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We investigated 2 acute cases and 1 previous case of Seoul hantavirus infection in workers in a feeder rodent breeding farm in Taiwan. Prevalence of hantavirus IgG among the tested feeder rats was 37.5%. Appropriate prevention measures, including using disinfection protocols and personal protective equipment, are crucial to lowering risk. [ABSTRACT FROM AUTHOR]

Due to the impact of the COVID-19 pandemic, people have reduced eating out, resulting in a severe drop in the revenue of the catering industry. Health risks have become a major factor affecting the revenue of this industry. Predicting the revenue of the catering industry during the COVID-19 pandemic will not only allow practitioners to adjust their business strategies, but also provide a reference for governments to formulate relief measures. To this end, this study proposes a fuzzy big data analytics approach in which random forests, recursive feature elimination, fuzzy c-means, and deep neural networks are jointly applied. First, random forests and recursive feature elimination are used to select the most influential factors. The data is then divided into clusters by fuzzy c-means. Subsequently, a deep neural network is built for each cluster to make predictions. The prediction results of individual clusters are then aggregated to improve prediction accuracy. The proposed methodology has been applied to forecast the revenue of the catering industry in Taiwan. The results of the experiment showed that the impact of new deaths on the revenue of the catering industry was far greater than the number of newly diagnosed COVID-19 cases. [ABSTRACT FROM AUTHOR]

Due to the influence of covid-19 pandemic, the market of adventure tourism in Taiwan has a significant growth in the last few years. With the increasing demand of adventure tourism, the pressure of adventure tourists' safety and environmental conservation also increases. This pressure has become an uneasy task for the Taiwanese government. Recently many studies show that establishing a partnership between tour operators and government agencies can benefit the management of tourism, safety of tourists, and conservation of natural environment. This study employed "Identity Theory" as a starting point to describe the potential roles can be identified by adventure tour operators in the post-pandemic era. These roles include "profit-oriented businessman", "safety guarantor", "adventure experiences provider", and "environmental educator". Moreover, this study employed Identity Theory to discuss which role (s) may have a higher position in adventure tour operators' role identity system when facing the conflict among roles. This study encourages tourists, adventure tour operators and government agencies to recognize the importance of the roles can be played by adventure tour operators. Having a better understanding among stakeholders on the roles of adventure tour operators can benefit the development of adventure tourism in the post- pandemic era. If this better understanding can be achieved, this study believes there will be a great benefit for tourists' safety, the government's management on adventure tourism and conservation, and adventure tour operators' business. [ABSTRACT FROM AUTHOR]

Sedum matsuense, a new species from the Matsu Islands, is described. This species is only found in Peigan Island and Dongju Island. Previously, this species has been misidentified as S. lineare. However, they can be easily distinguished by phyllotaxy (alternate vs. 3-or 4-verticillate) and leaf shape (linear-lanceolate to oblanceolate, apex acute vs. linear, apex subacute). The phylogenetic analysis also indicates that S. matsuense is distantly related to S. lineare and to the other resembling species. In this paper, to aid in identification, we provide descriptions, photographs, and line drawings. [ABSTRACT FROM AUTHOR]

Background: Hypertension, hyperlipidemia, and diabetes mellitus (DM) are common cardiovascular disease (CVD) comorbidities and well-known major determinants of atherosclerosis. However, their combined effects and relative contributions have not been well explored. This study aimed to characterize the characteristics of carotid atherosclerosis and dissect the relative effects of these common CVD comorbidities on the presence and severity of carotid atherosclerosis in community-dwelling elderly individuals. Methods: We enrolled 817 elders from communities in northern Taiwan. We evaluated their cardiovascular risk profiles and scanned their extracranial carotid arteries using high-resolution ultrasonography systems. Results: The prevalence rates for hypertension, hyperlipidemia, and DM were 45.4%, 37.1%, and 16.8%, respectively. Sixty-two (7.6%) and 188 (23.0%) elderly had all three and two of these common CVD comorbidities, respectively. The prevalent rates of carotid plaque and moderate-to-severe atherosclerosis were 62.9% and 35.5%, respectively. The percentages of one or more common CVD comorbidities in elders with carotid plaque and moderate-to-severe atherosclerosis were 78.2% and 83.1%, respectively. Multivariate analyses showed that the number of common CVD comorbidities was the most predictive determinant. Multivariable-adjusted odds ratios (ORs) per comorbidity for the presence of carotid plaque and advanced carotid atherosclerosis were 1.52 (95% CI, 1.28-1.81) and 1.57 (95% CI, 1.28-1.93), respectively. Models containing hypertension and DM were the second most predictive. Combinatory analyses showed distinct relationship patterns between carotid atherosclerosis and hypertension, hyperlipidemia, and DM. Hypertension was significantly correlated with higher ORs for the presence of carotid plaque and advanced carotid atherosclerosis but not for hyperlipidemia. Conclusion: Carotid plaques are highly prevalent in community-dwelling elders. The number of common CVD comorbidities was the most predictive determinant of carotid plaques and advanced carotid atherosclerosis. Our results indicate that to reduce the impact of atherosclerotic diseases, blood pressure controls precede the control of blood lipids and glucose in the community-dwelling elders. [ABSTRACT FROM AUTHOR]

