Search

With a conviction that general education should play a significant role in fostering the positive development of university students' character, several educators integrated various activities that could contribute to such development into general education courses in a technical university in Taiwan. This study surveyed the takers and non-takers of those courses and compared the differences in the scores of eight aspects of character development between the two groups of students. Results revealed that the implemented courses brought up small gains, particularly for male students in the second year, in most of the aspects including "logic and innovation," "social practices," "citizenship," "growth in learning," and "proactiveness and autonomy." Female students were found to score significantly higher than male counterparts in all of the aspects and the scores of most aspects exhibited a declining trend with the increasing university years. These results were discussed from the perspectives of the teaching strategies advantageous for character development as well as the mental difference between first-year and third- or fourth-year students.

The childbirth education training course aims to help nurses establish the basic ability to care for pregnant women. However, in traditional teaching, it is often difficult for learners to distinguish the meaning of different childbirth signs. While virtual reality (VR) may be connected in most people's minds with videos designed for immersive entertainment, in fact its early purpose was for nursing education. Initial forms of Spherical Video-based Virtual Reality (SVVR) were used to prepare and train nursing students, pilots, and military personnel. In this paper, an exploratory study using social learning theory embedded in SVVR for childbirth education training is presented; moreover, the learning performances of nursing students who participated in SVVR classroom learning and those who learned with the traditional approach were compared. The experimental results show that, compared with the traditional instruction, the learning motivation and learning satisfaction of the students who learned with SVVR were better, showing the potential of this powerful medium for enhancing nursing students' learning performance in the context of childbirth education.

This research used a quasiexperimental method to explore whether integrating Science Magic (SM) into 5E Learning Cycle (5ELC) in the development of teaching materials for a friction unit would impact students' learning outcomes and attitudes toward science. A total of 68 eighth-grade students were divided into experimental and control groups. The experimental group was taught using teaching materials and methods developed using the SM-based 5ELC, while the control group adhered solely to textbook-based materials, which were also based on the 5ELC but did not involve SM activities. Two major findings were obtained in this research. First, learning effects for the experimental group were significantly higher than the control group, especially in relation to characteristics of static friction, factors that affect friction, and relationships between frictional and normal force. Second, the experimental group showed significant improvements in their attitudes toward science when juxtaposed with the control group.

This study set out to analyze the relationship among teachers' workplace spirituality, sense of meaning in life, and psychological well-being. Taking 610 teachers as its subjects, the study employed three scales: one to measure the subjects' sense of workplace spirituality, another to measure their sense of meaning in life, and a third to measure their sense of psychological well-being. These three scales were pretested and found to have good reliability and validity. The questionnaire data were analyzed using hierarchical regression in order to understand the explanatory power of the predictors (workplace spirituality and meaning in life) to dependent variable of psychological well-being. The results showed 62.70% explanatory power. According to the research findings, this study suggests that teachers should understand the importance of having workplace spirituality, of being psychologically sound and of feeling they have a meaningful life. Future studies may further explore the factors that influence teachers' sense of psychological well-being.

As science textbooks are considered as one of the major source of climate change information of students, this study aims to examine the differences in energy saving and carbon reduction knowledge, attitude, and behavior between two groups of Taiwan's high school students using earth science textbooks of two different publishers. Some items of knowledge, attitudinal, and behavioral subscales reflecting significant differences largely coincide with the differences in the coverage amount, text specificity, and picture presence in relevant contents between two textbooks. Students using the textbook with those features performed better on most of those items, including higher percents correct of identifying types of radiations and greenhouse gases and stronger support for more wind power generators. Behavioral effects of the two textbooks seem comparable between two groups of students.

ADHD comorbidity has been associated with delayed diagnosis of ASD, but no study has investigated this association in an Asian country. Children with ASD were included and divided into three groups: ADHD before ASD, ADHD same/after ASD, and ASD only. Timing of ASD and ADHD diagnoses were assessed. The logistic regression model was performed to investigate the likelihood of being diagnosed with ASD after 6 years of age between three groups. ADHD before ASD (OR 10.93) group was more likely to being diagnosed with ASD after 6 years of age compared with ADHD same/after ASD (OR: 1.37) and ASD only groups. ADHD comorbidity would delay the diagnosis of ASD in the general clinical settings in Taiwan.

Although there have been numerous mobile learning studies, relatively few concerns the moderating impact of perceived fit on mobile learning outcomes. A total of 335 adult learners with a mobile language learning experience in Taiwan took part in this study. Partial least squares structural equation modelling (PLS-SEM) is used to determine the key factors that lead to better mobile learning performance. The results of this study show that perceived usefulness, playfulness and self-management of learning are positively linked to the intention to continue with mobile learning. The results also show that perceived flexibility and personal innovativeness have a positive impact on perceived usefulness and playfulness. It is also shown that perceived fit plays a moderating role in determining mobile learning continuance intention.

Background: The Heart Failure Post-Acute Care [HF-PAC] program is a specialized healthcare program aimed at providing comprehensive care and support for patients with heart failure [HF] as they transition from acute hospital settings to home. But the impact of the coronavirus disease 2019 [COVID-19] pandemic on the HF-PAC program remains unknown. Furthermore, the effects of the comprehensive COVID-19 vaccination program on these patients with HF-PAC warrants further investigation. Methods: A total of 265 patients with acute decompensated HF were admitted to the hospital between May 2020 and October 2022. Of these, 159 patients underwent planned HF-PAC follow-up for 6 months, followed by scheduled follow-up visits every 3 months and unscheduled telephone randomized visits for at least another 6 months. Results: The program completion rate was nearly 92%. COVID-19 significantly impacted patients with HF-PAC, leading to an increased mortality [13.3%] compared to before the pandemic [6.5%]. In our patient cohort, 83% had received at least 1 dose of vaccine and 61% had received > 3 doses. Of these patients with HF-PAC, 34% contracted COVID-19 infection post discharge, and 8.8% died owing to the infection. Of the mortality group, 42.9% patients were not vaccinated, and 28.6% received 1 vaccine dose, and their vaccination rate was lower than in the survival group [p = 0.01]. Conclusions: The COVID-19 pandemic had a significant impact on patients enrolled in the HF-PAC program; receiving more than 3 doses of the COVID-19 vaccine was associated with a significant reduction in mortality rates among these patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore graduate students' competencies in computer use and their attitudes toward online learning in asynchronous online courses of distance learning programs in a Graduate School of Education (GSOE) in Taiwan. The research examined the relationship between computer literacy and the online learning attitudes of these students. Data were collected via a survey through 252 GSOE students in Taiwan. Results revealed a significant positive relationship between computer literacy and online learning attitude among the students. Higher computer literacy was correlated with higher online learning attitude. However, no statistically significant difference was found in online learning attitude by gender or by age group. Suggestions and managerial implications were discussed in the study, and would provide contribution both to the body of knowledge in the filed of education management.

As an examination of the influences of a renewable energy teaching activity employing teaching aids on elementary students' knowledge of, attitude toward, and behavior of energy saving and carbon reduction, this study designed a teaching experiment in which experimental group was subjected to the teaching with four teaching aids for students to practice whereas the control group was not. Results revealed that the teaching activity significantly improved the attitude and increased some knowledge items but did not affect the behavior. The behavior was more connected to attitude and knowledge for experimental group than for control group. The formation of the positive attitude could be related to the sensory stimulation generated by the teaching aids and associated affective responses when it was analyzed from a product-trial perspective. The analysis should inspire the understanding of the possible mechanisms of how learning experiences affect attitude.

