomnia patients and 89 good sleepers participated in the study. Their sleep hygiene, sleep quality and insomnia severity were assessed with subjective rating scales. Among good sleepers, almost all domains of sleep hygiene correlated significantly with their sleep ratings. However, in insomnia patients, only the arousal-related behavior correlated with sleep ratings. The findings suggest that strategies in prevention and treatment of sleep disturbance may be different accordingly. [ABSTRACT FROM AUTHOR]

Recently, the vector dirty paper coding (DPC) achievable rate region has been shown to be the capacity region of a multiple-input multiple-output Gaussian broadcast channel (MIMO GBC). With DPC, the multiuser interference noncausally known at the transmitter can be completely removed. In this paper, we present a vector DPC structure for MIMO GBC. It is a generalization of the single antenna superposition dirty paper coding for the scalar Gaussian dirty paper problem proposed by Bennatan et al. In a theoretical random code setting, this construction is shown to be able to achieve the promised rate performance of the MIMO GBC. We also implement it with existing vector quantizer and capacity-achieving channel coding. "Combined with iterative decoding, a design example validates the effectiveness of our methods. [ABSTRACT FROM AUTHOR]

Oligodendrocyte precursor cells (OPCs) express receptors for many neurotransmitters, but the mechanisms responsible for their activation are poorly understood. We have found that quantal release of GABA from interneurons elicits GABAA receptor currents with rapid rise times in hippocampal OPCs. These currents did not exhibit properties of spillover transmission or release by transporters, and immunofluorescence and electron microscopy suggest that interneuronal terminals are in direct contact with OPCs, indicating that these GABA currents are generated at direct interneuron-OPC synapses. The reversal potential of OPC GABAA currents was -43 mV, and interneuronal firing was correlated with transient depolarizations induced by GABAA receptors; however, GABA application induced a transient inhibition of currents mediated by AMPA receptors in OPCs. These results indicate that OPCs are a direct target of interneuronal collaterals and that the GABA-induced Cl- flux generated by these events may influence oligodendrocyte development by regulating the efficacy of glutamatergic signaling in OPCs. [ABSTRACT FROM AUTHOR]

Temperature-dependent femtosecond pump–probe experiments are performed to explore the ultrafast carrier-relaxation processes in an InGaN/GaN quantum-well sample, in which nanometer-scale cluster structures have been identified. Combined with the time-resolved photoluminescence results, we can identify three stages of carrier relaxation. The fast-decay time, ranging from several hundred femtoseconds to 1 picosecond, corresponds to the process reaching a local quasi-equilibrium condition, in which carriers reach a thermal distribution within one or a few nearby indium-rich clusters. The slow-decay time, ranging from tens to a couple hundred picoseconds, corresponds to the process reaching a global quasi-equilibrium condition, in which carriers reach a thermal distribution among different clusters of various potential minima. In this stage, the mechanism of carrier transport over barriers between clusters dominates the relaxation process. Finally, carrier recombination dominates the relaxation process with the carrier lifetime in the range of a few nanoseconds. [ABSTRACT FROM AUTHOR]