Patients with Autoimmune Diseases (AD) are at increased risk of complications, which adversely affect the quality of life and prognosis. Recently, a large amount of literature suggested reduced oxidative stress by hydrogen supplements in reducing inflammation and improving prognosis. In this study, clinical trial NCT05196295, we randomly assigned different dosages (low, medium, and high) of hydrogen-rich coral calcium (HRCC) to patients with autoimmune diseases, including Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) patients in Ming-Sheng Hospital in Taiwan (age 54 years, 80% females). Participants were measured with their baseline health biomarkers including inflammatory indicators, haematologic, urinary biomarkers, and health status prior to the trial. Clinical and follow-up assessments were collected after 1 month of the treatment. We performed analyses to compare the baseline with the changes after the HRCC treatment. Together with the groups treated with different dosages, the treatment demonstrated no adverse effects on participants' responses to the HRCC. While the primary endpoint of the trial was met, the potential therapeutic effects of HRCC are addressed for future studies. This clinical trial of HRCC in safety response is the first-in-human study. [ABSTRACT FROM AUTHOR]

Many elementary school students find astronomical knowledge difficult to attain. Students cannot observe planetary motion in the universe, which makes the construction of astronomical knowledge abstract and incomprehensible for many students. To cope with this dilemma, this study proposed creative situated learning via augmented reality (AR) and developed an AR-based Cosmos Planet Go App to simulate the motion of planets in the universe. This allowed students to understand the characteristics and features of each planet through its simulated motion in the universe. This study adopted a quasi-experimental method and the qualitative analysis to conduct experiments on teaching astronomy in an elementary school in central Taiwan. The control group students were taught using traditional classroom narrative teaching, and the experimental group students were taught using the AR-based Cosmos Planet Go App. The results showed that students who learned with the use of the AR-based Cosmos Planet Go App performed significantly better than the control students on measures of learning effectiveness, learning motivation, and flow experience. Moreover, learning engagement, which occurs when students can use multiple perspectives to solve problems, is the most important element for evaluating the AR-learning environment in creative situations. This study extended the research field of digital technology-assisted learning to the discussion of integrated creative learning environment, which can be used as the basis and reference for scholars' research. [ABSTRACT FROM AUTHOR]

Background: Since 2011, Taiwan's National Health Insurance Administration (NHIA) issued a regulation on the reimbursement to anti-osteoporosis medications (AOMs). This study aimed to evaluate the impact of this regulation in reimbursement on the utilization of AOMs, clinical outcomes and associated medical expenditures of patients with incident hip fractures. Methods: By using the National Health Insurance Research Database (NHIRD), patients with incident hip fracture from 2006 to 2015 were identified as our study cohort. Patients younger than 50 years old or prescribed with AOMs within one year prior to incident fracture were excluded. Outcomes of interest were quarterly estimates of the proportion of patients who received bone mineral density (BMD) examination, who were prescribed AOMs, as well as who encountered subsequent osteoporotic fracture-related visits and associated medical expenditures. Particularly, age- and genderspecific estimates were reported. An interrupted time series study design with segmented regression model was used to quantitatively explore the impact of the changes of the reimbursement criteria on the level (immediate) and trend (long-term) changes of these outcomes. Results: Our study enrolled 118 493 patients with incident hip fracture with those patients aged older than 80 years old accounting for the largest proportion. A significantly decreased trend of AOMs prescription rates was observed immediately post regulation except for female aged between 65 and 80, while the long-term pattern showed no significant difference. However, the percentage of patients encountered subsequent osteoporotic fracture-related visit was not statistically different between pre- and post-regulation periods. Noteworthy, the policy regulation was associated with an increasing trend of osteoporotic fracture associated medical expenditures, especially for patients older than 80 years old. Conclusion: The regulation on the reimbursement for AOMs decreased the prescribing rate of AOMs immediately although the effect did not sustain thereafter. However, higher subsequent osteoporotic fracture-related medical expenditures were introduced, especially among those very old population. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between the escalation in housing prices and categories of Taiwan's domestic consumption. While disposable income remains constant, a rapid escalation in housing prices should have a negative impact on unaffordability within society. However, under the hypothesis of the housing wealth effect, an increase in housing values should compensate the macro-economy by increasing consumption in the GDP calculation. Taiwanese data from 2007Q1 to 2018Q1 were adopted as the sample. From the vector error correction model results, it was found that over the course of the long-run equilibrium relationship, there was a statistically significant positive relationship that the society consumes more on durable goods of communication-related nature, as well as on non-durable goods such as personal clothing and accessories and leisure/cultural tourism. As for the short-run dynamic adjustment, there was a statistically significant positive relationship that the society consumes more in the durable goods component categories. It was identified that transportationrelated consumption accounted for the major part of the durable goods component. Therefore, with the rapid escalation in housing prices, it was observed that these consumption would compensate the consumption figures in the GDP calculation in Taiwan, thereby providing evidence that housing prices were related to macroeconomic performance. [ABSTRACT FROM AUTHOR]