Although there is a plethora of mobile learning studies, relatively little attention has been paid to the roles of self-management of learning and personal learning initiative on mobile English learning outcomes. Accordingly, the primary purpose of this study is not only to examine the links between perceived flexibility advantage, self-management of learning, mobile English learning continuance intention and performance, but also to explore the moderating role of personal learning initiative in mobile language learning outcomes. A total of 323 undergraduate students with mobile English learning experience took part in this study. The partial least-squares structural equation modelling analysis and SPSS PROCESS (model 7) were utilised to assess the data. The study findings have not only indicated the perceived flexibility advantage and self-management of learning will have a positive influence on mobile English learning continuance intention and performance, but also revealed that mobile English learning continuance intention will mediate the link between perceived flexibility advantage and mobile English learning performance. Moreover, it has been found that personal learning initiative will play a moderating role in reinforcing the positive relationship between perceived flexibility advantage and mobile English learning continuance intention.

The SARS-CoV-2 virus has been a global public health threat since December 2019. This study aims to investigate the neurological characteristics and risk factors of coronavirus disease 2019 (COVID-19) in Taiwanese children, using data from a collaborative registry. A retrospective, cross-sectional, multi-center study was done using an online network of pediatric neurological COVID-19 cohort collaborative registry. A total of 11160 COVID-19-associated emergency department (ED) visits and 1079 hospitalizations were analyzed. Seizures were the most common specific neurological symptom, while encephalitis and acute disseminated encephalomyelitis (ADEM) was the most prevalent severe involvement. In ED patients with neurological manifestations, severe neurological diagnosis was associated with visual hallucination, seizure with/without fever, behavior change, decreased GCS, myoclonic jerk, decreased activity/fatigue, and lethargy. In hospitalized patients with neurological manifestations, severe neurological diagnosis was associated with behavior change, visual hallucination, decreased GCS, seizure with/without fever, myoclonic jerk, fatigue, and hypoglycemia at admission. Encephalitis/ADEM was the only risk factor for poor neurological outcomes at discharge in hospitalized patients. Neurological complications are common in pediatric COVID-19. Visual hallucination, seizure, behavior change, myoclonic jerk, decreased GCS, and hypoglycemia at admission are the most important warning signs of severe neurological involvement such as encephalitis/ADEM. [ABSTRACT FROM AUTHOR]

Objective: The use of illicit drugs by adolescents is a widespread problem in Taiwan. The aim of this study was to identify risk and protective factors. Design: Web-based survey of high school students. Setting: Senior high schools and vocational high schools in northern Taiwan. Method: Survey data were collected from 15,754 students. Logistic regression analysis examined potential risk and protective factors in individual, family and peer/school domains for lifetime, past-year and past-month illicit drug use and the single and/or multiple use of ketamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA) and marijuana. Results: The prevalence rates of illicit drug use varied from 1.18% to 2.19% by frequency and type of illicit drug use. Perceived availability of illicit drugs, betel nut chewing, drug use by a family member, peer drug use, missing classes and type of school were significant risk factors in lifetime, past-year and past-month use. Sensation seeking, family member and peer drug use were common factors in ketamine, methamphetamine, MDMA and marijuana use. Drug use by a family member increased the risk of multiple drug use. Smoking was a risk factor for ketamine use. Drug-related knowledge was a protective factor. Conclusions: These findings support the idea that there exist multilevel risk and protective factors for drug use, especially in the family and peer/school domains. School-based interventions should be designed to integrate different levels of risk and protective factors.

This study investigated the impact of paternalistic leadership on workplace deviant behavior among employees in five-star international tourist hotels in six municipalities under the Central Government of Taiwan. In addition, it examined whether employees' regulatory foci mediate this relationship. The data were collected through purposive sampling, targeting individuals knowledgeable about deviant behaviors. A total of 600 questionnaires (one supervisor per 10 employees) were distributed, resulting in 374 valid matched responses (374 employees and 52 supervisors), with a valid response rate of 62.33%. The findings indicate that paternalistic leadership significantly reduces workplace deviant behavior in employees. Furthermore, regulatory foci were found to partially mediate the relationship between paternalistic leadership and workplace deviant behavior. The article concludes with management implications and research recommendations. [ABSTRACT FROM AUTHOR]

Background and Objectives: The Taiwan Triage and Acuity Scale (TTAS) is reliable for triaging patients in emergency departments in Taiwan; however, most triage decisions are still based on chief complaints. The reverse-shock index (SI) multiplied by the simplified motor score (rSI-sMS) is a more comprehensive approach to triage that combines the SI and a modified consciousness assessment. We investigated the combination of the TTAS and rSI-sMS for triage compared with either parameter alone as well as the SI and modified SI. Materials and Methods: We analyzed 13,144 patients with trauma from the Taipei Tzu Chi Trauma Database. We investigated the prioritization performance of the TTAS, rSI-sMS, and their combination. A subgroup analysis was performed to evaluate the trends in all clinical outcomes for different rSI-sMS values. The sensitivity and specificity of rSI-sMS were investigated at a cutoff value of 4 (based on previous study and the highest score of the Youden Index) in predicting injury severity clinical outcomes under the TTAS system were also investigated. Results: Compared with patients in triage level III, those in triage levels I and II had higher odds ratios for major injury (as indicated by revised trauma score < 7 and injury severity score [ISS] ≥ 16), intensive care unit (ICU) admission, prolonged ICU stay (≥14 days), prolonged hospital stay (≥30 days), and mortality. In all three triage levels, the rSI-sMS < 4 group had severe injury and worse outcomes than the rSI-sMS ≥ 4 group. The TTAS and rSI-sMS had higher area under the receiver operating characteristic curves (AUROCs) for mortality, ICU admission, prolonged ICU stay, and prolonged hospital stay than the SI and modified SI. The combination of the TTAS and rSI-sMS had the highest AUROC for all clinical outcomes. The prediction performance of rSI-sMS < 4 for major injury (ISS ≥ 16) exhibited 81.49% specificity in triage levels I and II and 87.6% specificity in triage level III. The specificity for mortality was 79.2% in triage levels I and II and 87.4% in triage level III. Conclusions: The combination of rSI-sMS and the TTAS yielded superior prioritization performance to TTAS alone. The integration of rSI-sMS and TTAS effectively enhances the efficiency and accuracy of identifying trauma patients at a high risk of mortality. [ABSTRACT FROM AUTHOR]

The risk of glaucoma in patients suffering from Sjögren's syndrome has not been elucidated. We aimed for evaluating the absolute incidence as well as the relative risk of glaucoma in patients with SS at the level of the whole country population. We conducted a retrospective cohort study using a national health insurance database in Taiwan from 2000 to 2013. We used International Classification of Diseases, Ninth Revision, to categorise medical conditions for study group and comparison group. We used Cox proportional hazard regression analysis to determine adjusted hazard ratios (aHRs) of glaucoma between study and comparison group after adjusting for sex, age, and comorbidities. Among 17,398 patients with primary Sjögren's syndrome, 133 patients were diagnosis with glaucoma during follow-up. Of the 69,592 non-primary Sjögren's syndrome patients, 429 patients developed glaucoma. Glaucoma risk was elevated in patients with primary Sjögren's syndrome than in the non-Sjögren's syndrome group (adjusted hazard ratio [HR] 2.274, 95% in the confidence interval [95% CI] 1.847–2.800; P <.001). The risk of glaucoma among the population having Sjögren's syndrome was higher than those did not have Sjögren's syndrome. It indicated the necessity of regular examination for glaucoma in patients with Sjögren's syndrome. [ABSTRACT FROM AUTHOR]