Stroke is ranked third among the top 10 causes of death in Taiwan. Besides a high mortality rate, stroke survivors are often left with physical or functional sequela. This study aimed to explore ischemic stroke patients' decision-making process using Western medicine (WM) and complementary and alternative medicine (CAM). This study is a qualitative study based on grounded theory. A total of 12 participants were recruited. Findings revealed that the participants accepted WM and CAM treatments following the onset of ischemic stroke. Three categories and several subcategories emerged from stroke patients' decision-making process. These are "uncertainty of stroke," "delicate balance between WM and CAM," and "reestablishing confidence and faith." Eventually, they exhibited the core category of "breakthrough and the pursuit of a sense of rebirth." This study also found that the participants were unwilling to inform their health care professionals on their use of CAM. Therefore, health care professionals should empathize with the views and needs of their patients and respect their decision to combine WM with CAM. The views of other medical teams concerning CAM into their analysis of patients' decision-making process are recommended. Therefore, comprehensive insight into ischemic stroke patients' decision-making process for using CAM can be further explored. [ABSTRACT FROM AUTHOR]

Background: Although the prevalence of both obstructive sleep apnoea (OSA) and asthma are both increasing, little is known about the impact of OSA on the natural history of lung function in asthmatic patients.Methods: A total of 466 patients from our sleep laboratory were retrospectively enrolled. Of them, 77 patients (16.5%) had asthma with regular follow-up for more than 5 years. Their clinical characteristics, pulmonary function, emergency room visits, and results of polysomnography results were analysed.Results: The patients were divided into three groups according to the severity of the apnoea-hypopnea index (AHI). The decline in FEV1 among asthma patients with severe OSA (AHI > 30/h) was 72.4 ± 61.7 ml/year (N = 34), as compared to 41.9 ± 45.3 ml/year (N = 33, P = 0.020) in those with mild to moderate OSA (5 < AHI ≤ 30) and 24.3 ± 27.5 ml/year (N = 10, P = 0.016) in those without OSA (AHI ≤ 5). For those patients with severe OSA, the decline of FEV1 significantly decreased after continuous positive airway pressure (CPAP) treatment. After multivariate stepwise linear regression analysis, only AHI was remained independent factor for the decline of FEV1 decline.Conclusions: Asthmatic patients with OSA had substantially greater declines in FEV1 than those without OSA. Moreover, CPAP treatment alleviated the decline of FEV1 in asthma patients with severe OSA. [ABSTRACT FROM AUTHOR]

Background: Multidrug-resistant Pseudomonas aeruginosa has emerged as one of the most important healthcare-associated pathogens. Colistin is regarded as the last-resort antibiotic for multidrug-resistant Gram-negative bacteria, but is associated with high rates of acute kidney injury. The aim of this in vitro study is to search for an alternative treatment to colistin for multidrug-resistant P. aeruginosa infections.Methods: Multidrug and carbapenem-resistant P. aeruginosa isolates were collected between January 2009 and December 2012 at MacKay Memorial Hospital. Minimal inhibitory concentrations (MICs) were determined for various antibiotic combinations. Carbapenemase-producing genes including bla VIM, other β-lactamase genes and porin mutations were screened by PCR and sequencing. The efficacy of carbapenems (imipenem, meropenem, doripenem) with or without rifampicin was correlated with the type of porin mutation (frameshift mutation, premature stop codon mutation) in multidrug-resistant P. aeruginosa isolates without carbapenemase-producing genes.Results: Of the 71 multidrug-resistant clinical P. aeruginosa isolates, only six harboured the bla VIM gene. Imipenem, meropenem and doripenem were significantly more effective (reduced fold-change of MICs) when combined with rifampicin in bla VIM-negative isolates, especially in isolates with porin frameshift mutation.Conclusions: Imipenem + rifampicin combination has a low MIC against multidrug-resistant P. aeruginosa, especially in isolates with porin frameshift mutation. The imipenem + rifampicin combination may provide an alternative treatment to colistin for multidrug -resistant P. aeruginosa infections, especially for patients with renal insufficiency. [ABSTRACT FROM AUTHOR]

Background: Stroke is a leading cause of death worldwide and the third leading cause of disease-related mortality in Taiwan. Furthermore, stroke is a major cause of functional disability in adults, causing physiological, psychological, and social impacts. Little qualitative research has been conducted on the primary adaptation process of patients with first-ever stroke in Taiwan. Purpose: The present study explored the primary adaptation process of patients with first-ever stroke. Methods: This qualitative study used purposive sampling to enroll 12 patients with first-ever stroke for interviews, followed by theoretical sampling. Grounded theory guided the methodology and data analysis. Data analysis was performed simultaneously in accordance with the coding process. Results: The primary adaptation process used by the participants involved the two main categories of "impacts of stroke" and "adaptation after stroke", with three subcategories associated, respectively, with the former (loss of physical autonomy, diminishing perceptions of self-value, and stroke-related hardships turning into social isolation) and with the latter (regaining autonomy after rehabilitation, receiving support from family without being a burden, and release from suffering / becoming more positive). The core category that emerged from the present study was: "Facing stroke, hoping for the best, transforming lives." Conclusions / Implications for Practice: The above findings on the primary adaptation process of stroke patients provide an important reference for clinical nurses / healthcare professionals who have responsibilities to care for patients with first-ever stroke. In addition, healthcare professionals should offer more health education and psychological support to stroke patients based on individual patient needs. [ABSTRACT FROM AUTHOR]