Objective: Age-related macular degeneration (AMD), particularly its exudative form, is a primary cause of vision impairment in older adults. As diabetes becomes increasingly prevalent in aging, it is crucial to explore the potential relationship between diabetic retinopathy (DR) and AMD. This study aimed to assess the risk of developing overall, non-exudative, and exudative AMD in individuals with DR compared to those without retinopathy (non-DR) based on a nationwide population study in Taiwan. Methods: A retrospective cohort study was conducted using the Taiwan National Health Insurance Database (NHIRD) (2000–2013). A total of 3413 patients were placed in the study group (DR) and 13,652 in the control group (non-DR) for analysis. Kaplan–Meier analysis and the Cox proportional hazards model were used to calculate the hazard ratios (HRs) and adjusted hazard ratios (aHRs) for the development of AMD, adjusting for confounding factors, such as age, sex, and comorbid conditions. Results: Kaplan–Meier survival analysis indicated a significantly higher cumulative incidence of AMD in the DR group compared to the non-DR group (log-rank test, p < 0.001). Adjusted analyses revealed that individuals with DR faced a greater risk of overall AMD, with an aHR of 3.50 (95% CI = 3.10–3.95). For senile (unspecified) AMD, the aHR was 3.45 (95% CI = 3.04–3.92); for non-exudative senile AMD, it was 2.92 (95% CI = 2.08–4.09); and for exudative AMD, the aHR was 3.92 (95% CI = 2.51–6.14). Conclusion: DR is a significant risk factor for both overall, senile, exudative, and non-exudative AMD, even after adjusting for demographic and comorbid conditions. DR patients tend to have a higher prevalence of vascular comorbidities; however, our findings indicate that the ocular pathologies inherent to DR might have a more significant impact on the progression to AMD. Early detection and appropriate treatment of AMD is critically important among DR patients. [ABSTRACT FROM AUTHOR]

Using the technology acceptance model (TAM) as its theoretical foundation, this study intends to explore the use of Travelling Beam devices in road engineerings in Taiwan and offer suggestions based on its findings to encourage industry willingness for device deployment resulting in improving road pavement smoothness in Taiwan. The study subjects were pavement smoothness device operators in Taiwan. A total of 107 valid questionnaires were returned. The questionnaire results were analyzed using descriptive statistics, confirmatory factor analysis and structural equation modeling. Study results show that more training/support and perceived ease of use can lead to more willingness to use travelling beam devices and consequentially help improve pavement smoothness. Structural equation modeling (SEM) analysis results also indicate training/support, perceived ease of use and attitude will give users' positive attitudes towards use of travelling beam devices.

This study assessed the effects of a model that integrated the theory of planned behavior (TPB) with extrinsic motivation (EM) in predicting the intentions of fifth-grade students to not use illicit drugs. A cluster-sampling design was adopted in a cross-sectional survey (N = 571). The structural equation modeling results showed that the model attained an acceptable overall fit and explained 85% of the variance in intention. The EM variables influenced intention through subjective norms and perceived behavioral control. Study findings support the proposed TPB-EM model and show that EM can foster a social cognitive mechanism that indirectly affects intention.

Background: Ritodrine hydrochloride is a widely used beta-adrenergic agonist used to stop preterm labor in Taiwan. Many side effects causing maternal morbidity and mortality have been reported. We report a case complicated with ritodrine-induced side effects and mirror syndrome that was associated with placental chorioangioma. Case presentation: A 36-year-old singleton pregnant woman at 25 6/7 weeks of gestation, with an undiagnosed placental chorioangioma, underwent tocolysis due to preterm uterine contractions. Her clinical condition deteriorated, attributed to mirror syndrome and adverse events induced by ritodrine. An emergency cesarean section was performed at 27 1/7 weeks of gestation, delivering an infant with generalized subcutaneous edema. A placental tumor measuring 8.5 cm was discovered during the operation, and pathology confirmed chorioangioma. Gradual improvement in her symptoms and laboratory data was observed during the postpartum period. Identifying mirror syndrome and ritodrine-induced side effects poses challenges. Therefore, this case is educational and warrants discussion. Conclusion: Our case demonstrates mirror syndrome induced by chorioangioma, which is rare, and ritodrine-induced side effects. The cessation of intravenous ritodrine and delivery are the best methods to treat maternal critical status due to fluid overload. [ABSTRACT FROM AUTHOR]

Purpose: Our study aimed to explore the correlation between Sjögren syndrome, sociodemographic factors, comorbid conditions, and optic neuritis. Methods: This retrospective, nationwide, population-based, matched case-control investigation involved 33,190 individuals diagnosed with optic neuritis, identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes 377.30 for optic neuritis or 377.32 for retrobulbar neuritis. Patient data were extracted from the Taiwan National Health Insurance Research Database. Demographic characteristics, the presence of Sjögren syndrome, and pre-existing comorbid conditions were analyzed using univariate logistic regression. Continuous variables were assessed with a paired t-test. Adjusted logistic regression was employed to compare the prognosis odds ratio (OR) of patients with optic neuritis to controls. Results: After adjusting for confounding variables, individuals with Sjögren syndrome exhibited a significantly higher likelihood of developing optic neuritis compared to controls (adjusted OR, 9.79; 95% confidence interval [CI], 7.28-12.98; p < 0.0001). Other conditions associated with increased odds of optic neuritis included rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, systemic lupus erythematosus, and granulomatous vasculitis (adjusted OR: 1.57, 95% CI: 1.33-1.86; adjusted OR: 2.02, 95% CI: 1.65-2.48; adjusted OR: 140.77, 95% CI: 35.02-565.85; adjusted OR: 2.38, 95% CI: 1.71-3.30; adjusted OR: 18.28, 95% CI: 2.21-151.45, respectively), as well as systemic infections such as human herpes viral infection and tuberculosis infection (adjusted OR: 1.50, 95% CI: 1.35-1.66; adjusted OR: 4.60, 95% CI: 3.81-5.56, respectively). Discussion: Our findings strongly support the existence of an association between Sjögren syndrome, rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, systemic lupus erythematosus, granulomatous vasculitis, human herpes viral infection, tuberculosis, and optic neuritis. [ABSTRACT FROM AUTHOR]

It is necessary to develop innovative communication technologies to ensure efficient operation and effective data transmission in "smart railway" systems. For these systems, information security is of paramount importance. Fifth-generation (5G) technology is safe, reliable, and cost-effective for wireless communication in transportation systems. However, the robustness of the links between devices in a 5G network needs to be ensured for the safety of railway operations. Thus, Terrestrial Trunked Radio (TETRA) must be used with 5G technology for secure data transmission and communication. Safety monitoring, early warning, inspection patrols, and passenger services are required in smart transportation systems to prevent accidents and increase operation efficiency. TETRA and 5G technology have been integrated into an international airport in Japan and the railway system of Taiwan. In this study, we analyzed the advantages of the application of 5G technology and TETRA in a system. The integrated system with 5G technology and TETRA allows various applications and cost-effective smart railway systems. [ABSTRACT FROM AUTHOR]