With data from Taiwanese jiggers that targeted the Argentine shortfin squid (Illex argentinus) in the southwest Atlantic between 1986 and 2010, we used log-transformed catch per unit of effort (logU) as an index of the abundance of this squid to explore squid recruitment strength in response to environmental conditions. The logU was negatively correlated with subsurface seawater temperature (at a depth of 5 m) observed during February and April on the southern Patagonian shelf during the fishing season. The logU was also correlated with the Antarctic Oscillation (AAO), positively correlated in December of the fishing season and in March and May of the previous 2 years, and negatively correlated in November and December of the previous 2 years. A generalized linear model selected 4 environmental variables as predictors of annual catches that accounted for 83% catch variation: AAOs in November and March of the previous 2 years and subsurface seawater temperatures in March of the current and previous year in the southern location. The AAO would not directly affect the squid abundance more than 1 year later and biotic and abiotic linkages between atmospheric circulation patterns and stock fluctuations are not understood. [ABSTRACT FROM AUTHOR]

Introduction In this study, we explored the possible causes of death and risk factors in patients who overcame the initial critical circumstance when undergoing a damage control laparotomy for abdominal trauma and succumbed later to their clinical course. Methods This was a retrospective study. We selected patients who fulfilled our study criteria from 2002 to 2012. The medical and surgical data of these patients were then reviewed. Fifty patients (survival vs. late death, 39 vs. 11) were enrolled for further analysis. Results In a univariable analysis, most of the significant factors were noted in the initial emergency department (ED) stage and early intensive care unit (ICU) stage, while an analysis of perioperative factors revealed a minimal impact on survival. Initial hypoperfusion (pH, BE, and GCS level) and initial poor physiological conditions (body temperature, RTS, and CPCR at ED) may contribute to the patient's final outcome. An analysis and summary of the causes of death were also performed. Conclusions According to our study, the risk factors for late death in patients undergoing DCL may include both the initial trauma-related status and clinical conditions after DCL. In our series, the cause of death for patients with late mortality included the initial brain insult and later infectious complications. [ABSTRACT FROM AUTHOR]

Background: Shigellosis is rare in Taiwan, with an average annual incidence rate of 1.68 cases per 100,000 persons in 2000-2007. However, the incidence rate for a mountainous township in eastern Taiwan, Zhuoxi, is 60.2 times the average rate for the entire country. Traveling between Zhuoxi's 6 villages (V1-V6) is inconvenient. Disease transmission among the villages/tribes with endemic shigellosis was investigated in this study. Methods: Demographic data were collected in 2000-2010 for epidemiological investigation. Thirty-eight Shigella flexneri 2a isolates were subjected to pulsed-field gel electrophoresis (PFGE) genotyping and antimicrobial susceptibility testing (AST). Results: Fifty-five shigellosis cases were identified in 2000-2007, of which 38 were caused by S. flexneri 2a from 2000-2007, 16 cases were caused by S. sonnei from 2000-2003, and 1 case was caused by S. flexneri 3b in 2006. S. flexneri 2a caused infections in 4 of the 6 villages of Zhuoxi Township, showing the highest prevalence in villages V2 and V5. PFGE genotyping categorized the 38 S. flexneri 2a isolates into 2 distinct clusters (clones), 1 and 2. AST results indicated that most isolates in cluster 1 were resistant to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole and trimethoprim-sulfamethoxazole (ACSSuX); all isolates in cluster 2 were resistant to ACSSuX and tetracycline. Genotypes were primarily unique to different villages or tribes. Tribe V2-1 showed the highest endemic rates. Eighteen isolates recovered from V2-1 tribe members fell into 6 genotypes, where 5 were the same clone (cluster 1). An outbreak (OB2) in 2004 in village V2 was caused by different clonal strains; cases in tribe V2-1 were caused by 2 strains of clone 1, and those in tribe V2-2 were infected by a strain of clone 2. Conclusions: From 2000-2007, 2 S. flexneri 2a clones circulated among 4 villages/tribes in the eastern mountainous township of Zhuoxi. Genotyping data showed restricted disease transmission between the villages and tribes, which may be associated with difficulties in traveling between villages and limited contact between different ethnic aborigines. Transmission of shigellosis in this township likely occurred via person-to-person contact. The endemic disease was controlled by successful public health intervention. [ABSTRACT FROM AUTHOR]

This study aims to assess the measurement invariance of the three subscales of the newly developed Academic Performance Antecedent Scale (APAS) -- School Factors, Mother's Parenting Style, and Individual Factors--across native and new immigrant children in Taiwan. The study sample comprised 527 Grade 4 students (M age = 10.4 yr., SD = 0.6), 263 boys and 264 girls. The three groups were urban and rural children of Taiwanese natives (n = 343, 65.1%), and 184 children with non-Taiwanese mothers (34.9%). The four-factor structure of the School Factors Subscale, the three-factor structure of the Mother's Parenting Style Subscale, and the five-factor structure of the Individual Factors Subscale all showed at least acceptable fit for the groups. In addition, metric invariance was confirmed for the School Factors and Individual Factors Subscales. Metric invariance was partially obtained for the Mother's Parenting Style Subscale. The findings provide validity evidences for cross-cultural generalizability of the APAS. [ABSTRACT FROM AUTHOR]

The article profiles Hsiu-Wen Yu, a home-care nurse at Taichung Tzu Chi Hospital's Community Heath Center in Taiwan. It notes that Hsiu-Wen has an unwavering enthusiasm during medical emergency issues and home visits to patients and their families. It mentions that Hsiu-Wen has been organizing aerobic warm-ups at the lobby of the hospital wherein she is called by her colleagues as Ms. Cheerleader.

Background: Polypharmacy is common in outpatients and has been identified as a major risk factor for drug-drug interactions (DDIs), which are an important cause of adverse drug reactions. There has been a rapid increase in the number of elderly patients worldwide. However, there have been few studies quantifying the impact of both patient age and the number of concomitant drugs prescribed on the probability of potential DDIs per person in general outpatients. Objective: To assess the extent to which polypharmacy and aging are associated with potential DDIs in outpatients at a medical centre in Taiwan. Methods: The medications of 81 650 outpatients who visited a medical centre in Taiwan between January 2004 and March 2004 were retrospectively screened for potential DDIs using a computerized drug-interaction program. The main inclusion criteria were a minimum of two drug prescriptions and duration of use of 14 or more days. We also analysed the DDI pattern, which included severity, level of documentation and onset of potential DDIs, and assessed the impact of the number of drugs prescribed and of aging on the prevalence of potential DDIs per person. Results: The prevalence of potential DDIs was 25.6% (20 902 of 81 650). The mean±SD age of the 20902 patients with potential DDIs was 57.5±16.5 years, and 47.6% of these patients were male. The mean±SD number of prescribed drugs in patients with potential DDIs was 5.8 ±2.4, and 67.7% of these patients were prescribed more than four drugs. The majority (55.7%) of DDIs were of the C2 pattern (severity: moderate; documentation: probable). The prevalence of potential DDIs increased in a linear mode with increasing age (p<0.001) and with the number of drugs prescribed (p<0.001); furthermore, in addition to being independently associated with potential DDIs, these two factors interacted to increase the risk further. Conclusions: This study showed that approximately one-quarter of 81 650 outpatients who visited a medical centre in Taiwan over a period of 3 months in 2004 had potential DDIs. We observed independent increases in potential DDIs per person in association with aging and increasing number of prescribed drugs. Furthermore, a significant interaction between these two factors was observed: the effect of aging on the prevalence of potential DDIs increased as the number of prescribed drugs increased. Potential DDIs in outpatients can be reduced by minimizing the number of drugs prescribed following careful consideration of both their benefits and risks, particularly in the aging population. [ABSTRACT FROM AUTHOR]

The objectives of this study were (1) to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of rectal cancer development and (2) to determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of TTHM on risk of developing rectal cancer. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to rectal cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All rectal cancer deaths in the 53 municipalities from 1998 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from the Taiwan Environmental Protection Administration. Information on the levels of Ca and Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level was <4.9 ppb, the adjusted OR (95% CI) for rectal cancer occurrence was 1.04 (0.88-1.22) for individuals who resided in municipalities served by drinking water with a TTHM exposure ≥4.9 ppb. There was no evidence of an interaction of drinking-water TTHM levels with low Ca intake via drinking water. However, evidence of an interaction was noted between drinking-water TTHM concentrations and Mg intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of rectal cancer is influenced by Mg in drinking water. Increased knowledge of the interaction between Mg and TTHM in reducing rectal cancer risk will aid in public policymaking and standard setting. [ABSTRACT FROM AUTHOR]

Typhoon passages across Taiwan can generate sudden surface warming in downslope regions. Special characteristics and mechanisms for 54 such warming events that were identified during the 1961–2007 period are examined. Preferred warming regions were identified in northwest Taiwan, where warming is generated by downslope flow from east or northeast winds in westward-moving typhoons, and in southeast Taiwan, where it is generated by downslope flow from west or northwest winds in northwestward-moving typhoons. In addition to the orographic effect, warmings occurred exclusively within nonprecipitation zones of typhoons. Most northwest (southeast) warmings occur during the day (night) with an average lifetime of 4 (5) h, which roughly corresponds to the average time a nonprecipitation zone remains over a station. During the period examined, three typhoons generated warming events in both northwest and southeast Taiwan, and only Typhoon Haitang (2005) generated warmings with comparable magnitudes (∼12-K increase) in both regions. For Typhoon Haitang as an example, diagnostic analyses with two different approaches reveal that the majority of the warming is contributed by downslope adiabatic warming, but the warming associated with the passage of a nonprecipitation zone is not negligible. Similar results were found when these two diagnostic approaches were applied to the other warming events. The diurnal mode of the atmospheric divergent circulation over East Asia–western North Pacific undergoes a clockwise rotation. The vorticity tendency generated by this diurnal divergent circulation through vortex stretching may modulate the arrival time of typhoons to cause daily (nighttime) warming in the northwest (southeast). [ABSTRACT FROM AUTHOR]

The article focuses on a study which described the phylogenetic relationships of the Tanakia himantegus complex (Teleostei: Cyprinidae) in Taiwan and China. The study analyzed the complete cytochrome (Cyt) b deoxyribonucleic acid (DNA) sequences of 61 specimens of the Tanakia himantegus complex in order to understand their phylogeny, genetic differentiation and historical demography. A comparison between the characteristics of the Taiwanese himantegus and Chinese chii is also presented. Study authors concluded that bimodal or ragged mismatch distributions for the Chinese chii and Taiwanese himantegus demonstrate that they are either admixtures of two expanding populations or stable populations.