The causes of traffic accidents are diverse, including weather, road conditions, road design, and psychological factors. With the advancement of information technology, big data on traffic accidents can be collected and analyzed more easily than before. To identify the causes of traffic accidents, we analyzed the Traffic Enforcement Case Database and Traffic Accident Database of the Traffic Division of the National Police Agency in Taiwan. The main causes of traffic accidents from 2013 to 2020 were lane drifting, overspeeding, illegal turning, running red lights, and drunk driving. The number of traffic violations has increased every year in the same period, and the number of casualties and injuries has increased since 2018. It is necessary to customize sensor technologies to monitor such violations to prevent related accidents. Advanced data mining technologies should be used to analyze the data and obtain better information to prevent violations and accidents. The results of this study provide a basis for further study related to developing preventive measures for traffic violations and accidents using advanced sensor technologies. [ABSTRACT FROM AUTHOR]

The accuracy of the current buried pipeline management geographic information system (GIS) is not adequate to serve as base information for road digging control and permit in Taiwan. The existing positioning system for buried pipelines does not offer satisfactorily accurate surveying results for all the scenarios because the positioning accurateness decreases with an increase in the pipeline depth. The costly excavation and direct survey of the exposed pipeline method can provide precise measurement at the designed arbitrary interval and then the discrete point is interpolated into the continuous track. The required traffic controls and excavation permits for roads are the most critical drawback of this technology. The method of in-pipe inertial navigation system (INS) can record the complete, continuous pipe tracks, but such measurement drifts with an increase in the survey length. We proposed a pipeline positioning system by radiating an extremely low-frequency (ELF) magnetic field from the electrical coil placed on the ground to constrain the locating measurement of in-pipe INS. The proposed system could easily expand the diameters or increasing turns of a ground-based coil device to enhance the magnetic field intensity for accurately positioning the deeper buried pipes. The field tests were performed using a ductile cast iron pipe (DIP), and the corresponding results revealed that for the overburden depth of 3.4–4.2 m, the average positioning errors were 0.12 and 1.6 m in the horizontal and vertical directions, respectively. This approach is only plausible for an empty pipeline, and access to both ends of the pipe is required. A four-person crew handled the proposed system to locate the track of a 5-km-long buried pipeline in an 8-h-long working day when the pipeline was unfilled. Any pipeline with diameter larger than 10 cm (4 in.) could apply this system to locate the continuous track with the requirement of accessibility at both ends of the empty pipe. With 1.45-m coil, the maximum detectable buried depth is 15 m, and locating error is less than 20 cm at both directions for the cases with buried depth less than 5 m. Two people need to move and operate the magnetic coil at the ground and another two people must hoist the in-pipe unit at each end of the pipe simultaneously. With this arrangement, the continuous track of buried empty pipe could surveyed for 5 km in length within an 8-h working day. [ABSTRACT FROM AUTHOR]

Red yeast rice (RYR) is known for its lipid-lowering effects in patients with hypercholesterolemia; however, its comparative efficacy with statins and risk reduction remains uncertain. This retrospective study analyzed data from 337,104 patients with hyperlipidemia in the Chang Gung Research Database cohort, spanning from January 2016 to December 2021. Exclusion criteria were applied to ensure data completeness and compliance, including an age limit of < 1 8 years, absence of RYR or statin treatment, and a treatment duration of < 3 0 days. Propensity score matching was employed to minimize bias based on baseline factors, with one patient matching with four patients in the comparison group. The study encompassed a total of 5,984 adult hyperlipidemic patients, with 1,197 in the RYR group and 4,787 in the statin group. The patients were also stratified into statin (n = 8 8 0) or combined use (n = 2 2 0) groups for further comparison. Following one year of treatment, both the RYR and statin groups exhibited reductions in total cholesterol and triglyceride levels. Most biochemical parameters showed no significant differences, except for elevated glutamic oxaloacetic transaminase levels in the RYR group (p = 0. 0 2 6) and increased glycohemoglobin levels in the statin group at the three-month mark (p = 0. 0 3 5). In patients with comorbid diabetes, hypertension, kidney, or liver diseases, RYR and statins demonstrated comparable risks for emergency room (ER) visits, stroke, and myocardial infarction (MI). However, the combination of RYR and statins was associated with reduced stroke-related hospitalizations in patients with diabetes, hypertension, and kidney disease, as well as decreased MI-related hospitalizations in patients with hypertension and kidney disease (all p < 0. 0 0 0 1). In conclusion, both RYR and statins effectively lower blood lipid levels and mitigate related complications. Combining these therapies may lead to fewer ER visits, reduced stroke frequency, and fewer MI hospitalizations in hypertensive and kidney disease patients, and they decreased all-cause mortality in the kidney disease population. Further research on combined therapy is warranted. [ABSTRACT FROM AUTHOR]

This study analyzed the rainwater collected in Central Taiwan during the near typhoon period. Mercury (Hg) was analyzed and the Hg volume weighted mean concentrations (VWM) and wet depositions were calculated during the near typhoon period. In addition, the Hg wet depositions, VWM and precipitation values obtained were compared with Plum rain and regular precipitation periods. The relationship between wet Hg depositions, VWM and precipitations were also discussed. Wet Hg depositions, VWM and precipitations were also compared with the precipitation collected from other parts of the world during 2009 to 2021. The results indicated that the precipitations, VWM and wet Hg depositions in the near typhoon period were 152.5 mm, 0.82 ng/L, and 0.29 μg/m2, respectively. The Hg precipitation ratio values of this study to the plum rain and regular precipitation periods were 3.70 and 6.63, respectively. The Hg VWM ratios values of this study to the plum rain and regular precipitation periods were 12,852.56 and 1.56, respectively. Moreover, the wet Hg deposition ratios values of this study to the plum rain and regular precipitation periods (near typhoon period) were 105.97 and 9.90, respectively. The results further indicated that the Hg VWM and wet depositions obtained in the near typhoon period showed the lowest values when compared with plum rain and regular precipitations periods. Compared with Hg(p) VWM and Fw values obtained from plum season, regular precipitation, this study (typhoon period) demonstrated it has the average lowest VWM and Fw values among these three sampling periods. The correlation coefficient of precipitation and the mercury wet deposition was 0.72051 which was significant in this study. The correlation coefficient for the VWM of mercury was 0.0826 which displayed insignificant relationship in this study. Finally, when comparing the Hg VWM, wet deposition and precipitation values from various studies, the results further indicated that the near typhoon period has the lowest average Hg VWM, wet deposition and precipitation values. [ABSTRACT FROM AUTHOR]

This paper proposes a probabilistic hazard assessment model for debris flows considering the uncertainties of multiple influencing factors based on copula approaches. Fifty-nine rainfall-induced debris flows occurred between 2001 and 2009 in Taiwan are taken as an illustrative example to validate the proposed approaches. A copula-based probabilistic model is developed to model the joint probability distribution of debris-flow volume V and its influencing factors (e.g., rainfall intensity, RI and landslide area, AL). The developed model is then used to make probabilistic prediction of debris-flow volume for a specific hazard level, and compared with the empirical approaches. The proposed probabilistic model is also used to develop the exceedance probability charts of quantities for a specific debris-flow basin. Results show that the developed V–RI–AL probabilistic model can provide reasonable estimates of debris-flow volume in Taiwan for a specific probability level of 0.94, and show better predictive performance than the empirical relationships by using an independent debris-flow dataset in Taiwan for validation. The developed multivariate joint probabilistic model can also provide the exceedance probability of debris flows through considering the uncertainties of debris flow and its influencing factors, providing a preliminary reference for hazard assessment of the debris flows. [ABSTRACT FROM AUTHOR]

Tissue inhibitor of metalloproteinase-2 (TIMP-2) is an endogenous inhibitor of matrix metalloproteinase-2 and is highly expressed in breast cancer (BC) cases at diagnosis. However, the genetic investigations for the association of TIMP-2 genotypes with BC risk are rather limited. In this study, contribution of TIMP-2 rs8179090, rs4789936, rs2009196 and rs7342880 genotypes to BC risk was examined among Taiwan's BC population. TIMP-2 genotypic profiles were revealed among 1232 BC cases and 1232 controls about their contribution to BC using a PCR-based RFLP methodology. The TIMP-2 rs8179090 homozygous variant CC genotype was significantly higher in BC cases than controls (odds ratio (OR) = 2.76, 95% confidence interval (95%CI) = 1.78–4.28, p = 0.0001). Allelic analysis showed that C allele carriers have increased risk for BC (OR = 1.39, 95%CI = 1.20–1.62, p = 0.0001). Genotypic together with allelic analysis showed that TIMP-2 rs4789936, rs2009196 or rs7342880 were not associated with BC risk. Stratification analysis showed that TIMP-2 rs8179090 genotypes were significantly associated with BC risk among younger (≤55) aged women, not among those of an elder (>55) age. Last, rs8179090 genotypes were also associated with triple negative BC. This study sheds light into the etiology of BC in Taiwanese women. Rs8179090 may be incorporated into polygenic risk scores and risk prediction models, which could aid in stratifying individuals for targeted breast cancer screening. [ABSTRACT FROM AUTHOR]

Background: Diffuse large B-cell lymphoma (DLBCL) of the head-and-neck area primarily involvesthe Waldeyer ring (WR) and sinonasal area (SN). However, the differential clinical outcomes between patients with WR-DLBCL and those with SN-DLBCL in the rituximab era remain unclear. Methods: To avoid confounding factors contributed by advanced DLBCL with WR and SN involvement, we assessed the clinical outcomes of patients with stage I/II WR-DLBCL and SN-DLBCL and compared them with those having corresponding stages of DLBCL in the lymph nodes but without other extranodal involvement (LN-DLBCL) in the same period. We compared the patients' clinical characteristics, treatment modalities, event-free survival (EFS), and overall survival (OS) among the three subgroups. Results: We analyzed 67, 15, and 106 patients with WR-DLBCL, SN-DLBCL, and LN-DLBCL, respectively, between January 2000 and December 2019. All patients received front-line rituximab-based regimens, and>80% received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone-based regimens More patients with SN-DLBCL had revised International Prognostic Index (RIPI) score 3 (27%) when compared with those with WR-DLBCL (7%) and those with LN-DLBCL (10%, p=0.181). Patients with WR-DLBCL, LN-DLBCL, and SN-DLBCL had 5-year EFS and OS rates of 80.7%, 59.5%, and 41.9% (p=0.021) and 83.7%, 70.8%, and 55.8% (p=0.032), respectively. Compared to patients with LN-DLBCL, those with WR-DLBCL also had a significantly favorable 5-year EFS rate (p=0.021) and 5-year OS rate (p=0.023). Three of the 15 patients with SNDLBCL experienced lymphoma recurrence in the brain after front-line treatment. In multivariate analyses, R-IPI scores of 1–2 and 3 served as significantly poor prognostic factors for patients with poor EFS and OS. Conclusions: Compared to patients with LN-DLBCL, patients with WR-DLBCL receiving front-line rituximab-based treatments had favorable clinical outcomes; however, patients with SN-DLBCL had worse clinical outcomes. Further studies on molecular prognostic factors and treatment strategies for SN-DLBCL are warranted. [ABSTRACT FROM AUTHOR]

Patients with serious mental illness have a higher risk of hepatitis C virus (HCV) infection but suboptimal HCV care. The current study aimed to facilitate HCV treatment uptake by implementing an integrated outreach care model. Multidisciplinary outreach screening followed by HCV reflex testing and onsite treatment for schizophrenia patients was accomplished through the coordination of nongovernmental organizations, remote specialists, and local care providers. The objective was microelimination effectiveness, defined as the multiplication of the rates of anti‐HCV antibodies screening, accurate HCV RNA diagnosis, treatment allocation, treatment completion, and sustained virological response (SVR12; no detectable HCV RNA throughout 12 weeks in the post‐treatment follow‐up period). A total of 1478 of the 2300 (64.3%) psychiatric patients received HCV mass screening. Seventy‐three (4.9%) individuals were seropositive for anti‐HCV antibodies. Of the 73 anti‐HCV seropositive patients, all (100%) received HCV reflex testing, and 29 (37.7%) patients had HCV viremia. Eight patients (34.8%) had advanced liver disease, including 3 with liver cirrhosis and 2 with newly diagnosed hepatocellular carcinoma. Twenty‐three of the 24 (95.8%) patients who stayed in the healthcare system received and completed 8 weeks of glecaprevir/pibrentasvir treatment and post‐treatment follow‐up without significant DDIs or adverse events. The SVR12 rate was 100%. The microelimination effectiveness in the current study was 61.6%. Individuals with serious mental illness are underserved and suffer from diagnostic delays. This patient‐centered and integrated outreach program facilitated HCV care in this marginalized population. [ABSTRACT FROM AUTHOR]

Background: Multisystem inflammatory syndrome in children (MIS‐C) is a rare and serious systemic inflammatory disorder that occurs following a severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. This study aims to investigate the clinical manifestations, risk factors associated with pediatric intensive care unit (PICU) admission, and outcome among children with MIS‐C in Taiwan. Methods: A retrospective analysis was conducted among pediatric patients diagnosed with MIS‐C between June 2022 and February 2023 at Chang Gung Memorial Hospital, Linkou, Taiwan. Data on demographics, clinical features, laboratory findings, treatment modalities, and outcomes were collected and analyzed. Results: Twenty‐eight MIS‐C patients, including 9 boys and 19 girls, with an average age of 5.3 ± 3.8 years old, were enrolled. Most of the cases (78.6%) were diagnosed following the first pandemic wave of COVID‐19 in Taiwan. The leading clinical manifestations observed were fever (100%), skin rash (64.3%), tachycardia (46.4%), and vomiting (46.4%). Nine patients (32.1%) were admitted to the PICU due to hypotension or neurological manifestations. Higher levels of band‐form white blood cells, procalcitonin, ferritin, d‐dimer, prothrombin time, NT‐proBNP, and lower platelet levels on arrival were associated with PICU admission (p = 3.9 × 10−2,9 × 10−3, 4 × 10−3,1 × 10−3, 5 × 10−3, 4.1 × 10−2, and 3.4 × 10−2, respectively). Arrhythmia in one case (3.5%) and coronary artery abnormalities, including dilatation in two cases (7.1%) and small aneurysms in one case (3.5%) were identified. Regardless of ICU admission, no patients experienced systolic dysfunction or mortality following treatment. Conclusion: MIS‐C cases in Taiwan have a favorable outcome. Although one‐third of the patients required PICU admission, none of the MIS‐C cases resulted in severe cardiovascular morbidity or mortality. This study provides valuable insights into the clinical manifestations and outcomes associated with PICU admission in children with MIS‐C in Taiwan. [ABSTRACT FROM AUTHOR]