Northern Taiwan underwent mountain building in the early stage of the Taiwan orogeny but is currently subjected to post-collisional crustal extension. It may be related to gravitational collapse or to the rifting of the Okinawa Trough, which lies offshore northeastern Taiwan. The Ilan Plain, northeastern Taiwan, which is bounded by the normal fault systems and filled up with thick Pliocene–Pleistocene sedimentary sequences, formed under such an extension environment. Over there on 2005 March 5 two earthquakes with about the same magnitude ( ML= 5.9) occurred within 68 s and produced intense aftershocks activity according to the records of Central Weather Bureau Seismic Network of Taiwan. We relocated the earthquake sequence by the three-dimension earthquake location algorithm with the newly published 3-D Vp and Vp/ Vs velocity model, and determined the first-polarity focal mechanisms of the earthquake doublet. One major cluster of aftershocks which trends E–W and dips steeply to the south can be identified and picked up as a potential fault plane. The focal mechanisms of the two main shocks are both classified as normal type by first-polarity but strike-slip by centroid moment tensor inversion; however two methods both yield consistent E–W strike. Static coseismic deformation was additionally determined from Global Positioning System (GPS) daily solutions at a set of continuous GPS stations and from strong-motion seismographs. These data show NW–SE extension at high angle to the fault plane, which cannot be explained from a simple strike-slip double-couple mechanism. On the other hand, the small vertical displacements and steep fault plane cannot be explained from a simple normal event as well. We present from elastic dislocation modelling that the geodetic data are best explained by significant component of tensile source with centimetre-scale of opening on a 15-km-long fault extending from 1 to 13 km depth. We therefore interpret the crisis as the result of dyke intrusion at the very tip of the Okinawa Trough, which is reasonably driven by backarc spreading. [ABSTRACT FROM AUTHOR]

Background The risk of hepatocellular carcinoma (HCC) increases with increasing level of hepatitis B virus (HBV) in serum (viral load). However, it is unclear whether genetic characteristics of HBV, including HBV genotype and specific genetic mutations, contribute to the risk of HCC. We examined the HCC risk associated with HBV genotypes and common variants in the precore and basal core promoter (BCP) regions. Methods From January 5, 1991, to December 21, 1992, baseline blood samples were collected from 2762 Taiwanese men and women who were seropositive for HBV surface antigen but had not been diagnosed with HCC; the samples were tested for HBV viral load by real-time polymerase chain reaction and genotyped by melting curve analysis. Participants who had a baseline serum HBV DNA level greater than 104 copies/mL (n = 1526) were tested for the precore G1896A and BCP A1762T/G1764A mutants by direct sequencing. Incident cases of HCC were ascertained through follow-up examinations and computerized linkage to the National Cancer Registry and death certification profiles. A Cox proportional hazards model was used to estimate the risk of HCC associated with HBV genotype and precore and BCP mutants after adjustment for other risk factors. All statistical tests were two-sided. Results A total of 153 HCC cases occurred during 33847 person-years of follow-up. The HCC incidence rates per 100000 person-years for participants infected with HBV genotype B or C were 305.6 (95% confidence interval [Cl] = 236.9 to 388.1) and 785.8 (95% Cl = 626.8 to 972.9), respectively. Among participants with a baseline HBV DNA level of at least 104 copies/mL, HCC incidence per 100000 person-years was higher for those with the precore G1896 (wild-type) variant than for those with the G1896A variant (955.5 [95% Cl = 749.0 to 1201.4] vs 269.4 [95% Cl = 172.6 to 400.9]) and for those with the BCP A1762T/G1764A double mutant than for those with BCP A1762/G1764 (wild-type) variant (1149.2 [95% Cl = 872.6 to 1485.6] vs 358.7 [95% Cl = 255.1 to 490.4]). The multivariable-adjusted hazard ratio of developing HCC was 1.76 (95% Cl = 1.19 to 2.61) for genotype C vs genotype B, 0.34 (95% Cl = 0.21 to 0.57) for precore G1896A vs wild type, and 1.73 (95% Cl = 1.13 to 2.67) for BCP A1762T/G1764A vs wild type. Risk was highest among participants infected with genotype C HBV and wild type for the precore 1896 variant and mutant for the BCP 1762/1764 variant (adjusted hazard ratio = 2.99, 95% Cl = 1.57 to 5.70, P < .001). Conclusions HBV genotype C and specific alleles of BCP and precore were associated with risk of HCC. These associations were independent of serum HBV DNA level. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate whether exposure to disinfection by-products (DBP) is associated with bladder cancer. A matched case-control study was used to investigate the relationship between the risk of death from bladder cancer and exposure to total trihalomethanes (TTHM) in drinking water in 65 municipalities in Taiwan. All bladder cancer deaths of the 65 municipalities from 1996 through 2005 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by gender, year of birth,and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water in study municipalities were collected from the Taiwan Environmental Protection Administration. The municipality of residence for cancer cases and controls was assumed to be the source of the subject's TTHM exposure via drinking water. The adjusted odds ratios for bladder cancer death for those with high TTHM concentrations in their drinking water were 1.8 (1.18-2.74) and 2.11 (1.43-3.11) compared to the lowest group. The results of this study show that there was a significant positive correlation between the concentration of TTHM in drinking water and risk of death from bladder cancer. [ABSTRACT FROM AUTHOR]

Located in northern Taiwan, Taipei is a metropolis surrounded by hills and mountains that form a basin in which two river valleys funnel the surface airflow of this basin to the open sea. Because of the southwest monsoon, summer is a dry season in northern Taiwan but is the season of maximum rainfall in the Taipei basin. This unusual summer rainfall maximum in Taipei is largely produced by afternoon/evening thunderstorms—in particular, on the downwind side and slopes of mountains south of the city. The population in the city of Taipei and the county in which this city is located has more than tripled during the past four decades while land use for building and surface construction increased by a factor of 3. This urbanization may contribute to an increase of 1.5°C in daily mean temperature, a decrease of 1°C in daily temperature range, an increase of more than 67% in the frequency of afternoon/evening thunderstorms, and an increase of 77% in rainfall generated by thunderstorms. These findings may explain the reduction in the water supply deficit to the Taipei metropolitan area and the ground subsidence of the Taipei basin caused by the excessive use of groundwater. Results of this study also provide important information for urban planning and pollution control and for management of the increasing traffic hazards caused by the enhanced thunderstorm activity and rainfall. [ABSTRACT FROM AUTHOR]

Drug-related problems, particularly those that result from sub- or overtherapeutic doses of high-alert medications, have become a growing concern in clinical medicine. In this paper, we use a model-tree-based regression technique (namely, M5) and support vector machine (SVM) for regression to develop learning-based systems for predicting the adequacy of a vancomycin regimen. We empirically evaluate each system's accuracy in predicting patients' peak and trough concentrations in different clinical scenarios characterized by renal functions and regimen types. Our data consist of 1099 clinical cases that were collected from a major tertiary medical center in southern Taiwan. We also examine the use of Bagging for enhancing the prediction power of the respective systems and include in our evaluation a salient one-compartment model for performance benchmark purposes. Overall, our evaluation results suggest that both M5 and SVM are significantly more accurate than the benchmark one-compartment model in predicting patients' peak and trough concentrations across all investigated clinical scenarios. MS appears to benefit considerably from Bagging, which has a positive but seemingly smaller effect on SVM. Taken together, our findings indicate supervised learning techniques that are capable of effectively supporting clinicians' use of vancomycin or similar high-alert drugs in their patient care and management. [ABSTRACT FROM AUTHOR]

Background: SENV is a potential causative agent responsible for chronic liver diseases (CLDs) that are precipitated in early life. SENV prevalence in adolescents is unknown and its transmission route is uncertain. Methods: We randomly selected 824 serum samples from a cohort of 2383 adolescents aged 15–17 years who resided in Hualien County, an endemic area of liver diseases. Serum SENV genotype-D and genotype-H DNA were assayed by seminested polymerase chain reaction. Results: The positive rates for SENV-D and SENV-H DNA were 25.1% and 30.6%, respectively. Amis adolescents had a significantly higher rate of SENV-D viremia than Han Chinese adolescents (31.0% vs 22.2%; P = 0.025). Adolescents residing in rural or mountainous areas had significantly higher rates of SENV-H viremia than those residing in urban areas. There was no difference in the positive rates of SENV-D and SENV-H DNA among adolescents with or without hepatitis B virus (HBV) or hepatitis C virus (HCV) infection or history of hospitalization, surgery or blood transfusion. In multivariate analyses, males and adolescents residing in rural or mountainous areas had significantly higher risks of SENV-H viremia. As compared with those residing in urban areas, the multivariate-adjusted odds ratio (OR) for rural and mountainous areas were 1.49 (95% confidence interval [CI], 1.08–2.07) and 2.16 (95% CI, 1.32–3.53), respectively. Conclusion: SENV-D and SENV-H infection were frequent among adolescents in eastern Taiwan. SENV was unlikely to be transmitted via the parenteral route and factors associated with level of urbanization were probably the major determinants of SENV infection. [ABSTRACT FROM AUTHOR]

In Taiwan, home ownership has been seen as a privilege of military and civil officers since the R.O.C. government moved to Taiwan in 1949. Taiwan has become a more democratic regime since martial law was repealed in 1987 and presidential election by popular votes was initiated in 1996. Using documentary data, this paper aims to relate the transition in housing policy to Taiwan's political transition from authoritarianism to democracy. We found that after the lifting of martial law, a growing number of social movements were triggered in response to political democratization. Since then, concerns and debates have started on how to revise the housing legislation to promote the welfare and social inclusion of vulnerable groups. A new housing policy that was influenced by the advocacy efforts of an action group was developed in May 2005 to meet social needs and achieve social equity. [ABSTRACT FROM AUTHOR]

Objective: To assess the economic and humanistic outcomes of clinical pharma- cist interventions for patients with asthma and to assess the effect on patients' quality of life. Study design: A prospective cohort study was conducted at a medical centre in southern Taiwan. Patients and methods: Seventy patients with moderate to severe asthma were enrolled in the study from July 2003 to December 2003. Patients who were 17-53 years of age and were attending the outpatient clinic were referred to the pharmacist intervention programme. Patients were educated about their disease, pharmacotherapy, self-management and inhalation and peak flow meter techniques to use during the intervention period. A modified Asthma Quality-of-Life Questionnaire (AQLQ) was given to the patients at the first intervention (baseline) and 3 months later (intervention period) to assess quality of life. An asthma general knowledge questionnaire and an asthma diary chart were also used to assess patients' knowledge about asthma and the improvement in their symptoms. The cost effectiveness was evaluated based on the reduction in total costs/mean cost at each visit. Results: Of the 70 asthmatic patients enrolled in the study; 55 completed the questionnaires at baseline and after the intervention period. Only 25 of 55 (45.5%) patients completed the asthma diary chart. After the pharmacist intervention period, the patients' quality of life, common knowledge about asthma, and peak expiratory flow rate (PEFR) were significantly improved as compared with baseline (p < 0.00 1). The frequency of use of β2-agonists and corticosteroids were also reduced, although the reduction was not statistically significant. Total cost per patient at baseline was statistically different from that after the 3-month intervention period (New Taiwanese dollars [$NT] 2880 vs $NT 1683, respectively; costings are costs during the study period). Conclusion: For patients with moderate to severe asthma, pharmacist intervention can be a cost-effective addition to the management of patients at an outpatient clinic by improving PEFR and patient quality of life, and saving medical resources. [ABSTRACT FROM AUTHOR]