Hybrid therapy is a recommended first-line anti-H. pylori treatment option in the American College of Gastroenterology guidelines, the Bangkok Consensus Report on H. pylori management, and the Taiwan H. pylori Consensus Report. However, the cure rates of eradication therapy in some countries are suboptimal, and the factors affecting the treatment efficacy of hybrid therapy remain unclear. The aim of this study is to identify the independent risk factors predicting eradication failure of hybrid therapy in the first-line treatment of H. pylori infection. A retrospective cohort study was conducted on 589 H. pylori-infected patients who received 14-day hybrid therapy between September 2008 and December 2021 in ten hospitals in Taiwan. The patients received a hybrid therapy containing a dual regimen with a proton pump inhibitor (PPI) plus amoxicillin for an initial 7 days and a quadruple regimen with a PPI plus amoxicillin, metronidazole and clarithromycin for a final 7 days. Post-treatment H. pylori status was assessed at least 4 weeks after completion of treatment. The relationships between eradication rate and 13 host and bacterial factors were investigated via univariate and multivariate analyses. In total, 589 patients infected with H. pylori infection were included in the study. The eradication rates of hybrid therapy were determined as 93.0% (95% confidence interval (CI): 90.9–95.1%), 94.4% (95% CI: 93.8–97.2%) and 95.5%% (95% CI: 93.8–97.2%) by intention-to-treat, modified intention-to-treat and per-protocol analyses, respectively. Univariate analysis showed that the eradication rate of clarithromycin-resistant strains was lower than that of clarithromcyin-susceptible strains (83.3% (45/54) vs. 97.6%% (280/287); p < 0.001). Subjects with poor drug adherence had a lower cure rate than those with good adherence (73.3% (11/15) vs. 95.5% (534/559); p = 0.005). Other factors such as smoking, alcohol drinking, coffee consumption, tea consumption and type of PPI were not significantly associated with cure rate. Multivariate analysis revealed that clarithromcyin resistance of H. pylori and poor drug adherence were independent risk factors related to eradication failure of hybrid therapy with odds ratios of 4.8 (95% CI: 1.5 to 16.1; p = 0.009) and 8.2 (95% CI: 1.5 to 43.5; p = 0.013), respectively. A 14-day hybrid therapy has a high eradication rate for H. pylori infection in Taiwan, while clarithromycin resistance of H. pylori and poor drug adherence are independent risk factors predicting eradication failure of hybrid therapy. [ABSTRACT FROM AUTHOR]

Background The Taiwanese government made a concerted effort to contain a coronavirus disease 2019 (COVID-19) nosocomial outbreak of variant B.1.429, shortly before universal vaccination program implementation. This study aimed to investigate seroprevalence in the highest-risk regions. Methods Between January and February 2021, we retrieved 10 000 repository serum samples from blood donors to examine for antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid (N) and spike (S) antigens. A positive result was confirmed if anti-N and anti-S antibodies were positive. Overall, 2000 donors residing in the highest-risk district and donating blood in January 2021 were further examined for SARS-CoV-2 RNA. We estimated seroprevalence and compared the epidemic curve between confirmed COVID-19 cases and blood donors with positive antibodies or viral RNA. Results Twenty-one cases with COVID-19 were confirmed in the nosocomial cluster, with an incidence of 1.27/100 000 in the COVID-affected districts. Among 4888 close contacts of the nosocomial cases, 20 (0.4%) became confirmed cases during isolation. Anti-SARS-CoV-2 was detected in 2 of the 10000 blood donors, showing a seroprevalence of 2/10000 (95% CI, 0.55–7.29). None of the 2000 donors who underwent tests for SARS-CoV-2 RNA were positive. The SARS-CoV-2 infection epidemic curve was observed sporadically in blood donors compared with the nosocomial cluster. Conclusions In early 2021, an extremely low anti-SARS-CoV-2 seroprevalence among blood donors was observed. Epidemic control measures through precise close contact tracing, testing, and isolation effectively contained SARS-CoV-2 transmission before universal vaccination program implementation. [ABSTRACT FROM AUTHOR]

Taiwan is a densely populated industrialized country with high-polluting industries. In particular, petrochemical, steel, thermal power, and electronics plants consume a high level of energy. Furthermore, vehicle exhaust emissions are a major contributor to pollution. Collectively, these problems have resulted in high levels of greenhouse gas emissions. To solve these problems, the government of Taiwan has been active in promoting policies aimed at cultivating seed teachers in field of environmental education. In addition, courses on environmental protection have been made mandatory for students at all levels of education, from elementary school to university. To enhance the effectiveness of cultivating seed teachers in this field, this study adopted the analytic hierarchy process and utility theory to identify critical factors influencing the success of this initiative in environmental education. The results may serve as a reference in the formulation of future policies to environmental protection and education.

Understanding the nature of models and engaging in modeling practice have been emphasized in science education. However, few studies discuss the relationships between students' views of scientific models and their ability to develop those models. Hence, this study explores the relationship between students' views of scientific models and their self-generated models, and also whether views of models and modeling practice may be influenced by other factors, such as science learning performance and interest. The participants were 402 ninth-grade students in Taiwan. Data were collected using the Students' Understanding of Models in Science (SUMS) survey and students' self-evaluations of their own science learning interests and performance on a Likert-scale. The students' self-developed models explaining why three different magnetic phenomena occur were also evaluated on a schema of five levels, from lower (observational and fragmented models) to higher (microscopic and coherent models).The results reveal that most students' models remained only at the level of description of observable magnetic phenomena. A small number of the students were able to visualize unseen mechanisms, but these models were fragmented. However, several students with better science learning performance were able to develop coherent microscopic models to explain the three magnetic phenomena. The analyses indicated that most sub-factors of the SUMS survey were positively correlated with students' self-developed models, science learning performance and science learning interest. This study provides implications for teaching the nature of models and modeling practice.