Examines the intraindividual variability in aflatoxin B[sub 1]-albumin adducts on healthy adults in Taiwan. Effects of hepatitis B and C virus infection; Association of intraindividual variability in adduct levels to age of subjects and time intervals; Influence of endogenous factors.

The objective of this prospective study was to evaluate both thyroid function in children with Hashimoto’s thyroiditis and the necessity of lifetime thyroxine replacement therapy. A total of 47 patients with goiter and positive thyroid auto-antibodies participated in the study. Serum thyroxine and thyrotropin levels and titers of thyroid auto-antibodies were checked regularly throughout the follow-up period. At the beginning of the study, 25 patients were diagnosed as euthyroid, but at the end of the study, 22 patients initially diagnosed with euthyroidism remained euthyroid, while eight patients with subclinical hypothyroidism and three patients with overt hypothyroidism had become euthyroid. Thus, of the 22 patients with thyroid dysfunction at diagnosis, subclinical or overt, 11 became euthyroid during the follow-up period. The effect of thyroxine treatment on thyroid auto-antibody titers was not significant. Conclusion: Our data shows that Hashimoto’s thyroiditis in children has a benign course and that thyroid function in one half of the patients with thyroid dysfunction at diagnosis reverts to normal. Careful follow-up of thyroid function is important in order to determine the necessity and timing of thyroxine replacement therapy. [ABSTRACT FROM AUTHOR]

Citrus peel, a primary byproduct of citrus fruits, contains a variety of flavonoids. Heat treatment is a favorable food processing for solid peel to release bioactive compounds from tissues and intensify nutritional effects. In this study, we explored alterations of flavonoids by thermal treatment of mandarin peel and their effects on lipid accumulation and intracellular levels during differentiation of 3T3-L1 cells to adipocytes. The heat-treated sample showed stronger inhibition on the formation of lipid droplets than the nontreated sample, along with enhanced intracellular levels of flavonoids. Overall flavonoids, especially flavonoid aglycones showing better efficacy, were found to increase in the peel after heat-treatment. Our findings indicate thermal processing could help release flavonoids from citrus peel and convert them into aglycone forms, leading to efficient cellular uptake and suppression of lipid accumulation in 3T3-L1 cells. This study provides useful information of heat-treated citrus peel as potential dietary supplements with antiobesity- related effects. [ABSTRACT FROM AUTHOR]

Stress hyperglycemia is a common condition in critically ill patients. Inappropriate nutritional supplementation may worsen blood glucose control in these patients. The present study aimed to investigate the outcome of blood glucose control status when using various enteral formulas. Methods and Study Design: This retrospective study was conducted at the intensive care unit of a tertiary medical center in central Taiwan. Patients meeting the following inclusion criteria were enrolled in the study: age .20 years, respiratory failure requiring mechanical ventilation, and two consecutive blood glucose concentration measurements of .180 mg/dL. Demographic data, blood glucose samples, and hospital mortality were collected for analysis. Results: A total of 4,604 blood glucose samples from 48 patients were analyzed. Results demonstrated no significant difference in mortality rate or blood glucose control between patients fed semi-elemental formulas and those fed polymer formulas. Serum HbA1C of <7.5% was a risk factor for hospital mortality (OR: 0.18, 95% CI: 0.04.0.89). Enteral formulas containing less carbohydrate were associated with better blood glucose control. Conclusions: No significant difference in the outcome of blood glucose control was observed between patients fed semi-elemental formula and those fed polymer formula. To achieve better blood glucose control in critically ill patients, formulas with lower carbohydrate content should be considered. [ABSTRACT FROM AUTHOR]

Aims Current criteria of metabolic syndrome (MetS) give equal weight to each component and apply mostly the same cut-off values to all ages. The contribution of each component to MetS and the effects of age and sex on each component and MetS were explored. Methods We carried out a survey on residents aged 40-74 years of the northern coastal area of Taiwan. The prevalent rates of MetS in 646 males and 961 females were 32.4% and 27.8%, respectively. Logistic regression analyses were used to assess the main and interactive effects of age and sex. The Cronbach's α coefficient was calculated as the indicator of internal consistency of MetS components. Results There were significant age trends for MetS components, except for low HDL-C in both sexes and high fasting triglyceride in males. Logistic regression analyses showed that the effects of age and sex on MetS and its component were all different. The age-sex-specific Cronbach's α coefficients for MetS ranged from 0.43 to 0.61. The age trends of the coefficients in males and females were opposite. The exclusion of some components from the MetS resulted in an increase of the coefficients. Conclusions Our results indicate that the internal consistency of MetS was questionable. It seems that the currently defined MetS components of MetS did not formulate a single pathophysiological entity. Given equal weight to each component and used the same cut-off values for the subjects of all age groups in both sexes need to be reconsidered. [ABSTRACT FROM AUTHOR]