Background: Under the background of the increasing aging population and cancer burden in China, the role of hospice care has become increasingly prominent. The government has paid more attention to the development of hospice care and set up pilot hospitals to promote hospice care. Moreover, healthcare providers play a leading role in hospice care services. To improve the quality of hospice care, the National Health Commission of the People's Republic of China proposed to set up hospice care training bases in municipal or above-level hospitals with hospice care or relevant work foundations, and train healthcare providers on hospice care. This study aimed to investigate the current situation of cognition and attitudes about hospice care among healthcare providers and provide a theoretical basis for hospital training. Methods: We used a quantitative design. A questionnaire survey was conducted among 1591 healthcare providers from August 2022 to November 2022. SPSS 22.0 software was used to analyze the data. Results: As a significant way of continuing education for healthcare providers, hospital training hasn't been effectively exploited in hospice care education. The average score of hospice care knowledge among participants was (7.74 ± 2.242) and the average score of hospice care attitudes among participants was (4.55 ± 1.503). According to multivariate linear regression analysis, sex (p < 0.001), education levels (p < 0.001), and professional titles (p = 0.018) of participants had significant difference on the score of hospice care knowledge; education levels (p = 0.009) and professional titles (p = 0.016) of participants had significant difference on the score of hospice care attitudes. Conclusions: There were some misunderstandings about hospice care among healthcare providers and their attitudes towards hospice care were inactive. It's suggested that hospitals should carry out professional and systematic education courses to help healthcare providers understand hospice care correctly, and participate in hospice care services actively. [ABSTRACT FROM AUTHOR]

Objective: To explore the prevalence and distinctive features of Xue-Fu-Zhu-YuTang (XFZYT) prescriptions by analyzing the National Health Insurance Research Database (NHIRD) to identify the specific medical problems for which XFZYT is prescribed. Methods: This nationwide, population-based, cross-sectional study included 109,073 XFZYT users and 532,848 XFZYT non-users among Chinese herbal product (CHP) users in NHIRD. Chi-squared tests were used to analyze disparities between the XFZYT user and XFZYT non-user cohorts, and the mean age was evaluated using the Wilcoxon rank-sum test. Logistic regression was used to compute the odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: XFZYT was frequently used to treat pain. The top five conditions for which the Taiwanese traditional Chinese medicine (TCM) practitioners would prescribe XFZYT were chest pain; headache; myalgia and myositis; lumbago; and neuralgia, neuritis, and radiculitis. Conclusion: This study represents an inaugural comprehensive survey conducted on the utilization of XFZYT prescriptions among patients with diverse diseases. XFZYT is mostly used to treat pain conditions in Taiwan. Combined with the combination use of other CHPs, XFZYT is used to treat symptoms of the chest and respiratory system, soft tissue conditions, menstruation disorders, and joint and back discomfort. These results suggest that further clinical trials are warranted to verify the effects of XFZYT in pain management. [ABSTRACT FROM AUTHOR]

After observing a fight between two snowflake eels in southern Taiwan, we had difficulties locating scientific information on eel–eel aggressive behaviour and looked further afield. We collected and scored 34 videos posted on social media, to provide more insight into antagonistic behaviours in eels. The videos showed 12 different species of moray eels involved in aggressive interactions, with the genus Gymnothorax contributing to ~ 71% and Echidna contributing to 24% of the observed occurrences. 82% of the videos documented antagonistic interactions between conspecifics. The fights involved "knotting", when opponents curl around each other and shove with their bodies, and some biting. Overall, the incidence of injury and death of losers, as well as injury of winners, was higher in smaller-bodied opponents. Conspecific encounters elicited the greatest intensity of aggressive behaviour, which we interpreted as rivalry due to dominance hierarchies and territoriality. This normally included a visible resource the opponents fought over (a den, a food item, a mate). Same-species fights started after gaping mouths at each other, with individuals being roughly equal in size. Conspecific opponents were often injured, but never killed. Available videos with fights between different species included predatory attacks and defensive reactions. Except for one case, interspecific encounters often ended with one eel being killed and eaten, with the winner being a fish-eating Gymnothorax species. Pre-fight, the killer was observed displaying food searching behaviour by checking holes. Both conspecific and interspecific fights frequently incurred deep, V-shaped wounds that were not apparently life threatening. Old V-shaped scars occurred on the bodies of some eels. Such scars could be used in research further investigating aggressive behaviour in moray eels. [ABSTRACT FROM AUTHOR]

The potential risks of vapor intrusion (VI) can arise from low bulk soil contaminant concentration existing in shallow soils beneath a building foundation. To assess VI risks for such a contamination scenario, a comprehensive study was conducted on a factory building located at a trichloroethylene (TCE)-contaminated site. This study involved the integration of various types of field data, including groundwater, bulk soil, soil gas and indoor air data, along with the utilization of the Vapor Intrusion Screening Level (VISL) calculator. Previously observed high TCE concentrations in soil gas are attributed to accumulation of TCE vapor within the unsaturated soil beneath the building floor, since ground surface is extensively paved at this site. These soil gas data do not directly correlate with the magnitudes of bulk soil and/or groundwater TCE concentration with the linear adsorption model. Soil gas TCE concentration exceeding 107 μg/m³ (or bulk soil concentration exceeding 18.9 mg/kg) observed in shallow soils (at a depth of less than 1 m) may pose health risk to the workers inside the building due to VI, as we have detected TCE vapor concentrations exceeding indoor air screening level several times in the past. This bulk soil TCE concentration, however, falls below soil pollution control standards for TCE, i.e., 60 mg/kg, in Taiwan. As a result, soil remediation is not considered at this site. Soil gas TCE concentrations have reduced to less than 106 μg/m³ after two years of groundwater remediation work at this site. However, we have observed significantly higher soil gas TCE levels at a depth of 0.5 m compared to other depths. This discrepancy raises suspicions that an amount of TCE may still be trapped within the shallow soils that are not reached by groundwater table. [ABSTRACT FROM AUTHOR]

Severe Fever with Thrombocytopenia Syndrome (SFTS), caused by the SFTS Virus (SFTSV), is a global health threat. SFTSV in Taiwan has only been reported in ruminants and wild animals. Thus, we aimed to investigate the infection statuses of dogs and cats, the animals with closer human interactions. Overall, the SFTSV RNA prevalence was 23% (170/735), with dogs showing a 25.9% (111/429) prevalence and cats at 19.3% (59/306) prevalence. Noticeably, the prevalence in stray animals (39.8% 77/193) was significantly higher than in domesticated ones (17.2%, 93/542). Among the four categories analyzed, the highest SFTSV prevalence was found in the stray dogs at 53.9% (120/193), significantly higher than the 24.2% prevalence noted in stray cats. In contrast, domesticated animals exhibited similar prevalence rates, with 17.1% for dogs and 17.2% for cats. It is noteworthy that in the domesticated animal groups, a significantly elevated prevalence (45%, 9/20) was observed among cats exhibiting thrombocytopenia compared to those platelet counts in the reference range (4.8%, 1/21). The high infection rate in stray animals, especially stray dogs, indicated that exposure to various outdoor environments influences the prevalence of infections. Given the higher human interaction with dogs and cats, there is a need for proactive measures to reduce the risk associated with the infection of SFTSV in both animals and humans. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality in Taiwan. Some patients with HCC are diagnosed with macrovascular invasion (MVI), which is associated with a poorer prognosis. In Taiwan, sorafenib is the first-line therapy for patients with advanced HCC. However, the efficacy of adjuvant sorafenib therapy remains unclear for the subset of patients with HCC and MVI who are eligible for surgery. Therefore, we investigated the potential benefit of adjuvant sorafenib therapy for patients with HCC and MVI after surgery. Our study showed that the lack of improved PFS or OS of adjuvant sorafenib challenged the therapeutic benefit of postoperative sorafenib. Alcohol consumption and an α-fetoprotein level of ≥400 ng/mL were independent predictors of overall survival (OS); however, adjuvant sorafenib therapy was not a predictor of progression-free survival (PFS) or OS. In conclusion, our study indicated that adjuvant sorafenib therapy did not provide PFS or OS benefits in patients with HCC and MVI. [ABSTRACT FROM AUTHOR]

Liver cancer is caused by complex interactions among genetic factors, viral infection, alcohol abuse, and metabolic diseases. We conducted a genome-wide association study and polygenic risk score (PRS) model in Taiwan, employing a nonspecific etiology approach, to identify genetic risk factors for hepatocellular carcinoma (HCC). Our analysis of 2836 HCC cases and 134,549 controls revealed 13 novel associated loci such as the FAM66C gene, noncoding genes, liver-fibrosis-related genes, metabolism-related genes, and HCC-related pathway genes. We incorporated the results from the UK Biobank and Japanese database into our study for meta-analysis to validate our findings. We also identified specific subtypes of the major histocompatibility complex that influence both viral infection and HCC progression. Using this data, we developed a PRS to predict HCC risk in the general population, patients with HCC, and HCC-affected families. The PRS demonstrated higher risk scores in families with multiple HCCs and other cancer cases. This study presents a novel approach to HCC risk analysis, identifies seven new genes associated with HCC development, and introduces a reproducible PRS model for risk assessment. [ABSTRACT FROM AUTHOR]

Since government-provided annual cervical cytology testing for all Taiwanese women aged 30 years or older became available in 1995, both cervical cancer incidence and death have decreased significantly. However, with the 2018 introduction of the national immunization program for human papillomavirus (HPV) vaccination in all schoolgirls aged 13–15 years old, the positive predictive value of cytology testing is expected to decrease with rising vaccination rates, and therefore a transition to more sensitive HPV-based testing may be needed. This position paper, derived from discussions by a panel of experts in cervical cancer screening, provides short-, medium-, and long-term policy recommendations to manage the transition between cervical screening methods for Taiwan. The recommendations include concrete suggestions regarding testing procedures, standards, accreditation, monitoring, promotion, and implementation. It is hoped that comprehensive preparation and management of this transition will enable Taiwan to repeat the previous successes of the cervical cytology testing program. [ABSTRACT FROM AUTHOR]

Unawareness of hepatitis B virus (HBV) infection and lack of surveillance may serve as major barriers to HBV control and contributors to severe hepatocellular carcinoma (HCC) at presentation. This study evaluated the risk of HBV unawareness and its relationship with HCC severity. This retrospective study was conducted in a tertiary hospital in Taiwan. Patients with HBV‐related HCC diagnosed from 2011 to 2021 were enrolled. The demographic, clinical, and HCC characteristics were collected and compared between patients with HBV unawareness and awareness with and without surveillance. Of 501 HBV‐related HCC patients enrolled, 105 (21%) patients were unaware of HBV infection at the time of HCC diagnosis. Patients with HBV unawareness were significantly younger and had poorer liver function than those with HBV awareness. Patients with HBV unawareness also had a significantly higher rate of detectable HBV DNA and an advanced stage of HCC. Ninety‐one (23%) of the HBV‐aware patients did not receive regular surveillance. Patients with HBV unawareness and awareness without surveillance shared similar clinical characteristics with more severe HCC status. Further regression analysis demonstrated that HBV awareness with periodic surveillance was associated with early stage HCC. Meanwhile, we observed that there was no change in the proportion of HBV awareness over the past 10 years. Patients with surveillance also had better HCC survival than patients without surveillance or unawareness. HBV unawareness and lack of regular surveillance correlated with advanced HCC at presentation. Efforts to improve HBV education, disease awareness, and HCC surveillance are needed. [ABSTRACT FROM AUTHOR]

The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first detected in October 2021, possessed many mutations compared to previous variants. We aimed to identify and analyze SARS-CoV-2 Omicron subvariants among coronavirus disease 2019 (COVID-19) patients between January 2022 and September 2022 in Taiwan. The results revealed that BA.2.3.7, featuring K97E and G1251V in the spike protein compared with BA.2, emerged in March 2022 and persistently dominated between April 2022 and August 2022, resulting in the largest COVID-19 outbreak since 2020. The accumulation of amino acid (AA) variations, mainly AA substitution, in the spike protein was accompanied by increasing severity in Omicron-related COVID-19 between April 2022 and January 2023. Older patients were more likely to have severe COVID-19, and comorbidity was a risk factor for COVID-19-related mortality. The accumulated case fatality rate (CFR) dropped drastically after Omicron variants, mainly BA.2.3.7, entered Taiwan after April 2022, and the CFR was 0.16% in Taiwan, which was lower than that worldwide (0.31%) between April 2021 and January 2023. The relatively low CFR in Omicron-related COVID-19 patients can be attributed to adjustments to public health policies, promotion of vaccination programs, effective antiviral drugs, and the lower severity of the Omicron variant. [ABSTRACT FROM AUTHOR]

The aging process is complicated and involves diverse organ dysfunction; furthermore, the biomarkers that are able to reflect biological aging are eagerly sought after to monitor the system-wide decline associated with the aging process. To address this, we performed a metabolomics analysis using a longitudinal cohort study from Taiwan (N = 710) and established plasma metabolomic age using a machine learning algorithm. The resulting estimation of age acceleration among the older adults was found to be correlated with HOMA-insulin resistance. In addition, a sliding window analysis was used to investigate the undulating decrease in hexanoic and heptanoic acids that occurs among the older adults at different ages. A comparison of the metabolomic alterations associated with aging between humans and mice implied that ω-oxidation of medium-chain fatty acids was commonly dysregulated in older subjects. Among these fatty acids, sebacic acid, an ω-oxidation product produced by the liver, was significantly decreased in the plasma of both older humans and aged mice. Notably, an increase in the production and consumption of sebacic acid within the liver tissue of aged mice was observed, along with an elevation of pyruvate-to-lactate conversion. Taken together, our study reveals that sebacic acid and metabolites of ω-oxidation are the common aging biomarkers in both humans and mice. The further analysis suggests that sebacic acid may play an energetic role in supporting the production of acetyl-CoA during liver aging, and thus its alteration in plasma concentration potentially reflects the aging process. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate how learning materials based on Science Magic activities affect student attitudes to science. A quasi-experimental design was conducted to explore the combination of Science Magic with the 5E Instructional Model to develop learning materials for teaching a science unit about friction. The participants were recruited from among the students of a middle school in central Taiwan. Based on our results, we conclude that our combined teaching method involving Science Magic activities and the 5E Instructional Model is effective for developing learning materials for teaching, and that this method improves students' attitudes toward science.

The aim of this study is to investigate the effects of solution methods and question prompts on generalization and justification of non-routine problem solving for Grade 9 students. The learning activities are based on the context of the frog jumping game. In addition, related computer tools were used to support generalization and justification of non-routine problem solving. Non-equivalent pretest/posttest quasi experimental design was adopted in this study. The experimental results are summarized as follows: (1) generalization and justification performance of non-routine problem solving for students in the specific prompt group is significantly better than that for students in the general prompt group, and (2) generalization and justification performance of non-routine problem solving for students in the multiple-solution group is significantly better than that for students in the single-solution group. Finally, suggestions were proposed based on the results found in this study, which may serve as useful directions for teachers and future studies.